From Pathognomicha and Passiologia to Pathologia: concise history of a neologism (1486-1598)
The etymology of the term pathology refers to one to the various ancient (Hippocratic, Galenic and Pseudo-Galenic) suggestions for subdividing the medical arts (medicinae artis partes), suggestions that came into print during the late fifteenth century. Multiple variants of the term initially served to denote “pathology”. Jacques Dubois’s reading list for medical students, first published circa 1535, ultimately popularized neo-Latin pathologia; it entered the English language, via the French, in 1597.
It has commonly been assumed that Galenist Jean François Fernel (1484-1558) coined the neoclassical term pathologia in tandem with physiologia, as found juxtaposed in the title of his 1555 Medicina, physiologiam, pathologiam, methodumque complectens. On the first folium of his 1555 Pathologiae libri septem, an except published separately in one volume, Fernel discusses the term’s Greek components 1. Evident from Durling’s Dictionary of Medical Terms in Galen 2 and as elaborated in subsequent scholarship 3, variants of the terms go back to Galen, and with it, the wider historical question of the division of Western medicine. Physiologia/physiologica (“physics”, natural philosophy) was in wide use in late fifteenth-century printed work, here contrasted with mathematica and theologia/theologica, or with philosophia (some said: medicina est philosophia corporis). The term increasingly came to denote a subsection of medicine after the earliest (1490), Latin printing of Galen. But who coined neo-Latin pathologia, whence English pathology?
It is unknown who used the root Greek term first to describe a dimension of medicine, but it was evidently in use by the time of Soranus of Ephesus (c.98-c.138 AD). Among early authors using the term, Soranus mentions in the introduction to his Gynecology that some authors divided medicine up into “physiology, pathology, and therapy” (φυσιολογικών και [το] παθολογικών και [το] θεραπευτικόν) 4. The Latin term, however, is notably absent from the Clavis sanationis, Simon of Genoa’s (1270-1303) thirteenth-century medical dictionary, printed first in 1473. The history of the most pertinent Galenic text at this point, On the Divisions of the Art of Medicine (Περὶ τῶν τῆς ἰατρικῆς μερῶν; De partibus artis medicae/medicativae), is intricate. Arabic and Latin translations but no Greek manuscripts survive and one of a large number of Latin translations caused the work to long be considered spurious 5,6. In the Greek editio princeps of 1525, Galen was stated to have written: “Μέρη Ιατρικής τα μεν πρώτα εστι, τό τε φυσιολογικόν, και το αιτιολογικόν, ή παθολογικόν, και το υγιεινόν, και το σημειωτικόν, και το θεραπευτικόν” (The principal parts of medicine are physiology, etiology or pathology, hygiene, symptomatology, and therapy) 7. A competing 5-item listing is found in that edition’s Greek rendering of the Pseudo-Galenic text Definitiones medicae, which reads “φυσιολογικών, παθογνωμονικών, διαιτητικών, υλικών, θεραπευτικών”. Of Galen’s pathologikon and Pseudo-Galen’s pathognomonikon, the former, synonymized with “etiology”, inspired a neo-Latin rendering as pathologia. The 1541 (ed. Agostino Ricchi), 1550 and 1552 (Vettore Trincavelli) renderings of De Partibus all contained Latin adjective (partitio) pathologica[m]. The term shows up in Latin indexes of, prefaces to and commentaries on Galen’s Opera after 1541, and was in common use throughout the latter half of the century. Conrad Gessner speaks of libri pathologici in his 1545 Bibliotheca universalis, for instance. In a 1553 address to the reader prefacing Galen’s De urinis, edited by Spanish physician Fernando de Mena (c.1520-1585), for instance, we get: “Nam quú quinque partes sint totius artis medicæ physiologica, pathologica, salubris, diagnostica, curatoria” – pathology replacing its synonym etiology 8.
Galen and Pseudo-Galen were mostly read in Latin. Interestingly, many of Galen’s printed Latin translations after 1525, including the 1534 Varia Opera (translated by physician Johann Winter/Guenther von Andernach, 1505-1574) 9 and later ones including the 1550 Opera Omnia 10 (both published in France), paraphrased cited passage using terms as the Greeks had them (Græci vocant), in Greek typeface. In tune with this regard for linguistic rectitude, in the preface of his 1542 De naturali parte medicinae libri septem, Fernel used the Greek φυσιολογία; and his first use of Latin pathologia may only properly be dated to the 1554 edition of his Medicina 11.
So what did the Latin say before 1525? In the first unpaginated Latin edition of Galen’s collected work (1490) by Niccolò da Reggio, the rendering of Galen’s medical division appears as follows: “Partes quidem medicine sunt v[:] physiologica, causilogica vel pastologica [?]; sanativa; significativa; et curativa.” 12. One of the pertinent neologisms here appears to have a typo: did Da Reggio mean passologica? This appears to be the case, as the Omnes Galeni libros (1515) by Pietro Antonio Rustico had the second pair as “causiologica vel passiologica” 13. This early quintuple terminology is also found in the 1503 Galen in French by Lyonnese physician Symphorien Champier (1471-1539), though notably omitting the clearly problematic second term: “phisiologica…causiologica…sanativa…significativa…curativa” 14. The two synonymized terms do appear in Champier’s 1517 Latin tract, Speculum Galeni, which offers a definition: “Causiologica seu passiologica est in qua ca que pr[a]eter natura[m] inquirim” 15. These terms are also found in work on Galen before 1525, such as one published in 1520 and reprinted in 1523 by Leonardus Legius, who echoes Champier’s definition 16. (Medicinae pars) causiologica (etiology) and passiologica (pathology) were awkward hybrids, based on Latin causa (for Greek αἰτία, cause, origin) and passio (for πάθος, disease, affliction). The other terms were of course likewise Latin, based on signum (for σημεῖον, sign, symptom) and curatio (for θεραπεία). Latin editions after the 1525 Greek one unsurprisingly preferred the Greek. Moreover, multiple 1530 tracts, including a 1533 translation by Albanos Torino of the Galenic work on the pulse by Philaretus, and the work of Johann Agricola, went over to Greek-inspired Latin terms, again without mention of “pathology” (it was apparently considered redundant): physiologice, aetiologice, higiene, semiotice, terapeutice (the last subsuming diætetice, pharmaceutice, and chirurchice) 17.
Early Latin renderings of what were eventually considered Pseudo-Galenic texts also lent themselves for various translations. The first, 1490, translation of Introductio, Sive medicus (immediately before De Partibus) by Da Reggio had physiologia and causilogia. In 1528 and subsequent sources we encounter the following quintuplet of terms transliterating Pseudo-Galen’s 1525 Greek: “[pars] physiologica, pathognomica, diætica, materialis & curatoria”, with pathognomica referring to “illius, quod præter naturam est, noticia” (the knowledge of what is [medically] unnatural) 18,19. The translator, Jonas Philologus alias Johann Winter/Guenther von Andernach, later preferred the Greek, as observed above. A subsequent dictionary source, Otto Brunfels’ Onomasticon medicinae (1534) recites Guenther’s adjective, as well as a spelling variant, pathagnomica, while its Greek Galenic listing (under “medicinae partes sunt”) rather offers αιτιολογικόν 20. The spelling disparity still shows up in the 1543 and 1553 editions of this dictionary. The term had been rarely used, though found already in the 1486 printing (revised in 1492) of the florilegium (anthology of knowledge) of medieval friar Vincent de Beauvais (c.1184/1194-c.1264), which attributed to Hippocrates the triad of physica, pathognomicha, and therapeutica, the middle of which was subdivided by inspectionalis (diagnosis) and causalis (etiology) 21. In turn, a 1509 work (reprinted 1532) by Italian physician Niccolò Leoniceno (1428-1524) juxtaposed as two medical sub-disciplines anatomice and pathognomice, “so named by the Greeks” 22.
In a 1543 translation of a work by another pseudo-Galenic author, Definitiones medicae (entitled Finitiones medicae), we get “Ea medicinæ pars quae pathologica, quod de affectibus agat, appellatur” 23. Printed a year earlier in a translation by Bartholomaeus Sylvanius Salonensis, this passage notably read, “pars ea medicinæ quæ de affectibus agit”, without the term pathologica 24. So at least one, but not all, of the translations of Pseudo-Galen in the early 1540s was evidently among the places, beyond the corrected Latin Galen, where “pathology” entered early modern medical parlance.
Neo-Latin pathologia was ultimately popularized in a 30-page reading guide for prospective medical students by Fernel’s colleague anatomist-polymath Jacques Dubois (latinized as Jacobus Sylvius, 1478-1555), entitled Ordo et ordinis ratio in legendis Hippocratis et Galeni libris (The Order, and Reason for this Order, in Which the Books by Hippocrates and Galen Should Be Read). It was published in undated (c.1535?), 1539 (Chrétien Wechel), 1541, 1548, 1549 (Jacobus Gazellus), and 1561 (Gilles Gourbin) editions, and reproduced in the author’s Opera medica (1630) 25. The booklet was evidently popular, published with at least four publishers over a time span of over a quarter of a century. The 1539 edition published in Paris appears in essence unchanged from the undated, unpaginated version published in Basel with an unstated publisher, which is commonly dated to (circa) 1535. Dubois here defines six Galenic terms in succession, and clearly distinguishes “etiology” and “pathology”: physiologia, hygieine, and therapeutica, plus a subsidiary triad pertinent to medicine proper, pathologia, aetiologia and semiotice. In Dubois’ definition, “Pathologia affectus præter naturam, morborum silicet & symptomatum differentias declarat” (Pathology describes the unnatural conditions, namely the diversity of diseases and symptoms), while “Aetiologia docet causes morborum, symptomatum, sanitatis, & eorum quæ sanitatem sequuntur” (Etiology instructs on the causes of diseases, of symptoms, and of health, and on the corollaries of health; note the Latinization of σύμπτωμα). The section on pertinent works is marked off with the marginal text “Pathologia; Aetiologia” (Basel edition), subsequently “Pathologia, Aetiologia, Semeiotice” (1539), and finally by the latter text for a formal, all-caps heading (1541 and later).
Though undoubtedly trend-setting, Dubois’s own use of pathologia beyond Ordo et ordinis is sporadic; he used it once in a 1539 work on Galenic medicine but – even in the 1548 reprint – with a typo: pathelogia 26. His reading guide, however, is of historical interest for adding a clearly in-demand instructional, bibliographic dimension to Galen’s ancient division of medicine. It almost certainly influenced Fernel and contemporaries. Dubois’s schema can be found reproduced in a 1556 work entitled De medica theoresi liber primus 27.
The rest is medical history, though it is interesting that various authors of the latter half of the sixteenth century continued to use Greek terms, including παθολογία, in their Latin texts. The Greek terms still occur in a 1548 unpaginated Latin oration by Gerardus Fabritius Belloaspectius, held in Florence, for instance 28. We get παθολογία in Hugo Fridaevallis’ (fl. 1565-1567) De tuenda sanitate, libri VI (1568) and French physician Laurent Joubert’s (1529-1582) text, In artem componendi medicamenta, printed in 1570 and reprinted as late as 1668 (the earliest of which have a typo: πατολογία). In a 1562 work by a Belgian physician, one finds pathologia paired up with the apparent neologism nosologia as marginal keywords to a section on Galenic medicine 29. French pathologie is attested at least as early as 1582, and was in common use in the 1590s. The apparent first Anglophone outline of the Galenic partes medicinae, including clear distinction between pathologia and simiotica, is attested in the 1597 translation of La chirurgie françoise (1593) by French surgeon Jacques Guillemeau (1549?-1613): “Pathologia, vvhich treatethe of the cause, and occasione of the sicknesses & of the accidentes vnto the same, the vvhich three thinges are agaynste nature.” 30. Pathologia seemingly entered the Dutch language in that work’s 1598 Dutch translation, appearing with the same Dutch publisher 31.
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