“The first dispensation of Christ is medicinal” : Augustine and Roman medical culture
By Shelley Annette Reid
PhD Dissertation, University of British Columbia, 2008
Abstract: This study examines the knowledge and use of medicine in the writings of Augustine. An initial overview of Roman medical culture highlights that ancient medicine was both a practical and intellectual activity, that it was culturally linked with rhetoric, philosophy, and faith, and that many aspects of medicine were performed in a public setting. Knowledge of medicine formed part of the intellectual background of the well-educated Roman citizen, through autodidactic studies. Roman medicine underwent a minor renaissance in North Africa during Augustine’s lifetime; he would have obtained his knowledge of medicine through access to a range of textual and non-textual forms of information. Augustine’s interest in and knowledge of medical topics was more comprehensive than has been previously credited: he employed a sophisticated medical terminology; he was fascinated by aspects of human physiology, particularly the function of the senses; and he understood the philosophical divisions which separated the various medical sects. His greatest use of medicine was in the area of figurative language. His employment of medical metaphors, particularly that of Christus medicus (Christ the physician), was extensive, far exceeding that of other Latin patristics writers, both contemporaries and those who followed him. Various reasons can be adduced for the attraction which medical metaphors held for Augustine, including the popularity of the figure of Christus medicus in North Africa, the use of medicine and medical metaphor in Manichaean texts, and Augustine’s relationship with the physician Vindicianus. Augustine’s own experience with ill health was also a significant contributing factor. A painful illness in 397 likely provided an impetus to his writing of the Confessions, a work filled with medical metaphor, in which he confesses as a patient to a physician. Augustine expanded this medicalization of the self to the body of Christian sufferers through reference to the pain which ancient therapeutics inflicted. He used the metaphor of the sick bed to oppose the Donatist schism, by creating opportunities for ordinary Christians to turn their illnesses into martyrdoms. This allowed them simultaneously to reject unacceptable forms of healing and obtain full participation in the church.