Lady Philosophyí»s Therapeutic Method:

The í░Gentlerí▒ and í░Strongerí▒ Remedies in Boethiusí»s De Consolatione Philosophiae

Philip Edward Phillips

Lady Philosophy and the Application of Ancient Medical Theory

According to Michael Frede, there was a strong connection throughout Antiquity between philosophy and medicine, a relationship supported by early Hippocratic writings advising that philosophy be carried into medicine and medicine into philosophy. Not only did ancient medical authors, from the time of the Hippocratic writers onwards, rely upon philosophers í░for their views on physiology, but also for their conception of their art and their moral precepts for the doctor.í▒1) Frede points out that ancient philosophers showed considerable interest in medical questions, most notably after medicine came to be considered an intellectually respectable discipline in the fifth century B.C. This concern was practical, he argues, because in small communities one often had to care for oneself and, in the absence of regulation, doctors tended to be itinerant and unaccountable for their practices. Consequently, much of the responsibility for treatment was carried out by the patient, with the assistance of a doctor, whose role was to offer explanations, advice, and help. Frede emphasizes that í░the choice of treatment, hence the primary responsibility, was the patientí»s,í▒2) especially if the patient was an educated man who would have regarded medicine as one of the liberal arts and therefore worthy of his attention and study.

Since traditional medicine and the doctors who practiced it tended to view illness as í░a matter of the intrusion of a foreign entity, spiritual or grossly bodily, into the bodyí▒ and to rely upon í░the tradition of an accumulated experience with wounds, fractures, dislocations, and some vaguely diagnosed internal diseases,í▒ while philosophers, the originators of medical theory, tended to concern themselves more with humans and human behavior, í░one could have imagined some division of labor, e.g., one according to which the philosopher deals with the soul and the doctor takes care of the body.í▒3) Frede points out, however, that doctors as well as philosophers wrote treatises on the soul. As the writings of Asclepiades of Bithnynia, Soranus, Sextus Empiricus, and Caelius Aurelianus demonstrate, doctors tended to concern themselves not only with the bodily symptoms and the physical cause, but also with the sympathetic accord of body and soul in reference to such disturbances as insanity, effeminacy, lethargy, morbid hunger, melancholy, or hydrophobia. í░Doctors tended not just to the bodily effects of mental disturbances, but also to the mental effects of what they regarded as bodily disturbances,í▒ and, according to Frede, í░given that most philosophers and doctors did not accept a simple, sharp dualism between body and soul, a division of labor along these lines was not possible, even if it had been desired.í▒4)

In Boethiusí»s De Consolatione Philosophiae, Lady Philosophy assumes the role not only of Socratic teacher, who guides her pupil by means of dialogue back to an awareness of the summum bonum, but also of syncretic physician, who attends to both the body and soul of her ailing charge, Boethius, who awaits execution in a prison cell in Pavia. In writing his work within the tradition of the philosophical lamentatio and consolatio, Boethius also drew upon his knowledge of Greek and Roman medical theory in his presentation of the persona of Philosophy as doctor. It is, indeed, in the role of physician that Lady Philosophy embodies the ideals set forth by Galen, reputedly lauded as í░first among physicians, unique among philosophers,í▒ by Caelius Aurelianus.5) Galen (A.D. 129-ca.199), in his treatise, That the Best Doctor is also a Philosopher,6) maintained that a competent physician should possess all the parts of philosophyí¬logic, natural science, and ethicsí¬and, while he championed Hippocratic orthodoxy, he argued that medicine depends upon reasoning and theory as much as it does upon observation and experience.7) A student of Platonists, Peripatetics, and Stoics, Galen regarded himself as an eclectic, an adherent of no particular school but rather a syncretist who sought the truth in the best teachings of many schools, although he was influenced by the Timaeus and acknowledged that Plato was the í░greatest of the Ancients.í▒8) Lady Philosophy follows the model of Galen and attends to her charge in the capacity of both doctor and philosopher, identifying the exact nature of his illness and assisting her patient in his recovery though a Socratic method intended to render the patient/pupil capable of treating himself. Lady Philosophyí»s therapeutic method resembles that established in the Greek tradition by Galen and perpetuated later by Soranus through the Latin translations of Caelius Aurelianus, a contemporary of Cassiodorus and Boethius.

While scholars have long been interested in the persona of Lady Philosophy as í░otherworldly healer and physician,í▒ E. Gothein and W. Schmid were the first to give serious attention to the physical condition of the narrator in Boethiusí»s De Consolation Philosophiae in their respective studies.9) While Gothein notes Boethiusí»s use of medical imagery to discuss the manner in which Lady Philosophy attends to her patient, Schmid goes farther by focusing upon Lady Philosophyí»s specific diagnosis of the narrator, that he suffers from lethargy (1 p. 2.5), and by calling attention to the fact that, in ancient nosology, lethargy played an important part and í░stands for a clearly outlined pattern of symptoms,í▒10) identifiable in the description of the patient in Book I of the Consolation. Indeed, Boethius employs the symptoms of lethargy, which were current among physicians of the time, in his description of the dejected narrator, and he assigns Lady Philosophy the role of spiritual physician. The symptoms revealed in the patient are commensurate with his Platonic and spiritual exile from the summum bonum, or God.

A close examination of Lady Philosophyí»s role as physician in De Consolatione Philosophiae, alongside Caelius Aurelianusí»s definition, discussion, and recommended treatments of lethargy in On Acute Diseases will reveal Boethiusí»s indebtedness to contemporary theories of medicine in the Consolation and will support Galení»s view that í░the best doctors are philosophers.í▒ Lady Philosophyí»s therapeutic method, that seeks to discover the wound and to treat it accordingly with í░gentlerí▒ and í░strongerí▒ remedies, mirrors the ancient physicianí»s approach to acclimate the patient to the medicines of increasing strength as one prepares oneself slowly and by degrees for moving out of darkness into bright light. In the Consolation, the philosopher/physician assists her charge in his ascent from his darkened Platonic cave of í░forgetfulnessí▒ to the glorious light of philosophical truth and understanding, not incommensurate with the light of Christian truth. Whether its end is philosophical or spiritual enlightenment, Lady Philosophyí»s therapeutic method successfully employs the methods advocated by such writers as Galen and Caelius Aurelianus with the purpose of restoring the patient to health in both body and soul.

Caelius Aurelianus and the Symptoms of Lethargy

In On Acute Diseases, Caelius Aurelianus recommends avoiding strong medications in the case of tumores not yet in the process of receding and, like Lady Philosophy, urges gradual therapy for diseases such as lethargy. According to Schmid, Boethiusí»s conception of lethargy as described in De Consolatione Philosophiae is particularly close to Caelius Aurelianus, both in meaning and expression. Schmid notes that Cassiodorus, Boethiusí»s contemporary, acknowledges the í░high reputation of Caelius Aurelianus as a faithful mediator of Greek science in the sixth century.í▒11) It seems very probable that Boethius, a master of the liberal arts himself, drew upon his own familiarity with current medical theory and that of Caelius Aurelianus in his conception of lethargy and of the treatment administered by Lady Philosophy. Like Boethius, Caelius Aurelianus was a prolific translator and transmitter of ancient thought, particularly the works of Soranus of Ephesus, who studied medicine at Alexandria and practiced at Rome in the time of Trajan and Hadrian. Soranus, who is also known for his Gynaecia and his brief life of Hippocritus, was prolific and wrote on almost all aspects of medical theory and practice as well as on philosophical subjects. Soranus was well known after his death as the greatest Methodist physician,12) and in the third and fourth centuries, his work, after those of Galen, were among those most widely excerpted, translated, and consulted. These translations and abridgements became, moreover, crucial in the transmission of Greek medicine to the Middle Ages.13) Caelius Aurelianus, an African by birth and a Methodist, who probably lived during the fifth century, prepared Latin versions of a whole series of his works and made them available to a Roman audience. His method of discussing diseases was as follows: 1. the etymology of the name of the disease, 2. a definition of the disease, 3. its symptoms, 4. the method distinguishing similar diseases, 5. the part affected, 6. the treatment as practiced by the Methodist school, 7. the treatment as practiced by others, including a refutation of their methods.14) An examination of Caelius Aurelianusí»s entry for í░lethargyí▒ in On Acute Diseases, Book II, De Lethargo, will reveal the conception of that disease that informed Boethiusí»s description of his narrator in De Consolatione Philosophiae.

According to Caelius Aurelianus, lethargy í░receives its name from the loss of memory which the disease involves,í▒ and it derives from í░the Greek word for forgetfulnessíŽle?the? and for idleness argia,í▒ which, he continues, are í░the characteristics forced upon the body and soul by the power of this disease.í▒15) According to the treatise, lethargy can be characterized not as í░sleep with a hindrance of all the functions of normal activitiesí▒ but as í░a state of torpor which does not refresh the patient but rather depresses him.í▒16) Not only does lethargy involve sleep, but it also includes the í░loss of reason with acute fever leading to deathí▒; however, Caelius Aurelianus makes the distinction that í░one should speak of stupor, not of loss of reasoní▒ when discussing lethargy.17) Unlike the views of Atheaeus of Tarsus, who defines lethargy as í░mania together with depression,í▒ and others, who view lethargy as í░loss of reason with depression and uninterrupted sleep,í▒ Caelius Aurelianus asserts that it is í░not natural sleep that we observe in cases of lethargyí▒ but rather stupor that is í░generally relieved by periods of remission.í▒18)

Concerning the causes of lethargy, Caelius Aurelianus reserves judgment, claiming that others should not have set forth the causes in their treatises since the cause í░is obscure and a matter of dispute among the ancients, a dispute which is still unsettled.í▒19) Agreeing with Soranus, whose work he is translating, Caelius Aurelianus argues that lethargy is í░a swift or acute attack of stupor with acute fever and a large, slow and hollow pulseíŽmore common in old people, for impairment of the senses and depression are more characteristic of old age.í▒20) Concerning the symptoms of lethargy, he writes that the disease evinces the following signs:

acute and violent fever, often unremitting and hardly ever reaching the surface of the body, a feeling of heaviness in the head, sleep, sharp pain suddenly disappearing without any obvious reason ringing in the ears, face puffed up, pallor like that occasioned by excessive drinking of wine, and depression or rejection.21)

Moreover, Caelius Aurelianus adds that if the patient has been naturally talkative when in good health, then when suffering from lethargy the patient is í░silent and sluggish, never of his own motion beginning a discussion, but giving answers; he is silent about his malady or else says things that are devoid of reason.í▒22) Such a patient is overtaken by a deep sleep and has few, if any, dreams and is unable to recall what he has dreamt. Moreover, í░he frequently lies on his back contrary to his usual custom, yawns continually, and stretches out his legs, as if about to wake from sleep.í▒23)

Concerning the recognition of lethargy, Caelius Aurelianus advises the doctor to look for an accumulation of the following signsí¬not stupor or fever alone, but a combination of the impairment and dullness of the senses, stupor, acute fever either continuous or remittent, and large, slow, empty, and inflated pulseí¬for lethargy, he maintains, í░can neither exist nor be recognized in the absence of these indications.í▒24) Depending upon the severity of the disease, the patient may be in a sunken stupor, in indeterminate state that resembles sleep, but, when summoned, the patient may shake this off and, when questioned, make answer, not immediately, but after a while. In speaking, however, the patient will often forget what has been said and will require repetition or clarification. As the malady progresses, the patient will frequently í░lie on his back, his complexion becomes leaden or livid, his face drawn and wrinkled, eyebrows meeting, as we see in men plunged in sorrow or grief.í▒25) The patientí»s breathing, moreover, will become slow and large and accompanied by sighing and the inability to concentrate. Fortunately, Caelius Aurelianus observes, í░if the patient begins to show signs of a return to health and the disease appears to be abating, all the symptoms mentioned above are alleviated. And some patients indeed improve and completely regain their health. But others, though their stupor passes, are beset by loss of reason.í▒26) So, it seems, the stakes are high for the patient of lethargyí¬the patient can either completely regain his health, both physically and mentally, or lose his reason.

Finally, concerning the treatment of lethargy, Caelius Aurelianus writes that the patient should í░lie in a room that is bright and moderately warm,í▒ and that the patient should be awakened gently at intervals (rather than being continually tickled, shaken, or prickedí¬all of which simply serve to aggravate and irritate the patient, affording him no rest). He maintains, furthermore, that í░a calm state of stupor is better and more desirable than an excited and injurious state of wakefulness.í▒27) This gradual approach applies as well to Caelius Aurelianusí»s suggestions for feeding the patient and attending to his bodily comforts. As the patient begins to recover, he recommends í░deny[ing] the patient food on alternate days, if his strength permits, giving him [on those days] only mead.í▒ If the strength of the patient does not permit this regimen, then the patient should be given modest quantities of gruels on those days as well.28) If these methods are ineffectual, then the physician should gently rouse the patient and supply a liquid diet, along with warm sponges for his head, and mild and passive exercise. By using gentler remedies when the patient is weakest and most heavily beset by the symptoms of lethargy, the physician will more effectively be able to use stronger remedies in the end to restore the patient to health, which ultimately means restoring his reason.

Lethargy and the í░Gentlerí▒ and í░Strongerí▒ Remedies in the Consolation

Boethiusí»s Consolation of  Philosophy begins with the narrator lamenting his fall from Fortuneí»s favor in a meter that reveals many of the symptoms of lethargy described by Caelius Aurelianus in his treatise On Acute Diseases. In his introductory lament (1m1), the narrator complains: í░Carmina qui quondam studio florente peregi,/Flebilis heu maestos cogor inire modos.í▒29) Contrasting past and present, the narrator establishes that before his fall he eagerly wrote verses in contentedness but now he must write elegies that express his profound grief. The Muses had long been companions of the narrator, since his youth, and so they continue to be, but in a different capacity. Now, the narrator maintains that í░old ageí▒ has come early and unsought, and that his hair is turning white and his skin hangs loosely on his frame (1m1.9-12). Because of his fatigue, the narrator welcomes death as an end to his relentless sorrow. His eyes are blinded by tears, his skin lacks its former vigor, and he cries out in despair. He concludes by asking, í░Quid me felicem totiens iactastis amici?/Qui cecidit, stabili non erat ille gradu.í▒30) The meter clearly reveals the grief of one once at the pinnacle of life who has now fallen to depths of sadness as a result of changing fortune.

This introductory section of the work (1m1-2p1.35) establishes the nature of the narratorí»s spiritual illness and exposes the basis for his disease. Boethius employs medical imagery and language to describe both patient and physician, as well as the diagnosis of the illness and the methods used to cure it. In 1p1, Lady Philosophy appears before her former student, and the descriptive contrast between physician and patient is palatable. The narrator, who is divorced from his former environment does not immediately recognize his physician, at least not until 1p3.1. Whereas the patient has dulled vision and a haggard countenance, Lady Philosophyí»s í░burning eyes penetrated more deeply than those of ordinary mení▒ and í░her complexion was fresh with an ever-lively bloomí▒ (1p1.4-6). Whereas the narrator is lethargic, lacks robor and color, Lady Philosophy possesses inexhaustible vigor and vivid color. The narratorí»s other symptoms include oblivio (1p2.6; 1p6.10) and tumor (1p5.12), all symptoms of lethargy with both medical and philosophical significance. Although Lady Philosophy is described as ancient, she stands upright and her head seems, at times, to reach the heavens; the narrator, conversely, lies prostrate in the company of the Muses, who dictate words to accompany his tears and further cloud his vision. W. Schmid convincingly argues that there are two reasons why Boethius chose lethargy to describe his sufferings. First, it is Philosophy that rouses us from sleep, whereas lethargy is a pathological urge to sleep. Second, a lethargus and his cure can be more easily linked with the illumination metaphysic and its wealth of motifs important to Platonism and to Boethius in particular. Lethargy, Schmid maintains, was for medieval scholars a disease of the dark.31) Although Boethius does not include sopor in his description of the narrator, it is meant to be inferred. The narrator suffers instead from a metaphorical sleep, a drowsiness that dulls his mind and stifles his reason.

Lady Philosophy banishes the strumpet Muses and their siren songs in Book I, charging that they only acclimate the narrator to his illness instead of assisting in his recovery; however, she does not dismiss the medicinal potential of verseí¬only the misuse of poetry in pure lamentationes. Lady Philosophy cries out, with eyes ablaze, í░í«Quis,í» inquit, í«has scenicas meretriculas ad hunc aegrum permisit accedere quae Dolores eius non modo nullis remedies foverent, verum dulcibus insuper alerent venenis.í▒32) Lady Philosophy is all the more furious with the meretricious Muses because they were acclimating a learned man to his sorrows by clouding his reason with words of passion and emotion. Having sent the Muses away with eyes downcast, Lady Philosophy assumes the role of physician and ministers to her patient, who still does not know her as his former teacher, almost immediately with her own song (1m2), which seems to summarize the condition of her charge. His mind is dull and sunk in deep despair (1m2.1-2); he is blind to his inner light and is lost in outer darkness; whereas he once contemplated the heavens and sought the causes behind natural laws, he now lies prostrate, weighed down with heavy care, able to contemplate blindly the dull, solid earth (1m2.25-27). Having finished her song and having established that her patient is a prisoner, not physically but spiritually, Lady Philosophy says, í░Sed mediciniaeíŽtempus est quam querelae.í▒33) The first step towards a cure, however, is for Lady Philosophy to make her patient remember who she is, and the narratorí»s silence reveals to her the nature of his illness: í░í«Nihil,í» inquit, í«pericili est; lethargum [italics mine] patitur communem inlusarum mentium morbum. Sui paulisper oblitus est; recordabitur facile, si quidem nos ante cognoverit. Quod ut posit, paulisper lumina eius mortalium rerum nube caligantia tergamus.í▒34) Not only has the narrator forgotten his teacher, Philosophy, but he has more importantly forgotten himself and his true home. Wiping away the clouds from his eyes with her garment and singing yet another song (1m3), Lady Philosophy facilitates the narratorí»s recovery of sight. When he realizes his interlocutor as both physician and nurse, he finally remembers that she is Philosophy, his teacher from youth, a recognition that brings some hope.

Before progressing to her remedies, Lady Philosophy gives the narrator an opportunity to í░discover his woundsí▒ (1p4.5), which he does at length by complaining about his surroundings (his library has become a prison cell), about the unjust accusations leveled against him, and about the seeming lack of order in a world governed by a benevolent God, the form of reason itself (See 1m5). Lady Philosophy rebukes her patient in 1p5, calling his topics of defense symptoms of his disease. His illness is so serious, in fact, that she deems a gentler remedy necessary. However, before that remedy can be applied, Lady Philosophy insists upon a further diagnosis, this time to discover her patientí»s strengths through í░a kind of catechism.í▒35) Her diagnosis (1p6.68-90) reveals three causes of illness. First, the patient has forgotten himself, which is the cause of his sorrow over exile and the loss of his goods. Second, the patient is ignorant of the end of things, which causes him to believe that the wicked are both powerful and happy. Finally, the patient has forgotten the means by which the world is governed, resulting in the false assumption Fortune acts outside the purview of God. All three causes are sufficient not only to make the patient sick but also to kill him.36) In1p6 Lady Philosophy uses the Socratic method/catechism to í░discoverí▒ Boethiusí»s state of mind by asking him whether he believes the world to be governed by some rational principle. Because he affirms that he does believe the world to be governed by reason and not by chance, Lady Philosophy questions how he can be sick when he holds such a í░healthy belief.í▒ Although he knows the cause of things, he has forgotten their end and, indeed, has forgotten his true nature. Lady Philosophy remains optimistic, though, because her patient affirms that all things are governed by divine reason, a í░sparkí▒ that will be the basis for his recovery. What he must learn (or remember), ultimately, is that subordination to the summum bonum or God is í░absolute freedom,í▒ and in so doing he can become the agent of his own recovery.

While the opening lament in Book I reveals the symptoms of the narratorí»s spiritual and mental sickness, namely the subordination of reason to passion, the opening prose section of Book II serves as a bridge in which Lady Philosophy attributes her patientí»s illness to his longing for his former good fortune. Here, she begins her í░gentler remedy,í▒ which will consist of rhetorical arguments, before progressing to her í░stronger remedy,í▒ which will consist of philosophical arguments. The í░gentler remedyí▒ (2p1.36-2m4) is not meant to cure but rather to strengthen the patient though a combination of the í░sweet persuasiveness of Rhetoricí▒ and Music so that he can take the stronger medicine later.37) Her method is simple: Lady Philosophy assumes the role of Fortune, and plays devilí»s advocate in order for her patient to reach a new level of self-awareness that involves the recognition that what he has lost was never his to begin with and that those things of the highest value are immune to the effects of Fortuneí»s wheel. Calling attention to her patientí»s symptoms of grief and despondency, Lady Philosophy identifies the cause of his illness: í░Tu fortunam putas erga te esse mutatam; erras. Hi semper eius mores sunt ista natura.í▒38) Indeed, Fortune is by nature fickle; her only constancy is her inconstancy. Therefore, the weaker remedy demands that Boethius accept the mutability of Fortune. His only good fortune is his acknowledgment of her true nature.

Although he had previously enjoyed the gifts of Fortune, his fall and Lady Philosophyí»s gentle remedy reveal to him the fickle goddessí»s gifts are deceiving at best and provide no true comfort. Her nature is brilliantly summed up in the first meter of Book II:

Hae cum superba verterit vices dextra

Et aestuantes more fertur Euripi,

Dundum tremendos saeva proterit reges

Humilemque victi sublevat fallax vultum

Non illa miseros audit aut curat fletus

Ultroque gemitus dura quos fecit ridet.

Sic illa ludit, sic suas probat vires

Magnumque suis demonstrat ostentum, si quis

Visatur una stratus ac felix hora.39)

Lady Philosophy employs the famous image of Fortuneí»s wheel to reveal the nature of the goddess. Placing oneí»s trust in Fortuneí»s care is like placing oneí»s hope in gambling. It is Fortune, not humanity, who spins the wheel, but it is humanity that must abide by the wheelí»s turns. Lady Philosophy describes Fortuna as merciless, mocking, indifferent, and even malicious. To her, life is merely a game and humanity the victims. Although we want to believe that we are in control, it is Fortuna alone who can spin the wheel. What we can control, Lady Philosophy wishes to demonstrate, is our reaction to and our valuation of Fortunaí»s whims. She has power only when humanity places value in such gifts as wealth or honors. Lady Philosophy drives home her argument with the stoic commonplace that all such gifts are Fortuneí»s to give and to rescind, and that if they had truly belonged to the narrator then he never would have lost them (2p2).

Although Boethius must logically acknowledge the truth in his teacher's words, he cannot help feeling that her words only provide a temporary and superficial balm for a malady that affects him on a much deeper level and whose symptoms persist when the "honey and rhetoric of music" (2p3.4-9) wear off. She must acknowledge that her words were not meant to cure his condition but to serve as a "poultice" for his sadness (2p3.10-12), one of the symptoms of lethargy. Lady Philosophy, then, continues her "gentler"remedy by urging him not to seek pity but to remember that he has experienced more happiness than pain in his life, especially in respect to his family, his wife, and his own accomplishments and the accomplishments of his sons. The problem remains, though, that the memory of past happiness now haunts the narrator and reminds him all the more of what he no longer enjoys: "nec infitiari possum prosperitatis meae velocissimum cursum. Sed hoc est quod recolentem vehementius coquit. Nam in omni adversitate fortunae infelicissimum est genus infortunii fuisse felicem.í▒40) Lady Philosophy addresses his grief over former blessings by reminding him that he has not completely lost everything; indeed, he still possesses the love and devotion of his family, í░those things which no one doubts are dearer than lifeí▒ (2p4.28-30). Although Lady Philosophy knows that these are lesser goods, she reminds Boethius of them in order to put her patient in the right frame of mind to accept her í░strongerí▒ medicine. She tells him then to dry his eyes so that he may be able to see that his true home is the one found within, not subject to external affairs, the enjoyment of which depends solely upon the individual and the exercise of reason. Lady Philosophy fittingly concludes her argument by affirming that it is we who make our own misery when we fail to seek our happiness from within. Fortune, she concludes, with her temporary gifts cannot lead to happiness, which is the highest good of rational nature and the thing beyond which there is nothing elseí¬that which cannot be taken away if truly possessed. The prudent man who desires to build a í░stableí▒ house, Lady Philosophy sings in 2m4, will build his house on a í░low, rock baseí▒; though the winds of fortune will rage, such a man will weather the storm, smiling with equanimity at the angry skies.

Lady Philosophyí»s í░stronger remedyí▒ (2p5-end) begins with her announcement, í░Sed quoniam rationum iam in te mearum fomenta descendunt, paulo validioribus utendum puto.í▒41) Such stronger medicines include first an examination of the lesser goodsí¬including wealth, position, power, fame, and pleasureí¬followed by a rejection of each one for its inability to lead one to happiness and self-sufficiency. While Lady Philosophy concedes that all of these goods provide relative pleasure according to the individual seeking them, they ultimately cannot lead a person to the thing he or she most desiresí¬happiness. Fortune, moreover, is good only when she reveals temporal goods to be insufficient and deceiving. Using a negative philosophical method, Lady Philosophy demonstrates only in universal love can there be happiness. Although some may find her repetition and restatement of points tedious, I would argue that her pedagogical strategy is also a sound therapeutic method for one suffering from lethargy, or spiritual exile. As Lady Philosophy comments in 3p1, í░Talia sunt quippe quae restant, ut degustata quidem mordeant, interius autem recepta dulcescant.í▒42) Her rhetorical argument, sweetened with the aid of music, has worked on her patient, leaving the narrator refreshed and desirous to listen to her philosophical arguments in Book III. As a result of Lady Philosophyí»s í░gentlerí▒ remedy, Boethius announces that he feels capable of facing Fortuneí»s blows and eager to learn what true happiness is. In the first part of Book III, Lady Philosophy reinforces what she has already said concerning the lesser goods by taking each in turn and demonstrating that worldly goods are í░goodí▒ only insofar as they reflect the summum bonum.  By 3p8 Lady Philosophy has effectively dismissed these goods as false paths that lead one away from the highest good, and she urges her lethargic patient to turn his eyes from worthless things to the heavens. Now the patient is truly able to see; his vision is restored and he can face the light of truth without sharp pain. He is like Platoí»s cave dweller who has emerged into the world of light once his eyes have finally become acclimated to the suní»s rays.

It is important that the model of lethargy used by Boethius concurs with Caelius Aurelianus on the point that lethargy is a stupor, not a loss of reason. Significantly it is to Boethiusí»s reason, the divine element in humanity, that Lady Philosophy appeals in her í░strongerí▒ remedy. Only through reason can her patient come to understand that true happiness can only be found in that which is absolutely self-sufficient and that which is an end unto itselfí¬namely, the summum bonum, or God. Not only does Lady Philosophyí»s patient acknowledge that true happiness comes only from the summum bonum but he also agrees with his physician that in order to be worthy of discovering the source of the supreme good í░we must call upon the Father of all thingsí▒ (3p9.103). The invocation, or prayer that follows (3m9) is the heart of the Consolation and the foundation of the patientí»s recovery. After having praised the í░governor of the universeí▒ and í░creator of heaven and earthí▒ for granting motion to and ordering all things according to reason, the prayer concludes appropriately with a petition for vision:

Da pater augustam menti conscendere sedem,

Da fontem lustrare boni, da luce reperta

In te conspicuos animi defigere visus.

Dissice terrenae nebulas et pondera molis

Atque tuo splendore mica! Tu namque serenum,

Tu requies tranquilla piis, te cernere finis,

Principium, vector, dux, semita, terminus idem.43)

Together, physician and patient seek through this prayer to rid the mind of anything that separates the longing mind from the source of all goodness. The prayer identifies God with light, and it specifically requests the strength to rise up to the heavens and the ability to fix the eyes upon the source and end of all things. Having established the proper relationship between the patient and the summum bonum, Lady Philosophy proceeds to define the summum bonum as one and the same as God using closely reasoned logic in 3p10. Her philosophical method continues in Books IV and V as she responds to her patientí»s further questions concerning the problem of evil and the nature of time and eternity. In good philosophical and medical form, Lady Philosophy does not implant knowledge within her student or make her patient better; instead, she leads him to an understanding of the good through the Platonic process of remembering and she enables him to diagnose and treat his own illness.


In Boethiusí»s De Consolatione Philosophiae Lady Philosophy assumes the role of teacher and physician and employs the methods of both in her consolation. Lady Philosophy facilitates the spiritual recovery of her patient first by diagnosing his illness as lethargy and then treating it accordingly. It seems clear that Boethius, who devoted his life to the liberal arts and to the transmission of knowledge, was well acquainted with ancient medical theory on the nature and treatment of lethargy. His choice of lethargy was most appropriate as it is associated by its very etymology with the loss of memory. As Lady Philosophy maintains, the grieving prisoner has not been exiled; rather, he has exiled himself. Boethius effectively employs the symptoms of lethargyí¬the dulling of the senses, stupor, paleness, depression, and sensitivity to the light, among othersí¬to dramatize the consequences of separation from the highest good, our true home and source of peace. By employing such symptoms as those found in the writings of Caelius Aurelianus, Boethius suggests that our need for the summum bonum penetrates to our very core as human beings, involving both body and soul. Lady Philosophyí»s remedies lead to an examination of the lesser goods eventually to an embracing of the summum bonum, the only real source of health. In the Consolation, the patient goes from low to high, from dark to light, and from sickness to health because of Lady Philosophyí»s therapeutic method. Because Lady Philosophy in her dual role of Socratic teacher and physician so effectively diagnoses, treats, and oversees the recovery of her pupil/patient in De Consolatione Philosophiae, we must conclude not only that í░the best doctors are philosophersí▒ but also that the best philosophers are doctors.

(Middle Tennessee State University)

ó┬ Works Cited

Primary Works

Aurelianus, Caelius. On Acute Diseases and On Chronic Diseases. Ed. and Trans. I. E. Drabkin. Chicago: University of Chicago Press, 1950.

Boethius. Tractates, The Consolation of Philosophy. Trans. H. F. Stewart, E. K. Rand, and S. J. Tester. Loeb Classical Library. Cambridge: Harvard University Press, 1973.

Cassiodorus. Institutiones. Ed. R. A. B. Mynors. Online.

Galen. On Antecedent Causes. Ed. and Trans. R. J. Hankinson. Cambridge: Cambridge University Press, 1998.

          . On the Therapeutic Method, Books I and II. Trans. R. J. Hankinson. Oxford: Clarendon Press: 1991.

Secondary Works

Barnes, Jonathan. í░Galen on Logic and Therapy.í▒ Galení»s Method of Healing: Proceedings of the 1982 Galen Symposium. Eds. Fridolf Kundlien and Richard J. Durling. Leiden: E. J. Brill, 1991. 50-102.

Gothein, E. Boethiusí» Trost der Philosophie. Zurich, 1949.

Frede, Michael. Essays in Ancient Philosophy. Minneapolis: University of Minnesota Press, 1987.

Means, Michael. The Consolatio Genre in Medieval English Literature. Gainesville: University of Florida Press, 1972.

Schmid, W. í░Boethius and the Claims of Philosophy.í▒ Studia Patristica 2 (1957): 368-375.


Lady Philosophyí»s Therapeutic Method: The í░Gentlerí▒ and í░Strongerí▒ Remedies in Boethiusí»s De Consolatione Philosophiae

Philip Edward Phillips

In Boethiusí»s De Consolatione Philosophiae, Lady Philosophy assumes the roles of Socratic teacher and syncretic physician. While writing his work within the tradition of the philosophical lamentatio and consolatio, Boethius drew upon his knowledge of Greek and Roman medical theory in his presentation of the persona of Philosophy as doctor. Boethius employs the symptoms of lethargy, which were current among physicians of the time, in his description of the dejected narrator, and he assigns Lady Philosophy the role of spiritual physician. The symptoms that Lady Philosophy í░revealsí▒ in her patient are commensurate with his Platonic and spiritual exile from the summum bonum, or God. Lady Philosophyí»s therapeutic method, that seeks to discover the wound and to treat it accordingly with í░gentlerí▒ and í░strongerí▒ remedies, mirrors the ancient physicianí»s approach to acclimate patients to medicines of increasing strength. Lady Philosophyí»s therapeutic method successfully employs the methods advocated by such writers as Galen and Caelius Aurelianus with the purpose of restoring the patient to health in both body and soul.

Key Words: Lady Philosophy, therapeutic method, gentler, stronger, remedy, Boethius, The Consolation of Philosophy.

1) Frede, Michael, Essays in Ancient Philosophy (Minneapolis: U Minnesota P, 1987), 225.

2) Ibid., 225-226.

3) Ibid., 266-227.

4) Ibid., 227-228.

5) Praecog. XI.660.

6) Opt. Med., I.60-61.

7) Barnes, Jonathan, í░Galen on Logic and Therapy,í▒ Galení»s Method of Healing: Proceedings of the 1982 Galen Symposium, Ed. Fridolf Kundlien and Richard J. Durling (Leiden: E. J. Brill, 1991), 52.

 8) Galen, On the Therapeutic Method, Books I and II, Trans. R. J. Hankinson (Oxford: Oxford UP, 1991).

 9) Gothein, E., Boethiusí» Trost der Philosophie (Zurich, 1949); Schmid, W., í░Boethius and the Claims of Philosophy,í▒ Studia Patristica 2 (1957): 368-375.

10) Schmid, 369.

11) Ibid., 374; see also Cassiodorus, Institutiones, Book I, xxxi. De medicis, Ed. RAB Minors: í░Deinde Caeli Aureli de medicina et Hippocratis de morbis et curis diuersosque alios medendi arte compositos, quos uobis in bibliothecae nostrae sinibus reconditos deo auxiliante dereliqui.í▒

12) The Methodist school arose in apposition to the Dogmatic school and the Empirical school during the beginning of the Christian Era with Themison of Laodicea and Thessalus of Tralles. The Methodists were sceptical, but less radical than the Empiricists, and permitted the formation of general principles based upon the observation of individual cases (Drabkin, xvi).

13) Drabkin, I. E., Introduction to Caelius Aurelianus, On Acute Diseases and On Chronic Diseases, Ed. and Trans. I. E. Drabkin (Chicago: U Chicago P, 1950), xi.

14) Ibid., xii.

15) On Acute Diseases, 2.1.1.

16) Ibid., 2.1.3.

17) Ibid., 2.1.4.

18) Ibid., 2.1.6-7.

19) Ibid., 2.1.8.

20) Ibid.

21) Ibid., 2.2.10.

22) Ibid.

23) Ibid., 2.2.11.

24) Ibid., 2.3.14.

25) Ibid., 2.3.16.

26) Ibid., 2.3.19.

27) Ibid., 2.6.27.

28) Ibid., 2.6.29.

29) Boethius, Tractates, Tractates, The Consolation of Philosophy, Trans. H. F. Stewart, E. K. Rand, and S. J. Tester, Loeb Classical Library (Cambridge: Harvard University Press, 1973). All translations are from this edition. 1m1.1-2.: í░Verses I made once glowing with content;/Tearful, alas, sad songs must I begin.í▒

30) 1m1.21-22: í░Ah why, my friends, why did you boast so often my happiness?/How faltering even the step of one now fallen.í▒

31) Schmid, 371.

32) 1p1.28-32: í░Who let these theatrical tarts in with this sick man? Not only have they no cures for his pain, but with their sweet poison they make it worse.í▒

33) 1p2.1-2: í░ButíŽnow is the time for cure rather than complaint.í▒

34) 1p2.11-16: í░He is in no real danger, but suffers only from lethargy, a sickness common to deluded minds. He has for a little forgotten his real self. He will soon recoverí¬he did, after all, know me beforeí¬and to make this possible for him, let me for a little clear his eyes of the mist of mortal affairs that clouds them.í▒

35) Means, Michael, The Consolatio Genre in Medieval English Literature (Gainesville: U Florida P, 1972), 25.

36) Ibid., 26.

37) 2p1.21-25: í░Adsit igitur Rhetoricae suadela dulcedinis quae tum tantum recto calle procedit, cum nostra instituta non deserit cumque hac Musica laris nostri vernacula nunc leviores nunc graviores modos succinat.í▒

38) 2p1.28-30: í░You imagine that fortuneí»s attitude toward you has changed; you are wrong. Such was always her way, such is her nature.í▒

39) 2m1: í░So with imperious hand she turns the wheel of change/This way and that like the ebb and flow of the tide,/And pitiless tramples down those once dread kings,/Raising the lowly face of the conquered--/Only to mock him in his turn;/Careless she neither hears nor heeds the cries/Of miserable men: she laughs/At the groans that she herself has mercilessly caused./So she sports, so she proves her power,/Showing a mighty marvel to her subjects, when/The self-same hour sees a man first successful, then cast down.í▒

40) 2p4.2-6: í░íŽnor can I deny that I did enjoy, however briefly, great prosperity. But it is just that which most torments me, for in all the adversities of fortune, the most unhappy kind of misfortune is to have known happiness.í▒

41) 2p5.1-2: í░But since you are now well warmed by the poultices of my arguments, I think it is now time to use rather stronger medicines.í▒

42) 3p1.13-14: í░Those remedies that are left now are like those that sting on the tongue, but sweeten once taken within.í▒

43) 1m9.22-28: í░Grant, Father, my mind to rise to your majestic seat,/Grant me to wander by the source of good, grant light to see,/To fix the clear sight of my mind on you./Disperse the clouding heaviness of this earthly mass/And flash forth in your brightness. For to the blessed,yo/Are clear serenity, and quiet rest: to see you is their goal,/And you, alone and same,/Are their beginning, driver, leader pathway, end.í▒