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Table of Contents
1. Series page
2. Title page
3. Dedication
4. Copyright page
5. Acknowledgements
6. 1: Introduction: Some Historical Preliminaries
1. Notes
7. 2: Some Conceptual Preliminaries
1. Notes
8. 3: Empathy as Simulation
1. Notes
9. 4: A Priori and A Posteriori Empathy
1. Notes
10. 5: Re-enacting the Thoughts of Others
1. Notes
11. 6: Empathy and the Emotions
1. Notes
12. 7: Empathy and Ethics
1. Notes
13. 8: Empathy and Aesthetics
1. Notes
14. 9: Afterword
15. Bibliography
16. Index
17. End User License Agreement
List of Tables

1. Table 4.1 Three levels of explanation
List of Illustrations
1. Figure 4.1 The cognitive architecture of the mind

Series page
Key Concepts in Philosophy
1. Guy Axtell, Objectivity
2. Heather Battaly, Virtue
3. Lisa Bortolotti, Irrationality
4. Ben Bradley, Well-Being
5. Joseph Keim Campbell, Free Will
6. Roy T. Cook, Paradoxes
7. Douglas Edwards, Properties
8. Ian Evans and Nicholas Smith, Knowledge
9. Bryan Frances, Disagreement
10. Amy Kind, Persons and Personal Identity
11. Douglas Kutach, Causation
12. Carolyn Price, Emotion
13. Darrell P. Rowbottom, Probability
14. Ian Evans and Nicholas D. Smith, Knowledge
15. Daniel Speak, The Problem of Evil
16. Matthew Talbert, Moral Responsibility
17. Deborah Perron Tollefsen, Groups as Agents
18. Joshua Weisberg, Consciousness
19. Chase Wrenn, Truth

Dedication
Copyright © Derek Matravers 2017
The right of Derek Matravers to be identified as Author of this Work
has been asserted in accordance with the UK Copyright, Designs and
Patents Act 1988.
First published in 2017 by Polity Press
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Library of Congress Cataloging-in-Publication Data
Names: Matravers, Derek, author.
Title: Empathy / Derek Matravers.
Description: Malden, MA : Polity Press, 2017. | Includes
bibliographical references and index.
Identifiers: LCCN 2016027668 | ISBN 9780745670744 (hardback :
alk. paper) | ISBN 9780745670751 (pbk. : alk. paper)

Subjects: LCSH: Empathy. | Caring.
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Acknowledgements
My thinking about empathy has been helped by my being a member
of the International Network on Empathy, Sympathy, and the
Imagination (INSEI). The network has benefitted from a British
Academy/Leverhulme grant, which has enabled us to meet more
regularly, the results of which have influenced what can be found in
these pages. In addition to Louise Braddock, Louise Gyler, Katherine
Harloe, Holly High, Michael Lacewing, Riana Betzler, Carolyn Price,
Talia Morag and Adam Leite, I would like to give particular thanks to
Anik Waldow, Katy Abramson and Maarten Steenhagen, who read
sections of the manuscript. I would also like to thank Emma
Hutchinson, Pascal Porcheron and Ellen MacDonald-Kramer at Polity,
and the anonymous reviewers whose incisive comments did much to
improve the book.
This book is a long-delayed addition to a project on empathy led by
Amy Coplan and Peter Goldie. A conference, held in Fullerton in
2006, led to their seminal edited collection, Empathy: Philosophical
and Psychological Perspectives (Oxford University Press, 2011). I
had a hand in this, at least to the extent of introducing Amy and
Peter at the first of a succession of meetings, both intellectual and
social, that somehow managed to lift both philosophy and life to a
better level. Peter died in 2011; in writing this book I have been
reminded of my debt to him, which is reflected (however
inadequately) on every page. I have dedicated the book, with a
great deal of affection and respect, to Amy, fully conscious that she
will find most of it completely wrong-headed.
The final draft of the book was written during a two-month period of
leave which I spent in Las Palmas, Gran Canaria. For their fabulous
hospitality, I would like to thank Colm, Lourdes, Sinéad and Aislinn.
And, of course, the trip would not have been the same without my
wife, Jane, for whom, I suspect, I present a limiting case for the

claims that follow. Without her love and support life would not be
nearly as splendid as in fact it is.

1
Introduction: Some Historical Preliminaries
‘Empathy’ is one of the catchwords of our time. In the course of his
political career, Barack Obama has repeatedly called on people to
address what he sees as ‘an empathy deficit’; an inability or an
unwillingness to see the world from the perspective of those less
fortunate than ourselves. People who are training to be doctors are
required to show empathy to patients, or, at least, those playing the
role of patients for the purposes of examinations (Jamison 2014: Ch.
1). There are international movements dedicated to the cultivation of
empathy, an online empathy library, empathy classes in schools, and
a recent book has claimed that empathy is ‘a key to a global and
social revolution’ (Krznaric 2014). Furthermore, the range of human
endeavour in which empathy features is impressive. It is prominent
within philosophy: it features in the philosophy of mind and the
philosophy of history, ethics and aesthetics. It has a key role in the
human sciences, particularly within what is known as ‘the
phenomenological tradition’. Within psychology, it has a place in
developmental psychology, social psychology and clinical psychology.
It also features increasingly in the developing cognitive sciences.
As we shall see, ‘empathy’ is a term used to cover a fascinating
range of disparate phenomena. To enable us to set out on our
journey around these phenomena I will venture a broad
characterization: empathy is using our imaginations as a tool so as
to adopt a different perspective in order to grasp how things appear
(or feel) from there. Even such a broad characterization as this will
be controversial; in particular, it does not include any reference to
caring about, or helping, the person who is the object of the
empathic engagement. In this, it contrasts with another recent
attempt to gesture at the general area: an emotion is empathetic if
the person who feels it ‘is aware that it is caused by the perceived,
imagined, or inferred emotion or plight of another, or it expresses

concern for the welfare of another’ (Maibom 2014: 2). However, if
this catches the link to an interest in the welfare of another, it does
so at the expense of not covering at least some of the recent
debates in the philosophy of mind. We shall examine the similarities
and differences between these conceptions of the topic as the book
progresses. As we need to start somewhere, for the moment I will
let them stand as rough characterizations of what I will be talking
about.
It comes as something of a surprise to those who do not know, that
the English word ‘empathy’ was coined as late as 1909. It is worth a
brief historical digression to discover how this came about. In
looking at the historical roots of empathy, we need to distinguish the
history of the phenomenon from the history of the specific term. As
for the phenomenon, I assume that people have been able to
imagine themselves into another perspective (whether the
perspective of themselves in a different time and/or space or the
perspective of another person) for as long as people have been able
to think. The phenomenon surfaced as being of some particular
philosophical use in the work of David Hume and (more particularly)
Adam Smith in the eighteenth century. Both Hume and Smith used
the idea of sharing others' mental states as part of their explanation
of morality. Of course, they did not have our term, but their term,
‘sympathy’, clearly describes something in the same area. Here is a
famous passage from Hume in the Treatise:
We may begin by considering a-new the nature and force of
sympathy. The minds of all men are similar in their feelings and
operations, nor can anyone be actuated by any affection, of which
all others are not, in some degree, susceptible. As in strings equally
wound up, the motion of one communicates itself to the rest; so all
the affections readily pass from one person to the other, and beget
correspondent movements in every human creature. When I see the
effects of passion in the voice and gesture of any person, my mind
immediately passes from these effects to their causes, and forms
such a lively idea of the passion, as is presently converted to the
passion itself. In like manner, when I perceive the causes of any

emotion, my mind is convey'd to the effects, and is actuated with a
like emotion.
(Hume 1739–40: III.iii.i)
In this passage, Hume is talking in particular about a passion (an
emotion) passing from one person to another. He mentions two
different ways in which this might happen. The first way, ‘as in
strings equally wound up, the motion of one communicates itself to
the rest’, looks to be a simple case of what is called ‘emotional
contagion’, our ‘catching’ emotions from other people. For example,
being in the company of happy people can make us happy, or being
in the company of anxious people can make us anxious. We shall
examine this in greater detail in the next chapter. The second way, in
which ‘my mind immediately passes from these effects to their
causes, and forms such a lively idea of the passion, as is presently
converted to the passion itself’, looks slightly more complicated. In
the Treatise Hume's account of psychology largely works by
association. If, in the world, one thing is causally related to some
other thing, then a thought about the first thing will tend to be
followed by a thought about the second thing. The same is true if
the objects are related by resemblance or contiguity in time and
place. These associative links guide our thoughts, which suggests
that, as with emotional contagion, the mind ‘passing’ from one
mental state to another does not break into our conscious
awareness. That is, I do not make conscious inferences from others'
appearance and behaviour regarding how they feel, and then
consciously get myself to feel the same; rather, it happens
automatically. In Hume's later work, the Enquiries, his associationism
is largely set to one side in favour of a focus on our actual processes
of evaluation, which takes him closer to modern debates.1 However,
it is not Hume but Smith who is most startling in the way that he
prefigures current discussion.2
The opening few pages of his The
Theory of Moral Sentiments cover many of the arguments found in
contemporary work on empathy:

As we have no immediate experience of what other men feel, we
can form no idea of the manner in which they are affected, but by
conceiving what we ourselves would feel in the like situation.
Though our brother is upon the rack, as long as we ourselves are at
our ease, our senses will never inform us of what he suffers. They
never did, and never can, carry us beyond our own person, and it is
by the imagination only that we can form any conception of what
are his sensations. Neither can that faculty help us to this any other
way, than by representing to us what would be our own, if we were
in his case. It is the impressions of our own senses only, not those of
his, which our own imaginations copy. By the imagination we place
ourselves in his situation, we conceive ourselves enduring all the
same torments, we enter as it were into his body, and become in
some measure the same person with him, and thence form some
idea of his sensations, and even feel something which, though
weaker in degree, is not altogether unlike them.
(Smith 2002 I.i.i.2)
Neither is it those circumstances only, which create pain and sorrow,
that call forth our fellow-feeling. Whatever is the passion which
arises from any object in the person principally concerned, an
analogous emotion springs up, at the thought of his situation, in the
breast of every attentive spectator.
(Smith 2002: I.i.i.4)
Hume was concerned with the passions of other people affecting the
passions we feel ourselves. Smith's concern is more complex; in his
notion of sympathy, we play a more active part. We imagine
ourselves in the circumstances of the other person, imagining
enduring what they endure. In some sense we identify with that
person, and feel, if not exactly what they feel, at least something
commensurate with what they feel. It is in this way that we can
move ‘beyond our own person’ and discover what ‘our brother’ is
feeling. As we shall see, this is very close to at least some of the
standard modern accounts of empathy.

If we put aside the history of the phenomenon and look to the
history of the term itself, we are taken into a series of debates in
German psychology and aesthetics in the late nineteenth century. A
key term in such debates was Einfühlung. This is difficult to translate
literally – it is usually rendered as ‘feeling into’. A surprising feature
of these debates is that those involved were less interested in
sharing mental states with, or projecting mental states into, other
people as much as they were interested in projecting mental states
into other (inanimate) things.
A good deal of stage-setting took place before the emergence of
Einfühlung as a concept. Inasmuch as it broadly concerned the
relation between active mental life and the inanimate world, at least
part of that stage-setting is the concern with the relation between
subject and object prevalent in German thought since Kant and
Hegel. A further landmark in the history of the concept, which surely
had an influence on the more concrete developments at the end of
the nineteenth century, was Romanticism, in particular, German
Romanticism. The Romantic movement of the late eighteenth and
early nineteenth centuries was of such a disparate nature
(geographically, politically and in almost every other way) that
general claims about it will hardly rise above the banal. However,
one characteristic was a yearning for unity against the distinctions
characteristic of the time, whether subject and object, mind and
body, man and world, or reason and the imagination. Finding a way
in which our minds can enter into the world promises one way of
approaching such a unity.
One manifestation of this, which took Romanticism closer to the
modern use of the term ‘empathy’, occurs in the work of Johann
Gottfried von Herder. Herder uses the term Einfühlung in his This
Too a Philosophy of History for the Formation of Humanity (Herder
1774). Herder's most notable contemporary commentator, Michael
Forster, has argued that Herder was not talking about psychological
projection (which would take his use close to one important aspect
of the modern use) but was using the term metaphorically as a way
of describing ‘an arduous process of historical-philological enquiry’.

The cash value of the metaphor has five components, none of which
are particularly part of our history. Two of them, however, do take us
close to a few elements of at least some of the modern meaning of
the term ‘empathy’: ‘in order to interpret a subject's language one
must achieve an imaginative reproduction of his perceptual and
affective sensations’ and ‘the interpreter should strive to develop his
grasp of linguistic usage, contextual facts, and relevant sensations to
the point where this achieves something of the same immediate,
automatic character that it has for a text's original audience when
they understood the text in light of such things (so that it acquires
for him, as it had for them, the phenomenology more of a feeling
than a cognition)’ (Forster 2002: xvii–xviii). In short, when we read
historical texts we should, in the first instance, imagine ourselves
occupying the perspective of the producer of the text including
imaginatively reproducing his or her mental states, and, in the
second instance, we should do the same for the presumed
readership of the text. Furthermore, in the second instance, doing so
establishes a link to the feelings.
In ‘On the Cognition and Sensation of the Soul’, Herder describes the
process that becomes central for the later writers we will be
considering: ‘The more a limb signifies what it is supposed to signify,
the more beautiful it is; and only inner sympathy, i.e., feeling and
transposition of our whole human self into the form that has been
explored by touch, is teacher and indicator of beauty’ (Herder 1778,
quoted in Jahoda 2005: 154). Herder does not use the term
Einfühlung (‘feeling into’) here, but rather ‘inner sympathy’. This is
symptomatic of things to come; although Einfühlung emerges as the
favoured term, plenty of other terms flourish in the same hedgerow
to indicate either the same or some very similar concept.
The first signs of aesthetics taking up the term in a significant way is
in the writings of Friedrich Theodor Vischer, Karl Köstlin and
Hermann Lotze (Mallgrave and Ikonomou 1994: 20).3
However, it
was in the doctoral dissertation of Vischer's son, Robert, that
Einfühlung was first given a technical definition. From the welter of
Vischer's theorizing, we can identify three claims that, even if they

did not originate with Vischer, were brought together under the
concept Einfühlung. First, he distinguishes between passive
processes – bodily reactions to the world that involve no conscious
involvement – and more active processes. He characterizes this
distinction in several ways, including sensation versus feeling,
sensory empathy versus kinaesthetic empathy and seeing versus
scanning. Here is one characterization of whatever it is that is on the
first side of the divide: ‘By sensation I mean the sensory process
only and, more particularly, the sensory response to an observed
object’ (Vischer 1873: 95). In their discussion of Vischer's work,
Harry Francis Mallgrave and Eleftherios Ikonomou list, along with
Einfühlung, various other terms which characterize the second part
of the divide: ‘Anfühlung, Ineinsfühlung, Nachfühlung, Zufühlung,
and Zusammenfühlung’ (Mallgrave and Ikonomou 1994: 22).
Whatever the details, all these involve the active involvement of the
mind and imagination. Second, Vischer claims that a large part of
the passive process lies in a similarity between the outward forms
and the inner processes: ‘This is not so much a harmony within an
object as a harmony between the object and the subject, which
arises because the object has a harmonious form and the formal
effect corresponding to subjective harmony’ (Vischer 1873: 95).
Finally, Vischer introduces the notion of projection. In this, he was
influenced by a book by Karl Albert Scherner, Das Leben des Traums
(The Life of the Dream), which had been published in 1861
(Scherner 1861). The passage in which Vischer describes this
influence, culminating in his definition of Einfühlung, is worth
quoting in full:
The longer I concerned myself with this concept of a pure symbolism
of form, the more it seemed to me possible to distinguish between
ideal associations and a direct merger of the imagination with
objective form. This latter possibility became clear to me with the
help of Karl Albert Scherner's book Das Leben des Traums (The life
of the dream). This profound work, feverishly probing hidden
depths, contains a veritable wealth of highly instructive examples
that make it possible for any reader who finds himself unsympathetic

with the mystical form of the generally abstract passages to arrive at
an independent conclusion. Particularly valuable in an aesthetic
sense is the section on ‘Die symbolische Grundformation für die
Leibreize’ (Symbolic basic formation for bodily stimuli). Here it was
shown how the body, in responding to certain stimuli in dreams,
objectifies itself in spatial forms. Thus it unconsciously projects its
own bodily form – and with this also the soul – into the form of the
object. From this I derived the notion that I call ‘empathy’
[Einfühlung].
(Vischer 1873: 92)
There is at least one puzzle here: what Vischer means when he says
that the body ‘objectifies itself in spatial forms’. He approaches, but
never clearly says, that we identify ourselves with the object. The
simile he uses to make his point – ‘we have the wonderful ability to
project our own physical form into an objective form in much the
same way as wild fowlers gain access to their quarry by concealing
themselves in a blind’ – is evocative, but hardly perspicuous (Vischer
1873: 100).
In short, in Vischer's work, we see the outline of the contemporary
concept of empathy coming together. The three claims distinguished
above foreshadow three elements of the contemporary concept.
First, his distinction between passive and active processes is in some
ways akin to the distinction between (as we would put it) the sub-
personal and the personal. Second, he has the notion of a process
whereby the inner mental states mirror outer forms. Finally, he has
the notion of our projecting selves into an object and in that way
imbuing the form of that object with content. However, quite what
‘imbuing’ covers here is unclear.
If Vischer perhaps deserves to be relegated to being a footnote in
this history, the same should not be said of the man who picked up
and developed his ideas: Theodor Lipps. Lipps has rather faded into
obscurity, but, in his time, he was a major intellectual figure. Had
T. E. Hulme4 lived to complete his planned work on ‘Modern Theories
of Art’, two and a half of the projected nine chapters would have

been devoted to Lipps (Hulme 1924: 261–4). This would, no doubt,
have led to more of Lipps's work being translated into English, which
could have shored up his reputation in anglophone countries. As it
is, it is rare to find him mentioned anywhere apart from accounts of
the genesis of ‘empathy’.
At any particular time Lipps seems to have meant various things by
Einfühlung, and he also shifted his view so that he meant different
things at different times. The principal statement of his view is in his
1903 article, ‘ “Empathy”, Inward Imitation, and Sense Feelings’
(Lipps 1903).5
A contemporary review of his work puts it in a
recognizably Vischerean context:
Of late the question, or rather group of questions, which has excited
most debate among German aestheticians has to do with the
distinction between the object immediately presented to sense-
perception – say a rose with its characteristic form and colouring –
and the meaning which this has for our imagination, say full vitality
and pride of life.
(Anonymous 1908: 459)
Lipps distinguishes ‘aesthetic’ imitation from what he calls ‘voluntary’
imitation (Lipps 1903: 254). His account of the first is radical. Faced
with an aesthetic object, I feel various powerful and active emotions:
‘I feel myself strong, light, sure, resilient, perhaps proud and the
like’. Furthermore, ‘It is myself’ that I feel as having these emotions.
So far, so good. The radical element is how he gets those felt
emotions ‘into’ the object. He does so by identification: ‘I do not so
feel myself in relation to the thing or over against it, but in it…This is
what I mean by Empathy: that the distinction between the self and
the object disappears or rather does not yet exist’ (Lipps 1903: 253).
Lipps gives various other formulations of a similar sort (‘I am even
spatially in its position, so far as the self has a spatial position; I am
transported into it’ (Lipps 1903: 254)), although the idea does not
become less obscure. There is some degree of backtracking which at
least makes clear that Lipps is not claiming any straightforward
identity between the observer and the object:

In unimitative movement the activity belongs to my real self, my
whole personality endowed as it actually is, with all its sensations,
ideas, thoughts, feelings, and especially with the motive or inner
occasion from which the movement springs. In aesthetic imitation,
on the other hand, the self is an ideal self. But this must not be
misunderstood. The ideal self too is real, but it is not the practical
self. It is the contemplative self which only exists in the lingering
contemplation of the object.
(Lipps 1903: 255)
In common with other commentators, both those contemporary with
Lipps and those writing more recently, I find his account of ‘aesthetic
empathy’ obscure. However, it was the non-aesthetic use Lipps made
of the concept that arguably has had the greater effect on
contemporary thought. This is a significant step in the history of the
concept; the move from empathy with objects to empathy with
people.
Lipps moves seamlessly between talk of an object of beauty to talk
of broader properties of – specifically – human beings. His example
of something ‘strong, proud, and free’ is in fact ‘a human figure’:
I see a man making powerful, free, light, perhaps courageous
motions of some kind, which are objects of my full attention. I feel a
sense of effort. I may carry this out in real imitative movements. If
so, I feel myself active. I do not merely imagine but feel the
endeavour, the resistance of obstacles, the overcoming, the
achievement.
(Lipps 1903: 253–4)
In this passage, we have the familiar idea of ourselves undergoing
various perturbations, in this case including motor perturbations, and
feel what it is that the person in front of me is undergoing. We know
from work produced by Lipps in 1907 that he put his concept of
Einfühlung to work in thinking about the so-called ‘problem of other
minds’. In fact, the problem of other minds is really two problems:
how we can know that others have minds at all, and how (once we

are content they do have minds) we can know what goes on in
those minds. I shall refer to these as the ‘whether’ problem and the
‘how’ problem. The ‘whether’ problem arises because, although each
of us is acquainted with our own mind, we are not acquainted with
the minds of others. Without such acquaintance, what justification
do we have for thinking others have minds? Descartes had posed
the problem vividly in the seventeenth century: ‘I chanced, however,
to look out of the window, and see men walking in the street; now I
say in ordinary language that I “see” them…but what can I “see”
besides hats and coats, which may cover automata?’ (Descartes
1970: 73). A venerable solution to the ‘whether’ problem is ‘the
argument from analogy’. I know, in my own case, that certain
mental states come between certain inputs and certain outputs. For
example, I know that between the input of my hitting my thumb
with a hammer and the output of my crying out there is the
sensation of pain. Other people are similar to me in all kinds of
ways, so I infer that, between similar inputs and similar outputs,
other people have mental states similar to the ones with which I am
acquainted in my own case. An almost equally venerable rebuttal of
this argument is that it is methodologically suspect. As I am only
acquainted with a single case (my own), it would be irresponsible for
me to make an inference regarding how other people feel; there are
no grounds for thinking others are like me in this respect (Ryle 1963:
52).
Lipps, rightly unconvinced by the argument from analogy, sought to
replace it with an ‘instinct’ which gives us knowledge of other minds
without involving an inference:6
In the perception and comprehension of certain sensory objects,
namely, those that we afterward represent as the body of another
individual (or generally as the sensory appearance of such), is
immediately grasped by us. This applies particularly to the
perception and comprehension of occurrences or changes in this
sensory appearance, which we name, for example, friendliness or
sadness. This grasp happens immediately and simultaneously with
the perception, and that does not mean that we see it or apprehend

it by means of the senses. We cannot do that, since anger,
friendliness, or sadness cannot be perceived through the senses. We
can only experience this kind of thing in ourselves.
(Lipps 1907: 713; quoted in Jahoda 2005: 156; translated by Jahoda)
Lipps proposed that our grasp of other minds is a result of two
processes. In the words of Gustave Jahoda, ‘the object of sensory
perception comes from the external world, while the inner excitation
comes from within ourselves’ (Jahoda 2005: 156). I witness another
person's gesture of, for example, anger, and this raises a feeling
within my consciousness. It is unclear how this could be a solution to
the problem of whether other people have minds – we would simply
be acquainted with more of our own mental states. However, if we
put the ‘whether’ problem to one side (or assume it is solved), we do
look to have a solution to the ‘how’ problem. We manage to ‘read’
the minds of others by re-experiencing their mental states for
ourselves.
This leads naturally to the term's original introduction into English
(at least as ‘empathy’ – in 1908 the term had been translated as
‘infeeling’ (Anonymous 1908: 466)). Here is the passage in which the
psychologist Edward Titchener coined the term:
Not only do I see gravity and modesty and pride and courtesy and
stateliness, but I feel or act them in the mind's muscles. This is, I
suppose, a simple case of empathy, if we may coin that term as a
rendering of Einfühlung; there is nothing curious or idiosyncratic
about it; but it is a fact that must be mentioned.
(Titchener 1909: 21–2; quoted in Jahoda 2005: 161)
‘The mind's muscles’ is an inspired description. In the same way as a
frustrated football manager finds himself exercising his leg muscles
by mimicking on the sidelines his players’ kicks in the field, so our
minds’ muscles mimic in our minds what is going on in the minds of
others. The non-aesthetic developments of Lipps's thoughts, the
empathy with people and the subsequent broadening into the notion

of other minds, are what take us closer to the modern conceptions
of empathy.
The schema for ascertaining what is going on in the minds of others
is perfectly general. There is no reason to limit it to finding out what
emotion a person is feeling; it looks as if it could be anything that is
going on in the mind of another (I will be drawing various limits to
this claim throughout the book). This is in tension with the common
view of empathy (such as it is) that links it particularly to emotional
states. Indeed, we have already seen that empathy is an unholy
amalgam of a raft of different claims involving imagining another's
perspective, mirroring the properties of others (whether things or
people), projecting our mental states into others (whether things or
people) and taking on the emotions of others. This terrible tangle of
issues, as we shall see, continues to dog the contemporary
discussion.
Indeed, this terrible tangle puts an obstacle in the way of fulfilling
the laudable aim of books in this series: namely, to give a synoptic
view of some key concept. This presupposes that there is some unity
to the concept of which a synoptic view could be taken. Perhaps
matters are not quite as bad as I am making them out to be; Heidi
Maibom, in her introduction to a recent collection of essays on the
topic, claims that ‘the rumors about the impossibly diverse usage of
“empathy” are exaggerated’ (Maibom 2014: 2). However, the
characterization she goes on to give (quoted above), in its focus on
empathetic emotions and on caring behaviour leading from such
emotions, only covers a proportion of what is discussed, currently,
under the term ‘empathy’. In particular, it ignores the discussions
focusing on epistemology which do not take there to be a link
between empathy and the emotions, and which are far removed
from particular sorts of behaviour. I side with Dominic McIver Lopes
who writes that ‘Experts characterize what they call “empathy” in
several incompatible ways, and perhaps the definitions glom onto
distinct phenomena, none of which has the sole claim to the title of
“empathy” ’ (Lopes 2011: 121).7

Coming to terms with the difficulties posed by the fact that there are
many different phenomena, all of which lay claim to the term, has
dictated the shape of this book; I have largely restricted myself to
Anglo-American philosophy, broadly construed. This does not mean
that issues such as, for example, the nature of explanation in the
human sciences have been ignored; it means, rather, that the focus
has been on philosophy written in English. However, even with such
a restriction, the scope of the book is fairly vast. Chapters 3 and 4
focus on the philosophy of mind, in which the concept of empathy
has been central to one of the recent Homeric struggles concerning
interpersonal understanding (I shall use the term ‘interpersonal
understanding’, although there are other terms in common use such
as ‘mindreading’ (Nichols and Stich 2003: 1)). Chapter 3 will
motivate the claim that empathy, or ‘simulation’, is a key component
of interpersonal understanding and then focus on the deliberate
efforts we might make to work out what is going on in someone
else's head and to predict their behaviour. Chapter 4 will then try to
map the various attempts to argue for simulation. First, I will discuss
whether we can come to see that we are committed to there being
some degree of empathy (or ‘simulation’ or ‘co-cognition’) simply by
reflecting on what we know about how we understand each other.
This contrasts with the discussion in the second half of the chapter,
which has an empirical focus; that the claim that there is some
degree of empathy in our interpersonal understanding is a
hypothesis that needs to be tested against rival hypotheses. In
particular, it will look at the work of Alvin Goldman, and then at
contemporary work on ‘mirror neurons’ before a brief look at the
approach known as ‘homuncular functionalism’. Chapter 5 continues
to investigate attempts to use something like empathy to understand
what goes on in the heads of others. However, in this case it
concerns what it is to have a full grasp of others' reasons for action.
This evaluates a set of arguments from R. G. Collingwood about the
nature of historical explanation; arguments which have recently
been revised and reasserted by Karsten Stueber. Chapter 6 changes
the focus from broad epistemic questions to what is perhaps a more
familiar discussion in non-philosophical circles: empathizing with

someone with respect to the emotions they are feeling. This leads,
in chapter 7, to a discussion of the role that empathy plays in our
moral lives – or indeed of whether it plays a role at all. What is
revealed is a schism between the popular view of empathy as being
an unequivocal moral good, and the dominant view in both
psychology and philosophy, which is more ambivalent. Chapter 8
takes us back to the origins of the concept in aesthetics. We will see
that empathy had a limited role in early twentieth-century theorizing
but has had a return, particularly in the philosophy of literature. The
final chapter attempts some summary, and speculates about the
future of the concept. This includes a look at a recent attempt to
remove empathy from our picture of interpersonal understanding
and to take a broader, more social approach.
Given the truth of Lopes's observation, this book is more of a
smorgasbord than an overview. That such an approach is necessary
is part of the interest of the current debate. Although there is some
overlap, and accumulation of argument, I have written it in such a
way that I hope the chapters can be read independently. There are,
however, some distinctions common to several of the discussions
that need to be drawn, which will be the subject of the next chapter.
Notes
1 There is a substantial literature on this. For a discussion, see
Abramson (2001).
2 See Griswold (2006: Part 1).
3 The aesthetic history of the term is expertly traced in Guyer
(2014: ch.10).
4 The underrated Hulme was blown to bits by a German shell in
1917.
5 Jahoda translates the title as ‘Einfühlung, Inner Imitation, and
Organic Feelings’ (Jahoda 2005: 154).

6 My discussion here is drawn directly from an excellent paper by
Gustav Jahoda (2005).
7 A fellow sceptic is Noël Carroll (2011: 163). For a list of the ways
in which ‘empathy’ is currently understood, which is not claimed to
be exhaustive, see Coplan (2011: 4).

2
Some Conceptual Preliminaries
In the last chapter I gave a rough characterization of empathy as
using our imaginations as a tool so as to adopt a different
perspective in order to grasp how things appear (or feel) from there.
One manifestation of this, which plays a prominent role in current
debates, is simulation:1
we use our own minds as a model of other
minds. I shall introduce the idea by borrowing an analogy from Jane
Heal:
We can get at the key idea by considering the familiar example of
the model aircraft in the wind tunnel. (The case has some
misleading features, which we shall need to remark later, but it will
serve to get us started.) Suppose that we know, in general terms,
that aerofoils provide lift, that aircraft are liable to become unstable
in some circumstances and the like, but lack any detailed
quantitative theory of aerodynamics. We do not have a set of usable
equations relating all the significant variables, such as body shape or
wind speed, to the upshots, such as lift and stability, in which we are
interested. How can it be that we may nevertheless arrive at detailed
quantitative predictions on these matters? Here is a possible
method. If we are convinced (for example, by inductive
generalisation, or as a consequence of theoretical assumptions) that
a model aircraft will behave similarly to a real aircraft of the same
shape, at least in a usefully wide range of circumstances, then we
may test models with varying shape in varying wind speeds and so
on, measuring the quantitative outcome in various respects and
using those figures as a basis for the needed detailed predictions of
the actual aircraft. We use the model aircraft to simulate the real
aircraft.
(Heal 1996a: 64–5)
2

As Heal points out, we could learn something only if the ‘model
aircraft will behave similarly to a real aircraft of the same shape’.
Analogously, simulation will only work if the model (our mind)
behaves similarly to that of which it is a model (I shall refer to the
person to whom our attention is directed as ‘the target’). If we
assume our mental machinery and that of the target are roughly the
same then all we need to do is find some way of replicating their
inputs into our machinery, and this should yield an output from our
machinery which is the same as the output from their machinery.
Whether or not differences between us render empathy epistemically
unreliable is, as we shall see, a matter for considerable dispute.
There is also an issue of what can be simulated. Wind tunnels can
test for certain properties of aircraft, but they will not answer all of
an engineer's questions. Analogously, the scope of empathy – that
is, which kinds of mental states can be simulated – is also open to
dispute.
In addition to worries about the reliability and scope of simulation,
two further issues arise. First, there are differences in the means by
which we marshal the resources needed to take on the perspective
of the target. The simplest case might be that in which we are in
direct perceptual contact with the target. For example, you might be
watching someone out of the window about to get into his car. As he
does so, without realizing it, he drops his keys. You could simulate
being in his situation; you ‘input’ that you put your hand in your
pocket and find nothing there. Your simulation yields the thought
that you would check all your other pockets, before looking on the
ground around you. Having noted these ‘outputs’ in your own case,
you attribute them to the target. This is, in fact, what the target
does; your simulation has been successful. In cases in which you are
in direct perceptual contact with the target, you do not need to
exercise your imagination; all you need to do is to think what they
are thinking. As we shall see, some count this as an exercise of the
imagination (after all, the input is not the belief that you have lost
your keys). In addition to direct perceptual contact, there are various
other means by which you could marshal the resources you need.

Someone could describe a set of events from the perspective of the
target. You would not need to imagine (in the sense of ‘make up’)
the circumstances; you are being told them. However, it might
require an exercise of the imagination to adopt the target's point of
view; to come up with the right inputs from what you have been
told. Finally, we might simply imagine a set of circumstances from
the perspective of someone in those circumstances; it might be
some actual person, some hypothetical person, or some type of
person (such as a Roman soldier who trudged along this road
(Goldie 2000: 204)). This might require some effort; you might need
to imaginatively engage your senses and engage in visualizing or
imagining sounds. Indeed, as we shall see, the effort required
arguably renders the process epistemically unreliable.
The second issue concerns the nature of the inputs. As it is a
simulation, the inputs are not true of the simulator. That is, when I
simulate the person who has dropped his keys, the input is not ‘He
has dropped his keys’ but ‘I have dropped my keys’. What is
important is that these simulacra of beliefs (‘make-beliefs’, as they
have come to be called) turn the simulator's cognitive machinery in
the same way that beliefs turn the target's cognitive machinery. The
output (check the other pockets, look on the ground) stop short of
action by the simulator; you do not check your pockets, or look on
the ground around where you are sitting. Rather, the output is some
kind of representation of the motivation to so act; which motivation
you then attribute to the target. Empathy, construed as simulation,
needs it to be the case that make-beliefs have a similar enough
effect on the simulator's mental machinery as do beliefs on the
target's mental machinery. If not, the output from the simulator's
mental machinery will not be a reliable guide as to the target's
mental state. As we shall see, this too is open to dispute. We should
note, as it has caused some confusion, that generally we regard the
make-belief states as tracking the truth about the world, even if they
are not true of us but true of someone else. We make-believe that
there is nothing in our pockets because we believe that the target
believes there is nothing in their pockets. That is, the distinction

here between make-beliefs and beliefs is not the distinction between
stuff we make up and stuff we do not make up, or fiction and non-
fiction.
The characterization of empathy as simulation, which has the broad
purpose of finding out what is going on in someone else's head,
whatever that might be, is more characteristic of academic
philosophy than it is of discussions outside that discipline. Outside
academic philosophy there is more of a focus on affective or
emotional states (which I shall call ‘narrow empathy’). That is, to
empathize with someone is not to imagine the world from their
perspective so as to discover what they are thinking or what they
will do next, but to imagine the world from their perspective so as to
feel what they feel. For those for whom ‘empathy’ means ‘narrow
empathy’, there is an essential link with the emotions. Those who do
think thus might wonder why three entire chapters of this book are
taken up with something that seems to lack this essential link. My
defence of this is twofold. First, we should not take it for granted
that academic philosophy is the outlier. In the most in-depth
monograph on empathy to date, Karsten Stueber claims that it is the
philosophers who have grasped the interesting core of the concept
(a claim supported by the brief history of the concept given in the
last chapter):
I would object to the claim that empathy as a vicarious sharing of an
emotional state should be understood as the only right way of
defining and explicating the concept of empathy, as it is sometimes
asserted in this context. Empathy as understood within the original
philosophical context is best seen as a form of inner or mental
imitation for the purpose of gaining knowledge of other minds.
(Stueber 2006: 28; emphasis in original)
The second consideration is that empathy as a broad epistemic
concept, and empathy as a narrow affective concept, share a
common core: they both centrally involve taking on the perspective
of the other. Although the philosophical account has come to be
known as ‘simulation theory’, a name that seems to take it away

from our concerns here, it is altogether possible that it might instead
have been known as ‘the empathy view’ (see Davies and Stone
1995: 1; and Goldman 2006: 17). Furthermore, there are several
wrinkles in sorting out a defensible version of the broad notion of
empathy, which carry over to sorting out a defensible version of
narrow empathy.
Narrow empathy comes in two forms. First, the link with the
emotions might simply be that we imagine being in someone's
circumstances so as to find out what they are feeling. We can
consider the kind of example that Barack Obama had in mind in his
talk of ‘the empathy deficit’. We make the effort to take on the
perspective of someone who has been made redundant. We
simulate all kinds of input: worry about the effect on his or her
family, worry about paying the mortgage, belief that people with his
or her set of skills face limited opportunities and so on. We find
ourselves experiencing something like a feeling of panic. Hence, we
attribute to him or her a feeling of panic. (We shall see, in the next
chapter, that such examples are controversial.) In such cases, the
essential link with the emotions is simply that simulation does not
count as empathy unless our imaginative endeavours have, as their
output, an emotional state. However, using our imaginations to learn
what the target is experiencing is not the only, or even the usual
form of narrow empathy. The term more usually describes a
situation in which one believes that the target is experiencing some
emotion, and one takes on his or her perspective, not to learn what
emotion he or she is experiencing, but simply to show fellow-feeling,
or solidarity, by sharing that emotion (or something like it). Joel
Smith has termed this ‘transparent fellow feeling’ (Smith 2015).
One might describe this contrast as being between empathy
functioning epistemically (finding out how the target feels) and it
functioning for reasons of solidarity (simply sharing the target's
emotion). Smith sees matters differently. He argues that the latter,
which is what he takes empathy to be, is itself functioning
epistemically. He argues that unless we have transparent fellow-
feeling, there is some knowledge we lack about the target's

emotional state. We can know what they feel (panic), but we do not
know how they feel: ‘I suggest that A knows how B feels only if she
knows that B is Ψ and how it feels to be Ψ. Further, A knows how it
feels to be Ψ if and only if A knows that Ψ feels like this’ (Smith
2015: 5). It is the second of Smith's two claims that is controversial.
Why should we think that A only knows how it feels to be Ψ, if A can
occurrently identify Ψ in her own case? However, the claim is less
strong than it might appear. Smith allows that to be in a position to
judge that ‘Ψ feels like this’, all A needs is to have some version of
something like the state (which might come about as a result of
simulation, calling up the state from episodic memory, or perhaps by
some other means). In other words, provided A is familiar with Ψ, it
will be difficult for her to bring it to mind without also bringing to
mind some token of it to which she can refer. Independently, Kendall
Walton has worked out a similar account. His (characteristically
revisionary) account takes the core notion of ‘empathy’ to be
someone using their mental state as a sample for the mental state
of another: we take the other to be feeling like this, where ‘this’
refers to our own mental state (Walton 2015: 5–10).
I shall not take a stand on Smith's contention that transparent
fellow-feeling fills in what would otherwise be a gap in our
knowledge of the target's emotion; that is, whether it is impossible
to know how the target is feeling unless one knows that the target
feels like this, where ‘this’ refers to one's own occurrent mental
state. I will also not discuss Kendall Walton's suggestion, which is
too revisionary to belong to a book of this sort (although it does get
a brief mention again in chapter 6). I shall, however, make use of
Smith's characterization of transparent fellow-feeling. Sometimes our
motivation for empathizing with another is nothing to do with
discovering what is going on in their heads, but sharing what is in
their heads. As Smith notes, the point had been made many years
ago by his namesake, Adam Smith: ‘nothing pleases us more than to
observe in other men a fellow-feeling with all the emotions of our
own breast’ (Smith 2002: I.i.ii.1).3

So far, I have been speaking of empathy as something that happens
above the level of consciousness. However, some philosophers,
notably those closer to the cognitive sciences, extend the term to
sub-personal systems by which we come to understand each other
(here we have to construe ‘understand’ broadly enough so as to
cover the sub-personal). We met a paradigm instance of this in the
last chapter, in the quotation from Hume. This was an instance of
the phenomenon of ‘emotional contagion’: ‘As in strings equally
wound up, the motion of one communicates itself to the rest; so all
the affections readily pass from one person to the other, and beget
correspondent movements in every human creature.’ This is a fairly
familiar experience; anxious people tend to make people around
them anxious; we can ‘catch’ the joy from a crowd of joyful people.
Stephen Davies has given a more formal analysis:
Emotional contagion involves the arousal in B by A of an affect that
corresponds either to an affect felt and displayed by A or, where A is
non-sentient, as for the case of music and house décors, to the
expressive character experienced by B as displayed in A's
appearance, and while B's arousal must derive from A's displaying
the relevant affect, so that A's affect is the perceptual object of B's
reaction, A's affect is not the emotional object of B's response,
because B does not believe (or imagine) of A's affect what is
required to make it an appropriate emotional object of the response
B experiences.
(Davies 2011: 146)
It is not required, for something to count as an instance of emotional
contagion, that the person affected is aware of the cause of their
affect, or even consciously aware that they have been affected. The
mechanisms of contagion are distinctly sub-personal – here
described by Amy Coplan:
The main processes involved in contagion are motor mimicry and the
activation and the feedback it generates. Initiated by direct sensory
perception, these processes do not involve the imagination, nor are
they based on any cognitive evaluation or complex appraisal. Thus

emotional contagion is a bottom-up process that operates much like
a form of perception. We encounter another person, automatically
react to the other's expressions of emotion through involuntary
imitation, and end up experiencing the same emotion ourselves.
(Coplan 2011: 8)
These mechanisms are not only sub-personal; they do not involve
any kind of perspective-taking (we shall find, later in the book,
arguments for there being sub-personal instances of perspective
taking). In short, emotional contagion does not seem to fall under
even the rough, and deliberately wide, working definition of
‘empathy’ I gave earlier. This suggests that conceptual hygiene is
served by distinguishing emotional contagion from empathy,
reserving the latter for activities that involve taking the perspective
of the other (which is, indeed, the line Coplan takes (Coplan 2011:
9)).
Coplan is surely right to want to mark this distinction, but I shall not
take a strong line on the use of the term. To do so would be to
cause a twofold problem. First, it would make it difficult to discuss
the views of those in the area who do count emotional contagion as
a form of empathy (Maibom 2014: 4). Second, and relatedly, the
kinds of mirroring mechanisms that underpin emotional contagion
underpin capacities that are broader and more significant. Alvin
Goldman has argued that such automatic mechanisms play an
important role in interpersonal understanding; these he describes as
‘low level empathy’ (Goldman 2006). Karsten Stueber uses the term
‘basic empathy’ to refer to ‘mechanisms that underlie our
theoretically unmediated quasi-perceptual ability to recognize other
creatures directly as minded creatures and to recognize them
implicitly as creatures that are fundamentally like us’ (Stueber 2006:
20).
A distinction I shall observe, however, is that between empathy and
sympathy. We have seen that Hume and Smith used the term
‘sympathy’ to cover a range of phenomena, including the kind of
perspective-taking we now associate with empathy. In current

debates, a broad consensus has emerged to use the terms to
distinguish between two different phenomena (or, rather, the
collection of phenomena that go by the name ‘empathy’ and some
other, more clearly defined, phenomenon that goes by the name
‘sympathy’). The standard case of sympathy is that in which the
target feels some negative emotion, to which the person feeling
sympathy feels, well, sympathetic (I have described this as ‘the
standard case’ as there are others as well). Some want to extend the
term to cover cases in which a target is feeling a positive emotion,
and so that we can ‘sympathize’ with the success of others (Maibom
2014: 3). I am sure that some people do use the term in this way,
but I shall put this use aside in my discussion as the case of
sympathizing with another's unhappiness is more central. We speak
of someone who has suffered a chance misfortune as ‘deserving of
sympathy’; we would not usually say that of someone who had won
the lottery.
What is it to ‘feel sympathetic’? In the standard case, a person
comes to believe that the target is in some kind of distress; that is,
they are in pain, or they are feeling one of the negative emotions.
Such a person might come to this belief by perception (they can see
that the target is in distress) or via testimony (they are reliably
informed that the target is in distress). This provokes in them a
feeling which is directed towards the target. We are not generally
very precise in the way we describe this feeling. We sometimes
simply describe it as ‘sympathy’; we claim to feel ‘a great deal of
sympathy for so-and-so’. Sometimes we might describe it as ‘pity’,
‘concern’, ‘sadness’, ‘compassion’ or simply ‘feeling sorry for’.
There are two important contrasts with empathy. First, sympathy
does not necessarily involve imagining what it is like for the other
person. All that is needed is that the person comes to believe that
the target is distressed and, as I said above, they can come to this
belief in a variety of ways. Second, sympathy does not necessarily
involve having the same feeling as the other person. That is, it is not
part of the phenomenon that we feel exactly what they feel. Rather,
we are feeling an emotion (sympathy) towards them. Indeed, to

move from the ‘standard’ case described above, it is possible to feel
sympathy towards someone who is not themselves feeling an
emotion. Someone could be in a terrible situation but, because of
their resolute Stoicism or because of a brain injury, they do not feel
distress. They would still be a proper target for sympathy.
It is not part of my claim that all phenomena can be neatly classified
under one of the headings given above. Consider seeing someone
shut their fingers in a car door. The car door shuts, they cry out with
pain, and you, the witness, wince horribly. Is this sympathy,
empathy, emotional contagion or something else? It does not seem
quite like sympathy; what we feel is something like pain, rather than
any feeling of sympathy (although, of course, a feeling of sympathy
might quickly follow). Is it then empathy – albeit a very simple form
of empathy? No, for two reasons. First, we do not imagine what it is
like to be the person. At least, we do not consciously imagine this;
although there might be some measure of automatic perspective-
taking (I say more about this below). Second, we do not have the
same feeling as the target; we do not feel pain. It is true that there
is an overlap between the areas of the brain that are active when we
witness pain and the areas of the brain that are active when we feel
pain ourselves (Maibom 2014: 9). However, this is not enough to say
that the witness feels pain; we do not feel what the person who shut
their fingers in the door feels, even to a degree. For the same
reason it is not an instance of emotional contagion; pain is not the
kind of sensation that can be spread in this way. It does not fit
neatly under any of these headings but partakes of a little of each of
them. To conclude, that is not a problem – there is no reason to
think that all mental phenomena can be neatly divided so as to fit
into a number of headings specified in advance.
Notes
1 Most sides to the debate agree that ‘simulation’ is an unhelpful
term, as it also means too many things to too many people.
However, as I am only giving an overview I shall continue with the

term, marking relevant distinctions where necessary. Nichols and
Stich give a helpful taxonomy (Nichols and Stich 2003: 133–4).
2 Heal's caveat, concerning ‘misleading features’, is well taken.
The analogy is limited in various ways, particularly, as she is well
aware, with respect to her own view. See Heal 1988: 111 and
passim.
3 To multiply Smiths, Murray Smith makes the same distinction
using the labels ‘mind-reading’ and ‘mind-feeling’ (Smith 2011:
114).

3
Empathy as Simulation
As discussed in chapter 2, outside philosophy empathy has been
largely associated with taking the perspective of another so as to
share their emotions, or, at least, to get a better appreciation of their
concerns. Within philosophy most of the debate has been in a quite
different area: that of interpersonal understanding. In order to see
where empathy comes in, I shall need to put in place some of the
other pieces of the debate; in particular, the account which the
‘empathy theory’ sought to replace.
Let us begin with a very broad question. How is it that we
understand things? That is, how is it that the world does not usually
surprise us? When I press the ‘on’ switch on my radio it comes on
(all things being equal). When I push the pedal down on my bicycle,
the back wheel goes round (all things being equal). There does not
seem any great mystery here. I have learned, either from experience
or by working it out, that when I press the ‘on’ switch the radio
comes on and when I press the pedal the back wheel goes round. I
have beliefs of the following sort: in circumstances C, if P happens
then Q will happen (all things being equal). We need the ‘all things
being equal’ clause because, occasionally, P will happen and Q not
happen. These will be the occasions when, perhaps, the batteries in
the radio have run out of power, or the chain has fallen off the
bicycle. To introduce a bit of jargon, we might say that we have
(rather elementary) theories as to how radios work and how bicycles
work.
Does this general account of the way we understand things cover
the way we understand people? One might think that it does. After
all, it is plausible that people are only rather complicated machines.
The general schema I gave in the previous paragraph might seem to
apply. In the usual circumstances, if people want X, and they believe
that doing Y will bring them X, and there is nothing else to be said

against doing Y, then they will do Y. If Jane would like coffee, and
she believes going to the café will enable her to buy coffee, and she
has time to go to the café and the means to buy coffee, then I shall
not be surprised if she goes to the café. Each of us is aware of a
vast body of information about the causes and effects of
psychological states. We may well be consciously aware of part of
this body of information, but the greater part of it we know
implicitly. It could not be that we employ it consciously; that would
be far too laborious, and our interactions with other people and the
world generally would grind to a halt. However, the way we
understand other people is by applying this information to what we
know about the particular person in front of us so as to come up
with a prediction about what is going on in their heads or about their
subsequent behaviour. This account of how we understand each
other is known as ‘theory theory’: that is, it is the theory that we
each have a theory as to how people work.
Theory theory is part of a larger view of the mind and mental states
known as functionalism; the view that mental states are identified
with ‘functional roles’, rather than states of the soul or states of the
brain. A mental state's functional role is given in terms of its
characteristic inputs, outputs and relations to other mental states.
Hence, the role can be captured by the kinds of information
embodied in the theory described above (whether those are laws,
some other kinds of nomological generalization, or mere rules of
thumb). In recent years, functionalism has been the dominant
account of the mind, and, as a result, theory theory has been the
dominant account of interpersonal understanding. The reaction
against theory theory began in 1986 when two philosophers
independently proposed an alternative; in the United States, Robert
M. Gordon wrote ‘Folk Psychology as Simulation’ and, in the United
Kingdom, Jane Heal wrote ‘Replication and Functionalism’ (Gordon
1986; Heal 1986). This alternative proposal holds that we do not
bring theoretical knowledge to bear in understanding each other, but
rather we simulate: we imagine ourselves in the position of the
other. There were differences both of substance and emphasis in

Gordon's and Heal's accounts, and, since then, the literature has
blossomed and brought forth many further accounts.
The principal argument against theory theory is its basic
implausibility. It would be a dizzying task to articulate the theory that
we would need to understand other people. The elements of the
theory would be people's mental states: beliefs, desires, hopes, fears
and so on. The theory would need to relate those elements in the
kind of schema we saw above: ‘When someone is in so-and-so
combination of mental states and receives sensory stimuli of so-and-
so kind, he tends with so-and-so probability to be caused thereby to
go into so-and-so mental states and produce so-and-so motor
responses’ (Lewis 1972: 272). Here are two reasons why attributing
such a theory to each of us is implausible. First, it is not clear what it
means to say that each of us possesses such a theory. Second, it is
not clear that there could actually be any such theory; that is, it is
not clear that such a theory could be formulated, even in principle.
How could we show that we possess and use such a theory? We
might think we could borrow a thought from the less sophisticated
end of theories of artificial intelligence. The thought is that if we
build a machine that can do everything we can do (that, at a
minimum, could pass ‘the Turing test’), then we have created
something akin to ourselves in respect of how our minds work. That
is, a machine that has the same capacities as us must, with respect
to those capacities, work in the same way as we do. Let us assume
that we could specify the enormously complicated theory that would
be needed. Let us further assume that we could, even if only in
principle, build a machine that, using such a theory, is able to
interact with other people in a way that mimics how we actually do
interact with other people. According to the above thought, this
would be enough to show that we actually use such a theory.
However, would building a machine that mimicked our behaviour by
using a theory show that we actually possess and make use of that
theory? It would not; it is simply a mistake to think that if we build a
machine that does what we do, that shows that we work in the way
in which the machine works (see Blackburn 1995: 275). Theory

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medizinische Theorie ist ein Gemenge von
Fragmenten der Humoralpathologie und des
Methodismus. Unverkennbar ist es mehr die
ärztliche Genossenschaft in toto als die Individualität
einzelner Verfasser, welche in den Erstlingsschriften
der Salernitaner zu Worte gelangt[11].
Als Hauptrepräsentant der salernitanischen
Frühepoche ist Gariopontus ( † um 1050)
anzusehen, von dessen (angeblichen) Werken sich
insbesondere ein Handbuch der speziellen Pathologie
und Therapie, der „Passionarius” als Prototyp für
die medizinischen Studien größter Beliebtheit bei
Zeitgenossen und späteren Aerzten erfreute. Es ist
dies keineswegs ein selbständiges Opus, sondern nur
eine geschickte, mosaikartige Zusammenfügung von
verschiedenartigen literarischen Bruchstücken, die
teils aus spätrömischen Autoren (namentlich
Theodorus Priscianus), teils aus alten lateinischen
Uebersetzungen (bezw. Bearbeitungen) antiker und
byzantinischer Schriftsteller herstammen[12].
Gariopontus kann dabei nicht einmal das Verdienst in
Anspruch nehmen, mit seiner Kompilation,
abgesehen vielleicht von der Auswahl und Anordnung
der Exzerpte, etwas Eigenartiges hervorgebracht zu
haben, denn tatsächlich handelte es sich bloß um

eine Neuredaktion alter Vorlagen. In das Zeitalter des
Gariopontus — vielleicht aber noch weiter zurück —
ist auch die Practica des „Petroncellus” zu
verlegen, welche mit einer historischen Einleitung
anhebt. Von der schriftstellerischen Tätigkeit einiger
anderer zeitgenössischer Autoren, des Alphanus, des
älteren Joh. Platearius und des älteren Kophon haben
wir nur durch Hinweise oder einzelne Fragmente in
der späteren Literatur Kenntnis. Wie die Genannten,
ja teilweise sogar in noch höherem Grade, erfreute
sich die salernitanische Aerztin Trotula (um 1059)
eines lang anhaltenden Ansehens als Verfasserin von
Schriften über die Pathologie und Therapie,
namentlich über die Krankheiten der Frauen und
deren Behandlung. Manches, was davon auf uns
gekommen ist, mag freilich nur mit Unrecht ihren
Namen tragen und weit später entstanden oder
mindestens durch Interpolationen sehr verändert
worden sein[13].
Gariopontus (Guaripotus, Garimpotus, Garimpontus,
Warmipotus, Warimbotus, Raimpotus, Warbodus u. s. w.) war
wahrscheinlich ein Longobarde und wirkte in der ersten Hälfte
des 11. Jahrhunderts. Der unter dem Namen des Gariopontus
gehende Passionarius, auch unter dem Titel ad totius
corporis aegritudines remediorum πράξεων libri quinque
(Basil. 1531), eine Kompilation aus lateinischen
Uebersetzungen griechisch-byzantinischer Autoren

(Hippokrates, Galen ad Glauconem, Alexander von Aigina),
ferner aus Caelius Aurelianus, Theodorus Priscianus, Aurelius
═ Esculapius u. a. wurde von ihm nicht verfaßt, sondern wohl
nach weit älteren Vorlagen umredigiert. Der Passionarius
erfreute sich bei den Zeitgenossen und den späteren Aerzten
großen Ansehens, was besonders aus dem, einer ganz
falschen Voraussetzung entspringenden, Titel „Galeni
Pergameni Passionarius” (Lugd. 1526) hervorgeht. Mit
den fünf Büchern des Passionarius bildete wahrscheinlich der,
in manchen Ausgaben vorkommende, Traktat de febribus
ursprünglich ein Ganzes. Das Werk ist sprachlich interessant
(wegen mancher Uebergänge vom Lateinischen ins
Italienische) und gewährt einen ausgezeichneten Einblick in
die, zur damaligen Zeit geltenden medizinischen
Grundanschauungen (Vermengung der Humoralpathologie mit
dem Methodismus). In den Handschriften wird der
Passionarius nicht immer auf Gariopontus zurückgeführt.
Bezeichnenderweise lautet in der Baseler Hdschr. der Titel:
Passionarium, seu Practica morborum Galeni, Theodori
Prisciani, Alexandri et Pauli, quem Gariopontus quidam
Salernitanus ejusque socii una cum Albicio emendavit,
ab erroribus vindicavit et in hunc librum redegit. Die früher
für einige pseudogalenische Schriften, de simplicibus
medicamentis ad Paternianum de dynamidiis, de
catharticis, in Anspruch genommene Autorschaft des
Gariopontus ist auf Grund neuerer Forschungen abzuweisen,
wahrscheinlich war er aber an der, in salernitanischen Kreisen
unternommenen, Redaktion dieser Schriften beteiligt. Von
Gariopontus berichtet Petrus Damianus folgendes: Dicam,
quod mihi Guarimpontus senex, vir videlicet honestissimus,
apprime litteris eruditus ac medicus retulit.
Petroncellus (Petrocellus, Petricellus, Petronsellus,
Petronius). Die unter diesem Namen laufenden Fragmente
rühren nicht von einem und demselben Autor her. — Von der
Practica (Coll. Salern. IV, 185-291) stammt das erste Buch,

welches sich sprachlich durch eine Menge von latinisierten
griechischen Worten charakterisiert, aus der Epoche des
Gariopontus oder aus noch früherer Zeit; das zweite und
namentlich das dritte Buch (beide nur in Bruchstücken
erhalten) sind davon erheblich verschieden. In der Materia
medica des Petroncellus kommen bereits einzelne, durch den
Handelsverkehr zugeführte, arabische Drogen vor. Die
fragmentarischen Curae (Coll. Salern. IV, 292-315) dürften
weit späteren Ursprungs sein. — Der angelsächsische
Traktat (um die Mitte des 12. Jahrhunderts) περὶ διδάξεων ═
Lehren sc. der mediz. Schulen (ed. O. Cockayne in
Leechdoms etc. vol. III) erweist sich zum größten Teile als
eine Uebersetzung der Practica des Petroncellus (vgl. die
Parallelstellen bei M. Löweneck in Erlanger Beitr. zur engl.
Philologie XII, 1896).
Alphanus (um die Mitte des 11. Jahrhunderts),
vorübergehend Mönch in Monte Cassino, Freund des
Desiderius, später Erzbischof von Salerno, verfaßte nach
Angabe des Petrus Diaconus u. a. die Schriften de quatuor
elementis corporis humani, de unione corporis et
animae.
Trotula, aus der Familie der Ruggiero, vermutlich Gattin
des Joh. Platearius I., von den Zeitgenossen wegen ihrer
Gelehrsamkeit gefeiert[14], „sapiens matrona”, und von
späteren Autoren häufig zitiert, gilt als Verfasserin mehrerer,
zumeist bloß handschriftlich erhaltener, Schriften. Die unter
ihrem Namen gedruckte Schrift „de mulierum
passionibus ante, in et post partum” erweist sich als
ein literarisches Produkt des 13. Jahrhunderts, stellt aber
höchstwahrscheinlich den Auszug aus einem, die gesamte
Medizin behandelnden, Werke der Trotula dar (ed. in der Coll.
Aldina, Venet. 1547, in Casp. Wolph., Gynaec., Basil. 1566, in
Spach, Gynaecior., Argent. 1597, als Einzelausgabe ed.
Kornmann, Leipz. 1778). Die Schrift handelt auch über
manche, nicht zum Titel passende Gegenstände, z. B. über

körperliche Erziehung der Kinder, Dentition, Kosmetik etc.
Neben vielem Abergläubischen findet sich in den
geburtshilflichen Kapiteln die seit Soranus vergessene
Vorschrift über den Dammschutz (vgl. Bd. I, S. 345), die
Beschreibung der Perinaeoraphie bei totalem Dammriß, die
Empfehlung, zur Austreibung des toten Kindes Schüttelungen
vorzunehmen. — Fragmente über verschiedene Themen der
Medizin finden sich in der anonymen Schrift de
aegritudinum curatione, vgl. unten.
In diese Epoche (um 1050) gehört auch das Speculum
hominis (Coll. Salern. V, 173-198), ein unvollständig
erhaltenes medizinisches Lehrgedicht (1011 Verse), welches
wahrscheinlich ein Italiener um die Mitte des 11. Jahrhunderts
verfaßt hat. Es handelt vom Menschen und seinen Teilen, von
den Altersstufen, von den Verwandtschaftsverhältnissen, der
Ehe, von akuten und chronischen Leiden. Der Hauptsache
nach liegt eine Versifikation der entsprechenden Abschnitte
des Isidorus (Origin. XI. 1, 2, IX. 5, 6, 7, IV. 6, 7) vor,
weshalb auch hier die etymologischen Erklärungsversuche
vorwalten. Der Zweck und die Quelle des Lehrgedichts ist in
den nachfolgenden Versen angegeben:
Est homo mens: nitor de partibus eius 5.
Ethimologias, et earum ponere causas.
Que mea metra serunt, aliorum prosa fuerunt, 10.
Prosam imitavi, quia metrum plus placet auri.
De variis hominis sum partibus ista locutus 735.
Ysidorum super hiis pro magna parte secutus.
Die Erstlingsschriften der Schule von Salerno
zeigen in anerkennenswerter Weise, was der
strebsame Geist echten Arzttums selbst einem

äußerst kärglichen Boden noch an Früchten fürs
praktische Leben zu entlocken vermag. Ein
Hinauswachsen über die einmal erreichte,
bescheidene Höhe lag aber schon deshalb kaum im
Bereiche der Möglichkeit, weil die Stoffzufuhr aus der
kümmerlichen Hinterlassenschaft der Antike gerade
bei intensiver Verarbeitung derselben allzu rasch
versiegen mußte. Darum besitzt die Salernitaner
Medizin dieser Epoche zwar den Reiz keuscher
Jugendfrische, aber sie erscheint mit ihrem recht
losen theoretischen Unterbau, mit ihrer roh
gezimmerten Symptomatik, mit ihrem noch
armseligen therapeutischen Rüstzeug naiv und
dürftig, wenn die Bilder der gleichzeitigen
byzantinischen oder gar der arabischen Heilkunde
auftauchen.
Eine Entwicklung im Sinne einer strafferen und
breiter angelegten Theoretisierung, im Sinne einer
feiner ausgesponnenen Symptomatik und erweiterten
Therapie macht sich erst seit den letzten Dezennien
des 11. Jahrhunderts in der, nunmehr auch
bedeutend anschwellenden, Literatur geltend. Dieser
Umschwung, der fast akut einsetzte, wurzelt nicht in
inneren Momenten, sondern ist auf die ungemein
fruchtbare schriftstellerische Tätigkeit eines Mannes

zurückzuführen, dessen Beziehungen zur Schule von
Salerno zwar keineswegs klar gestellt sind, dessen
kräftige Impulse aber in ihren Leistungen während
der Folgezeit deutlich zu Tage treten, nämlich auf das
Wirken des Constantinus Africanus ( † 1087),
welcher durch seine lateinischen Uebersetzungen
und Kompilationen der Medizin des Abendlandes
neues Forschungsmaterial zuführte und zugleich (auf
dem Umwege über das Arabische) das weithin
verschüttete Quellgebiet der Antike wieder in
größerem Umfange bloßlegte.
Die Nachrichten, welche über die Lebensgeschichte des
Constantinus (Afer s. Africanus, auch C. Memphita) auf uns
gekommen sind, bieten nur wenig sichere Anhaltspunkte und
sind zum größten Teil ins Gebiet der Mythe zu verweisen.
Constantinus dürfte im ersten Viertel des 11. Jahrhunderts
(um 1018) in Karthago geboren worden sein (ob als Christ ist
zweifelhaft) und soll sich auf vieljährigen Studienreisen, die
sich tief in den Orient erstreckten (angeblich nach Babylonien,
Indien, Aegypten, Aethiopien) eine erstaunliche und
vielseitige Gelehrsamkeit, verknüpft mit gründlichster
Kenntnis der morgenländischen Sprachen, erworben haben.
Er kehrte zunächst nach seiner Vaterstadt zurück, mußte aber
von dort schon nach kurzer Zeit flüchten, weil er wegen
seines überlegenen Wissens in den Verdacht der Zauberei
geriet und daher Verfolgungen ausgesetzt war. Constantinus
zog nach Italien und lebte einige Jahre in Salerno (angeblich
als Sekretär des Herzogs Robert Guiscard), ohne daß wir
bestimmt wissen, ob er an der dortigen Schule als
Lehrer auftrat. Sichergestellt ist nur, daß er in der
klösterlichen Abgeschiedenheit von Monte Cassino, wo er

(nach 1070) unter dem gelehrten und um die dortige
Bibliothek so verdienten Abte Desiderius als Mönch
freundlichste Aufnahme fand, seine umfangreiche
schriftstellerische Tätigkeit entfaltete. Dort dürfte er um 1087
oder noch später gestorben sein.
Ausgaben der Werke des Constantinus.
Opera, Basil. 1536 enthalten: De omnium
morborum, qui homini accidere possint, cognitione
et curatione (7 Bücher)[15], de remediorum et
aegritudinum cognitione ═ „Liber aureus” (cui autor
ipse titulum fecit aureus, qualem jure meretur, cum propter
brevem omnium morborum descriptionem tum magnam
remediorum vim), de urinis, de stomachi naturalibus
et non naturalibus affectionibus liber vere aureus,
de victus ratione variorum morborum liber, de
melancholia, de coitu, de animae et spiritus
discrimine, de incantationibus et adjurationibus
epistola, de mulierum morbis, de ea medicinae
parte quae dicitur Graecis χειρουργία liber, de
gradibus quos vocant simplicium liber.
Operum reliqua, Basil. 1539, enthalten: De
communibus medico necessariis locis (10 Bücher)[16].
Als Anhang zur lateinischen Ausgabe der Werke des Isaac
Judaeus Repertoriorum seu indicum omnium operum Ysaac in
hoc volumine contentorum coadunatio, Lugd. 1515, finden
sich: Libri Pantechni (quorum primi decem theoricam, alii
autem decem practicam concernunt), de gradibus
medicinarum, Viaticum (7 Bücher), de oculis, de
stomacho, de virtutibus simplicium medicinarum,
Therapeutica: megatechni libri Galeni, a Constantino
Africano ... studiose abbreviati et ad epitomatis formam
reducti), de oblivione.

Liber de humana natura, de membranis
principalibus corporis humani, de elephantie et de
remediorum ex animalibus materia (aus Albucasis
Methodus medendi), Basil. 1541.
Therapeutica s. megatechni (in Symphorianus
Champerius Speculum medicinae, Galeni, Lugd. 1517).
Breviarium dictum viaticum (in Rhazis opera parva),
Lugd. 1510.
Die Chirurgie der Pantegni (nach einer von den
Druckausgaben abweichenden Berliner Handschrift) ed.
Pagel, Archiv f. klin. Chirurgie 81, Bd. I[17].
Die angeführten Schriften führen zum größten Teile ganz
mit Unrecht den Namen des Constantinus. Einerseits trägt
dieser selbst daran Schuld, weil er Uebersetzungen oder
Bearbeitungen fremder Schriften als eigene ausgab,
anderseits kommt auch der Irrtum späterer Abschreiber in
Betracht. Ohne hier auf die Einzelheiten der bisherigen, noch
nicht abgeschlossenen, Forschungen einzugehen, seien nur
einige der Identifizierungen beispielsweise angeführt. Der
Liber Pantegni (Pantechni) entspricht dem Liber regalis
des Ali Abbas, das Viaticum rührt von Ibn al-
Dschezzar her, de oculis ist eine Bearbeitung des, von
Hunain ben Ischak verfaßten, Lehrbuchs der
Augenheilkunde, de melancholia ist wahrscheinlich
identisch mit der gleichbetitelten Schrift des Ischak ben
Amran; de animae et spiritus discrimine gehört dem
Kosta ben Luka, die Chirurgie entspricht dem 9. Buch
der Practica des Liber regalis des Ali ben Abbas u. s. w.,
außerdem finden sich in der Sammlung pseudogalenische
Schriften, z. B. de incantationibus, de mulierum morbis, de
humana natura ═ de compagine membrorum[18].
Abgesehen von einer nicht geringen Zahl
angeblich eigener Werke, von denen sich aber die

meisten der bekannt gewordenen als Bearbeitungen
oder Uebertragungen von arabischen erwiesen haben
(Ali Abbas, Isaac Judaeus, Ibn al-Dschezzar u.
a.) übersetzte Constantinus (nach arabischen
Versionen) mehr oder minder frei z. B. die
hippokratischen Aphorismen, die Ars parva
(Mikrotechne) Galens und Kommentare dieses
Autors zu hippokratischen Schriften ins
Lateinische, wodurch der Umkreis medizinischer
Kenntnisse im Abendlande unleugbar ganz erheblich
erweitert, das Studium der antiken Literatur neu
belebt und ein Vorbild wissenschaftlicher
Zusammenfassung und Darstellungsweise für die
Zukunft gegeben wurde.
Als eigentliche Schüler des Constantinus sind bloß
die Mönche Atto[19] und Johannes Afflacius
bekannt, welch letzterer eine Zeitlang in Salerno
gelebt haben dürfte und in seinen Schriften de
febribus et urinis und Curae (Afflacii) manchen
Beweis von guter Beobachtung liefert.
Johannes Afflacius (um 1040-1100) „Saracenus”. Der
dem Constantinus zugeschriebene „Liber aureus” rührt
wahrscheinlich von ihm her oder beruht auf seinen Schriften.
Tractactus de febribus aus „curae de febribus et
urinis” (Coll. Salern. II, 737-767). Hier findet sich die
Vorschrift, bei Fiebernden für die Abkühlung der Luft im
Krankenzimmer folgendermaßen zu sorgen: fiat etiam

artificialiter pluvialis aqua circa aegrum et haec facienda sunt
si tempus fuerit calidum. Pluviali modo fiat. Accipiatur olla in
fundo minutissime perforata et impleatur aqua, postea ligetur
fortiter cum corda juxta lectum aegrotantis, ita ut guttae
cadant in eum et sic infrigidabitur aer, ejus infrigidatio magis
confert aegrotanti quam medicina interius recepta.
Der Einfluß des „magister orientis et
occidentis”[20] reicht aber viel weiter, er läßt sich
deutlich bei allen nun folgenden Salernitanern
nachweisen, von denen ihn manche auch zitieren.
Nicht als ob mit Constantinus die Systemsucht
und Polypharmazie der Araber sogleich ihren Einzug
gehalten hätte — dafür war der Boden im
Abendlande noch gar nicht vorbereitet, auch sind es
verhältnismäßig ungekünstelte arabische Autoren
gewesen, wie Isaak und Ali Abbas, welche der Mönch
von Cassino zugänglich gemacht hatte! Nicht als ob
durch Constantinus die hippokratische Tradition in
Salerno verdrängt worden wäre — in der
salernitanischen Literatur während des ausgehenden
11. und während der ersten Dezennien des 12.
Jahrhunderts herrscht die schlichte Beobachtung, die
einfache Deutung, die unbefangene, klare
kasuistische Schilderung der Krankheitsvorgänge, die
Neigung zu einer diätetischen oder doch mit
Medikamenten nicht gar zu sehr überladenen

Therapie noch weitaus vor. Aber nach dem Auftreten
des Constantinus ist die Darstellungsweise, ohne in
Schwülstigkeit und gelehrte Zitatenwut zu verfallen,
unverkennbar gereifter geworden, die
wissenschaftliche Grundlage ist — dank der
Vermittlung bisher verschollener oder unvollständig
bekannter Schriften antiken Ursprungs — bedeutend
breiter, der Sinn für die medizinische Theorie
prävaliert nunmehr entschieden gegenüber der
früheren Empirie, die Auffassungen in der Pathologie
zeigen größere Schärfe und Präzision, der
Galenismus beginnt zusehends die letzten Reste
des aus Römerzeiten noch nachklingenden
Methodismus zu überwinden und gleichzeitig
verfeinert sich die Semiotik, freilich hauptsächlich im
Sinne einer subtilen Pulslehre und Harnschau.
Derartigen Charakter besitzt die Practica des
Bartholomaeus, die Ars medendi des jüngeren
Kophon, die Practica brevis des jüngeren
Johannes Platearius.
Von Kophon hat sich auch ein Werkchen
erhalten, welches deshalb von besonderem Interesse
ist, weil es zum ersten Male in der mittelalterlichen
Literatur des Abendlandes vom praktischen Betriebe

der Anatomie Kunde bringt — die sog. Anatomia
porci. Im Zusammenhang mit einer, bald darauf
verfaßten anonymen, gewöhnlich als Demonstratio
anatomica bezeichneten, Schrift erhalten wir durch
diese Abhandlung überraschenden Einblick in das,
freilich nur durch Tierzergliederung erworbene,
anatomische Wissen und in die anatomischen
Unterrichtsverhältnisse der Salernitaner,
welche gewiß nicht jungen Datums waren.
Ein nicht minder wertvolles Gegenstück hierzu —
nämlich insofern wir daraus ein deutliches Bild von
dem Betragen des Salernitaner Arztes am
Krankenbette empfangen —, bildet die ärztliche
Hodegetik und klinische Propädeutik des
Archimatthaeus, betitelt De adventu medici ad
aegrotum s. de instructione medici. Dieselbe
enthält Maximen der ärztlichen Politik, Anweisungen
über das Untersuchungsverfahren (besonders
Pulsfühlen und Harnschau), über die eventuelle
Vornahme des Aderlasses, über die Krankendiät,
über das Verhalten des Arztes bei der
Prognosenstellung und schließt mit Ratschlägen, wie
man sich hinsichtlich der Honorarfrage benehmen
solle. Aus allem spricht reiche Erfahrung und ein
höchst anerkennenswertes Streben nach einer

individualisierenden, vorzugsweise diätetischen,
Behandlungsweise. Eine von demselben Verfasser,
leider nur unvollständig, auf uns gekommene
Practica will, wie einleitend gesagt wird, nichts
anderes als eine Sammlung von klinischen, auf
eigener Erfahrung beruhenden Vorträgen bieten; sie
zeigt, welche unverdorbene jugendfrische
Beobachtungsgabe den Vertretern der Schule eigen
war, wie man den Unterricht auch am Krankenbette
pflegte, und wie man mit einfachen vorzugsweise
diätetischen Mitteln eine oft ganz zweckmäßige
Therapie einzuschlagen wußte.
Bartholomaeus verfaßte ein übersichtliches Lehrbuch,
die Practica (Coll. Salern. IV, 321-408), mit dem Nebentitel
„Introductiones et experimenta in practicam Hippocratis,
Galieni, Constantini, graecorum medicorum”. Für die
langdauernde Beliebtheit desselben sprechen Kommentare,
namentlich frühzeitige Uebersetzungen resp. Auszüge und
Bearbeitungen in verschiedenen Nationalsprachen.
Bruchstücke einer niederdeutschen Bearbeitung in J. v.
Oefele, die angebliche Practica des B., Papierhandschr. d.
herzogl. Sachsen-Coburg-Gothaischen Bibliothek, Neuenahr
1894. Bruchstücke einer altdänischen Uebersetzung in H.
Harpestreng's Danske Laegebog ed. Chr. Molbech,
Kopenhagen 1826. Bartholomaeus erscheint als vortrefflicher
Beobachter und nach feinerer Diagnostik strebender Arzt.
Kophon (II.) der Jüngere (denn er zitiert einen anderen,
also älteren [vgl. S. 284], welcher der ersten
Salernitanerperiode angehört haben muß und ebenfalls
schriftstellerisch tätig gewesen zu sein scheint), verfaßte

(1085-1100) eine anatomische Abhandlung, die gewöhnlich
als Anatomia porci (fälschlich früher A. parvi galeni)
bezeichnet wird (Coll. Salern. II, 388-391, weit vollständiger
herausgegeben von J. Schwarz in „Die medizinischen
Handschriften der k. Universitätsbibliothek zu Würzburg”,
Würzburg 1907, p. 71-76) und eine Practica, mit
vorangehender Ars medendi s. Modus medendi et
conficiendi (Coll. Salern. II, 415-505).
Die Anatomia porci ist eine Anleitung zum praktischen
Studium der Anatomie an einem Schweine, gegründet auf das
Beispiel der Alten, welche die Ergebnisse von
Tierzergliederungen auf den Menschen anwendeten, und auf
die Annahme, daß die inneren Organe des Schweines
den menschlichen am meisten ähneln: Quoniam
interiorum membrorum corporis humani compositiones
omnino erant ignotae, placuit veteribus medicis et maxime
Galeno, ut per anatomiam brutorum animalium interiorum
membrorum partes manifestarentur. Et cum bruta animalia
quaedam, ut simia, in exterioribus nobis inveniantur similia
„interiorum partium nulla inveniuntur adeo similia,
ut porci, et ideo in eis anatomiam fieri
destinavimus”. Einige Textproben mögen die
Darstellungsweise beleuchten. „Est autem anatomia recta
divisio, quae sic fit. Porcum debes inversum ponere, quem per
medium gutturis incides, et tunc primum tibi lingua occurret,
quae dextrorsum et sinistrorsum quibusdam nervis alligata
est, qui motivi dicuntur. ... In radicibus linguae oriuntur duo
meatus, scilicet trachea arteria, per quam transit ad
pulmonem aer, et aesophagus, per quem mittitur cibus ad
stomachus, et est trachea arteria super aesophagum, super
quam est quaedam cartilago, quae dicitur epiglottis, quae
clauditur aliquando, ut cibus et potus per eam non descendat,
et aperiatur, ut aer intret et exeat. ... Tunc debes separare
tracheam arteriam ab aesophago, et invenies pulmonem et
cor. Cor vero est magis in sinistra parte; quorum quidlibet in

sua capsula continetur. In capsula cordis colligitur materia,
quae facit syncopen, in capsula pulmonis colligitur, materia,
quae facit peripneumoniam. ... Et quod pulmo sit cavernosus,
potestis probare, si cum calamo intromisso infletur. ...” Man
ersieht aus diesen Sätzen, daß jedenfalls auch eigene, freilich
sehr rohe Untersuchungen (selbst pathologisch-
anatomischer Art) angestellt wurden. Die eigentümlichen
anatomischen Bezeichnungen kennzeichnen deutlich die
Abhängigkeit von griechischen und arabistischen Schriften,
nämlich dem liber pantegni des Constantinus, z. B. zirbus,
siphach.
Die Ars medendi (um 1090 entstanden) betrifft die
allgemeine Therapie (diätetische Vorschriften,
Verhaltungsmaßregeln nach der Purgation, Behebung von
Verdauungsstörungen) und enthält auch einige Kapitel über
Arzneizubereitung (de modo conficiendi); die Practica
behandelt nach einer Einleitung über Pathologie und Therapie
zunächst die Fieber, sodann die übrigen Krankheiten (darunter
auch Ulzerationen des Rachens, Polypen der Nase und
Kondylome), zum Schlusse die Lepra. Die Schrift
unterscheidet sich durch verhältnismäßige Reinheit der
Sprache und auch inhaltlich vorteilhaft von anderen. Gestützt
auf die hippokratischen Aphorismen befleißigt sich der
Verfasser im Gegensatz zu den Zeitgenossen einer mehr
einfachen, das Krankheitsstadium berücksichtigenden,
häufiger mit äußeren als inneren Mitteln hantierenden
Therapie. In dieser kommen Grundsätze der Methodiker noch
hie und da zur Geltung. Die Diagnostik beruht zum großen
Teile auf der Uroskopie.
Demonstratio anatomica (Coll. Salern. II, 391-401).
— Die Demonstratio anatomica stellt eine Vorlesung dar,
welche sich auf eine vorzunehmende und auf eine im
vergangenen Jahre vorgenommene Sektion eines Schweines
bezieht, im wesentlichen bildet der Inhalt nur eine erweiterte
Ausführung der Anatomia porci des Kophon. Der Verfasser

apostrophiert heftig seine Schüler, polemisiert mehrfach
gegen Kophon, beruft sich auf Hippokrates (Aphorismen),
Galen, den Liber pantegni, auf Isaac Judaeus (de urinis) und
gedenkt seiner eigenen Erläuterungen zu Philareti lib. de
pulsibus, sowie zu Johannes Damascenus. Bezüglich der
Vorbereitungen zur Sektion wird empfohlen, das Schwein
mittels Durchschneidung der Halsgefäße zu töten und, an den
Hinterbeinen aufgehängt, gehörig ausbluten zu lassen. Die
Tötung durch Herzstich sei zu verwerfen, weil sonst viel Blut
in die „Membra spiritualia” eindringe, wodurch deren
Demonstration erschwert würde; ebenso müsse man mit der
Zergliederung beginnen, noch bevor der Kadaver erkaltet ist,
weil sich sonst die „Arterien, Venen und Nerven”
zusammenzögen und undeutlich würden. Die Körperteile sind
unterschieden nach der Funktion als Membra animata,
spiritualia und naturalia, die letztgenannten zerfallen wieder
in nutritiva und generativa. In jeder dieser Gruppen gibt es
wieder Haupt- und Nebenorgane mit
unterstützenden Funktionen. Inter animata cerebrum
est principale, quia virtus animalis in eo principaliter
fundatur et quia alia ab eo oriuntur ut nervi, et ipsum
quaedam sunt defendentia, quaedam expurgantia,
quaedam adjuvantia vel deservientia. Defendentia sunt
haec pia mater, quae in modum piae matris amplectens
cerebrum defendit ipsum a duritie durae matris et dura
mater, quae defendit cerebrum et piam matrem a duritie
carnis et carneum, quae defendit omnia ab exterioribus.
Expurgantia et adjuvantia sunt aures, oculi, nares et
lingua cum palato. Aures namque depurgant ipsum a
superfluitate colerica, oculi a melancholico, nares a
sanguinea et flegmatica, palatum namque a flegmatica
tantum. Haec eadem sunt adjuvantia. In der Gruppe der
membra spiritualia ist das Hauptorgan das Herz;
Schutzorgane sind für dasselbe Rippen, Häute, Zwerchfell,
Herzbeutel; Reinigungsorgane und Hilfsorgane: Brustmuskel,
Lunge, Arterien; Hauptorgan der membra nutritiva ist die

Leber, zu ihren Schutzorganen zählen die Venen, zu den
Reinigungsorganen Lunge, Hirn, Milz, Gallenblase, zu den
Hilfsorganen z. B. Zähne, Magen, Därme. Nach denselben
Prinzipien werden die membra generativa eingeteilt. In
der folgenden sehr eingehenden Beschreibung einer Sektion
wird stets auf die Physiologie (Teleologie) Rücksicht
genommen, auch beziehen sich manche Bemerkungen auf die
Pathologie. Beispielsweise setzen wir die Schilderung des
Herzens hierher: Post haec inspicietis cor latere sinistro
locatum, a pulmone lateraliter circumdatum et quodam
panniculo undique apertum qui et dicitur capsula cordis in qua
bene potest fieri apostema in corde aut nunquam aut
difficillime. Saepe autem abundant in eo humor corruptus, qui
facit syncopim, sed substantia cordis de partibus villosis et
nervosis diverse positis et carne dura est composita, et hoc
est propter motuum dilatationis scilicet et constitutionis
diversitatem, eorundemque magnitudinem et velocitatem, ne
molli substantia compositum ex his facile competeretur, sed
forma ejus pineata est inferius lata superius acuta concava ex
concavitatibus diversis, ut et facilior fieret motus et ne in
angulis retenta superfluitas causa esset molestia.
Johannes Platearius[21] (II.) der Jüngere, so
bezeichnet zum Unterschied von seinem Vater — Johannes
Platearius (I.) —, verfaßte ein systematisch geordnetes
Handbuch der inneren Medizin Practica brevis (Ferrara
1488, Venet. 1497 u. ö., Lugd. 1525), von dem noch
handschriftlich alte italienische und französische
Uebersetzungen vorhanden sind[22], ferner Regulae
urinarum (Coll. Salern. IV, 409-412); wahrscheinlich geht
auf ihn auch die Schrift de conferentibus et nocentibus
corpori humani (!) zurück.
Archimathaeus, vielleicht identisch mit Matthaeus de
Archiepiscopo (Matteo de Vescova), von dem eine Schrift de
urinis (Coll. Salern. IV, 506-512) erhalten ist, gilt als
Verfasser einer Practica (Coll. Salern. V, 350-376) und einer

an alte Vorlagen (vgl. S. 257) anknüpfenden ärztlichen
Hodegetik de adventu medici ad aegrotum (Coll.
Salern. II, 74-81) oder de instructione medici (Coll.
Salern. V, 333-350). Die Practica enthält eine Kasuistik mit
daran angeschlossenen klinischen Vorträgen, wobei auf
Systematik verzichtet wird („Nec librum de novo contexere,
nec ordinem me servare proposui, nec quocunque de
quallibet egritudine sum dicturus, sed tantum ea que in
quibusdam non omnibus experimento didici meliora et in
quibus in manu mea Deus optatum posuit effectum”); auf die
diätetische Therapie ist das Hauptgewicht gelegt.
Die Schrift des Archimathaeus de instructione
medici deckt sich mit der anonym überlieferten de
adventu medici, nur ist letztere weniger ausführlich in den
Einzelheiten. Der deontologische Abschnitt derselben — ein
Gemisch von Frömmigkeit, Naivität und Schlauheit — gibt ein
ausgezeichnetes Bild von dem genau geregelten Betragen des
mittelalterlichen Arztes am Krankenbette, von seiner
Untersuchungsweise, von seinem Verkehr mit den Kranken
und seiner Umgebung. Unterlag doch im Mittelalter
das ganze äußere Benehmen bestimmten Regeln,
gegen die ein Gebildeter niemals verstoßen sollte, so daß
etwas Stereotypes durch die Menschen ging, wofür die
Bilder in den Handschriften die anschaulichsten Zeugnisse
geben.
Cum igitur, o medice, ad aegrotum vocaberis, adjutorium
sit in nomine Domini. Angelus qui comitatus est Tobiam
affectum mentis et egressum corporis comitetur.
Intrante tuo a nuntio sciscitare quantum est ex quo
infirmus, ad quem vocaris, laboraverit; qualiter ipsum
aegritudo invaserit: haec autem sunt necessaria, ut quando
ad ipsum accesseris, aegritudinis ejus non omnino inscius
videaris; ubi post visa urina, considerato pulsu, licet per ea
aegritudinem non cognoveris, tamen si sinthoma quod

praesciveras dixeris, confidet in te, tamquam in autore suae
salutis, ad quod summopere laborandum est. Cum igitur
ad domum ejus accesseris, antequam ipsum adeas,
quaere si conscientiam suam sacerdoti
manifestaverit, quod si non fecerit vel faciat vel se
facturum promittat; quia si inspecto infirmo
consideratis aegritudinis signis super his sermo
fit, de sua incipiet desperare salute, quia et te
desperare putabit. Ingrediens ad infirmum nec
superbientis vultum, nec cupidi praetendas affectum,
assurgentes tibi pariter et salutantes humili vultu resalutans
et gestu eis sedentibus sedeas. Cum vero jam potus
resumpseris, quibusdam verbis interpositis, quibus debes
situm regionis illius laudare, dispositionem domus in qua es,
si expedit, commendare, vel liberalitatem gentis extollere.
Tandem ad infirmum conversus qualiter se habeat
quaeras et bracchium tibi exhiberi praecipias. Et quia ex carne
spiritus, in te moti sunt, et infirmus, quia in adventu tuo
multum delectatur, vel quia tamquam avarus de munere
cogitat, propter diversas complexiones tum tui tum infirmi
multoties in pulsuum cognitione deciperis. Data ergo
securitate aegro interea jam spiritu quiescente
pulsum consideres et attende ne super latus illud
jaceat, ne digitos habeat extensos, vel in palmam
reductos, et tu cum sinistra sustentes bracchium
et usque ad centesimam percussionem ad minus
consideres, ubi et diversa pulsuum genera
investiges, et astantes ex longa expectatione, verba tua
gratiora suscipiant.
Post jubeas tibi afferri urinam, ut aeger et aegritudinem
non solum per pulsum sed per urinam cognovisse putet. In
urina autem diu attendas colorem, substantiam,
quantitatem et contentum; post aegroto cum Dei auxilio
salutem promittas. Cum autem ab eo recesseris, domesticis
ejus dicas ipsum multum laborare, quia ab hoc, si liberabitur,

majoris meriti eris et laudis, si vero moriatur testabuntur et a
principio de ejus desperasse salute. Unde praeterea moneo
ne uxorem vel filiam, vel ancillam oculo cupido respicias; haec
medici excoecant animum operantis et Dei immutant
sententiam cooperantis, et medicum aegro faciunt onerosum
et de se minus bene sperantem. Sis ergo sermone blandus,
vitae spectabilis, divino attentius expetens auxilio adjuvari.
Cum autem te ad prandium, ut solet fieri, qui domui praesunt
invitaverint, nec te importunum ingeras, nec in mensa primus
eligas locum, licet sacerdoti et medico, ut solet fieri, primus,
accubitus praeparatur; potum vel cibum non contemnas, nec
fastidias quae forte de rure et ergo rusticano pane miliaceo
ventris exuriem vix consueveras, refrenare. Dum autem
comedis per aliquem astantium aegri saepe statum requiras;
sic enim de te plurimum confidet infirmus, quem viderit inter
delicias sui oblivisci non posse. Surgens autem de coena dicas
tibi optime ministratum fuisse, de quo aeger valde laetabitur.
... Nun folgen Vorschriften über die Krankendiät, über die
(schon von Anbeginn der Kur an nötige) Verordnung der
Digestiva (z. B. Oxymel, Syr. rosarum vel violarum, Syr.
acetosus etc.) event. leichten Diuretica (z. B. Aq.
petroselini, foeniculi, sparagi etc.) über den Aderlaß.
Bezüglich des letzteren ist auf das Krankheitsstadium, die
Jahreszeit, den Kräftezustand und das Lebensalter des
Kranken und den Krankheitssitz zu achten. Et a principio
autumni usque ad principium veris a sinistro
detrahe sanguinem, a principio autem veris a
dextro; et propter passionem cerebri venam incide
cephalicam, pro morbo spiritualium (Herz-,
Lungenleiden) medianam, pro aegritudine
nutrimentorum epaticam (═ basilicam). Sanguinis
colorem attendas ut si fieri potest tamdiu detrahatur sanguis
donec color malus mutetur in bonum.
Sehr interessant ist die Bemerkung, daß die exspektative
Behandlung nach den Regeln des Hippokratismus, aus

Gründen der ärztlichen Politik, unter Umständen durch eine
Scheintherapie verschleiert werden müsse: Sed quia
quidam aegri avaritiae inebriati veneno, dum
vident sine medici auxilio naturam triumphasse de
morbo, meritum medici retrahunt pariter et
retardant dicentes: quid fecit medicus? Syrupis,
unctionibus, fomentis videamur salutem inducere
quam dedit natura et in alterius intremus labores,
dicentes morbum post facturum graviorem
insultum, nisi ei per medicinam succuratur, et sic
quod natura fecit imputabitur medico.
Ziemlich eingehend werden die Zeichen der Krise und die
Therapie während derselben, ferner die Behandlung der
Rekonvaleszenten erörtert. Den Schluß der Schrift bildet eine
Anweisung über das angemessene Verhalten des Arztes beim
Abschied.
Die beste Uebersicht über die spezielle Pathologie
und Therapie der Schule von Salerno während ihrer
Blüteepoche gewinnt man aus einem anonymen, im
12. Jahrhundert niedergeschriebenen Werke De
aegritudinum curatione[23], welches in seinem
ersten Teile die Fieberlehre, in seinem zweiten,
ziemlich umfangreichen Teile die örtlichen
Krankheiten a capite ad calcem abhandelt. Während
die Fieberlehre — an Einfachheit der Klassifikation
hervorstechend — von einem und demselben
unbekannten Verfasser herrührt, ist die zweite, die
Lokalaffektionen betreffende, Abteilung eine
Nebeneinanderstellung der Lehrmeinungen von

sieben der bedeutendsten Meister der Schule über
die gleichen Gegenstände, wobei die (S. 293
erwähnte) Practica des Joh. Platearius (die ihrem
ganzen Umfange nach aufgenommen ist) den Faden
bildet, und sodann stets in der nämlichen Anordnung
Kapitel aus den Werken des Kophon, Petronius,
Afflacius, Bartholomaeus, hie und da auch
Abschnitte aus den Schriften des Ferrarius[24] und
der Trotula[25] folgen. Dieses mosaikartige
Kompendium, welches geradezu als Schulbuch der
inneren Medizin von Salerno betrachtet werden kann,
spiegelt den, in der ersten Hälfte des 12.
Jahrhunderts erreichten, Wissensstand wohl am
getreuesten wieder und zeigt, daß sich die führenden
Meister schon bis zu einem gewissen Grade zur
Selbständigkeit in der Krankheitsauffassung und
Behandlungsweise emporzuringen vermochten. Nur
ganz vereinzelt lassen sich — in Hinweisen auf Janus
Damascenus (vgl. S. 204) und die „Libri
Saracenorum” — die Vorboten des beginnenden,
aber noch recht unwesentlichen Einflusses der
arabischen Medizin erkennen.
De aegritudinum curatione (Coll. Salern. II, 81-385).
Nach dem Vorbilde der antiken Doktrinen werden die Fieber
(je nachdem am Pneuma, in den festen Teilen oder in den
Säften die Krankheitsursache liegt) eingeteilt in Eintagsfieber

(effimera), hektische (ethica) und Faulfieber (putrida);
die Faulfieber zerfallen wieder in intermittierende
(interpolata: cotidiana, tertiana, quartana) und
kontinuierliche (mit verschiedenen Unterarten: z. B. Synochus
und Hemitriteus). Die Behandlung war vorzugsweise
diätetisch oder kühlend (Umschläge, Einpackungen, Bäder),
im Sinne einer Kausaltherapie wandte man Purganzen, bei
Wechselfiebern Brechmittel an. Nervenleiden und
Psychosen. Phrenitis (frenesis) gilt als Apostema (Abszeß)
der vorderen Gehirnkammer, Lethargus (litargia) als Apostem
der hinteren Gehirnhöhle. Gleiche Lokalisationsversuche
finden sich in den Definitionen anderer Affektionen, z. B.
Apoplexia est opilatio omnium ventriculorum cerebri cum
privatione vel diminutione sensus et motus.... Epile(m)psia est
opilatio principalium ventriculorum cerebri.... Mania est
infectio anterioris cellulae capitis cum privatione
imaginationis. Melancholia est infectio mediae cellulae capitis
cum privatione rationis (vgl. hierzu die Gehirnlokalisationen
des Poseidonios und Nemesios). Melancholie und Manie
unterscheiden sich dadurch, daß bei der ersteren der Sitz der
Vernunft, bei der letzteren der Sitz der Einbildungskraft
betroffen ist. Unter den Ursachen werden auch
Gemütsaffekte, Ueberanstrengung, Geldverlust etc.
angeführt. Das Krankheitsbild variiert je nach der zugrunde
liegenden Säfteanomalie; liegt die Krankheitsursache in der
gelben Galle, so sind Symptome der Exaltation im
Vordergrunde (furor, maniaca confidentia, clamant, saltant,
currunt, se et alios percutiunt, vigilant), während die
schwarze Galle Depressionserscheinungen und
Zwangsvorstellungen hervorruft (timent, plangunt, in angulis
domorum et in latebris latitant, sepulcra mortuorum
inhabitant vel falsas et varias habent suspiciones, quidam
putant se non habere caput, quidam putant, angulum
sustinere mundi ... alii tenent pugnum clausum ita quod non
potest aperiri, credunt nimirum se tenere thesaurum in manu,
vel totum mundum ...). Die Therapie der Psychosen war

somatisch (Diät, Purgieren, Blutentziehungen, innere und
äußere Mittel) und psychisch (verborum, dulcedine et etiam
artificio falsae suspiciones removendae sunt ... adsint soni
musicorum instrumentorum u. a.). In der Behandlung der
Epilepsie spielt die Diät eine wichtige Rolle (unter anderem
Enthaltung a medullis, cerebellis) neben vielerlei
absonderlichen Mitteln (darunter auch sanguis per
scarificationem extractus cum ovo corvi). Paralysis ist definiert
als lesio partis cum privatione vel deminutione sensus vel
motus vel utriusque; der begleitende Tremor wird erklärt
durch die Annahme einer unterbrochenen Nervenleitung.
Krampf entsteht ex inanitione et repletione; aus sedativ
wirkenden Substanzen zusammengesetzte Pflaster sind am
Hals und an der Wirbelsäule zu applizieren (est nimirum ibi
origo omnium nervorum et principium!). Ungemein reichhaltig
ist der Abschnitt über die verschiedenen Formen des
Kopfschmerzes und ihrer Begleiterscheinungen (cephalea,
emigranea), daran reiht sich dolor frontis, inflatio cerebri,
scotomia (vertigo). Gegen Hysterie, suffocatio matricis,
kommen vorzugsweise scharf riechende Medikamente
(Moschus und Ambra) zur Anwendung, überdies Vorschriften,
die sich aufs Geschlechtsleben beziehen. Unter den
Affektionen des Respirationstraktes finden
Nasenleiden (Epistaxis, Fetor narium, Nasenpolypen),
Ulceration der Trachea, Synanche (squissantia, Sammelbegriff
für Krupp, Angina, Retropharyngealabszeß etc.), Heiserkeit,
Husten, Asthma, Pneumonie, Pleuritis, Empyem, Phthise mehr
oder minder eingehende Darstellung. Die Pneumonie
(peripleumonia) wird als Apostema circa pulmonem, die
Pleuritis (pleuresis) als Apostema in pleura definiert, die
Differentialdiagnose stützt sich hauptsächlich auf das
Verhalten des Schmerzes und des Urins; man unterschied von
beiden Affektionen verschiedene Unterarten, welche aus der
Aetiologie (Krankheitsursache in einem der vier Kardinalsäfte)
hergeleitet wurden. Therapie: vorzugsweise diätetische
Maßnahmen (Pneumoniker mußten sich in gleichmäßig

erwärmter Luft aufhalten), Diaphoretika, bei kräftigen
Personen Aderlaß (auf der dem Krankheitssitz
gegenüberliegenden Seite; per antipasen ═ antispasin);
am kritischen Tage (7., 9.) suchte man eventuell Nasenbluten
zu erregen durch Kitzeln der Nasenschleimhaut mittels
Schweineborsten. Von guter eigener Beobachtung zeugen
mehrere der angeführten prognostischen Sätze, z. B.: Sputum
sanguineum a principio, quod circa VII et IX diem in saniem
convertitur et facile projicitur, bonum signum; sputum vero
nigrum vel lividum vel viride perseverante dolore malum;
urina nigra et residens non malum, urina tenuis et alba sine
aliqua critica detentione raptum materie significat et mortem.
Unter den Ursachen der Phthise wird auch das Austreten von
Blut (aus einem geborstenen Gefäße) und dessen nachherige
Umwandlung in Eiter angeführt: sanguis vertitur in saniem, et
sanies inficit et ulcerat pulmonem. Bei beginnender
Schwindsucht wird auf kräftige Ernährung das Hauptgewicht
gelegt. Das Zustandekommen des hektischen Fiebers ist ganz
mechanisch erklärt und zwar damit, daß die Lunge wegen der
bestehenden Ulceration ihre Bewegungen einschränkt,
weniger Luft aufnimmt und demgemäß das Herz nicht genug
abkühlt. Es gibt zwei Arten der Schwindsucht, eine mit
Ulceration, eine andere ohne Ulceration der Lunge.
Diagnostisch wird besonderer Wert gelegt auf den fötiden
Geruch des Atems, das beständige aber nicht hoch
ansteigende Fieber, die Abmagerung, die gekrümmten Nägel,
die Beschaffenheit des Sputums (foetidum si super carbones
infunditur et si sputum in vase aliquo in nocte recipiatur et
mane aqua calida super effundatur apparet in superficie
aquae quasi quaedam crassities, in fundo putredine
remanente) Haarausfall und Durchfälle verkünden den Exitus.
Haemoptöe (roborierende Behandlung) läßt sich von
Haematemesis durch die Betrachtung des Blutes
unterscheiden, im letzteren Falle ist es „fetidus et corruptus”.
Syncope wird an verschiedenen Stellen teils auf den Magen,
teils auf Schwäche des Herzens (der Herzbewegung)

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