erhart kahle (erlangen, r.f.a.)

Erhart KAHLE (Erlangen, R.F.A.)

B 12

I n t h e ped ia t r i c t r ea t i s e s of t he med ieva l t r a n s l a t i o n s f r o m t h e Arabic , par t i ­cu la r ly t hose of Rhazes a n d Avicenna, a n i l lness ca l led « m a t e r p u e r o r u m » is descr ibed. This t e r m w a s of ten d i scussed in the ch i ld ren ' s r e g i m e n s of t he Renais­s ance (1) a n d in t h e h i s to r i ca l ped i a t r i c l i t e r a t u r e of t h i s c e n t u r y (2) b e c a u s e i t s m e a n i n g is no t comple te ly c lea r (3). The lack of c la r i ty w h i c h s u r r o u n d s th i s t e r m r e s u l t s f rom t h e fact t h a t t h e a spec t s of t w o dif ferent i l lnesses , pavor n o c t u r n u s a n d epilepsy a r e classif ied u n d e r it.

The aspec t of t h e i l lness pavor n o c t u r n u s is l i s ted u n d e r « m a t e r p u e r o r u m » in t h e P rac t i ca p u e r o r u m by Rhazes (4), w h o s e Arabic or ig inal h a s been lost , o r p e r h a p s n o t ye t found aga in . We q u o t e h e r e t h e t r a n s l a t i o n a f te r Radbi l l (5) :

N o w follows abou t a ce r t a in affliction w h i c h is cal led m a t e r p u e r o r u m . This in f i rmi ty happens t o c h i l d r e n in t h e f i rs t per iod of life f requent ly . The sign of i t is g rea t wa i l ing o r m u c h fear d u r i n g the sleep, a n d fever i nc rea sed by t h e s leeplessness ; a n d f rom t h e chi ld ' s m o u t h a foul o d o r i ssues for th . T h e c a u s e of th is a i l m e n t is t h e t a k i n g of m o r e mi lk t h a n t h e chi ld can digest . The t ex te j u s t quo t ed above f rom t h e P r a c t i c a p u e r o r u m d i rec t ly fol lowed t h e

c h a p t e r on epilepsy. None the les s , Redbil l sti l l i n t e r p r e t s th is i l lness as epilepsy a n d n o t as pavor n o c t u r n u s . Let m e quo te h i s i n t e rp r e t a t i on (6) :

M a t e r p u e r o r u m . t h e m o t h e r of ch i ldren , is a t r ans l a t i on of t h e Greek hys te r i a , r e fe r r ing t o t h e u t e r u s o r m a t r i x , supposedly t h e s ea t of th i s d i sease . All t h r o u g h t h e Eng l i sh l i t e r a t u r e w e r e a d of « t h e m o t h e r » w h i c h even tua l ly w a s supp lan ted by t h e « vapour s ». H ippoc ra t e s ca l led i t « p a t h o s pa idon », t h e infant i le d isease , a t e r m long u s e d for epilepsy in ch i ld ren .

I n h is sugges ted i n t e rp r e t a t i on Radbi l l w a s inf luenced t o a g r e a t ex t en t by Sti l l . In « The Hi s to ry of Paed ia t r i c s » Sti l l devotes a l m o s t an en t i r e chap t e r t o t h e d i scuss ion of th i s t e r m (7). Howeve r , for h i s i n t e r p r e t a t i o n of t h e t e r m « m a t e r p u e r o r u m » h e t akes one of two descr ip t ions of t h e i l lness , wh ich w e wil l quo te below, f rom a n o t h e r w o r k by Rhazes , t h e Con t inens (Ki tab al-hawi) . Unfo r tuna te ly , h e uses t h e incor rec t ly t r a n s l a t e d sect ion. Never the le s s , he , too , c o m e s t o t h e conclus ion t h a t « m a t e r p u e r o r u m » is a s y n o n y m for epilepsy. Th i s is probably because h e w a n t e d t o see t h e t e r m t r a n s l a t e d g r a m m a t i c a l l y a l i t t le b i t m o r e freely as « the m o t h e r in ch i ld ren ». I n h is sugges ted t r a n s l a t i o n h e m a k e s t h e s a m e m i s t a k e t h a t t h e med ieva l t r a n s l a t o r s m a k e w h e n t r a n s l a t i n g t h e Arabic t ex t s i n t o La t in : H e t r a n s l a t e s w o r d for w o r d a n d n o t s y n t a g m a t i c a l l y (8).

I n sho r t , t h e t e r m « M o t h e r » by itself, c a m e to m e a n w h a t w e k n o w as t h e globus hys t e r i cus , a n d t h e n a hys t e r i ca l fit of any sor t . I s i t no t p robab le t h a t t he u s e of t h e t e r m in r e g a r d to ch i ld ren a rose f rom t h e supposed s imi la r i ty of

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MATER PUERORUM, THE HISTORY OF A TERM

s o m e ne rvous a t t a c k s in ch i ld ren t o the hys t e r i ca l a t t a c k s in w o m e n ? a n d indeed a n igh t - t e r ro r m i g h t well sugges t s u c h a s imi lar i ty , a n d hys t e r i ca l fi ts a r e n o t u n k n o w n in ch i ld ren . I n shor t , « M a t e r p u e r o r u m » should be t r a n s l a t e d « The M o t h e r », in ch i ld ren , w h i c h gives i t s r ea l m e a n i n g ; w h e r e a s Chi ld ren ' s Mother , o r M o t h e r of Chi ldren , a n d st i l l m o r e Mis t r e s s of Chi ldren , as i t h a s been t r a n s l a t e d , a r e mis l ead ing .

I n h is a r t i c le on « m a t e r p u e r o r u m » S. Ko t t ek d e m o n s t r a t e d t h a t t h e t e r m in t h e L a t i n t r a n s l a t i o n s is ac tua l ly de r ived f rom t h e Arabic t e r m « u m m as-s ibyan »(9) . F o r t h a t r ea son w e m u s t d igress a bit on t h e m e a n i n g of t h e or ig ina l Arab ic t e r m a n d t h e aspec t s of t h e d i seases i t w a s a t t r i b u t e d w i t h . T h e e n u m e r a ­t ion of t h e va r ious m e a n i n g s wil l be p r e s e n t e d chronological ly .

Rhazes descr ibes « m a t e r p u e r o r u m » ( u m m as-sibyan) » twice in h i s Con t inens (Ki tab al-hawi) . I n t h e f i rs t r e fe rence h e m e n t i o n s a t ex t by Ju r j i s Ibn J ibr i l I b n B a k h t i s h u , w h o says (10) :

The d i sease cal led m o t h e r of t h e ch i ld ren ( u m m as-sibyan) is a convuls ion w h i c h o c c u r s t oge the r w i t h an acu te , bu rn ing , d ry a n d severe fever. The u r i n e is wh i t e . S m a l l ch i ld ren suffer m o s t because of t h e m o i s t u r e [in t h e m i x t u r e ] of t h e i r ne rves . In t r a n s l a t i n g the h o m o n y m / y s l w n / , w h i c h can be r e a d e i t h e r as / y a s l u n / =

to be exposed to sth. , to suffer f rom sth. , o r / y a s i l u n / = to be free, t h e t r a n s l a t o r F a r r a g i u s p rompt ly chose t h e w r o n g equ iva len t a n d t r a n s l a t e d / l i b e r a n t u r / , so t h a t h i s text t h e n b e c a m e : « ... a n d ch i ld ren a r e f reed f rom th i s d i sease » (11).

The second re ference in t h e Cont inens refers to a n u n k n o w a u t h o r a n d is as follows (12) :

Ma jhu l : W h a t is cal led m o t h e r of t h e ch i ld ren ( u m m as-sibyan) is a d r y convuls ion wh ich only ch i ld ren can be hea led of. The s t r i c k e n person often cr ies a n d h a s an acu t e fever. The sk in d r i e s ou t a n t h e tongue t u r n s dark. . . B o t h aspec t s of t he d i sease descr ibed by Rhazes a r e cha rac t e r i zed by t h e

s y m p t o m convuls ion . B e c a u s e t hey a r e l i s ted in t h e c h a p t e r o n epilepsy a n d n o t u n d e r o t h e r k inds of fits such as apoplexy, t e t a n u s , etc. , it m i g h t be a s s u m e d t h a t h e a l so u n d e r s t o o d th is to be a n epilept ic convuls ion. B o t h aspec t s of t h e d i sease descr ibed in the Con t inens a n d the i r c lass i f icat ion dev ia te f rom t h e descr ip t ion in t h e P r a c t i c a p u e r o r u m . T h e only iden t ica l s y m p t o m is t h a t of crying. Toge the r w i t h m a n y o t h e r d i sc repanc ies b e t w e e n t h e P r a c t i c a p u e r o r u m a n d o t h e r w o r k s of Rhazes , inc lud ing t h e mi s s ing or iginal of t h e P rac t i ca , t h e suspic ion a r i ses t h a t t h e P rac t i c a p u e r o r u m is a p seudep ig raphous w o r k compi led f rom La t in t rans la ­t ions , probably no t even by Rhazes .

The o t h e r a u t h o r w e wou ld l ike to q u o t e is Avicenna. H e w r i t e s in the Canon (a l -qanun fi t-tibb) (13) :

The severe epilepsy caused by b lack bile is d a n g e r o u s . If it is caused by p h l e g m it is usua l ly dange rous . B lack b i le epilepsy o b s t r u c t s t h e p n e u m a -chana l s . According to s o m e a u t h o r s especial ly t h e m o t h e r of t h e ch i ld ren ( u m m as-sibyan) l eads to ce r t a in dea th . In the ch i ld ren ' s r e g i m e n of h i s Canon, Avicenna does n o t u s e the t e r m « m o t h e r

of t h e ch i ld ren ( u m m as-sibyan) for epilepsy, b u t r a t h e r « w i n d of t h e ch i ld r en ( r ih as-sibyan) (14). We wil l say a few w o r d s about th i s t e r m a l i t t le la te r . O the r Arabic a u t h o r s of t h e 9th a n d 10th c e n t u r y w h o a r e r e l evan t for t h e La t in Midd le Ages, such as 'Arib Ibn Sa ' id a n d Ibn al-Jazzar, do no t u s e t h e t e r m « m a t e r p u e r o r u m ». They call epilepsy t h e « d i sease of ch i ld ren ( ' i l l a t / m a r a d as-sibyan) (15). T h a t is t h e t r a n s l a t i o n of t h e h ippocra t ic t e r m « p a t h o s p a i d o n » . As of t h e 12th cen tu ry , t h e t e r m « m a t e r p u e r o r u m ( u m m as -s ibyan)» w a s u s e d genera l ly a s a s y n o n y m for epilepsy (16).

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H o w can t h e des igna t ions epilepsy o r convuls ive fits be expla ined as « m a t e r p u e r o r u m » if w e have , then , j u s t r e j ec t ed t h e i n t e r p r e t a t i o n s of Radbi l l a n d Stil l ? S. K o t t e k s h o w e d in h is a r t i c l e t h a t ar t i f ic ial ly c o n s t r u c t e d e tymologys for t h e t e r m « m a t e r p u e r o r u m » a r e mi s l ead ing (17). This is a n i n t e rp re t a t i on w h i c h w e can only endor se , as w e h a v e a l r eady r e j ec t ed Sti l l ' s i n t e rp re t a t i on , a l t h o u g h t t h e Arab ic sorely t e m p t s u s t o f ind a c o n s t r u c t e d « e tymologica l » i n t e r p r e t a t i o n for t h e t e r m « u m m as-s ibyan ».

I n a c t u a l fact , t h e t e r m « m a t e r p u e r o r u m » o r ig ina te s in Arab ic folk-medicine, o r r a t h e r folklore. In h e a t h e n Arabia , i t w a s a c o m m o n belief t h a t i l lnesses w e r e caused by d e m o n s (18). These a r e beliefs t h a t h a v e b e e n r e t a i n e d in t h e Or ien t fo r t h o u s a n d s of yea r s . If a pe r son w a s n o t o r d id no t appear t o be in a fully consc ious s ta te , h e w a s sa id to be p l agued by d e m o n s . Often th i s belief w a s a t t r i b u t e d t o en t i r e g roups of people, for i n s t a n c e poe ts o r p r i e s t s ( soo thsayers ) . A synonym for epilepsy can be easily de r ived f rom th i s : t h e p r ies t ' s o r soo thsaye r s i l lness ( m a r a d al -kahini) (19). « M a t e r p u e r o r u m ( u m m as - s ibyan)» can be s imi lar i ty expla ined. B e h i n d th i s t e r m l u r k s t h e des igna t ion for a f emale ch i l db i r t h d e m o n . This female d e m o n der ives f r o m t h e P a n t h e o n of t he S u m e r i a n s , w h e r e she b ea r s t h e n a m e L a m a s h t u n (20). S h e is a t r a d i t i o n a l figure in the folklore of t h e Or ien t . In Pe r s i a she w a s a n d stil l is cal led Al (21) ; in Canaan i t i c folklore she is n a m e d Li l i th (22) ; a n d in Is lamic-Arabic bel iefs she appears u n d e r t h e n a m e of « m o t h e r of t h e ch i ld ren ( u m m as-sibyan) »(23), « w i n d of t h e ch i ld ren ( r ih as-sibyan) »(24), « compan ion (qar ina) » (25), « fo l lower ( tabi 'a ) »(26) a n d o t h e r n a m e s . T h e f igure of Lil i th w a s ce r ta in ly q u i t e i m p o r t a n t for t h e explana t ion of th i s f igure in I s l amic folklore ; in J e w i s h folklore Lil i th developed f rom t h e f i rs t wife of A d a m (27) in to a n evil d e m o n (28) a n d l a t e r in to goddess (29). I n t h e Is lamic-Arabic r e a l m va r ious p roper t i e s of h e r s have been personif ied. T w o of h e r n a m e s w e r e t h e n i n t e g r a t e d i n t o med ica l t e rmino logy . However , h e r e only one of t h e compla in t s w h i c h t h e d e m o n caused , i.e., epilepsy, w a s n a m e d for he r .

I n shor t , it c an be sa id t h a t « m a t e r p u e r o r u m » in t h e La t in t r ans l a t i ons of Arabic m e d i c a l t ex t s is t h e l i te ra l t r a n s l a t i o n of t h e Arab ic t e r m « u m m as-sibyan ». W i t h t h e except ion of t h e P r a c t i c a p u e r o r u m by Rhazes w h e r e t h e aspec t of pavor n o c t u r n u s is a t t r i b u t e d t o th i s t e r m , « m a t e r p u e r o r u m » a lways m e a n s epilepsy in t h e Arabic m e d i c a l l i t e r a tu r e . T h e t e r m itself is de r ived f rom t h e folklor ic n a m e of a female ch i ldb i r th -demon, which , a m o n g o t h e r th ings , could br ing on epilepsy in ch i ld ren .

N O T E S AND R E F E R E N C E S

(1) Cf. Roe lans , Cornel ius : Liber de aegri tudinibus infant ium. Printed in : Sudhoff, Karl : Erst l inge der paediatr ischen Literatur. Miinchen 1925.

(2) Cipriani, Mariano : « Mater puerorum » s inonimo di epi leps ia s e c o n d o vecchie concezioni c t io logiche . In : Rivista di Storia della Medic ina 14 (1970) 172-179.

Kottek, Samuel S. : « Mater Puerorum ». A Medieval N a m i n g for an Enigmat ic Children's Disease . In : Europe an Journal of Pediatrics 137 (1981) 75-79.

Radbil l , Samuel X. : The First Treatise on Pediatrics . In : American Journal of Diseases of Children 122 (1971) 369-376; p . 371.

Sti l l , George Frederic : The History of Paediatrics . Oxford 1931, p p . 43-46. (3) When this lecture topic w a s first sugges ted I did not k n o w that S. Kottek already had an

article on this subject in print . The d i scuss ion of the term 'mater puerorum' amongs t the authors of the 15th and 16 centuries is dealt w i th by h i m in detail and for that reason I wil l not go into this point any further.

(4) Rhazes : Practica puerorum. Traduzione e C o m m e n t o della Vera Tavone Passalacqua. Estrato da « Pagine di Storia della Medicina » Anno III -N. 3-Maggio/Giunio 1959. Cf. chapter 8, p . 19.

(5) Radbill (1971) 373. The translat ion by Radbil l was translated back in to Arabic by Qasim M u h a m m a d , Mahmud : Ar-Razi fi amrad al-atfal wal- inaya b ih im. Bagdad 1979. In addit ion, there still e x ; s t s an Italian translat ion by Passalacqua (1959) 29-43. However , it put s a ques t ion mark

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next to the term ' madre '. This translat ion is t o be found again in Latronico, Nico la : Storia del la pediatria . Torino 1977, p p . 112-117.

(6) Radbil l (1971) 371. (7) Sti l l (1931) 43-46. (8) St i l l (1931) 46. (9) Kottek (1981) 75. (10) Ar-Razi : Kitab al-hawi fi t -t ibb. Vo l s . 1-23. Haidarabad 1955-1978 ; Vol . i, p . 138, 5. (11) Rhazes : Cont inens . Bresc ia 1486 ; Liber 1, cap . 5 : « ... et pueri l iberantur ex hoc m o r b o

propter mul tas humid i ta tes ex i s tentes in eorum nervis . » (12) Razi , Hawi . Vol . 1, p . 148. (13) Ibn Sina : Al-qanun fi t-t ibb. M I L Bulaq 1294/1877 ; vol . 2, p . 77. Avicenna m e d i c o r u m Arabum principis , Liber canonis . Basi lae 1556, l iber 3, fenn 1, tractatus 5

p . 384 E . (14) Qanun (1877), vol . 1, p . 157. Lib. canonis (1556) 111A ( = l iber 1, fenn 3, doctr ina 1). Cf.

a l so Kahle , Erhart : Avicenna ( Ibn Sina) ueber Kinderkrankhei ten im Kinderregimen se ines Qanun. Erlangen 1979, p p . 21 & 34.

(15) Arib Ibn Sa' id al-Katib al-Qurtubi : Kitab Khalq al-Janin wa-Tadbir al-H'abala wal -Mawludin . Le l ivre de la Générat ion du Foetus et le Trai tement des F e m m e s ence intes et des Nouveau-nés , publ ié , traduit et annoté par Henri Jahier et Abdelkader Noureddine . Alger 1375/1956. (Publ icat ions de la Faculté mixte de m é d e c i n e et de pharmacie d'Alger 3), p . 68.

Ibn al-Jazzar : Siyasat as-s ibyan wa- tadbiruhum. Tunis 1968, p . 97. (16) Ibn Hubal : Kitab al -mukhtarat fi t-t ibb. I-IV. Haidarabad 1362-1364/1943-1944. Vol . 3, p . 55 :

The mis fortune of epi lepsy , w h e n it pers i s t s , ki l l s . The k ind of ep i lepsy cal led ' u m m as-s ibyan ' is deadly. It often occurs in chi ldren . Only w h e n they have many pustu la o n their heads and frequently have catarrh can they be cured of this i l lness .

Ash-Shacrani : Mukhtasar tadhkira as-Suwaidi . Misr 1356/1937, p. 13. Ibn an-Nafis : Sharh kulliyat al -qanun. Staatsbibl iothek Ber l in /West , m s . orient . , 901, fol. 13r. Ibn al-Khatib : Kitab carnal m a n tabba l i-man habba. Ed. Maria Conception Vazquez de

Beni to . Salamanca 1972. (Acta Sa lamant icens ia , fi losofia y lettras 66), p . 259. At-Tabari, 'Ali Ibn Sahl Rabban : Firdausu' l -Hikma, or Paradise of Wisdom. Ed. M. Z. S iddiqi .

p . 14 & vol . I l l , p . 130 in margine . (17) Kottek (1981) 75. (18) Wel lhausen, Jul ius : Reste arabischen H e i d e n t u m s . Berl in 1927, p . 155. (19) Al-Baladi : Kitab tadbir al-habala wal-atfal was-s ibyan wa-hifz s ihhat ih im wa-mudawat

al-amrad al-carida lahum. Tahqiq Mahmud al-Hajj Qasim Muhammad. Bagdad 1401/1980. (Si ls i la kutub ct-turath 96), p . 245.

At-Tabari, cAli Ibn S?.hl Rabban : Firdausu' l -Hikma, or Paradise of Wisdom. Ed. M. Z. S iddiqi . Ber l in 1928, p. 138, 6.

(20) Ei lers , Wilhe lm : Die AI, e in pers i sches Kindbet tgespenst . In : Bayerische Akademie der Wissenschaften, Phi los . -Histor . Klasse , S i tzungsber ichte , Jahrgang 1979, Heft 7, p. 1.

Kriss , Hubert & Rudolf : Volksg laube im Bere ich des I s lam. Vol . 2. Wiesbaden 1962, p . 24. (21) Ei lers (1979). (22) Patai, Raphael : The H e b r e w Goddes . N e w York 1967, p p . 207-244. (23) Winkler H.A. : S a l o m o und die Karina. Stuttgart 1931. (Veröffent l ichungen des Oriental ischen

Seminars der Universität Tübingen, 4. Heft) , p . 43. (24) Cf. note 13 ; al-Baladi (1980) 256 : ruh as-s ibyan ; Winkler (1931), p p . 40, 41, 43, 44 ;

Ei lers (1979) 51. , , (25) Winkler (1931) 58 ; D.B. Macdonald : Karin. In : The Encyclopaedia of I s lam, Vol . 4.

Leiden 1978, p . 178 ; Canaan, Taufic : Dämoneng laube im Lande der Bibel . Leipzig 1929 (Morgenland, Heft 4), p . 47 ; Canaan : Aberglaube und Volksmediz in im Lande der Bibel . Hamburg 1924. (Abhand­lungen des Hamburg i schen Kolonia l inst i tuts , Bd. 22 /Reihe B, Bd . 12), pp . 26-28.

(26) Winkler (1931) 58 ; Ei lers (1979) 63. (27) Patai (1967) 220 ; Wünsche , August : Schöpfung und Sündenfal l des ersten Menschenpaares im

jüd i schen und m o s l e m i s c h e n Sagenkre ise mit Rücks icht auf die Uberl ieferungen in der Keilschriftl i-teratur. Leipzig 1906. (Ex oriente lux, Bd . 2), pp . 25-28.

(28) Patai (1967) 221. (29) Patai (1967) 242.

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