Table Of ContentOXFORD EARLY CHRISTIAN STUDIES
General Editors
Gillian Clark Andrew Louth
THE OXFORD EARLY CHRISTIAN STUDIES series includes scholarly volumes on
the thought and history of the early Christian centuries. Covering a wide range of
Greek, Latin, and Oriental sources, the books are of interest to theologians, ancient
historians, and specialists in the classical and Jewish worlds.
Titles in the series include:
The Minor Prophets as Christian Scripture in the Commentaries of
Theodore of Mopsuestia and Cyril of Alexandria
Hauna T. Ondrey (2018)
Preaching Christology in the Roman Near East: A Study of Jacob of Serugh
Philip Michael Forness (2018)
God and Christ in Irenaeus
Anthony Briggman (2018)
Augustine’s Early Thought on the Redemptive Function of Divine Judgement
Bart van Egmond (2018)
The Idea of Nicaea in the Early Church Councils, ad 431–451
Mark S. Smith (2018)
The Many Deaths of Peter and Paul
David L. Eastman (2019)
Visions and Faces of the Tragic: The Mimesis of Tragedy and
the Folly of Salvation in Early Christian Literature
Paul M. Blowers (2020)
Art, Craft, and Theology in Fourth-C entury Christian Authors
Morwenna Ludlow (2020)
Nemesius of Emesa on Human Nature: A Cosmopolitan
Anthropology from Roman Syria
David Lloyd Dusenbury (2021)
Spiritual Direction as a
Medical Art in Early
Christian Monasticism
JONATHAN L. ZECHER
Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide. Oxford is a registered trade mark of
Oxford University Press in the UK and in certain other countries
© Jonathan L. Zecher 2022
The moral rights of the author have been asserted
First Edition published in 2022
Impression: 1
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by licence or under terms agreed with the appropriate reprographics
rights organization. Enquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above
You must not circulate this work in any other form
and you must impose this same condition on any acquirer
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America
British Library Cataloguing in Publication Data
Data available
Library of Congress Control Number: 2022937050
ISBN 978–0–19–885413–5
DOI: 10.1093/oso/9780198854135.001.0001
Printed and bound in the UK by
Clays Ltd, Elcograf S.p.A.
Links to third party websites are provided by Oxford in good faith and
for information only. Oxford disclaims any responsibility for the materials
contained in any third party website referenced in this work.
For Richard, who could well say
Tratto t’ho qui con ingegno e con arte;
lo tuo piacere omai prendi per duce;
fuor se’ de l’erte vie, fuor se’ de l’arte.
(Purgatorio, Canto 27, ll. 130–2)
Contents
Preface xi
List of Figures and Tables xv
Abbreviations xvii
A Note on Editions and Series xxi
Introduction 1
I. Rationale 1
II. A Plan of the Work 3
III. Scholarly Backgrounds 4
IV. Approaching Spiritual Direction 6
V. Dramatis Personae 10
I. LOGICS OF PRACTICE
Biopsychosocial Models of Health and Illness 23
1. A (Relatively) Brief Outline of the Galenic Medical Art 31
I. Galen in a World of Encyclopedists and Christians 33
II. “The End Is Where We Start From” 36
III. Biopsychosocial Knowing 39
III.1 Dissection and Humours: Knowing Bodies 40
III.2 Knowing Souls (and Bodies, Again) 43
III.3 Ecologies: Social and Environmental Embeddedness 46
IV. Diagnostic Knowing 50
IV.1 Symptomology 50
IV.2 Pathology 53
IV.3 Nosology 54
IV.4 Diagnosis and Prognosis 55
V. Therapeutic Tactics 57
V.1 Calibration and Hierarchy 58
V.2 Hygiene and Ethics 60
VI. Conclusion: Knowledge, Strategies, and Tactics 61
2. Evagrius the Diagnostician, or What to Expect When
You’re Dreaming 64
I. The Entangled Mechanisms of Dreams 67
II. Whence Dreams May Come 79
III. An Oneiric Symptomology 82
IV. Competitive Dream Diagnosis 89
viii Contents
3. Cassian the Oneirologist: So, You’ve Had a Wet Dream . . . 93
I. The Viscera of the Soul 95
II. Nocturnal Emissions and Wet Dreams 97
III. Dreams as Sites of Diagnosis and Therapy 107
IV. Chastity and the Boundaries of Flesh and Spirit 114
V. Conclusion: The Body’s Confession, and a Bit of Foucault 124
4. John Cassian’s Nosology of the Soul 128
I. The Monk Dissected 129
II. The Oozing Humor of Vice 137
III. Vice, Considered Capite ad Calcem 151
IV. Conclusion 156
5. Pathologies of Passion and Embodiment in the Ladder 159
I. The Logic of Effect: A Short Galenic Interlude 160
II. The Pathology of Thought 163
III. The Pathology of Passions 169
IV. The Pathology of Embodiment 183
V. John’s Cookbook, or Fasting as Biopsychosocial Therapy 193
II. REPRESENTATIONS
Metaphors and Expertise 199
6. Trust Me, I’m a Doctor: Expertise and Clinical Relationships
in Late Antique Medicine 206
I. Market Conditions 207
II. Medical Ethics 212
III. Competition and Self- Presentation 224
IV. Expertise and Trust in Relationships 230
7. Basil of Caesarea on the Spiritual Physician and His
Galenic Competitor 232
I. Introduction: Asceticism, Expertise, and the Medical Art 232
II. Rules of the Game 234
III. Scope of Practice 237
IV. Character Counts 243
V. A Contest of Experts 249
VI. Conclusions 257
8. Patient Physicians and Patient Disobedience in Cassian 259
I. Abba Moses on Trail- Craft and Confession 259
II. Recognizing the (Not Always) Ideal Physician 263
III. The Apostle Paul Copes with Patient Disobedience 275
IV. Conclusion: Repetition, Community, Willingness 288
Contents ix
9. A Physician, a Judge, and a Shepherd Walk into a Monastery . . . 294
I. King and Physician in the Great Coenobium 295
II. Physician and Judge in Cell and Church 304
III. Prison, Amputation 312
IV. Conclusion: The Monastery as Clinic 315
Conclusions, and Prognoses 319
I. Recapitulation 319
II. Consequences 320
III. Ways Forward 322
Bibliography 327
Index of Select Ancient Authors 365
Index of Select Modern Authors 367
Subject Index 368
Index of Greek Terms 370
Index of Latin Terms 371
