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Astrology took its place in the body of Western knowledge with the spread of astrological lore from Babylon to Greece several centuries before Christ. This transmission began with Berosus, a priest of the temple of Bel, who settled on the island of Cos, the home of Hippocratic medicine, where he established a school of astrology at the end of the fifth century bc. However, the full application of astrology to medicine called iatromathematica, was developed subsequently in Hellenistic Egypt.Both Greek medicine and Greek astrology shared the predominant Aristotelian physics of the day: that everything was composed of the 4 elements of fire, air, water, and earth in varying proportions.The 12 signs of the zodiac were divided into four groups of three, each group or ‘triplicity’ being associated with one of these elements, whose qualities of heat, cold, dryness, and moisture they symbolized. A particularly Egyptian feature was to give to each zodiac sign signification over certain parts and organs of the body, the first sign, Aries, signifying the head, through to the twelfth sign, Pisces, for the feet. Moreover, the four humours, which Hippocratic medicine held to constitute the human body as the elements composed the physical world as a whole, were assigned planetary significators, along with the organs which contained them: Jupiter ruled the blood, the liver, and the veins; the Moon, phlegm and the brain; Mars, yellow bile and the gall bladder; and Saturn, black bile and the spleen. The Moon in addition represented the humours as a whole, while the Sun denoted the vital spirit of the body, radiating from the heart via the arteries. Venus governed the genitourinary system, while to the seventh planet, Mercury, was given rulership of the mind.

The continuous movement of the planets in their courses, and their mutual interactions, were seen to correlate with the constant changes in the physical world: the cycle of the seasons, its mirroring in the four ages of Man, and the alternations between health and disease in an individual or community. The birth horoscope was used to identify the individual temperament, whether sanguine, choleric, melancholic, phlegmatic, or a combination of these, from which followed advice on the correct diet and lifestyle to maintain health and avoid the diseases to which that particular temperament was liable. The horoscope cast for the time of a person falling ill, called a decumbiture, was employed to help identify the nature, origin, and location of the disease, the likely prognosis, the kind of treatment to be given, and the most propitious times for its administration. The critical days in a disease, when an alteration in the condition for better or worse was anticipated, were calculated from the movements of the Moon and Sun for acute and chronic conditions respectively.Medicine, as systematized by Galen in the second century ad, combined with late Stoic and Hermetic doctrines concerning the influence of the seven planets in the zodiac on terrestrial matters — encapsulated in the notion of a ‘cosmic sympathy’ and in the phrase ‘as above, so below’ — produced a positive science of astrological medicine for medieval men. A more fated attitude took hold among Arab, Jew, and Christian, that everything was ‘written in the stars’.
When astrological medicine was transmitted to Western Europe in the later Middle Ages; it required harmonizing with Christian theology. The position came to be accepted that the stars incline but do not compel, keeping intact Man's essential free will. For, although the human body might be subject to alteration and change occasioned by the movements of the planets in the zodiac, Man's immortal soul remained free from such influences so that he could indeed command the stars, insofar as he commanded his passions. This theme, that ‘the wise man rules his stars, the fool obeys them’, was powerfully developed by Marsilio Ficino, a fifteenth-century Florentine priest and physician steeped in Plato. The notion of a pre-ordained length of life, calculated from the points of life (apheta or hyleg) and destruction (anareta) in the natal horoscope, was overturned by correct physical habit and spiritual development, which nurtured the health of the body and soul, so extending the lifespan. However, the planets were still held accountable for epidemic diseases. The medical establishment in Paris blamed the triple conjunction of Mars, Jupiter, and Saturn for the outbreak of the Black Death in 1348. The spread of syphilis at the end of the fifteenth century was thought to be caused by the conjunction of many planets in Scorpio in 1484, while the very name ‘influenza’ is testimony of the belief in the celestial origin of that disease.

Nicholas Culpeper, the famous seventeenth-century herbalist and astrologer, was one of the last to practise with integrity the combination of Galenic medicine and astrology, before the celestial art was relegated among the educated to a superstition, along with alchemy, which depended on astrology for its correct operations. Culpeper popularized astrological medicine by issuing inexpensive books in straightforward English on these learned subjects, with the effect of extending people's knowledge beyond the simple rules for seasonal blood-letting, purging, and bathing, and the times for doing so according to the zodiac sign occupied by the Moon, which were common to many popular almanacs of the time.

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