Continuing Galen’s bedside manner advice

Posture. The physician should maintain a mean when it comes to the posture of his whole body, both when entering and when seated: neither so low as to invite contempt, nor so lax as to advertise arrogance. Some come in and sit down rigid and sprawling; others do so in a slack, careless way; others are bent over and abject. You must avoid every extreme and try to stay between them. If, on rare occasions, the patient seems particularly humble, it is better to incline yourself a little from the mean toward the lower side. If the patient is disposed the other way, you should do the opposite, briefly stepping away from the mean and from what is natural toward something more elevated.

Clothing. The same rule applies here. Let it be moderate: neither lavish, so as to suggest arrogance, nor dirty and excessively shabby, unless the patient himself is immoderately fond either of luxury or of roughness. In such cases you should move away from the mean toward what the patient finds more agreeable, so far as you judge it still fitting for you.

For the patient. I said that this phrase, inserted in the middle, creates a difficulty. If it had been placed at the beginning of the whole discussion or at the end, it would be clear that the physician should do all these things in a way that pleases the patient: his entrances, his conversation, the bearing of his whole body, his clothing, the trimming of his hair, the proper length of his nails, and his scent. In entrances, the right measure is different for different patients, as I said earlier, and likewise in conversation. Some enjoy doctors who tell stories; others are irritated by them. Some take pleasure in dignified speech; others in witty talk. As for posture and clothing, I have just explained how one must aim at what the patient finds pleasing.

Haircut. the best haircut would naturally be the one that aims at the health of the head, since different styles suit different people. Among the sick, however, what is pleasing is not the same for everyone. You must take this into account too, keeping your eye on the person being treated, just as all those who attended on Antoninus, the father of Commodus, kept their hair cropped close. Lucius used to call them “mimes,” and for that very reason those who later accompanied him let their hair grow long again.

Nails. He himself taught how long a physician’s nails should be in On the Surgery, making their proper length part of being pleasant to those who see them. As for nails with scabs or anything of that sort, just as with alopecia or ophiasis of the hair on the head, there is no need to say a word. Such conditions, being already against nature, are most disgraceful for a physician, just like severe gout or anything similar.

σχῆμα. καὶ τὸ σχῆμα τοῦ σώματος ὅλου κατά τε τὴν εἴσοδον καὶ τὴν καθέδραν ὁ ἰατρὸς ἐχέτω μέσον, μήτε ταπεινὸν ὡς εὐκαταφρόνητον εἶναι μήτε χαυνότητά τινα καὶ ἀλαζονείαν ἐνδεικνύμενον. ἔνιοι μὲν γὰρ ἀνατεταμένοι καὶ πλατεῖς εἰσίασί τε καὶ καθέζονται, ἔνιοι δὲ διατεθρυμμένοι, τινὲς δὲ ἐγκεκυφότες καὶ ταπεινοί. φεύγειν οὖν ἁπάσας χρὴ τὰς ὑπερβολὰς καὶ πειρᾶσθαι μέσον αὐτῶν εἶναι. εἰ δέ ποτε κατὰ τὸ σπάνιον ὁ κάμνων φαίνοιτό σοι φιλοτάπεινός τις, ἀπὸ τοῦ μέσου βραχὺ πρὸς τὸ ταπεινότερον ἄμεινόν ἐστι σχηματίζειν ἑαυτόν. εἰ δ' ἐναντίως ἔχοι, καὶ σὺ τἀναντία ποιήσεις ἐπὶ βραχὺ τοῦ μέσου τε καὶ κατὰ φύσιν ἐφ' ὑπέρτερα παραχωρῶν.

ἐσθής. καὶ αὕτη κατὰ τὸν αὐτὸν λόγον ἔστω μέση, μήτε πολυτελὴς ὡς ἀλαζονείαν ἐμφαίνειν μήτε ῥυπαρὰ καὶ πάνυ ταπεινή, πλὴν εἴ ποθ' ὁ κάμνων αὐτὸς εἴη τῶν ἀμετρότερον ἢ τὰ πολυτελῆ φιλούντων ἢ τοῖς ῥυπαροῖς ἡδομένων. ἐπὶ τούτων γὰρ ἀπὸ τῆς μεσότητος ἐπὶ τὸ τῷ κάμνοντι φίλτερον ἀποχωρήσεις, ὅσον ἂν εἰκάσῃς ἔσεσθαί σοι σύμμετρον.

τῷ νοσοῦντι. διὰ μέσου τοῦτ' ἔφην ἐγκείμενον ἀπορίαν παρέχειν· εἰ δέ γε κατὰ τὴν ἀρχὴν τῆς ὅλης ῥήσεως ἢ τὴν τελευτὴν εἴρητο, σαφὲς ἂν ἦν ὡς ἅπαντα ταῦτα τῷ νοσοῦντι κεχαρισμένως προσήκει πράττειν τὸν ἰατρόν, εἰσόδους, λόγους, σχῆμα τοῦ παντὸς σώματος, ἐσθῆτα, κουρὰν τριχῶν, ὀνύχων συμμετρίαν, ὀσμήν. ἐπί τε γὰρ εἰσόδων ἄλλη πρὸς ἄλλον ἐστὶ τῶν νοσούντων ἡ συμμετρία, καθότι πρόσθεν εἶπον, ἔν τε τοῖς λόγοις ὡσαύτως· οἱ μὲν γὰρ μυθολογοῦσι τοῖς ἰατροῖς ἥδονται, τινὲς δὲ ἀνιῶνται, καὶ τινὲς μὲν σεμνοῖς λόγοις, τινὲς δ' εὐτραπέλοις χαίρουσι. καὶ περὶ τῶν σχημάτων δὲ καὶ τῆς ἐσθῆτος ἀρτίως εἴρηται, τίνα τρόπον ἐστοχάσθαι χρὴ τῶν ἡδέων τῷ νοσοῦντι.

κουρή. τῶν τριχῶν ἡ κουρὰ φύσει μὲν ἀρίστη γένοιτο ἄν, εἰ στοχάζοιτο τῆς κατὰ τὴν κεφαλὴν ὑγείας. ἄλλοις γὰρ ἄλλο προσήκει. τοῖς νοσοῦσι δὲ τὸ τῆς κουρᾶς εἶδος οὐ ταὐτὸν ἅπασιν ἡδύ. στοχάζεσθαι τοίνυν σε χρὴ καὶ τούτου πρὸς τὸν ἰατρευόμενον ἀποβλέποντα, καθάπερ ἐπ' Ἀντωνίνου τοῦ Κομμόδου πατρὸς ἐποίουν οἱ συνόντες ἅπαντες ἐν χρῷ κειρόμενοι. Λούκιος δὲ μιμολόγους αὐτοὺς ἀπεκάλει. καὶ διὰ τοῦτο πάλιν ἐκόμων οἱ μετ' ἐκείνου.

ὄνυχες. πηλίκους εἶναι χρὴ τοὺς ὄνυχας τοῖς ἰατροῖς αὐτὸς ἐδίδαξεν ἐν τῷ Κατ' ἰητρεῖον, συνάπτων αὐτῶν τὴν συμμετρίαν ἡδεῖαν εἶναι τοῖς ὁρῶσι. περὶ δὲ τῶν ψώραν ἐχόντων ὀνύχων ἤ τι τοιοῦτον καθάπερ γε καὶ περὶ τῆς ἐν κεφαλῇ τῶν τριχῶν ἀλωπεκίας ἢ ὀφιάσεως οὐδὲ λόγου δεῖται. ταῦτα γὰρ ὡς ἤδη παρὰ φύσιν αἴσχιστόν ἐστιν ἔχειν ἰατρῷ, καθάπερ γε καὶ ἀρθρῖτιν ἰσχυρὰν ἤ τι τοιοῦτον ἕτερον.

Galen, Commentary on Epidemics VI 4.10, 17B.148-150K = 205-206 Wenkebach