Pseudo-Galen, what is a heart?

“The heart is sinewy, muscular and full of veins, having arteries as well. It is conical in shape, somewhat fatty; the arteries and veins, through which blood and pneuma are distributed, grow out from it. In another way: the heart is muscular, having a conical shape and two ventricles, in which are generated the innate heat and the vital pneuma. The arteries grow out from it, also the veins grow out from it. Through these, both the life-bearing seed and the innate heat are supplied to the whole body.”

Καρδία ἐστὶ νευρώδης καὶ μυώδης καὶ φλεβώδης, ἔχουσα καὶ ἀρτηρίας. κωνοειδὴς τῷ σχήματι, ὑποπίμελος, ἐξ ἧς ἐκπεφύκασιν ἀρτηρίαι καὶ φλέβες δι' ὧν ἐπιπέμπεται αἷμα καὶ πνεῦμα. ἄλλως. καρδία ἐστὶ μυώδης, ἔχουσα σχῆμα κωνοειδὲς καὶ δύο κοιλίας ἐν αἷς γεννᾶται τὸ ἔμφυτον θερμὸν καὶ τὸ ζωτικὸν πνεῦμα. ἐξ ἧς ἐκπεφύκασιν ἀρτηρίαι καὶ φλέβες ἐκφύονται. δι' ὧν χορηγεῖται τῷ παντὶ σώματι ὅ τε ζωτικὸς γόνος καὶ ἡ ἔμφυτος θερμασία.

Ps.-Galen, Medical Definitions 49 (XIX 360 Kühn)

Pseudo-Galen, what is nature?

“Nature is an artistic fire proceeding on the way to generation and actively moving out of itself. According to Plato, it is defined differently: nature is divine art; or, nature is a sort of artistic power. A different definition: nature is inflamed pneuma moving out of itself, generating, completing and maintaining the human being in accordance with spermatic powers. Or it is defined in this way: nature is a power moving out of itself, a cause of generation, formation, and completion producing and completing a human being. Nature is said to be mixture, and nature is said to be state. Nature is also said to be a motion in accordance with effort. Nature is said to be the power controlling an animal. It can also be defined in this way: nature is the inflamed pneuma moving out of itself, generating, completing and maintaining a human being in accordance with spermatic principles determining lifetime and size.”

Φύσις ἐστὶ πῦρ τεχνικὸν ὁδῷ βαδίζον εἰς γένεσιν καὶ ἐξ ἑαυτοῦ ἐνεργητικῶς κινούμενον. ἑτέρως κατὰ Πλάτωνα. φύσις ἐστὶ θεία τέχνη. ἢ φύσις ἐστὶν οἵα τεχνικὴ δύναμις. ἑτέρως. φύσις ἐστὶ πνεῦμα ἔνθερμον ἐξ ἑαυτοῦ κινούμενον καὶ κατὰ τὰς σπερματικὰς δυνάμεις γεννῶν τε καὶ τελειοῦν καὶ διατηροῦν τὸν ἄνθρωπον. ἢ οὕτως. φύσις ἐστὶ δύναμις ἐξ ἑαυτῆς κινουμένη, αἰτία γενέσεώς τε καὶ διαπλάσεως καὶ τελειότητος γεννῶσά τε καὶ τελειοῦσα τὸν ἄνθρωπον. φύσις καὶ ἡ κρᾶσις λέγεται, φύσις καὶ ἡ ἕξις. φύσις καὶ ἡ καθ' ὁρμὴν κίνησις. φύσις καὶ ἡ διοικοῦσα τὸ ζῶον δύναμις λέγεται. δύναται δὲ καὶ οὕτως ὁρίσασθαι. φύσις ἐστὶ πνεῦμα ἔνθερμον ἐξ ἑαυτοῦ κινούμενον κατὰ σπερματικοὺς λόγους γεννῶν τε καὶ τελειοῦν καὶ διατηροῦν τὸν ἄνθρωπον ἐν χρόνοις καὶ μεγέθεσιν ὡρισμένους.

Ps.-Galen, Medical Definitions 95 (XIX 371 Kühn)

Moving Causes

More trouble with the Definitions...

In On Cohesive Causes, Galen mentions that Athenaeus took over some causal theory from Posidonius, particularly the notion of the synectic or cohesive cause, i.e., the cause responsible for something remaining what it is.

According to Galen, Athenaeus distinguished cohesive causes from two other kinds of causes: preceding (or prohegoumena) causes and antecedent (or prokatarctic) causes. A preceding cause is something internal that over time leads to disease. Examples Galen gives are venom and poison. An antecedent cause is something that gets some process going (On Cohesive Causes 2.3, CMG Suppl. Or. II ed. Lyons p.54). Something like what Aristotle calls an efficient cause.

In the pseudo-Galenic Medical Definitions, we find entries for six kinds of causes, including cohesive, preceding and antecedent causes, as well as an entry for cause in general. In Kühn’s text of the Definitions, Athenaeus’ name appears in definition 155 (XIX 392-3K), the definition of the procatarctic or antecedent cause. Here’s the whole bit from the Definitions on causes:

“154. A cause is that which produces something in the body and is itself incorporeal. Or a cause is, as the philosophers say, what is productive of something or through which something comes to be. Cause is three-fold: there is the antecedent [prokatarctic], preceding [prohegoumenon] and cohesive [synectic].

155. So, an antecedent [prokatarctic] [cause] is that which, having produced the effect, is separate, as the bite [is separate] from the dog, the sting from the scorpion, and the inflammation which produces a fever [is separate from] from the sun. Athenaeus of Attaleia speaks in this way. The agent is a cause, i.e.,  the antecedent [cause]. Otherwise. The antecedent causes are whatever [causes] begin before the result is entirely complete and of which there is nothing preceding.

156. A preceding [prohegoumenon] cause is that which is constructed or co-produced by the antecedent cause and precedes the containing cause. Others in this way. A preceding cause is that which, when it is present, the result is present; when it increases, the result increases;  when it decreases, the result decreases; and when it is removed, the result is removed.

157. A cohesive [synectic] cause is that which, being present, preserves the presence of the disease, but when removed, removes [the disease], as the stone in the bladder; as the hydatid [i.e., a sac filled with fluid unconnected to tissues], as the pterugion [i.e., some kind of obstruction on the eye]; as the enkanthis [i.e., another obstruction of the eye]; [and] as other such things called containing causes, things which the very best physicians [thought] not only [should be placed] in an account of causes, but also [thought were distinct] from settled conditions.

158. A self-complete [autoteles] cause is what produces an end itself by itself.

159. A contributing cause [sunaition] is that which has adequate power with another to produce the result, but it is not being able to produce [the result] on its own power alone.

160. A coöperator [sunergon] is a cause which, when something produces a result but with difficulty, contributes to its more easy generation, not able to produce something on its own.”

[392K] ρνδʹ. Αἴτιόν ἐστιν ὃ ποιοῦν τι ἐν τῷ σώματι καὶ αὐτὸ ἀσώματόν ἐστι. ἢ αἴτιόν ἐστιν, ὡς οἱ φιλόσοφοι λέγουσι, τό τινος ποιητικὸν ἢ δι’ ὅ τι γίνεται. τριπλοῦν δὲ αἴτιον· ἔστι δὲ τὸ μὲν προκαταρκτικὸν, τὸ δὲ προηγούμενον, τὸ δὲ συνεκτικόν.

ρνεʹ. Προκαταρκτικὸν μὲν οὖν ἐστιν ὃ ποιῆσαν τὸ ἀποτέλεσμα κεχώρισται ὡς ὁ δακὼν κύων καὶ ὁ πλήξας σκόρπιος καὶ ἡ ἀπὸ τοῦ ἡλίου ἔγκαυσις ἡ τὸν πυρετὸν ἐργαζομένη. Ἀθήναιος δὲ ὁ Ἀτταλεὺς οὕτω φησίν. αἴτιόν ἐστι τὸ ποιοῦν. τοῦτο δέ ἐστι τὸ προκαταρκτικόν. ἄλλως. τὰ προκαταρκτικὰ αἴτιά ἐστιν ὅσα προκατάρχει τῆς ὅλης συντελείας τοῦ ἀποτελέσματος καὶ ὧν οὐδὲν προηγεῖται.

ρνστʹ. Προηγούμενον αἴτιόν ἐστι τὸ ὑπὸ τοῦ προκαταρκτικοῦ ἤτοι κατασκευαζόμενον ἢ συνεργούμενον καὶ προη-|[393K] γούμενον τοῦ συνεκτικοῦ. οἱ δὲ οὕτως. προηγούμενον αἴτιόν ἐστιν οὗ παρόντος πάρεστι τὸ ἀποτέλεσμα καὶ αὐξομένου αὔξεται καὶ μειουμένου μειοῦται καὶ αἱρουμένου αἱρεῖται.

ρνζʹ. Συνεκτικὸν αἴτιόν ἐστιν ὃ παρὸν μὲν παροῦσαν φυλάττει τὴν νόσον, ἀναιρούμενον δὲ ἀναιρεῖ, ὡς ὁ ἐν τῇ κύστει λίθος, ὡς ὑδάτις, ὡς πτερύγιον, ὡς ἐγκανθὶς, ὡς ἄλλα τοιαῦτα συνεκτικὰ καλούμενα αἴτια, ἅπερ οἱ γενναιότατοι τῶν ἰατρῶν οὐκ ἐν αἰτίων μόνον λόγῳ, ἀλλὰ καὶ ἐκ παθημάτων τιθέντων ταῦτα.

 ρνηʹ. Αὐτοτελὲς αἴτιόν ἐστι τὸ αὐτὸ καθ’ αὑτὸ ποιοῦν τέλος.

 ρνθʹ. Συναίτιόν ἐστιν ὃ σὺν ἑτέρῳ δύναμιν ἴσην ἔχον ποιοῦν τὸ ἀποτέλεσμα, αὐτὸ δὲ κατ’ ἰδίαν μόνον οὐ δυνάμενον ποιῆσαι.

 ρξʹ. Συνεργόν ἐστιν αἴτιον ὃ ποιοῦν ἀποτέλεσμα, δυσχερῶς δὲ, συλλαμβάνον πρὸς τὸ ῥᾷον αὐτὸ γενέσθαι, κατ’ἰδίαν τι ποιεῖν οὐ δυνάμενον.

[Galen] Definitiones 154-160, XIX 392-3 K

The phrase attributed to Athenaeus looks like a statement about antecedent causes: they are productive or efficient causes. This claim fits nicely with what Galen says in On Cohesive Causes. He tells us Athenaeus contrasted antecedent causes, causes of change, with cohesive causes, causes of stability.

Oddly, we get a different picture from both the Aldine and and the BL ms. They put Athenaeus’ statement about efficient causes under the definition of the cohesive cause:

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The 1525 Aldine edition of Galen's Definitions (v.4; ὃροι ἰατρικοί., p.13) reports Athenaeus’ definition of the prokatarctic cause under the heading for the “synectic cause.”  From the BIU Santé / Université Paris Déscartes.

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The misplaced definition is found in the 15th c. British Library’s Add ms. 11888 f.9r

What Athenaeus is supposed to have said is the same in the Aldine, BL, and Kühn texts. Still, I can't figure out why someone would have placed it under the definition of the cohesive cause. Is it merely misplaced, as Kühn seems to have thought? Or, did someone think—whoever composed the text followed by Aldus and the BL ms.—Athenaeus identified cohesive and antecedent causes?

An ambiguous reference in [Galen] Medical Definitions 31 (XIX 356K)

This problem was first brought to my attention by David Leith in a paper he gave on Athenaeus of Attalia’s theory of the elements at Humboldt-Universität in January 2015. His talk inspired me to write this post, and to put together a forum for discussing these kinds of problems as my work on Athenaeus continues. 

The pseudo-Galenic text called the Medical Definitions is one of our main sources for the lost writings of Athenaeus of Attalia. Normally, I am happy if a source has one direct quotation or excerpt from Athenaeus’ works. The Definitions has three.

Athenaeus of Attalia was a physician from the 1st c. BCE. For a time, he likely practiced medicine in Anatolia, where he became a student of the Stoic natural philosopher, Posidonius. At some point, he may have moved to Rome, but waters here are murky. All we know for sure is that he was most well known for the ancient medical school he is said to have founded. Known as the Pneumatic School, those reported to be its adherents combined Hippocratic medicine with Stoic ontology and epistemology; they read and engaged with the biological writings of Aristotle and Theophrastus; and they had close ties with Empiricism and / or Methodism. In many ways, the Pneumatic “school” manifests the kind of eclecticism we typically associate with Galen. From what we are told about him by our sources, this eclectic approach to medicine was already present in the writings of Athenaeus.

But Athenaeus’ major work, On Remedies (ΠΕΡΙ ΒΟΗΤΗΜΑΤΩΝ), is lost. Anything we know about it is known only through fragments—some excerpts preserved in later authors like Oribasius and Aëtius—and second-hand reports in Galen, the pseudo-Galenic Introduction or the Physician, and the Medical Definitions. And right now I am trying to figure out how much our sources can tell us about this lost work.

Of all these sources, the Definitions is special. It’s not only the quantity of direct quotations—which is great—but their content that is exciting. Definitions are a special kind of testimony. As the author of the Definitions tells us at the beginning his work, all the definitions collected and written down were chosen because physicians and philosophers used them as starting-points for thinking and teaching about science and medicine. As starting-points, these definitions can help us to figure out the shape of their thought. And so any definitions attributed to Athenaeus give us a good place from which to reconstruct his medical views, as well. 

The Definitions also help us understand the medical and philosophical context Athenaeus was working in. Among the hundreds of unattributed definitions recorded in the text, there are a few I'm pretty sure were written by Athenaeus (or at least by some people sympathetic to his views);  there are many other definitions written by thinkers who are hostile to him. These nameless and hidden fragments still manifest traces of the debates going on between various natural philosophers and physicians concerning the nature of the human body, of health and disease, and of the structure of science.

The Definitions, however, is a difficult text to use. If you can do your research without it, many scholars will tell you it is best to avoid it. The text of the Definitions is in bad shape. Bits and pieces were continually being added, removed, or shuffled around. And the result is a text that varies a lot from edition to edition. Kühn's text, which is a de facto standard, is especially problematic, since you would have no idea from reading it that the problem even exists. And even with an edition, centuries of corruption may have made impossible to tell what the author (or collator or editor) of the Definitions meant to attribute to particular authors. 

One example of this kind of problem was discussed by David Leith in his talk at the Pneumatist workshop at Topoi, which he also organized with Orly Lewis and me. It is Definition 31, the definition of “element,”  attributed to Athenaeus. Kühn’s text reads:

“31. (i) An element is the first and simplest thing out of which everything has come to be and the simplest and final thing into which everything resolves. And Athenaeus of Attaleia in the third book speaks in this way. (ii) The elements of medicine are just what some of the ancients held, the hot, the cold, the moist and the dry, the first apparent simplest and smallest things out of which humans are composed, and the last apparent simplest and smallest things into which they have their resolution.”

λαʹ. Στοιχεῖόν ἐστιν ἐξ οὗ πρώτου καὶ ἁπλουστάτου τὰ πάντα γέγονε καὶ εἰς ὃ ἁπλούστατον τὰ πάντα ἀναλυθήσεται ὂν ἔσχατον. καὶ Ἀθηναῖος ὁ Ἀτταλεὺς ἐν τῷ τρίτῳ βιβλίῳ φησὶν οὕτως. στοιχεῖα τῆς ἰατρικῆς ἐστι καθάπερ τινὲς τῶν ἀρχαίων ὑπέλαβον, τὸ θερμὸν καὶ τὸ ψυχρὸν καὶ τὸ ὑγρὸν καὶ τὸ ξηρὸν, ἐξ ὧν πρώτων φαινομένων καὶ ἁπλουστάτων καὶ ἐλαχίστων ὁ ἄνθρωπος συνέστηκε· καὶ εἰς ἃ ἔσχατα φαινόμενα καὶ ἁπλούστατα καὶ ἐλάχιστα τὴν ἀνάλυσιν λαμβάνει.

[Galen], Definitiones 31, XIX 356 K

As David pointed out, the way the text is written, it’s ambiguous whether Athenaeus is supposed to have given the first definition (i. of “element”), or the second definition (ii. of “the elements of medicine”). If Athenaeus goes with the first (i. of “element”), it would be a bit strange: why would the author have bothered attributing such a general definition to anyone? It’s a pretty standard Hellenistic definition, and Chrysippus or Zeno could equally well have been cited. If “Athenaeus” goes with the second definition (ii. of “elements of medicine”), then we at least have a reason why Athenaeus (and not someone else) is mentioned (he was a physician). And David believes this definition can actually tell us quite a bit about Athenaeus’ views —about how he saw himself in relation to the “ancients”, about his epistemology, and about his theory of elements. The definition also lets us compare him to other philosophers and physicians to see where he fits in the doxography. And that can tell us a bit more about his context. 

“καὶ Ἀθηναῖος ὁ Ἀτταλεὺς ἐν τῷ τρίτῳ βιβλίῳ φησὶν οὕτως.”

It would be great if it turned out Athenaeus gave the second definition. And it would be strange if the author of the Definitions singled Athenaeus out as the author of the first one. When I looked through the literature, I expected to find lots of different views on the question. It turns out, no one has bothered to make a case for attributing either definition to Athenaeus. Even Wellmann leaves it totally vague. He mentions in a note that Athenaeus’ definition follows the Stoics (“Seine Definition von στοιχεῖον (Gal. XIX 356) ist durchaus stoisch. Vgl. Diog. Laert. VII 136”, DPnS,133n5), but both (i) and (ii) could be said to be in line with the Stoics for different reasons. The selection from Diogenes Laertius which Wellmann cites could also be used to support either interpretation. Did Wellmann think both were Athenaean? And would looking at texts other than Kühn be of any help?

Checking the Aldine

Looking at the Aldine edition of Galen from 1525, the same ambiguity appears:

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The 1525 Aldine edition of Galen doesn't make it any clearer what Athenaeus was supposed to have said. From the BIU Santé / Université Paris Déscartes

The Aldine text of this definition is quite similar to Kühn’s. And like in the Kühn text, Athenaeus’ assertion is followed by the adverb, οὕτως, which normally looks forward to what comes next. So, it's pretty reasonable to think that already in the Aldine, the author attributed the second definition, about the elements of medicine, to Athenaeus. 

But, this isn’t conclusive. David suggested that perhaps both definitions are being attributed to Athenaeus: they make up a kind of definition-pair. I learned a great deal from David’s paper, and I’m mostly convinced by it; but, the 15th c. manuscript of the Definitions which David consulted for his talk has made me a bit worried.

A surprise from Nikolaos 

The manuscript is British Library Add. MS 11888. It seems to remove the ambiguity of attribution in a pretty surprising way. The scribe, named “Νικόλαος”, seems to have attributed only the first definition to Athenaeus. 

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David Leith's tricky case -- British Library Add MSS 11888 f.2v

Not only does he seem to have taken Athenaeus’ name with the former definition, but he also split the definitions of “element” and “elements of medicine” into different sections. (At least this is what it looks like to me.)

This doesn’t conclusively show that the second definition isn't from Athenaeus. Maybe our scribe copied something like the Aldine text, where both definitions were together, but assumed these definitions had been incorrectly combined and helpfully split them up again, adding question titles. Then again, it is possible that the question titles and divisions were original, and that later scribes removed them to save space. Once the titles were removed, it’s easy to see how the two definitions might be run together. 

This leaves me with a bit of a puzzle concerning the Definitions on Athenaeus on the elements. It’s got to be more than a coincidence that Athenaeus’ is the only definition recorded, and that both fit with things he is reported to have said elsewhere. But I’m curious if there are any other earlier sources for the Definitions that might help lead to a solution?