“Implausible explanations of things that don’t happen”: Galen on Sabinus on first times

Galen talks about ancient readings, his critics, the difference between conversational and written commentary, and why he sometimes feels he has to write as much as he does.

He’s arguing against a reading of Hippocrates by Sabinus. Now Sabinus is a Hippocratic commentator, roughly contemporary with Galen, maybe a generation or two before. Galen sometimes refers to him directly, sometimes he refers to his circle. It’s not clear whether there’s anything to this. Galen thinks Sabinus’ commentaries, along with those of Rufus of Ephesus and Numisianus, are worth reading—high praise from Galen—, but here he takes issue with his comments on an aphorism about sex and gassy bellies. I’m not sure I’ve totally understood what Galen is saying about why Sabinus thinks the passage is about people just starting to have sex, but Galen thinks this is wrong. It’s not impossible that Hippocrates wrote what Sabinus thinks, however, and so Galen needs to defend his reading in another way, namely by appealing to experience. What Sabinus attributes to Hippocrates never happens, at least according to Galen, and since it doesn’t happen, it’s not something Hippocrates is likely to have said.

Thanks to David and Peter for help with the translation.

Here’s the aphorism as recorded in Wenkebach’s text (it’s different from Littré and Smith, which I also inlcude):

“For some, the belly becomes gassy when they have sex, like Damnagoras; for others, a noise in them, like Arcesilaus.”

Οἷσιν, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστὴρ ὡς Δαμναγόρᾳ, οἷσι δ' ἐν τούτοισι ψόφος <ὡς> Ἀρκεσιλάῳ.

Epidemics 6.3.12 (136,11–13 Wenkebach-Pfaff)

6.3.5 (3.5 V 294,7–8 Littré) οἷσιν, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστὴρ, ὡς Δαμναγόρᾳ· οἷσι δ' ἐν τούτῳ ψόφος, Ἀρκεσιλάῳ δὲ καὶ ᾤδεεν. Τὸ φυσῶδες ξυναίτιον τοῖσι πιτυρώδεσι, καὶ γάρ εἰσι φυσώδεες.

6.3.5 (236,18–21 Smith) ἔστιν οἷσιν ὅταν ἀφροδισιάζωσι φυσᾶται ἡ γαστὴρ, ὡς Δαμναγόρᾳ, οἷσι δ' ἐν τούτῳ ψόφος. Ἀρκεσιλάῳ δὲ καὶ ᾤδει. τὸ φυσῶδες ξυναίτιον τοῖσι πτερυγώδεσι, καὶ γάρ εἰσι φυσώδεις.

And here is Galen’s commentary:

‘Different people write the passage in different ways, and some add to it the phrase “when they begin”, leaving out the “for some” at the beginning and composing the sentence like this: “when they begin to have sex, the belly becomes gassy”. They want it to say that those who are beginning to have sex, i.e., those who are first trying out this activity, suffer what was indicated in the passage that follows. Now, no ancient book or commentator knows this reading. Nevertheless, Sabinus’ circle says his [i.e. Hippocrates’] account is about those beginning to have sex, even though Hippocrates mentioned one man by name, Damnagoras. This is something he usually does when he goes through something that happens only to a few people. And without anything written about these things by Hippocrates, one should have learned about the phenomenon from experience. For it is not the case that those who are beginning to have sex suffer intestines filled with gas or have a noise contained in them; it is rather that, in rare cases, some of those past their prime and who have the affection called flatulent, hypochondriac and melancholic, more often suffer from intestines filled with gas when they have sex. These same people also have a constant desire for sex.

“Well then, I have said it before many times already: whether I neglect the readings which others have offered in this passage, or whether I talk about them all, there are many people who will find fault with either of them, since they judge the appropriate length of the discussion by their own desires, not the nature of the subject matter. And of course even if I should talk about some things that have been said or written down, and leave out others, even then some of them will blame me because I should have left out some of the things that I discussed since they are clearly frivolous, while I should have discussed some of the things I left out since they are not inferior to what I did discuss. For in our day-to-day intercourse, once we have found out from those present what kind of explanation they want to hear from us, we try to adapt it [sc. the explanation] to their wishes. In a book, however, this is not possible to do. That is why in the majority of passages I generally chose not to mention variants from the ancient reading or interpretations that are altogether unusual. In some cases, however, either when the transmitted text is not altogether implausible *** The readers should keep the commentaries in mind, to mention them in each passage they are burdensome *** [the text is problematic].

‘Sabinus’ circle, then, said that those who attempt sex for the first time suffer what was described in the passage, and assuming this is true, they try to explain the cause of it; but contrary to them, some took [ἐποιήσαντο] this reading of the passage: “it is the case for some that when they have sex, the belly becomes gassy.” Those in Sabinus’ circle say, not without reason, that this happens to those who are beginning to have sex. First, <they say> big and strange changes are happening to the body (for they write like this), and because of these strange changes, epilepsy and nephritis and other chronic conditions affect them. And then <they say> that Democritus said, “man springs from man in sexual intercourse” [DK 32B]. And so for this reason, they say, there is a great deal of irritation since they are unaccustomed to semen and they are affected by the acridity; and in fact the account is common, so they say, to both women and men, and they say the cause in the case of women is clear. For the intestines lie under the womb, while the bladder lies on top of it. It is likely, then, that it holds back the excretion from both when it is stretched and engorged; and so, since the gas is continually stopped up inside, she suffers a build-up of pneuma, and since the urine is stopped, the area around the belly becomes swollen. This, then, is what Sabinus’ circle says, giving implausible explanations of things that do not happen. For these things do not happen to young people when they begin having sex, but to those called melancholic and flatulent, who experience these kinds of things after they are past their prime. For generally being filled with gas occurs because of weakness of the natural heat; when this is strong, none of these things happens.

‘In the Problemata, Aristotle also inquires into the cause on account of which melancholics are sexually excited, and he says they have a lot of gassy pneuma that collects in their hypochondrion, which is why these kinds of affection are called pneumatic and hypochondriac, and both Diocles and Pleistonicus and many other doctors say this is how they are called. It would not be a bad idea to mention a passage from what was written by Aristotle, which goes like this: “Why are melancholics sexually excited? Is it because they are full of pneuma? For semen is an outlet for pneuma. Thus, for this reason when there is much of it, necessarily one often desires to be purged, for then they are relieved” [Problemata 4.30, 880a30-33]. Thus, also for this reason, Rufus chose to write “fear” instead of “noise”, so that Hippocrates’ discussion would be about melancholics, for whom fear is particularly specific. For while their fears are different, there is always some one thing for each of them when they are moderately depressed, otherwise there are two or more, or very many, for some of them even everything. Thus, according to Rufus, the passage will be as follows: “for some, when they have sex, the belly becomes gassy, as for Damnagoras, while for some there is fear in them”; but according to the ancient commentators, it is as it has been written at the start, for I always add their reading, even if it seems to be in error according to the first copyists. For as I have said many times already, once we have said how it was discovered to have been written, we should right away offer some interpretation in addition indicating this very thing. The interpretation of Sabinus’ circle has been discussed.

‘Kapito however wrote it in this way: “It is the case for some, when they have sex, the belly becomes gassy, as for Damnagoras, while for some there is a noise in them.” Dioscorides in this way: “while for some, when they have sex, the belly becomes gassy, as for Damnagoras, for some there is a noise in them.” For he left out the letter delta. Actually, none of the interpreters agree with one another on the interpretation of the word “noise”, some saying it means intestinal rumbling, some belching, some passing gas downwards, some whichever of these is simplest, whatever movement in the intestines is perceptible to hearing, for there are some other motions and “sounds” in the intestines beyond intestinal rumbling, some like echoes, some like hissing or some such manner of noise.

‘“For Arcesilaus, it also used to become swollen.” “For Arcesilaus”, he says, not only did “the belly used to be gassy”, but also “swollen”, i.e., he had an oedema. I have said already many times that he calls all masses that are contrary to nature “oedema”, whether they are inflammatory, erysipelic, or like a hardened swelling; the moderns, however, call only the spongy mass an “oedema”. But just what kind of mass he said Arcesilaus developed is no small inquiry. He seems to me to have meant what is specifically termed such by the moderns. It is implausible that he developed an erysipelas or inflammation or hardened swelling or some other such thing around the time of sexual activities or a little later, and again in addition to not establishing it much. This whole problem has been left out by the commentators. Nevertheless, Hippocrates mentions this Arcesliaus in another place in the book, where he says: “at the onset of this, it is the case that some pass gass, like Arcesilaus.” And so it is clear that for such people the belly is full of gas and that it is caused to be emitted by the tension that arises during sex. Dioscorides wrote the passage in this way: “But for Arcesilaus bad gassiness swelled up” instead of “the gassiness smelled bad”, wanting it to be written in this way, while everyone else begins the second passage with “the gassiness”, as it is written next.’

Καὶ ταύτην τὴν ῥῆσιν ἄλλος ἄλλως γράφει καί τινες προστιθέασιν αὐτῇ τὸ “ὅταν ἄρχωνται”, τὸ κατὰ τὴν ἀρχὴν εἰρημένον «οἷσιν» ἀφαιροῦντες καὶ ποιοῦντες τὴν λέξιν τοιαύτην· “ὅταν ἄρχωνται «ἀφροδισιάζειν, φυσᾶται ἡ γαστήρ»”, βουλόμενοι τοὺς ἀρχομένους ἀφροδισίων, τουτέστι τοὺς πρῶτον ἐπιχειροῦντας τῷ ἔργῳ τούτῳ, πάσχειν τὰ διὰ τῆς ῥήσεως ἐφεξῆς δηλούμενα. καίτοι τὴν γραφὴν ταύτην οὔτε βιβλίον | τι παλαιὸν οὔτ' ἐξηγητὴς οἶδεν. ἀλλ' ὅμως οἱ περὶ τὸν Σαβῖνον ἐπὶ τῶν ἀρχομένων ἀφροδισιάζειν τὸν λόγον αὐτῷ εἶναί φασι, καίτοι μνημονεύσαντος αὐτονομαστὶ τοῦ Ἱπποκράτους ἑνὸς ἀνθρώπου, τοῦ Δαμναγόρου. τοῦτο δ' εἴωθε ποιεῖν, ὅταν ὀλίγοις τισὶ γινόμενον πρᾶγμα διέρχηται. καὶ χωρὶς δὲ τοῦ γεγράφθαι τι περὶ τούτων Ἱπποκράτει τὸ φαινόμενον ἐχρῆν ἐκ τῆς πείρας μαθεῖν. οὐ γὰρ συμβαίνει τοῖς ἀρχομένοις ἀφροδισίων «ἐμφυσᾶσθαι» τὴν κοιλίαν ἢ «ψόφον» ἴσχειν ἐν αὐτῇ, ἀλλὰ μᾶλλον ἐνίοις ἐν τῷ σπανίῳ τῶν παρακμαζόντων τε καὶ τὸ καλούμενον πάθημα φυσῶδές τε καὶ ὑποχονδριακὸν καὶ μελαγχολικὸν ἐχόντων «ἐμφυσᾶσθαι» συμβαίνει μᾶλλον «τὴν γαστέρα», ὅταν «ἀφροδισίοις» χρήσωνται. τοῖς δ' αὐτοῖς τού<τοις> ὑπάρχει καὶ τὸ συνεχῶς ὀρέγεσθαι μίξεως.

ὅπερ οὖν πολλάκις ἤδη πρόσθεν εἶπον, ἐάν τε παραλείπω τὰς γραφὰς ἃς ἐποιήσαντο κατὰ τήνδε τὴν ῥῆσιν, ἐάν τ' εἴπω πάσας, ἑκατέρῳ μέμψονται πολλοὶ ταῖς ἑαυτῶν ἐπιθυμίαις κρίνοντες τὸ σύμμετρον ἐν τοῖς λόγοις, οὐ τῇ τῶν πραγμάτων φύσει. καὶ μέντοι κἄν | τινα μὲν εἴπω τῶν εἰρημένων τε καὶ γεγραμμένων, τινὰ <δὲ> παραλείπω, καὶ οὕτως ἔσονταί τινες οἱ μεμψάμενοί τινα μὲν τῶν εἰρημένων ὡς ἐχρῆν παραλελεῖφθαι καὶ ταῦτα ληρώδη γε ὄντα, τινὰ δὲ τῶν παραλελειμμένων ὡς ἐχρῆν εἰρῆσθαι μὴ χείρω τῶν εἰρημένων ὄντα. κατὰ μὲν γὰρ τὰς ὁσημέραι γινομένας συνουσίας ὁποίαν τινὰ βούλονται τὴν ἐξήγησιν ἀκούειν οἱ παρόντες, αὐτῶν ἐκείνων πυθόμενοι ἁρμόττεσθαι πειρῶνται ταῖς βουλήσεσιν αὐτῶν. ἐν βιβλίῳ δ' οὐκ ἔστι πρᾶξαι τοῦτο. διόπερ εἱλόμην ἐν μὲν ταῖς πλείσταις τῶν ῥήσεων ἢ μηδ' ὅλως μνημονεύειν τῶν ὑπαλλαττόντων τὴν ἀρχαίαν γραφὴν ἢ παντάπασιν ἀλλοκότως ἐξηγησαμένων. ἐπί τινων δ' ἤτοι τὰ μὴ παντάπασιν ἀπιθάνως εἰρημένα *** μεμνῆσθαι χρὴ τοὺς ἀναγινώσκοντας τὰ ὑπομνήματα καθ' ἑκάστην <γὰρ> τὴν ῥῆσιν ἀναμιμνῄσκειν αὐτῶν ἐπαχθές.

ὅπερ οὖν ἔλεγον οἱ μὲν περὶ τὸν Σαβῖνον ὡς τοῖς πρῴην τῶν ἀφροδισίων πειρωμένοις συμβαίνει τὰ κατὰ τὴν ῥῆσιν εἰρημένα πάσχειν, ὡς ἀληθὲς ὑποθέμενοι πειρῶνται λέγειν τὴν αἰτίαν αὐτοῦ. τινὲς δ' | ἔμπαλιν τοῖσδε τὴν γραφὴν τῆς λέξεως ἐποιήσαντο τοιάνδε· “εἰσὶν «οἷσιν, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστήρ».” οἱ μὲν περὶ τὸν Σαβῖνον οὐκ ἀλόγως φασὶ τοῖς ἀφροδισιάζειν ἀρχομένοις τοῦτο συμβαίνειν· πρῶτον μὲν ὅτι μέγας ὁ ξενισμὸς γίνεται περὶ τὸ σῶμα (γράφουσι γὰρ οὕτως αὐτοί), δι' ὃν ξενισμόν φασιν ἐπιληψίαν τε καὶ νεφρίτιδας αὐτοῖς ἕτερά τε χρόνια γίνεσθαι· ἔπειτα δὲ καὶ ὅτι <Δημόκριτος> εἶπεν “ἄνθρωπον ἐξ ἀνθρώπου ἐν ταῖς συνουσίαις ἐκθόρνυσθαι”. καὶ μέντοι καὶ διότι φασὶ πολὺν ὀδαξησμὸν διὰ τὴν ἀήθειαν τοῦ θοροῦ καὶ τὴν δριμύτητα πάσχουσι, καὶ κοινοῦ γε, ὡς λέγουσιν, ὄντος τοῦ λόγου θηλειῶν τε καὶ ἀρρένων, ἐπὶ θηλειῶν φασι σαφῆ τὴν αἰτίαν εἶναι· τῇ γὰρ ὑστέρᾳ τὸ μὲν ἔντερον ὑπεστόρεσται , ἡ κύστις δ' ἐπίκειται· εἰκὸς οὖν ἐντεινομένην αὐτὴν καὶ σφριγῶσαν ἐπέχειν τὴν ἀμφοτέρων ἀπόκρισιν· ἐναπολαμβανομένης οὖν τῆς φύσης συνεχῶς ἐμπνευματοῦσθαι καὶ τοῦ οὔρου δὲ κατεχομένου τὸ ἐπιγάστριον οἰδεῖν. ταῦτα μὲν οὖν οἱ περὶ τὸν Σαβῖνον λέγουσιν, ἀπιθάνους αἰτίας ἀποδιδόντες τῶν μὴ γινομένων. οὐ γὰρ συμβαίνει ταῦτα τοῖς ἀρχομένοις ἀφροδισίων μειρακίοις, ἀλλὰ τοῖς μελαγχολικοῖς καὶ φυσώδεσιν ὀνομαζομένοις, οἳ καὶ μετὰ τὴν παρακμαστικὴν ἡλικίαν τὰ τοιαῦτα πάσχουσιν. ὅλως γὰρ τὸ φύσης ἐμπίπλασθαι δι' ἀσθένειαν γίνεται τῆς ἐμφύτου θερμάσιας. ἐρρωμένης γὰρ ταύτης τῶν τοιούτων οὐδὲν συμβαίνει.

Ἀριστοτέλης δ' ἐν τοῖς Προβλήμασι καὶ τὴν αἰτίαν ζητεῖ, δι' ἣν ἀφροδισιαστικοὺς συμβαίνει γίνεσθαι τοὺς μελαγχολικούς, ἀθροίζεσθαί τε πνεῦμά φησιν αὐτοῖς ἐν ὑποχονδρίοις φυσῶδες οὐκ ὀλίγον, διὸ πνευματώδη τε καὶ ὑποχονδριακὰ προσαγορεύεσθαι τὰ τοιαῦτα πάθη, καὶ <Διοκλῆς> δὲ καὶ <Πλειστόνικος> ἕτεροί τε πολλοὶ τῶν ἰατρῶν οὕτως ὀνομάζεσθαί φασιν αὐτά. οὐ χεῖρον δὲ καὶ λέξιν τινὰ τῶν τῷ Ἀριστοτέλει γεγραμμένων εἰπεῖν ἔχουσαν ὧδε· “διὰ τί οἱ μελαγχολικοί <εἰσιν> ἀφροδισιαστικοί; ἢ ὅτι πνευματώδεις. τὸ γὰρ σπέρμα πνεύματος ἔξοδός ἐστι. διότι οὖν πολὺ τὸ τοιοῦτον, ἀνάγκη πολλάκις ἐπιθυμεῖν καθαίρεσθαι, κουφίζονται γάρ.” διὰ τοῦτ' οὖν καὶ Ῥοῦφος [ἔλεγεν] ἀντὶ τοῦ «ψόφος» εἵλετο γρά|φειν “φόβος”, ἵνα ὁ λόγος ᾖ τῷ Ἱπποκράτει περὶ τῶν μελαγχολικῶν, οἷς ἐστιν ἰδιαίτατος ὁ φόβος· ἄλλῳ μὲν γὰρ ἄλλο φοβερόν, ἓν γοῦν τι πάντως καθ' ἕκαστον αὐτῶν, ὅταν γε τὰ μέτρια δυσθυμῶσιν, εἰ δὲ μή, καὶ δύο καὶ πλείω καὶ πάνυ πολλὰ καί τισιν αὐτῶν ἅπαντα. γενήσεται <δ'> οὖν κατὰ μὲν τὸν <Ῥοῦφον> ἡ λέξις οὕτως ἔχουσα· «οἷσιν, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστήρ, ὡς Δαμναγόρᾳ, οἷσι δ' ἐν τούτοις ὁ φόβος»· κατὰ δὲ τοὺς παλαιοὺς ἐξηγητάς, ὡς ἐν ἀρχῇ γέγραπται, τὴν γὰρ ἐκείνων γραφὴν ἀεὶ προστίθημι, κἂν ἡμαρτῆσθαι δοκῇ κατὰ τοὺς πρώτους ἀντιγραψαμένους. ἄμεινον γάρ, ὡς εἶπον ἤδη πολλάκις, ὅπως εὑρέθη γεγραμμένον εἰπόντας, οὕτως ἤδη προσεπινοεῖν αὐτούς τι δηλοῦντας αὐτὸ τοῦτο. λέλεκται δὲ καὶ ἡ <τῶν> περὶ τὸν Σαβῖνον ἐξήγησις [τε].

Καπίτων δὲ οὕτως ἔγραψεν· ἔστιν «οἷς, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστήρ, ὡς Δαμναγόρᾳ, οἷσι δ' ἐν τούτοισι, ψόφος». Διοσκουρίδης δὲ οὕτως· «οἷσι μὲν, ὅταν | ἀφροδισιάζωσι, φυσᾶται ἡ γαστήρ, ὡς Δαμναγόρᾳ, οἷσιν ἐν τούτοισι ψόφος». ἀφεῖλε γὰρ οὗτος τὸ δέλτα. οὐ μὴν οὐδὲ κατὰ τὴν ἐξήγησιν τοῦ «ψόφος» ὀνόματος ὡμολόγησαν ἀλλήλοις οἱ ἐξηγηταί, τινὲς μὲν βορβορυγμὸν δηλοῦσθαι λέγοντες, ἔνιοι δ' ἐρυγήν, ἔνιοι δὲ τὰς κάτω διεξιούσας φύσας, ἔνιοι δ' ὅ τι ἂν ᾖ τούτων ἁπλῶς, ἡτισοῦν ἐν τοῖς ἐντέροις κίνησις αἰσθητὴ ταῖς ἀκοαῖς, εἰσὶ γὰρ καὶ ἄλλαι τινὲς ἔξωθεν τῶν βορβορυγμῶν ἐν τοῖς ἐντέροις κινήσεις τε καὶ «ψόφοι», τινὲς μὲν ἤχοις ἐοικότες, τινὲς δὲ συριγμοῖς ἤ τινι τοιουτοτρόπῳ ψόφῳ

Ἀρκεσιλάῳ δὲ <καὶ ᾤδεε. Ἀρκεσιλάῳ>, φησίν, οὐ μόνον «ἐφυσᾶτο ἡ γαστήρ», ἀλλὰ καὶ «ᾤδει», τουτέστιν οἴδημα εἶχεν. εἴρηκα δὲ ἤδη πολλάκις οἴδημα καλεῖν αὐτὸν ἅπαντα τὸν παρὰ φύσιν ὄγκον, εἴτε φλεγμονώδης εἴτ' ἐρυσιπελατώδης εἴτε σκιρρώδης εἴη, τῶν νεωτέρων μόνον τὸν χαῦνον ὄγκον οἴδημα καλούντων. ἀλλά γε ποῖόν τινα λέγει τὸν ὄγκον γενέσθαι τῷ Ἀρκεσιλάῳ, ζήτημά ἐστιν οὐ μικρόν. ἐμοὶ μὲν οὖν δοκεῖ τὸν ἰδίως ὑπὸ τῶν νεωτέρων ὀνομαζόμενον εἰρη|κέναι. [οὐκ] ἔστι δ' ἀπίθανον ἐρυσίπελας ἢ φλεγμονὴν ἢ σκίρρον ἤ τι τῶν τοιούτων <αὐτῷ> γενέσθαι περὶ τὸν τῶν ἀφροδισίων καιρὸν ἢ σμικρὸν ὕστερον, αὖθίς τε μετ' οὐ πολὺ καθίστασθαι τοῦτο. τοῖς δ' ἐξηγηταῖς ὅλον τοῦτο παραλέλειπται τὸ σκέμμα. τοῦ μέντοι Ἀρκεσιλάου τούτου καὶ καθ' ἕτερον τόπον τοῦ βιβλίου μέμνηται ὁ Ἱπποκράτης, ἔνθα φησίν· “ἐν τῇσι προσόδοισιν <ἔστιν> οἳ <ἀπο->ψοφοῦσιν, ὡς Ἀρκεσίλαος.” εὔδηλον οὖν ὅτι τοῖς τοιούτοις φύσης ἐστὶν ἡ γαστὴρ μεστὴ καὶ ταύτην ὑπὸ τῆς γινομένης συντονίας ἐν τοῖς ἀφροδισίοις ἐκκρίνεσθαι συμβαίνει. Διοσκουρίδης δὲ οὕτως ἔγραψε τὴν ῥῆσιν· “Ἀρκεσιλάῳ δὲ κακὸν ὤδει τὸ φυσῶδες”, ἀντὶ τοῦ “κακὸν ὤζετο τὸ φυσῶδες”, ὡδὶ γεγράφθαι βουλόμενος, οἱ δ' ἄλλοι πάντες ἀρχὴν τῆς δευτέρας ῥήσεως ἐποιήσαντο “τὸ φυσῶδες”, ὡς ἐφεξῆς γέγραπται.

Galen, Commentary on Epidemics 6.3.12, 17B.25–32 K. = 136,11–140,23 Wenkebach-Pfaff

***Wenkebach or Pfaff notes the Arabic translation in the apparatus, which they translated into German:

Ich habe bei einigen Reden erwähnt, was nicht sehr weit vom Unbefriedigenden ist, oder was gesagt wurde, wie es sich nicht gehört, aber doch unverdienterweise gelobt wurde.

“In a few discussions, I have mentioned what was not very far from being unsatisfactory, or what was said in a way that was inappropriate, but undeservedly praised.”

The first part seems to translate “ἐπί τινων δ' ἤτοι τὰ μὴ παντάπασιν ἀπιθάνως εἰρημένα […]” = “in a few discussions, <I have> mentioned what was not very far from being unsatisfactory.” The next part is anyone’s guess, but it probably continued the second disjunct ἢ and a finite verb. Then a new sentence and a question whether μεμνῆσθαι goes with χρὴ or not. μεμνῆσθαι χρὴ τοὺς ἀναγινώσκοντας τὰ ὑπομνήματα, καθ' ἑκάστην <γὰρ> τὴν ῥῆσιν ἀναμιμνῄσκειν αὐτῶν ἐπαχθές or μεμνῆσθαι. χρὴ […] ἀναμιμνῄσκειν. If we try the latter and take out Wenkebach’s “γὰρ”, we have: χρὴ <δὲ?> τοὺς ἀναγινώσκοντας τὰ ὑπομνήματα καθ' ἑκάστην τὴν ῥῆσιν ἀναμιμνῄσκειν αὐτῶν ἐπαχθές. This isn’t totally intelligible, and says something like “it is necessary that those who read commentaries in each passage remember them nuisances.” This obviously isn’t right—I have no idea what to do with ἐπαχθές and I’m not sure if καθ' ἑκάστην τὴν ῥῆσιν goes with ὑπομνήματα or ἀναμιμνῄσκειν. I would like it if the passage says what Wenkebach wants it to say (or what I think he wants it to say), something like “it is necessary for the readers to keep the commentaries in mind, for to recall them in each passage would be burdensome”, but I can’t see how this would work. “Nuisance” (ἐπαχθές) seems to modify “the commentaries” (τὰ ὑπομνήματα)—I can’t see what else it might be doing.

Galen on fear, depression and the health of the body: the story of Maiandros

Taken from a part of Galen’s commentary on Epidemics 6 that is extant in Arabic but not in Greek. I’m following Pfaff’s German translation of the Arabic. Galen is commenting on an aphorism which states that our mental and physical habits—things like daily routine, our home, our sex life and our mental habits—have an effect on our body’s health:

“The kinds of habits that influence our health: diet, shelter, work, sleep, sex, thought.”

ἔθος δὲ, ἐξ οἵων ὑγιαίνομεν, διαίτῃσι, σκέπῃσι, πόνοισιν, ὕπνοισιν, ἀφροδισίοισι, γνώμῃ.

Epidemics 6.8.23

Galen defends and elaborates on the claim using an example from his own experience, where being overcome by emotion led to illness and death.

“I know a great number of people who were overcome by fear of death and whom this fear first made ill and then brought to death. Some were plunged into such fear by a dream; for others, such fear was caused by a premonition, or an omen, or a strange apparition they had, or the fall of a bolt of lightning. Some were brought to it by the sign they found in the entrails of the sacrificial animal, or by an augury of some kind of bird, as happened to the augur, Maiandros. This man was overcome by such a fear of death that he died of it, not to mention the illness he suffered. The story of Maiandros goes like this: he was a man from that part of Mysia which lies near the Hellespont and is a part of our province of Asia. His place of residence in this country was primarily Pergamon. The practice of augury was his occupation. It was his livelihood and his profession. Everyone who consulted him attested to his skill in his occupation. Now it was the custom of this Maiandros every year on his birthday to ask the gods to send him a sign by which he could see how he would fare in the following year. So one year he went out to observe the flight of birds and saw an eagle flying in a way that signified death. It then became certain in his soul that this was a sign from which there was no escape. He went back to the city from the place of the bird’s flight, slumped over, miserable and yellow in colour, so that those who met him asked him whether he was in any physical pain. To those he trusted, he told the truth. Then it came about that he lay sleepless for whole nights and was oppressed by sorrow all day long, so that he completely fell apart. Eventually mild, gentle fevers arose. When the fevers set in, his mind became so confused that he was outside himself and had to stay in bed. Two months after his birthday he died because his body gradually wasted away until it completely dissolved.”

So kenne ich eine große Zahl von Leuten, welche Furcht vor dem Tode überkam und welche diese Furcht zuerst krank machte und dann zu Tode brachte. Manche stürzte ein Traum in solche Furcht. Bei manchen erzeugte solche Furcht eine Ahnung oder ein Vorzeichen oder eine seltsame Erscheinung, die sie hatten, oder das Niedergehen eines Blitzstrahles. Manche brachte dazu das Anzeichen, welches sie in so den Eingeweiden des Opfertieres fanden, oder ein Augurium von irgendwelchen Vögeln, wie es dem Augur Maiandros erging. Diesen Mann überkam eine solche Angst vor dem Tode, daß er schon an ihr starb, ganz abgesehen von der Krankheit. Die Geschichte des Maiandros ist folgende: er war ein Mann aus dem Teile Mysiens, der dem Hellespont nahe liegt, und es ist ein Teil von unserem Lande Asien. Sein Aufenthalt in diesem Lande war meistens Pergamon. Die Ausführung des Auguriums war seine Tätigkeit. Sie war sein Broterwerb und sein Beruf. Jeder, der ihn zu Rate zog, bezeugte ihm seine Fertigkeit in seiner Tätigkeit. Nun war es die Gewohnheit dieses Maiandros, alljährlich an seinem Geburtstag Gott den Allmächtigen und Erhabenen zu bitten, ihm ein Zeichen zu schicken, an dem er erkennen könne, wie es ihm im folgenden Jahre ergehen werde. Und so ging er eines Jahres zur Beobachtung des Vogelfluges hinaus und sah einen Adler, der ih einer Form flog, die den Tod bedeutet. Da ward es ihm in seiner Seele gewiß, daß dies ein Zeichen sei, vor dem es kein Entrinnen gebe. Da ging er von dem Ort des Vogelfluges zusammengesunken, elend und gelb von Farbe nach der Stadt zurück, so daß diejenigen, welche ihm begegneten, ihn fragten, ob er irgend einen körperlichen Schmerz habe. Zu wem er Vertrauen hatte, sagte er die Wahrheit. Dann stellte es sich ein, daß er ganze Nächte schlaflos lag und ihn auch den ganzen Tag der Kummer bedrückte, so daß er ganz zerfiel. Schließlich traten leichte, sanfte Fieber auf. Als die Fieber sich einstellten, wurde sein Geist so verwirrt, daß er überhaupt nicht mehr bei sich war und das Bett hüten mußte. Zwei Monate nach seinem Geburtstage starb er dadurch, daß sein Körper allmählich dahin schwand, bis er sich ganz auflöste.

Galen, Commentary on Hippocrates‘ Epidemics 6.8, 485,25-486,12 Wenkebach/Pfaff

Nicknames

I

Satyros from Thasos, nicknamed Griffinfox (Γρυπαλώπηξ).* When he was around 25 years old, he started having frequent wet dreams. It happened to him often during the day, as well. Around the time he turned 30, he became consumptive and died.

Σάτυρος ἐν Θάσῳ παρωνύμιον ἐκαλεῖτο Γρυπαλώπηξ* περὶ ἔτεα ἐὼν πέντε καὶ εἴκοσιν, ἐξωνείρωσσε πολλάκις. προῄει δ’ αὐτῷ καὶ δι’ ἡμέρης πλεονάκις· γενόμενος δὲ περὶ ἔτεα τριήκοντα φθινώδης ἐγένετο καὶ ἀπέθανεν.

Hippocrates, Epidemics 6.8.29, 5.354 Littré (nb: I’ve given Smith’s text)

Στρυμάργου: Dioscorides knows this reading, as well—not only Στομάργου [see IV below]. He doesn’t interpret this one as a proper name, either; instead, he says it indicates someone with manic excitement about sex. For many other epithets are also mentioned in Hippocrates in the same way, like Μυοχάνη, Σαράπους, Γρυπαλώπηξ.* But even in Erasistratos, he says, [we find] ῥινοκολοῦρος.

Στρυμάργου: οἶδε καὶ ταύτην τὴν γραφὴν ὁ Διοσκουρίδης, οὐ μόνον τὴν Στομάργου, ἀλλὰ καὶ τοῦτο οὐχ ὡς κύριον ὄνομα ἐξηγεῖται, ἀλλὰ τὸν μανικῶς ἐπτοημένον, περὶ τὰ ἀφροδίσια δηλοῦσθαί φησιν. εἰρῆσθαι γὰρ παρὰ τῷ Ἱπποκράτει καὶ ἄλλα πολλὰ κατὰ τὸν αὐτὸν τρόπον ἐπίθετα, καθάπερ Μυοχάνη, Σαράπους, Γρυπαλώπηξ. ἀλλὰ καὶ παρ' Ἐρασιστράτῳ φησὶν ὁ ῥινοκολοῦρος.

Galen, Glossary of Hippocrates’ Terminology, 19.142 K.

*γρυπαλώπηξ: γρύψ (griffin) + ἀλώπηξ (fox). γρύψ enters English as both the griffin and the wyvern, a bipedal dragon.

II

Raw and liquid feces are checked with solid millet cooked in oil—like the sailor-boy and <Myriochaune or the woman with her mouth open or> the joking-woman.

Τὰ ὠμὰ διαχωρήματα καὶ ὑγρὰ κέγχρος στερεὸς ἐν ἐλαίῳ ἑφθὸς ἵστησιν, οἷον τὸ ναυτοπαίδιον, καὶ ἡ Μυριοχαύνη.

Hippocrates, Epidemics 2.1.12, 5.82 Littré (Smith’s text)

Μηριοχάνη: a woman's name.

†Μηριοχάνη· ὄνομα γυναικός.

Erotian, Collection of Words used by Hippocrates, μ 2 (59,8 Nachmanson)

Μυοχάνη: epithet of a woman with her mouth open. But if Μυριοχαύνη is written, she would be a woman who makes lots of jokes.

Μυοχάνη: ἐπίθετον χασκούσης. εἰ δὲ Μυριοχαύνη γράφοιτο, ἡ ἐπὶ μυρίοις ἂν εἴη χαινουμένη.

Galen, Glossary of Hippocrates’ Terminology, 19.142 K.

III

Serapis <or the woman with her toes splayed> was swollen from a moist belly. Itching started—I don’t know on what day. No progress. She had an abscess in her waist; when it blackened, she died.

Ἡ Σεράπις ἐξ ὑγρῆς κοιλίης ᾤδησεν· κνησμοὶ δ' οὐκ οἶδα ποσταίῃ, οὐ πρόσω· ἔσχε δ’ ἔτι καὶ ἀπόστημα ἐν κενεῶνι, ὅπερ μελανθὲν ἀπέκτεινεν.

Hippocrates, Epidemics 2.2.3, 5.84 Littré (Smith’s text)

Σαράπους: A woman having the toes of her feet spread out and splayed.

Σαράπους: ἡ διασεσηρότας καὶ διεστῶτας ἔχουσα τοὺς δακτύλους τῶν ποδῶν.

Galen, Glossary of Hippocrates’ Terminology, 19.142 K.

IV

And <the Babbling-Woman or> the wife of Stymarges, after a confusion lasting a few days, was very constipated. She aborted a female child after the constipation, was healthy for four months, then became swollen.

Καὶ ἡ Στυμάργεω ἐκ ταραχῆς ὀλιγημέρου πολλὰ στήσασα, καὶ παιδίου μετὰ στάσιν θήλεος ἀποφθορῆς τετραμήνου ὑγιήνασα, ᾤδησεν.

Hippocrates, Epidemics 2.2.4, 5.84-6 Littré (Smith’s text and name for the woman)

Στομάργου: In the second book of the Epidemics, Dioscorides writes as follows: ‘and it refers to manic babbling,’ he says. But others write Στυμάργου and interpret it as a proper name.

Στομάργου: ἐν τῷ δευτέρῳ τῶν ἐπιδημιῶν ὁ Διοσκουρίδης οὕτως γράφει καὶ δηλοῦσθαί φησι τοῦ λαλοῦντος μανικῶς. οἱ δὲ ἄλλοι στυμάργου γράφουσι καὶ ὄνομα κύριον ἀκούουσι.

Galen, Glossary of Hippocrates’ Terminology, 19.141 K.

"When the soul is inflamed", part II

... Galen discusses the opinions of Aristotle, Plato and the Stoics on the relationship between nature, soul, vital breath and innate heat. Some physicians, perhaps the Pneumatists, were interested in finding the Stoic view already articulated by Hippocrates, particularly in a work called On Sevens, and in Epidemics 6, which is being discussed here. I've added paragraph breaks to make the text easier to read. This is a continuation from part i...

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In fact, some of those who wrote commentaries on the book under discussion say the word 'born' was written in the sense of 'becomes better'. They suppose it [sc. the soul] becomes better over time for those who are concerned about science and wisdom. This discussion, however, is neither medical nor is it consistent with what comes next, for it is clear from the following quotation that 'produced' is said about the substance of [the soul]: "when it is inflamed together with disease, the soul also consumes the body." The word 'inflamed' would seem to indicate Hippocrates thinks the substance of the soul is the innate heat, which he uses as a cause of natural activities in many other places.

On this point, there is also a great difference of opinion among philosophers. Some believe the substance of the soul and of nature are identical, some of these ones positing its existence in pneuma, others in a specific quality of the body. Certain people think it is not one substance, but claim each of them is distinct and differ not just in a small way in species, but wholly in kind. In this case, they think that the substance of nature is perishable, while that of the soul is imperishable.

Now, Aristotle and Plato introduce both capacities using one word, not only calling that by which we think and remember 'soul', but also the capacity in plants by which they are nourished, increased and preserved until they dry out over time. For the Stoics, on the other hand, it is customary to refer 'nature' to that by which plants are governed, 'soul' that by which animals are. They posit that the substance of both is the co-natural pneuma, and they think these differ from each other by quality: the pneuma of the soul is drier, that of nature more moist, but both require not only food in order to persist, but also air.

Whoever thinks the person who introduced this opinion is Hippocrates, according to what was mentioned in On Sevens, say the word 'born' is mentioned concerning the production in them of additional stuff from both substances, of food and air, since it is clearly observable and we know the usefulness of each of them. For it has been proven that respiration preserves the balance of the innate heat, while ingestion of food replenishes the flowing-out of bodily substance. Moreover, if the soul is a kind of form of the body, it would be appropriate to say that 'it is born until death.'  

Now, if there is some other substance, then concerning the one called 'nature', which Aristotle calls 'threptic', Plato 'epithumetic', what was said would be true; but it would not be true in the case of the 'dianoetic' soul. Certainly, that the innate heat, to which Hippocrates very often refers bodily functions, is inflamed, not only when it is no longer able to complete its previous activities or nourish us —which is its most important function—but also when it destroys and consumes like fire does, this is clear to us when we look carefully at the text and when we see the colliquesence of the body produced by excessively hot fevers.

Left out of the whole discussion is the third 'soul' or 'capacity' or whatever you might want to call it, which Plato called 'spirited'. It is good to mention this so that nothing is left out of our discussion about the soul. One kind of innate warmth, by which blood is produced, is contained in the liver. But a different, greater warmth has been received by the heart for the production of emotion. For if there is some use for it, as it has been pointed out in On the Opinions of Hippocrates and Plato, the one warmth needs respiration, the other transpiration. For thus it is customary for doctors to call what occurs through the artery along its whole body a 'double-activity', sending out residues at systole, drawing in outside air at diastole.

τῶν μέντοι γραψάντων ὑπομνήματα τοῦ προκειμένου βιβλίου τινὲς ἀντὶ τοῦ βελτίων γίνεται τὸ «φύεταί» φασιν εἰρῆσθαι. γίνεσθαι δ' αὐτὴν ἐν τῷ χρόνῳ βελτίονα νομίζουσι τοῖς προνοουμένοις ἐπιστήμης τε καὶ σοφίας, ἀλλ' οὔτε ἰατρικὸς ὁ λόγος οὔθ' ὁμολογῶν τοῖς ἐπιφερομένοις. ὅτι γὰρ ἐπὶ τῆς οὐσίας αὐτῆς εἴρηται τὸ «φύεται», δῆλον ἐκ τοῦ φάναι· «ἢν δ' ἐκπυρωθῇ, ἅμα τῇ νούσῳ καὶ ἡ ψυχὴ <καὶ> τὸ σῶμα φέρβεται». καὶ δόξειε δ' ἂν ἐνδείκνυσθαι τὸ «ἐκπυρωθῇ» ῥῆμα τὴν οὐσίαν τῆς ψυχῆς ἡγεῖσθαι τὸν Ἱπποκράτην τὸ ἔμφυτον εἶναι θερμὸν, ὃ καὶ τῶν φυσικῶν ἔργων αἰτιᾶται πολλαχόθι.

μέγιστον δ' ἐνταῦθα κινεῖται δόγμα διαπεφωνημένον καὶ αὐτοῖς τοῖς φιλοσόφοις. ἔνιοι μὲν ἡγοῦνται μίαν οὐσίαν εἶναι ψυχῆς τε καὶ φύσεως, οἱ μὲν ἐν τῷ πνεύματι τιθέμενοι τὴν ὕπαρξιν αὐτῶν, οἱ δ' ἐν τῇ τοῦ σώματος ἰδιότητι. τινὲς δὲ οὐ μίαν, ἀλλ' ἰδίαν ἑκατέρᾳ τὴν οὐσίαν εἶναί φασι καὶ οὐ σμικρῷ γ' <εἴδει> τινὶ διαφερούσας, ἀλλ' ὅλῳ τῷ γένει, ὅπου γε καὶ τὴν μὲν τῆς φύσεως φθαρτὴν εἶναι ἡγοῦνται, τὴν δὲ τῆς ψυχῆς ἄφθαρτον.

Ἀριστοτέλης μὲν οὖν καὶ Πλάτων ὑπὸ μίαν προσηγορίαν ἀμφοτέρας ἄγουσι τὰς δυνάμεις, οὐ μόνον ᾗ λογιζόμεθα καὶ μεμνήμεθα ψυχὴν καλοῦντες, ἀλλὰ καὶ τὴν ἐν τοῖς φυτοῖς, ᾗ τρέφεταί τε καὶ αὔξεται καὶ διασῴζεται, μέχρι περ ἂν ἐν τῷ χρόνῳ ξηρανθῇ. τοῖς Στωϊκοῖς δ' ἔθος ἐστὶ φύσιν μὲν ὀνομάζειν, ᾗ τὰ φυτὰ διοικεῖται, ψυχὴν δὲ ᾗ τὰ ζῷα, τὴν οὐσίαν ἀμφοτέρων μὲν τίθενται τὸ σύμφυτον πνεῦμα καὶ διαφέρειν ἀλλήλων οἴονται ποιότητι. ξηρότερον μὲν γὰρ πνεῦμα τὸ τῆς ψυχῆς, ὑγρότερον δὲ τὸ τῆς φύσεως εἶναι, δεῖσθαι δ' ἄμφω πρὸς διαμονὴν οὐ τροφῆς μόνον, ἀλλὰ καὶ ἀέρος.

καὶ ὅσοι γε τοῦ δόγματος τούτου νομίζουσιν ἡγεμόνα τὸν Ἱπποκράτην γεγονέναι, καθάπερ ἐν τῷ Περὶ ἑβδομάδων εἴρηται, τὸ «φύεσθαι» λέγουσιν εἰρῆσθαι κατὰ τῆς γινομένης ἐν αὐτοῖς προσθέσεως ἐξ ἀμφοτέρων τῶν οὐσιῶν, τῆς τε <τροφῆς καὶ> τοῦ ἀέρος, <ὡς> ἐναργῶς φαίνεται καὶ τὴν ἑκατέρου χρείαν ἐπιστάμεθα (δέδεικται γὰρ ἡ μὲν ἀναπνοὴ τὴν συμμετρίαν τῆς ἐμφύτου θερμασίας φυλάττειν, ἡ δὲ τῶν σιτίων προσφορὰ τὸ διαρρέον τῆς σωματικῆς οὐσίας ἀναπληροῦν) καὶ, εἴπερ εἶδός τι τοῦ σώματός ἐστιν ἡ ψυχή, προσηκόντως ἂν λέγοιτο «φύεσθαι μέχρι τοῦ θανάτου». 

εἰ δ' ἐστὶν ἑτέρα τις αὐτῆς <ἡ> οὐσία, <περὶ ταύτης> τῆς φύσεως, ἣν Ἀριστοτέλης μὲν ὀνομάζει θρεπτικὴν, ἐπιθυμητικὴν δὲ Πλάτων, ἀληθὲς ἂν εἴη τὸ εἰρημένον, οὐκ ἀληθὲς δὲ ἐπὶ τῆς διανοητικῆς ψυχῆς. ὅτι μέντοι τὸ ἔμφυτον θερμόν, ᾧ μάλιστα ἀναφέρει τὰ σωματικὰ τῶν ἔργων ὁ Ἱπποκράτης, ἐκπυρωθὲν οὐ μόνον οὐκέτι δύναται τὰς ἔμπροσθεν ἐνεργείας ἐπιτελεῖν οὐδὲ τρέφειν ἡμᾶς, ὅπερ ἦν ἔργον αὐτῷ κυριώτατον, ἀλλὰ διαφθείρει τε καὶ τήκει καθάπερ τὸ πῦρ, εὔδηλόν ἐστι τῷ λόγῳ σκοπουμένοις ἡμῖν καὶ τὰς <γινομένας> ὑπὸ τῶν διακαῶν πυρετῶν συντήξεις τοῦ σώματος ἐναργῶς ὁρῶσι.

παραλελειμμένης δὲ κατὰ τὸν εἰρημένον λόγον ἅπαντα τῆς τρίτης ψυχῆς ἢ δυνάμεως ἢ ὅπως ἂν ἐθέλῃς ὀνομάζειν αὐτήν, ἣν ὁ Πλάτων ἐκάλει θυμοειδῆ, καὶ περὶ ταύτης ἄμεινόν ἐστιν εἰπεῖν ἕνεκα τοῦ μηδὲν ἔτι ὑπολείπεσθαι κατὰ τὸν περὶ ψυχῆς λόγον. θερμασία μέν τις ἔμφυτος ἐν ἥπατι περιέχεται, καθ' ἣν αἷμα γεννᾶται· θερμασία δὲ ἑτέρα πλείων ἐστὶ κατὰ τὴν καρδίαν εἰς θυμοῦ γένεσιν ἡμῖν δοθεῖσα. καὶ γὰρ <εἰ> χρεία τούτου τίς ἐστιν, ὡς ἐν τοῖς Περὶ τῶν Ἱπποκράτους καὶ Πλάτωνος δογμάτων ἐπιδέδεικται, δεῖται μὲν αὕτη ἡ θερμασία τῆς ἀναπνοῆς, ἡ δ' ἑτέρα τῆς διαπνοῆς. οὕτω γὰρ ὀνομάζειν ἔθος ἐστὶ τοῖς ἰατροῖς τὴν διὰ τῶν ἀρτηριῶν γινομένην καθ' ὅλον τὸ σῶμα διττὴν ἐνέργειαν, ἐκπεμπουσῶν αἰθαλῶδες περίττωμα κατὰ τὴν συστολὴν, ἑλκουσῶν δὲ τὸν πέριξ ἀέρα κατὰ τὴν διαστολήν.

Galen, Commentary on Hippocrates' Epidemics 6, 5.5 (272,10-274,11 Wenkebach = XVIIB 249-253 Kühn)

"When the soul is inflamed", part I

(edit: the sequel can be found here)

While I've been collecting the fragments of Athenaeus of Attalia, I've also been tracking down texts about the Pneumatist school of medicine. They are pretty elusive, and this makes me wonder whether it was a medical 'school' in the normal sense (like the 'Rationalists' , Empiricists', or 'Methodists'). I'm also curious about the idea of 'belonging to a school' and how what it meant to doctors changed during the first and second centuries.

Galen's commentary on Epidemics 6 is a good place to go to with these questions. It contains lots of discussions of people Galen disagrees with, and some of them sound pretty close to people he calls "Pneumatikoi" in other places. He never names them in the commentary, which means I need to file them away as possible testimonies. Still, whether or not the "τινές" – the "some people" – Galen talks about here are Pneumatists, this passage is further evidence that Epidemics 6 and its interpretation was an important locus for the revival of Hippocratean medicine, and for bringing medicine, natural philosophy and ethics closer together.

I'll post this comment on Epidemics 6.5.2 in two parts. The first part deals with medical views on the soul and its relation to pneuma (or spirit), as well as Galen's thoughts on the soul's importance for medicine. The second records the views of Platonists, Aristotelians and Stoics on the soul.

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Lemma: A person's soul is ever born until death, but when the soul is inflamed with disease, it consumes the body.

Ἀνθρώπου ψυχὴ αἰεὶ φύεται μέχρι θανάτου· ἢν δὲ ἐκπυρωθῇ ἅμα τῇ νούσῳ καὶ ἡ ψυχὴ, τὸ σῶμα φέρβεται.

'Hippocrates', Epidemics 6.5.2 (V 314,14-15 Littré)

Galen's Commentary: One needs the power of prophecy more than any method, if one is going to figure out what the person who wrote [the word] "born" intended it to mean. One can take it in the sense of "begotten", like Asclepiades later understood it; or one can take it in the sense of "increased"; or, one can take it, as some people did, in the sense of "preserved", since we engage in nutrition and respiration—for all those who consider the soul to be pneuma say it is preserved by an exhalation of the blood and the air drawn through the trachea into the body during inspiration. Obviously, it is impossible for us to maintain that any of these claims are true, without first having identified the substance of the soul precisely. If, therefore, as in the case of On Sevens, in which the book's author clearly stated his opinion about the substance of the soul, it was likewise mentioned in some of the other books which are agreed to be the genuine works of  Hippocrates, then I would have to say something about the word "born". Since, however, Hippocrates nowhere in the genuine books states his opinion clearly [...Wenkebach marks a lacuna...] whatever the word "produced" means.

In addition to my ignorance about this, I myself am not convinced that I can know the substance of the soul with any certainty. That the brain controls perception and voluntary movement for all the parts of an animal, I have demonstrated in The Opinions of Hippocrates and Plato. I am convinced, moreover, that the pneuma in the ventricles [of the brain] is a primary kind of psychic instrument, which it would be rather rash for me to claim is the substance of the soul. Whether the whole nature of the brain arose out of the mixture of the four elements to form some specific quality of the substance, because of which it becomes the primary source of perception and voluntary movement in animals (and obviously also of imagination, memory and thought), or whether some further incorporeal capacity is fastened to us at the brain by a craftsman and then separated again from us when we are dying, I have no sound demonstration. But I also think that those who have an opinion about this have a larger share than mine of rashness rather than wisdom.

And in fact, I think it is superfluous for doctors to know the substance of the soul. For those who practice the art of medicine in a rational way, it is enough to know that as long as the natural mixture of the brain itself and the pneuma in its ventricles is preserved, then the animal is able to live. When the pneuma in the ventricles is completely destroyed, or is diverted a good deal from its natural mixture along with the substance in the brain, then either psychic disease or death necessarily follow. When the doctor knows these things, he will provide for their good-mixture and for the subsistence <of the pneuma>, always according to the methods we mentioned in the notes on Matters of Health (De sanitate tuenda) and The Therapeutic Method (Methodus medendi), all of which I showed Hippocrates had discovered first.

For this reason, then, I think the present passage is not genuine, but was written by someone, as it were, not too far removed, perhaps even his son Thessalus. They say he strung together his father's writings, which he found written on papyrus, parchment and writing-tablets, and inserted passages like these ones along with them.

Μαντείας δεῖ μᾶλλον ἤ τινος μεθόδου, καθ' ἣν εὑρήσει τις, ὅ τί ποτε σημαίνειν βουληθεὶς ἔγραψε τὸ «φύεται». δύναται μὲν γὰρ ἀκούεσθαι καὶ <ἀντὶ> τοῦ "γεννᾶται", καθάπερ ὁ Ἀσκληπιάδης ὕστερον ὑπέλαβε, δύναται δὲ καὶ <ἀντὶ> τοῦ "αὐξάνεται", δύναται δ', ὥσπερ τινὲς ἤκουσαν, ἀντὶ τοῦ "διασῴζεται", τροφῇ καὶ ἀναπνοῇ χρωμένων ἡμῶν· ὅσοι γὰρ οἴονται τὴν <ψυχὴν> εἶναι πνεῦμα, διασῴζεσθαι λέγουσιν αὐτὴν ἔκ τε τῆς ἀναθυμιάσεως τοῦ αἵματος καὶ τοῦ κατὰ τὴν εἰσπνοὴν <ἀέρος> ἑλκομένου διὰ τῆς τραχείας ἀρτηρίας εἴσω τοῦ σώματος. οὐκ ἄδηλον δ' ἐστὶ καὶ ὡς οὐδὲν ὧν εἶπον ἀποφήνασθαι δυνατὸν ἡμῖν ἐστι διατεινομένοις, ὡς ἀληθὲς εἴη, μὴ πρότερον οὐσίαν ψυχῆς ἀκριβῶς ἐξευροῦσιν. εἰ μὲν οὖν, ὥσπερ ἐν τῷ Περὶ ἑβδομάδων ὁ γράψας τὸ βιβλίον ἐκεῖνο σαφῶς ἀπεφήνατο περὶ ψυχῆς οὐσίας, οὕτως καὶ κατ' ἄλλο τι τῶν ὁμολογουμένων γνησίων Ἱπποκράτους συγγραμμάτων ἦν εἰρημένον, εἶχον ἄν τι κἀγὼ λέγειν περὶ τοῦ «φύεται» ῥήματος. ἐπεὶ δ' οὐδαμόθι τῶν γνησίων βιβλίων Ἱπποκράτης ἀπεφήνατο σαφῶς ***, ὅ τί ποτε σημαίνει τὸ «φύεται» ῥῆμα.

πρὸς δὲ τῷ τοῦτ' ἀγνοεῖν οὐδ' αὐτὸς ἐμαυτὸν πέπεικα ψυχῆς οὐσίαν ἐπίστασθαι βεβαίως. ὅτι μὲν γὰρ ὁ ἐγκέφαλος αἰσθήσεώς τε καὶ κινήσεως τῆς καθ' ὁρμὴν ἡγεμών ἐστι τοῖς τοῦ ζῴου μορίοις ἅπασιν, ἐν τοῖς Περὶ τῶν Ἱπποκράτους καὶ Πλάτωνος δογμάτων ἀποδέδειγμαι. πέπεισμαι <δὲ> καὶ πρός γε τούτῳ τὸ κατὰ τὰς κοιλίας αὐτοῦ πνεῦμα πρῶτόν τι τῶν ὀργάνων εἶναι τῶν ψυχικῶν, ὅπερ ἦν μοι προπετέστερον ἀποφηναμένῳ ψυχῆς οὐσίαν εἰπεῖν. εἴτε δὲ ἡ ὅλη τοῦ ἐγκεφάλου φύσις ἐκ τῆς τῶν τεττάρων στοιχείων κράσεως εἰς τοιαύτην <τῆς> οὐσίας ἦλθεν [ἢ] ἰδιότητα, καθ' ἣν αἰσθήσεώς τε καὶ κινήσεως τῆς καθ' ὁρμὴν ἀρχηγὸς ἔσται τῷ ζῴῳ καὶ δηλονότι <καὶ φαντασίας> καὶ μνήμης τε καὶ νοήσεως, εἴτε τις ἄλλη δύναμις ἀσώματος ὑπὸ τοῦ δημιουργήσαντος ἡμᾶς ἐνδεῖταί τε τῷ ἐγκεφάλῳ καὶ χωρίζεται πάλιν ἀποθνῃσκόντων, οὐδεμίαν ἔχω ἀπόδειξιν βεβαίαν, ἀλλὰ καὶ τοὺς ἀποφηναμένους περὶ τούτων ἡγοῦμαι πλεονεκτεῖν ἐμοῦ προπετείᾳ μᾶλλον ἢ σοφίᾳ.

καὶ μέντοι καὶ περιττὸν εἶναι νομίζω τοῖς ἰατροῖς ἐπίστασθαι ψυχῆς οὐσίαν. ἀρκεῖ γὰρ γινώσκεσθαι τοῖς τὴν ἰατρικὴν τέχνην λογικῶς μεταχειριζομένοις, ὡς, ἡ κατὰ φύσιν κρᾶσις αὐτοῦ τοῦ ἐγκεφάλου καὶ τοῦ κατὰ τὰς κοιλίας αὐτοῦ πνεύματος ἄχρι περ ἂν διασῴζηται, ζῆν δυνάμενον τὸ ζῷον. ἐὰν δὲ ἤτοι τὸ κατὰ τὰς κοιλίας πνεῦμα διαφθαρῇ παντάπασιν ἢ τῆς κατὰ φύσιν κράσεως ἐπὶ πλεῖστον ἐκτραπῇ, μετὰ τῆς κατὰ τὸν ἐγκέφαλον <οὐσίας ἀναγκαῖον αὐτῇ ἢ ψυχικὴν νόσον ἢ θάνατον> ἀκολουθῆσαι. ταῦτα γὰρ γινώσκων ὁ ἰατρὸς τῆς τ' εὐκρασίας αὐτῶν καὶ τῆς ὑπάρξεως προνοήσεται <τοῦ πνεύματος> ἀεὶ κατὰ τὰς εἰρημένας μεθόδους ὑφ' ἡμῶν ἔν τε τοῖς Ὑγιεινοῖς καὶ τοῖς Θεραπευτικοῖς ὑπομνήμασιν, ἃς ἔδειξα πάσας Ἱπποκράτην πρῶτον εὑρηκότα.

διὰ τοῦτ' οὖν οὐδὲ γνησίαν νομίζω τὴν προκειμένην ῥῆσιν εἶναι, παρεγγεγράφθαι δ' ὑπό τινος ὥσπερ καὶ ἄλλας οὐκ ὀλίγας, ἴσως δὲ καὶ τὸν υἱὸν αὐτοῦ Θεσσαλόν, <ὃν> ἀθροῖσαί φασι τὰς ὑπογραφὰς τοῦ πατρὸς εὑρόντα γεγραμμένας ἐν χάρταις τε καὶ διφθέραις καὶ δέλτοις, καὶ τοιαύτας τινὰς παρεντεθεικέναι ῥήσεις.

Galen, Commentary on Hippocrates' Epidemics 6, 5.5 (270,21-272,9 Wenkebach = XVIIB 246-249 Kühn)

Galen on how to avoid kakozelia and sound like Hippocrates

Galen, In Hippocratis Epidemiarum librum 3, commenting on Hippocrates, De morbis popularibus, 3.2.11 (102,26-103,16 Wenkebach = XVIIA 638-9 K)

In my commentary on the Prorrhetikon I already pointed out the reason why what's written there as evidence for these conditions are bad signs. I will mention them now in order to jog our memories, although I'll refrain from writing the same thing again. It says in the Prorrhetikon, "squinting of the eyes that comes from a throbbing of the loins is a bad sign", and so in this passage they [i.e., some other interpreters] recall "the woman" mentioned in the passage in the Prorrhetikon. Surely, as it has been shown, the [signs written down in the Prorrhetikon] are all bad signs, since we know that, generally speaking, a squinting of the eyes is not a good sign, whether it comes from a sudden throbbing of the loins or anywhere else, in addition to the fact that the passage is written with bad style and is far from Hippocrates' diction. For [Hippocrates] would not say, "from a throbbing of the loins", but as he does in the text of the Prognostics, "the pains with fever arise about the lower back and the lower places."

τὰ δ' ὡς μαρτυροῦντα τούτοις ἐν τῷ Προρρητικῷ γεγραμμένα φθάνω δείξας ἐν τοῖς εἰς ἐκεῖνο τὸ βιβλίον ὑπομνήμασιν ὅπως ἐστὶ μοχθηρά. μνημονεύσω μέντοι νῦν κἀκ τούτων τινῶν ἀναμνήσεως ἕνεκα, καίτοι παρῃτημένος τὰ τοιαῦτα γράφειν. εἰρημένου τοίνυν ἐν τῷ Προρρητικῷ «ἐξ ὀσφύος ἀναδρομῆς ὀφθαλμῶν ἴλλωσις κακόν», διὰ τοῦτο «τῆς γυναικὸς» ταύτης ἀναμιμνῄσκουσιν ἐν τοῖς περὶ ταύτης τῆς ἐν τῷ Προρρητικῷ ῥήσεως. ἔστι μὲν οὖν, ὡς ἐδείχθη, τὰ τοιαῦτα πάντα μοχθηρά, γινωσκόντων ἡμῶν ἐν τῷ καθόλου τὴν διαστροφὴν τῶν ὀφθαλμῶν οὐκ ἀγαθὸν εἶναι σημεῖον, ἐάν τ' ἐξ ὀσφύος ἀναδρομῆς ἐάν θ' ὁπωσοῦν γένηται, μετὰ τοῦ κακόζηλον εἶναι τὴν ἑρμηνείαν καὶ πόρρω τῆς Ἱπποκράτους λέξεως. οὐ γὰρ ἂν εἶπεν “ἐξ ὀσφύος ἀναδρομῆς”, ἀλλ' ὡς ἐν τῷ Προγνωστικῷ κατὰ τήνδε τὴν λέξιν· “αἱ δὲ σὺν πυρετῷ ὀδύναι γινόμεναι περὶ τὴν ὀσφὺν καὶ τὰ κάτω χωρία, ἢν τῶν φρενῶν ἅπτωνται τὰ κάτω ἐκλείπουσαι, ὀλέθριον κάρτα.”

Hippocrates, De morbis popularibus 3.2.11

Another woman after a miscarriage around the fifth month, the wife of Hicetas, was seized with fever. At the beginning she had alternations of coma and sleeplessness; pain in the loins; heaviness in the head. Second day. Bowels disordered with scanty, thin stools, which were uncompounded. Third day. Stools more copious and worse; no sleep at night. Fourth day. Delirium; fears; depression. Squinting of the right eye; slight cold sweat about the head; extremities cold. Fifth day. General exacerbation; much wandering, with rapid recovery of reason; no thirst; no sleep; stools copious and unfavourable throughout; urine scanty, thin and brackish; extremities cold and rather livid. Sixth day. Same symptoms. Seventh day. Death.

«Ἑνδέκατος ἄρρωστος. Ἑτέρην ἐξ ἀποφθορῆς περὶ πεντάμηνον Ἱκέτεω γυναῖκα πῦρ ἔλαβεν. ἀρχομένη δὲ κωματώδης ἦν καὶ πάλιν ἄγρυπνος, ὀσφύος ὀδύνη, κεφαλῆς βάρος. δευτέρῃ κοιλίη ἐπεταράχθη ὀλίγοισι, λεπτοῖσιν, ἀκρήτοισι τὸ πρῶτον. τρίτῃ πλείω καὶ χείρω, νυκτὸς οὐδὲν ἐκοιμήθη. τετάρτῃ παρέκρουσε, φόβοι, δυσθυμίαι. δεξιῷ ἴλλαινεν, ἵδρου [τὰ] περὶ κεφαλὴν ὀλίγῳ ψυχρῷ, ἄκρεα ψυχρά. πέμπτῃ πάντα παρ|ωξύνθη, πολλὰ παρέλεγε καὶ πάλιν ταχὺ κατενόει· ἄδιψος, ἄγρυπνος, κοιλίη πολλοῖσιν ἀκαίροισι διὰ τέλεος· οὖρα ὀλίγα, λεπτά, ὑπομέλανα· ἄκρεα ψυχρά, ὑποπέλιδνα. ἕκτῃ διὰ τῶν αὐτῶν. ἑβδόμῃ ἀπέθανε.»

'Hippocrates', Prorrheticon 1.69 V 526,13 Littré (Galen doubts this was written by Hippocrates)

Squinting of the eyes from a throbbing in the loins is a bad sign.

Ἐξ ὀσφύος ἀναδρομὴ, ὀφθαλμῶν ἴλλωσις, κακόν.

Solids, Liquids, Gases

On the style of Epidemics 6, Wesley Smith (who translated the text for the Loeb Classical Library) writes: 

“[The Epidemics] are technical prose from a time when prose was coming into being and authors were realizing its potential: unique jottings by medical people in the process of creating the science of medicine.”

Hippocrates VII: Epidemics 2 & 4-7, Harvard University Press, 1994, p.2

The Epidemics is a text without a model, an attempt to capture in writing the experience and practice of medicine. The style, Smith thinks, manifests this naivety. He refers to it as the text’s “innocence” — innocent from later conventions and styles that would come to characterize medical and scientific writing. This innocence makes the Epidemics (like other Hippocratic writings) quite unique; it also makes it quite difficult to read.

Later medical texts look almost nothing like the Epidemics. Medical writers pretty quickly developed standards of exposition that made their writing easier to follow, and one of the effects of this standardization was that a medical text came to be recognizable as such, a distinct form of writing with its own questions, rules, vocabulary and order.

This innovation is already evident in the fourth century, in Diocles’ writings. He had structured his writing on regimen according to times of day, with each time divided into parts dealing with appropriate foods and exercises. Writers on disease, too, began to structure their works: some, according to the location of diseases from head to toe; some, by diseases according to whether they were acute or chronic; some into sections on cause and treatment. And a standard form of medical text, called Remedies  (Peri Boêthêmatôn) was developed by the Pneumatist school, which divided remedies according to the way they acted on the body.

Certainly some authors were not as clear as all this. Dioscorides’ Materia Medica (Peri Hulês) follows a notoriously obscure structure, something later authors complained about. It would have been easier, they thought, if he had ordered things alphabetically. But this just shows that doctors were thinking about the form medical writing should take, and began to adopt standards to avoid the type of obscurity we find in the Epidemics. 

Epidemics 6, however, was also canonical, at least to those sympathetic to Hippocratic medicine. The style of the text may have been obscure, but most everyone who practiced Hippocratic-style medicine would have been familiar with it. And interpreting the text became a way of debating new ideas about what medicine is and how it should be practiced.

Evidence of a tradition of interpretation exists, preserved for the most part by Galen, but also in earlier authors like Dioscorides and Athenaeus and later ones like Palladius. For these Hippocratic doctors, the Epidemics could not simply be read. It needed to be deciphered. And part of the game of interpretation seems to have been to show that, whatever new idea they were promoting, the insight was already present in the writings of Hippocrates (or by showing, especially in the case of Epidemics 6, that parts of it were not by Hippocrates at all, and so could be ignored).

Now, one passage from Epidemics 6 was generally agreed to be a kind of keystone for the whole work. It is found at Epidemics 6.8.7:

“Things from the small tablet to be observed. Regimen consists in repletion and evacuation of foods and drinks. Changes of these: what from what, how it is. Odors: pleasant, noxious, filling, tempting. Changes, from what kinds of things, how they are. The pneumata that come in or go out, [solid] bodies also. Better sounds, and those that harm. And of the tongue, what things are evoked by what. Pneuma, what is hotter to the tongue, colder, thicker, thinner, dryer, wetter, filled up, less and greater. From what come changes, what out of what kinds of things, how they are. Things that contain, impart impulse, or are contained. Speech, silence, saying what one wishes. The words, what one says, either loud or many, truthful or fraudulent. (Smith trans., modified)”

τὰ ἐκ τοῦ σμικροῦ πινακιδίου σκεπτέα. δίαιτα γίνεται πλησμονῇ, κενώσει, βρωμάτων, πομάτων· μεταβολαὶ τούτων, οἷα ἐξ οἵων, ὡς ἔχει. ὀδμαὶ τέρπουσαι, λυποῦσαι, πιμπλῶσαι, πειθόμεναι· μεταβολαὶ, ἐξ οἵων οἵως ἔχουσιν. τὰ ἐσπίπτοντα, ἢ ἐξιόντα πνεύματα, ἢ καὶ σώματα. ἀκοαὶ κρείσσονες, αἱ δὲ λυποῦσαι. καὶ γλώσσης, ἐξ οἵων οἷα προκαλεῖται. πνεῦμα, τὸ ταύτη θερμότερον, ψυχρότερον, παχύτερον, λεπτότερον, ξηρότερον, ὑγρότερον, πεπληρωμένον, μεῖόν τε καὶ τὸ πλεῖον· ἀφ' ὧν αἱ μεταβολαὶ, οἷαι ἐξ οἵων, ὡς ἔχουσιν. τὰ ἴσχοντα, ἢ ὁρμῶντα, ἢ ἐνισχόμενα. λόγοι, σιγὴ, εἰπεῖν ἃ βούλεται· λόγοι, οὓς λέγει, ἢ μέγα, ἢ πολλοὶ, ἀτρεκεῖς, ἢ πλαστοί. (V 344-6 Littré)

(I’ve adopted some of the changes suggested by Smith in the Loeb text and ignored others. Notably, I’ve left out “σώματα” after “ἐνισχόμενα”, following Littré, since as Littré pointed out, no one in antiquity mentions it being there.)

This text has puzzled interpreters for a long time. It is elliptical, confident, and somewhat mysterious. But later doctors saw in it the basis of a system: a list of observations that need to be made in order to assess the health of a patient. 

Two aspects of the list were to become especially important in later medical writers. One is the distinction of pneuma into hot, cold, thick, thin, wet or dry. This distinction has an interesting history that I hope to come back to. But here I want to focus on the distinction of things into “containing, imparting impulse, and contained (τὰ ἴσχοντα, ἢ ὁρμῶντα, ἢ ἐνισχόμενα).” 

We have been working on tracing this distinction for a paper we’re writing on the Pneumatist school. It came to be associated with a way of understanding human physiology that would have a long influence: the division of the constituents of the body into solid parts, humours, and pneuma. It is explicitly mentioned in Galen, the pseudo-Galenic Introduction, pseudo-Alexander on Fevers. It might be in Nicolaus of Damascus On Plants. And in De causis contentivis, especially in chapter 4, Galen hints that it played some role in Pneumatist physiology and causal theory. 

This left us with a bit of a puzzle. How did a distinction of the body into containing parts, parts imparting impulse, and contained parts come to be identified with solids, liquids and gases? This is far from obvious and there is nothing in the text of the Epidemics that suggests it. Why would anyone have interpreted the text this way? Why did it become widely accepted? And how is it related to other ways of describing human physiology, for example, in terms of the elements (...interesting that the distinction is absent from the Definitiones...)?

We looked through the literature, but didn’t find anything substantial. So I thought I would gather all the texts here to make them available. Some of them are still untranslated, and there are likely more texts than the ones below. I will continue to translate and add more as we find them. But hopefully it will be something of a start to sorting out how this interpretation of Epidemics 6 came about and why it became so influential.

I
The Pseudo-Galenic author of Introduction or The Physician

“Others say the human is in fact composed out of three compounds, as well, from wet things, dry things and pneumata. Hippocrates calls them things containing, things contained and things which impart impulse. Containing are whatever are solid bodies—bones, nerves, veins and arteries—out of which muscles, flesh, and every mass of the body are compounded, both internal and external structures. Contained are the wet things carried in the channels and scattered through the whole body, what Hippocrates calls the four humours previously mentioned. Things which impart impulse are the pneumata. According to the ancients, there are two pneumata: psychic and natural. The Stoics also add a third: hectic, which they call a state.”

οἱ δὲ ἐκ τῶν τριῶν καὶ συνθέτων τὸν ἤδη γενώμενον ἄνθρωπον ἐκ τῶνδέ φασι συγκεῖσθαι, ἔκ τε τῶν ὑγρῶν καὶ ξηρῶν καὶ πνευμάτων. καλεῖ δὲ αὐτὰ Ἱπποκράτης ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα. ἴσχοντα μὲν οὖν ἐστιν ὅσα στερεὰ, ὀστᾶ καὶ νεῦρα καὶ φλέβες καὶ ἀρτηρίαι, ἐξ ὧν οἵ τε μύες καὶ αἱ σάρκες καὶ πᾶς ὁ τοῦ σώματος ὄγκος πέπλεκται, τῶν τε ἐντὸς καὶ τῶν ἐκτὸς τὰ συγκρίματα. ἰσχόμενα δέ ἐστι τὰ ὑγρὰ τὰ ἐν τοῖς ἀγγείοις ἐμφερόμενα καὶ κατὰ πᾶν τὸ σῶμα διεσπαρμένα, ἅπερ καλεῖ Ἱπποκράτης χυμοὺς τέσσαρας τοὺς προειρημένους. ἐνορμῶντα δέ ἐστι τὰ πνεύματα. πνεύματα δὲ κατὰ τοὺς παλαιοὺς δύο ἐστὶ, τό τε ψυχικὸν καὶ τὸ φυσικόν. οἱ δὲ Στωϊκοὶ καὶ τρίτον εἰσάγουσι τὸ ἑκτικὸν, ὃ καλοῦσιν ἕξιν.

[Galen] Introductio 9, 14.696.14-697.8 K

“Hippocrates, then, put forward three, saying the elements of man are things contained, containing and imparting impulse, through which he included all the elements of those who came after him, as well as elemental physiology and the aetiology of things contrary to nature. But those after him, I don't know why, divide this divine and truly Asclepian medicine into three, although it is really a unity, and they dispersed the parts that make it up. (i) Some referred only to the humours [when explaining] the composition of things according to nature and the cause of things contrary to nature, as Praxagoras and Herophilus [did]. Others posited the solid bodies as the primary and elemental things, and believed that things are composed out of these and the causes of diseases originate from them, as Erasistratus and Asclepiades [did]. And those around Athenaeus and Archigenes claim that all the natural things are created only by means of the pneuma pervading through them and that all the diseases are governed by it, because it [sc. the pneuma] is the thing affected first – for this reason they are called Pneumatists.”

Ἱπποκράτης μὲν οὖν διὰ τριῶν κεχώρηκεν, εἰπὼν στοιχεῖα ἀνθρώπου ἴσχοντα, ἰσχόμενα, ἐνορμῶντα, δι' ὧν τὰ πάντα τῶν μετ' αὐτὸν περιείληφε στοιχεῖα καὶ τὴν κατὰ στοιχείων φυσιολογίαν τε καὶ αἰτιολογίαν τῶν παρὰ φύσιν· οἱ δὲ μετ' αὐτὸν οὐκ οἶδ' ὅπως μίαν οὖσαν τὴν θείαν ταύτην καὶ ἀληθῶς Ἀσκληπιοῦ ἰατρικὴν τριχῇ διανειμάμενοι καὶ διασπάσαντες τὰ ἐν αὐτῇ συμφυῆ μέρη, οἱ μὲν μόνοις τοῖς χυμοῖς τῶν τε κατὰ φύσιν τὴν σύστασιν καὶ τῶν παρὰ φύσιν τὴν αἰτίαν ἀνέθεσαν, ὡς Πραξαγόρας καὶ Ἡρόφιλος. οἱ δὲ τὰ στερεὰ σώματα τὰ ἀρχικὰ καὶ στοιχειώδη ὑποθέμενοι, τά τε φύσει συνεστῶτα ἐκ τούτων καὶ τῶν νόσων τὰς αἰτίας ἐντεῦθεν λαμβάνουσιν, ὡς Ἐρασίστρατος καὶ Ἀσκληπιάδης· οἱ δὲ περὶ Ἀθήναιον καὶ Ἀρχιγένην μόνῳ τῷ διήκοντι δι' αὐτῶν πνεύματι καὶ τὰ φυσικὰ συνεστάναι τε καὶ διοικεῖσθαι καὶ τὰ νοσήματα πάντα, τούτου πρωτοπαθοῦντος γίνεσθαι ἀπεφήναντο, ὅθεν καὶ πνευματικοὶ χρηματίζουσι.

[Galen], Introductio 9, 698.12-699.10 K

II
Nicolaus of Damascus, Plants (distinct tradition?)

“A plant has three powers, the first derived from the element of earth, the second from that of water, the third from that of fire. From the earth the plant derives its growth, from water its cohesion, and from fire the union of the cohesion of the plant. We see much the same thing in vessels of pottery, which contain three elements—clay, which is, as it were, the material of pottery; secondly, water, which binds the pottery together; and, thirdly, fire, which draws its parts together, until it completes the process of manufacture.”

Τὸ δένδρον τρεῖς ἔχει δυνάμεις, πρώτην ἐκ τοῦ γένους τῆς γῆς, δευτέραν ἐκ τοῦ γένους τοῦ ὕδατος, τρίτην ἐκ τοῦ γένους τοῦ πυρός. ἀπὸ τῆς γῆς γάρ ἐστιν ἡ ἔκφυσις τῆς βοτάνης, ἀπὸ τοῦ ὕδατος ἡ σύμπηξις, ἀπὸ τοῦ πυρὸς ἡ ἕνωσις τῆς συμπήξεως τοῦ φυτοῦ. Βλέπομεν δὲ πολλὰ τούτων καὶ ἐν τοῖς ὀστρακώδεσιν. Εἰσὶ γὰρ ἐν τούτοις τρία, πηλός, ἐξ οὗ γίνεται πλίνθος ὀστρακώδης, δεύτερον ὕδωρ, ὅπερ ἐστὶ τὸ στερεοῦν τὰ ὀστρακώδη, τρίτον τὸ πῦρ τὸ συνάγον τὰ μέρη αὐτοῦ, ἔστ’ ἂν δι‘ αὐτοῦ πληρωθείη ἡ τούτου γένεσις.

[Aristotle], De Plantis 2.1

III
The Pseudo-Alexandrian author of Fevers

Φανερὸν μὲν οὖν διὰ τούτων καὶ ὡς τρία μόνα τὰ ἐν ἡμῖν, ἐν οἷς ἡ παρὰ φύσιν θερμότης, μόρια, χυμοί, πνεύματα· τὰ αὐτὰ δὲ καὶ παρ' Ἱπποκράτει ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα καλεῖται, ἴσχοντα μὲν τὰ μόρια, ἃ καὶ στερεὰ προσαγορεύεται, ἰσχόμενα δὲ οἱ χυμοί, ἐνορμῶντα δέ γε τὰ πνεύματα, ἕκαστον ἐκ τῆς ἰδίας δυνάμεως τὴν προσηγορίαν ἁρμόζουσαν εἰληφός. 

Ἴσχει μὲν γὰρ καὶ κατέχει τὰ στερεά, ἐνίσχεται δὲ καὶ ἐμπεριέχεται ὑπὸ τούτων τὰ ὑγρά τε καὶ διαρρέοντα, ταὐτὸν δὲ εἰπεῖν οἱ χυμοί, ὁρμᾷ δὲ τὰ ἐν ἡμῖν πνεύματα, λεπτομερεστάτης οὐσίας ὄντα καὶ θερμοτάτης, καὶ ῥᾷστα διὰ πάντων χωροῦντα τῶν μορίων τοῦ σώματος.

[Alexander], De febribus 17.1-2

IV
Galen, Differences of Fevers

νῦν δὲ ἀρκεῖ τό γε τοσοῦτον γινώσκειν, ὅπερ, οἶμαι, καὶ ὁ Ἱπποκράτης ἐνδεικνύμενος ἔλεγε, τὰ ἴσχοντα καὶ τὰ ἐνισχόμενα καὶ τὰ ἐνορμῶντα· ἴσχοντα μὲν αὐτὰ τὰ στερεὰ μόρια τοῦ σώματος, ἐνισχόμενα δὲ τὰ ὑγρὰ, ἐνορμῶντα δὲ τὰ πνεύματα προσαγορεύων.

Galen, De differentiis febrium, 7.278.11 K

V
Galen, On Tremor, Palpitation, Spasm and Rigor

μέμνηται δέ πως αὐτῶν ὧδε, τὰ ἴσχοντα λέγων, καὶ τὰ ἐνισχόμενα, καὶ τὰ ἐνορμῶντα· ἴσχοντα μὲν τὰ στερεὰ καλῶν, περιέχει γὰρ καὶ ἀποστέγει τὰ ὑγρά· ἐνισχόμενα δὲ, τὰ ὑγρὰ, περιέχεται γὰρ ὑπὸ τῶν στερεῶν· ἐνορμῶντα δὲ τὰ πνεύματα, πάντῃ γὰρ ἐξικνεῖται τοῦ σώματος ἐν ἀκαρεῖ χρόνῳ ῥᾳδίως τε καὶ ἀκωλύτως.

Galen, De tremore, palpitatione, convulsione et rigore, 7.597.3-9 K

VI
Galen, Commentary on Epidemics 6
(only available in Pfaff’s German translation of the Arabic summary, online at the CMG)

(V 346, 5.6 L[ittré]) Hippocrates: Das Enthaltende und das Eindringende und das Enthaltene.

Galen: Auch diese Worte erklärt jeder von den Kommentatoren anders. Die beste Erklärung ist nach meiner Meinung die Erklärung derjenigen, welche sagen, daß er unter ‘das Enthaltende’ die festen Grundkörper [solid parts] und unter ‘das Eindringende’ oder ‘das Durchdringende’—diese Worte werden auf diese beiden Arten geschrieben—die Winde [pneumata] und unter ‘das Enthaltene’ die Feuchtigkeiten [humors], die die Körper enthalten, verstehe. Hippokrates verlange also, daß man von diesen drei Dingen aus, aus denen jeder lebende Körper bestehe, untersuche und erforsche, welches die Natur und die Kraft eines jeden von ihnen sei.

Galen, In Hippocratis Epidemiarum librum VI commentaria I-VI, CMG V 10,2,2 p.446 Wenkebach

VII
Palladius, Overview of on Fevers

Ἰστέον ὅτι τῶν πυρετῶν τρία εἰσὶ τὰ γένη· τὰ μὲν γὰρ αὐτῶν ἐπὶ ὑγροῖς γίνονται καὶ ἐξάπτονται, τὰ δὲ ἐπὶ στερεοῖς, τὰ δὲ ἐπὶ πνεύμασι, περὶ ὧν ὁ Ἱπποκράτης λέγει ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα, ἴσχοντα μὲν καλῶν τὰ στερεά, ἰσχόμενα δὲ τὰ ὑγρά, ἐνορμῶντα δὲ τὰ πνεύματα. Ὁ δὲ Γαληνὸς ἀναφέρει ὅτι ἀναμέμικται ἔν τε ταῖς ἀρτηρίαις ἁπάσαις διὰ πολλῶν ὀπῶν ἅμα πνεούσαις ἡ ἀερώδης οὐσία τῷ αἵματι καὶ κατὰ τὴν καρδίαν οὐδὲν ἧττον, ὡς ἂν σύρρους ὑπάρχουσα πάσαις αὐταῖς.

Palladius, Synopsis de febribus, 4.1-2

Galen and Palladius on Mental Exercise and the Boundaries between Medicine and Philosophy

In a fragment on diet for women, Athenaeus quotes an aphorism from the sixth book of the Epidemics. He writes:

“One must encourage exercises (gymnasia) that are suitable for women: of the soul by means of the studies proper for women and concerns about the household because ‘a soul's walk is concern for people’, as the venerable Hippocrates said; while, of the body [exercise] by means of spinning wool and the other work around the house.”

γυμνάσια δ’ ἐπιτρεπτέον τὰ γυναιξὶν ἁρμόζοντα, ψυχῆς μὲν τὰ διὰ τῶν οἰκείων αὐταῖς μαθημάτων καὶ τῶν κατὰ τὴν οἰκίαν φροντίδων («ψυχῆς γὰρ περίπατος φροντὶς ἀνθρώποισι», ὡς εἶπεν ὁ παλαιὸς Ἱπποκράτης), σώματος δὲ διὰ τῆς ταλασιουργίας καὶ τῶν ἄλλων τῶν κατὰ τὴν οἰκίαν πόνων.

Athenaeus of Attalia apud Oribasius, Libri Incerti 23, CMG VI 2,2 112,19-24 Raeder

The aphorism Athenaeus quotes from is found at Epidemics 6.5.5. He seems to think it is about exercise, but the aphorism itself is pretty ambiguous. I’ll translate it literally to try to emphasize just how ambiguous it is:

“Exertion for the joints and for flesh, food, sleep for the viscera. A soul's walk is concern for people.”

Πόνος τοῖσιν ἄρθροισι καὶ σαρκὶ σῖτος ὕπνος σπλάγχνοισιν. Ψυχῆς περίπατος φροντὶς ἀνθρώποισιν.

‘Hippocrates’, Epidemics 6.5.5, V 316,9-10 Littré

The term I translate as “concern” (phrontis) usually means something more like “apprehension” or “worry”. Athenaeus, however, takes it to be a word for any kind of serious thinking, i.e., sustained intellectual activity. The term peripatos, “walk”, can just as easily mean “wandering about”. So the aphorism could be describing apprehensiveness as a kind of wandering thought.

But Athenaeus takes Hippocrates to be claiming that concerns, thoughts, studies, etc., are quite literally forms of exercise—activities that will “nourish” a woman’s (or anyone else’s) soul, just as physical exercise, ponos, nourishes the body. 

His interpretation also likely implies a kind of corporeal dualism like what we find in the Stoics and the Pneumatic physicians. It was this kind of interpretation that two later readers took issue with. They are Galen and Palladius.

The commentaries of Galen and Palladius on the Epidemics are pretty great, if for no other reason than that they give us a glimpse into the game of Hippocratic exegesis playing out in Greek-speaking parts of the Roman empire. But they also give us a sense of how doctors tried to navigate disputes between medicine and philosophy—disputes about disciplinary boundaries, and about whose responsibility it was to treat the ailing soul or mind.

Although this is something of a simplification, it is not too much of a distortion to say that around Galen’s time medicine was usually thought of as restricted to the care of the body; philosophy, on the other hand, was a discipline whose aim was the care of the soul or mind. Some doctors, however, considering that our bodies and our health are affected by our psychological states, started to think it was also important that doctors treat the soul as well. But when these considerations were discussed, they were often accompanied by discussion of the legitimacy of medical intervention in the treatment of the soul. Doctors in other words felt they had to justify the encroachment on philosophy.

Interestingly, their justification was not usually aimed at appeasing philosophers, but other doctors who felt it was not their place to treat the soul. The two passages which follow are clearly aimed at doctors, and are examples of the kind of justification one might give, if not for the medicalization of the mind, then at least for its importance in physiology and therapeutics.

1. Galen, In Hipp. Epid. 6, 17B.263.1-264.6 Kühn = CMG V 10,2,2 280,6-281,6 Wenkenbach

“All the book’s interpreters take ‘walk’ [peripatos] to mean ‘exercise’, so that the sentence would be:

‘for humankind, concerns are an exercise.’

They think [Hippocrates] used the familiar term, ‘walk’ [peripatos], because the word means a kind of exercise. Dioscorides, however, reasonably avoided this interpretation because it is affectatious [kakozêlos]*; he did not write peripatos [in his edition], but added the letter ‘n’, [so that it reads] ‘peri pantos’: 

‘concern for the soul above all belongs to humankind’.

So that what is meant by it is:

‘above all, for humankind what is to be practiced is reasoning.’ 

For after all acts of thinking [dianoêseis] are called ‘concerns’ [phrontides], which is why Socrates, too, was called ‘concerned’ and the man’s wise counsels were called ‘concerns’, as one can even find in the Clouds of Aristophanes, where he makes fun of Socrates and mocks him as an idle-talker.

But if it should seem to anyone that the phrase belongs to philosophical speculation, not medicine—first, let them consider that it applies to all the rational arts in which one needs to exercise reasoning, as it has been said by many other physicians, and not a few times by Erasistratus.** And furthermore, certain affections occur, some, for instance, which numb the soul’s rational faculty and the faculty of memory, others which are stuporific [karôdê] and soporific [kataphorika]. In these cases, one must consider thinking to be beneficial, just as in other places he [sc. Hippocrates] taught that anger is useful for good humour and regaining a state in accordance with nature.”

Τὸν περίπατον ἀντὶ τοῦ γυμνασίου πάντες ἤκουσαν οἱ ἐξηγησάμενοι τὸ βιβλίον, ἵν' ὁ λόγος ᾖ τοιόσδε· “τοῖς ἀνθρώποις αἱ φροντίδες γυμνάσιον”, <νομίσαντες αὐτὸν τῇ> προσηγορίᾳ κεχρῆσθαι τῇ τοῦ περιπάτου, δηλούσης τῆς φωνῆς ταύτης εἶδός τι γυμνασίου. κακοζήλου δὲ τῆς ἑρμηνείας οὔσης, εἰκότως αὐτὴν ὁ Διοσκουρίδης φυλαττόμενος, οὐ περίπατος ἔγραψεν, ἀλλὰ προσθεὶς τὸ ν γράμμα “περὶ παντὸς”, ὥστε γενέσθαι τὴν λέξιν τοιάνδε· ψυχῆς περὶ παντὸς φροντὶς ἀνθρώποις, ἵν' ᾖ δηλούμενον ἐξ αὐτῆς· “περὶ παντὸς τοῖς ἀνθρώποις ἀσκητέον ἐστὶ τὸν λογισμόν.” αἱ γάρ τοι διανοήσεις ὀνομάζονται φροντίδες, ὅθεν καὶ τὸν Σωκράτην φροντιστὴν ἐκάλουν καὶ φροντίδας τὰ σοφὰ βουλεύματα τἀνδρὸς ὠνό- μαζον, ὡς κἀν ταῖς Ἀριστοφάνους Νεφέλαις <ἔστιν> εὑρεῖν, ἔνθα κωμῳδεῖ καὶ σκώπτει τὸν Σωκράτην ὡς ἀδολέσχην. εἰ δέ τῳ δόξει φιλοσόφου θεωρίας, οὐκ ἰατρικῆς ὁ λόγος ἔχεσθαι, πρῶτον μὲν ἐνθυμείτω κοινὸν ἁπασῶν εἶναι τῶν λογικῶν αὐτὸν τεχνῶν, ἐν αἷς τὸν λογισμὸν χρὴ γυμνάζειν, ὡς ἄλλοις τε πολλοῖς εἴρηται τῶν ἰατρῶν Ἐρασιστράτῳ τ' οὐκ ὀλιγάκις. ἔπειτα δὲ καὶ πάθη τινὰ γίνεται τὰ μὲν οἷον ναρκοῦντα τὸ λογιστικὸν καὶ τὸ μνημονευτικὸν τῆς ψυχῆς, τὰ δὲ καρώδη καὶ καταφορικά. τούτοις οὖν ἡγητέον ὠφελίμους εἶναι τὰς φροντίδας, ὡς ἐν ἄλλοις ἐδίδαξε τὰς ὀξυθυμίας εἶναι χρησίμους εἰς εὐχυμίαν τε καὶ τῆς κατὰ φύσιν ἕξεως ἀνάκτησιν.

Galen, In Hipp. Epid. 6, 17B.263.1-264.6 Kühn

2. Palladius, Commentarii in Hippocratis librum sextum de morbis popularibus, Scholia in Hippocratem et Galenum vol. 2 Dietz, 136,11-137,5

“Having put aside medical matters, Hippocrates comes again to the soul. ‘Soul’—not as in the warmth we were speaking about earlier, but the really immaterial and immortal [soul]. There are two ways it is possible to interpret this statement: for either [it says] ‘walk’ [peripatos] or ‘above all’ [peri pantos]. And ‘above all’ in this sense:

‘that for humankind there is a concern to consider the soul above all [peri pantos]’

since a person ought to honour nothing above this. For Hippocrates says just as the body is exercised, so too the soul ought to be exercised. But the soul is exercised through more [activities], since a walk is one form of exercise. Concern is any exercise [of the soul]. ‘Concern’—not in order to seek after a profit or after a woman, but to seek the comprehension of the truth, the differentiation of true things from false things. For these are exercises. And concern, especially, is [an exercise] of the rational soul. This is why we speak about the ‘Thinkery’ (phrontistêrion) of Socrates and Plato, not because they were generally concerned, but because they dwelled on the truth.

And he [sc. Hippocrates] added, ‘for humankind’ for a reason. He knows that by nature humans are distinguished in this: the spirited [part of the soul] is [a part] in a person’s real nature, but to rule belongs to reason.*** That is why, as much as it concerns philosophers, we are also able to refer the statement to what belongs to us. For if having come to a sick person, you found him tired and drowsy at the wrong time, know that it is a great evil. For whenever the material in the head is excessive, brings heavy sleep, [and] threatens apoplexia, then you ought to command spirit with concern, in order that the boiling [caused by rousing the spirit] will make this humour thin and disperse it. And thus this statement is fitting for both physicians and philosophers.”

Ἐάσας τὰ ἰατρικὰ ὁ Ἱπποκράτης ἐπὶ τὴν ψυχὴν πάλιν ἔρχεται. ψυχὴν δὲ, οὐχ ὡς ἄνω ἐλέγομεν τὴν θερμασίαν, ἀλλὰ τὴν ὄντως ἄϋλον καὶ ἀθάνατον. διττῶς δέ ἐστιν ἐξηγήσασθαι τοῦτον τὸν λόγον. ἢ γὰρ <περίπατος>, ἢ <περὶ παντός>. καὶ περὶ παντὸς οὕτως· ὅτι φροντίς ἐστι τοῖς ἀνθρώποις τοῦ περὶ παντὸς ποιήσασθαι τὴν ψυχήν. οὐδὲν γὰρ ταύτης ὀφείλει προτιμῆσαι ὁ ἄνθρωπος. λέγει γὰρ Ἱπποκράτης, ὥσπερ γυμνάζεται τὸ σῶμα, οὕτως ὀφείλει καὶ ἡ ψυχὴ γυμνάζεσθαι. γυμνάζεται δὲ ἡ ψυχὴ διὰ πλειόνων, ἐπειδὴ ἓν εἶδος γυμνασίου ἐστὶν ὁ περίπατος. πᾶν γυμνάσιον ἡ φροντίς. φροντὶς δὲ, οὐχ ἵνα ζητῇ ἢ περὶ κέρδους, ἢ περὶ γυναικὸς, ἀλλὰ ζητεῖν τὴν κατάληψιν τῆς ἀληθείας, τὴν διάκρισιν τοῦ ἀληθοῦς καὶ ψευδοῦς. ταῦτα γὰρ γυμνάσιά εἰσιν. καὶ μάλιστα τῆς λογικῆς ψυχῆς ἡ φροντίς. ἔνθεν λέγομεν Σωκράτους καὶ Πλάτωνος φροντιστήριον, ὅτι οὐχ ἁπλῶς ἐφρόντιζεν, ἀλλ' ὅτι τὴν ἀλήθειαν κατεγένετο. οὐ μάτην δὲ προσέθηκε τὸ τοῖς ἀνθρώποις. ἀλλ' οἶδεν ὅτι κατὰ φύσιν ἄνθρωπος ἐν τούτῳ κρίνεται, ἐν τῷ ὑπόστασιν μὲν τὸ θυμοειδὲς, ἄρχειν δὲ τῷ λόγῳ. ταῦτα οὖν ὅσα κατὰ φιλοσόφους, δυνάμεθα καὶ ἐπὶ τὰ ἡμέτερα ἀγαγεῖν τὸν λόγον. εἰσελθὼν γὰρ πρὸς τὸν κάμνοντα, εὗρες αὐτὸν καταφερόμενον ἀκαίρως καὶ ὑπνώττοντα, γίνωσκε ὅτι μέγα κακόν. ὕλη γὰρ πλεονάζουσα ἐν τῷ ἐγκεφάλῳ, ὠδίνει κάρον, ἀπειλεῖ ἀποπληξίαν, τότε ὀφείλεις φροντίδι θυμὸν ἐπιτάξαι, ἵνα τοῦτον ἡ ζέσις ἐκλεπτύνῃ καὶ διαφορήσῃ τὸν χυμὸν, ὥστε καὶ ἰατροῖς καὶ φιλοσόφοις πρέπει οὗτος ὁ λόγος.

Palladius, Commentarii in Hippocratis librum sextum de morbis popularibus, Scholia in Hippocratem et Galenum vol. 2 Dietz, 136,11-137,5

Notes

*Galen does not tell us why he and Dioscorides thought this interpretation is affectatious—why it is kakozêlos. The great stylist Hermogenes of Tarsus (roughly contemporary with Galen) says that kakozêlos describes a figure of speech that is implausible or unconvincing, either for reasons of impossibility, inconsistency, ugliness, impiety, injustice, or contrariness to nature—something that makes us think, “that does not seem do-able [οὐκ εἰκὸς τόδε πραχθῆναι]” (Herm. Inv. 4.12 Rabe). One example he uses is Od. 9.481 where Odysseus says the Cyclops, Polyphemus, “lobbed the peak of a great mountain after having snapped it off [ἧκε δ᾽ ἀπορρήξας κορυφὴν ὄρεος μεγάλοιο].” When Galen uses kakozêlos, he tends to use it in this sense (he does not use it often). The majority of Galenic examples are in the Hippocratic commentaries, where he uses it in two ways:

• (i) Sometimes he uses it to describe Hippocrates’ bad style. For example, in Aph. 7.66, Hippocrates calls food “strong for the healthy” and “disease for the sick”, a claim Galen thinks is kakozêlos since food is not itself literally either strong or disease. The sense, however, is clear enough: food is either productive of strength or disease (Hipp. Aph. XVIIIA 179 K). The problem is merely a matter of style.
• (ii) More often, he uses it as a reason for rejecting an interpretation of Hippocrates. For example, there is an aphorism in Epid. 6, which states: “weaker foods have shorter life [βιοτὴν]” (Epid. 6.5.14, V 318,20 L.). Galen thinks the natural reading is that weaker foods are used up and expelled rapidly; and he goes on to say it is kakozêlon to think Hippocrates’ meant that weaker food “continues to live” [μονὴν ζωὴν] in our body for a short time (Hipp. Epid. VI 5.21 (CMG V 10,2,2 299,20-21 Wenkebach = XVIIB 282 K).

In either case, Galen and Dioscorides think “walk” [περίπατος] is kakozêlos enough to warrant an emendation to the text. This may be because it implies thinking is literally a kind of exercise that heats you up; but this would be odd, since Galen himself admits that rational activity is important for maintaining the soul’s heat, e.g., San. Tu. 1.8 (VI 40K).

**On Erasistratus, Wenkebach gives a parallel in his edition: PHP VII 5, 602 Kühn. This is almost certainly wrong. In PHP VII 5, Galen mentions Erasistratus’ views on the anatomy of the nerves and brain. The only thing he says remotely related to the Epidemics 6.5.5 passage is that Erasistratus had time to make precise dissections ‘when he was old and had leisure to focus on the study of the art’ (440,24-25 Wenkebach). What Galen must have in mind is Erasistratus’ belief that practice of the rational arts improves their performance, a view which Galen attributes to Erasistratus at De Consuetudinibus 1, Scripta Minora II 17,1-22 Helmreich.

*** ἀλλ' οἶδεν ὅτι κατὰ φύσιν ἄνθρωπος ἐν τούτῳ κρίνεται, ἐν τῷ ὑπόστασιν μὲν τὸ θυμοειδὲς, ἄρχειν δὲ τῷ λόγῳ.  This sentence is difficult. I’ve translated “but he knows that by nature humans are distinguished in this: that the spirited part of the soul is in the hypostasis, but to rule belongs to reason.” Palladius may be reluctant to say that reason is a part of a the hupostasis, the real nature, of a person; but I’m not sure I understand the point he is making and I’ve found no parallels anywhere else.