Ancient Medicine

  • Home
  • About
  • Contact

Goat, located in Fiesch, Valais (Switzerland). Source: Armin Kübelbeck via Wikimedia Commons.

How to smell nice: Galen's advice for doctors

December 25, 2025 by Sean Coughlin in Ancient Medicine

The last part of Galen’s comment on Epid. 6.4.7, here on smell, including advice on how to use deodorants and breath fresheners — and a nice Quintus’ story as well.


Odour. Some people naturally have an unpleasant smell, whether of the body as a whole or of the mouth, while others are naturally free of it. In other cases it arises from carelessness, when doctors think they are doing nothing wrong even if they go to see patients reeking of garlic or onions. Something like this actually happened to Quintus, who practiced medicine in Rome in our fathers’ day. After lunch he went to visit a wealthy and very influential man smelling strongly of wine. The patient was running a fairly high fever, with headaches as well, and so could not tolerate the smell coming from the wine. He asked Quintus to stand a little farther away, since he was distressed by the strong smell of wine. In saying this the patient seemed to be speaking reasonably enough. But Quintus handled it clumsily and told him to endure the smell. He said that he himself put up with the stench of the patient’s fever, and that it was hardly the same thing to smell a fever as to smell wine.

I also know of another doctor in our part of Asia whose armpits were foul-smelling, to the point that no sick person could bear his presence, or any healthy person either. He ought first to have treated this condition in himself, and only then attempted to treat others. For even if the smell is congenital, as it is in goats, it is still possible to make it milder, and then to reduce it further each day by using powders that blunt bad odours. At any rate, there was one man whose mouth was naturally foul, who took care to make it more moderate by cleansing and by taking suitable medicines for this purpose, and who each day took a very small amount of something aromatic, sometimes amomum, sometimes a leaf of malabathrum, sometimes some other fragrant substance, and in this way would leave the house.

ὀδμή. καὶ τῆς ὀδμῆς τοῦ σώματος ὅλου καὶ τοῦ στόματος ἡ μέν τίς ἐστιν ἐνίοις φύσει μοχθηρά, καθάπερ γε καὶ ἄλλοις τισὶν ἄμεμπτος, ἡ δ' ἐξ ἀμελείας ἐγγίνεται μηδὲν ἡγουμένων ἁμαρτάνειν τῶν ἰατρῶν, ἐὰν ἤτοι σκορόδων ἢ κρομύων ὄζοντες ἐπισκοπῶνται τοὺς νοσοῦντας. ἐπὶ δὲ Κοΐντου τοῦ κατὰ τοὺς πατέρας ἡμῶν ἰατρεύοντος ἐν Ῥώμῃ καὶ τοιοῦτό τι συνέβη· μετ' ἄριστον ἐπεσκέπτετό τινα τῶν πλουσίων τε καὶ πολὺ δυναμένων ἀνδρῶν ὄζων οἴνου σφοδρῶς. πυρέττων οὖν ἱκανῶς ὁ κάμνων ἅμα κεφαλαλγίαις καὶ διὰ τοῦτο μὴ φέρων τὴν ἐκ τοῦ οἴνου προσπίπτουσαν ὀσμὴν ἠξίου προσωτέρω χωρήσειν τὸν Κόϊντον, ἀνιᾶν γὰρ αὐτὸν ἐξόζοντα σφοδρῶς οἴνου. ταῦτα μὲν οὖν ὁ κάμνων ἐφαίνετο μετρίως λέγειν· ὁ Κόϊντος δ' ἀβελτέρως αὐτῷ προσενεχθεὶς ἐκέλευσεν ἀνέχεσθαι τῆς ὀσμῆς. καὶ γὰρ ἑαυτὸν ἔφη τοῦ κάμνοντος ἀνέχεσθαι πυρετοῦ ὄζοντος, εἶναι δ' οὐκ ἴσον ἢ πυρετὸν ἢ οἶνον ὀσμᾶσθαι.

ἕτερον δ' ἰατρὸν ἐπὶ τῆς ἡμετέρας Ἀσίας οἶδα δυσώδεις ἔχοντα τὰς μάλας, ὡς διὰ τοῦτο μὴ φέρειν αὐτοῦ τὴν εἴσοδον ἄνθρωπον νοσοῦντα μηδένα καθάρειον. ἐχρῆν οὖν αὐτὸν ἑαυτοῦ πρῶτον ἰᾶσθαι τὸ σύμπτωμα καὶ οὕτως ἐπιχειρεῖν ἑτέρους θεραπεύειν. ἐγχωρεῖ γάρ, εἰ καὶ σύμφυτον ὥσπερ καὶ τοῖς τράγοις ἐστίν, ἀλλά τοι μετριώτερόν γ' αὐτὸ ποιήσαντα τὸ μέτριον αὖθις τοῦτο πραΰνειν ἑκάστης ἡμέρας διαπάσμασιν ἀμβλυντικοῖς δυσωδίας. ἄλλος γοῦν τις ἔχων δυσῶδες φύσει τὸ στόμα προὐνοήσατο μετριώτερον αὐτὸ ποιήσασθαι διά τε καθάρσεως καὶ φαρμάκων πόσεως ἐπιτηδείων εἰς τοῦτο, καὶ καθ' ἑκάστην ἡμέραν ὀλίγιστόν τι λαμβάνων εἰς αὐτὸ ποτὲ μὲν ἀμώμου, ποτὲ δὲ μαλαβάθρου φύλλου, ποτὲ δ' ἄλλου τινὸς τῶν εὐωδῶν οὕτως ἐκ τῆς οἰκίας προήρχετο.

Galen, Commentary on Epidemics VI on Epidemics VI 4.10, 17B.151-152K = 206-207 Wenkebach

December 25, 2025 /Sean Coughlin
Galen, garlic, onions, Epidemics, Hippocratic Commentary, bedside manner
Ancient Medicine
Comment

Votive relief from the sanctuary of Amphiaraos at Oropos (Γ 3369). Source: National Archaeological Museum, Athens.

More on how not to talk to patients

December 23, 2025 by Sean Coughlin in Ancient Medicine

Continuing Galen’s bedside manner advice


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

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

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

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

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

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

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

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

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

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

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

December 23, 2025 /Sean Coughlin
Galen, Hippocratic Commentary, bedside manner, Epidemics
Ancient Medicine
Comment

Fragment of bas-relief, female patient on a bed. In copyright. Source: Wellcome Collection.

"Patroclus died as well" (How Not to Talk to Patients)

December 13, 2025 by Sean Coughlin in Ancient Medicine

Let’s get back into this. A story from Galen on how not to talk to patients, and how to use Hippocrates to get them on your side.


“The comforts for those who are ill, like doing things in a clean way when it comes to drink, food, and whatever they may see; with softness whatever they touch. [There are other measures as well]. What does no great harm, or is easily borne [or easily gotten?], like something cold, when it is needed. Entrances, words, posture, clothing, for the patient, haircut, nails, smells.”

Αἱ τοῖσι κάμνουσι χάριτες, οἷον τὸ καθαρίως δρῇν ἢ ποτὰ ἢ βρωτὰ ἢ ἃ ἂν ὁρᾷ, μαλακῶς ὅσα ψαύει· [ἄλλαι·] ἃ μὴ μεγά[λα] βλάπτει, ἢ εὐανάληπτα, οἷον ψυχρὸν, ὅκου τοῦτο δεῖ· εἴσοδοι, λόγοι, σχῆμα, ἐσθὴς, τῷ νοσέοντι, κουρὴ, ὄνυχες, ὀδμαί.

Epidemics 6.4.7, 5.308L

Galen’s comments

All of the words obviously refer to the doctor, but the phrase “for the patient” inserted in between them raises a question; consequently, some have entirely removed it and pretended not to have found it written at all. However, the ancient interpreters are aware of this reading. Maybe we’ll find some plausible solution for it if we first examine each of the things mentioned individually. [1]

Τούτων τὰ μὲν ἄλλα πάντα προφανῶς ἐπὶ τὸν ἰατρὸν ἀναφέρεται, μεταξὺ δ' αὐτῶν παρεγκείμενον τὸ «τῷ νοσοῦντι» παρέχει τινὰ ζήτησιν, ὅθεν ἔνιοι παντάπασιν ἐξελόντες αὐτὸ προσεποιήσαντο μηδ' ὅλως εὑρηκέναι γεγραμμένον. ἀλλ' οἵ γε παλαιοὶ τῶν ἐξηγητῶν ἴσασι καὶ ταύτην τὴν γραφήν. ἴσως δ' ἄν τινος εὐπορήσαιμεν εἰς αὐτὴν πιθανοῦ προεπισκεψάμενοι τῶν εἰρημένων ἕκαστον ἰδίᾳ.

Entrances. And first, he spoke about the doctors’ “entrances” to the patient, and how they may occur in a pleasing manner. For some patients find it annoying when doctors check on them frequently, while others enjoy this very much. There are some doctors who behave so foolishly as to intrude upon sleeping patients with the noise of their feet or a loud voice; the patients, sometimes woken up by this, are aggravated with them and say they have been caused greatest harms. Therefore, a doctor must consider all these things ahead of time in order not to appear at an inappropriate time, or rush in headlong with a lot of noise and a loud voice, or an awkward gait or look, or anything of this sort at all.

καὶ πρώτας γε ἔλεγε τὰς πρὸς τὸν κάμνοντα τῶν ἰατρῶν «εἰσόδους» ὅσαι κεχαρισμένως αὐτοῖς γίνονται. τινὲς μὲν γὰρ ἐνοχλεῖσθαι νομίζουσιν ὑπὸ τῶν πολλάκις αὐτοὺς ὁρώντων, ἔνιοι δὲ πάνυ τούτῳ σφόδρα χαίρουσιν. ἰατροὶ δέ τινές εἰσιν οἳ μέχρι τοσούτου μωραίνουσιν, ὡς καὶ τοῖς κοιμωμένοις ἐπεισιέναι μετὰ ψόφου ποδῶν ἢ φωνῆς μείζονος, ὑφ' ὧν ἐνίοτε διεγερθέντες οἱ νοσοῦντες ἀγανακτοῦσί τε πρὸς αὐτοὺς καὶ βεβλάφθαι τὰ μέγιστά φασι. ἅπαντ' οὖν ταῦτα προορᾶσθαι χρὴ τὸν ἰατρόν, ὡς μήτε κατὰ καιρὸν ὃν οὐ χρὴ παραγίνεσθαι μήτε προπετῶς μετὰ ψόφων πολλῶν καὶ φωνῆς μεγάλης ἢ βαδίσματος ἀσχήμονος ἢ βλέμματος ἢ ὅλως οὑτινοσοῦν τοιούτου.

Conversation. This is one of the greatest issues regarding whether patients are being treated appropriately or inappropriately by their doctors. Some of them are utterly witless, the sort of people Zeuxis says Bacchius described in his Memoirs of Herophilus and his House regarding Callianax the Herophilean. For once, when a patient said to Callianax, “I am going to die,” they say he responded with this verse:

“Unless Leto of the Fair Children gave birth to you.” [2]

And to another who said the same thing, he said:

“Patroclus died as well, who was much better than you.” [3]

Some doctors today, even if they are more moderate than Callianax, are still rough on patients, so that they are hated. Others, conversely, who flatter in a slavish manner, are despised for this very reason. Just as the doctor should not appear worthy of hatred to the patient, neither should he be easily despised; rather, he should maintain his dignity while being humane, moderate, and pleasant. For unless the patient admires the doctor like a god, he will not be obedient; and if he is not willingly obedient, it is better not to flatter him to the point of being despised, nor to be boorish and rough like Callianax. This will happen if the doctor maintains dignity in his look, speech, and the posture of his whole body, while instructing the patient to obey his orders.

There are many “conversations”, and I will not hesitate to provide you with one as an example. The doctor, in a persuasive introduction, can review with the patient what Hippocrates wrote about these matters: first in the Aphorisms, saying, “One must not only do what is necessary oneself, but also make the patient, the attendants, and the externals cooperate” (Aph. 1.1); then in the first book of Epidemics: “The art has three factors: the disease, the patient, the physician. The physician is the servant of the art. The patient must cooperate with the physician in combating the disease” (Epid. 1.2.5). And since there are three factors, doctor, disease, and patient, if the patient leaves the doctor to fight the disease alone, or goes over to the disease and opposes the doctor, the doctor will be defeated by the disease. But if the patient leaves the disease and becomes an ally to the doctor against it, there is great hope of victory with two men fighting one disease. Conversely, it provides no hope if the patient joins the disease and opposes the doctor; for he, being isolated, would be defeated by the two.

This example is sufficient for you, who are capable of understanding that many similar things happen to the patient in relation to doctors. Not only should the intention of the <words> spoken by doctors to patients be appropriate, but the volume of the voice, the tone, and the whole delivery should correspond to the thought behind the words. And even if one is speaking to an educated man, one should take care not to commit solecisms or barbarisms. [4] For doctors appear contemptible to patients due to such things.

<λόγοι.> τῶν μεγίστων ἐστὶ καὶ τοῦτο πρὸς τοὺς κάμνοντας ὑπὸ τῶν ἰατρῶν ἤτοι προσηκόντως ἢ οὐ προσηκόντως τι γινόμενον. ἔνιοι μὲν γὰρ αὐτῶν ἐσχάτως εἰσὶν ἀβέλτεροι τοιοῦτοί τινες ὄντες, οἷον ὁ Ζεῦξίς φησιν ὑπὸ Βακχείου γεγράφθαι Καλλιάνακτα γεγονέναι τὸν Ἡροφίλειον ἐν τοῖς Ἀπομνημονεύμασιν Ἡροφίλου τε καὶ τῶν ἀπὸ τῆς οἰκίας αὐτοῦ· νοσοῦντος γάρ τινος, εἶτ' εἰπόντος τῷ Καλλιάνακτι «τεθνήξομαι», φασὶν αὐτὸν ἐπιφωνῆσαι τόδε τὸ ἔπος·

«εἰ μή σε Λητὼ καλλίπαις ἐγείνατο».

ἑτέρῳ δὲ ταὐτὸ τοῦτ' εἰπόντι φάναι·

«κάτθανε καὶ Πάτροκλος, ὅπερ σέο πολλὸν ἀμείνων».

ἔνιοι δὲ τῶν νῦν ἰατρῶν, εἰ καὶ μετριώτεροι Καλλιάνακτός> εἰσιν, ἀλλὰ τραχέως καὶ αὐτοὶ προσφέρονται τοῖς νοσοῦσιν ὡς μισηθῆναι, καθάπερ ἄλλοι τινὲς ἐξ ὑπεναντίου δουλοπρεπῶς κολακεύοντες ἐξ αὐτοῦ τούτου κατεφρονήθησαν. ὥσπερ δὲ οὐ χρὴ μίσους ἄξιον φαίνεσθαι τῷ κάμνοντι τὸν ἰατρόν, οὕτως οὐδ' εὐκαταφρόνητον, ἀλλ' ἐν τῷ φιλανθρώπῳ καὶ μετρίῳ καὶ ἡδεῖ τὸ σεμνὸν φυλάττειν. εἰ μὴ γὰρ ὥσπερ θεὸν αὐτὸν ὁ κάμνων θαυμάσειεν, οὐκ ἂν εὐπειθὴς γένοιτο, εἰ δὲ μὴ ἑκὼν εὐπειθὴς γένοιτο, βέλτιόν [οὖν] ἐστι μήτε κολακεύειν εἰς τοσοῦτον ὥστε καταφρονεῖσθαι μήτ' ἄγροικόν τε καὶ τραχὺν ὁμοίως εἶναι τῷ Καλλιάνακτι. γενήσεται δὲ τοῦτο φυλάττοντος μὲν ἔν τε τῷ βλέμματι καὶ τῷ φθέγματι καὶ τῷ παντὶ τοῦ σώματος σχήματι τὸ σεμνὸν τοῦ ἰατροῦ, ἐκδιδάσκοντος δὲ τὸν κάμνοντα πείθεσθαι τοῖς προσταττομένοις ὑφ' ἑαυτοῦ.

πολλοὶ δ' εἰσὶ λόγοι, καί σοι παραδείγματος ἕνεκεν οὐκ ὀκνήσω παραθέσθαι τινά. δυνήσεται γὰρ ὁ ἰατρὸς ἐπὶ προοιμίῳ πιθανῷ μετὰ ταῦτα πρὸς τὸν κάμνοντα διελθεῖν, ὅσα περὶ | τῶν τοιούτων Ἱπποκράτης ἔγραψε, πρῶτον μὲν ἐν τοῖς Ἀφορισμοῖς εἰπών· «Δεῖ δὲ οὐ μόνον ἑωυτὸν παρέχειν τὰ δέοντα ποιέοντα, ἀλλὰ καὶ τὸν νοσέοντα καὶ τοὺς παρεόντας καὶ τὰ ἔξωθεν», εἶτ' ἐν τῷ πρώτῳ τῶν Ἐπιδημιῶν· «Ἡ τέχνη διὰ τριῶν, τὸ νόσημα, ὁ νοσέων, ὁ ἰητρός· ὁ ἰητρὸς ὑπηρέτης τῆς τέχνης. ἐναντιοῦσθαι τῷ νοσήματι τὸν νοσέοντα μετὰ τοῦ ἰητροῦ χρή».

καὶ ὡς τριῶν ὄντων, ἰατροῦ καὶ νοσήματος καὶ κάμνοντος, ἐὰν ὁ νοσῶν ἐάσῃ μόνον πολεμεῖν τῷ νοσήματι τὸν ἰατρὸν ἢ καὶ πρὸς αὐτὸ μεταστὰς ἐναντιώσηται τῷ ἰατρῷ, συμβήσεται νικηθῆναι τὸν ἰατρὸν ὑπὸ τοῦ νοσήματος. ἐὰν δὲ καταλιπὼν τὸ νόσημα σύμμαχος κατ' αὐτοῦ γένηται τῷ ἰατρῷ, μεγάλην ἐλπίδα τῆς νίκης ἔσεσθαι δυοῖν ἀνθρώπων πρὸς ἓν νόσημα μαχομένων, ὡς τό γε ἐναντίον ἔμπαλιν οὐδεμιᾶς ἐλπίδος ἔσται παρεκτικόν, ἐὰν ὁ κάμνων μετὰ τοῦ νοσήματος γενόμενος ἐναντιῶται τῷ ἰατρῷ· μονωθεὶς γὰρ ἂν οὗτος ὑπὸ τῶν δυοῖν νικηθείη ἄν.

ἀρκεῖ δέ σοι τὸ παράδειγμα τοῦτο νοῆσαι δυναμένῳ κατὰ τὸ παραπλήσιον ἕτερα πολλὰ τοιαῦτα τῷ νοσοῦντι γίνεσθαι πρὸς τῶν ἰατρῶν. οὐ μόνον δὲ τῶν λεχθησομένων λόγων τοῖς κάμνουσιν ὑπὸ τῶν ἰατρῶν τοιαύτην εἶναι προσήκει τὴν διάνοιαν, ἀλλὰ καὶ τὸ μέγεθος τῆς φωνῆς καὶ τὸν τόνον καὶ τὴν ὅλην ὑπόκρισιν ἀνὰ λόγον εἶναι τῇ διανοίᾳ τῶν λόγων. εἰ δὲ καὶ πεπαιδευμένῳ διαλέγοιτό τις ἀνδρί, † καὶ μετὰ τοῦ μὴ σολοικίζειν τε καὶ βαρβαρίζειν. καὶ γὰρ ἐκ τῶν τοιούτων εὐκαταφρόνητοι τοῖς κάμνουσιν οἱ ἰατροὶ φαίνονται.

Galen, Commentary on Epidemics VI 4.10, 17B.145-148K = 202-205 Wenkebach

Notes

[1] The Epidemics passage is usually taken as a checklist of things that affect how a sick person feels. On the modern reading (e.g. Smith), τῷ νοσέοντι (“for the patient”) is taken as a dative of reference. Everything that follows belongs to the patient’s world: what they eat and drink, what they see and touch, the general atmosphere, and even practical details like clothing, hair, nails, and smells. It’s classic Epidemics: observe, adjust, don’t make things worse.

Galen (and maybe others at the time) reads the list very differently. For him, it’s about the doctor’s own behavior and grooming: speak politely, dress sensibly, keep your hair and nails neat, don’t smell of wine or garlic. A kind of ancient bedside-manner code. He takes τῷ νοσέοντι to mean “for the sake of the patient.”

Grammar probably favors the simpler view, and Galen has to do some gymnastics to make his reading work. His interpretation is fun, and great evidence for later medical etiquette, but it probably tells us more about Galen’s world than about what this Hippocratic text originally meant.

[2] Leto, goddess, mother of Apollo and Artemis.

[3] Iliad 21.107, what Achilles says to Lykaon just before he kills him.

[4] Technical terms. “Solecism” is incorrect grammar/syntax; “Barbarism” is the use of non-Greek words.

December 13, 2025 /Sean Coughlin
bedside manner, Hippocratic Commentary, Galen, Herophilus, Epidemics
Ancient Medicine
Comment
16th c. manuscript illustration by Francesco Salviati of a reduction of the humerus. From a Latin translation of Galen’s commentary on Hippocrates’ Fractures. Par. lat. 6866, fol. 90 via BnF Gallica.

16th c. manuscript illustration by Francesco Salviati of a reduction of the humerus. From a Latin translation of Galen’s commentary on Hippocrates’ Fractures. Par. lat. 6866, fol. 90 via BnF Gallica.

Galen’s Commentary on Hippocrates’ Fractures

Humboldt-Universität zu Berlin
July 16, 2021 by Sean Coughlin in Ancient Medicine

It’s almost impossible to find English translations of Galen’s Hippocratic commentaries. There’s an English translation by W. J. Lewis of Galen’s commentary on the Nature of the Human Being available at the Society for Ancient Medicine site at Cambridge; and there are English translations by Uwe Vagelpohl of Arabic translations of some of Galen’s commentaries for the Corpus Medicorum Graecorum. That’s about it for English. The situation is only marginally better for French, German, Italian and Spanish (see the CMG’s Galen catalogue).

It is frustrating because Galen’s commentaries contain a huge amount of material on Greek scholarship of the second century—not only philosophy and medicine, but literature and philology as well. They are also important parts of the reception of earlier philosophy, medicine, literature and philology, since many later scholars drew from and responded to them in Syriac, Arabic, Latin and Greek traditions. Making them more widely available in modern language translations would help to open the field up quite a bit.

As for the texts themselves, some of Galen’s commentaries have modern critical editions and are available online in Greek and / or in Arabic at the Corpus Medicorum Graecorum of the Berlin-Brandenburg Academy of Sciences. Some are in preparation (like Airs, Waters, Places in Arabic). Others are still to be edited, like much of the Aphorisms commentary.

A lot of in-depth scholarship is still behind paywalls. The most important study, for instance, is the 1994 contribution, “Galeno commentatore di Ippocrate” by Daniela Manetti and Amneris Roselli, to the Aufstieg und Niedergang der römischen Welt (I see De Gruyter sells the article for 30 EUR). There’s also great new work by Manetti and Roselli in a few recent volumes, as well as work by (and the following are merely examples) Hans Diller, Georg Harig and Jutta Kollesch, Geoffrey Lloyd, Mario Vegetti, Paola Manuli, Heinrich von Staden and P. N. Singer. I’d add Glenn Most’s work on ancient Greco-Roman scholarship and David Sedley’s work on commentary and philosophical allegiance to the list of important resources that are not always easy to find online (less of a necessity for now while the pandemic restrictions are being relaxed). There are surely many others.

There is however a scholarly and open-access discussion of Galen’s Hippocratic commentary and Hippocratism in a piece by Jacques Jouanna called “Galen’s Reading of the Hippocratic Treatise The Nature of Man: The Foundations of Hippocratism in Galen” from the 2012 volume of his collected papers published by Brill. And there’s the wonderful 1979 book The Hippocratic Tradition by Wesley Smith that’s available online in a special electronic edition Smith revised for BIU Santé in 2002.

Lately, I’ve been posting translations of the more programmatic or weird bits of Galen’s commentaries to try to make them a bit more accessible (also to motivate me while I write a chapter on them for a handbook). This time it’s the preface to Galen’s commentary on Hippocrates’ Fractures.

Galen’s commentary on Hippocrates’ Fractures belongs to an earlier period of Galen’s Hippocratic scholarship, when he was writing mainly at the request of friends (as in last week’s post). The period includes commentaries on Aphorisms, Fractures, Joints, Prognosis, Regimen in Acute Diseases, Wounds, Injuries of the Head, and Epidemics 1. Eventually, he says he started producing commentaries for wider publication, after he came across some particularly bad but popular commentaries written by a couple of physicians named Lycos and Julian. These are commentaries on Nature of the Human Being, Epidemics 2, Epidemics 3, Epidemics 6, Humours, Nutriment, Prorrhetic, Surgery and Airs, Waters, Places.

The preface to the commentary on Fractures is unique because it contains a summary of Galen’s reflection on interpretation (exegesis) from his lost essay On Interpretation.* In that work, Galen says he defined interpretation as the ability to make what is obscure in written texts clear. He also distinguishes two kinds of interpretation according to a distinction between two kinds of obscurity: obscurity per se and obscurity relative to the audience (perhaps drawing on Platonist categorial distinction between things that exist kath’auto and pros ti). Something is obscure per se when it implies a contradiction. Something is obscure relative to an audience when the audience is unfamiliar with the subject of the discussion.

Galen thinks the result is that interpreting something that is obscure per se will be different from interpreting something that is only obscure relative to the audience. In the latter case, Galen says he’ll nearly always clarify what is relatively obscure in the case of anatomical claims, but for the most part he’ll target people who are already fairly well trained in philosophy, literature and medicine. We also find Galen’s views on what teaching at different levels consists in.

Comments on the translation welcome.

Galen’s Commentary on Hippocrates’ Fractures, preface

“Before going on to individual interpretations, it is better to have an understanding of interpretation in general: that its capacity is to make clear whatever in written treatises is obscure. To demonstrate something written down as true, or to refute it as false—even if someone alleges [the position] was defended sophistically—is distinct from interpretation, although it is customary for just about everyone who writes commentaries to do this. And, by god, there is nothing to prevent the interpreter from touching on this in moderation, but to be completely contentious about the opinions of the author is to exceed the boundaries of interpretation. Therefore, since I am not making this my aim, but what has been mentioned, I will make concise additions to the actual interpretation for the sake of making what was said plausible.

“Nevertheless, there are two different kinds of interpretation, because obscurity itself has two kinds. I think it is better to speak about this in advance; however, I will only speak briefly about these things, like a kind of summary, since they have been discussed at length in my essay On Interpretation. In that work I showed what is actually obscure being such itself through itself, and what in itself did not arise at first, but when there happened to be many differences among readers of the discussion, either in being educated and trained in argument or completely untrained, or with respect to some people being naturally sharp and intelligent, others dull and unintelligent.

“For example, in the book under discussion, On Fractures, where Hippocrates says ‘it must then be stated which of the errors of doctors one wishes to teach, which to unteach’, the passage is obscure itself through itself, since we do not expect there to be any errors that should be taught. Similar also is this one: ‘and the extension of the joint in this configuration has been bent.’ For he is saying the bent configuration of the outstretched arm has the joint at the elbow, but it seems absurd to say that the straight has been bent.

“Nevertheless, what has been said in the following way: ‘if the hinge-like part of the humerus in the cavity of the ulna is fixed in this kind of position, it makes a line with the bones of the ulna and humerus, as if the whole were one’—if someone had observed what the bones under discussion are like, there would be no obscurity; but to someone who does not know the nature of the articulation at the elbow, the passage reasonably appears obscure.

“I think it is better to interpret all such passages, because the majority of the book's readers have not learned anatomy. Nevertheless, it is fitting to pass over what is not like this, saying to those reading this book only this much about them: if you think one of the passages I have interpreted is obscure, first look into whether your book has mistakes by comparing and collating it with the most trustworthy copies. If it appears to be correct, read the same passage a second and a third time paying precise attention to it. For when I read a book together with someone in person, I am able to target the appropriate interpretation precisely, considering on each occasion the ability of the student. But when I am writing for everyone, I do not target those who are best or worst prepared. For in the former case, the interpretation will be obscure for most people; in the latter, it will be irritating for those who have to spend a long time on things that are clear.

“I think what is best, therefore, is to target one whose ability is in the middle; but when I miss this, I rather look to those who are more capable. For in general I do not think it is valuable for those whose ability is less than mediocre to read commentaries: they must be content to understand what has been said by listening many times to their teacher give the same explanations in passage after passage.”

Πρὸ τῆς τῶν κατὰ μέρος ἐξηγήσεως ἄμεινον ἀκηκοέναι καθόλου περὶ πάσης ἐξηγήσεως, ὡς ἔστιν ἡ δύναμις αὐτῆς, ὅσα τῶν ἐν τοῖς συγγράμμασίν ἐστιν ἀσαφῆ, ταῦτ' ἐργάσασθαι σαφῆ. τὸ δ' ἀποδεῖξαί τι τῶν γεγραμμένων ὡς ἀληθὲς ἢ ὡς ψεῦδος ἐλέγξαι, καὶ εἰ κατηγόρησέ τις σοφιστικῶς ἀπολογήσασθαι, κεχώρισται μὲν ἐξηγήσεως, εἴθισται δὲ γίγνεσθαι πρὸς ἁπάντων ὡς εἰπεῖν τῶν γραφόντων ὑπομνήματα. καὶ νὴ Δία οὐδὲν κωλύει καὶ τούτου μετρίως ἅπτεσθαι τὸν ἐξηγητήν. τὸ δ' ἀγωνίζεσθαι τελέως ὑπὲρ τῶν τοῦ γράφοντος δογμάτων ἐκπέπτωκε τὸν ὅρον τῆς ἐξηγήσεως. οὐ πρὸς τοῦτον οὖν τὸν σκοπὸν, ἀλλὰ πρὸς τὸν εἰρημένον ἀποβλέπων ἐγὼ προσθήσω ταῖς ὄντως ἐξηγήσεσιν ἑκάστοτε βραχέα τῆς πίστεως ἕνεκα τῶν εἰρημένων.

οὔσης μέντοι καὶ κατὰ ταύτην τὴν ἐξήγησιν διαφορᾶς διττῆς, ὅτι καὶ τὸ ἀσαφὲς αὐτὸ διττόν ἐστιν, ἄμεινον εἶναί μοι δοκεῖ καὶ περὶ τούτου προειπεῖν, εἰρήσεται δὲ καὶ αὐτὰ ταῦτα διὰ βραχέων, οἷον ἐπιτομή τις, ὧν ἰδίᾳ λέλεκται διὰ μακροτέρων ἐν τῷ περὶ ἐξηγήσεως ὑπομνήματι. δέδεικται δὲ ἐν ἐκείνῳ τὸ μὲν ὄντως ἀσαφὲς αὐτὸ δι' ἑαυτὸ τοιοῦτον ὑπάρχον, τὸ δὲ ἐν αὐτῷ πρότερον τὴν γένεσιν οὐκ ἔχον, ἐπειδὴ τῶν ἀκουόντων τοῦ λόγου διαφοραὶ πάμπολλαι τυγχάνουσιν οὖσαι κατά τε τὸ προπαιδεύεσθαι καὶ γεγυμνάσθαι περὶ λόγους ἢ παντάπασί γε ἀγυμνάστους ὑπάρχειν, εἶναί τε φύσει τοὺς μὲν ὀξεῖς τε καὶ συνετοὺς, τοὺς δὲ ἀμβλεῖς καὶ ἀσυνέτους.

αὐτίκα γοῦν ἐν αὐτῷ τῷ προκειμένῳ βιβλίῳ τῷ περὶ τῶν καταγμάτων, ἔνθα μέν φησιν ὁ Ἱπποκράτης· ῥητέον οὖν ὁκόσας ἂν ἐθέλει τῶν ἁμαρτάδων τῶν ἰητρῶν τὰς μὲν διδάξαι, τὰς δὲ ἀποδιδάξαι, τὴν ἀσάφειαν ἔχει αὐτὴ δι' ἑαυτὴν ἡ λέξις, οὐ προσδεχομένων ἡμῶν εἶναί τινας ἁμαρτίας, ἃς διδάξαι χρὴ, τοιοῦτόν ἐστι κἀκεῖνο· καὶ ἡ ἀνάτασις τοῦ ἄρθρου κέκλασται ἐν τουτέῳ τῷ σχήματι. τὸ γὰρ ἐκτεταμένης τῆς χειρὸς σχῆμα κεκλασμένον, φησὶν, ἔχει τὸ ἄρθρον τὸ κατ' ἀγκῶνα. δοκεῖ δὲ τοῦτ' ἄτοπον εἶναι κεκλάσθαι φάναι τὸ εὐθύ.

τὸ μέντοι λελεγμένον οὕτως· εἰ τοῦ βραχίονος τὸ γιγγλυμοειδὲς ἐν τῇ τοῦ πήχεος βαθμίδι, ἐν τοιουτέῳ τῷ σχήματι ἐρεῖδον, ἰθυωρίην ποιέει τοῖσιν ὀστέοισι τοῦ πήχεος καὶ τοῦ βραχίονος, ὡς ἓν εἴη τὸ πᾶν. εἰ μέντοι τις ἑώρακεν ὁποῖόν ἐστι τῶν ὀστῶν ἑκάτερον, ὑπὲρ ὧν ὁ λόγος ἐστὶν, οὐδεμίαν ἀσάφειαν ἔχει. τῷ δ' ἀγνοοῦντι τῆς κατ' ἀγκῶνα διαρθρώσεως τὴν φύσιν ἀσαφὴς εἰκότως ἡ λέξις φαίνεται.

δοκεῖ δέ μοι βέλτιον εἶναι καὶ τὰ τοιαῦτα πάντα ἐξηγεῖσθαι, διὰ τὸ τοὺς πλείστους τῶν ἀναγινωσκόντων τὸ βιβλίον ἀμαθεῖς ἀνατομῆς εἶναι. τὰ μέντοι μηδὲν ἐχόντων τοιοῦτον παρέρχεσθαι προσήκει, τοσοῦτον προειπόντα περὶ αὐτῶν ἔτι τοῖς ἀναγνωσομένοις τὸ βιβλίον, ἐάν τινα λέξιν ὧν ἐξηγησάμην ἀσαφὲς ἔχειν τι νομίσῃς, ἐπίσκεψαι μὲν πρῶτον εἰ μὲν τὸ βιβλίον ἡμάρτηταί σου παραβάλλων τε καὶ ἀντεξετάζων τοῖς ἀξιοπίστοις ἀντιγράφοις· εἶτ' ἂν ὀρθῶς ἔχειν φαίνηται, δεύτερόν τε καὶ τρίτον ἀνάγνωθι τὴν αὐτὴν λέξιν προσέχων ἀκριβῶς αὐτῇ τὸν νοῦν. ἐγὼ γὰρ ὅταν μὲν παρὼν παρόντι συναναγινώσκω τι βιβλίον, ἀκριβῶς στοχάζεσθαι δύναμαι τοῦ μέτρου τῆς ἐξηγήσεως, ἀποβλέπων ἑκάστοτε πρὸς τὴν τοῦ μανθάνοντος ἕξιν. ὅταν δὲ γράφω πᾶσιν, οὔτε τοῦ ἄριστα παρεσκευασμένου οὔτε τοῦ χείριστα στοχάζομαι. τὸ μὲν γὰρ τοῖς πλείστοις ἀσαφὲς ἔσται, τὸ δὲ ἀνιᾶται χρονίζοντας ἐν τοῖς σαφέσιν.

ἄριστον οὖν ἡγοῦμαι τῶν μέσην ἕξιν ἐχόντων στοχάζεσθαι· τούτου δὲ ἀποτυγχάνων ἐπὶ τοὺς ἑκτικωτέρους ἐπόπτειν μᾶλλον. οὐδὲ γὰρ ὅλως ὑπομνήμασιν ἐντυγχάνειν ἀξιῶ, τοὺς κατωτέρους τῆς μέσης ἕξεως, οἷς ἀγαπητόν ἐστι παρὰ διδασκάλων ἀκούσασι πολλάκις τὰ αὐτὰ κατ' ἄλλην καὶ ἄλλην λέξιν ἑρμηνευόμενα συνιέναι τῶν λεγομένων.

Gal. Hipp. Frac. 18B 318–322 K.

July 16, 2021 /Sean Coughlin
Galen, Hippocratic Commentary, Hippocrates, Commentaries
Ancient Medicine
Comment

Frontispiece to De morbo attonito liber unus by Justus Cortnumm, Leipzig, 1677. Via BSB.

Two reasons Galen wrote commentaries

Humboldt-Universität zu Berlin
July 09, 2021 by Sean Coughlin in Ancient Medicine

Because his friends asked him to.

“You have two treatises [by me] which contain everything to do with critical days and crises—for I’m saying this to you, my friends, who compelled me against my better judgment to write commentaries on the works of Hippocrates. Keep in mind that I also wrote those works (sc. on critical days and crises) not intending that they would be distributed, but that they would be for you alone, but they happened to get out and into the hands of many people, just like many others I’ve written for you. That’s why I preferred not to interpret any of Hippocrates’ books in written commentaries. For whatever one needs to learn from him that is useful for the art has been written down by me in many treatises along with the appropriate interpretations [of Hippocrates].

“But since some of the passages that were not expressed very clearly [in Hippocrates’ writings] received a bad interpretation, so that none of those who wrote commentaries satisfied you, and you thought I was better than they were at figuring out Hippocrates’ thought, for this reason you asked me to provide for you in writing what you heard me say in my lectures. And I said the same thing to you earlier, that the interpretations will necessarily be uneven, since I won’t be interpreting all the passages equally, but I will speak more thoroughly about those that I haven’t mentioned in any of my other treatises, while I will speak in summary about those I’ve already gone through in detail elsewhere, so that I’m not forced to write about the same things many times.”

Δύο πραγματείας ἔχετε (πρὸς ὑμᾶς γὰρ λέγω τοῦτο τοὺς ἑταίρους, ὅσοι κατηναγκάσατέ με μὴ προῃρημένον ἐξηγήσεις γράψαι τῶν Ἱπποκράτους συγγραμμάτων), ἐν αἷς ἅπαντα περί τε κρισίμων ἡμερῶν εἴρηται καὶ κρίσεων. ἴστε δ’ ὅτι καὶ αὐτὰς οὐχ ὡς ἐκδοθησομένας, ἀλλ’ ὡς παρ’ ὑμῖν μόνοις ἐσομένας ἔγραψα. συνέβη δ’ ἐκπεσεῖν αὐτὰς καὶ παρὰ πολλοῖς εἶναι, καθάπερ καὶ ἄλλα πολλὰ τῶν ὑμῖν γενομένων. ὅθεν οὐδ’ ἐξηγεῖσθαι προῃρούμην ἐν ὑπομνήμασιν οὐδὲν τῶν Ἱπποκράτους βιβλίων. ὅσα γὰρ εἰς τὴν τέχνην χρήσιμα παρ’ αὐτοῦ μαθεῖν ἔδει, γέγραπταί μοι κατὰ πολλὰς πραγματείας ἅμα ταῖς οἰκείαις ἐξηγήσεσιν.

ἐπεὶ δ’ ἔνιαι τῶν λέξεων ἀσαφέστερον εἰρημέναι μοχθηρᾶς ἐξηγήσεως ἔτυχον, ὡς ἀρέσκειν ὑμῖν μηδένα τῶν γραψάντων ὑπομνήματα, βέλτιον δὲ αὐτῶν στοχάσασθαι τῆς Ἱπποκράτους γνώμης ἐδόκουν ὑμῖν ἐγώ, διὰ τοῦτό με καὶ διὰ γραμμάτων ἠξιώσατε, παρασχεῖν ὑμῖν, ἅπερ ἐν ταῖς διὰ λόγων συνουσίαις ἠκούσατε. κἀγὼ τοῦτ’ αὐτὸ προεῖπον ὑμῖν, ὡς ἀναγκαῖον ἔσται τὰς ἐξηγήσεις ἀνωμάλους ἔσεσθαι μὴ πάσας ὁμοίως ἐξηγουμένου μου τὰς λέξεις, ἀλλὰ τελεώτερον μέν, ὑπὲρ ὧν οὐδαμόθι τῶν ἐμῶν πραγματειῶν ἐμνημόνευσα, διὰ κεφαλαίων δέ, περὶ ὧν ἤδη τελέως ἐν ἐκείναις διῆλθον, ἵνα μὴ πολλάκις ὑπὲρ τῶν αὐτῶν πραγμάτων ἀναγκάζωμαι γράφειν.

Gal. Hipp. Prog. 3.6, 18B.229–231 K. = 328,4–22 Heeg

Because he would be criticized if he didn’t.

“Well, let them say these things, but let them not falsely accuse Herophilus, nor intimidate with a sacred name those who are ignorant of Herophilus’ writings, nor use it to contrive trust in their argument. For it is shameful to dispute something on the basis of witnesses as if one were in a court of law. If you are able to argue towards a demonstration, I’ll gladly listen to you, but to call on Herophilus and the Herophileans as witnesses is to run away from a direct dispute and argument, and for fear of refutation invent evasions and deceptions.

“Clearly, false witnesses are brought in for the sake of a story, not in order to inquire into the matter further. ‘Does Herophilus say this?’ ‘Certainly not.’ ‘But doesn’t that mean you are lying?’ ‘Why don’t you show that I’m lying, show what he says.’ And then some kind of ambiguous passage is presented and there is a fight about what the passage says and what it means. Suddenly, rhetorical exercises on language and meaning are being rolled out, then others on ambiguity and, by Zeus, on inference. But they even apply the whole theory of rhetoric, as if they were practicing a speech, not bringing the subject to a conclusion. For what hasn’t been said by modern doctors about this question, some maintaining that Herophilus also knows this differentia of the pulse, others trying to show that he does not know it?

“Well, both groups have had a hard life and deserve to be pitied, the first for their ignorance, the second for their competitiveness. But we also have a hard life, since it is not enough for us to practice the proper theoretical study of the art, but we want to know what Herophilus said, what Heraclides, Chrysermus, and Hegetor interpreted incorrectly, and what Apollonius and Bacchius and Aristoxenus said. And even if we do not want to, at any rate we are forced to do it and we get to enjoy both troubles: that we get involved in this nonsense when it is unnecessary and that we unwillingly act like they do. Now it turns out that I must do one of two things: either appear to say the opposite of Archigenes, Herophilus and countless others, or show that there is no full pulse according to Herophilus.

“If, therefore, I had chosen this task, I would be just as blameworthy as they are for the vanity of the study; however, as the case stands, having refuted their opinion according to the actual truth of the matter, I will let those people leave who are interested in the practice of the art itself, since we’ve already completed our inquiry into the subject. Anyone who wants and has time to learn about ancient history, I will add the whole thing, showing that Herophilus does not use the term ‘the full pulse’ anywhere for anything.”

ταῦτ’ οὖν αὐτοὶ μὲν λεγέτωσαν, Ἡροφίλου δὲ μὴ καταψευδέσθωσαν, μηδὲ δυσωπείτωσαν ὀνόματι σεμνῷ τοὺς ἀμαθεῖς τῶν Ἡροφίλου γραμμάτων, μηδ’ ἐκ τούτου τὴν πίστιν τῷ λόγῳ ποριζέσθωσαν. αἰσχρὸν γὰρ ἐπὶ μαρτύρων ἀγωνίζεσθαι, καθάπερ ἐν δικαστηρίῳ. εἰ λέγειν ἔχεις εἰς ἀπόδειξιν, ἡδέως ἀκουσόμεθά σου. τὸ δ’ Ἡρόφιλόν τε καὶ Ἡροφιλείους καλεῖν μάρτυρας, ἀποδιδράσκοντός ἐστι τὸν ἐξ εὐθείας ἀγῶνα καὶ λόγον καὶ διαδύσεις τε καὶ μηχανὰς ἐξευρίσκοντος ἐλέγχου φόβῳ.

δῆλον, ὡς ἕνεκα τοῦ μὴ περὶ πράγματος ἔτι ζητεῖν, ἀλλ’ ἱστορίας οἱ κατεψευσμένοι μάρτυρες ἐπεισάγονται. λέγει τοῦθ’ Ἡρόφιλος; οὐ μὲν οὖν. ἀλλὰ οὐδὲ ψεύσῃ; δεῖξον πῶς ψεύδομαι, δεῖξον πῶς λέγει. κᾄπειτα λέξις, εἰ οὕτως ἔτυχεν, ἀμφίβολος προβάλλεται καὶ πόλεμος ἄμφ’ αὐτῇ συνίσταται, τί ποθ’ ἡ λέξις λέγει καὶ τί ποτε βούλεται, καὶ κατὰ ῥητὸν ἤδη καὶ διάνοιαν ἐπιχειρήματα ῥητορικὰ καλινδεῖται, καὶ κατ’ ἀμφιβολίαν ἕτερα καὶ κατὰ συλλογισμοὺς νὴ Δία. ἀλλὰ καὶ πᾶσαν οὕτω μεταφέρουσιν τὴν ῥητορικὴν, ὥσπερ ὑπόθεσιν μελετῶντες, οὐ τὸ προκείμενον περαίνοντες. τί γὰρ οὐκ εἴρηται τοῖς νεωτέροις ἰατροῖς εἰς τὸ πρόβλημα, τοῖς μὲν κατασκευάζουσιν ἐπίστασθαι τὸν Ἡρόφιλον καὶ ταύτην τοῦ σφυγμοῦ τὴν διαφορὰν, τοῖς δ’ ὡς οὐκ οἶδεν ἐγχειροῦσι δεικνύειν;

ἀταλαίπωροι μὲν οὖν ἑκάτεροι καὶ ἐλεεῖσθαι δίκαιοι, τῆς μὲν ἀμαθείας οἱ πρότεροι, τῆς φιλονεικίας δ’ οἱ δεύτεροι. ἀταλαίπωροι δὲ καὶ ἡμεῖς, οἷς γε οὐκ ἀρκεῖ τὴν ἰδίαν ἀσκεῖν θεωρίαν τῆς τέχνης, ἀλλὰ τί μὲν Ἡρόφιλος εἶπεν, τί δ’ Ἡρακλείδης τε καὶ Χρύσερμος καὶ Ἡγήτωρ οὐκ ὀρθῶς ἐξηγήσαντο, τί δ’ ἂν εἶπεν Ἀπολλώνιός τε καὶ Βακχεῖος καὶ Ἀριστόξενος εἰδέναι βουλόμεθα. καὶ εἰ μὴ βουλόμεθα δὲ, πάντως ἀναγκαζόμεθα καὶ διττῶν ἀπολαύομεν κακῶν, ὅτι τε φλυαροῦμεν οὐδὲν δέον ὅτι τε μὴ βουλόμενοι τοῦτο δρῶμεν, ὥσπερ ἐκεῖνοι· νῦν γοῦν ἐμὲ δεῖ δυοῖν θάτερον, ἢ δοκεῖν Ἀρχιγένει τε καὶ Ἡροφίλῳ καὶ μυρίοις ἄλλοις τἀναντία λέγειν, ἢ δεικνύειν, ὅτι καθ’ Ἡρόφιλον οὐδείς ἐστι πλήρης σφυγμός.

εἰ μὲν οὖν ὡς ἔργον αὐτὸ προὐχειρισάμην, ἦν ἂν ὁμοίως ἐκείνοις ἄξιος μέμψεως ἐπὶ τῇ ματαίᾳ σπουδῇ· νυνὶ δὲ κατ’ αὐτὴν τῶν πραγμάτων τὴν ἀλήθειαν ἐξελέγξας αὐτῶν τὴν δόξαν, τοὺς μὲν πρὸς αὐτὰ τὰ ἔργα τῆς τέχνης σπεύδοντας ἀπολύσω πρὸς ἐκεῖνα, συντετελεσμένης ἡμῖν ἤδη τῆς προκειμένης ζητήσεως. ὅσοι δὲ καὶ ἱστορίαν ἐκμανθάνειν παλαιὰν ἐθέλουσι, καὶ χρόνον εἰς τοῦτ’ ἔχουσιν, ἅπαντα προσθήσω, δεικνὺς ὅτι μηδαμοῦ χρῆται πρὸς μηδὲν Ἡρόφιλος τῷ πλήρει σφυγμῷ.

Gal. Dig. Puls. 4.3, 8.954–956 K.

July 09, 2021 /Sean Coughlin
Galen, Hippocratic Commentary
Ancient Medicine
Comment
Ariadne, sleeping, with Bacchus and Eros behind. Samandaĝ, mosaic, 2nd/3rd c. Image by Dosseman via Wikimedia Commons.

Ariadne, sleeping, with Bacchus and Eros behind. Samandaĝ, mosaic, 2nd/3rd c. Image by Dosseman via Wikimedia Commons.

Galen on Sleep, Health and Heartbreak

Humboldt-Universität zu Berlin
June 04, 2021 by Sean Coughlin in Ancient Medicine

More of Galen’s comments on the aphorism attributed to Hippocrates:

“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

Other cases: Maiandros, the augur who predicted his own death; a Cappadocian man who thought the sky would fall.

“In Rome, I recently saw a grammarian named Kallistos whose books were destroyed in the Great Fire that had burned the Temple of Peace. He grieved about this and could no longer sleep. First, he was taken with fever, and then, in just a short time, he wasted away until he died. I have seen quite a number of people like this—whose bodies waste away, be it from grief or from a bad mental state. I will limit myself to a few cases, because their number is too large. First, I mention the story of the mother of the lawyer Nasutus. The story of this woman is as follows. She received news that a woman she loved very much, who was seventy years old, was going by invitation to another place. She arrived there and returned home after having made the long journey. When she returned, she lay down on the bed and asked for some water to drink. The servant replied, “I'll bring it to you right away,” but she fell asleep before the servant returned with the water. By then, some time had passed without the people around the woman noticing anything. When, however, they called to her, she gave no answer. The servants were then compelled to shake her, but she did not wake up. They examined her and touched her body to see what had happened. Her whole body was cold and it was clear that she was dead. They covered her with the clothes in which she had died. When the mother of Nasutus found out about this, it went to her heart so much that she could no longer sleep the way she usually used to do, and eventually she could no longer sleep at all. Her body wasted away from insomnia. She began to have a fever and four days after the news of her friend’s death, she too passed away.”

In Rom sah ich vor kurzem einen Grammatiker, namens Kallistos, dem seine Bücher bei dem großen Brand in Rom, bei dem der Tempel, der “Tempel des Friedens” heißt, verbrannte, vernichtet wurden. Darüber grämte er sich und fand keinen Schlaf mehr. Zuerst begannen bei ihm Fieber, und dann in nicht langer Zeit siechte er dahin, bis er starb. Ich habe noch eine ganze Anzahl derartiger Menschen gesehen, deren Körper dahinsiechte, sei es aus Gram oder einer schlechten Geistesverfassung. Ich beschränke mich auf ein paar Fälle, da ihre Zahl ja zu groß ist. Zuerst erwähne ich die Geschichte der Mutter des Rechtsgelehrten Nasutus. Die Geschichte dieser Frau ist folgende: Sie erhielt die Nachricht, daß eine Frau, die sie sehr liebte und die siebzig Jahre alt war, nach einem anderen Orte auf eine Einladung hin ging. Sie war dort eingetroffen und auch wieder zurückgekehrt, nachdem sie den weiten Weg gemacht hatte. Nach ihrer Rückkehr hatte sie sich auf das Bett gelegt und verlangte etwas Wasser zu trinken. Der Diener hatte geantwortet: “Ich bringe es dir sofort.” Sie schlief aber ein, bevor der Diener mit dem Wasser zurück war. Es verging nun einige Zeit, ohne daß die Leute um die Frau etwas gemerkt hatten. Dann aber riefen sie sie an, aber sie gab keine Antwort. Die Diener sahen sich deshalb gezwungen, sie zu rütteln. Sie wachte aber nicht auf. Sie machten sich nun daran, die Sache zu untersuchen, und befühlten sie, um zu sehen, was mit ihr vorgegangen war. Ihr ganzer Körper war kalt, und es war klar, daß sie tot war. Sie deckten sie mit dem Kleid zu, in dem sie gestorben war. Als die Mutter des Nasutus dies erfuhr, ging es ihr so zu Herzen, daß sie sich nicht mehr zum Schlafen niederlegen konnte, wie sie es sonst gewöhnt war, und überhaupt keinen Schlaf mehr finden konnte. Da siechte auch ihr Körper infolge der Schlaflosigkeit dahin. Sie begann zu fiebern, und schon nach vier Tagen seit der Todesnachricht verschied auch sie.*

Galen, Commentary on Hippocrates‘ Epidemics 6.8, 486,19-487,12 Wenkebach/Pfaff

*Pfaff’s German translation of Hunayn’s school’s Arabic translation (the Greek is lost).

June 04, 2021 /Sean Coughlin
Galen, Hippocratic Commentary, Medicine of the mind, mental health
Ancient Medicine
Comment
Scene from the Casa di Lupanare piccolo in Pompeii, fresco, first century CE. Image via wikimedia commons.

Scene from the Casa di Lupanare piccolo in Pompeii, fresco, first century CE. Image via wikimedia commons.

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

Humboldt-Universität zu Berlin
May 21, 2021 by Sean Coughlin in Ancient Medicine

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.

May 21, 2021 /Sean Coughlin
Galen, Hippocratic Commentary, Sabinus, sex, Democritus, Epidemics
Ancient Medicine
Comment
Apollo, pouring a libation, and a bird, perhaps an omen. The kylix of Apollo. Fifth century BCE. At the Delphi Archaeological Museum. Image by Jean-Pierre Dalbéra via wikimedia commons.

Apollo, pouring a libation, and a bird, perhaps an omen. The kylix of Apollo. Fifth century BCE. At the Delphi Archaeological Museum. Image by Jean-Pierre Dalbéra via wikimedia commons.

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

Humboldt-Universität zu Berlin
January 29, 2021 by Sean Coughlin in Ancient Medicine

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


January 29, 2021 /Sean Coughlin
Medicine of the mind, Galen, Hippocratic Commentary, Epidemics
Ancient Medicine
Comment
Detail of a monk working on a manuscript. BL Royal MS 14 E III, fol. 6v. Via the British Library.

Detail of a monk working on a manuscript. BL Royal MS 14 E III, fol. 6v. Via the British Library.

Reading with Galen: when good authors say false things

Humboldt-Universität zu Berlin
February 06, 2020 by Sean Coughlin in Ancient Medicine

Another one Maria pointed out to me.

Idola theatri

“Whenever an obviously false statement is found in the writings of an intelligent author, it’s normal for their students to become puzzled. At first, they doubt themselves and do not trust that they understand what is obvious; then, after a while, they suspect something of what they are reading is false.”

Ὁπόταν ἐν ἀνδρὸς φρονίμου συγγράμματι λόγος εὑρεθῇ προφανῶς ψευδής, εἰκότως ἀπορεῖσθαι συμβαίνει τοὺς ἀναγινώσκοντας αὐτόν, καὶ πρῶτον μὲν ἑαυτοῖς ἀπιστεῖν, ὡς μηδὲ τὰ φανερά γινώσκουσι, εἶθ᾿ ἑξῆς ὑποπτεύειν, μή τι τῶν ὑποκειμένων ψευδὲς εἴη.

Galen, Commentary on Hippocrates’ Aphorisms 6.34, 18A.55 Kühn

The aphorism in question…

“Bald people do not get large varicose veins; bald people who do get varicose veins grow their hair back again.”

Ὁκόσοι φαλακροὶ, τουτέοισι κιρσοὶ μεγάλοι οὐ γίνονται· ὁκόσοισι δὲ φαλακροῖσιν ἐοῦσιν κιρσοὶ γίνονται, πάλιν οὗτοι γίνονται δασέες.

Aphorisms 6.34, 4.570 Littré

February 06, 2020 /Sean Coughlin
Hippocratic Commentary, Galen
Ancient Medicine
Comment
Hippocrates, gaining the respect of the youth.

Hippocrates, gaining the respect of the youth.

Conspiracy Theories

Humboldt-Universität zu Berlin
January 20, 2020 by Sean Coughlin in Ancient Medicine

After a couple years’ work, Maria Βörno and I are finishing up a paper about the criteria Galen uses to decide when a work should or should not be attributed to Hippocrates. Galen’s work on this, On the Genuine and Spurious Writings of Hippocrates (Περὶ τῶν γνησίων τε καὶ νόθων Ἱπποκράτους συγγραμμάτων), is lost, but Maria is preparing a critical edition of Galen’s commentary on the seventh book of the Aphorisms, which is a great source for examples of how Galen attacks earlier Hippocratic interpreters’ attributions.

Maria found this one, where Galen invents something like a conspiracy theory explaining why the seventh book is full of spurious material (we give Kühn’s text below):

“Still, I think the people who interpolated these aphorisms composed them using these words for the following reason: to make the passage confusing, like an enigma, and need a lot of research, at which point they can position themselves as interpreters of what was said and gain the respect of the youth. Just from looking at this aphorism, it should be obvious to you that all of these unclear passages provide the sophists a pretext for garrulity.”

ἀλλ᾽ οἱ τούτους τοὺς ἀφορισμοὺς παρενθέντες δοκοῦσί μοι χάριν αὐτοῦ τούτοις συνθεῖναι, τοῦ συγκεχύσθαι τε τὸν λόγον, ὥσπερ αἴνιγμα, καὶ δεῖσθαι ζητήσεως πολλῆς, ἐν ᾗ καθιστάντες ἑαυτοὺς ἐξηγητὰς τῶν λεγομένων εὐδοκιμοῦσι παρὰ τοῖς μειρακίοις. ὅτι δὲ οἱ λόγοι πάντες οἱ ἀσαφεῖς ἀφορμὰς πολυλογίας παρέχουσι τοῖς σοφισταῖς δῆλον ἔσται σοι κατ᾽ αὐτὸν τοῦτον τὸν ἀφορισμόν.

Galen, Commentary on Hippocrates’ Aphorisms VII 69 (XVIIIA 184–185 K.)


January 20, 2020 /Sean Coughlin
Hippocrates, Hippocratic Commentary, Aphorisms, Galen
Ancient Medicine
Comment
  • Newer
  • Older
 

CATEGORIES

  • Ancient Medicine
  • Botany
  • Events
  • Philosophy

SEARCH

 

RECENT POSTS

Featured
Dec 31, 2025
Botany, Philosophy
Concerning a Variant in the de Fuentes Manuscript
Dec 31, 2025
Botany, Philosophy
Dec 31, 2025
Botany, Philosophy
Dec 25, 2025
Ancient Medicine
How to smell nice: Galen's advice for doctors
Dec 25, 2025
Ancient Medicine
Dec 25, 2025
Ancient Medicine
Dec 23, 2025
Ancient Medicine
More on how not to talk to patients
Dec 23, 2025
Ancient Medicine
Dec 23, 2025
Ancient Medicine
Dec 13, 2025
Ancient Medicine
"Patroclus died as well" (How Not to Talk to Patients)
Dec 13, 2025
Ancient Medicine
Dec 13, 2025
Ancient Medicine
Sep 18, 2023
Ancient Medicine
Galen, Simple Drugs, Book 11, Preface (II)
Sep 18, 2023
Ancient Medicine
Sep 18, 2023
Ancient Medicine