Galen rants against Chrysippus because he’s a immigrant

As part of a project at the Einstein Centre Chronoi on time and ancient medicine, Peter N. Singer, Orly Lewis and I have been reading through Galen’s writings on the pulse. We came across a passage where Galen goes on a racist rant against the philosopher, Chrysippus. Galen tells us that Chrysippus moved to Athens from the town of Soli in Cilicia (in modern day Turkey), and for that reason, has no business using Attic Greek in novel ways. Galen seems to be alluding to (and rejecting) a hypothetical defence of Chrysippus’ language, one based on a story that must have been making the rounds. The story is an attempt to give the etymology of the word “solecise”. It claims that the citizens of Soli, a town supposedly founded by Solon, the legendary Athenian ruler, originally spoke Attic, but over time, spoke a corrupted dialect. Here is how Diogenes Laertius tells it:

When he (sc. Solon) left that place, he arrived in Cilicia and founded a city, which he called Soli after himself. And he settled a few Athenians there, who over time corrupted the language and were said to “solecise.”

ἐκεῖθέν τε ἀπαλλαγεὶς ἐγένετο ἐν Κιλικίᾳ, καὶ πόλιν συνῴκισεν ἣν ἀπ᾽ αὐτοῦ Σόλους ἐκάλεσεν: ὀλίγους τέ τινας τῶν Ἀθηναίων ἐγκατῴκισεν, οἳ τῷ χρόνῳ τὴν φωνὴν ἀποξενωθέντες σολοικίζειν ἐλέχθησαν.

Diog. Laert. 1.51

Here is Galen:

For among other things, [the Pneumatist] school also claims that you should betray your state more quickly than you betray your beliefs. But if you keep quiet while they are making decrees and you don’t say anything in opposition, and then allow them to discuss something, they immediately blurt out something contrary to their own decree. This is very much in line with the forefather of their sect, Chrysippus. For he makes decrees about terminology more than Solon set down laws for the Athenians to write on their wooden tablets. He’s the one who first confused these things, and when you ask his successors who follow his decrees, ‘why on earth isn’t he consistent with his own edicts?’, they say, ‘he is speaking loosely.’ ‘Well then, my my fine fellows, is it possible for people to speak loosely without falling into error by doing so?’ ‘It’s possible,’ they say, since what else could they say when they are, as the saying goes, trapped in a well? Well, why on earth don’t they allow other people [to speak loosely]? Or is it only possible for Chrysippus and his followers to do so? By the gods, why? Because, obviously, he was from the race of Atticans, from the line of Kodros and Erechtheus. But if he really was from this race, then he would not have debased, so to speak, the currency of the customary language of their ancestors. And in fact, the worst thing is that Chrysippus wasn’t born in Athens and wasn’t raised there. Instead, he shows up, fresh off the boat from Cilicia, and before he properly learns any Greek, he makes decrees to the Athenians about terminology, like “the jay imitating the siren”—as if I should say a jay, rather than a jackdaw, or a crow, or another more appropriate word to use for someone so shameless.

τά τε γὰρ ἄλλα καὶ ἡ αἵρεσις αὐτῶν θᾶττον πόλιν ἢ δόγμα φησὶ χρῆναι προδιδόναι, ἀλλ' ἐὰν σιωπήσῃς νομοθετούντων καὶ μηδόλως ἀντείπης, εἶτ' ἐπιτρέψῃς περί τινος διαλέγεσθαι, παραχρῆμα ταῖς ἑαυτῶν νομοθεσίαις ἐναντία φθέγγονται. πολὺ δὲ τοῦτ' ἔστι παρὰ τῷ προπάππῳ τῆς αἱρέσεως αὐτῶν Χρυσίππῳ. νομοθετεῖ μὲν γὰρ ὀνόματα πλεῖον ἢ Σόλων Ἀθηναίοις ἱστᾷν τοῖς ἄξοσι νομίσματα. συγχεῖ δ' αὐτὸς πρῶτος αὐτά. καὶ εἰ ἔροιο τοὺς διαδόχους αὐτοῦ τῆς νομοθεσίας, τί δή ποτε οὐκ ἐμμένει τοῖς ἑαυτοῦ παραγγέλμασι, καταχρῆται, φασίν. ἔξεστιν οὖν, ὦ βέλτιστοι, καταχρῆσθαι, καὶ οὐχ ἁμαρτάνουσιν οἱ τοῦτο ποιοῦντες; ἔξεστι, φασί. τί γὰρ ἄλλο εἰπεῖν ἔχουσιν, ὅταν ἐν φρέατι, τοῦτο δὴ τὸ τοῦ λόγου, συσχεθῶσι; τί δή ποτ' οὖν τοῖς ἄλλοις ἀνθρώποις οὐκ ἐπιτρέπουσιν; ἢ μόνῳ Χρυσίππῳ καὶ τοῖς ἀπ' αὐτοῦ τοῦτο δρᾷν ἔξεστι; διὰ τί πρὸς τῶν θεῶν; ὅτι δηλαδὴ γηγενὴς Ἀττικὸς ἦν τῶν ἀμφὶ Κόδρον τε καὶ Ἐρεχθέα. ἀλλ' εἰ τῶν τοιούτων ὄντως ἦν, οὐκ ἂν παρεχάραττεν οἷον νόμισμά τι τὸ τῆς παλαιᾶς φωνῆς ἔθος. νυνὶ δὲ τὸ δεινότατον οὔτε γεννηθεὶς Ἀθήνῃσιν οὔτε τραφεὶς, ἀλλὰ χθὲς καὶ πρώτως ἥκων ἐκ Κιλικίας, πρὶν ἀκριβῶς αὐτὸν ἐκμαθεῖν ἡντιναοῦν Ἑλλάδα φωνὴν, Ἀθηναίοις ὑπὲρ ὀνομάτων ἐπιχειρεῖ νομοθετεῖν ἃ κίττα τὰν σειρῆνα μιμουμένα, ἵνα κίτταν εἴπωμεν, μὴ κολοιὸν, μηδὲ κόρακα, μηδ' ἄλλο μηδὲν ὧν οἰκειότερον ἦν εἰπεῖν τὸν οὕτω θρασύν.

Galen, De differentia pulsuum, 2.10 (8.630-8.632 Kühn)

Sources for the Pneumatist School

Puzzles about the Pneumatist school of medicine. Continued from here.

II. Transferring Schools

G. Galenus, De differentia pulsuum 3.2 (VIII 646K)

“For Magnus, mind you, who professes himself to come from the Pneumatist school, says the strength of the beat (of the pulse) is produced differently from the way Archigenes does.”

ὁ γάρ τοι Μάγνος, καὶ αὐτὸς ἀπὸ τῆς πνευματικῆς αἱρέσεως εἶναι προσποιούμενος, ἑτέρως τὸ ἰσχυρὸν τῆς πληγῆς γίνεσθαί φησιν ἢ ὡς Ἀρχιγένης.

H. Galenus, De differentia pulsuum 3.1 (VIII 640K)

“Magnus clearly knows that he is not arguing against the other doctors about facts, but about the proper or improper use of terms. This is made especially clear through the following example: for he asks Demetrius [the Cynic?], to whom he has dedicated these books On the Discoveries after the Time of Themison, to investigate it [sc. the pulse] with him as well, since he is a philosopher and someone who knows more precisely what is a proper term and what is not.”

οἶδεν οὖν σαφῶς ὁ Μάγνος ὅτι μὴ περὶ πράγματος, ἀλλὰ τοῦ κυρίως ὀνομάζειν, ἢ μὴ κυρίως, πρὸς τοὺς ἄλλους ἰατροὺς ἀμφισβητεῖ. σαφέστατον δ' ἔτι ποιεῖ τοῦτο διὰ τῶν ἐφεξῆς· ἀξιοῖ γὰρ τὸν Δημήτριον, ᾧ ταῦτα τὰ βιβλία τὰ περὶ τῶν ἐφευρημένων μετὰ τοὺς Θεμίσωνος χρόνους ἀνέθηκε, συνεπισκέψασθαι καὶ αὐτὸν, ὡς ἂν φιλόσοφόν τε ὄντα καὶ τί τὸ κύριον ὄνομα καὶ τί τὸ μὴ τοιοῦτον ἀκριβέστερον εἰδότα.

I. Caelius Aurelianus, Celeres passiones, 2.10.58 (CML VI 1, 166,9-12 Bendz)

“But no one identified this disease [sc. catalepsy] as such until the time of the Methodists. For it was Magnus, from our [school, i.e., the Methodists], who first determined its characteristics, and he was soon followed by Agathinus and then by Archigenes [...].”

sed neque alius quisquam hanc passionem [sc. catalepsis] cognouit usque ad Methodicorum tempora. name ex nostris primus Magnus eius argumenta constituit, atque mox Agathinus, dehinc Archigenes [...].

Sources for the Pneumatist School of Medicine

For the last few years, Orly Lewis and I have been working on a project on the Pneumatist school of medicine. ‘School’ translates hairesis—the word from which we get ‘heresy’ in English. The root meaning of hairesis is ‘choice.’ It later came to mean the group who chooses to follow the same teacher or leader, or, more abstractly, people who choose to follow the same set of philosophical or moral principles.

The Pneumatists are a hairesis, we are told, because its members chose to believe that pneuma is the cause of life, health and disease (instead of, or in addition to, other things like humours, blocked pores, etc.). It is generally thought to have been founded by Athenaeus of Attalia in the late first century BCE or early first century CE. What is interesting, however, is that only three sources name this school—Galen, the author of Introduction or the Doctor (Introductio seu Medicus), and John of Alexandria—and the earliest of these sources is from the mid- to late 2nd century. That leaves about 150 years where no one mentions the Pneumatist hairesis. Furthermore, apart from Athenaeus, the doctors whom Galen and the author of the Introduction associate with the Pneumatist hairesis are said either to belong to other schools or to have founded other schools by other (and sometimes earlier) sources. Soranus / Caelius Aurelianus associates Agathinus and Magnus with the Methodists, the author of the Medical Definitions says Agathinus founded a hairesis the some people called “episynthetic”, others “eclectic”, and the author of the Introduction in one place says Archigenes was “eclectic,” in another place a Pneumatist. How many schools can one person belong to? How exclusive are they? Is membership in a school an act of self-identification, or is it applied from outside? —it’s far from clear.

The semester is starting in Berlin, so here are some passages about haireseis which we’ve been collecting, passages which we think emphasize why it’s time for historians of science to come up with new ways of understanding self- and other-presentation among ancient professionals (good work has been done by Heinrich von Staden, Philip van der Eijk, David Leith, and others, but there’s more to do). Part one of three.

I. What school do you go to?

A. Galenus, De causis contentiuis 2.1 (CMG Suppl. Or. II, 134,3-4 Schöne; Lyons tr., modified)

Athineum igitur Attaleum, quit spiritualem nominatam heresim in medicatiua primo cepit [...]

As for Athenaeus of Attalia, he founded the medical school known as that of the Pneumatists [...]

B. Anonymus Bambergensis, Codex Bambergensis L.iii.8 med. i (411 Sudhoff)

subsequente autem tempore facti sunt rationabiles potentes medici Diocles, Praxagoras, Herophilus, Erasistratus, Asclepiades, Athenaeus, Agathinus, Ariston, Archigenes, Herodotus, Philumenus, Antyllus.

Dicoles : Deoclex codd. | Praxagoras : Praxacoras codd. | Herophilus : Herophilos codd. | Athenaeus : Atheneus codd. | Agathinus : Agatheneus codd. | Philumenus : Philominus codd. | Antyllus : Antillus codd.

In the subsequent period, however, the Rationalist physicians became powerful: Diocles, Praxagoras, Herophilus, Erasistratus, Asclepiades, Athenaeus, Agathinus, Ariston, Archigenes, Herodotus, Philumenus, Antyllus.

C. Anonymus, Initia Medicinae (52 Firpo)

subsequenti autem tempore facti sunt rationabiles [et] potentes medici, idest Diocles, Praxagoras, Herophilus, Erasistratus, Asclepiades, Athenaeus, Agathinus, Ariston, Archigenes, Herodotus, Philumenus, Antyllus.

et] delevi | Herophilus : Erophilus codd. | Athenaeus : Atheneus codd. | Agathinus : Agathenus codd. | Philumenus : Philomenus codd. | Antyllus : Antillus codd.

In the subsequent period, however, the rationalist physicians became powerful, i.e., Diocles, Praxagoras, Herophilus, Erasistratus, Asclepiades, Athenaeus, Agathinus, Ariston, Archigenes, Herodotus, Philumenus, Antyllus.

D. Galenus, De differentia pulsuum 3.6 (VIII 673-674 Kühn)

τὸ γὰρ δὴ τρίτον τῶν σημαινομένων (sc. τοῦ κενοῦ) οὔτε Ἀρχιγένης οὔτε Ἀγαθῖνος οὔτε Μάγνος οὔτ' Ἀθήναιος οὔτε ἄλλος οὐδεὶς τῶν πνευματικῶν ἰατρῶν ἀληθὲς ὁμολογήσει.

The third meaning (sc. of 'empty'), neither Archigenes, Agathinus, Magnus, Athenaeus, nor any other of the Pneumatist doctors will agree to its truth.

E. [Galenus], Definitiones medicae 14 (IX 352-353K)

πόσον κατὰ ἰατρικῆς αἱρέσεις; ἰατρικῆς αἱρέσεις αἱ πρῶται δύο ἐμπειρικὴ καὶ λογικὴ καὶ τρίτη μεθοδική. δοκεῖ δὲ καὶ τετάρτην αἵρεσιν ἐξευρεῖν Ἀγαθῖνος ὁ Λακεδαιμόνιος, ἣν ὠνόμασεν ἐπισυνθετικὴν, ἔνιοι δὲ ἐκλεκτικήν, ἕτεροι τὴν ἑκτικήν.

How many schools of medicine are there? The main medical schools are two: the Empiricist and the Logical, and a third is the Methodist. Agathinus of Lacedaemon seems to have invented a fourth school, which is called episynthetic, but some call eclectic, others hectic.

F. [Galenus], Introductio seu Medicus 4 (XIV 684 K)

ἐγένοντο δέ τινες καὶ ἐπισυνθετικοὶ, ὡς Λεωνίδης ὁ Ἀλεξανδρεύς. καὶ ἐκλεκτοὶ, ὡς Ἀρχιγένης ὁ Ἀπαμεὺς τῆς Συρίας.

Some were also episynthetic, like Leonides of Alexandria, and some eclectic, like Archigenes of Apamea in Syria.

Galen on Hippocrates in Stobaeus: a fragment of Antyllus? or, Antyllus and the Pneumatist School

(a short essay for my 36th birthday)

I came across this text in Stobaeus' Eclogae. It's a characterization of Hippocrates' beliefs about medicine, purportedly from Galen, but I doubt this attribution is correct. (I'll explain why in a minute.)

Jouanna made an edition of it in 2008 with French translation and discussion [J. Jouanna, « Un Galien oublié: "Caractéristiques propres à Hippocrate" (Stobée, Anthologie 4.37.14), avec une nouvelle édition », Storia della tradizione e edizione dei medici greci. Atti del VI Colloquio internazionale, Paris 12-14 aprile 2008, Collectanea 27, Napoli, M. D'Auria, 2010, p. 199-229], but I couldn't find an English translation or discussion of it, so I translated it here.

I think lots can be said about it, and I hope this gives more people a chance to take a look.

The text comes from a section of the Eclogae on regimen or healthy way of life (περὶ ὑγείας καὶ τῆς περὶ τὴν διαμονήν αὐτῆς προνοίας = Eclogae 4.37). The section includes quotations from Pythagoras, Alcmaeon, Plato, Plutarch, Aristoxenus, "Socrates", "Gorgias", and "Hippocrates" — quite a weird mix.

There is one other author, who is quoted more than the others (eight times total): the doctor and surgeon, Antyllus. And four of these fragments of Antyllus' writings come immediately after this passage, on differences in the air according to things like time of day, time of year, and geography. (Air was often thought to be a cause of disease: more famously in extreme cases, like the miasmata, i.e., the gases given off when things rot and decay; sometimes in cases we don't think too much about today, like the effects of morning or afternoon air; and sometimes in cases we still think about, like smokey or dirty city air.) Is there a connection between this text and the Antyllus fragments that follow it?

The text presents a series of claims about medicine which are "believed by Hippocrates" ("ἀρέσκει δὲ αὐτῷ" and variants). First, we are given Hippocrates' beliefs about physiology (and in what texts he wrote about them). Physiology here begins with whatever things are 'evident' (ἐναργῆ), and that means the primary division is that of the body into solids, liquids and gases. These are in turn associated with tissues (solids), pneuma and the four humours (liquids). Next, we get a statement of his beliefs about correlations among humours, times of life of a human being, seasons of the year, times of day, and about the basis of those correlations in different mixtures of the qualities hot, cold, moist and dry. Then, a discussion of the differences in qualities (hot cold moist dry) of men and women, of the function of the humours, his views on reproduction, and the relationship between bodily axes (right / left, up / down). Last come his views on pathology, followed by therapy and prognostics, and especially the importance of knowing critical days and affected parts.

In Hense's text of the Eclogae, he prints "Galen's" ("Γαληνοῦ'), and there is nothing in the critical apparatus to suggest it was attributed to any other author. Hense, who edited Stobaeus for Teubner in the early 1900s, writes: "ecl. cum lemm. hab. S, om. M A. Gesnerum fere sequitur Charterius." I think what he is saying is that the title is missing in manuscripts M and A (although maybe it means the whole thing is missing in M and A?), and also that Chartier, who included it in his edition of Galen of 1638/9, followed Gesner's 1559 edition of Stobaeus (or followed him in attributing it to Galen? or what? I don't know how to read these properly). I haven't checked M (codex Mendozae Escurialensis LXXXX Σ II 14) or A (codex Parisinus Graecus 1984) to see what they say, but it would be worth doing.

Whether or not Galen's name is in the manuscripts, I think it is pretty unlikely that this text comes from him. It seems to me to contradict some basic commitments Galen ascribes to Hippocrates, particularly about the elements and about the relationship between the seasons of the year, times of life, the humours, and the four-qualities. For example, in Mixtures 1.3-4, Galen says that the attempts to find strong correlations, like the ones in our passage, result from a lack of scientific training, and he suggests the passages from Hippocrates' writings, which others use to support the correlations, are misinterpreted. (Of course, someone might object to what I’ve just said: Galen does not state explicitly what he thinks Hippocrates' views on this relationship are, only that it is incorrect to think there is in fact a strong correlation between seasons and bodily mixtures, and that in each season only one quality dominates. But in response I think we could say, the fact Galen thinks these people get it wrong is a pretty strong indication he thinks Hippocrates would not commit such an error.)

Regarding the elements, Galen wrote a whole book explaining that the primary elements according to Hippocrates are earth, air, water and fire, which are not elements evident to perception. I have not come across any passages where Galen attributes the three-fold division of the body (into solid parts, liquid parts, and pneumata) to Hippocrates, although he writes of other doctors who did. I've written about these passages here before.

My hunch then is that this text is not from Galen, but that it comes either from Antyllus, or from some book (or passage in a book) incorrectly ascribed to Galen. Antyllus because he is the medical source Stobaeus relies on the most and the fragments we have from him generally agree with the beliefs ascribed to Hippocrates in this text. A pseudo-Galenic work because there are many instances of texts, like the Introductio or Definitiones, carrying Galen's name even though they were not written by him. It could also come from an earlier compilation with a similar incorrect attribution.

Because of the correspondence between this text and the passages from Antyllus that come after, I'd like to think it's from him. Antyllus is an interesting thinker and writer, but he is mysterious. This makes my claim a bit hard to prove. There are lots of fragments preserved in Oribasius, but we have almost no other evidence about him. The best we can say is that he probably lived after Archigenes (fl. around the time of Trajan), since Archigenes' name shows up in a passage attributed to Antyllus in Oribasius (Coll. med. 9.23.18 at the end). That would put him at the earliest around 100 CE. And we can say, since Oribasius quotes him, that it is very likely that he lived before Oribasius (who was born early fourth century). That would put him at the latest around the 350s or so. Somewhere in those 250 years, we can find Antyllus.

I have an ulterior motive in wanting to attribute the text to Antyllus. What I find interesting about this text is how similar it sounds to views scholars often ascribe to the Pneumatist school of medicine, of which Antyllus is often said to be a member. I think historians of medicine too often assume that the Pneumatists were a more distinctive group of doctors than they actually were. I have read that the Pneumatists shared a unique set of beliefs, beliefs that differ markedly from their contemporaries. These are beliefs about the composition of the human being (either out of three kinds of parts, solids, liquids, gases; or out of the four qualities, hot cold moist and dry); beliefs about analogies between the seasons, times of life and bodily humours; beliefs about the causes of diseases and their treatment through opposites; and I have heard people say that the Pneumatists had an interest in developing a way of doing medicine which followed the doctrines of "Hippocrates".

There is however very little evidence tying these beliefs and practices specifically to the doctors called 'Pneumatist' in our sources. Texts like the pseudo-Galenic Introductio and Definitiones, and even the Anonymus Londinensis, show that these characteristics were common to a lot of doctors in the 00s and 100s CE. On the other hand, what our sources say was distinctive about the Pneumatists is in fact very little: we are told they, following the Stoics, believe pneuma controls health and disease, that they follow Hippocrates, and that Hippocrates identifies pneuma with the innate heat. That's it.

When people claim Antyllus is a Pneumatist, they almost never offer any evidence. When they do, the evidence tends not to be very convincing. I think there are two reasons for this. First, there are no complete writings by Antyllus which survive, no contemporary discussions about him and we have no precise evidence for when he lived. He is an obscure figure in the history of medicine, and any evidence we have is going to be controversial and require a lot of interpretation and speculation. That's fine - the same goes for most ancient authors - but I also think it means we should be a bit more careful.

Second, Antyllus does not call himself a Pneumatist in any of the fragments we have. This means the evidence usually comes from places where Antyllus mentions some Pneumatist authors, or where he mentions things that sound Pneumatist in the fragments. People especially point to cases where he uses the word 'pneuma.' But the fact that he adopts views from Athenaeus or discusses Archigenes does not make him a Pneumatist any more than it makes Galen one. Neither does the fact that Antyllus occasionally talks about pneuma or "tension" (tonos - a Stoic and Pneumatist technical term, but the word is by no means limited to them) make him a Pneumatist any more than it makes one of Caelius Aurelianus (who uses Latin equivalents for both but calls himself a Methodist). Just about everyone in antiquity after Aristotle who writes about living things mentions pneuma, and no one thinks they're all Pneumatists.

This, then, is the unconvincing evidence. There is, however, some better evidence that Antyllus is a Pneumatist doctor. For one thing, he fits the description of some people whom Galen calls the "followers of Athenaeus". (I've placed the text from Galen at the end of this piece.) I have also found some striking similarities between a fragment of Athenaeus preserved in Aetius and some fragments of Antyllus preserved in Oribasius' Medical Collections (and in their parallels in this section of Stobaeus). In fact, Antyllus takes over whole sentences from Athenaeus, always without attribution, and he expands on them as if he were trying to explain or refine Athenaeus' views.

Nevertheless, I do not find even this evidence all that persuasive. Athenaeus was followed by lots of people, but that does not imply each follower was committed to the all or even the most central of the ideas associated with him: that pneuma controls health and disease. I haven't found any evidence for this belief in the fragments of Antyllus. Given this lack of evidence and given we don't know Antyllus' dates, it's even harder to place him among the Pneumatists. He may have been a later medical writer who liked what Athenaeus had to say, or both he and Athenaeus may have been drawing on the same source material. We just don't know.

I admit that whether Antyllus was a Pneumatist or not is not a terribly important historical question. I guess the question of whether he wrote this particular text isn't that important either. Still, whoever it was who wrote the characateristics of Hippocrates, it's a nice example of the ideal of a "Hippocratic" medicine, an ideal which was developed and promoted in the 00s and 100s CE (and after), and which has endured until today. It's only recently that historians of medicine like Philip van der Eijk began to try to understand this ideal: scholars who raise the question of how and why the idea of "the Hippocratic" was constructed and how it rose to such prominence. Along with other texts like the pseudo-Galenic Introductio, I think this little fragment (which I'd still like to think was written by Antyllus) tells part of this story.

Stobaeus, Eclogae, 4.37.14 (Vol. 5, 883,2-886,6 Hense)

Galen’s “Characterizations of Hippocrates”

He says that it is clearly his opinion that the elements of the art are those which are evident. So, he says "human beings and all animals are composed from solids, liquids and pneumata." The nature of plants are not without a share of the three-fold kind of these things; however, it lives, increases, reproduces and grows by their composition in accordance with nature, and it becomes diseased, decays, dies and withers by their imperfection and dissolution.

He refers the composition of the solid parts to bones, nerves and cartilage, and further membrane, artery and vein. For in some [of his writings] he also says these belong to the solid kind. Following what is reasonable, he shares the opinion the principle of their assembly and formation is the head. He has also devoted to [the subject of] the nature of the solid parts the [books] On Fractures, On Joints, and those similar to them; while to the pneumata, [he devoted] the book called (peculiarly) On Winds; to the liquids, [he devoted] the [books] On Humours, On the Nature of the Human Being, and [he wrote about them] here and there in other works. These are blood and phlegm, and the two biles, yellow and black. [He says] the nature of blood is moist and hot, its colour red, and its quality sweet. Phlegm is cold and moist, white and salty. Yellow bile is hot and dry, ochre and bitter, while the other is cold and dry, black and sea-weedy.

It is also his opinion that the age of a person and the seasons of the year alike are divided into four. Each of the humours mentioned exceed the others in amount at the proper age and season of each of them. So in the time of childhood and in the season of spring, blood exceeds the others. In the time of the prime of life and in the season of summer, yellow bile. In the time past one's prime and in the autumn, black [bile]. And [in the time of] of old age and in winter, phlegm. For the natures of humours resemble those of the seasons. Therefore, the spring is hot and moist, like blood, and the summer is hot and dry. Fall is cold and dry, while winter is cold and wet, in proportion with the humours. The day is also divided in accordance with them, both in number and nature, as if in a small proportion. Generally, the natures of men differ from those of women. For the former tend towards hotter and drier, the latter towards colder and wetter. There is a smaller difference in kind for each of these and relative to one another, following the locations of the places, the particular qualities of the airs, and how people lead their lives. Each of the humours in the nature of a human being provides a special use. So blood nourishes, heats, moistens and is productive of good complexion. Yellow bile holds the body and the pores together, lest it be relaxed, stimulates perception, completes concoction, and provides easy passages for excretions. Black [bile] is a seat and, as it were, pedestal of the other humours. Phlegm [provides] for rapidity of movement to the nerves, membranes, cartilage, and tongue.

He thinks the seed contributes to reproduction, that of the male and of the female equally, and that it comes from all the parts of the body. And that males are generated on the right side of the womb, females on the left. The [parts] on the right side [of the body] are dominant relative to those on the left, and the upper [parts] relative to the lower ones.

And he thinks, concerning the causes of diseases, that some are from violent blows, some are from the environment, while the majority come from the liquids we mentioned, according to excess and defect, and change in quality or change from place to place [in the body]. 

It is also his belief that one [should] use remedies from things which are contrary to the causes [of the disease]. Of diseases, some are by nature acute, some chronic, some unclear. Acute diseases come about for the most part from bile and blood, and occur in the prime of life, and in summer and spring. Chronic diseases come from phlegm, black bile, and occur in the elderly and in winter. Unclear diseases are those which have mixed causes. And further, he makes prognoses about which of them one can recover from and which are fatal. He also thinks prognosis and prediction are both necessary for the art and that they differ from one another. For, sometimes the doctor only needs to make a prognosis, but sometimes it is safe to predict. He divides prognosis into past and present symptoms, as many have an uncertain quantity, and into future ones. 

It is also his opinion that one recognize the critical days. For the most part, the odd-numbered days belong to acute diseases, the even-numbered ones to chronic [diseases]. And those in the summer time, in youths, in the right-side parts [of the body], and in the upper parts [occur on] odd-numbered days, while in the case of their contraries, on even-numbered days. And further, he recommends knowing the places affected primarily, the recognition of which contributes no small part to indication and therapy.

Γαληνοῦ χαρακτηριάζοντα εἰς Ἱπποκράτην (=II p. 72 Chart.)

Τὰ τῆς τέχνης στοιχεῖα σαφῶς ἀρέσκειν αὐτῷ λέγει τὰ ὅσα ἐναργῆ. συνέστηκεν οὖν, φησίν, ὅ τε ἄνθρωπος καὶ τὰ σύμπαντα ζῷα ἐκ στερεῶν ὑγρῶν καὶ πνευμάτων. οὐκ ἀμοιρεῖ δὲ οὐδ' ἡ τῶν φυτῶν φύσις τῆς τούτων τριγενείας, ἀλλὰ ζῇ τε καὶ αὔξεται καὶ γεννᾷ καὶ φύεται τῇ τούτων συστάσει κατὰ φύσιν, νοσεῖ δὲ καὶ φθίνει καὶ θνῄσκει καὶ αὐαίνεται τῇ τούτων πλημμελείᾳ καὶ διαστάσει.

τὴν μὲν οὖν τῶν στερεῶν σύστασιν ὀστοῖς ἀνατίθησι καὶ νεύροις καὶ χόνδροις, ἤδη δὲ καὶ ὑμένι καὶ ἀρτηρίαις καὶ φλεψί· καὶ γὰρ ταῦτα τοῦ στερεοῦ γένους ἔν τισιν εἶναι λέγει. τῆς δὲ τούτων συμπηγίας καὶ διαπλάσεως, ἑπόμενος τῷ εὐλόγῳ, τὴν κεφαλὴν εἶναι ἀρχὴν συνδοκεῖ. ἀνατέθεικε δὲ τῇ τῶν στερεῶν φύσει τό τε περὶ ἀγμῶν καὶ τὰ περὶ ἄρθρων καὶ τὰ τούτοις ὅμοια· τῷ δὲ πνεύματι τὸ περὶ φυσέων ἰδίως ἐπιγραφόμενον σύγγραμμα· τοῖς δ' ὑγροῖς τὸ περὶ χυμῶν καὶ τὸ περὶ ἀνθρώπου φύσεως, ἤδη δὲ καὶ σποράδην ἐν ἄλλοις· ἔστι δὲ ταῦτα αἷμα καὶ φλέγμα, χολὴ διττή, ξανθὴ καὶ μέλαινα. εἶναι δὲ τὸ μὲν αἷμα τὴν φύσιν ὑγρὸν καὶ θερμὸν καὶ τὴν χρόαν ἐρυθρόν, τὴν δὲ ποιότητα γλυκύ· τὸ δὲ φλέγμα ψυχρὸν καὶ ὑγρὸν καὶ λευκὸν καὶ μᾶλλον ἁλμυρόν· τὴν δὲ ξανθὴν χολὴν θερμήν τε καὶ ξηρὰν καὶ ὠχρὰν καὶ πικράν, τὴν δὲ ἑτέραν ψυχρὰν καὶ ξηρὰν καὶ μέλαιναν καὶ φυκώδη.

ἀρέσκει δὲ αὐτῷ καὶ τὰς ἡλικίας διαιρεῖν εἰς δʹ καὶ τὰς ὥρας τοῦ ἔτους ὁμοίως. πλεονάζειν δὲ τῶν εἰρημένων χυμῶν ἕκαστον ἐν τῇ ἡλικίᾳ καὶ τῇ ὥρᾳ τῇ οἰκείᾳ ἑκάστου. καὶ ἐν μὲν τῇ τῶν παίδων ἡλικίᾳ πλεονάζειν τὸ αἷμα, καὶ τῇ ὥρᾳ τοῦ ἔαρος· ἐν δὲ τῇ τῶν ἀκμαζόντων τὴν ξανθὴν χολήν, καὶ ὥρᾳ θέρους· ἐν δὲ τῇ τῶν παρηβώντων τὴν μέλαιναν, καὶ φθινοπώρῳ· ἐν δὲ τῇ τῶν γερόντων τὸ φλέγμα, καὶ χειμῶνος· ἐοικέναι γὰρ τὰς τῶν χυμῶν φύσεις ταῖς τῶν ὡρῶν. τὸ γοῦν ἔαρ θερμόν τε καὶ ὑγρόν, ὡς τὸ αἷμα· καὶ τὸ θέρος θερμόν τε καὶ ξηρόν· τὸ δὲ μετόπωρον ψυχρόν τε καὶ ξηρόν· ὁ δὲ χειμὼν ψυχρὸς καὶ ὑγρός, ἀναλόγως τοῖς χυμοῖς· κατὰ ταὐτὰ δὲ καὶ τὴν ἡμέραν διαιρεῖ, καὶ τῷ ἀριθμῷ καὶ τῇ φύσει, ὡς ἐν μικρᾷ τῇ ἀναλογίᾳ. καθόλου γε τὰς τῶν ἀνδρῶν φύσεις πρὸς τὰς τῶν γυναικῶν διαφέρειν. εἶναι γὰρ τοὺς μὲν ἐπὶ τὸ θερμότερον καὶ ξηρότερον, τὰς δὲ ἐπὶ τὸ ψυχρότερον καὶ ὑγρότερον. ἐν ἑκάστου δὲ τούτων γένει καὶ πρὸς ἀλλήλους ἔχειν μικροτέραν διαφοράν, παρά τε τὰς τῶν χωρίων θέσεις καὶ τὰς τῶν ἀέρων ἰδιότητας καὶ τὰς τῶν διαιτημάτων ἀγωγάς. παρέχειν δὲ καὶ τῶν χυμῶν ἕκαστον ἐν τῇ φύσει τοῦ ἀνθρώπου χρείαν ἐξαίρετον. καὶ τὸ μὲν αἷμα τρέφειν καὶ θερμαίνειν καὶ ὑγραίνειν καὶ εὐχροίας εἶναι ποιητικόν· τὴν δὲ ξανθὴν χολὴν συνέχειν τὸ σῶμα καὶ τοὺς πόρους μὴ ἐᾶν ἐκλύεσθαι, καὶ μυωπίζειν τὴν αἴσθησιν, καὶ συντελεῖν τῇ πέψει, καὶ τὰς ὁδοὺς τῶν ἐκκρίσεων παρέχειν εὐπετεῖς· τὴν δὲ μέλαιναν ἕδραν καὶ οἱονεὶ βάθρον τῶν ἄλλων χυμῶν· τὸ δὲ φλέγμα νεύροις ὑμέσι καὶ χόνδροις καὶ ἄρθροις καὶ γλώττῃ πρὸς τὸ εὔδρομον τῆς κινήσεως.

δοκεῖ δὲ αὐτῷ καὶ τὸ σπέρμα πρὸς ζῳογονίαν τό τε τοῦ ἀνδρὸς καὶ τὸ τῆς γυναικὸς ἐπίσης συντελεῖν καὶ ἀπὸ πάντων τῶν μελῶν φέρεσθαι τοῦ σώματος. καὶ τὰ μὲν ἄρρενα ἐν τοῖς δεξιοῖς τῆς μήτρας, τὰ δὲ θήλεα ἐν τοῖς ἀριστεροῖς γεννᾶσθαι. ἰσχύειν δὲ καὶ τὰ δεξιὰ ὡς πρὸς τὰ ἀριστερά, καὶ τὰ ὑπερκείμενα ὡς πρὸς τὰ ὑποκείμενα.

δοκεῖ δ' αὐτῷ καὶ τὰς αἰτίας τῶν νοσημάτων ἃς μὲν ἐκ πληγῶν βιαίων, ἃς δὲ ἐκ τοῦ περιέχοντος εἶναι· τὰς δὲ πλείστας ἐκ τῶν ὑγρῶν τῶν εἰρημένων κατὰ πλῆθος καὶ ἔλλειψιν καὶ μεταβολὴν τὴν κατὰ ποιότητα ἢ τὴν ἐκ τόπου εἰς τόπον.

ἀρέσκει δὲ αὐτῷ καὶ τὰ βοηθήματα εἰσφέρειν ἐκ τῶν ἐναντίων ἱσταμένων ταῖς αἰτίαις. τῶν δὲ νοσημάτων ἃ μὲν εἶναι φύσει ὀξέα, ἃ δὲ χρόνια, ἃ δὲ ἐνδοιαστά. γίνεσθαι δὲ ὡς πολὺ ἀπὸ χολῆς καὶ αἵματος καὶ ἡλικίας ἀκμαζούσης καὶ θέρους καὶ ἔαρος τὰ ὀξέα· τὰ δὲ χρόνια ἀπὸ φλέγματος καὶ μελαίνης χολῆς καὶ ἐν πρεσβύταις καὶ χειμῶνι· τὰ δ' ἐνδοιαστά, ὁπόσα μεμιγμένας ἔχει τὰς αἰτίας. ἤδη δὲ καὶ τίνα αὐτῶν σωτήρια καὶ τίνα θανατικά, προγινώσκει· βούλεται δὲ καὶ τὴν πρόγνωσιν καὶ τὴν πρόρρησιν ἀναγκαίαν τε εἶναι πρὸς τὴν τέχνην καὶ διαφέρειν ἀλλήλων. ὅπου μὲν γὰρ προγνῶναι χρὴ μόνον τὸν ἰατρόν, ὅπου δὲ καὶ προειπεῖν ἀσφαλές. διαιρεῖ δὲ τὴν πρόγνωσιν εἴς τε τὰ προγεγονότα καὶ τὰ ἐνεστῶτα τῶν συμπτωμάτων, ὁπόσα † ἔχει πόσην ἀδηλότητα, καὶ εἰς τὰ μέλλοντα.

ἀρέσκει δ' αὐτῷ καὶ τὰς κρισίμους ἡμέρας ἐπεγνωκέναι. γίνεσθαι γὰρ ὡς τὸ πολὺ τὰς μὲν περιττὰς κριτικὰς τῶν ὀξέων νοσημάτων, τὰς δὲ ἀρτίους τῶν χρονίων. καὶ τὰς μὲν θέρους καὶ ἐπὶ νέων καὶ τῶν δεξιῶν μερῶν καὶ τῶν ὑπερκειμένων τὰς περισσάς· τὰς δὲ ἀρτίους ἐπὶ τῶν ἐναντίων. ἤδη δὲ καὶ τοὺς πρωτοπαθοῦντας τόπους εἰδέναι παραινεῖ, ἐκ τῆς τούτων ἐπιγνώσεως οὐ μικρὰν συμβαλλομένης μοῖραν εἰς σημείωσίν τε καὶ θεραπείαν.

Galen, Mixtures 1.3 (8,28-10,3 Helmreich = I 522-523K)

When attacking these kinds of arguments [against the non-existence of hot/wet diseases], some of the followers of Athenaeus of Attalia force the issue, saying there is nothing wrong with a wet and hot condition, and asserting that no illness has been discovered that is wet and hot; rather, in every case [illness] is either hot and dry like fever, cold and wet like dropsy, or cold and dry like melancholia. And they also mention at this point the seasons of the year, asserting that the winter is wet and cold, the summer dry and hot, and the autumn cold and dry, while the spring, they say, is well-mixed, [being] at the same time a hot and wet season.

And so they also say that, of the ages of life, youth is well-mixed and [is] both hot and wet. They consider the good balance of it [sc. youth] to be shown also from [the fact that] the activities of nature are strong especially at this time. And then they also say that death leads the bodies of animals to dryness and cold—at any rate, corpses are called "alibas" because they no longer possess any "libas", i.e., moisture: at the same time, they have been desiccated due to the departure of the hot and solidified by the cooling. 'But if,' they say, 'death is such, then necessarily life, being the opposite of this, will be both hot and wet.' And they say, 'if life is something hot and wet, it is also altogether necessary that the mixture most resembling it [sc. life] be best. But if [it is best], it is altogether clear [that it is] as well-mixed as possible. Therefore, in regard to the same thing, it follows that a well-mixed [person?] has a wet and hot nature and good-mixture is nothing other than the prevalence of the wet and the hot.'

These, then, are the arguments of those around Athenaeus. In a way, the opinion of the philosopher Aristotle and of Theophrastus seems to be the same, and also after them, of the Stoics, so that we are embarrassed by the majority of witnesses. But concerning Aristotle, how he used to understand hot and wet mixture, perhaps, if it is needed, I will explain as the argument proceeds. For they seem to me to have misunderstood him.

πρὸς δὴ τοὺς τοιούτους λόγους ἀπομαχόμενοί τινες τῶν ἀπ' Ἀθηναίου τοῦ Ἀτταλέως ὁμόσε χωροῦσιν οὔτε κατάστασιν ὑγρὰν καὶ θερμὴν μέμφεσθαι λέγοντες οὔθ' εὑρεθῆναί τι νόσημα φάσκοντες ὑγρὸν καὶ θερμόν, ἀλλὰ πάντως ἢ θερμὸν καὶ ξηρὸν ὑπάρχειν ὡς τὸν πυρετόν, ἢ ψυχρὸν καὶ ὑγρὸν ὡς τὸν ὕδερον, ἢ ψυχρὸν καὶ ξηρὸν ὡς τὴν μελαγχολίαν. ἐπιμέμνηνται δ' ἐνταῦθα καὶ τῶν ὡρῶν τοῦ ἔτους, ὑγρὸν μὲν καὶ ψυχρὸν εἶναι τὸν χειμῶνα φάσκοντες, ξηρὸν δὲ καὶ θερμὸν τὸ θέρος καὶ ψυχρὸν καὶ ξηρὸν τὸ φθινόπωρον, εὔκρατον δ' ἅμα καὶ θερμὴν καὶ ὑγρὰν ὥραν εἶναί φασι τὸ ἔαρ.

οὕτω δὲ καὶ τῶν ἡλικιῶν τὴν παιδικὴν εὔκρατον θ' ἅμα καὶ θερμὴν καὶ ὑγρὰν εἶναί φασιν. δηλοῦσθαι δὲ τὴν εὐκρασίαν αὐτῆς νομίζουσι κἀκ τῶν ἐνεργειῶν τῆς φύσεως ἐρρωμένων τηνικαῦτα μάλιστα. καὶ μὲν δὴ καὶ τὸν θάνατόν φασιν εἰς ξηρότητα καὶ ψῦξιν ἄγειν τὰ τῶν ζῴων σώματα. καλεῖσθαι γοῦν ἀλίβαντας τοὺς νεκροὺς ὡς ἂν οὐκέτι λιβάδα καὶ ὑγρότητα κεκτημένους οὐδεμίαν, ἐξατμισθέντας θ' ἅμα διὰ | τὴν ἀποχώρησιν τοῦ θερμοῦ καὶ παγέντας ὑπὸ τῆς ψύξεως. ἀλλ' εἴπερ ὁ θάνατος, φασί, τοιοῦτος, ἀναγκαῖον ἤδη τὴν ζωήν, ὡς ἂν ἐναντίαν οὖσαν αὐτῷ, θερμήν τ' εἶναι καὶ ὑγράν· καὶ μὴν εἴπερ ἡ ζωή, φασί, θερμόν τι χρῆμα καὶ ὑγρόν, ἀνάγκη πᾶσα καὶ τὴν ὁμοιοτάτην αὐτῇ κρᾶσιν ἀρίστην ὑπάρχειν· εἰ δὲ τοῦτο, παντί που δῆλον, ὡς εὐκρατοτάτην, ὥστ' εἰς ταὐτὸ συμβαίνειν ὑγρὰν καὶ θερμὴν φύσιν εὐκράτῳ καὶ μηδὲν ἄλλ' εἶναι τὴν εὐκρασίαν ἢ τῆς ὑγρότητός τε καὶ θερμότητος ἐπικρατούσης.

οἱ μὲν δὴ τῶν ἀμφὶ τὸν Ἀθήναιον λόγοι τοιοίδε. δοκεῖ δέ πως ἡ αὐτὴ δόξα καὶ Ἀριστοτέλους εἶναι τοῦ φιλοσόφου καὶ Θεοφράστου γε μετ' αὐτὸν καὶ τῶν Στωϊκῶν, ὥστε καὶ τῷ πλήθει τῶν μαρτύρων ἡμᾶς δυσωποῦσιν. ἐγὼ δὲ περὶ μὲν Ἀριστοτέλους, ὅπως ἐγίγνωσκεν ὑπὲρ θερμῆς καὶ ὑγρᾶς κράσεως, ἴσως ἄν, εἰ δεηθείην, ἐπὶ προήκοντι τῷ λόγῳ δείξαιμι· δοκοῦσι γάρ μοι παρακούειν αὐτοῦ.
 

"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.

---

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)

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

John of Alexandria on Hippocrates and the Pneumatic School

“People ask, why does Hippocrates everywhere throughout the whole book credit pneuma with the creation of the child […]? Was he a Pneumatist? We answer, no, he was not a Pneumatist…”

ζητοῦσιν ὅτι πῶς ὁ Ἱπποκράτης πανταχοῦ ἐν ὅλῳ τῷ συγγράμματι αἰτιᾶται τὸ πνεῦμα τῆς δημιουργίας τοῦ παιδὸς [...]; πότερον πνευματικὸς ὑπῆρχε; φαμέν, ὅτι οὐκ ἤν πνευματικός...

John of Alexandria, In Hippocrates De natura pueri commentarium 49, (CMG 11 1,4, 174,11-14 Bell et al. = Dietz, Scholia in Hippocratem et Galenum, vol II p. 234-5).