Bathing with Galen's Friend

“In fact, someone recently asked me why we urinate cold urine in the baths, but hot outside them. He did not understand that urine itself is equally warm both in the baths and out of them, and that it is the surface of one's body that is not in the same state while bathing and before. For when we are bathing, our body's surface is warmer than the urine, but outside it is colder, so it's reasonable that the urine seems hot to it when outside the bath, but cold inside.”

καί τις ἔναγχος ἡμῖν προὔβαλε διὰ τί ψυχρὸν μὲν ἐν τοῖς βαλανείοις οὐροῦμεν, ἔξω δὲ θερμὸν, οὐ παρακολουθῶν ὅτι τὸ μὲν οὖρον αὐτὸ χλιαρὸν ὁμοίως ἐστὶν ἔν τε τοῖς βαλανείοις κᾀκτὸς, ἡμεῖς δὲ οὐχ ὡσαύτως διακείμεθα τὴν ἐπιφάνειαν τοῦ σώματος ἔν τε τῷ λούεσθαι καὶ πρὸ τούτου. λουόμενοι μὲν γὰρ θερμοτέραν ἔχομεν αὐτὴν ἢ κατὰ τὸ οὖρον, ἔξω δὲ ψυχροτέραν· ὥστε εὐλόγως αὐτῇ καὶ τὸ οὖρον ἔξω μὲν τοῦ βαλανείου θερμὸν, ἔνδον δὲ ψυχρὸν φαίνεται.

Galen, Simple Drugs 3.8, 11.554–555 Kühn

Holding it in

“You can learn for yourself what I’m saying is true if you consider something that often happens to people. There are times when a biting humour builds up in the area around the anus and it makes us really need to go to the bathroom, but we are forced to hold it in because we are in the middle of some public business; once we’re done with it, we can’t go to the bathroom anymore and as a result we often we also get a headache and an upset stomach.”

ὅτι δὲ ἀληθές ἐστιν ὃ λέγω, πάρεστι μαθεῖν ἑκάστῳ τῶν πολλάκις ἡμῖν συμβαινόντων ἀναμνησθέντι. δακνώδης γοῦν ἐνίοτε χυμὸς εἰς τὰ κατὰ τὴν ἕδραν χωρία παραγενόμενος, ἐρεθίζει μὲν ἡμᾶς ἐπὶ τὴν ἔκκρισιν αὐτοῦ· κατασχεῖν δὲ αὐτὸν ἀναγκασθέντες, ἐπειδὰν ἐν πολιτικαῖς ὦμεν πράξεσιν, ἀπαλλαγέντες αὐτῶν οὐκέτ' ἀποκρίνομεν, αἰσθανόμεθά τε κἀκ τούτου πολλάκις τῆς κεφαλῆς ὀδυνηρᾶς γινομένης ἀνατρεπομένης τε τῆς γαστρός.

Galen, Matters of Health 6.10, 6.433 K. = 190,1–7 Koch

“For when people really need to poo but because they are held up in the agora or some other unsuitable place they hold it in for a long time, they are either no longer able to poo or their poo is small and dry. Why does this happen? Clearly it’s because effluvia have come off from them inside of us as well, from which it is clear that what is present in our intestines is also nourishment.”

οἱ γ(ὰρ) προθυμίᾳ γ(ινόμενοι) πρὸς τὸ διαχωρῆσαι,
καταλαμβανόμενοι δὲ ἐν ἀγορᾶι ἢ
ἐν ἀνεπιτηδείοις, εἶτα συσχόν-
τες ἐπὶ πλεῖον, οὐκέτι διαχωρο(ῦσιν)
ἢ διαχωροῦσιν ἐλάχιστά τε καὶ ξηρ(ά).
τίνος αἰ(τίας) γι(νομένης); δῆλον ὅτι ἀποφορᾶς καὶ ἐ̣ν(τὸς)
ἀπ' αὐτ(ῶν) γεγενημέν(ης). ἐξ ὧν φανερόν,
ὡς τροφή (ἐστιν) καὶ ἡ ἐν ἐντέροις παρακειμένη.

Anonymus Londinensis, Fragment 1,1–9 Diels

Thanks to Peter, Ralph and David for pointing these out.

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.
 

How to live a long life: learn magic or get some exercise

Pseudo-Lucian talks about the prophecy and piety of the Magi (along with ethnographies of other tribes) as part of a discussion of life-expectancy: why do some groups of people live longer than others? Pseudo-Lucian thinks you could live a long time too if you just exercised and ate properly. Inspired by this article at the BBC: "We learn nothing about nutrition, claim medical students".

---

"Stories have been told of whole races who have a long life expectancy because of their way of life.* There are those called the 'Sacred Scribes' in Egypt, the 'Interpreters of Myths' in Assyria and Arabia, those called 'Brahmans' in India, men completely devoted to the study of philosophy, and those called the 'Magi', a prophetic race who dedicate themselves to the gods, found among the Persians, Parthians, Bactrians, Chorasmians, Arians, Sacae, Medes, and many other Barbarians. They are strong and long-lived because they lead their life in strict observance of magic.

"There are also whole nations who have a long life expectancy, like in the stories they tell about the Seres, who live up to three-hundred years, some attributing the cause of their old age to the climate, others to the land, and still others to their way of life: for, they say, this is a whole nation of water-drinkers. Stories are also told of the people of Athos living up to one- hundred and thirty years, and there is a report that the Chaldeans live over one-hundred years, using bread made from barley because it acts as a drug for preserving good eyesight. They also say that on account of this diet, their other senses are better than those of other people.

"But that's enough about the life expectancy of these races and nations, those which they say survive for a long time either because of the land and climate, or way of life, or both. I, however, want to propose to you that your hopes [of a long life] are easy to achieve, by telling you about men in every land and in every climate who have become long-lived by using the right kind of exercises and a healthy diet."

καὶ γένη δὲ ὅλα μακρόβια ἱστορεῖται διὰ τὴν δίαιταν, ὥσπερ Αἰγυπτίων οἱ καλούμενοι ἱερογραμματεῖς, Ἀσσυρίων δὲ καὶ Ἀράβων οἱ ἐξηγηταὶ τῶν μύθων, Ἰνδῶν δὲ οἱ καλούμενοι Βραχμᾶνες, ἄνδρες ἀκριβῶς φιλοσοφίᾳ σχολάζοντες, καὶ οἱ καλούμενοι δὲ μάγοι, γένος τοῦτο μαντικὸν καὶ θεοῖς ἀνακείμενον παρά τε Πέρσαις καὶ Πάρθοις καὶ Βάκτροις καὶ Χωρασμίοις καὶ Ἀρείοις καὶ Σάκαις καὶ Μήδοις καὶ παρὰ πολλοῖς ἄλλοις βαρβάροις, ἐρρωμένοι τέ εἰσι καὶ πολυχρόνιοι διὰ τὸ μαγεύειν διαιτώμενοι καὶ αὐτοὶ ἀκριβέστερον.

ἤδη δὲ καὶ ἔθνη ὅλα μακροβιώτατα, ὥσπερ Σῆρας μὲν ἱστοροῦσι μέχρι τριακοσίων ζῆν ἐτῶν, οἱ μὲν τῷ ἀέρι, οἱ δὲ τῇ γῇ τὴν αἰτίαν τοῦ μακροῦ γήρως προστιθέντες, οἱ δὲ καὶ τῇ διαίτῃ· ὑδροποτεῖν γάρ φασι τὸ ἔθνος τοῦτο σύμπαν. καὶ Ἀθῴτας δὲ μέχρι τριάκοντα καὶ ἑκατὸν ἐτῶν βιοῦν ἱστορεῖται, καὶ τοὺς Χαλδαίους ὑπὲρ τὰ ἑκατὸν ἔτη βιοῦν λόγος, τούτους μὲν καὶ κριθίνῳ ἄρτῳ χρωμένους, ὡς ὀξυδορκίας τοῦτο φάρμακον· οἷς γέ φασι διὰ τὴν τοιαύτην δίαιταν καὶ τὰς ἄλλας αἰσθήσεις ὑπὲρ τοὺς ἄλλους ἀνθρώπους ἐρρωμένας εἶναι.

Ἀλλὰ ταῦτα μὲν περί τε τῶν μακροβίων γενῶν καὶ τῶν ἐθνῶν, ἅτινά φασιν ὡς ἐπὶ πλεῖστον διαγίγνεσθαι χρόνον, οἱ μὲν διὰ τὴν γῆν καὶ τὸν ἀέρα, οἱ δὲ διὰ τὴν δίαιταν, οἱ δὲ καὶ δι' ἄμφω. ἐγὼ δ' ἄν σοι δικαίως τὴν ἐλπίδα ῥᾳδίαν παράσχοιμι ἱστορήσας ὅτι καὶ κατὰ πᾶσαν γῆν καὶ κατὰ πάντα ἀέρα μακρόβιοι γεγόνασιν ἄνδρες οἱ γυμνασίοις τοῖς προσήκουσιν καὶ διαίτῃ τῇ ἐπιτηδειοτάτῃ πρὸς ὑγίειαν χρώμενοι.

Pseudo-Lucian, Long Lives (Marcobii), 4-8

* διὰ τὴν δίαιταν I'm translating as "way of life" or "diet" depending on the context. Keep in mind that it includes more that just what one eats, but also hygiene more generally: one's daily routine of sleep, waking, food, drink, work and sex.

Galen's advice on how to never get sick ("read my books and pay attention")

"After I turned 28, I had convinced myself that there exists an art of hygiene and I followed its precepts the whole rest of my life. The result was that I never got sick except for the occasional ephemeral fever; but, surely it is possible for someone to preserve themselves completely if they have secured a life of freedom.* This already became clear in the previous sections, and it will become even clearer in the sections that follow should you choose to pay attention. For I say no buboes** can be produced in anyone who has rigorously prepared for health, simply if their body is free from of each kind of excess residue, both in quantity and quality."

ἀλλὰ μετά γε τὸ εἰκοστὸν ὄγδοον ἔτος ἀπὸ γενετῆς ἐμαυτὸν πείσας, ὡς ἔστι τις ὑγιεινὴ τέχνη, τοῖς προστάγμασιν αὐτῆς ἠκολούθησα παρ' ὅλον τὸν ἑξῆς βίον, ὡς μηκέτι νοσῆσαι νόσημα μηδέν, ὅτι μὴ σπάνιόν που πυρετὸν ἐφήμερον. ἔστι δὲ δήπου καὶ τοῦτον αὐτὸν φυλάξασθαι τελέως, ἐλεύθερον ἑλόμενον βίον, ὡς ἔν τε τοῖς ἔμπροσθεν ἤδη γέγονε δῆλον ἔτι τε μᾶλλον ἔσται σαφὲς ἐν τοῖς ἐφεξῆς εἰρησομένοις, εἰ θέλοι τις προσέχειν τὸν νοῦν. ἐγὼ γάρ φημι μηδὲ βουβῶνα δύνασθαι γενέσθαι τοῖς ἀκριβῶς παρεσκευασμένοις εἰς ὑγείαν, εἴ γ' ἀπέριττον αὐτοῖς ἐστι τὸ σῶμα τοῦ γένους τῶν περιττωμάτων ἑκατέρου, τοῦ τε κατὰ τὸ ποσὸν καὶ τοῦ κατὰ τὸ ποιόν.

Galen, De sanitate tuenda, 5.1, 6.309-10 Kühn

*Galen is referring to something he said a bit earlier: that he gets an occasional fever because sometimes he works too much. In other words, he is not free, since he is dedicated to his practice. If you are free, all the more reason you should remain healthy if you follow his advice.

**not quite sure why Galen is singling out buboes here.

Advice for having children

From the works of Athenaeus. Preparation for Producing Children.

"Those entering into the production of children should be in a very strong state with respect to soul and body. That is, the soul [must be] tranquil and neither in pain, distress, nor seized with some other passion, while the body [must be] healthy and in no way generally diminished. It is not from those who are tranquil and healthy, but those who are sick that sicknesses arise [in offspring], both in the whole body and in each part of it. For this reason, in fact, it is useful to prepare by regimen, making use of exercises that are sufficient and separate from any bad passions, and of foods that are easy to digest, productive of good humors, nutritious, and moderately wet and warm, [while] refraining from those that are too hot: acidic juice, rue, cardamom, rocket, savory, onion, garlic, generally, foods that are pungent, sour, bitter and salty. And in addition, let them behave well with respect to these things even on the days beforehand, so that the semen that is collected is sufficient and has been concocted, and so that an impulse and suggestion for sex should truly be inflamed, because the body is excited. For those who constantly have sexual intercourse gather seeds that are raw and unripe, as Andreas says. In general, one should give an interval [between periods] of pregnancy to those women planning on producing children. For, in general women who are constantly pregnant become very malnourished and grow very ill in their bodies, and the offspring they give birth to are in about the same state. The equivalent appears to happen also in the case of plants. For plants that frequently bear and produce much fruit also grow old faster, while plants that are sterile and produce little fruit [grow old] after a longer period of time. Thus, trees which often produce a great amount of fruit decayed due to the abundance, because their nature was exhausted on the fruit."

ἐκ τῶν Ἀθηναίου. παρασκευὴ πρὸς παιδοποιΐαν.

«τοὺς δ' ἐπὶ παιδοποιΐαν ἰόντας καὶ ψυχῇ καὶ σώματι χρὴ διακεῖσθαι κράτιστα· τοῦτο δ' ἐστὶ τῆς μὲν ψυχῆς εὐσταθούσης καὶ μήτε λύπαις μήτε μερίμναις σὺν πόνοις μήτε ἄλλῳ πάθει κατεχομένης, τοῦ δὲ σώματος ὑγιαίνοντος καὶ κατὰ μηδὲν ἁπλῶς ἐλασσουμένου· ἀπὸ δὲ τῶν εὐσταθῶν καὶ τῶν ὑγιεινῶν οὐχί, ἀλλὰ τῶν νοσερῶν, [ὑγιεῖ καὶ] νοσερὰ καθ' ὅλον τε τὸν ὄγκον καὶ καθ' ἕκαστον αὐτοῦ μέρος· διὸ καὶ προδιαιτᾶσθαι χρήσιμον, γυμνασίοις μὲν αὐτάρκως καὶ χωρὶς πάσης κακοπαθείας κεχρημένους, τροφαῖς δ' εὐκατεργάστοις καὶ εὐχύμοις καὶ εὐτρόφοις καὶ μετρίως ὑγροτέραις καὶ θερμοτέραις, ἀπεχομένους τῶν θερμαντικωτέρων, ὀποῦ, πηγάνου, καρδάμου, εὐζώμου, θύμβρας, κρομμύων, σκορόδων, κοινῶς τῶν δριμέων καὶ ὀξέων καὶ πικρῶν καὶ ἁλυκῶν. καὶ πρὸς τούτοις εὐτακτείτωσαν δὴ καὶ ταύτας τὰς ἔμπροσθεν ἡμέρας, ὅπως ἱκανόν τε καὶ πεπεμμένον ὑπάρχῃ τὸ συνηγμένον σπέρμα, καὶ ὁρμὴ καὶ ὑπόμνησις καῇ γε περὶ τῆς μίξεως, ὀργῶντος τοῦ σώματος· οἱ γὰρ συνεχῶς πλησιάζοντες ὠμὰ καὶ ἄωρα τρυγῶσι τὰ σπέρματα, καθά φησιν Ἀνδρέας. καθόλου δὲ ταῖς παιδογονίας προνοουμέναις διάλειμμα δοτέον τῆς συλλήψεως· αἱ γὰρ συνεχῶς καθόλου συλλαμβάνουσαι αὐταί τε ἀτροφώταται καὶ κακοφυέστεραι γίνονται τοῖς σώμασι καὶ τὰ βρέφη τίκτουσι καὶ αὐτὰ παραπλήσια. τὸ δ' ἀνάλογον ἔοικε συμβαίνειν καὶ περὶ τὰ φυτά· τὰ γὰρ πολύφορα καὶ πολύκαρπα καὶ αὐτὰ θᾶττον καταγηρῶσιν, τὰ δὲ στεριφὰ καὶ ὀλιγόκαρπα χρονιώτερα. πολλάκις οὖν ὑπερκαρπήσαντες δένδροι δι' εὐθένειαν εὐρωτίασαν διὰ τὸ ἐξαναλῶσαι τὴν φύσιν εἰς τοὺς καρπούς.»

Oribasius, Collectiones medicae (libri incerti) 23 (115,33-116,20 Raeder)

Athenaeus of Attalia's Advice on Old Age

In this fragment, Athenaeus give his reflections on the kind of person we should strive to be in old age if we want to remain healthy. Works on "dietetics" (Περὶ ὑγιεινῆς διαίτης) or lifestyle were common in the ancient world; but, Athenaeus pushes the field quite far into all areas of human life. Here, he speaks to the physical, psychological, and social aspects of old-age and he advocates for changes in lifestyle that will best preserve the health of both mind and body. In this respect, his advice sounds remarkably modern.

Athenaeus of Attalia On Healthy Regimen in Old Age

"Old age requires a more exact regimen and additional aids. For the psychic and physical capacities [ψυχικαί τε καὶ φυσικαὶ δυνάμεις] which hold us together and preserve us lose their strength, their functions are brought to an end, and the body wrinkles and becomes malnourished, loose and dry. Whenever, therefore, the capacity which keeps the body straight, which offers resistance against the things that cause us injury from outside , and which fights against certain spermatic principles and natural necessities [κατά τινας σπερματικοὺς λόγους καὶ φυσικὰς ἀνάγκας], should give way under foot [i.e., decline], the body is easily affected and easily injured, requiring [only] a small cause and chance influence for harm.

"At the start, then, from an early age, one should also take precautions for the time of old age. For as those who wear out their cloak in the summer spend the winter in tatters, so those who, in their youth, neglect their bodily strength suffer the clothes of old age with great difficulty. And at this age especially, one should strive after gentleness and magnanimity, since such a person is not burdensome to everyone, but is longed for by all and cared for with goodwill and sympathy. Endeavour to have people living with you who are pleasing and not irksome, with whom it is the sweetest custom to engage in desirable conversation. And spend time in delightful places, and, in general, always live in good cheer. But, if this is not possible, for the most part, [give yourself time] to be at leisure. And be engaged in the care of oneself rather than [caring] for others, so that, of the urgent symptoms in each season that have to do with the care of the body, none should be deemed worthy of postponing. For, as having grown weary in the course of time, old age requires more rest.

"Best is the old age of those who carry-on in culture and rational studies, because of their diligence and the self-control of this way of life, because of the tranquility of their soul, and because they are always at leisure and find relief in their own works and the works of their predecessors. For what better companion might a man of reason discover for himself, or with what might he occupy himself that is even more pleasant, if he has given up the study of such great people? How great is the joy and how much the elation a soul receives, inquiring together with the predecessors of philosophy and medicine, and with the other champions of universal learning, and frequently trying one’s hand in [these inquiries] alongside them?"

τοῖς δὲ παρακμάζουσιν ἁρμόζει δίαιτα ὑφειμένη καὶ ψυχῆς καὶ σώματος, τά τε γυμνάσια, ὁποῖά ποτε ἂν ᾖ, κατὰ λόγον ἀεὶ τούτων ὑφαιρετέον, τῆς δυνάμεως αὐτῶν μειουμένης. καὶ τὰς τροφὰς ἐκ προσαγωγῆς συσταλτέον, τῆς ἕξεως αὐτῶν ἀρχὴν ψύξεως λαμβανούσης. τὸ δὲ γῆρας ἀκριβεστέρας μὲν διαίτης, περισσοτέρας δ’ ἐπικουρίας δεόμενον τυγχάνει· αἱ γὰρ συνέχουσαι καὶ διασῴζουσαι ἡμᾶς ψυχικαί τε καὶ φυσικαὶ δυνάμεις μαραίνονται, καὶ τὰ τούτων ἔργα καταλύονται, καὶ τὸ σῶμα ῥακοῦται καὶ ἄτροφον καὶ χαῦνον καὶ ξηρὸν γίνεται. ὅταν οὖν ἡ μὲν διευθύνουσα τὸ σῶμα δύναμις καὶ τοῖς ἔξωθεν λυμαινομένοις ἡμῖν ἀντερείδουσα καὶ μαχομένη κατά τινας σπερματικοὺς λόγους καὶ φυσικὰς ἀνάγκας ὑπὸ πόδας χωρῇ, τὸ δὲ σῶμα εὐπαθὲς ὑπάρχον καὶ εὐαδίκητον, μικρᾶς αἰτίας χρεία καὶ ῥοπῆς τῆς τυχούσης πρὸς βλάβην.

ἄνωθεν μὲν οὖν ἀπὸ τῆς πρώτης ἡλικίας καὶ προνοητέον τοῦ γήρως χρόνῳ· ὡς γὰρ οἱ τὴν χλαῖναν ἐν τῷ θέρει κατατρίψαντες ἐν τῷ τρίβωνι τὸν χειμῶνα διάγουσιν, οὕτως οἱ ἐν τῇ νεότητι τὴν ῥώμην καταλύσαντες τὸν τοῦ γήρως χιτῶνα σφόδρα δυσκόλως φέρουσιν. ζηλωτέον δ’ ἐν τῇδε τῇ ἡλικίᾳ μάλιστα πραότητι καὶ μεγαλοψυχίᾳ· ὁ γὰρ τοιοῦτος ἀβαρὴς καὶ ποθεινὸς παρὰ πᾶσι καὶ ἐπιμελείας τυγχάνων μετ’ εὐνοίας τινὸς καὶ συμπαθείας. σπουδάζειν δὲ καὶ τοὺς συζῶντας ἔχειν εὐαρεστουμένους καὶ μὴ ὀχληρούς, μεθ’ ὧν ὡς ἥδιστα εἰώθει καὶ ὁμιλιῶν ἐνάρχεσθαι ποθεινῶν καὶ ἐν τόποις ἐπιτερπεστέροις διατρίβειν καὶ καθόλου ζῆν μετ’ εὐθυμίας τὸν ἅπαντα χρόνον· εἰ δὲ μή γε, τὸν πλεῖστον ἑαυτὸν σχολάζειν καὶ πρὸς τὴν ἑαυτοῦ μᾶλλον ἢ πρὸς τὴν ἑτέρων ἀσχολεῖσθαι θεραπείαν, ἵνα μηδὲν ὑπερθέσεως ἠξιῶται τῶν καθ’ ἕκαστον καιρὸν κατεπειγόντων πρὸς τὴν τοῦ σώματος ἐπιμέλειαν· τὸ γὰρ γῆρας ὥσπερ κεκοπιακὸς ἐν τῷ προεληλυθότι χρόνῳ ἀναπαύσεως δεῖται περισσοτέρας.

ἄριστον δὲ γῆρας τῶν ἐν παιδείᾳ καὶ μαθήσει λογικῇ διαφερόντων, διά τε τὴν προσοχὴν καὶ τὴν νῆψιν τῆς διαίτης καὶ διὰ τὴν τῆς ψυχῆς εὐστάθειαν καὶ διὰ τὸ σχολάζειν ἀεὶ καὶ προσαναπαύεσθαι τοῖς τε ἑαυτῶν καὶ τοῖς τῶν προγενεστέρων πόνοις· τίνα γὰρ εὕροι νοῦν ἔχων ἀνὴρ συνομιλητὴν ἑαυτοῦ βελτίονα, ἢ τίσιν ἂν ἥδιστα συνδιατρίβοι παρεὶς τὰς τοιαύτας καὶ τηλικούτων ἀνδρῶν πραγματείας; πηλίκον δὲ χάρμα καὶ πόσον ἔπαρμα ψυχὴ λαμβάνει, συζητοῦσα τοῖς προγενεστέροις τῶν φιλοσόφων τε καὶ ἰατρῶν καὶ τοῖς ἄλλοις τοῖς προϊσταμένοις τῶν ἐγκυκλίων μαθημάτων καὶ παρεγχειροῦσα τούτοις πολλάκις;

Athenaeus of Attalia, ap. Oribasius, libri incerti 39 (CMG VI 2,2 140,9-141,9 Raeder)

Habituation and the health of mind and body

Athenaeus of Attalia was one of the first doctors we know to work out a unified medical theory that covered both mental and physical health and habits. Before Athenaeus it was more often the business of philosophers to talk about good and bad mental habits, and of doctors to talk about physical habits like eating and exercise. Athenaeus, however, consciously brings philosophy and medicine together into one discipline, speaking interchangeably about habits of either mind or body. He calls the effects of these behaviours, "habituation", and our habituation in turn determines what things are good for us and what things are bad.

Athenaeus thinks of habituation as a kind of "state" or "innate disposition", but he also calls it (perhaps following Aristotle) "second nature", probably to emphasize that its effects on both body and mind can be quite permanent. There's a long tradition in Greco-Roman thought that treats art as something subordinate to nature; however, physicians (and farmers) were well aware that art can get the upper hand. Here, Athenaeus explains how. His thoughts were preserved by Oribasius.

"From the works of Athenaeus. On Habituation.

"Habituation is a state of the soul or body established over time with respect to benefit or harm when we are healthy or sick. For habit over time establishes something through itself in the soul and in the body, and this sometimes makes something beneficial, sometimes [something] harmful. Not only is it strong in times of health, but it often extends even into times of illness. And a habit that lasts for a long time is like an acquired nature. For this reason, if any self-mover undergoes a change [?], it is dangerous and introduces disease. Of these [changes], changes of place make a big difference: for change from healthy [places] to more diseased ones produces a greater and more serious alteration, while the [change] from diseased [places] to healthy ones [produces] a smaller [alteration] in both magnitude and duration. Indeed, every change, especially a sudden one, and most especially one which is not customary and unusual, alters bodies for the worse for the reason we gave. Habituation is so powerful that those who have been seized by it cannot exist separately [from it], being held in its bonds. An athlete, for example, has difficulty recovering: if he wishes to return to his original way of life by suddenly abolishing his acquired disposition, just like a second nature, then he will quickly be destroyed, because a way of life continued for a long time is (so to speak) a powerful form of being accustomed. Thus, a sudden departure from habit makes a great difference. For this reason it drives out of their proper place of rest those who do not abolish the earlier habituation gradually and by means of another, different habituation."

Ἐκ τῶν Ἀθηναίου. Περὶ συνηθείας.[1]

Συνήθειά ἐστιν ἕξις ψυχῆς ἢ σώματος ἐν χρόνῳ κατεσκευασμένη πρὸς ὠφέλειάν τε καὶ βλάβην ὑγιαινόντων τε καὶ νοσούντων· τὸ γὰρ ἔθος ἐν χρόνῳ κατασκευάζει τι δι’ ἑαυτοῦ περὶ τὴν ψυχὴν καὶ τὸ σῶμα, καὶ τοῦτό ποτε μὲν ἐπ’ ὠφέλειαν[2] ποιεῖ τινα, ποτὲ δὲ καὶ ἐπὶ βλάβην. καὶ οὐ μόνον ἐφ’ ὑγιαινόντων ἰσχύει, διατείνει δὲ πολλάκις καὶ πρὸς τοὺς νοσοῦντας. τὸ δὲ πολυχρόνιον ἔθος οἷον φύσις ἐστὶν ἐπίκτητος· διὸ πᾶν τὸ κινοῦν ἑαυτὸ μεταβάλλει, ἐπισφαλὲς καὶ προσαγωγὸν εἰς νόσον. τούτων δὲ διαφέρουσιν αἱ μεταβολαὶ τῶν τόπων· ἡ μὲν γὰρ ἐξ ὑγιεινῶν εἰς νοσερώτερα μεταβολὴ μείζονα ποιεῖ τὴν ἀλλοίωσιν καὶ χαλεπωτέραν, ἡ δ’ ἐκ νοσερῶν εἰς ὑγιεινὰ ἐλάσσονα καὶ τῷ μεγέθει καὶ τῷ χρόνῳ. πᾶσα μέντοι μεταβολή, καὶ μάλιστα αἰφνίδιος, καὶ ὡς ἔνι μάλιστα ἀσυνήθης καὶ ξένη, ἐπὶ τὸ χεῖρον μετακινεῖ τὰ σώματα δι’ ἣν ἀπεδώκαμεν αἰτίαν. οὕτως δ’ ἰσχυρὸν ἡ συνήθεια, ὥστε τοὺς ληφθέντας ὑπ’ αὐτῆς μηδὲ χωρισθῆναι δύνασθαι δεσμῷ κατεχομένους· δυσανάληπτος γὰρ ἀθλητής, εἰ θέλει πρὸς τὸν πρῶτον ἐπανελθεῖν βίον αἰφνιδίως τὴν ἐπίκτητον διάθεσιν ὥσπερ δευτέραν τινὰ φύσιν καταλύων, συντόμως ἀναλυθήσεται· οἷον γὰρ τρόπος ὁ πολυχρόνιος ἐθισμὸς ἰσχυρός. οὕτως ὁ αἰφνίδιος ἐξεθισμὸς μεγάλας ἔχει τὰς διαφοράς· διόπερ ἐξίστησι τῆς ἰδίας καταπαύσεως τοὺς μὴ ἐκ προσαγωγῆς καὶ δι’ ἑτέρας πάλιν συνηθείας τὴν προτέραν καταλύοντας συνήθειαν.

Athenaeus ap. Oribasius, libri incerti 17 (CMG VI 2,2 106,8-29 Raeder)

[1] cf. Sextus Empiricus, PH 1.146.3-4: ἔθος δὲ ἢ συνήθεια (οὐ διαφέρει γάρ) πολλῶν ἀνθρώπων κοινὴ πράγματός τινος παραδοχή. Sextus treats "habituation" and "habit" as synonyms, whereas Athenaeus considers habituation to be the result of habits over a long period of time.

[2] Must be ἐπ ὠφελειᾳ / ἐπὶ βλάβῃ

Advice for autumn weather

“At times when it varies between hot and cold on the same day, one must expect the illness of autumn.”

Ἐν τῇσιν ὥρῃσιν, ὅταν τῆς αὐτῆς ἡμέρης ὁτὲ μὲν θάλπος, ὁτὲ δὲ ψῦχος γένηται, φθινοπωρινὰ τὰ νουσήματα προσδέχεσθαι χρή.

Hippocrates, Aphorisms III 4, IV 483 Littré

“When it comes to the weather in late autumn, one must be extremely cautious, since it is variable. Therefore, you mustn’t go walking around barefoot in the early morning and the afternoon, and you mustn’t jump into cold water naked. You also mustn’t go harvesting crops without your tunic on, even if you think the cold air is pleasant and gratifying—it is so difficult to prepare for bad weather, especially when the damage slips in with what seems pleasant. Stay away from the cool breezes coming off of rivers and lakes—they not only cool you down, but they also moisten your dispositions. And make sure to guard against rich foods, like thick and astringent new wines, crackers made from very fine flour, dates, raisins, eggs, snails, grape hyacinths, very meaty fish, sliced sausages, lamb, and mutton. Also, don’t forget to get a bit of exercise.”

τὰς δ’ ἐν τῷ μετοπώρῳ πολλῷ μᾶλλον δεῖ εὐλαβεῖσθαι· γίνονται γὰρ μετ’ ἀνωμαλίας. δεῖ τοίνυν μήτε ἀνυποδέτους περὶ τὸν ὄρθρον καὶ τὸ δείλης διάγειν μήτε ἀσκέπως εἰς ψυχρὸν ὕδωρ ἐμβαίνειν μήτε ἀχίτωνας θερίζοντας διὰ τὸ κεχαρισμένον καὶ ἡδὺ τῆς ψύξεως· τοσοῦτον γὰρ τὸ κακὸν δυσφύλακτον ὅσῳπερ καὶ τὴν ἡδονὴν ὑποδύεται τὸ βλάπτον. ἐκκλιτέον δὲ καὶ τὰς ὑπαίθρους κοίτας καὶ τὰς ἀπὸ τῶν ποταμῶν καὶ λιμνῶν ἀποπνεούσας αὔρας· οὐ γὰρ μόνον ψύχουσιν, ἀλλὰ καὶ ὑγραίνουσι τὰς ἕξεις. φυλακτέον δὲ καὶ τὰ πολύτροφα καὶ τὰ παχυντικὰ τῶν προσφερομένων, οἷον οἶνον νέον καὶ παχὺν καὶ στυπτικόν, ἄρτον σεμιδαλίτην ἄζυμον, φοίνικας, σταφίδας, ὠά, κοχλίας, βολβούς, ἰχθύων τοὺς πολυσάρκους, ταρίχων τοὺς τεμαχιστούς, κρεῶν τὰ ἄρνεια καὶ προβάτεια. οὐκ ἀμελητέον δ’ οὐδὲ τῶν γυμνασίων.

Athenaeus of Attalia in Oribasius, Medical Collections libri incerti 41, CMG VI 2,2 148,4-16 Raeder

“Autumn is less hot than summer, but less cold than winter. Thus, it is not simply hot or cold, since it is both, and neither of them in excess. But there is a different problem with it, one Hippocrates also mentioned in the Aphorisms, when he says: “whenever it varies between hot and cold on the same day, one must expect the illnesses of autumn” (Aphorisms III 4). And surely this is what makes autumn most likely to bring about illness: the variability of the mixture. So, it is not right to call it cold and dry, since it is not observed to be cold in itself, like winter, but compared with summer it is colder. And yet it is not evenly well mixed, like the spring, but it is different from that season in that it does not have a consistent good mixture and evenness through the whole day. For it is much hotter during midday than at dawn or dusk. Also, unlike spring, it is not precisely balanced between wet and dry, but it tends towards dryness. It has less dryness than summer, but not as much as it lacks heat. Clearly, then, as autumn is not to be called simply, as those others say, cold and dry. It has neither in extreme; sure, the dry does predominate over the wet, and one might rightly call it dry. But with respect to the difference between hot and cold, it is a mixture of both and it is variable.”

Ἀλλὰ καὶ τὸ φθινόπωρον ἧττον μὲν ἢ τὸ θέρος θερμόν, ἧττον δ' ἢ ὁ χειμὼν ψυχρόν. ὥστε ταύτῃ μὲν οὔτε θερμὸν ἁπλῶς οὔτε ψυχρόν, ἀμφότερα γάρ ἐστι, καὶ οὐδέτερον ἄκρως. ἕτερον δέ τι πρόσεστιν αὐτῷ κακόν, ὅπερ ἐπεσημήνατο καὶ Ἱπποκράτης ἐν Ἀφορισμοῖς εἰπών· ‘ὁκόταν τῆς αὐτῆς ἡμέρης ὁτὲ μὲν θάλπος, ὁτὲ δὲ ψῦχος ποιέῃ, φθινοπωρινὰ τὰ νοσήματα προσδέχεσθαι χρή’. καὶ τοῦτό γ'ἐστὶ τὸ μάλιστα νοσῶδες ἐργαζόμενον τὸ φθινόπωρον, ἡ ἀνωμαλία τῆς κράσεως. οὐκ ὀρθῶς οὖν εἴρηται ψυχρὸν καὶ ξηρόν, οὐ γάρ ἐστι ψυχρὸν αὐτὸ καθ' αὑτὸ θεωρούμενον, ὥσπερ ὁ χειμών, ἀλλὰ τῷ θέρει παραβαλ|λόμενον ἐκείνου ψυχρότερον. οὐ μὴν οὐδ' ὁμαλῶς εὔκρατον, ὡς τὸ ἔαρ, ἀλλ' ἐν τούτῳ δὴ καὶ μάλιστα διενήνοχεν ἐκείνης τῆς ὥρας, ὅτι τὴν εὐκρασίαν τε καὶ τὴν ὁμαλότητα διὰ παντὸς ἴσην οὐ κέκτηται. πολὺ γὰρ θερμότερόν ἐστι κατὰ τὴν μεσημβρίαν ἢ κατὰ τὴν ἕω τε καὶ τὴν ἑσπέραν. ὑγρότητος δὲ καὶ ξηρότητος οὐκ ἀκριβῶς μέν ἐστι μέσον, ὡς τὸ ἔαρ, ἀλλ' ἐπὶ τὸ ξηρότερον ῥέπει. λείπεται δὲ κἀν τούτῳ τοῦ θέρους, οὐ μὴν τοσοῦτόν γ' ὅσον θερμότητι. δῆλον οὖν, ὡς οὐδὲ τὸ φθινόπωρον ἁπλῶς οὕτω ῥητέον, ὡς ἐκεῖνοι λέγουσι, ψυχρόν τ' εἶναι καὶ ξηρόν. ἄκρως μὲν γὰρ οὐδέτερόν ἐστιν, ἐπικρατεῖ δ' ἐν αὐτῷ τὸ ξηρὸν τοῦ ὑγροῦ καὶ δικαίως ἂν λεχθείη ταύτῃ μὲν ξηρόν, ἐν δὲ τῇ κατὰ θερμότητα καὶ ψυχρότητα διαφορᾷ μικτὸν ἐξ ἀμφοῖν καὶ ἀνώμαλον.

Galen, De temperamentis i 4, I 527-528 Kühn

Athenaeus’ Back to School Advice

A fragment from the lost works of Athenaeus of Attalia, preserved in Oribasius, libri incerti 39:

“From six and seven-years, give your children over to gentle and benevolent elementary school teachers. Educators who teach using a combination of persuasion and compassion, and who offer lots of praise as well, are successful teachers and will encourage the children more. Also, their teaching is accompanied with joy and relaxation, and when the soul is relaxed and joyful, it contributes a good deal to the body’s thriving. But those educators who are relentless with their punishments will end up making the children miserable, fearful, and hostile to education. When they thrash their students, they are forcing them to learn and memorize things at the exact same moment they are being punished—in other words, when the children are least likely to be able to think! Also, don't oppress new students for the whole day with lessons. Instead, give over a greater portion of the day to amusement. In fact, we see among children who are pretty strong and mature for their age that, when they are always working hard at their lessons, their bodies become thoroughly corrupted.

“Twelve-year old children should go to geometry teachers as well as elementary teachers, and they should start taking gym. Also, their helpers and supervisors should be sound-minded and not completely inexperienced. This way, you know they will keep track of the proper times and portions of food, exercise, baths, sleep and everything else that has to do with being healthy. I feel I need to say this because most people spend a lot of of money hiring someone to groom their horse, making sure to choose a person who is careful and experienced; but, regarding a supervisor for their children, the same people will hire someone with no experience, or who is completely useless, and who cannot help at all in matters of life.”

ἀπὸ δὲ τῶν ϛˊ καὶ ζˊ ἐτῶν τούς τε παῖδας καὶ τὰς κόρας γραμματισταῖς παραδιδόναι πραέσι καὶ φιλανθρώποις· οἱ μὲν γὰρ προσαγόμενοι τὰ παιδία καὶ πειθοῖ καὶ παρακλήσει διδάσκοντες, πολλάκις δὲ καὶ ἐπαινοῦντες, ἐπιτυγχάνουσι προτρέπονταί τε αὐτοὺς μᾶλλον καὶ μετὰ χαρᾶς καὶ ἀνέσεως διδάσκουσιν (ἡ δ’ ἄνεσις καὶ χαρὰ τῆς ψυχῆς εἰς εὐτροφίαν σώματος μεγάλα συμβάλλεται)· οἱ δ’ ἐπικείμενοι τῇ διδασκαλίᾳ καὶ πικροὶ ταῖς ἐπιπλήξεσι δουλοπρεπεῖς αὐτοὺς <καὶ> καταφόβους ποιοῦσι καὶ ἀλλοτρίους πρὸς τὰς μαθήσεις· δέροντες γὰρ μανθάνειν καὶ μνημονεύειν ἀναγκάζουσιν ἐν αὐταῖς ὄντας ταῖς πληγαῖς, ὅτε καὶ τοῦ φρονεῖν ἔξω γεγόνασιν. οὐκ ἀναγκαῖον δ’ οὐδὲ δι’ ὅλης τῆς ἡμέρας θλίβειν τοὺς ἀρτιμαθεῖς, μερίδα δὲ διδόναι παιδιᾷ αὐτῶν πλείονα· ὁρῶμεν γὰρ καὶ τῶν ἰσχυροτέρων καὶ τετελειωμένων ταῖς ἡλικίαις τοὺς ἐπιμελῶς καὶ ἀδιαλείπτως προσεδρεύοντας τοῖς μαθήμασι καταφθειρομένους τοῖς σώμασιν.

τοὺς δὲ δωδεκαετεῖς τῶν παίδων πρός τε γραμματικοὺς φοιτᾶν ἤδη καὶ γεωμέτρας καὶ τὸ σῶμα γυμνάζειν· ἀναγκαῖον δὲ νουνεχεῖς εἶναι τούς τε παιδαγωγοὺς αὐτῶν καὶ τοὺς ἐπιστάτας καὶ μὴ τελείως ἀπείρους, ὅπως τούς τε καιροὺς καὶ τὰς συμμετρίας ἴδωσι τροφῆς, γυμνασίων, λουτρῶν, ὕπνου, τῶν ἄλλων τῶν κατὰ τὴν δίαιταν· οἱ γὰρ πολλοὶ τῶν ἀνθρώπων ἱπποκόμους μὲν πλείονος ὠνοῦνται τοὺς ἐπιμελεῖς καὶ ἐμπείρους ἐκλεγόμενοι, παιδαγωγοὺς δὲ τῶν τέκνων καθιστᾶσι τοὺς ἀπείρους καὶ ἀχρήστους ἤδη γεγονότας καὶ μηδὲν ἔτι δυναμένους ὑπηρετεῖν τῶν κατὰ τὸν βίον.

Oribasius, libri incerti 39.3-5, CMG VI 2,2 138,28-139,15 Raeder