Ancient Histories of Medicine: Essays in Medical Doxography and Historiography in Classical Antiquity 9004105557, 9789004105553

Citation preview

ANCIEN T HISTOR IES OF MEDICI NE Essays in Medical Doxography and Historiography in Classical Antiquity

edited by

PHILIP J. VAN DER EIJK

li .:;:, ,0

""

;,, ,-

d'.

I-'

?

,-..

I

-('

. I 6 8

>.

-4 ',

BRILL LEIDEN · BOSTON· KOLN 1999

This book is printed on acid-free paper.

Library of Congress Cataloging-in-Publication Data Ancient histories of medicine : essays in medical doxography and historiography in classical antiquity / edited by Philip J. Van Der Eijk. p. cm. - (Studies in ancient medicine, ISSN 0925-1421 ; v. 20) Includes bibliographical references and index. ISBN 900410555 7 (cloth : acid-free paper) 1. Medicine, Greek and Roman-Historiography. 2. Authors, Greek. 3. Authors, Latin. I. Eijk, Ph. J. van der (Philip J.) II. Series. Rl38.A63 1999 610'.938-dc21 99-39183 CIP

Die Deutsche Bibliothek - CIP-Einheitsaufuahme Ancient histories of medicine : essays in medical doxography and historiography in classical antiquity / ed. by Philip J. van der Eijk. Leiden ; Boston ; Kain : Brill, 1999 (Studies in ancient medicine ; Vol. 20) ISBN 90-04-10555-7

ISSN 0925-1421 ISBN 90 04 I 0555 7 © Copyright 1999 by Koninklijke Brill NV, Leiden, 1he Netherlands

All rights reserved. No part ef this publication may be reproduced, translated, stored in a retrieval system, or transmitted in arry farm or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission ftom the publisher. Authorization to photocopy items far internal or personal use is granted by Brill provided that the appropriate fees are paid directly to 1he Copyright Clearance Center, 222 Rosewood Drive, Suite 91 0 Danvers MA 01923, USA. Fees are subject to change. PRINTED IN THE NETHERLANDS

A medical student who has followed the right course of instruction will be able to describe the doctrines of each of these famous physicians (i.e. Hippocrates, Diodes, Pleistonicus, Phylotimus, Praxagoras, Dieuches, Herophilus, and Asclepiades). If he is really perfect, he will be able to describe to you the doctrines of the Ancients, together with those of their successors, outlining their differences and agreements.

Galen, On Examinations by which the Best Physicians are Recognized 5.2-3 (p. 69 Iskandar)

CONTENTS

Introductory Chapter One: Historical awareness, historiography and doxography in Greek and Roman medicine Philip J van der Eijk ................................ ................. ............... .

1

Introductory Chapter Two: What is doxography? David T. Runia . ............................... ....................... ......... ........

33

Chapter Three: Aristoteles als Medizindoxograph Jochen Althoff.......................................................................

57

Chapter Four: 'Aristotle' and the role of doxography in the Anonymus Londiniensis (PBrLibr Inv. 137) Daniela Manetti . . . . . . .. . . . . . .. . . . . . . .. . . . .. . . . . . . . . .. . . . . . .. . . . . . . . . . .. .. . . . . . .. . .

95

Chapter Five: Rupture and continuity: Hellenistic reflections on the history of medicine Heinrich von Staden..............................................................

143

Chapter Six: The placita ascribed to doctors in Aetius' doxography on physics David T. Runia .......................................................................

189

Chapter Seven: Celsus as historian? Heinrich von Staden..............................................................

251

Chapter Eight: The Anonymus Parisinus and the doctrines of "the Ancients" Philip J van der Eijk . . .. . . . . . .. . . . . . . .. . . . . . . .. . . . . . . . .. . . . . . . .. .. . . . . . . . . .. . . . . . 295 Chapter Nine: Tradition and truth. Forms of philosophicalscientific historiography in Galen's De placitis Mario Vegetti........................................................................

333

Chapter Ten: Notes on the doxai of doctors in Galen's commentaries on Hippocrates Amneris Roselli.....................................................................

359

Chapter Eleven: Historiographical strategies in Galen's physiology (De usu partium, De naturalibus facultatibus) Mario Vegetti........................................................................

383

Vlll

CONTENTS

Chapter Twelve: Antiquarianism and criticism: Forms and functions of medical doxography in Methodism (Soran us and Caelius Aurelianus) Philip J van der Eijk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

397

Chapter Thirteen: Doctrine et tactique doxographique dans l' Anonyme de Bruxelles: Une comparaison avec I' Anonyme de Londres Armelle De/nu.......................................................................

453

Chapter Fourteen: Doxographical hints in Oribasius' Collectiones medicae Roberto de Lucia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 73

Notes on Contributors.................................................................... List of abbreviations ........... .......... ........... ............. ............... ......... ... General Index.................................................................................. Index Loco rum................................................................................

491 493 495 509

INTRODUCTORY CHAPTER ONE

HISTORICAL AWARENESS, HISTORIOGRAPHY AND DOXOGRAPHYIN GREEK AND ROMAN MEDICINE Philip J. van der Eijk

Attitudes of medical writers to the history of their own subject

Recent years have seen a growing scholarly interest in what may be tentatively called ancient intellectual historiography, i.e. the ways in which Greek and Roman authors viewed and wrote about the history of philosophy and the sciences. 1 This in itself is entirely justified 1 On the ancient historiography and doxography of philosophy see, e.g., G. Cambiano (ed.), Storiografia e dossografia nella filosofia antica, Turin, 1986; M. Frede, "Doxographie, historiographie philosophique et historiographie historique de la philosophie", in: A. Laks (ed.), Doxographie antique (Revue de Mctaphysique et de Morale 97, 1992, No. 3), pp. 311-325; P. Kingsley, "Empedocles and his interpreters: the Four-Element doxography", Phronesis 39 ( 1994), pp. 235-254; A. Laks, "Du temoignage comme fragment", in: G.W. Most (ed.), Collecting Fragments -}ragrnente sammeln, Gottingen, 1997, pp. 289-314; C. Levy, "Doxographie et philosophie chez Ciccron", in: C. Levy (ed.), Le concept de nature a Rome, Paris, 1996, pp. 109-123;]. Mansfeld, "Chrysippus and the Placita", Phronesis 34 ( 1989), pp. 311-342; "Doxography and dialectic: the Sitz im Leben of the 'Placita"', Aufstieg und Niedergang der romischen Welt II 36.2 (1990), pp. 3056-3229; id., Studies in the Historiography of Greek Philosophy, Assen, 1990; id., "Physikai doxai e Problemata physica da Aristotele ad Aezio (ed oltre)", in: A.M. Battegazzore (ed.), Dimostrazione, argomentazione dialettica e argomentazione retorica nel pensiero antico, Genoa, 1993, pp. 311-382; id., Heresiography in Context, Leiden, 1994; id., "Doxographical studies, Quellenforschung, tabular presentation and other varieties of comparativism", in: W. Burkert et al. (ed.), Fragmentsammlungen philosophischer Texte - Le raccolte dei frammenti di filosofiantichi (Aporemata 3), Gottingen, 1998, pp. 16-40;]. Mansfeld and D. Runia, Aetiana. The Method and Intellectual Context of a Doxographer, vol. I, Leiden, 1997; D. Runia, "Xenophanes on the moon: a doxographicum in Aetius", Phronesis 34 ( 1989), pp. 245-269; id., "Xenophanes or Theophrastus? An Aetian doxographicum on the sun", in: W.W. Fortenbaugh, D. Gutas (eds.), Theophrastus. His Psychological, Doxographical and Scientific Writings, New Brunswick and London, 1992, pp. 112-140; H. Baltussen, Theophrastus on Theories of Perception, Diss. Utrecht, 1993; see also the vols. 11.36.5 and II.36.6 (both 1992) of Aujstieg und Niedergang der romischen Welt. On the historiography of medicine in antiquity see W.D. Smith, The Hippocratic Tradition, Ithaca - London, 1979; id., Hippocrates. Pseudepigraphic Writings, Leiden, 1990; id., "Notes on ancient medical historiography", Bulletin of the History of Medicine 63 ( 1989), pp. 73-109; J. Rubin Pinault, Hippocratic Lives and Legends, Leiden, 1992. Among the older works to be cited are P. Diepgen, "Zur Geschichte der

2

PHILIP J. VAN DER EIJK

considering that reflection on the achievements of the past was, from the earliest stages of Greek thought up to late antiquity, an integral part of most intellectual projects of some ambition. Many ancient philosophers and scientists (as well as historians) regarded themselves as part of a long tradition. They explicitly discussed the value of this tradition, and their own contribution to it, in a prominent part of their own written work, often in the preface.2 Medicine posed no exception to this. To be sure, medicine in antiquity, as distinct from philosophy, (theoretical) physics and mathematics, was regarded as a practical art primarily intended to be applied with skill and dexterity to a great variety of individual cases. Yet a considerable number of Greek and Roman doctors, especially those of a more intellectual type, 3 attached great value to literacy, theory, and book-learning. 4 Most of these physicians considered the past of their subject relevant for its present in one way or another, and they encouraged their apprentices to take the study of the works of earlier authorities very seriously. This interest in the medical past was not restricted to unqualified acceptance of inherited views, slavish imitation of authoritative paradigms or faithful exegesis of the sayings of past masters. It also allowed of addition, correction or even criticism. Thus Galen, in a well-known passage from his work On the Natural Faculties, writes: Historiographie der Medizin", in: Medizin und Kultur. Gesammelte Aufsatze von Paul Diepgen, ed. W. Artelt, E. Heischkel, and]. Schuster, Stuttgart, 1938, pp. 8-30, and E. Heischkel, Die Medizingeschichtsschreibung von ihren Anfiingen ms zum Beginn des 16. Jahrhunderts (Abhandlungen zur Geschichte der Medizin und Naturwissenschaften, Heft 28), Berlin, 1938. On the ancient historiography of the sciences see my forthcoming chapter "La storiografia delle scienze e la tradizione dossografica" in: G.E.R. Lloyd et al. (eds.), Scienza Antica (Enciclopedia Italiana, Storia delle Scienze, vol. 1). 2 On the role of tradition in ancient science in general see, e.g., G.E.R. Lloyd, Science, Folklore and Ideology, Cambridge, 1983; FJ. Ragep and S.P. Ragep (eds.), Tradition, Transmission, Transformation, Leiden, 1996; W.D. Smith, The Hippocratic Tradition (see previous note); J. Kollesch and D. Nickel (eds.), Galen und das hellenistische Erbe, Stuttgart, 1993. On the role of prefaces in scientific literature see the collection of studies by C. Santini and N. Scivoletto (eds.), Prefazioni, prologhi, proemi di opere tecnico-scientifiche latine, 2 Vols., Rome, 1990-1992; see also L. Alexander, The Preface to Luke's Gospel, Cambridge, 1993. 3 On distinctions between doctors see Plato, Leges 720 a ff. and 857 d 2; Aristotle, Politica 1282 a 3-4; Metaphysica 981 a 30 ff.; see also Galen's discussion of what the good doctor should read in De optimo medico cognoscendo 5.3 and 9.22 (CMG Suppl. Or. IV, p. 69, 9-19 and p. 115,20-23 Iskandar). 4 See D. Bates (ed.), Knowledge and the Scholarly Medical Tradition, Cambridge, 1995; J. Scarborough, "Roman medicine to Galen", Aufstieg und Niedergang der romischen Welt 11.37.1, 1993, pp. 40-48.

HISTORICAL AWARENESS, HISTORIOGRAPHY, AND DOXOGRAPHY

3

"As I said before, we have not set ourselves the task of stating what has been demonstrated sufficiently by the ancients, as we are unable to surpass them in intelligence or in style. However, there are certain things they have stated without demonstration as if these were selfevident, for they could not suspect that there would be such evil sophists who depise the truth contained in their writings; and there are also things they completely omitted. It is these things which we think we ought to demonstrate and discover. "5

According to Galen, the writings of "the ancients" contain much that is true and of great value and relevance to contemporary medicine. However, some of their statements, though true, are in need of clarification or indeed demonstration ( apodeixis). This is either because the wording is unclear and unspecific in certain respects which, in the later history of medicine, have acquired special significance, or because they are based on presuppositions which have later become disputed and hence are in need of demonstration. Furthermore, some of their statements may be in need of factual supplementation in the light of later discoveries (heuresis), e.g., in the areas of anatomy, neurology, or pulse-lore. 6 Accordingly, in many places in his works we find Galen not shying away from criticizing even venerable authorities such as Diodes, Aristotle and Herophilus for what he considers factual errors. 7 This nuanced attitude towards the medical past is by no means peculiar to Galen. From as early as the fifth and fourth centuries BCE onwards, medical authors explicitly take account of the achievements of predecessors and define their own work in relation to these. Thus in the Hippocratic Corpus, the author of On Regi,men begins by saying that while his discussion of dietetics accepts as a starting point the correct statements made by the "many" authors who have dealt with the subject before him, he will at the same time try to surpass them in providing a truly comprehensive treatment of the subject. 8 Likewise, the author of On Ancient Medicine explicitly places himself in a long tradition of experiential dietetic knowledge that has gradually accumulated and been refined. 9 In a more critical vein, the author of De naturalilms Jacultatilms 2.8 (2.116-117 K.). For Galen's views on the relation between timeless truth and the possiblity of a progressive unfolding of the truth in time, see Mario Vegetti' s chapter 9 below. 7 See, e.g., Gal., De uteri dissectione 9.5 (CMG V 2,1, pp. 48-50 Nickel; 2.900-901 K.); In Hippocratis De natura hominis commentarium 2.6 (CMG V 9,1, p. 70 Mewaldt; 15.136 K.). 8 De victu 1.1 (CMG I 2,4, p. 122Joly-Byl; 6.466-468 L.). 9 De vetere medicina, passim (esp. ch. 2, 3, 5). 5 6

PHILIP J. VAN DER EIJK

4

On Regi,men in Acute Diseases castigates earlier discussions of therapy by diet and states that the subject has not received serious attention from "the ancients" (oi apxa101). 10 Slightly later in the fourth century BCE, Diodes of Carystus appeals to "the ancients" for the view that correct interpretation of the positions and movements of the celestial bodies can be of great significance for medical prognosis; 11 and in his work Archidamus, according to what may be regarded as the first extant fragment of medical doxography in antiquity, Diodes reports at great length, and in indirect speech, the views on hygiene held by one of his predecessors (possibly his father), Archidamus. 12

Passages such as these testify to the strong belief, among Greek and Roman physicians, in the relevance of the past history of medicine for the theory and practice of the present. This relevance also provided one of the justifications for writing about this past historyapart from more straightforward reasons such as preservation of what might otherwise fall into oblivion and facilitating access to it. 13 It is of some importance to realize this, as Greek and Roman historiography in general was inspired by a belief in the "usefulness" of history for later generations (a lesson to learn, a paradigm to follow, etc.) and its edifying function for education. 14 Accordingly, in ancient medicine and medical education, the lives ( bioi) of famous doctors, and the Devictuacutoruml (2.226L.). Diodes, fr. 99 Wellmann. 12 Diodes, frs. 147-148 Wellmann. If the report of the Anonymus Bruxellensis (chs. 5-7, pp. 211-212 Wellmann) can be interpreted as saying that Diodes quoted, paraphrased and commented on works of Hippocrates and Aristotle, and if this report is reliable, it provides further evidence of Diodes' use of other authors' doxai for argumentative purposes. 13 For these reasons of literacy in medicine see P.J. van der Eijk, "Towards a rhetoric of ancient scientific discourse. Some formal characteristics of Greek medical and philosophical texts (Hippocratic Corpus, Aristotle)", in: E.J. Bakker (ed.), Grammar as Interpretation. Greek Literature in its Linguistic Contexts, Leiden, 1997 (Mnemosyne Supplements, No. 171), pp. 93-99. 14 On the paradigmatic function of history and the notion of "usefulness" in ancient historiographical theory see C.M.J. Sicking, "Lucian, Cicero and historiography", in: id., Distant Companions, Leiden, 1999, pp. 158-167, which is primarily based on passages in Lucian, Cicero and Polybius (on Lucian see H. Homeyer, Lukian: wie man Geschichte schreiben soll, Munich, 1965; G. Avenarius, Lukians Schrift zur Geschichtsschreibung, Meisenheim am Gian, 1956). On the purposes of ancient historiography see also A. Momigliano, The Classical Foundations of Modern Historiography, Berkeley, Los Angeles and Oxford, 1990; C.W. Fomara, The Nature of History in Ancient Greece and Rome, Berkeley, Los Angeles and London, 1983; R. Nicolai, La storiografia nell' educazione antica, Pisa 1992; J. Marincola, Authority and Tradition in Ancient Historiography, Cambridge, 1997. 10 11

HISTORICAL AWARENESS, HISTORIOGRAPHY, AND DOXOGRAPHY

5

agreement between their teaching and their actual practice, were the subject of a considerable biographical activity. Their doctrines ( doxaz) were accepted as authoritative, or at least to be taken into account very seriously, and hence worthy of written transmission from one generation to another (doxography), and of being memorized in the form of definitions or catechisms structured according to a questionand-answer pattern. Finally, their writings invited analysis, semantic and lexicographical exegesis, and commentary. However, the past could also be used as a starting point for criticism, apologetics and self-definition. Furthermore, as we shall see in chapter 12, the Methodist school of medicine presents an interesting example of a school of thought in which an antiquarian interest in the past as such could very well be combined with a severely critical attitude towards the doctrines of earlier medical authors. This brings us to a second, perhaps more pertinent reason for the recent surge of interest in the role of tradition and historical awareness in ancient medicine, science and philosophy.

Versions of the medical past: methods, strategi,es, sources

Modern scholarship has become increasingly aware of the great variety of ways in which traditional material was received and used in ancient scientific discourse, and of the wide range of different purposes and strategies the description of this material served. Ancient scientists received, or indeed constructed, particular versions of the history of their own subject, which were the product of a sometimes long, possibly distorting and inevitably selective process of transmission, interpretation, "re-cycling" and updating. The modalities of these processes have turned out to be very complicated indeed, and it has become clear that the subject of 'tradition' in ancient science comprises much more than just one authoritative scientist exercising influence on another. This awareness is probably related to the more general realization that, as recent publications in 'meta-history' have shown, any written account of the past may have a wide variety of strategic purposes and rhetorical features. 15 The relevance of this insight to the study of 15 See in particular the publications of Hayden White, Metahistory. The Historical Imagination in Nineteenth-Century Europe, Baltimore and London, 1973 (especially the Introduction); id., Tropics of Discourse: Essays in Cultural Criticism, Baltimore and

6

PHILIP J. VAN DER EIJK

ancient historiography is further enhanced by the fact that historiography in antiquity was a literary genre, 16 in which a considerable amount of rhetoric, exaggeration and dramatization was permitted and indeed encouraged in order to promote clarity (sapheneia) and vividness of presentation ( enargeia) so as to enhance involvement on the part of the audience. 17 This is not to say that ancient historiographers did not have to bother about standards such as truthfulness and accuracy in order to satisfy their critics, but there was considerable flexibility in the interpretation of these standards and in the extent and the level to which they were applied. 18 Thus in the use of direct speech, the historian was under no obligation to report the ipsissima verba of the speaker as long as he kept faithful to the 'gist' of what was said, and a similar poetic licence existed with regard to the characterization of personalities and the arrangement of events (the latter of which affected the question of presentation of items in a chronological order). These conventions provided historians with considerable room for manoeuvre, manipulation or even fabrication, and for creating versions of the past that suited their own agendas or those of their audiences, e.g., by concealing, distorting or selectively emphasizing certain aspects of the past at the expense of others, or by putting the present into a particular light or perspective, thus using history for such purposes as self-definition, polemic, apolegetics, etc. 19 These considerations apply no less to the historiography of philosophy, medicine and science in general. Versions of the intellectual past may similarly be inspired by underlying agendas in order to put certain ideas or thinkers into a certain perspective, or to associate oneself with, or dissociate oneself from, certain philosophical or ideological strands of the past. Moreover, opportunities for tendentious London, 1975, and id., The Content of Form: Narrative Discourse and Historical Representation, Baltimore, 1987. See also D. LaCapra, Rethinking Intellectual History: Texts, Contexts, Language, Ithaca and London, 1983. 16 See AJ. Woodman, Rhetoric in Classical Historiography, London, 1988; Nicolai, o.c. (n. 14 above), pp. 147 ff.; and S. Hornblower (ed.), Greek Historiography, Oxford, 1994. 17 On this see the useful discussion by T.P. Wiseman, "Lying historians: Seven types of mendacity", in: C. Gill and T.P. Wiseman (eds.), Lies and Fiction in the Ancient World, Exeter, 1993, pp. 122-146. 18 See J.L. Moles, "Truth and untruth in Herodotus and Thucydides", in: Gill and Wiseman (see previous note), pp. 88-121. 19 See the publications by Woodman, Wiseman, and Moles mentioned in the preceding notes. See also G.E. Sterling, Historiography and Seif-Definition. josephos, Luke-Acts and Apologetic Historiography, Leiden, 1992, pp. 1-19.

HISTORICAL AWARENESS, HISTORIOGRAPHY, AND DOXOGRAPHY

7

interpretations and manipulations are enhanced by the fact that the 'truthfulness' or 'faithfulness' of a report is a less straightforward thing in the case of ideas than with political or military events. 20 Again, this is highly relevant to the ways in which the history of philosophy and science was written in the ancient world. For example, it explains why so many ancient scientists, in the prefaces to their works, insert a brief historical overview of their subject in order to define their own position in relation to the achievements of their predecessors. 21 It also makes it easy to see how distortions could occur in the rendering of an earlier thinker's ideas, for this was often done in indirect speech-something which ancient writers of the history of thought had very few qualms about, because the dianoia, the "meaning" or "gist" of what someone had said, was considered more important than the lexis, the literal phrasing of the statement itself. 22 A further relevant fact here is that accounts of the course of thought may be structured according to established patterns and topoi. In ancient intellectual history, for example, the notion of the "first inventor" (np&toc; dipEt~c;) of a science, or of particular scientific "discoveries" (dip~µam) often served as a principle of selection and arrangement. 23 Another example is the commonplace that the origin of philosophy and mathematics was to be found in Egypt, or at any rate among the "barbarians"-an expression of the interest in foreign culture that arose in the 5th and 4th century BCE but which

°

For some of the methodological issues of intellectual history see LaCapra (n. 15 above), and R. Rorty, J.B. Schneewind, and Q. Skinner (eds.), Philosophy in History. Essays in the Histmiography of Philosaphy, Cambridge, 1984. 21 E.g., the prefaces to Dioscorides' and Scribonius Largus' works on pharmacology, Celsus' work on medicine, Aristoxenus' work on harmony, Proclus' commentary on Euclid's Elements, Philo of Byzantium's work on artillery, Hero of Alexandria's work on pneumatics, etc. 22 For this distinction see Galen, De usu respirationis 1.2 ( 4.4 71 K). 23 On this topos, and on the literature "On Discoveries" (I1Ept EUpT]µa'trov) see A. Kleingiinther, 11:pwwc; evpt:rryc;. Untersuchungen zur Geschichte einer Fragestellung; Leipzig (Philologus Supplementband 26, Heft 1), 1934; K Thraede, "Das Lob des Erfinders", Rheinisches Museum 105 (1962), p. 158-186. Although antecedents of this notion can already be found in archaic Greek literature, the quest for a "first inventor" became the subject of more systematic study in works entitled IlEpt EUpT]µa'trov by Hellanicus of Lesbos, Scymon of Mytilene and the historian Ephorus (frs. 104-106 Jacoby), and a vast literature of this kind seems to have been produced in the Peripatetic school. For an example of its usage in ancient accounts of the history of science see Eudemus' history of mathematics, frs. 133-149 Wehrli. 2

8

PHILIP J. VAN DER EIJK

established itself as a sort of dogma in the later historiographical tradition. Furthermore, the recent expansion of scholarly studies in orality and literacy, the ethnography of literature, and the transmission and dissemination of knowledge has made students of ancient thought more perceptive to the conditions and the modalities of "intellectual exchange" and Wissensvermittlungin antiquity.2 4 It is realized that the portrayal of the (intellectual) past may not only, on the level of authorial strategies, be influenced and manipulated by a variety of rhetorical techniques, but also be constrained or even determined by factors beyond the author's control. For example, his sources may be scarce, he may have had restricted access to the writings of the thinkers whose ideas he describes or have been dependent on intermediary sources or hearsay, or his rendition of predecessors' views may be biased as a result of an interpretative tradition in which he stood (e.g., commentaries on predecessors' works, or oral traditions). Again, this point is particularly relevant to the ancient world, where the availability of primary literature was for the most part awkward and the dependence on intermediary material great. The study of the medical (and philosophical) thought of predecessors in antiquity relied heavily upon an extensive apparatus of secondary literature comprising doxographic catalogues of names and doctrines, introductions to a particular author or subject, bibliographies, biographical accounts, compendia, lexica, commentaries, and other introductory ('isagogic') material that accumulated during a long tradition. Although most of this material is lost, it had a great impact on the perspective from which the medical past was viewed and described by later writers, and it appears to have exercised a powerful influence on ancient practices of interpretation of medical texts. 25 Thus the same Galen who appeared to have such a high respect for the venerable authorities of old, especially Hippocrates and Plato, has been shown to make a very selective and discriminating use of their views and sayings. In particular, he has been shown to have constructed a highly peculiar image of Hippocrates as the great 24 See the important collection of studies edited by W. Kullmann and J. Althoff, Vermittlung und Tradierung von Wissen in der griechischen Kultur, Tubingen, 1993. 25 J. Mansfeld, Prolegomena, Leiden, 1994. See also A.Z. Iskandar, "An attempted reconstruction of the late Alexandrian medical curriculum", Medical History 20 ( 1976), pp. 235-258; L.G. Westerink, "Philosophy and medicine in late antiquity", Janus 51 (1964), pp. 169-177.

HISTORICAL AWARENESS, HISTORIOGRAPHY, AND DOXOGRAPHY

9

authority, which was partly inspired by his desire to use the authority of Hippocrates as a powerful tool in the battles he had to fight with his medical contemporaries, but which had also been prepared for him, at least to some extent, by a long tradition of earlier Hippocratic exegesis. 26 Such an interpretative tradition was by no means a unified strand providing a self-evident, coherent and uncontroversial picture of the medical past. There was debate among ancient medical writers about the correct interpretation of the views of earlier authorities, about the authenticity of their works, the meaning of certain technical terms they used, and indeed about the extent of their authority. 27 Furthermore, there was a variety of views on such wider issues as the course or direction in which medicine, as part of human civilization, had developed: 28 thus the author of the Hippocratic work On Ancient Medicine adopted a 'progressivist' theory of the development of medicine, in which the accumulation and refinement of experiential dietetic knowledge from one generation to another was viewed as a continuous improvement of the ways in which mankind had managed to master the effects of the various foods and drinks on the human body. Yet also the 'primitivist' view had its representatives, such as the anonymous "most refined physicians" (yAacpupol'ta'tOt impoi) who are reported by the Peripatetic philosopher Dicaearchus to have believed in a sort of primordial medical Golden Age, in which man enjoyed permanent health as a result of an exactly appropriate diet, which prevented his body from producing residues (perittomata), which in their turn were to become the causes of diseases. 29 Another example of differences in viewpoint among ancient medical writers concerning the way in which medicine had originated and On Galen's Hippocratism see G.E.R. Lloyd, "Galen on Hellenistics and Hippocratean: contemporary battles and past authorities", in: Kollesch and Nickel, o.c. (n. 2 above), pp. 125-143 (also in id., Methods and Problems in Greek Science, Cambridge, 1991, pp. 398-416; G. Harig and]. Kollesch, "Galen und Hippokrates", in: L. Bourgey and J. Jouanna (eds.), La collection Hippocratique et son role dans l'histoire de la medecine, Leiden, 1975, pp. 257-274; H. Diller, "Empirie und Logos. Galens Stellung zu Hippokrates und Platon" in: K. Doring and W. Kullmann (eds.), Studia Platonica. Festschrift H. C,undert, Amsterdam, 1974, pp. 227-238. 27 See W.D. Smith, The Hippocratic Tradition (n. 1 above). 28 On cultural history in general see T. Cole, Democritus and the Sources of Greek Anthropology, Atlanta, 1990 and the publications by Kleingunther and Thraede quoted above (n. 23). 29 Dicaearchus, fr. 49 Wehrli. For a discussion of this fragment see T.J. Saunders, "Dicaearchus' historical anthropology", in: W.W. Fortenbaugh (ed.), Dicaearchus and Demetrius of Phaleron (forthcoming). 26

10

PHILIP J. VAN DER EIJK

developed, was the relation with philosophy. This had been a contentious issue from as early as the Hippocratic Corpus onwards, with some authors (such as the writers of On Fleshes and On Regi,men) freely adopting speculative notions derived from contemporary natural philosophy, while the authors of On the Nature of Man and On Ancient Medicine explicitly rejected the influence of philosophy ( though by no means remaining free from those influences themselves). 30 It may have been the latter Hippocratic work which, more than four centuries later, prompted the Roman encyclopaedist Celsus, in the historical preface to his On Medicine, to portray Hippocrates as the one who separated medicine, i.e. the treatment of diseases ( morborum curatio), from philosophy (studium sapientiae, rerum naturae contemplatio)-a separation which Celsus considers healthy and to be acclaimed. 31 On the other hand, the close connection between medicine and (natural) philosophy, and indeed the desirability of this, was stressed by Aristotle by reference to the fact that "the more sophisticated doctors" (oi xapifvn:~ t&v iatp&v) base their medical investigations and practice on principles derived from the study of nature, while conversely some of the more serious physicists also take account of the principles of health and disease. 32 This Aristotelian view was endorsed by many doctors (such as Diodes of Carystus and Galen) and natural philosophers (e.g., Theophrastus, Strato, and Alexander of Aphrodisias), and accordingly the reciprocal relationship between medicine and (natural) philosophy was reflected in the historiography of both subjects. Thus the medical doxography of the Anonymus Londiniensis 33 incorporates Plato and Philolaus in his account of theories of the causes of diseases,

°

For the early stage of this debate see J. Longrigg, Greek Rational Medicine, London, 1993. For the later discussion see M. Frede, "Philosophy and medicine in antiquity", in: id., Essays in Ancient Philosophy, Oxford, 1987, pp. 225-242, and id., "Introduction" to: Galen, Three Treatises on the Nature of Science, Indianapolis, 1985. 31 Celsus, De medicina, proem 8. However, it is possible that this remarkably selective view on Hippocratic medicine has been transmitted to Celsus through an Empiricist source; on Celsus see chapter 7 by von Staden below. 32 De sensu et sensibilibus 436 a 17-b 2; De respiratione 480 b 22-31. For a discussion of these passages see P.J. van der Eijk, "Aristotle on 'distinguished physicians' and on the medical significance of dreams", in: P .J. van der Eijk, H.F .J. Horstmanshoff, P.H. Schrijvers (eds.), Ancient Medicine in its Socio-Cultural Context, Amsterdam -Atlanta 1995, vol. 2, pp. 447-459. 33 See the discussion by Manetti in ch. 4 (below). On the role of "philosophers" (designated as such) in medical doxography see also ch. 8, p. 303 (on the "philosopher" Democritus in the Anonymus Parisinus); see also Caelius Aurelianus, De morbis acutis 3.13.111; 3.15.123; De morbis chroniis 1.5.154; 4.1.4. 3

HISTORICAL AWARENESS, HISTORIOGRAPHY, AND DOXOGRAPHY

11

while doctors such as Diodes, Asclepiades, and Herophilus figure prominently in the 4th and 5th books of Pseudo-Plutarch's doxography on physics. 34 In their turn, the champions of a non-philosophical approach to medicine, such as the Empiricists, managed to establish a medico-doxographical tradition free from philosophical influences, tracing the origin of their method to the ancient fifth century Sicilian doctor Acron. 35

Genres of medico-historiographical writing Having looked at some attitudes of medical writers in classical antiquity towards the past history of their own profession, we may now consider how these were reflected in the ways in which they described this medical past. What topics constituted the subject-matter for the writing of medical history? What modes or 'genres' of medical historiography existed in antiquity, what purposes did they serve, and for what sort of audience were they intended?

Lives First, there was the biographical approach, which must have generated an extensive corpus ofliterature of which, regrettably, very little survives. Similarly to the Lives of famous poets36 and philosophers, 37 ancient doctors were the subject of biographical treatment and pseudepigraphical epistolary activity. Thus in the Methodist school of medicine, biographies of Hippocrates and other famous doctors were written, excerpts of which survive in Byzantine compilations such as 34 See the discussion by Runia in chapter 6 (below). The role of "specialists" (on astronomy, meteorology, mathematics, optics, etc.) in the doxography on (natural) philosophy would constitute an interesting subject for further research; for some tentative remarks see P J. van der Eijk, o.c. (note 1 above). 35 See K. Deichgraeber, Die griechische Empirikerschule. Sammlung der Fragmente und Darstellung der Lehre, Berlin and Zurich, 1965 (second edition), frs. 5, 6, 7a, 7b, 7d. See also the discussion by von Staden in chapter 5 (below). 36 For a collection of the surviving material and a critical discussion see M.R. Lefkowitz, The Lives of the Greek Poets, London, 1981. Still valuable on ancient biography is F. Leo, Die griechisch-riimische Biographie nach ihrer litterarischen Form, Leipzig, 1901; for a more recent treatment see A. Momigliano, The Development of Greek Biography, Expanded edition, Cambridge Mass. and London, 1993. 37 As found in Diogenes Laertius' Lives and Doctrines of the Famous Philosophers. From Diogenes' references to earlier sources, one can infer the existence of an extensive literature On Lives (I1Ept Bicov).

12

PHILIP J. VAN DER EIJK

the Suda-lexicon and the Chiliades of John Tzetzes, 38 and similar biographical accounts were produced by the Herophileans (see chapter 5). Letters allegedly written by famous doctors such as Hippocrates, Herophilus, Diodes, etc. 39 and other documents related to their life and public performance (such as decrees and speeches) were fabricated in order to revive the medical past by means of "imaginative historical dramatization". 40 Documents such as these are likely to have been intended for a wider, non-specialist audience and to have served propagandist purposes. These biographical and pseudepigraphic writings have recently attracted considerable scholarly attention. 41 But it may be proper to say something about the motives underlying them. 42 There was the topos of consistency between life and doctrine, practice and preaching, which particularly inspired writing about the lives of moral philosophers, 43 but was also relevant to the medical domain, where issues of medical ethics and the proprieties of the profession (such as philanthropia and charis) were bound to be related to the personality and conduct of the main authorities. 44 This, as well as panhellenic or For a survey and critical discussion of this see J. Rubin Pinault, o.c. (n. 1 above); A.E. Hanson and M. Green, "Soranus of Ephesus: Methodicorum princeps", Aufstieg und Niedergang der riimischen Welt 11.37.2 (1994), p. 979; 0. Temkin, Hippocrates in a World of Pagans and Christians, Baltimore, 1991, pp. 51-75. 39 On ancient pseudepigraphic letters by doctors see H. von Staden, Herophilus, Cambridge, 1989, pp. 579-581; see also C. Opsomer, R. Halleux, "La lettre d'Hippocrate a Mecene et la lettre d'Hippocrate a Antiochus", in: I. Mazzini and M. Fusco (eds.), I testi di medicina latini antichi, Macerata, 1985, pp. 339-364. 40 W.D. Smith, Hippocrates. Pseudepigraphic Writings (n. 1 above), p. 1, which offers a critical edition with translation and discussion of the pseudepigraphic writings associated with Hippocrates; see also D. Sakalis, Hippokratous Epistolai, Ioannina, 1989, and Th. Rutten, Demokrit - lachender Philosoph und sanguinischer Melancholiker, Leiden, 1992. 41 In addition to the literature cited in the previous note see also Smith, "Notes on ancient medical historiography" (seen. l above), pp. 103-107. Some aspects of the ancient biographical tradition on Hippocrates are discussed in this volume by H. von Staden, ch. 5 below. 42 See H. von Staden, "Character and competence. Personal and professional conduct in Greek medicine", in: H. Flashar andJ.Jouanna (eds.), Medecine et morale dans l'Antiquite (Entretiens sur l'Antiquite Classique, tome 43), Vandreuvres Geneva, 1997, pp. 175-179. For a discussion of the purposes of biographies of poets see Lefkowitz, o.c. (n. 36 above), pp. 136-138. 43 Cf. J. Mansfeld, Prolegomena (n. 25 above), pp. 180 ff. 44 Cf. Galen, De placitis Hippocratis et Platonis 9.4 (CMG V 4, 1, 2, p. 564 De Lacy; 5.751-752 K.). On this see K. Deichgraeber, Medicus gratiosus. Untersuchungen zu einem griechischen Arztbild (Akad. d. Wiss. u. d. Lit., Mainz, Abh. d. geistes- und sozialwiss. Kl. 3), Wiesbaden, 1970; Temkin, o.c. (n. 38 above), pp. 18-35; 220-223; H. Flashar, "Beitrage zur spiitantiken Hippokratesdeutung", Hermes 90 (1962), pp. 402-418. 38

HISTORICAL AWARENESS, HISTORIOGRAPHY, AND DOXOGRAPHY

13

regionalist tendencies to identification with a great medical hero, probably explains the popularity of such episodes as Hippocrates' brave resistance against the Persian king, his heroic curing of the Athenian plague, etc. The tendency, in ancient intellectual biography and indeed in ancient biography as a whole, to focus on such episodes of spectacular achievement, was further enhanced by processes of selection and distortion which were inherent in ancient biographical traditions and caused the genre to acquire a rather anecdotal form, often verging on the sensational. 45 Doctrines

This is the area of doxography, which occupies the major part of the present volume. In chapter 2, David Runia deals at considerable length with the forms and functions of doxographical discourse in antiquity, and the following chapters are devoted to the most important medical specimens that have survived. Literature on "Schools of thought" and on "Successions"

This may be seen as a mixture of biography and doxography. Ancient medicine displayed, or at any rate was perceived as displaying, a differentiation into various 'schools' or 'sects' ( haireseis or sectae) similar to philosophy. To what extent such 'schools' actually existed and had some form of institutional organization, is not in all cases easy to decide, and the evidence varies from one hairesis to another. 46 However this may be, the division into such 'schools' and the classification of individual thinkers as members of a particular school provided a convenient historiographical pattern, and is likely to have contributed to schematization and indeed simplification of processes of intellectual development that must in reality have been far more complicated and diverse (it should be noted that the habit of putting labels of Schulangehorigkeit on individual philosophers and physicians has persisted in the study of ancient thought up to the present day).

45 Related to this is the literary portrayal of doctors' activities in non-medical contexts, e.g. in historiography or biography; a famous example is Herodotus' account of the physician Democedes (3.129-131). 46 See H. von Staden, "Hairesis and heresy: The case of the haireseis iatrikai", in: B.F. Meyer and E.P. Sanders, Self-Definition in the Graeco-Roman World, London, 1982, pp. 76-100 and 199-206.

14

PHILIP J. VAN DER EIJK

Just as philosophy was divided into such 'schools' (the Stoics, Epicureans, Sceptics, Peripatetics, etc.), the history of medicine was described in terms of different schools such as the 'Dogmatists' ,47 'Empiricists', 'Herophileans', 'Erasistrateans', 'those associated with Diodes' (oi 1t£pt 'tOV ~toKAfo), 48 etc., which were believed to adhere to particular doctrines and to be in continuous competition with one another. Furthermore, just as the early history of philosophy was described by later doxographers in terms of the emergence of two (or sometimes three) 'schools' (the Ionian philosophers, the Italians, with the Eleatics sometimes distinguished as a third) ,49 likewise early Greek medicine was believed (from the Hellenistic period onwards) to have displayed a diversification into a Coan, a Cnidian and a Sicilian school of thought. 50 Literature on the sects and on sectarian history seems particularly to have flourished in the period when medicine actually differentiated into several distinct 'sects', and these schools of thought ( especially the Herophileans) developed their own historiographical traditions, in which the doxography of one's own school but also that of rival schools was often used for purposes of self-assertion or polemics. 51 Again, the example of Soranus' Lives, Schools and Writings of Doctors must be mentioned, or Apollonius Mys' On the Sect of Herophilus, 52 Bacchius' Memoirs on Herophilus and the Members of his House, 53 Serapion's work Against the Sects, 54 Heraclides' On the Empiricist Sect, 55 etc. Regrettably, all these works are lost. 56 To some extent, Galen's (extant) writings on the sects ( On the Sects for Beginners, An Outline of Empiricism, On Medical Experience, On the Best Sect) 57 can also 47

On this see F. Kudlien, "Dogmatische Arzte", RE Suppl. 10 (1965), cols. 179-

180.

On this expression see M. Dubuisson, Hai amphi tina hoi peri tina. L'evolution des sens et des emplois, Liege, 1976. 49 See W. von Kienle, Die Berichte iiber die Sukzessionen der Philosophen in der hellenistischen und spiitantiken Literatur, Diss. Berlin, 1961, pp. 9-31. 50 Galen, De methodo medendi l.l (10.5 K.); see W.D. Smith, "Galen on Coans versus Cnidians", Bulletin of the History of Medicine 47 ( 1973), pp. 569-585. 51 See von Staden, Herophilus (n. 39 above), pp. 456-457. 52 Caelius Aurelianus, De morbis acutis 2.13.88 (= fr. AM.5 von Staden). 53 Galen, In Hippocratis ~Epidemiarum 6.4. 7 comment 4.10 (CMG V 10,2,2, p. 203 Wenkebach; 17B.145 K.) (= fr. Ba.78 von Staden). 54 Caelius Aurelianus, Acut. 2.6.32 (=fr. 144 Deichgraeber). 55 Gal., De libris propriis9 (SMII, p. 115 Muller= fr. 1 Deichgraeber; 19.38 K.). 48

See the discussion of the surviving evidence by von Staden in ch. 5 below. The first three are conveniently available in an English translation with extensive introduction by M. Frede in Galen, Three Treatises on the Nature of Science, tr. R. Walzer and M. Frede, Indianapolis 1985. 56

57

HISTORICAL AWARENESS, HISTORIOGRAPHY, AND DOXOGRAPHY

15

be related to this, although they occupy a rather special place in that the exposition of the doctrines of the various sects is here integrated in, and subordinated to, an epistemological and methodological discussion of the science of medicine. The interplay between dependence on doxographical traditions and manipulative portrayal, rhetoric and self-assertion in these treatises deserves a study in its own right. 58 Related to this literature on the haireseis, and to some extent underlying it, is the historiographical pattern of the diadochai or "successions", according to which intellectual history is viewed as a continuous succession of thinking from teacher to pupil, suggesting an almost genealogical line of descent. 59 This pattern of thought can already be perceived in Theophrastus' doxographical work, but it developed into a separate genre in the Hellenistic period, with Sotion of Alexandria (second century BCE) as its main representative. It greatly influenced the later doxographical and biographical tradition (e.g., Diogenes Laertius), in which intellectual kinship between two thinkers was often romanticized into a personal relationship of teacher and pupil by using the formula "X heard the teaching of (~KOUos is never found in ancient literature, 14 the reference to 86sm in the neologism has an identifiable ancient background. As early as Aristotle we find a reference to the "opinions of earlier thinkers" in a quasi-technical sense (De anima 1.2, 403 b 22) .15 Such references later became standard in ancient philosophical and scientific studies. In the 2nd century CE, for example, when the Christian apologist Athenagoras wishes to indicate that he made use of what we would call doxographical material he states that "we turned to the opinions". 16 But there is also a less positive side to the invention. In his opus magnum Diels collected together and presented critical editions of ten texts. The implication, clearly, is that these are the products, directly or indirectly, of doxographi. In his dedicatory letter to his teacher Usener he speaks of hoc doxographorum volumen. But one page earlier, in a kind of table of contents he lists these ten documents under the title Placitorum scriptores insunt. Here another term is used, placita (literally "what it pleases someone to think"), which has as Greek equivalent apfoKov'ta.17 These terms are virtually synonymous with 86sm and its Latin equivalent opiniones. 18 These terms occur quite often in the titles of ancient writings. 19 Both the term Placita and the notion of 'Placita literature' had already been extensively used by Diels and his predecessors. Diels in fact does not adequately explain the relation between his neologism and the existing use of the concept of Placita literature. The latter term is an excellent description of the work of the protagonist of the Doxographi Graeci, Aetius. But it fits other members of the collection, such as Arius Didymus and Hippolytus, less well. The unspoken assumption of an identifiable doxographical genre that is broader than merely the Placita-literature is one the chief reasons for the unclarity surrounding the notion of 'ancient doxography'.

This can be verified in a matter of seconds by doing an index check of oo~oypa