Galen: Writings on Health: Thrasybulus and Health (De sanitate tuenda) 9781009159517, 9781009159524, 2022043214

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GALEN: WRITINGS ON HEALTH

Galen’s Health (De sanitate tuenda) was the most important work on daily exercise, diet and health regimes in antiquity. This book presents the first reliable scholarly translation of this work in English, alongside the related theoretical work Thrasybulus. A substantial introduction and thorough annotation elucidate both works and contextualize them within the framework of ancient health practices, conceptions of the body and debates between medical and philosophical schools. The texts are of enormous interest from three points of view: (1) the wide range of insights they give into ancient everyday lifestyles, especially as regards diet, bathing, exercise and materia medica, as well as aspects of daily intellectual life; (2) the light they shed on ancient debates within medicine and philosophy, on fundamental conceptions of the body and the relationship between body and mind; (3) the enormous influence that Health had in mediaeval and early modern times. p. n. singer is a Research Fellow at the Einstein Center Chronoi, Berlin and an Honorary Research Fellow at Birkbeck, University of London. He has published Galen: Selected Works (1997) and Time for the Ancients: Measurement, Theory, Experience (2022), co-authored Galen: Psychological Writings (2013) and Galen: Works on Human Nature, Volume 1 (2018) and co-edited Mental Illness in Ancient Medicine: From Celsus to Paul of Aegina (2018).

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cambridge galen translations General editor: Philip van der Eijk Galen’s works represent one of the most impressive monuments of Classical medicine. They dominated medical theory, teaching and practice in the mediaeval European and Islamic worlds and remained a key source of medical wisdom down to the twentieth century. But his works also concern themselves with all the philosophical issues involved in understanding the human body, soul and health, and in diagnosing and treating illness, and Plato and Aristotle were key influences on his thought. Furthermore, as the court physician of several Roman emperors, Galen is an important source of information about social and cultural life in the early Empire. Cambridge Galen Translations provides a co-ordinated series of scholarly English translations of works of Galen in a unified format with substantial introduction and annotation, glossaries and indices. Many of the translations have been newly commissioned, while others are revised versions of good translations which have for some time been out of print. Editors and translators are drawn from the world’s leading scholars of Galen and of ancient medicine. The series is intended both to contribute to international Galenic scholarship and to make Galen’s work more easily accessible for a wider, non-specialist readership including historians and philosophers of science and readers with a medical background. Titles in series: Psychological Writings, edited by P. N. Singer, translated with introductions and notes by Daniel Davies, Vivian Nutton and P. N. Singer, with the collaboration of Piero Tassinari Works on Human Nature, Volume 1: Mixtures (De temperamentis), translated with introduction and notes by P. N. Singer and Philip van der Eijk, with the assistance of Piero Tassinari In preparation: Works on Human Nature, Volume 2: Commentary on Hippocrates’ The Nature of the Human Being, translated with introduction and notes by R. J. Hankinson Writings on Plato’s Timaeus, translated with introductions and notes by Aileen Das, Pauline Koetschet and Mark Schiefsky Commentary on Hippocrates’ Prognostic, translated with notes by Christine Salazar, revised with introduction by P. N. Singer Simple Drugs I–V, translated with introduction and notes by John Wilkins The Function of the Parts of the Human Body, translated by M. T. May, revised with introduction and notes by Julius Rocca Writings on the Pulse, Volume 1: The Distinct Types of Pulse and The Discernment of the Pulse, translated with introduction and notes by P. N. Singer and Orly Lewis

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GALEN: WRITINGS ON HEALTH Thrasybulus and Health (De sanitate tuenda) translated with introduction and notes by P. N. S I NGER

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University Printing House, Cambridge CB2 8BS, United Kingdom One Liberty Plaza, 20th Floor, New York, NY 10006, USA 477 Williamstown Road, Port Melbourne, VIC 3207, Australia 314–321, 3rd Floor, Plot 3, Splendor Forum, Jasola District Centre, New Delhi – 110025, India 103 Penang Road, #05–06/07, Visioncrest Commercial, Singapore 238467 Cambridge University Press is part of the University of Cambridge. It furthers the University’s mission by disseminating knowledge in the pursuit of education, learning, and research at the highest international levels of excellence. www.cambridge.org Information on this title: www.cambridge.org/9781009159517 DOI: 10.1017/9781009159524 © Cambridge University Press 2023 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2023 Printed in the United Kingdom by TJ Books Limited, Padstow Cornwall A catalogue record for this publication is available from the British Library. Library of Congress Cataloging-in-Publication Data Names: Galen, author. | Singer, P. N. (Peter N.), 1962– translator, writer of added commentary. | Galen. Thrasybulus. English (Singer) | Galen. De sanitate tuenda. English (Singer) | Galen. Works. English   (Cambridge Galen translations) Title: Galen : writings on health : Thrasybulus and Health (De sanitate tuenda) / translated with introduction and notes by P.N. Singer. Other titles: Writings on health : Thrasybulus and Health (De sanitate   tuenda) Description: New York, NY : Cambridge University Press, 2022. | Series:   Cambridge Galen translations Identifiers: LCCN 2022043214 | ISBN 9781009159517 (hardback) | ISBN   9781009159524 (ebook) Subjects: MESH: Galen. | Hygiene | Medicine Classification: LCC RA776 | NLM WZ 290 | DDC 613–dc23/eng/20221109 LC record available at https://lccn.loc.gov/2022043214 ISBN 978-1-009-15951-7 Hardback Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

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To Piero in friendship and memory

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Contents

List of illustrations Series editor’s preface Preface and acknowledgements Note on citations and abbreviations Note on the translation: principles and problems Introduction

page viii ix xiii xvii xviii 1 97

thrasybulus health

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Book I Book II Book III Book IV Book V Book VI

155 202 247 285 323 364

Appendix: Galen and others on the parts of medicine List of departures from the editions of Helmreich and Koch List of titles, abbreviations, editions and online resources of   Galenic works Bibliography English–Greek glossary Greek word index Index of names Index of texts and passages cited General index

403 410

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414 437 454 467 494 496 504

List of illustrations

1 Some varieties of massage: diagram showing ‘vertical’, ‘sloping’, ‘oblique’, ‘up-slanting’ and ‘transverse’ massage (see Health, Book II, n. 20). From: Gadaldini (1565), p. 70. page 209 2 Plans of the main types of Roman baths and bath-andgymnasium complexes, showing the typical transitions between rooms of different temperatures, as well as the integration of baths with the palaistra. Redrawn from the illustration in Der Neue Pauly, ‘Thermen’, p. 415, by kind permission of Brill. 277 3 The parts of medicine and the location of healthfulness.  407

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Series editor’s preface

The works of Galen of Pergamum (129–c. 215 CE), ‘the Prince of Physicians’, constitute one of the most impressive monuments of Classical medicine. They comprise all areas of medical theory and practice, ranging from anatomy, physiology, pathology, diagnosis and prognosis, dietetics and regimen in health, therapeutics, pharmacology and surgery, gynaecology, embryology and theory of reproduction to psychiatry and ethics. In addition, they cover philosophical and methodological aspects fundamental to the acquisition, systematization and communication of medical knowledge, such as logic, terminology, epistemology, philosophy of nature and theory of causation. And however voluminous and wide-ranging, they are bound together by an intrinsic and coherent (if eclectic) comprehensive theory of the human body, the human psyche, their place within the natural world, the nature of medical knowledge and the technical and ethical components of medical expertise. Galen’s works were of enormous influence on the subsequent history of medicine and science, both in the West and in the East, and Galen’s authority remained powerful until well into the seventeenth century and, in some respects, beyond that. Yet, more recently, Galen’s works have also found strong resonance beyond the domain of medical history. Galen was, after all, not only a brilliant doctor and prolific writer but also the court physician of several Roman Emperors, a keen public debater and dissector and an active participant in social and cultural life, first in Pergamum and subsequently in Rome. It is therefore not surprising that Galen’s work commands a rapidly growing interest from classicists, ancient historians and students of Greek and Roman literature, philosophy and society; and his writings are being exploited as a rich source for the social, cultural and intellectual history of the early Imperial period. Yet Galen’s works are difficult to access. Many are available only in old editions that do not meet current standards of classical scholarship, such as the nineteenth-century edition by Carl Gottlob Kühn (Greek text with ix

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Latin translation), which is still the most recent edition aspiring to completeness but which is universally regarded as unsatisfactory; and, in spite of its title Opera omnia, it lacks a number of Galenic works preserved in Latin or Arabic adaptation or deemed lost but later discovered (such as the recently found Avoiding Distress). For only a handful of Galenic texts have the basic modern philological requirements of a critical edition with translation and commentary been fulfilled; and although Galenic scholarship of the last decades has seen significant improvement, it is still the case that large parts of Galen’s work are not available in English translation. While interest in Galen thus seems greater than ever before, the language skills required to read him in the original are becoming more and more scarce. The Cambridge Galen Translations series aims to address this need. The purpose of the series is to provide a co-ordinated series of scholarly English translations of works of Galen in a uniform format consisting of introduction, translation, explicative notes, glossaries and indices. The series has been planned in close co-ordination with other ongoing Galen projects, such as the Corpus Medicorum Graecorum (CMG) at the Berlin-Brandenburg Academy of Sciences,1 the Galen volumes in the Budé series published by Les Belles Lettres (Paris),2 and those in the Loeb Classical Library published by Harvard University Press,3 in order to minimize duplication and, where possible, to promote international collaboration. Indeed, the translations in the present volume and in those to follow are based on critical editions that have been published, or are being prepared for publication, in the CMG, or Belles Lettres, or in some cases by other publishers (such as, for Thrasybulus in the present volume, the Teubner series). 1

A list of works published in the CMG (which was founded in 1907) and of works in preparation can be found on the CMG website at http://cmg.bbaw.de/Startseite.html. 2 See J. Jouanna and V. Boudon, ‘Présentation du projet d’édition de Galien dans la Collection des Universités de France’, Bulletin de l’Association Guillaume Budé 1993, pp. 101–135. So far, ten volumes have been published: Ars Medica/Protrepticus (Boudon, 2000), De ossibus ad tirones/ Dedissectione musculorum (Garofalo and Debru, 2005), De libris propriis/De ordine librorum suorum/Quod optimus medicus (Boudon-Millot, 2007), De dissectione nervorum/De dissectione venarum et arteriarum (Garofalo and Debru, 2008), Introductio sive medicus (Petit, 2009), De indolentia (Boudon-Millot, Jouanna and Pietrobelli, 2010), De alimentorum facultatibus (Wilkins, 2013), De theriaca ad Pisonem (Boudon-Millot, 2016), In Hippocratis De diaeta in morbis acutis commentarium, liber I (Pietrobelli, 2019) and De theriaca ad Pamphilianum (Boudon-Millot, 2021). 3 So far, twelve Galenic works have been published: De naturalibus facultatibus (Brock, 1916), De methodo medendi (Johnston and Horsley, 3 vols., 2011), De constitutione artis medicativae, De methodo medendi ad Glauconem and Ars medica (Johnston and Horsley, 2016), De sanitate tuenda, Thrasybulus (Johnston, 2018), De temperamentis, De inaequali temperie, Quod animi mores corporis temperamenta sequantur, De optima corporis constitutione and De bono habitu (Johnston, 2020).

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Yet the novelty of the project lies not only in its provision of English translations. It also aims to make a new contribution to international Galenic scholarship, especially through substantial introductions, notes and glossaries, which are intended to provide resources for the study of Galenic language and thought, and indeed for Greek medical terminology at large. In this regard, the format of the series is closely modelled on Richard Sorabji’s Ancient Commentators on Aristotle (now published by Bloomsbury), from which it has drawn much of its inspiration, and on the CUP series of translations of Proclus’ Commentary on Plato’s Timaeus. Moreover, the project is meant to open up Galen’s work to other disciplines beyond Classics and History of Medicine, such as the History of Philosophy, the History and Philosophy of Science, Cultural History, Linguistics and Literary Studies, and to readers with a medical background. Galen’s work is vast, and the series will therefore, in the first instance, give priority to works that have not yet been translated into English (or indeed in any modern language), or to works for which an English translation exists which, however, is out of print,4 or in need of revision or replacement in the light of recent developments in Galenic scholarship. A further consideration in the planning of the series has been the interest of the texts to be included and their relevance to some of the major issues that Galen’s work raises. Thus the texts translated in the present volume, Health and Thrasybulus, are of central importance for Galen’s views on the preservation of health and the promotion of a healthy style of living, and on the status of medicine as the authoritative discipline dealing with this area. They are also of great interest to issues in today’s medicine and healthcare. They are here presented with an elaborate introduction and notes elucidating their content, method and structure and placing them in the tradition of Greek medical writings on health and in the social (and competitive) context of health practitioners in early Imperial Rome. The volume offers extensive discussion of Galen’s theory of health and its relationship to his physiological ideas more generally, his practical measures for the management and improvement of health and his consideration of people’s ­individual circumstances. It also provides detailed discussion of the psychological aspects of health and the soul–body relationship against the background of earlier philosophical approaches, especially in the Platonic and Aristotelian traditions. 4

E.g., P. N. Singer’s Galen: Selected Works, Oxford 1997; translations of a number of Galenic texts included there are revised, with extensive new introductions and notes, for the present series.

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Further volumes to follow in the series will testify to Galen’s views on the nature and methodology of medical prognosis and prediction (Commentary on Hippocrates’ Prognostic); to his engagement with Plato’s Timaeus (Compendium of Plato’s Timaeus; Commentary on the Medical Statements in the Timaeus) and with the Hippocratic theory of human nature (Commentary on Hippocrates’ The Nature of the Human Being); to his theory and therapeutic practice of simple medicines (Simple Drugs I–V); to his views on the structure and purposive arrangement of the human body (The Function of the Parts of the Human Body); and to his detailed understanding and use of the pulse as a diagnostic indicator (The Distinct Types of Pulse, The Discernment of the Pulse). All these works also provide insight into the ways in which Galen arrived at his views and tried to justify them, how he accommodated and appropriated the various intellectual traditions, both medical and philosophical, to which he was indebted, and how successful he was in his attempts to create a synthesis out of these often conflicting tendencies. Furthermore, they will give a lively picture of the social and cultural environment in which Galen lived and how it impinged on the formation and development of his ideas; and finally, they will be illuminating for Galen’s activities as a writer and communicator, for the ways in which he presented his ideas, the consistency of his terminology, the audiences for whom he wrote, the genres he used to disseminate his ideas and the rhetorical strategies he employed to persuade his readers and to distinguish himself from rival doctors with whom he was in constant competition. It is a pleasure to acknowledge the generous financial support of the Wellcome Trust through a History of Medicine Programme Grant, which allowed the appointment, at Newcastle University, of three designated academic staff for the first six years of the project. We are very grateful to Newcastle University for its institutional support during these years. We gladly acknowledge the support of the Alexander von Humboldt Foundation, the Deutsche Forschungsgemeinschaft and the Humboldt University, which have ensured the continuation of the project, and provided additional funding, after my move to Berlin. For the practical organization of the project, we would like to thank Cambridge University Press, and in particular its Classics Editor Michael Sharp, who has supported the idea right from the start and has been a patient source of help throughout the production of the volumes in the series. Philip van der Eijk

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Preface and acknowledgements

This book presents new translations of Galen’s two major – but very different – works on the theory of health and the practices required for its maintenance. They are not the first translations of these works into English: in the case of Health (or Hygiene), that honour goes to R. M. Green in 1951, followed by I. Johnston in the Loeb Classical Library series in 2018, while in the case of Thrasybulus the first English translation appeared in my own 1997 Oxford World’s Classics volume. The nature and purpose of the present volume is, however, very different from that of those publications: namely, to provide a precise scholarly translation,1 accompanied by substantial explanatory notes and introduction, which aim to elucidate Galen’s arguments and theories; to address problems in their interpretation, including those which arise from difficulties in the manuscript readings; and to assist the understanding of Galen’s work through a contextualization within both his intellectual – philosophical and medical – and his social milieu. The volume also offers substantial further scholarly aids and reference materials: a Greek word index, a glossary of English–Greek equivalents, a note on translation problems and a full bibliography, as well as a list of all Galen’s works and their recent editions and translations. In the case of Thrasybulus, the text presented here started life as a revision of that published in the 1997 Oxford World’s Classics volume, but has ended up – in line with the above aims – as something more like a fresh translation. As a function of their content, intellectual aims and intended audiences, the works contained in this volume touch, either directly or indirectly, upon many of the most important topics raised by the study of 1

On the principles of, and problems and challenges for, this translation project, see further Note on the translation.

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this author: the underlying medical and physical theories; Graeco-Roman views on the nature, status and branches of medicine; medical-­ philosophical approaches to the relationship of soul and body; the nature of medical practice at Rome, and relationship between rival health practitioners; the performance, and technical language, of public intellectual debate at Rome; Galen’s position in the history of medicine; his engagement with both philosophical predecessors, especially Plato and Aristotle, on the one hand, and a very wide range of medical authorities (including many whose work is largely lost) on the other; the chronology, genres and aims of his writings; and the broader social structures, attitudes and practices relating to health in imperial Rome, including materia medica, exercise, athletics, bathing, massage, food and leisure. The above remarks are offered less as an overview of the content and interest of the treatises – on which more in the Introduction that follows – than as a partial justification of the length, both of the book’s gestation and of that Introduction, which may function not just as a preamble to the treatises themselves, but also as an overview of Galen’s career, physical theories, health-related practices and relationship with his socio-­intellectual background. The translation and related work on this volume commenced nearly ten years ago, and have occupied varying proportions of my time since then. I have incurred many debts over that period. Philip van der Eijk initiated the project ‘Towards a Galen in English’, within the framework of which the volume was conceived and the first phase of work carried out. I am hugely indebted to him for supporting my research within that project and beyond it, as well as for close collaboration on the principles, process and detailed content of the translation and commentary, and on the structure of the series more broadly. I have also greatly benefited from contact and discussion with many in his research group in Berlin, and from the collegial culture of collaboration that was created there, within the project ‘Medicine of the Mind, Philosophy of the Body’, and around it. Institutionally, my thanks go to the Wellcome Trust, which funded both the above project, from 2009 to 2014, and a personal research fellowship, from 2016 to 2019; to Birkbeck, University of London for hosting that fellowship; to the Humboldt-Stiftung for funding periods of research in Berlin; and to the Einstein Center Chronoi, Berlin, at which I have held a number of fellowships since 2019. I have learnt from and been guided by many during work on this volume, and cannot hope to name all of them. Let me at least record my

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gratitude – for help on matters large or small – to Glen Cooper, Armelle Debru, Julien Devinant, Catharine Edwards, Jim Hankinson, Matyáš Havrda, Matteo Martelli, Lucia Raggetti and Thomas Rütten; and to Christine Salazar, whose death in the autumn of 2021 was an enormous loss – to the present project; to scholarship on Graeco-Roman medicine more broadly; and to all who knew her. She is sorely missed, as scholar and as friend. A particular debt of gratitude is owed to a group of colleagues and friends who joined me in a series of online reading sessions of Health throughout much of 2020 and 2021, during which my draft translation and notes were subjected to invaluable scrutiny: Sean Coughlin, David Leith, Orly Lewis, Ralph Rosen and John Wilkins. They made many invaluable suggestions, generously offered me the fruits of their expertise and saved me from many errors. It goes without saying that those which remain are my own responsibility. There was, to be sure, a considerable irony in finding oneself immersed in an ancient magnum opus on the preservation of health during an unprecedented current global health crisis. I could not have wished for more helpful and supportive – albeit enforcedly distanced – colleagues during that phase. Sincere thanks go also to participants in an occasional series of reading sessions earlier in the process, held mainly at Exeter University, including (in addition to some of those already named) Chris Gill and Robert Leigh. In a final phase, I am very grateful to Dorothea Keller, Martin Müller and Sara von Seggern for assisting in the compilation and completion of the Greek word index, a task to which they devoted a large number of hours; and I owe a particular debt of gratitude to the Cambridge University Press copy-editor, Malcolm Todd, whose extremely meticulous and thoughtful audit of a very long and complex manuscript improved the book in all sorts of ways, and saved it from numerous errors. (Again, those that remain are of course my own responsibility.) Thanks are due also to Michael Sharp at Cambridge University Press, for his patience and his support of the project. Of course, my intellectual debts and gratitude stretch back far before the period of direct work on this volume, and again I cannot hope to record all of them. But I must at least mention Geoffrey Lloyd, who first stimulated my interest in ancient science, as well as shaping my understanding of it; the much-missed Paola Manuli and Mario Vegetti, from both of whom I learnt much; Tamsyn Barton, who for some reason refused to allow me to abandon these pursuits entirely; my excellent

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teachers at the City of London School; and my parents Jean and Konrad Singer, who – alongside so much else – encouraged my first philosophical and scientific curiosity, and always supported my studies. Finally, a special word about Piero Tassinari, who was a crucial member of the Cambridge Galen Translations team from its inception in 2010 until he left us, much too early, in 2017. He contributed hugely to the development of the project, as well as to ancient medicine studies more broadly. He was also a brilliant colleague and a constantly stimulating and inspiring friend, who enlivened scholarly study – and far more than just scholarly study – with his intellectual curiosity, his eclectic range of interests, the breadth and depth of his knowledge, and his zest for life. He is sorely missed. The present volume is dedicated to him, in friendship and gratitude.

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Note on citations and abbreviations

Titles of works of ancient authors, if given in full in a discursive context, usually appear in English translation. Precise references in footnotes generally use the standard abbreviations of the Oxford Classical Dictionary, 4th edition. Galenic works, however, are cited according to the abbreviations given in the List of titles, abbreviations, etc. at the end of the book. Such references are by chapter number, or where applicable book and chapter number, followed by page and line number of the most recent critical edition, the editor’s name (usually abbreviated) and the volume and page number of the older edition of C. G. Kühn (1821–1833) (K.), where this is available. Typical references would thus be: Hipp. Elem. 2, 64,1 DL (I.420 K.); Nat. Fac. I.2, 103,18–105,9 H. (II.4–6 K.). Similarly, quotations from the works of the Hippocratic Corpus are identified by the volume and page numbers of the standard edition of E. Littré (1839– 1861) (L.), as well as those of the most recent critical edition. Throughout the translation, references to the Kühn page numbers (K.) are printed in the left-hand margin. References to page and line numbers of the modern critical editions used as the basis for the translation are printed in the right-hand margin: for Thrasybulus, Helmreich (1893), abbreviated ‘H.’, and for Health, Koch (1923), abbreviated ‘Ko.’ The traditional division of the texts into chapters has also been retained, although this is not due to Galen. Thematic headings have been added to the chapters, or groups of chapters, by the translator, to assist the reader in following the sense and structure of the argument.

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Note on the translation: principles and problems

Principles of translation and ‘technical’ terminology The translation aims to stay as close as possible to the structure and syntax of the original texts, and to translate individual Greek words consistently with the same individual English ones, insofar as both these aims are achievable without departing excessively from normal or acceptable English idiom. The glossary and the Greek word index both show the individual choices that have been made. It is of course to be understood that anything approaching one-to-one correspondence – especially in the direction of English to Greek – is not to be expected, and would take us far beyond the realms of a readable English translation. Especially in the case of terms with a technical significance within Galen’s medical and philosophical system, however, I have tried to choose a single equivalent in English, or at least a small and consistent range of equivalents. The texts translated contain a considerable number of such theoretical technical terms, that is ones used by Galen in specific senses which can only be understood in close connection with his medical or philosophical theories and systems of explanation. A few prominent examples are: apodeixis (‘demonstration’), araios (‘porous’), chreia (‘function’, ‘utility’), chumos (‘fluid’), diagnōsis (‘discernment’), diathesis (‘state’), dunamis (‘capacity’), duskrasia (‘bad-mixture’), epistēmē (‘scientific knowledge’), euexia (‘goodcondition’), eukratos (‘well-mixed’), hexis (‘condition’), homoiomerēs (‘uniform’), kataskeuē (‘constitution’), ousia (‘substance’), pathos (‘affection’, ‘ailment’), pepsis (‘coction’), perittōma (‘residue’), plēthos (‘build-up’), psuchē (‘soul’), proairesis (‘choice’, ‘decision’), sarkoun (‘fleshen up’), summetros (‘well-balanced’), thumos (‘spirit’), zētēma (‘enquiry’). For clarification of such equivalences, including sometimes discussion of the problems behind the translation choice adopted, and for discussion of the relevant theoretical background, the reader should xviii

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consult the English–Greek glossary in conjunction with the Greek word index. While the glossary lists equivalences, the Greek word index may then be used to trace both the main (in some cases, all) occurrences of that word in the texts, as well as the editorial notes discussing its connotations and translation. I proceed to consider some challenges and problems arising in specific technical areas.

Disease entities and anatomical terms Disease entities present a particular challenge for translation, and indeed for translatability. Our understanding of disease pathologies – in the ancient world as now – is closely dependent on our theoretical conceptions concerning the body and its functioning; there can thus be no direct corresponding modern term for an ancient disease category, for example melancholia, any more than there can be found a direct ancient equivalent of a modern category, such as ‘virus’ or ‘cancer’. The problem is further complicated, however, by the fact that, for historical reasons (most modern disease names derive, directly or indirectly, from the ancient Greek medical ones), there are many apparent such equivalences. Thus, a Greek treatise ‘about onkoi’ may well appear to be a treatise of oncology, whereas in fact onkos is a term of very broad application, to a wide variety of growths or swellings, and of course the ancients had no conception of cell multiplication nor any distinction between benign and malignant growths. Melancholia, meanwhile, has the apparent modern equivalent ‘melancholy’, which is itself an outdated term, medically speaking (such developments within the modern period of course provide a further layer of complexity to the problem); but we have no modern equivalent for a disease understood as arising from an imbalance of fluids involving excess black bile, and from the anatomically complex motions of such fluid through the body. Even apparently unproblematic equivalences will lead to misunderstanding: the ancient epilēpsia, for example, involves a number of manifestations and connotations which are significantly different from those involved in ‘epilepsy’ – quite apart from the fundamental mismatch in the causal accounts in each case; similarly, ancient ‘fever’ (puretos) involves a range of manifestations and varieties, and a whole conceptual framework, far beyond the simple notion of high temperature indicated by the modern term. Other terms (e.g. herpēs) will be completely misleading if presented in their modern transliteration. A few (e.g. haimorrhoides, ‘haemorrhoids’)

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are arguably sufficiently close in their sense that such transliteration is not misleading. To avoid such anachronisms and misunderstandings, then, my policy is in general either to provide an English translation that renders reasonably accurately the ancient understanding of the term, or to give the term in transliterated form, but in italics: so, marasmos ‘withering’ rather than ‘marasmus’; plēthōra ‘fulness’ rather than ‘plethora’; and melancholia, epilēpsia, rather than ‘melancholy’, ‘epilepsy’. In a few well-known cases of a conventional equivalence (e.g. ‘fever’), I have retained the established translation, and occasionally, where there seems little danger of confusion (e.g. ‘haemorrhoids’), used the descendant English medical term. Again I have attempted to explain important conceptual issues, as well as likely sources of misunderstanding, in the notes. Anatomical terms are less problematic, although here too caution must be exercised. There are fundamental differences in ancient and modern conceptions, even of such apparently unproblematic entities as veins, arteries and nerves; so, for example, we encounter several times the notion, which in itself makes no sense in modern terms, of the ‘first veins’; and the word neuron (with earlier connotations of ‘sinew’) is not always or unproblematically translatable as ‘nerve’. There are also specific cases where the structures observed are categorized or divided up in different ways. Specific examples are the hupochondrion and epigastrion – regions of the abdomen that have no precise equivalent in modern usage; and, to give two fairly unimportant examples which, however, illustrate the point, the Basilic vein and the larunx, neither of which, again, corresponds to an anatomical entity as now defined. Here too I have sometimes resorted to transliterated terms, though I have more often given the closest modern English (or medical Latin) equivalent. This has been done, however, on the basis that the above caveats should be taken into account; and again I have added notes passim explaining some of the difficulties, and in some cases indicating other texts where Galen gives explanations of the structures in question and his understanding of them.

Minerals, plants and animals The translation of ancient words for minerals, plants and animals, and products made from them, also presents methodological difficulties, to some extent overlapping with and to some extent distinct from those just outlined. In the particular case of plants (although similar problems apply in the other two cases), the problem is a complex and layered one.

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It is not just a question of trying to establish which plant is referred to by a particular Greek plant name. To frame the question in that way is to ignore two further questions: (a) did people in the ancient Mediterranean have the same plants available to them that we find in modern botanical works, or indeed that are found in the Mediterranean region today? (b) did they draw the line between different species or varieties in the same places that we do, i.e. can we expect a one-to-one correspondence between an ancient plant name and a modern plant (even assuming a positive answer to the first question)? It seems clear that, at least in some cases, the answer to both questions will be ‘no’. In the first case, specific factors to be taken into account are evolutionary developments in the plant population over the last 2,000 years and the later date of introduction to the Mediterranean of many plants now considered common, and in some cases referred to by ancient names (or their descendants). Recent research has shown – to take just two examples, that go no further than the cucurbit family – that our cucumber was absent from the ancient Mediterranean (although the word still frequently appears in translations), and that the varieties of melon known in the ancient world bear little relation to those familiar to us by that name.1 The second question is also pertinent: before modern taxonomical procedures, different species and varieties will have been referred to under a single term, and vice versa. This problem applies also in the animal world, where species identification was in our terms approximate, as well as doubtless involving regional variations (although as it happens there are a lot fewer animal than vegetable examples in the texts translated here). Principles of classification – for example, the perceived or expected properties of the plant or animal in question – may also affect naming and identification. For example, Galen identifies a distinct category of fish ‘of the rocks’ (petraioi), by which he means those that swim in shallow waters, and the term oniskos (conventionally translated ‘cod’) bears some relation to that, but the equivalence is unlikely to be precise; birds are also classified according to habitat, which is thought to have a fundamental effect on their physical composition, for example, ‘birds of the marshes’. Moreover – and especially in the plant world – there are considerable problems, in terms of modern scholarship and modern identifications, even if the above two questions were left to one side. That is: even if we 1

See Janick, Paris and Parrish (2007).

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accept that the correspondences we produce will be at the most approximate ‘best guesses’, the particular guesses arrived at by early twentiethcentury scholarship, and therefore present in standard dictionaries, were not always very good at all. The problematic scholarly history which led to a fundamental unreliability in the equivalences offered by the standard Greek–English lexicon of Liddell and Scott (LSJ), as well as the methodological problems raised above, were analysed by John Raven in the 1970s.2 Research subsequent to LSJ, in particular that on a number of ancient authors with pharmacological content, contemporary with or subsequent to Galen – Dioscorides, Oribasius, Aëtius – has at least made some of the guesses more probable. Such research proceeds partly through consideration of equivalences that were established later, partly on the basis of what seems plausible on the basis of the description and properties ascribed to the plant in question. In the latter case there is, of course, some risk of circularity; and in all cases the provisos given at (a) and (b) above must always be borne in mind.3 Thus, names of ancient plants and animals should be taken as to some extent conventional, and certainly provisional and to be treated with caution. In general, I have followed the names arrived at by Lily Beck in her translation of Dioscorides,4 but I have also consulted Sean Coughlin, to whom I am indebted both for his advice and guidance in this area and more specifically for sharing some results of the work in progress on Aëtius. Minerals, finally, present a set of problems which again overlap with but partially diverge from those already mentioned. Straightforward identification is not always easy, but even when we believe that identification has been successful, it is important to avoid anachronistic scientific terms which imply a conceptual framework wholly foreign to the text, 2

In his 1976 Gray lectures at Cambridge, published in updated form with further scholarly contributions as Raven, Lindsell and Raven (2000). 3 Important contributions in this area, with various levels of engagement with the methodological problems, are Amigues’ publications on Theophrastus, André (1985), Touwaide (1993) and (1997), Reveal (1996), Hardy and Totelin (2016) and Haars (2018). Relevant work on Aëtius is also ongoing at the Freie Universität, Berlin, within the research project SFB 980, ‘Episteme in Bewegung: Wissenstransfer von der Alten Welt bis in die Frühe Neuzeit’ (Teilprojekt A02). More broadly on the trade in and use of plants in ancient diet and pharmacology see Miller (1969), Raschke (1978), Riddle (1985), Nutton (1985), Detienne (1994), Wilkins et al. (1995), De Romanis and Tchernia (1997), Dalby (2000) and (2003), Scarborough (2010), De Romanis and Maiuro (2015), Totelin (2016a) and (2016b). 4 Beck (2005).

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such as ‘sodium carbonate’ (the translation offered by LSJ for both nitron and aphronitron, on which see further below). And again, a single term in Greek may refer to a range of substances which would be defined as different if subjected to modern chemical analysis. What is crucial from the point of view of a scholarly translation is to understand the terms used in relation to historically and geographically specific practices. Thus, when Galen speaks of hals or (in the plural) hales, the English ‘salt’ is essentially what is meant, but it is helpful to understand that he is referring to a variety of products harvested from different parts of the Mediterranean region, which he takes to have different specific properties. Some may have admixtures of other minerals. Nitron, meanwhile, is a naturally occurring deposit consisting of various compounds of sodium which in the ancient world were harvested especially from dry lake beds in Egypt, and used for a number of medicinal purposes. According to modern chemical analysis, it is a mixture of (mainly) sodium carbonate decahydrate with sodium bicarbonate, along with small quantities of sodium chloride and sodium sulphate. Here the translation ‘natron’ has been used, which was itself an alternative ancient form of the word, and is commonly used to refer to this substance today (even though, somewhat confusingly, ‘natron’ is also used to refer to commercially available bicarbonate of soda, for example in Germany). Aphronitron (literally, ‘foam of nitron’) was a commercially produced preparation based on nitron, and used as a kind of soap (see SMT IX.3, XII.212 K., with which cf. SMT IV.20, XI.695 K.); here the transliterated Greek term has been kept. We similarly encounter theion, brimstone or sulphur, which was also found in natural deposits (the related adjective theiōdēs is used in reference to naturally occurring water sources with a sulphurous odour), and asphalt (asphaltos), which was found for example in the Dead Sea (Caus. Symp. III.7, VII.245 K.). Galen gives his views on the differing properties of ‘salts’ of different origins, as well as on the relationship of those properties to those of natron and aphronitron, and also on the properties of asphalt, at SMT XI.2 (XII.372–375 K.), where he focusses for example on the distinctive properties of the salt derived from certain inland lakes, including the Dead Sea; cf. SMT IV.20 (XI.690–695 K.). A particular point of interest here is the properties of different springs or other natural water sources, which vary in relation to their admixtures of these minerals; he discusses these further at SMT I.1–6.

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Weights and measures Galen uses a combination of Greek and Latin terms for weights and measures. These will of course have varied, in terms of their precise quantities, over time and place; and here again it is more important to understand the historical conceptions, and the internal relations involved, than to try to give precise equivalents in terms of grams or litres – although in fact some reasonably close equivalents suggest themselves, which facilitate translation.5 As measures of volume, the recipes in Health use the xestēs (Latin sextuarius, so called because it was a sixth of a chous) and the kotulē, which is half of a xestēs. It seems that the xestēs corresponds roughly to a pint (or half a litre) and the kotulē to a half-pint; I have adopted the translations ‘pint’ and ‘cup’ respectively. For dry goods, the xestēs was also used; again, it can be understood as a dry pint, sixteen of which make up a modius (‘peck’). Galen also mentions the kochliarion (‘spoon’); in some sources this is associated with a precise measure, but as he specifically suggests different sizes of kochliarion for different cases it seems sensible to translate simply ‘spoon’. Weights are based on divisions of the Roman libra (in Greek litra, very roughly equivalent to 320 g) into 12 unciae, which are further divided into 8 drachmae. I have translated these as ‘pound’, ‘ounce’ and ‘dram’, the latter two being the derived terms in English, and the equivalence between modern ounces and unciae, at least, being quite close. (It is incidentally noteworthy that this same fundamental system, of what were known as Troy measures, and in particular the use of the dram by apothecaries, survived well into the twentieth century – of course with many individual local variations in terms of the precise weights.) Somewhat confusingly, finally, the litra was also used as a measure of volume, whereby, according to Galen, it is equivalent to a kotulē. Smaller measures of weight are used too; in Health Galen also mentions the karuon Pontikon, literally ‘filbert’, which was roughly an eighth of an uncia.

Tastes In this particularly thorny area, the translator has to find solutions which represent a compromise between at least three conflicting demands, those of (a) writing recognizably idiomatic English, (b) communicating the 5

See especially Wikander (2008).

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actual taste experiences, in terms of correspondences with particular substances, that Galen has in mind (e.g. ‘sour’ as the taste of unripe cherries), (c) doing justice to the theoretical suppositions behind Galen’s terminology, suppositions which involve a different set of ‘fundamental’ tastes, and relationships between them, from ours, as well as related physical/physiological theories about how they work on the tongue. No translation choice is ideal in this area, and inevitably the terms chosen will (at best) do justice to one or other of the above demands more satisfactorily than the others. Galen’s understanding of the different categories of taste, then, which is summarized most clearly in Simple Drugs, involves four basic tastes or taste types, each itself divided into a less and a more intense form. The eight main taste terms used, with the English translations chosen, are laid out in tabular form, in the pairs A–D below; I have included a core example for each taste, to clarify what Galen has in mind.

A

B

taste term

trans.

example

austēros

tart

quince

stuphōn or struphnos

astringent or sour

unripe cherry

oxus

sharp

vinegar

drimus

acrid

garlic

C

D

taste term

trans.

example

halukos

salty

salt

pikros

bitter

ash

liparos

smooth

oil

glukus

sweet

honey

One of the problems that become apparent, as regards the interpretation of the ancient terminology from a modern perspective, is that at least three of the classes on the left-hand side of the table will fall within our general category of ‘sour’; the pairing, moreover, of salty with bitter, and the inclusion of ‘smooth’ as a taste, are further features that surprise modern perceptions. There is, finally, a problem of detail, in that Galen is not always consistent in his use of stuphōn and struphnos, sometimes apparently using the former term in a broader sense, of which austēros and struphnos are the less and more intense versions, sometimes to refer precisely to that more intense version itself (see e.g. SMT IV.7, XI.640–642 K.).

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Introduction

1 Overview Galen’s writings on health constitute a fascinating and important resource, in at least three senses. From a social-historical point of view, first of all, they throw vivid light on ancient Graeco-Roman theories, practices and debates regarding the health and care of the body – as well as, in passing, also a whole range of other aspects of everyday ancient life. Secondly, they represent a central element of Galen’s own oeuvre, elaborating his views on the nature of the medical art itself, of the role of ‘healthfulness’ (to hugieinon) within this, and of the physiology of the human body in optimal and suboptimal states. Particular topics that the texts elucidate in this area are his understanding of nutrition, the role of fluids (or ‘humours’) in the body and the biology of aging; they also offer important insights into his understanding of the relationship of ‘soul’ and ‘body’, in the context of the healthy life. Thirdly, the treatise Health – in Greek, Ta hugieina, in Latin De sanitate tuenda – has a long and important intellectual history, both as a title or genre of work, and in terms of its own direct influence in subsequent centuries. Works devoted to and with the title of ‘health’ (ta hugieina) had been written since at least the fourth century BCE; but Galen’s is the only surviving ancient medical representative of the genre. Writings in this tradition and with this focus, however, gained great importance and popularity, both within professional medical circles and beyond them, over a very wide geographical and chronological span. They range from the Health Precepts of the philosopher Plutarch, about a generation before Galen, through the widely diffused Regimen sanitatis of the Salernitan school and that of Maimonides in Andalusia (both of the twelfth century), to works by Thomas Elyot and Girolamo Cardano in sixteenth-century England and Italy – to give just a few prominent examples. Galen’s 1

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Introduction

magnum opus itself, meanwhile, acquired a particular prominence, especially in Renaissance and early modern times, when it was thought to contribute crucially to practical medical knowledge, and received several translations into Latin, including that of Thomas Linacre, dedicated to King Henry VIII, and many printings of those translations. In more recent times it has excited the interest of readers interested in challenging certain aspects of modern medical practice, and in rediscovering, or asserting, the importance of preventive medicine; the role of a range of different dietary, lifestyle and environmental factors in prescriptions for health; and the focus on the individual in clinical practice.

2 Galen in the tradition of ‘health’ writings 2.1 ‘Healthfulness’ Central to Galen’s health writings is the special role they accord to ‘healthfulness’ in the definition and understanding of medicine and healthy living. It is worth pausing for a moment here to address a problem of translation. The Greek words used for this subject area are hugieinē, hugieinon and hugieina. All are forms of the adjective meaning ‘healthy’ or ‘healthful’, which, however, in certain grammatical contexts may be used also as nouns. The first, feminine, form may be translated ‘the art concerning health’ (here the feminine noun technē is taken as understood); the second, neuter, form may be taken as an abstract noun, ‘healthfulness’, or in some contexts also, with the noun morion implied, as ‘the healthful part [of the art]’.1 The third is the plural form of the second, and may again be translated either as an abstract noun – ‘things/ matters concerned with health’ – or as ‘writings concerned with health’. In the Latin tradition, the standard title of Galen’s work came to be De sanitate tuenda, ‘On the preservation of health’, and this title is still often used to refer to the treatise, even though it is really a gloss or interpretation of what is referred to by the title, rather than a translation proper.2 It 1

Cf. San. Tu. I.1, 3,3 Ko. (VI.1 K.), with n. 2. Of course, central to ‘healthfulness’ for Galen – and what crucially distinguishes it from the healing art proper, as we shall see – is precisely that it consists in preserving the healthy body in its current state. This Latin title is due to the sixteenth-century translator Thomas Linacre; the first Latin translator, Burgundio da Pisa, in the twelfth century, used the title De regimine sanitatis (‘On the regimen of health’) while the reliably literal Niccolò da Reggio in the fourteenth called it simply Libri sanativi (‘Health books’). On the Greek title see section 9.2; on the Latin translations see section 9.2, and further the website https://galenolatino.com.

2

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would be possible also to use the transliterated form Hygieinē:3 the English word ‘hygiene’ could until quite recent times still be used in a sense roughly corresponding to Galen’s, although this sense is no longer in everyday use. It is also the case that the title of Galen’s major work on health appears, in references within his other writings, in a number of slightly different forms, and that the precise meaning of some of these is ambiguous.4 For all these reasons the simpler title ‘Health’ has been preferred for the present volume. The identification of a distinct domain of ‘healthfulness’, either within or separate from medicine proper, is not unique to Galen. It is in Galen, however, that we find the full justification and elaboration of this identification, in a way that does not appear elsewhere. Both in Health and (with more logical precision) in Thrasybulus, Galen is concerned to locate ‘healthfulness’ in its correct position in relation to medicine – or to put it more precisely, within the ‘single art concerned with the body’. In the latter text, what is at stake is not only the definition and positioning of ‘healthfulness’, but its relationship to the art of the physical trainer, gumnastikē – a topic which it pursues with considerable logical and dialectical sophistication, in part as a function of the original argumentative context and intended audience of this text. The argument there belongs within the polemical context of a strategy of elevating the art of the doctor, and denigrating that of the athlete and his trainer (gumnastēs), as the appropriate expert to give advice on procedures leading to health of the body. Rather strikingly, in that polemical context Galen expresses himself in much more hostile terms towards trainers, gumnastai, in general (and to some individuals amongst them in particular), than he does in Health.5 2.2 Health; the status of medicine; athletics Such, then, in outline, is Galen’s view of the distinct art of ‘healthfulness’, and his attitude to athletic practices. Let us now consider some of the intellectual–historical background to his position. Galen was a highly educated and literate intellectual, for whom that education and that literate culture fundamentally informed his understanding 3

As indeed was done by Johnston (2018a) and (2018b). In particular there is some doubt, in line with the different senses of the adjective just outlined, as to whether the title refers rather to a kind of writing, or to a kind of study, art, theory and practice; on the forms of the title see further below, section 9.2. 5 For the translation of the terms gumnastēs and gumnastikē, see Thras., n. 6. 4

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Introduction

of the human body and his practice of medicine. He had studied both ­medicine and philosophy – a study which included all the most important ‘classic’ texts within both disciplines – to the highest level.6 This is relevant here in two ways. First, Galen takes it that for the correct practice of medicine, or the correct instruction in health care, an understanding of the internal workings of the body is necessary, including a detailed knowledge of its anatomy, elemental composition, and physiology. This understanding he claims himself to have acquired through meticulous training in anatomy and medicine, as well as through detailed attention to the most relevant texts by his predecessors; equally, he is certain that it is not available either to uneducated physical trainers, or to practitioners of other medical sects who either aim to do without, or grossly simplify and distort, such anatomical or physiological knowledge. (The same stricture also applies, in a different way, to the various practitioners of medical specialisms who abounded in the Graeco-Roman world – people whose profession consisted in the performance of, for example, certain eye operations, but who had no broader understanding of the body and its health.)7 Also necessary – both in order to acquire the relevant knowledge and in order to stand a chance of distinguishing true from false arguments, and genuine from fake practitioners – is a certain level of training in logic and argumentation, and in particular an understanding of what constitutes a logically sound demonstration (apodeixis).8 Secondly, Galen claims that his understanding of the human body and the art of medicine

6

On Galen’s biography, education and social background, for accessible accounts see Mattern (2008), (2013) and Nutton (2020); for briefer summaries Hankinson (2008b), Singer (2019a); for more detail Nutton (1973); Boudon-Millot (2007), ‘Introduction générale’; Schlange-Schöningen (2003). ‘Philosophy’ informs Galen’s work in a number of crucial ways (as summarized by Singer (2016/2021)): he interests himself in certain specialist areas of philosophy, such as ethics and logic; but the philosophical tradition of enquiry into physics and biology is also of direct relevance to his views on the human body and its functioning. 7 On Galen’s attitude to the rival sects of his time, Empirics and Methodists in particular, see further below. For Galen’s attitude to narrow medical specialisms, cf. n. 34, as well as the discussion in Parts of Medicine, on which see further the Appendix, ‘Galen and others on the parts of medicine’. 8 Galen is dismissive of most of the actual practitioners of philosophy in his own time (on which point see in particular Aff. Pecc. Dig. II, and Singer 2014a), but regards training in the fundamentals of logical argument as essential in order to be able to form one’s own judgement on the veracity or falsity of arguments, and in this context repeatedly points the student to the essential training in this area offered by one of his own works (now unfortunately lost), Demonstration (see esp. Ord. Lib. Prop. 1, 90,23–91,12 BM, XIX.52–53 K.). There is a considerable literature on Galen’s theory and practice of demonstration; for an excellent summary and overview see Havrda (forthcoming); further Barnes (1991), (1993), (2003), Hankinson (1991), (2008c), Havrda (2022); Tieleman (1996).

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is based closely on the knowledge of the ‘old masters’,9 most particularly, on the philosophical side, Plato, and on the medical, Hippocrates. (I do not enter here into the vexed ‘Hippocratic question’ – that of which, if any, of the texts in the so-called Hippocratic corpus may be attributed to the historical Hippocrates. For present purposes what matters is Galen’s understanding of Hippocrates as a genuine historical figure, who wrote particular works in that corpus – on which point, see further p. 6 with n. 11 below.)10 Both these intellectual approaches inform the definition of healthfulness in Thrasybulus, as well as its attack on the ‘perverted art’ of the athletes. Galen’s principal aim in the work is to prove that healthfulness does indeed belong within the domain of the doctor, not that of the trainer. Underlying the hostility to the athletic model is the notion of balance, and the view that the athletic goal of achieving a ‘peak’ takes away from and endangers that balance. But the means by which Galen aims to establish his main probandum are deeply connected with his commitment and self-alignment to that philosophical and medical tradition of ‘the old masters’. First, he does so through a sophisticated argumentative procedure, which displays his skill in the deployment of Aristotelian terminology and dialectical techniques. Secondly, in his attitude to athletes, and in his dismissal of the skill of the trainer as a ‘perverted art’ or form of ‘flattery’, he relies on a close engagement with, and detailed textual citation from, those masters, in the former case Hippocrates and in the latter Plato’s Gorgias and Republic. Galen is able, as it were, to enlist Plato’s cultural support for the view that physical training or athletics – at least as actually practised – represents an unbalanced, perverted form of health. It is in relation to his Hippocratic and Platonic forebears, too, that he constructs his intricate argument for the distinct status of to hugieinon within the doctor’s art, as sanctioned by the tradition: his views on this point are in agreement with theirs, he claims, even though they did not  9

Galen typically uses the term hoi palaioi, usually translated ‘the ancients’, in his respectful references to personages in this grand tradition. (See below, section 2.3, with n. 23, on the opposed term neōteroi.) 10 For overviews of the Hippocratic corpus see Jouanna (1992/1999); Craik (2015). The term ‘Hippocratic corpus’ itself has been problematized in recent scholarship, especially by van der Eijk (2015a). The ‘corpus’ as we have it is essentially a Renaissance collection; given the lack of agreement amongst scholars as to the authenticity of any of the works in this corpus, as well as about the nature of the historical figure of Hippocrates, and given the arbitrariness and murkiness of the historical processes by which texts came to be included in the ‘corpus’, it seems methodologically sounder to abandon the term altogether, and to use more historically precise terminology, e.g. that of ‘classical’ Greek medical texts for those of the fifth–fourth centuries BCE.

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Introduction

in classical Greek usage have the explicit terminology of to hugieinon. Hippocrates wrote expertly on this subject area, but it was a subject area which had not yet come to be regarded separately or given the heading to hugieinon or hugieinē; therefore the relevant works are not so called. The fact that Plato talks of physical training (gumnastikē) but not to hugieinon is, Galen claims, partly due to the different perceived needs of his time.11 We shall also explore further the social and cultural status of athletic practices in Galen’s time, and his response to that, in section 3.1 below; and use of and engagement with the Platonic texts in this work further in section 8.5. Thus Galen elaborates his view of ‘healthfulness’ as a part of the medical expertise, but distinct from ‘the healing part’ (therapeutikon) of that art. The notion of healthfulness occupying this liminal role recurs a number of times in Health, where some topics – those more directly concerned with disease, or those involving drugs rather than foods – are deferred for discussion elsewhere, but on the other hand a certain level of discussion of ‘morbid symptoms’ is appropriate within the treatise on health too.12 Central to his position, however, in both works, and in spite of subtly shifting statements in different places, are the two propositions of (1) the singleness of the art of medicine (or more precisely: the art concerning the 11

Galen claims that Hippocrates’ writing on to hugieinon is not given this title, but consists of the works ‘on daily regime’ and ‘on waters and airs and places’ (that is to say, the treatises Regimen and Airs, Waters, Places); and that Plato uses the term gumnastikē to refer to healthfulness as a whole because ‘he did not see a need for daily regime in general in the case of healthy persons’ (Thras. 39, 87,8–13 H., V.881 K.; for Plato’s view cf. also 34, 80,18–23 H., V.872 K.). The latter claim doubtless involves an archaizing or nostalgic view of the superior health of people of previous ages, due to their not having succumbed to the decadent morals of more recent times. When referring to the former Hippocratic work just mentioned, Galen in fact sometimes subtly alters its title to ‘on daily regime for the healthy person [or, for the health-practitioner]’ (Peri diaitēs hugieinōi) (HVA I.17, 135,2 H., XV.455 K.), while he insists on the alternative title ‘on the healthful daily regime’ (Peri diaitēs hugieinēs) for another work, traditionally regarded as the third part of The Nature of the Human Being, but in his view a separate work appended to the latter in error (HNH III, praef., 89,1–14 M., XV.174–175 K.). On early Greek dietetics see Smith (1980), who offers an important reflection on the relationship between empirical or traditional elements and theoretical systematization in ‘Hippocratic’ and later (Diocles, Mnesitheus) works on diet, as well as on Galen’s response to that; further Craik (1995); Jouanna (2008/2012); and on the relationship of dietetics to pharmacology Totelin (2015). For the early history of diaita in relation to health, including in non-medical sources, see Wöhrle (1990), especially 31–95; prominently attested for their interest in diet are the early Pythagoreans, and an important (though controversial) figure in the early history was Herodicus, whom we shall encounter in Plato’s account of him in book III of the Republic. 12 Further on Galen’s theory and practice in relation to drugs (pharmaka) see Debru (1997a), esp. the chapters of Debru, Jacques, van der Eijk and von Staden; Scarborough (2010); Petit (2017); Singer (2020b) and (2022a); Wilkins (2020). See e.g. San. Tu. IV.1, 103,7–12 Ko. (VI.233–234 K.), and further below on the parallel function of Health and The Therapeutic Method.

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Introduction

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body) and (2) the fact that this art is one requiring a high level of logical training, as well as a high level of knowledge of human physiology and pathology as a whole. (This conception of the singleness of the art of medicine is connected with his view of the subordinate role of narrow specialisms, already mentioned.) 2.3 Galen’s relationship with the medical tradition on health It was observed earlier that the treatise Health belongs within a long existing tradition on this topic; in fact, Galen himself is one of the main sources of evidence for this previous tradition, listing a number of previous authors who were particularly prominent and influential in this tradition of ‘health’ writing; in Thrasybulus the following names appear as a list of respected predecessors in the discipline: ‘Hippocrates, Diocles, Praxagoras, Philotimos, Erasistratus, Herophilus’.13 (His attitude to some of his predecessors is, however, at least somewhat fluid: he takes issue with Erasistratus, Herophilus and Praxagoras elsewhere, on particular points of physiology; and he has specific criticisms of Erasistratus’ views even with the domain of health, as we shall see.) Diocles of Carystus (fourth century BCE) wrote a work on health (Hugieina pros Pleistarchon); Galen is clearly indebted to his work in certain areas, although he does not discuss Diocles in Health, nor in Thrasybulus apart from the two honorific mentions just cited. 14 Erasistratus (third century BCE) also wrote a work of this title, and Galen implies that he coined a usage, sometimes also adopted by Galen himself, whereby ho hugieinos (i.e. the masculine singular of the same 13

Thras. 38, 85,22–23 H. (V.879 K.); the list is repeated almost identically at 47, 99,16–17 H. (V.898 K.). And similar lists of the ‘most distinguished’ predecessors appear in other contexts in his work too, e.g. at Cris. III.5 (IX.728 K.): ‘Diocles, Pleistonicus, Praxagoras, Philotimos’; Di. Dec. I.2 (IX.775 K.): ‘the followers of Philotimos, Diocles and the other ancients, and before them the followers of the most sainted Hippocrates’; MM I.3 (X.28 K.) (in sarcastic mode, a list of the medical authorities over whom the upstart Thessalus ludicrously claims his superiority): ‘Herophilus … his fellow student Philotimos, his teacher Praxagoras … alongside and before these Erasistratus, Diocles, Mnesitheus, Dieuches, Philistion, Pleistonicus, Hippocrates himself ’. 14 Galen does, however, preserve an extensive and important fragment from Diocles’ treatise at Alim. Fac. I.1, 202,26–203,21 H. (VI.456 K.) = (fr. 176 van der Eijk), where the discussion is of the correct empirical approach to the assessment of the capacities of foods, drinks and drugs, a theme central to Galen’s work in this area. (As Galen presents him, whether reliably or not, Diocles is less theoretically grounded in his approach to diet than ‘Hippocrates’; on this point see Smith 1980.) Diocles’ focus on the importance of leisure for the optimal healthy lifestyle (fr. 182 van der Eijk) is also strongly echoed in Galen’s approach, as we shall see. On Diocles see further van der Eijk (2000/2001); and for his importance to Galen in the specific context of his theory of melancholy, see Pormann (2008).

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adjective) may refer to the expert in this branch of the art.15 (This is translated below as ‘health-practitioner’.) Galen quotes directly and apparently approvingly – although only very occasionally – from this work of Erasistratus, for example in the passage just cited from Thrasybulus. Praxagoras and Philotimos also receive positive mentions, and indeed contemporaries are criticized for paying insufficiently detailed attention to their writings. An opposition is set up here between these serious medical authorities on the one hand and trainers, such as Theon, who write specialist works on physical training (gumnastika) but who distort the reality through insufficient understanding both of the body and of the writings of ‘the ancients’. It is also important to consider Galen’s indebtedness to a health tradition, or to specific writings and authors on health practices, which he does not explicitly acknowledge. Such matters as the care of small children, the use of milk and the choice of nurses, for example, as also about the value of exercise in everyday life, including for its psychological effects – to take just some particularly prominent examples – were established topics of discussion in the medical tradition (as well as in some less technical literature), before Galen. They were treated by a number of prominent and influential authors of recent generations whom Galen either does not mention at all, or does not mention in this context (e.g. Antyllus, Athenaeus, Herodotus, Rufus), as well as by those authors that he does mention approvingly as writers in the health tradition (e.g. Diocles, Mnesitheus) – but even in the latter case, he gives no acknowledgement of such discussions or contributions, nor any account of his own agreement or disagreement with them on points of detail. It would be possible to draw detailed connections between Galen’s views in these areas and what is known of this previous discourse, much of which comes to us mainly through quotations in later authors, especially the fourthcentury Oribasius; but in Galen’s time they would have been known, and in some cases influential, authors. (On the problem of Galen’s vagueness with regard to recent influences, as well as a particular area of fairly clear influence from Antyllus and Herodotus, see further below, p. 38.) 16 15

Thras. 38, 86,17–87,5 H. (V.880–881 K.); San. Tu. I.15, 35,34–37 Ko. (VI.77 K.). And Galen suggests that this is in some sense the proper usage: San. Tu. II.8, 60,17–21 (VI.135 K.). 16 For the references to Praxagoras and Philotimos see San. Tu. IV.4, 112,26–28 Ko. (VI.255 K.); IV.6, 122,9–17 Ko. (VI.276–277 K.) and IV.6, 123,6–9 Ko. (VI.278 K.). Elsewhere too, especially in relation to the theory of fluids (chumoi), Galen aims to assimilate his own views to those of Diocles, Praxagoras and Philotimos (as well as those of Hippocrates, Plato and Aristotle): see Nat. Fac. II.8, 186,10–14 H. (II.117 K.); II.9, 203,6–22 H. (II.140–141 K.) and III.10, 230,8–13 H. (II.178 K.). (On the distortion of Praxagoras’ views involved here, see Lewis (2017): 194.) For

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Galen’s attitude to the medical predecessors that he does acknowledge in the health tradition, meanwhile, is not uncritical. Erasistratus, for example, is taken to task (it seems inaccurately) for disapproving of exercise;17 and Praxagoras and Philotimos are respectable practitioners within the tradition, not authorities to be followed uncritically. It will be worthwhile to consider this in relation to the broader question of Galen’s self-positioning within the medical tradition – his attitude to the respected ‘ancients’ (palaioi), and to the authority of Hippocrates, on the one hand, and to various contemporaries and ‘more recent’ (neōteroi) figures, on the other. Much has been written on this subject. Galen wishes to present himself as authentically Hippocratic – as, in a sense, an avatar of Hippocrates, whom he regards as at once an exemplar of scientific method, an expert in medical theory and practice, and an ethical model. But already by Galen’s time there was both (a) an advanced scholarly debate about the authenticity of different works handed down under the name ‘Hippocrates’, as well as about their interpretation in detail, and (b) a wide discrepancy, amongst doctors, as to how important it was to study these works. Let us consider Galen’s position in relation to both these conflicts. In response to (a) the scholarly-scientific debate, Galen retrojects his own views onto Hippocrates – one might more dramatically say, constructs Hippocrates in his own image – by both selecting the core texts which he regards as authentic and interpreting them in such a way that they can be shown to support Galen’s own views. And he uses a repertory of sophisticated scholarly techniques of textual criticism – many of them still familiar to classical scholars to this day – to that end. Texts inconsistent with the Hippocratic (or Galenic) doctrine are rejected as spurious; apparent departures from such doctrine may be accounted for by changes in the meaning of Greek words since classical times, as well as by corruptions or insertions at particular points in the text; and much is to be explained by the well-known Hippocratic brachulogia – the brevity or concision whereby information is often conveyed in laconic utterances, or in summary form. True, Galen does not use his own agreement with content as the sole criterion of authenticity, nor does he find himself obliged to agree with extracts of discussions from previous authors on the early care of children, choice of nurses and use of milk, for example, see Oribasius, Libri Incerti 30–38, 121–138 Raeder, a selection which is followed by substantial extracts on healthy lifestyle in general by both Athenaeus and Diocles (ibid., 39–41, 138–148 Raeder) – with neither of which, again, Galen engages explicitly. 17 See San. Tu. I.8, 18,20–24 Ko. (VI.37 K.), with n. 68.

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everything in texts that he regards as authentic – nor, vice versa, wholly to reject the value of works which he does not actually believe to have been written by the master. His scholarly approach is more complex and subtle than that; moreover, he does also allow the possibility of a certain (fairly limited) degree of scientific progress since the time of Hippocrates. The central view, however, that emerges, and that Galen is at pains to emphasize, is of Hippocrates as representing the highpoint of the medical art, and of the fundamental continuity between Galen’s theories and practice and the work of the master, passages from which he frequently cites as authority or support for his own views, both in his work on health and elsewhere. Galen indeed devoted many voluminous commentaries to the explication of the Hippocratic texts which he regarded as most i­mportant – especially Aphorisms, The Nature of the Human Being, four books of the Epidemics – in what was far from a merely scholarly exercise.18 So, within Thrasybulus and Health, and in accordance with his usual practice, Galen at various points cites passages from several different Hippocratic texts, passages which he takes to provide support for his arguments, and for his polemical attacks on opponents. Examples are the statement about the unhealthiness of the athletic state, and the summary of the effect of different qualities and amounts of massage. (It is worth mentioning that he does not primarily, or indeed frequently, quote from the Hippocratic work ‘on daily regime’ (Peri diaitēs, Regimen), and that –  in a further ramification of the complexity of approach outlined above – he seems not actually to consider it an authentic work of Hippocrates, although he is happy to cite it from time to time for support.)19 18

Purely scholarly study of works in the ‘Hippocratic corpus’ had begun in Hellenistic times, and was particularly associated with Alexandria. It seems, however, that the approach which combined such scholarship with a reverential attitude to Hippocrates as a central source or foundation of medical knowledge – the notion of the ‘father of medicine’ familiar to us from Galen and still in a sense current today – was a comparatively recent development in Galen’s time. On Galen’s attitude to and use of Hippocrates, and on his own Hippocratic scholarship, see Smith (1979); Manuli (1984); Von Staden (1992); Manetti and Roselli (1994); Singer (1996), (2021b); Dean-Jones and Rosen (2015); Börno and Coughlin (2020); Coughlin (forthcoming). For Galen’s views on the limited, but significant, scope for scientific progress from the level of knowledge of the ancients, see Hankinson (1994b). Further on Galen’s construction of authority and techniques of argumentation in relation to ‘ancients’ and ‘moderns’, see Lloyd (1993); Vegetti (1999a), (1999b); Von Staden (2009); and on ancient medical authors’ attitudes to their predecessors also van der Eijk (1999b) and König and Woolf (2017), esp. the chapters of Lehoux, Lloyd and Rosen. 19 At HVA I.17, 135,2–10 H. (XV.455 K.) he mentions a number of other figures to whom the text has been attributed, commenting that it may actually be a text that predates Hippocrates. As a still further ramification of the complexity, one should consider Grimaudo’s observation (2021) that Galen almost wholly ignores the Hippocratic text Ancient Medicine, even though it seems to chime quite closely with his views in the domain of health.

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Let us turn to Galen’s response to (b), the contemporary conflict over the medical value of Hippocrates. In the process of elevating the status of Hippocrates, and aligning his own views with those of ‘the ancients’, Galen attacks, as we have already seen, those medically uneducated practitioners who lack the relevant understanding of the human body to engage meaningfully in the debate. And one thing he holds against them is precisely their lack of knowledge of, lack of interest in, or misunderstanding of, the relevant works of Hippocrates. One particular, and repeated, butt of Galen’s criticism on these grounds is the founder of the Methodist medical sect, Thessalus, who claimed to be able to teach the entire art of medicine in six months, and whose physiological and medical system is a simplistic one which reduces all pathological conditions to two fundamental types of bodily state (‘looseness’ and ‘constriction’ of the pores). 20 Methodism in a sense was clearly presenting itself as a rejection of unnecessary book learning, and of ‘the ancients’ in general, including Hippocrates. Within his writings on health, meanwhile, the recipients of Galen’s harshest criticism on similar grounds are the trainers, gumnastai, and at one particular point in Health, Theon. In both cases – that of Thessalus and the Methodists and that of Theon and the physical trainers – it is clear that there is a social, rather than merely an intellectual, aspect to Galen’s attack. Thessalus and Theon both in different ways reject Hippocrates. Galen’s response to their views is couched in terms which – sometimes more, sometimes less explicitly – emphasize their lack of education, their lower social status, their intellectual incapacity. These kinds of practitioner, Galen is suggesting, are not just mistaken on points of fact and in their general intellectual approach, which leads them to depart from the views of ‘the ancients’: they are in fact not intellectually equipped to engage with Hippocrates and the ancients in the first place. There are many points at which his attacks on both these groups extend far beyond points of intellectual disagreement into denigration of their character, social background, education and moral worth. This surely bespeaks a deep rivalry, a competition waged from different sides – the elite, philosophically and medically educated

20

Galen’s understanding of the theoretical views of the Methodists is presented in his Sects for Beginners; see further Frede (1985); Hankinson (1991), (2008b); Leith (2008). For the slant and tone of his repeated character assassination of Thessalus, see the next note. Further on his engagement with them in his writings on health, see below p. 13 with n. 24.

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intellectual and the artisan practitioner – to establish one’s authority as expert on the health of the body.21 We shall return to this point shortly. First, we should conclude our account of Galen’s relationship with the medical tradition. As already mentioned, counterbalancing Galen’s attitude of respect to ‘the ancients’ (hoi palaioi) is his tendentially scornful attitude to ‘the more recent’ doctors (hoi neōteroi). The latter seems a vaguer and more fluid term in its reference.22 Galen is seldom, if ever, explicit or precise as to what he means by the term, and it seems to have a fairly broad chronological application, extending three or four centuries back in time, but also including people amongst his own contemporaries.23 The general implication, however, is clear, namely that of people who have departed from the level of understanding exemplified by hoi palaioi, and are guilty of a variety of simplifications, distortions or intellectual misunderstandings. Sometimes it seems that members of the so-called ‘Pneumatist’ school are meant, such as Archigenes and Athenaeus. It may at times also include the Methodists already mentioned. And a problem arises precisely from this vagueness, for the understanding of Galen’s intellectual influences and formation (although it perhaps need not concern us too deeply here). Galen is vague and allusive when referring to neōteroi, to more recent writers or indeed contemporaries. He places his views very explicitly in relation to those of such 21

For social-historical analysis of the competition between rival sects in Galen’s time, including of the historical success of the Methodists, see Nutton (1992), (2013). Galen speaks of Thessalus as an upstart, and associates him with ‘cobblers, carpenters, dyers and metal-workers’, in an attack which emphasizes his lack of education and status as a manual labourer (MM I.1, X.4–5 K.; cf. ibid. V.10, X.353 K.). The attack on the trainer Theon, meanwhile, emphasizes his inability to understand or judge correctly the works of Hippocrates (including at points his inability to realize that he is in some senses not actually disagreeing with the view outlined in the Hippocratic text); see San. Tu. II.3–4, especially II.4, 31–35 Ko. (VI.105 K.); and cf. the much more hostile attack on Theon in Thrasybulus, where again central to the rhetoric is the contrast between him and Hippocrates and the other masters (Thras. 47, 99,16–26 H., V.898 K.), with nn. 113 and 114. One may also consider here the tone of the broadside against athletes in the Exhortation to Study the Arts, where, so far from enjoying the benefits of the soul, they are unaware that they even have a soul, and are compared to irrational beasts (Protr. 11, 106,3–11 B., I.27 K.). 22 The reference of hoi palaioi is itself not entirely straightforward, as Galen assembles different sets of ‘ancient’ authority in support of his views in different contexts. (See the bibliography on Galen’s use of authority cited in n. 18 above.) But central – or highest – in the list, consistently, are Hippocrates on the medical side and Plato amongst philosophers, with Aristotle and Theophrastus (and sometimes even Chrysippus and the Stoics) in some instances following the latter, and lists of doctors like those already mentioned from Thrasybulus following the former. 23 At one point Galen seems to offer a more explicit account of the chronological boundaries implied by the terms, saying that by the term neōteroi he means those who lived after the death of Alexander, which makes its upper limit coincide interestingly with that of the ‘Hellenistic’ period in modern scholarly usage: Hipp. Epid. VI VII, 399,10–11 WP. (Galen uses the death of Alexander as a temporal demarcator also at HNH I.44, 55,10–14 M., XV.105 K.) It should be noted that the distinction palaioi/neōteroi itself seems to have its origin in Hellenistic scholarship.

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earlier authors as Plato, Hippocrates, Aristotle, Erasistratus, Chrysippus – authors who flourished at periods between roughly 550 and 400 years earlier than his own – at times conducting an argument as though it were addressed directly to one of them, while he tends to engage much less directly and clearly with those closer to him in time, whom he refers to sometimes anonymously, sometimes mentioning names but giving rather sketchy accounts of the points of disagreement. This is problematic not just because it leaves these matters themselves unclear, but also because it seems likely that in some cases Galen was quite significantly influenced by these more sketchily mentioned individuals – that is, that he owes more to some of the shady neōteroi than he is letting on, while exaggerating, in his self-positioning, the role of the glorious ancients.24 Indeed, he is at times happy to adopt terminology or classifications which he explicitly attributes to neōteroi. This is true for example of the terminology of ‘stable’ and ‘unstable’ health (see section 4.2 below), and also of the fourfold classification of ‘materials’ of health (see section 5.2 below). In the latter context, indeed, he seems to be definitely influenced not just by specific authors, but also by a whole genre of recent medical writings, to which, however, he makes no reference – other than that vague use of the word neōteroi.

3 Health in Graeco-Roman society: practitioners and their clients 3.1 The tradition of ‘healthful’ practices We have seen that there is a tradition of writing about health and healthy practices that goes back at least to the Greek classical period. Let us turn to consider the tradition of the practices themselves. In terms of diet, clearly a sophisticated discourse developed on what foods and drinks were appropriate both for patients in acute stages of disease and for those in health, the latter being the domain relevant to us here.25 It is very 24

This seems clearly true for example of Archigenes, especially in Galen’s work on the pulse, and probably of Athenaeus in the theories of elements and mixtures; and see further below on Antyllus and Herodotus. One may also question whether Galen’s elaborate repertory of massage practices owes more to Methodist practice than he would admit: the central distinction between the ‘constrictive’ and ‘relaxing’ effects of massages – i.e., that of closing or opening up the pores or channels – maps precisely onto the core Methodist distinction of bodily states. Galen, of course, wishes to incorporate the distinction into a larger scheme, where other factors are relevant too; but the prominence of the distinction in the understanding of how massage functions may seem telling. (A similar point is made by Leith 2007; see also SMT IV.25, XI.781–783 K. on the extent to which Methodist terminology may be understood and adopted, in the context of the pores.) 25 On the Hippocratic texts relevant to this domain, and for literature on this Hippocratic dietetics, see n. 11 above.

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­ ifficult to say how significant, or widespread in their influence, were the d writings or dietary prescriptions of doctors, as a matter of historical reality, although certainly we can talk in more general terms of the growth of medicine as an expertise in the fifth century BCE, attested both by the production of a number of writings and by mentions of doctors and medicine in literary and epigraphic sources. Exercise, especially in the form it took in relation to athletic competition, was also a notable feature of classical Greek culture. In early times its use seems clearly connected with a military function; athletic competitions, in the archaic and classical periods, doubtless retain a close connection with an original military purpose. The variety of athletic competitions of ancient Greece – running, javelin, boxing – surely owe their origins to the significance of these individual activities in combat. In classical and Hellenistic Greek times, we have evidence, both from inscriptions and from literary sources, of the cultural and historical importance of athletic training, as well as for its competitive nature and role in the moral and militaristic socialization of the young – or to be more precise, of an elite group of young males. In this earlier Greek context it has a particular association with the institution of the ephēbeia, a period of quasi-military service imposed on males from a certain section of society, for up to two years around the ages of eighteen to twenty, as well as with athletic competitions such as the Olympic games. The institution of the gumnasion subsequently came to acquire cultural importance, not just as the exercise compound within which the relevant physical training took place, but also as a location of intellectual pursuits, teaching and learning.26 Within the literary and philosophical tradition, too, strong views are expressed, in particular by Plato, on the importance of gumnasion training properly conducted, and on the way in which it conduces to the health of society as a whole – views with which, as we will see, Galen directly engages. Moving forward in time, to the Roman imperial period, we find that a number of culturally Greek cities strongly maintain these traditions of ephēbeia and gumnasion, and of sporting and athletic practices. These remained culturally and educationally important, at least in certain geographical areas and for certain social groups – although much of our evidence in this area, especially from epigraphic sources, is for the 26

On the history of sporting activities and of the gumnasion, as well as for the centrality of competitive and athletic activity to Greek culture, see: Sweet (1987); Gauthier (1995/2010); Golden (1998), (2008); Kah and Scholz (2004); König (2005), (2010), (2017); Kennell (2009); Fischer (2010); Scanlon (2014); Kyle (2015).

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competitions towards which activity in the gumnasion was aimed, rather than for everyday or non-competitive exercise practices carried out there. We can go further, and suggest that competitive athletics, with its deep roots in archaic and classical Greek culture, was central to the public life of the elite communities of Greek cities in Roman imperial times, and for many constituted a crucial way in which they asserted and celebrated their cultural history and identity. It seems very likely that, even amongst cultured and educated citizens, the athletic model of Greek culture represented, at least, a respectable rival to the philosophical-literary one championed by Galen.27 Galen is hostile to athletes, and also to the related form of physical training, at least in its extreme and competitive form. And when he attacks athletes and their trainers for their intellectual or spiritual poverty, and for the unhealthiness and decadence of their lifestyle, he is undoubtedly tapping into an established cultural trope. Here he is in the Exhortation to Study the Arts, in full rhetorical flow: that athletes have never, even in a dream, enjoyed the benefits of the soul, is clear to everyone. To begin with, they are unaware that they have a soul, so far are they from understanding its rational nature. Because they are always occupied in the business of amassing flesh and blood, their souls are as it were smothered in a heap of mire, unable to ­contemplate anything clearly, mindless as beasts without reason. Protr. 11, 106,3–11 B. (I.27 K.)

We find similar terms in the anti-athletic satire of Galen’s close contemporary Lucian, who comments in much more parodic vein on the vulgarity and excess body mass of a famously successful athlete.28 Both 27

As argued in particular by van Nijf (2012), who also draws attention to the significant honours – including multiple citizenship – available to outstanding athletes, precisely during Galen’s own period. For further discussions relevant to the continued thriving of both competitive athletic activities in general, and the gumnasion and ephebate in particular, in the Greek city culture of Roman times (and the importance of these to their cultural identity), see Pleket (1975/2010); Robert (1984/2010); Mitchell (1990); Gauthier (1995/2010); Newby (2005); König (2005), (2010); Kennell (2009); van Nijf (2001), (2010). 28 At Dialogues with the Dead 20.5, he has Hermes, in his capacity as conveyor of the dead across the river to Hades, reject the athlete Damasias for apparently having failed to present himself for the crossing naked, as required – he has ‘covered himself with so much flesh’ that he appears to be clothed; and at Anacharsis 1 he has Anacharsis enquire of Solon in bewilderment why there are people rolling around in the mud like pigs. In Lucian as in Galen, there is a moralistic tone to the satire: Hermes also tells Damasias to throw off his victor’s garlands, and to put aside a list of other items in order not to burden the vessel, all of which are signs of vanity and attachment to worldly goods or reputation: wealth, luxury, epitaphs, ancestral fame, nobility of birth. For Galen’s relationship with the satirical tradition, see Rosen (2010).

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Galen and Lucian are adopting the moral high ground of the Greek cultural and philosophical tradition, and mocking athletes, their lifestyles and their vanities, from that perspective. Yet it seems more than likely that for every intellectual in the elite of Pergamum, or indeed in the culturally Greek cities of the Roman empire in general, to whom Galen’s anti-athletic rhetoric was persuasive, and who would be inclined to join him in his sophisticated mockery of these body-builders, there would be at least as many to whom the athletic model represented a high-status and attractive expression of that cultural Greekness. Here, an informative counterbalance to Galen’s ideology and approach is offered by his near contemporary, the sophist Philostratus, who alongside Galen provides the best evidence for athletic and physical-training practices at this period. In fact, while Philostratus, in obvious contrast with Galen’s attitude, offers a defence or encomium of gumnastikē, the points of contact are as informative as the differences. On the one hand, Philostratus argues that physical training is a form of wisdom (sophia), and presents the reader with a markedly different hierarchy of the arts from that which we have seen in Galen (with astronomy accepted, but only in moderation) (Gymnasticus 1–2). On the other hand, Philostratus’ account, like Galen’s, has strong Platonic echoes. He even reverses the Platonic ‘flattery’ accusation (which Galen takes from the Gorgias to use against the gunmnastai) and turns it against certain forms of medicine (44). Also like Galen, he offers a formal subdivision of arts, within which gumnastikē is, in fact, a part of medicine (14). The focus on good balance, summetria, and aesthetic criteria also presents points of congruence with Galen’s views; moreover – perhaps the closest point of contact – he laments the degenerate practitioners of today who have betrayed the art, with disastrous health consequences for their clients (43–47). Thus, while we start from a fundamentally different definition of the official status of the art – for Philostratus it is in principle noble, a form of wisdom, for Galen it is in its nature inferior and subordinate – the practical outlook, as it were, may not be hugely different. Philostratus will agree with Galen that the actual gumnastai of today are degenerate and not to be trusted, that they fall short of true or useful knowledge.29 29

On Philostratus’ Gymnasticus see König (2005), (2009) and in Rusten and König (2014): 347 and 353–354, drawing attention to such points of contact with Galen’s views. There are also specific points of contact in the Gymnasticus with Galen’s discussion of palaistra exercise in Health, for example: the ‘preparatory’ form of exercise (46–47); indicators of a suboptimal condition (48–54); types of fatigue (49); exercise after sex (48 and 52); rolling, oil and types of dust (50, 52 and 56);

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It should also be pointed out that – as has been explored by a large body of recent scholarship – the relationship between ‘Greek’ and ‘Roman’ (and indeed other local) cultural identities is not a straightforward or unidirectional one. Galen comes from a Greek-speaking elite, acknowledges only Greek-language literary models and intellectual forebears, and refers to the medical, lifestyle and cultural practices that underlie Health as ‘Greek customs’. Yet Greek culture neither exists in isolation from or subjection to Roman power, on the one hand, nor is superior to and free from Roman cultural and political influence, on the other. In the particular context of the athletic institutions, professions and pursuits under discussion here: while such daily regimes and practices do indeed have their origin in the classical and Hellenistic gumnasion, it is also true both that such practices were adopted by elite Romans and that the form the gumnasion took, even in culturally ‘Greek’ cities in imperial times, was substantially influenced by Roman models and Roman control. In particular, the bath-plus-gymnasium complex, which becomes widespread in cities of Roman Asia, can be seen – alongside the gladiatorial arena, another institution in which Galen happily participated – as a key indicator of Romanization, though it is one which is readily incorporated within the culturally Greek institution.30 The terminology of ‘baths’ and ‘gymnasia’ even come to be used somewhat ­interchangeably, in the Roman context; and the institutions and physical locations that Galen mentions as the context for the practices recommended in Health are the Hellenic/Roman bath-cum-gymnasium complexes of the Roman city. To return to Galen’s engagement with these institutions: it is important to be clear what he is recommending to his clients and what exactly is his equipment and techniques for its use (55–58). On Philostratus as a cultural figure more broadly, see Bowie and Elsner (2009). For Philostratus’ evidence for the actual kinds of practitioner in gumnasia, see n. 33 below. It is perhaps worth remarking that in spite of the title of Philostratus’ work, it focusses less on the detail of gumnasion practices than does Galen’s work (though it does give some such evidence, which to an extent overlaps with that provided by Health), being more concerned with questions of the history and cultural profile of the art. 30 The phenomenon is explored by Woolf (1994), who argues that a clear independent Greek cultural identity was maintained by the communities of these cities, which, however, was not threatened by the adoption of particular Roman customs – such as baths, or symposia including both sexes. The presence of women at the baths, and by extension in the gumnasion, would also be a significant departure from Greek norms. On the other side of the coin, there is a need to Romanize in order to exert and maintain political influence, even amongst rulers who are typically perceived as ‘philhellene’. For further explorations of questions of Greek and Roman (and other) cultural identities in the Graeco-Roman world, and their relationship with power dynamics, see Bowersock (1969); Bowie (1974); Mitchell and Greatrex (1990); Gleason (1995); Swain (1996); Schmitz (1997); Hall (1997), (2002); Goldhill (2001); Whitmarsh (2001), (2010); Borg (2004); Follet (2004); Bowie and Elsner (2009); Dench (2017). On the institution of the baths see further n. 32.

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attitude to the practices and practitioners in question. Exercise in the gumnasion in fact constitutes a significant part of the activities positively discussed by Galen in Health. His quarrel with the gumnastai, however, is twofold: first, that they are aiming at a precarious, heightened form of health – the athletic one – which is in fact from all sorts of points of view unhealthy; secondly (and relatedly), that they lack the overall knowledge appropriate to a technē – specifically, the knowledge of the human body which will enable them to prescribe for its health. While Galen is, as we have seen, hostile to the profession of the gumnastēs, and in particular to its athletic focus and its pretension to take over the whole domain of ‘healthfulness’, the exercises practised and recommended by that profession are of use, provided that they are supervised by true medical expertise. In short, a gumnastēs is fine, so long as he knows his place, which is subordinate to that of the doctor, and follows the latter’s instructions, producing individual exercises tailored to the needs and aims that the doctor has identified. (Cf. below, n. 34, on Galen’s attitude to artisan practitioners and to subordinate arts within medicine.) Of course, the pursuit of health is an elite one in this society, both on the athletic understanding and on the Galenic one. Galen frequently reasserts the requirement of leisure, in the sense of the freedom to manage one’s own time, for the performance of all the practices relevant to health, at least in their optimal form.31 One slight qualification to that – both to the overlap between Galenic practices and athletic ones, and to the notion of health as an elite preserve – is that certain everyday activities may have the same function as ‘wrestling-school exercises’ (palaismata) – a perception validated by Galen, and also attested earlier in the medical tradition. In this respect, too, then, Galen’s approach is one which to some extent tends to undermine the status and value of the gumnastēs. Nevertheless, central to Galen’s programme for health, as to the health programmes of the gumnastai, is a range of activities performed in the gumnasion – including in particular not just a complex range of exercises and forms of physical training performed in the wrestling-school (palaistra), but also the associated practices of massage and bathing, both of which also admit of a high degree of complexity in the variety of their prescriptions.32 31

E.g. San. Tu. I.11, 29,11–17 Ko. (VI.62 K.); II.1, 38,11–26 Ko. (VI.82–83 K.); VI.1, 168,25–26 Ko. (VI.383 K.); cf. Bon. Mal. Suc. 12, 426,14–16 H. (VI.810 K.) and see further below, section 5. 32 For detail on the institution and activities of the bath house, and its role in Roman life, see Yegül (2010). As already noted, baths, gumnasion and palaistra are typically part of the same complex, in terms both of exercise regime and of physical location; cf. n. 30 above. While the palaistra has its

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It is these activities, it seems, alongside choices of food and drink – as well as the relationship between all these factors – that constituted the main elements of the healthy daily regime as understood in elite GraecoRoman society, whichever particular individual or theory was chosen to regulate those choices. Between them, these also make up the bulk of the content of the treatise Health, as far as its practical recommendations are concerned. As an incidental consequence of that, Galen gives us fuller information in detail, in relation to some of these practices and prescriptions – both of the gumnasion and of diet – than we find in any other ancient author. 3.2 Health practitioners and Galen’s relationship with them Alongside the gumnastēs, the trainer, Galen mentions – and in some cases comments explicitly on the role of – a number of other categories of practitioner, in particular the paidotribēs (‘instructor’) and the progumnastēs (‘training assistant’). These figures are attested elsewhere in our sources, although it seems that none gives a clearer picture of their relative roles – at least as understood by Galen in his Roman milieu – than does Health.33 The paidotribēs is presented as a subordinate role to that of the gumnastēs, or one which gives specific attention to particular tasks and their performance, rather than to their purpose or role within the appropriate exercise programme aimed at the individual’s health. The latter is rather the domain of the gumnastēs – or rather that of the ideal gumnastēs, whose expertise is itself subordinate to the doctor’s art, rather than that of origins in wrestling, and the term is cognate with the Greek palaiein, ‘to wrestle’, it must be understood that by Roman times a wide range of exercises, including ball games, took place there; the translation ‘gymnasium’ would in many ways capture the sense more accurately. I have nevertheless kept the translation ‘wrestling-school’ for this term, (and ‘wrestling-school exercise’ for the cognate palaisma), to avoid confusion with the Greek gumnasion (which in general refers to the larger building complex, not just this exercise centre). 33 For Galen’s mentions of the role of the paidotribēs see e.g. Thras. 33, 79,5 H. (V.870 K.); San. Tu. I.10, 25,28 Ko. (VI.54 K.); II.9, 63,28 Ko. (VI.143 K.), with notes ad loc. In classical sources, such as Plato, the terms paidotribēs and gumnastēs seem more or less synonymous; closer to Galen’s time, Philostratus gives an account of the art of paidotribikē as inferior to, and a part of, the more complete art of gumnastikē (Gymnasticus 13), in a way which seems broadly consistent with Galen’s view; on this see also Grimaudo (2008), König (2009): 251. (And cf. Aristotle, Politics IV.1, 1288b10ff., mentioning the gumnastēs as an example, alongside others, of technicians with specialist knowledge.) See also the discussion of the terms by Wöhrle (1990: 96–107), pointing out that the term gumnastēs appears first in Plato, and mentioning the suggestion of Jüthner (1909) that its introduction might have been due to Herodicus. The term progumnastēs occurs only a few times elsewhere in Greek literature, often – e.g. in Epictetus – in a metaphorical sense; for Galen’s (albeit brief ) account of their role see San. Tu. III.2, 78,28 Ko. (VI.177 K.), with nn. 15 and 16; III.4, 82,32 Ko. (VI.187 K.).

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the actual gumnastai whom Galen considers as rivals and whose activity may be tendentially focussed more on the training of athletes than on training for everyday health. (As we noted above, there is some shift in the presentation of and attitude to gumnastai as between Thrasybulus and Health – the former work presenting a much more hostile attitude to the whole profession, the latter acknowledging a role for the gumnastēs if medically informed or if acting under the supervision of a good doctor.) Broader socio-medical issues are again relevant here: for Galen, as for other doctors of his status, there is a range of subordinate or subservient (hupēretikai) arts: low-level or largely manual skills which are essential to medicine, but the performance of which must be directed by the supervisor or expert who understands the human body, its physiology and its pathologies, in the round.34 These rivalries, as already suggested, were surely real ones in GraecoRoman society, where highly literate, philosophically educated doctors like Galen had to compete with other kinds of artisan practitioner, including the established physical trainers – the gumnastai – who plied their trade in the gumnasion or palaistra.35 It seems clear, moreover, that Galen’s actual clientele in this area would be confined to elite members of Roman society, who had both the leisure to spend time in the gumnasion and the intellectual interest or education to follow or adopt Galen’s approach. (Galen at least strongly implies that the emperor Marcus Aurelius was one such, and that he was himself amongst those that attended the emperor in the performance of his exercises.) How many such elite members of Roman society thought it important to have specifically medical guidance for the performance of their exercise, baths and massage – or indeed for their diet – is impossible to tell. It seems clear from the evidence of Galen’s own texts that his model of healthcare found favour, at least in some of the highest circles of Roman society, and also that he perceived a genuine threat or rival to that model from gumnastai who believed themselves experts in health and the body more broadly. How successful, in broader sociological terms, the Galenic practitioner was in countering that threat – that is, what was the relative success or popularity of the model of the philosophically educated doctor 34

See Hipp. Epid. VI V, 256,29–257,19 WP (XVIIB.229–230 K.), listing ‘rootcutters, perfume makers, cooks, plasterers, cleansers, clysterers, cutters, phlebotomists, and cuppers’, and comparing the doctor both to an architect who supervises the other craftsmen on the site and to the helmsman on a ship. See the relevant discussion of Flemming (2007), and cf. Korpela (1995). 35 Galen for example speaks of that form of physical training ‘which enjoys popularity (eudokimousan) these days’, at Thras. 35, 80,28–9 H. (872–873 K.).

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as against that of the athletic or physical trainer – must remain largely unknowable. 3.3 Audiences for the health writings This leads us to the question of the intended or actual audience, either for Galen’s treatises on health themselves or for his healthcare precepts and prescriptions more generally. Thrasybulus can be understood both as a polemical display piece and an exercise in logical method (its relevance to practical health provision being less prominent). As such, although nothing explicit is said about the audience, beyond that mention of the public context and the formal address to the otherwise unknown Thrasybulus, it can be placed alongside other Galenic works aimed at proving a thesis in a competitive context; other examples would be Affections and Errors and, on a much larger scale, The Doctrines of Hippocrates and Plato.36 Elsewhere Galen tells us of such public debates, as well as anatomical demonstrations, taking place in the precincts of the Temple of Peace in the Forum, and it seems that there was a considerable community of intellectuals and elite Romans with intellectual or medically-oriented interests who might frequent such events; and Thrasybulus is directed at some such group, rather than at medical students. A vivid picture of at least some of the group that might gather on such occasions – including philosophers, rhetoricians and Roman citizens of the highest rank – is painted in Galen’s self-publicizing autobiographical work, Prognosis (the immediate context there is that of an anatomical demonstration); and it is clear from that work that it was partly by proving himself in such contexts that Galen established himself as a leading doctor and intellectual in elite Roman society.37 The text of Prognosis also gives a lively picture of the rivalries between individual doctors at the highest level of Roman society, 36

Both these works also explicitly mention an original oral context; the former also has a specific addressee to whom the written-up work is being sent. Further examples, which do not explicitly mention oral context but nevertheless clearly arise from a competitive context and are designed to prove a polemical thesis, are The Capacities of the Soul Depend on the Mixtures of the Body and An Exhortation to Study the Arts. 37 The atmosphere of public competition and intellectual debate at Rome, and Galen’s own participation in it, are described especially at Lib. Prop. 3, 144,2–145,15 BM (XIX.21–22 K.), and the intellectual and social milieu in which Galen strove to prove himself further in Praen. 5, 96,5– 100,6 N. (XIV.627–630 K.). For discussions of Galen’s rhetorical and anatomical activity in relation to this ‘Second Sophistic’ milieu see Debru (1995), von Staden (1997a), Gill, Whitmarsh and Wilkins (2009) (esp. the chapters of Gleason and von Staden), Mattern (2008), (2017), Petit (2018), Salas (2021). See also n. 40 below.

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and the importance to Galen of proving his superiority over them. Thrasybulus presumably belongs in a similar context, whether or not any of the actual individuals mentioned there was present at its ‘performance’. There, the project is that of proving his personal superiority to other doctors; here, the parallel one of proving the superiority of medicine as an art to that of physical training. Health, by contrast, is much less polemical in its tone and structure, and gives no indication of an original public context. Nor, however, is it a work aimed explicitly or clearly at a group of students or medical followers, and it does not appear to have any such close community as its intended readership. In this it contrasts with other medical works which imply such an audience through a repeated use of a plural ‘you’ (or in some cases, even more specifically, ‘you, my followers’).38 Indeed, one of the main points of interest of the work is that it explicitly sets itself up as not belonging within the category of such specialist medical works, or paedagogic texts for students or fellow practitioners. The intended audience is explicitly defined, by the term philiatroi – literally, ‘medicinelovers’ (or ‘doctor-friendly’ persons). The precise connotations here may be debated, but clearly Galen means to address people who take the claims of medicine seriously, who have an interest in the pursuit of health, and who are willing to devote time to this pursuit along the lines outlined by Galen, in contradistinction to medical professionals or experts.39 It seems likely that there is a considerable overlap, at least, between the people meant by philiatroi and the set of elite, educated Romans whom Galen is keen to impress (and by his own account does impress) in the account in Prognosis, already mentioned.40 It is also relevant here to consider the work’s non-inclusion in Galen’s main account of his own works, My Own Books. This is admittedly a problematic criterion, from which no firm conclusions can be drawn; but it is at least a hypothesis worth considering that its non-inclusion in that work, within the main listing of the correct paedagogic order of Galen’s works of medical importance, is due to the fact that this work does not 38

On Galen’s uses of pronouns in his works, and what this may tell us about their intended audiences and assumed communities, see van der Eijk (2013). 39 Further on this term, and this distinction of audiences, see San. Tu. IV.5, 118,33 Ko. (VI.269 K.), with n. 44. 40 See n. 37 above. In Prognosis Galen does not use the term philiatroi, but again has a group of educated, intellectually serious and medically interested people in mind in his use of the terms idiōtai tēs iatrikēs technēs, ‘amateurs of medicine’, at 4, 88,14 N. (XIV.619 K.) and philologoi (andres), ‘intellectuals’, at 5, 98,12 N. (XIV.629 K.) and 100,5 N. (XIV.630 K.). (Both translations are Nutton’s.)

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belong within such a formal medical curriculum or paedagogic programme. At the one place where the work is mentioned, meanwhile, in The Order of My Own Books, it is noteworthy that it seems to have been included almost as an aside, and linked, unusually, with the word hapasin, ‘for everyone’ – again apparently emphasizing this broader intended audience.41 A further point of relevance is its functional status and relationship with Galen’s major works of a specifically medical or clinical nature. He explicitly (and repeatedly) defines its function as separate from but complementary to that of the ‘pragmateia of healing’ – by which he means both the study or practice of therapeutics in general, and his treatise The Therapeutic Method specifically. This complementarity consists not just in the fact that Health is concerned with preserving, or making small adjustments to, existing states, while The Therapeutic Method is concerned with the rectification of morbid states. It is also that the former work is to a considerable extent giving ‘do-it-yourself ’ recommendations, whereas the latter is describing procedures that must be left to the specialist: the practice of healthfulness, at least to some extent and at least after a certain point, is something that can be carried on by the individual, without medical intervention or supervision. Health therefore gives a number of recipes, with detailed instructions including quantities or proportions, methods of preparation and dosages, whereas – as Galen explains – this is not his practice in either The Therapeutic Method or his specialist works, because there a specialist is relied on for the actual drug preparation. (Galen makes a related distinction, throughout, between drugs proper, or foods or drinks with a ‘drug-like quality’ – which are the province of that other discipline – and foods or drinks which perform alterations in the body in a subtler and more gradual way.) 3.4 Asclepius In any overview of the interventions adopted in the Graeco-Roman world in the pursuit of health, one must mention also the role of Asclepius – a role which is, indeed, explicitly mentioned in Book I of Health. A broad question arises here, of the relationship between Galen, or Galenic medicine, and temple medicine – a question which concerns not 41

As discussed below (section 8), inclusion or non-inclusion of works in My Own Books or The Order of My Own Books may also be understood as related to date; it is also true that the criterion can only be used with the greatest caution.

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just the variety and interrelationship of belief systems and practices in the Graeco-Roman world, but also the nature of the institutions themselves, including in Galen’s home city of Pergamum. While from a modern perspective we might expect the two medical models and sets of practices to be clearly distinct, and antagonistic towards each other, it seems clear that in fact the situation was at least one of peaceful co-existence and mutual toleration, and to some extent even of cross-fertilization and mutual respect. One thing that it is important to understand here is the presence of ‘normal’ ancient medical practitioners and practices, alongside faith-based or miraculous ones, in the temple complexes themselves. The Asclepieion (alongside other similar sanctuaries) is best known for the practice of incubation, whereby the patient sleeps in an allotted place within the sanctuary in the hope of either experiencing a god-sent cure or receiving a dream which will indicate a medical or quasi-medical procedure to be followed in order to achieve a cure. In the latter (more common) kind of case, the procedures included venesection and particular kinds of bath, and medical practitioners would be on hand to administer or supervise them. And the Asclepieion’s best-known devotee, Aelius Aristides, talks of his consultations with other doctors, not just those of the temple. Conversely, the attitude of Galen both to the person of Asclepius and to the institutions set up in his name seems to be one of respect.42 Whether we can go further, and suggest that there was actual institutional overlap – that is, that at Pergamum either the medical education and intellectual debate in which a doctor like Galen participated, or his medical practice, took place partially within the Asclepieion rather than within the city itself – seems to be a question which cannot be definitively answered on the basis of our evidence.43 (The two locations are some three miles distant.) The following three facts, at least, may be stated with certainty. First, Galen’s appointment (157–161 CE) as doctor to the gladiators of the city – a position which represented a formative and crucial stage of his career – was bestowed upon him by the ‘high priest of the city’. Secondly, Galen accepts the reality of Asclepius’ posi42

For testimonies of the Asclepius cult and its relevance to medicine in the ancient world, fundamental is Edelstein and Edelstein (1945/1998). See further Habicht (1969); Temkin (1991); Graf (1992); Mitchell (1995); Hoffman (1998); Jones (1998); De Miro, Sfameni Gasparro and Calì (2009); Perilli (2006a), (2006b), (2009); Petsalis-Diomidis (2010); Oberhelman (2013); Pietrobelli (2013); Harris (2016); Russell, Trapp and Nesselrath (2016); Steger (2016) (who emphasizes the cross-over between medical approaches and practices inside and outside the Asclepieion, in a way consistent with my argument here); Petridou (2017). 43 The question is explored in Singer (2019a); cf. the papers of Perilli cited in the previous note.

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tive medical interventions, something which – in the form of dreams advocating a certain procedure, which saves the patient (or in his own case, transforms his career) – he claims to have experienced personally.44 Thirdly, within the text of Health itself, he cites with approval the type of healthcare recommendation that has been frequently made by ‘our patron god Asclepius’; by this, although no further specification is given of the process, it seems clear that he means us to understand the kind of prescription given by priests or other practitioners within the Asclepieion of Pergamum. Although the passage in question is a brief one, 45 the precise nature of these prescriptions is of considerable interest. Galen mentions two kinds: the individual allocation of exercises, designed to excite or enliven the person’s spirit to precisely the correct degree, and instructions to the patient to compose or perform songs or comic sketches, again with particular intended consequences for the emotional state. From Galen’s point of view, the passage is important for the light it sheds on his understanding of the relationship between soul and body within the health context (on which, see further below); from the sociomedical point of view, it indicates the extent to which the elite educated practitioner of the Graeco-Roman world was happy to draw upon, or accept the validity of, practices taking place within the Asclepieion.

4 Galen’s theory of health 4.1 Health: definitions and distinctions Fundamental to Galen’s understanding of human health is the notion of summetria, that is, the correct balance of elements within the body, also understood as a midpoint or median between undesirable extremes. This is a notion with a long history in the Greek tradition.46 More precisely, 44

Galen recounts his appointment to the position of sole doctor to the gladiators by the high priest – and the renewal of the appointment by the next four priests in succession – at Comp. Med. Gen. III.2 (XIII.599–600 K.). For Asclepius’ interventions through dreams, which have the effect of (1) steering Galen himself towards a career in medicine, (2) saving him from a potentially fatal abscess, by recommending that he perform arteriotomy on a particular place on his hand (as well as subsequently persuading the emperor Marcus Aurelius to leave him in Rome rather than take him on military campaign), and (3) saving other patients, see, respectively: (1) Ord. Lib. Prop. 4, 100,2–4 BM (XIX.59 K.); (2) Lib. Prop. 3, 142,14–20 BM (XIX.18–19 K.); Ven. Sect. Adv. Eras. 4 (XI.314–315 K.); (3) ibid. (XI.315 K.); Morb. Diff. 9 (VI.869 K.); Prop. Plac. 2, 173,4–6 BMP. 45 San. Tu. I.8, 20,14–22 Ko. (VI.41–42 K.). 46 The concept of isonomia – ‘equality of rule’ – found in Alcmaeon is arguably relevant here; and one may even draw a connection with Anaximander’s notion of reciprocal justice in a cosmic sense; on these texts in the context of health, see Wöhrle (1990): 47–49, who discusses also the arguable relationship of these early ‘balance’ theories to Pythagoreanism. Hippocratic texts, explic-

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for Galen – who here offers an analysis strongly indebted to Aristotle – ‘while the health of what are known as the “uniform” parts consists in some kind of good balance of cold, hot, dry and wet, that of the organic parts is brought about from the composition, quantity, magnitude and shaping of the uniform ones’.47 Further definitional questions arise regarding the relative role of states of the body and of the performance of its natural activities or functions. Properly speaking, Galen says, the primary good of the body is the perfection of performance of the bodily activities, while health (or more precisely the excellence or ‘good-condition’ (euexia) of health; see further below) is the necessary condition for the achievement of this primary good. Thus, health itself is conceived as a state of the body, and it is this end at which the health practitioner aims; but the proper performance of bodily functions will follow automatically from the achievement of this aim.48 The logical distinction is thus unimportant for practical purposes, since the state and the performance of activities are, in causal terms, inextricably linked. Philosophically, Galen’s view is related to his further views of the fundamental unity of bodily goods, and of the inextricable connectedness of beauty, also, to the other two. The state of health at which the practitioner aims, then, will bring about both good performance of the activities, and beauty, as its necessary consequences. Further specifications may be made within each of these categories: ‘good-condition’ (euexia) constitutes the excellence, or optimal version, of a state of health, while ‘vigour’ (eurōstia) constitutes the excellence of the performance of activities. And further distinctions may be made, too, in relation to both the excellence and the stability of health. There is a scale,

itly, and Aristotle, less explicitly acknowledged, seem to provide the clearest model for Galen’s version of the theory. 47 San. Tu. I.1, 3,13–17 Ko. (VI.2 K.). ‘Uniform’ (homoiomerē) parts are e.g. flesh, nerve, bone; ‘organic’ (organika) are organs such as the heart or liver, but also complex parts with distinct functions, such as blood vessels. For the fundamental physical analysis see further section 4.5.1. The analysis of health as consisting in these two levels is explored elsewhere in Galen’s work, too; cf. e.g. Ars Med. 2, 278,10–12 B. (I.309–310 K.): ‘The healthy body is that which is from birth wellmixed in its simple, primary parts, and well-balanced in the organic parts composed of these.’ Further on Galen’s theory of health see Grimaudo (2008); Singer (2014b); Wilkins (2016). The notion of health as consisting in a balance or midpoint also suggests strong echoes of Aristotle’s ethics; indeed, Aristotle not only uses a medical analogy in his theory of the mean (Nicomachean Ethics II.2, 1104a34ff.) but also speaks of health itself as a mean (ibid. V.11, 1138a30f. and X.3, 1173a23ff., in the latter place describing health as something which ‘admits of the more and less’). He also mentions excess and deficiency of exercise or foods as causing harm (ibid. II.2, 1104a15ff.). 48 Thras. 15, 51,18–52,21 (V.831–833 K.).

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at the top of which is euexia, followed, at equal distances, by ‘stable health’ and ‘unstable health’.49 4.2 The spectrum of health; the ‘neither’ This distinction of levels within health is related to another theoretical concept upon which Galen insists, that of the broad spectrum (platos) within health – a range of states which may legitimately be counted as healthy. Crucially, it is not only the optimal, or most perfect imaginable, state which should be termed healthy. Otherwise, persons in almost all actual states will define themselves as ill – a doctrine which Galen refers to as that of ‘constant suffering’ or ‘constant pathology’ (aeipatheia), and which he argues has no value for practical purposes. Rather, while the absolutely optimal, or perfect, state of health may be thus narrowly defined, one should also use the term ‘healthy’ in reference to a much broader range of states, which fall some way short of this ideal.50 In objecting to the notion of aeipatheia, and of perfection as the requirement for inclusion in the category of the healthy, Galen is taking a philosophical view on the status of health – one of relevance, indeed, to modern debates about the definition of health and in particular ‘gradualism’.51 The debate is, indeed, one of more than just semantic importance. It is of great practical significance, from two points of view. First, for all individuals or natural constitutions, a spectrum of states is envisaged which should be considered healthy. It makes no sense to define oneself as ill just because one has fallen slightly below one’s own best state. And Galen offers a concrete criterion for what should count as unhealthy or pathological – one based on the individual’s own experience. 49

Literally, ‘health in hexis’ and ‘health in schesis’, where the former term, hexis, for Galen refers to a state which is ongoing or stable, as opposed to temporary or occurrent: Thras. 7, 40,2–18 Ko. (V.816 K.); cf. San. Tu. V.4, 142,23–26 Ko. (VI.330 K.); and further on this terminology see Thras., n. 13. The distinction between a lower grade of health and one which additionally includes vigour is present also in the previous tradition. Celsus, in particular, distinguishes between the categories of ‘sanus homo, qui … bene valet’ and ‘imbecillis’, Med. I.1–2, 29–30 Marx; see further Singer (2014b) and (2021c): 282 with nn. 13 and 14. 50 The sense of the metaphors in play here may be worthy of consideration. A platos is literally a ‘breadth’, or any wide space. It may be contrasted in Galen’s thought with the notion of health existing only at a peak (akmē) – a word used commonly in ancient medical contexts, but with an original application to geographical heights or pinnacles. One might thus interpret Galen’s use of the term platos as invoking a broad space, or plateau, with room for a large number of healthy individuals, below the level of the pinnacle which represents ‘absolute’ health. (The translation for platos used here, ‘spectrum’, is a term now in common medical use which itself of course ultimately draws on a different metaphor.) 51 For further discussion of Galen’s notion of health from a philosophical perspective, see Singer (2014b), (2021c): 281–282; Lewis, Thumiger and van der Eijk (2017); cf. also n. 47 above.

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This is that of actual distress, or noticeable impairment of any of the natural activities: it is only when ‘the damage to the activity reaches a perceptible level’ that we should call it ‘sickness’.52 Secondly, in rejecting the narrow conception of a single, perfect form of health, with all slight deviations from it considered pathological, Galen is making a statement, and pointing towards a range of interventions, of considerable pragmatic significance. Health is not the sole prerogative of the person who is endowed with the best natural constitution (kataskeuē), and who in addition to such endowments has the leisure to devote to the perfection of his or her health. Certainly, such a person is held up as an ideal or standard. But departures from that ideal – departures from both kinds of optimal condition, that afforded by nature and that afforded by the individual’s social circumstances – should not be thought to preclude less fortunate persons from access to health, even if their health will not be of the same order as that ideal one. To give a mythical – and rather striking – example, the health of Thersites, famously considered to have the worst physical attributes amongst the Greeks at Troy, and indeed to be seriously disabled, is the same thing as the health of Achilles: both are instances of health, although they differ in degree.53 Moreover, the aspiration of avoiding disease should be very widely available, even if – as Galen claims is his own case – one has not been endowed with a good natural constitution (on this see further below, section 5.2). Here one should also consider the tradition, apparently attributable to Herophilus, of defining medicine in a tripartite manner, in terms of the healthy, the unhealthy (or morbid) and the ‘neither’ (or neutral). In one sense, this might be taken as contradictory to the ‘spectrum’ view: the ‘neither’ category seems to be brought in to exclude dubious or intermediate cases from health proper, and would presumably correspond to much that Galen would include in his broader understanding of the healthful. In another sense, it might be thought a different way of expressing the same intuition, namely of the fluidity and non-unitary nature of the subject matter. In any case, Galen does not regularly use this terminology, although he seems relaxed about adopting it on occasion. He does so in particular at the beginning of Book IV, in the context of his discussion of the position of ‘morbid symptoms’ in the work: these 52

For the notion of the platos of health see San. Tu. I.4, 7,34–8,4 Ko. (VI.12 K.); for the argument in relation to aeipatheia and the criterion of perceptible harm or impairment of activities, I.5, 10,13–35 Ko. (VI.18–19 K.); and cf. I.5, 14,20–28 Ko. (VI.28–29 K.). 53 San. Tu. I.5, 9,33–35 Ko. (VI.17 K.), with nn. 36 and 37.

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might be thought to belong within the present work or alternatively within the treatise on healing – or possibly in a work to which one gives the heading ‘neither’ (and the particular status of old age may be particularly relevant here; see further section 5.5). 54 Galen is thus here attempting to do justice to the fluidity of the boundary, to the sense that there is an area, of both symptoms and patient experiences, which is liminal between health and disease. 4.3 Different life circumstances and lifestyles But there is more to this discussion of a spectrum of health than simply a pragmatic acceptance of compromise with individual bodily natures and circumstances, or the view that different forms of health appear at different points upon a scale of excellence. More positively, and more interestingly, Galen suggests that there are qualitatively different forms of health, and interventions relevant to the achievement of health, for persons who have (whether through choice or force of circumstances) adopted different models of life – and also for different times of life. It is posited – even if this argument and approach are not elaborated in very great detail – that different prescriptions, in terms of diet, exercise and education, are appropriate for those who adopt different lifestyle or professional roles.55 So, too, the everyday activities practised within certain professions or lifestyles may be taken as forms of exercise. A related point, on which Galen insists in Book VI of Health, is that most forms of professional life are compatible with at least some form of healthy daily regime, provided that one makes best use of whatever free time one has. There is, further, a specific category of health of the old, a state which is in one sense on the borderline between health and illness (a point to which we shall return below, section 5.5). While, as we have 54

See San. Tu. IV.1, 103,7–18 Ko. (VI.233–234 K.) and VI.2, 171,10–14 Ko. (VI.388 K.), where Galen states (as the view of Herophilus, but one which he seems to accept as reasonable) that this third state, intermediate between health and morbidity, is that of those recovering from violent fevers and also that of the old. In The Art of Medicine, in a much more theoretical summary, Galen does state as his own view that ‘medicine is the science of [things] healthful, morbid and neither’, further specifying that each of these three terms has a threefold application – to bodies, to causes, or to signs (1b, 276,6–11 B., I.307 K.). Further on the category of the ‘neither’ in relation to the subdivisions of the art of medicine, see Appendix, ‘Galen and others on the parts of medicine’. 55 See San. Tu. I.12, 28,32–29,8 Ko. (VI.60–61 K.), envisaging a plurality of different life roles or forms of life. Four are explicitly enumerated, though these are conceived in broad terms: the philosopher or intellectual; the soldier or athlete; all varieties of artisan; the farmer or businessman. It is suggested that each of these – as well as the various subdivisions within them – may require different early training and dietetic prescriptions.

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seen, this form of health may be put in the category of the ‘neither’, some also term it a ‘natural sickness’. For Galen, old age admits of health in its own terms, but this is not health in the absolute sense, and can never aspire to vigour. Relatedly, it demands its own particular form of care (gērokomikon).56 4.4 Galen’s self-positioning and his criticism of alternative positions As we have already seen, Galen traces his views on health, in broad terms, to the great ‘ancients’, above all to Plato and Hippocrates. We have also seen that it is in some cases difficult to identify the true nature of his relationship with, or the basis of attacks on, the medical practitioners closer to his own time, with whom he takes issue (e.g. Asclepiades, Theon), although the rhetoric of palaioi versus neōteroi is a constant theme. In some cases, it is also difficult to identify the individuals behind certain positions attacked. This is the case, for example, with the theoretical notion of ‘constant pathology’ (aeipatheia): we have no clear evidence of a medical authority that subscribed to this view, although it seems possible that it has an Atomist heritage. In another case, Galen ridicules an obscure individual of his own time who claimed to be able to offer immortality to those who followed his health prescriptions.57 A further aspect of Galen’s positioning of his own views in relation to those of others, in the specific context of the discussion of the definition of health in Health, is that in this work – designed, as already discussed, for a wide educated audience and far less polemical in outlook than Thrasybulus or much of his other work – he presents a more conciliatory or inclusive approach towards the views of rivals whom elsewhere he rejects as beyond the pale. It may even be said that there is an attempt to find a consensus – to establish a minimal level of doctrine, or broad approach to health, on which all medical thinkers, even Galen’s fiercest rivals, agree. Central here is the notion with which we started this section, that of balance. Possibly at the cost of some simplification, Galen presents his view that health is a balance as one that is historically shared between all sects, whatever the 56 57

See San. Tu. VI.2, 171,2–28 Ko. (VI.387–389 K.), which includes the reference to Herophilus’ view already mentioned. Further on the notion of aeipatheia, and a possible Atomist connection, see San. Tu. I, n. 40. We learn little in detail about this person, who is referred to in Health as ‘a certain contemporary philosopher’, I.12, 29,23–26 Ko. (VI.63 K.) and a ‘sophist’, VI.3, 176,5–7 Ko. (VI.399 K.); it seems that the same person is referred to as ‘the Egyptian’ at Marc. 4 (VII.678 K.). See also Theoharides (1971).

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differences of detail. Giving a sweeping overview of the various competing medical theories of the composition of the human body, Galen claims that ‘health is definitely a balance of some kind, according to all the sects’, and that these rival sects differ only as to what – in accordance with those various theories – they say it is a balance of.58 True, he criticizes (again in vague terms, without mentioning particular targets) those who say that health is only a balance of elements, and who thus ignore the second part of the two-leg formulation – that in terms of both the balance of low-level elements and the composition, shaping, etc. of the organic ones – mentioned at the beginning of section 4.1. One may see here an attempt to broaden the consensus on the nature of health in a fundamental way. In The Distinct Types of Disease, Galen again claims that there is universal agreement that health consists in the proper performance of their functions by the parts of the body, and on the notion of summetria, stating that ‘of whatever [things] health is a balance, of these disease is an imbalance’.59 In the following chapters of that text he goes further: while he is clear that the views of the Atomists and the Methodists (which he sees as constituting the main opposed alternative to his own view) are fundamentally flawed, he nevertheless presents a dialectical argument which places the two fundamentally opposed physical hypotheses in parallel and considers what follows from each, including the level of agreement when it comes to actual diseases. The point seems to be that not only is there fundamental agreement on some notion of balance as constitutive of health, but also that there will be considerable agreement, even on the Methodist view, when it comes to consideration of the health of the ‘composite’ or ‘organic’ parts of the body. People may disagree at the lower level of physical analysis, but come together at the higher one, in terms which are more relevant to actual practice. 4.5 The theoretical–physiological framework It will be helpful here to understand in more detail Galen’s own theoretical views in the areas of the physical composition of the human body and its physiology, which function as the crucial background to his recommendations for the maintenance and preservation of health. 58

E.g. bulks, ‘unjointeds’ and channels (onkoi, anarma, poroi) according to the followers of Asclepiades, or atoms according to Epicureans; See San. Tu. I.5, 9,8–13 Ko. (VI.15 K.), with n. 35. For Galen’s own understanding of channels (poroi), see San. Tu. I, n. 117; and cf. n. 24 above and San. Tu. II, n. 13. 59 Morb. Diff. 2 (VI.836–837 K. and VI.839 K.).

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4.5.1 Elements; levels of composition For Galen human bodies, in common with all animals and plants, and indeed all objects in the universe quite generally, are composed of some mixture (krasis) of the fundamental qualities – the hot, the cold, the wet and the dry. (These may also, more or less interchangeably, though much less frequently in Galen’s usage, be understood in terms of the four fundamental elements or bodies, fire, air, water and earth.) In this element theory, as in his views on physics and change in the natural world more broadly, he is fundamentally influenced by Aristotle.60 Mixtures of fundamental qualities or elements, however, although they do have great explanatory power, do not provide the whole story. The fundamental qualities constitute the lowest level of analysis. The broader picture, which is also Aristotelian in outline, is as follows: from particular mixtures of the four qualities arise the uniform (‘homoiomerous’) parts, such as nail, bone or flesh; and from particular arrangements of the latter are formed the organic parts, which include e.g. legs and fingers, as well as the internal organs such as the heart or the liver. In Health Galen takes this Aristotelian schema as the basis for an understanding of different levels at which the health of the body should be defined.61 And, as we have already seen, both the ‘uniform’ and the ‘organic’ levels of analysis are relevant to health. In this context it is relevant to mention also the philosophical question of the relationship of ‘bottom-up’, physical causation and teleology in the explanation of these physical structures. This, indeed, is an important 60

Galen’s views in this area, as well as their justification, are most fully given in Elements According to Hippocrates and Mixtures. But both the details of Galen’s element theory, and its precise relationship with the previous tradition, are complex and not always completely clear. In terms of influence, he claims to be in agreement with Hippocrates, and in particular with the treatise The Nature of the Human Being, although that work expounds a humour- or fluid-based theory of composition, with element theory proper at best very much in the background (see further below, section 4.5.3, for Galen’s theory of chumoi). In terms of precise theoretical details, his element theory is fundamentally Aristotelian: it seems that he follows the Aristotelian view whereby each of fire, earth, air and water corresponds to a mixture of two of the fundamental qualities, rather than the Stoic view, according to which each corresponds to one quality; but this is nowhere completely clearly expressed, and there seems to be some influence from Stoic theory too. On Galen’s theory of elements and of mixtures, and its relationship with those of his predecessors, see Hankinson (2008d), (2017) and (forthcoming); Kupreeva (2014); Leith (2014); Mirrione (2017); Singer (2021b); Singer and van der Eijk (2018), especially 27–37. For overviews of Galen’s physiological views see Debru (2008); Salas (forthcoming). 61 See San. Tu. I.1, 3,13–17 Ko. (VI.2 K.); VI.9, 184,21–26 Ko. (VI.420 K.), with n. 48. The Aristotelian schema distinguishes three suntheseis (‘compositions’) or sustaseis (‘constitutings’) of bodies (below the level of the whole body): those arising from the elements, from the uniform (or ‘homoiomerous’) parts and from the non-uniform (‘anhomoiomerous’) parts: see especially PA II.1, 646a13–24; and cf. Gen. an. I.1, 715a9–11.

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question for Galen’s theory of causation and his fundamental metaphysics, and one which arguably involves some tension or internal conflict in his analysis, although it is beyond our scope to enter into it here.62 4.5.2 Innate heat; inflow and outflow; coction Central to Galen’s physiology is the notion of the body’s innate or connate heat (emphuton or sumphuton thermon), which in turn is linked with the conceptions of inflow and outflow of stuffs to and from the body, and with that of digestion or ‘coction’ (pepsis). The body’s innate heat, centred in the blood and the heart, is in a sense what guarantees the living being’s life and vigour. Heat and blood are conceived on the analogy of a hearth or furnace, which needs to be fuelled and maintained. There is a constant process of outflow or diminution, as the innate heat uses up resources, brings about a ‘flowing-away of the substance’, which thus needs to be constantly replenished by similar material.63 Food is the raw material which, according to Galen’s theory of digestion and nutrition, is transformed into blood – which itself provides the material from which the parts of the body are formed and by which they are maintained. Digestion is essentially a cooking or ‘coction’ (pepsis) of the foods taken in – a process performed by the internal heat, which is at the same time fuelled by these foods. This process relies on the specific capacities (dunameis) of different organs of the body – attractive, alterative, retentive and separative or expulsive – which enable them to extract what they need from the food, take it (at various stages of digestion) to the right parts of the body, and remove and expel the unwanted byproducts. 64 Thus, depending on variations in both the nature of the stuffs ingested and the body’s capacity to assimilate them, coction may be better or worse performed. In all cases, waste products or residues (perittōmata) 62

On this question see Temp. I.9, 36,23 H. (I.567 K.) and II.6, 79,24–25 H. (I.636 K.), with the commentary of Singer and van der Eijk (2018) ad loc.; also Vegetti (1981); Singer (1997b); van der Eijk (2017); Havrda (2017). 63 See San. Tu. I.2–3, 5,14–6,3 Ko. (VI.6–7 K.). 64 The four mentioned are the well-known ‘natural faculties’ (though I prefer the translation ‘capacities’ for dunameis) of Galen’s physiological theory, which give its title to his major ­physiological work, Natural Capacities (Nat. Fac.); they are succinctly summarized at Temp. III.1, 91,2–5 H. (I.654 K.). His account of digestion is elaborated especially in Natural Capacities and in The Function of the Parts of the Human Body, book IV. The process is begun in the stomach and intestines, and completed in the liver, from which blood is transported through the body by the veins. For clear accounts of the complex process see Lewis (forthcoming); Salas (forthcoming).

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will be produced in the process, the nature and amount of them again depending on both factors related to the body’s health and the nature of the foods themselves. These residues must then be expelled or excreted (ekkrinein) from the body – something which takes place in nature through a variety of processes: urination and defaecation; ‘transpiration’ through the pores of the skin; various forms of blood loss; and vomiting. Each of these processes may, however, be provoked or assisted by dietetic or medical interventions. 4.5.3 Fluids (humours) and residues The residues are kinds of fluid (chumos, traditionally translated ‘humour’). Blood itself is a chumos, and arguably the only one which is natural or useful to the body in a state of health. Certainly the other fluids arise constantly in the process of the body’s self-maintenance; but rather than contributing positively to any physiological process, or to either the construction or the maintenance of the parts of the body, their relevance seems to be simply that they require regulation – i.e. that none should be present in excess. We note a strong point of departure here from the ‘Hippocratic’ model expressed especially by The Nature of the Human Being, with which – confusingly – Galen claims to be in fundamental agreement. There, the ‘four humours’ which later came to be a canonical part of the theory associated with classical medicine – blood, phlegm, yellow bile and black bile – are the essential building blocks from which the human body is formed. For Galen, all except blood are essentially byproducts of digestion.65 It is, however, relatedly true that all foods or 65

The nature of any positive role for the other three fluids in Galen, and also the relationship of his view to the ‘Hippocratic’ one (on which see also n. 60 above, with literature there cited; and cf. n. 18), are difficult to pin down with complete precision. It is true that Galen explicitly claims that all four fluids are present even in health, against the ‘plausible’ view of some others that ‘blood alone is the fluid proper to our nature’ (Prop. Plac. 12). It is also true that some passages seem at least superficially to support the view of the fluids as ‘building blocks’ in human composition: see HNH I, 32–51 M. (XV.59–97 K.) and PHP VIII.3, 498,23–34 DL (V.672 K.), alongside my discussion in Singer (2021b), with n. 47 there. But overwhelmingly Galen regards the qualities, hot, cold, wet and dry, and not the fluids as fundamental, and blood as the only one of the latter which has a major role in the formation of the parts of the body. The position (summarized well at Nat. Fac. II.8, 186,14–19 H., II.117 K.) seems to be that blood arises in the process of nutrition from the best balance of the internal heat, while the other fluids arise from its imbalance. (Relevant also is the discussion of black bile by Stewart (2019), on the basis of which, however, again, it is difficult to detect a clear positive or constitutive role for the fluids.) The complexity and elusiveness of Galen’s theory in this area indeed reflect the difficulty inherent in his harmonization of Aristotelian with ‘Hippocratic’ views. For Aristotle, who operates without the Hippocratic concept of fluids, blood is itself a uniform part, as indeed are the remaining three ‘fluids’, which, however, are categorized rather as residues; for the author of The Nature of the Human Being, who

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drinks that one may ingest bear some relationship to these fluids, and are sometimes classed in terms of their propensity to produce this or that fluid (that is, as potentially ‘phlegmatic’, ‘bilious’, and so on). It should, further, be understood that it is rarely, if ever, that one encounters these fluids in pure form in a body: each appears rather as an admixture within the veins, and it is more usual and relevant in most contexts to talk of ‘melancholic blood’ or ‘bilious blood’ than of black bile or yellow bile as stuffs in their own right. A subtle and complex picture thus emerges, of the nature and interrelationship of the ‘four humours’. In a sense, they exist on a spectrum, intimately related to the details of the process of coction. The purpose of coction is to produce good or useful (chrēston) blood in the living being; but that blood itself never appears in pure form. Inadequate coction of foods taken in gives rise to the colder fluid, phlegm, while excessive coction produces yellow bile, associated with illnesses of heat and dryness. The production of blood represents as it were the perfect mean between these two; but perfection is hard to come by, and in actual bodies the veins will contain a fluid which is in fact somewhere or other on this spectrum – neither pure phlegm or bile, on the one hand, nor pure blood on the other.66 4.5.4 Breathing and pneuma A little should be said, to complete this overview of Galen’s physiology, about the process of respiration and the role of air or breath (pneuma), even though this is touched on only tangentially within the works in this volume. In line with the furnace analogy mentioned above, inhalation of air into the lungs both fans the flames and also plays a role in the regulation, or cooling, of the innate heat.67 It is also responsible for the production or nourishment of the ‘psychic pneuma’. Pneuma plays a central role in Galen’s physiology, both of the heart and vascular system and of the brain and nerves.68 After inhalation, pneuma is produced in the lungs, which is not exactly the same as the air initially inhaled, but is a operates without the notion of uniform and non-uniform parts, blood is one of the four fluids, which are the basic constituents of the body. For such analysis see especially San. Tu. IV.4, 112,33–36 Ko. (VI.255 K.); and cf. previous note. 67 For the role and function of breathing see Ut. Resp., especially 2.11, 96 Furley/Wilkie (V.483–484 K.) and 5.3, 124 Furley/Wilkie (V.505 K.). Breathing conduces to the balance (summetria) of the heat, and has the function of both cooling and fanning (ἀναψυχούσης τε καὶ ῥιπιζούσης), Ut. Resp. 5.8, 132 Furley/Wilkie (V.510 K.). (The relationship between the cooling and the fanning – sometimes also ‘strengthening’ or ‘kindling’ – functions is perhaps less than entirely clear.) The whole analogy between the internal heat and a fire is developed through Ut. Resp. 3; and it is explored by Debru (1996). 68 For an overview of the theoretical position see Singer (2020a); also Rocca (2003), (2021). 66

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processed version of this, and is in some way mixed with blood in the arteries, where it performs a role in the maintenance of vital functions. From this ‘vital pneuma’, in a further process of elaboration, is formed the ‘psychic’ or ‘soul’ pneuma, which is a key element in the account of the activities of the brain and the nervous system: it is the ‘first instrument’ of the soul, communicating in both directions between the ‘leading-part’ or command centre (hēgemonikon) located there and the rest of the body, in the processes of perception and voluntary motion. Pneuma, again in combination with blood, is also implicated in states of emotional disturbance or excitement.69

5 Theory in practice 5.1 Health preservation: principles and means So, the art of healthfulness aims at the preservation of an existing state of good balance within the body, and works by constantly replacing what is lost with things of a similar nature, and by maintaining the body at its existing level, in terms of hot, cold, wet and dry. It is thus a distinct branch of ‘the art concerning the body’, complementary to medicine proper, or the art of healing (therapeutikē). The latter cures by opposites – for example correcting excessive moisture in a body by means of some drying factor – whereas healthfulness treats by similars, or else by making very small adjustments in cases of imperfect, threatened or unstable health (where by contrast therapeutikē is an art involving large restorations, the body in question being a long way from the desired balance). How does the art of healthfulness achieve this aim?70 The answer is through all things which affect the internal balance or mixture of the body or its parts in the relevant ways. These are the everyday lifestyle elements already discussed above in sections 2.3 and 3.1, and grouped together in Greek medical writing under the heading diaita, consisting essentially of food and drink, exercise, baths and the physical environment. To this range of factors which in general affect – or preserve in its current state – the mixture of the body, we must add those which are specifically aimed at drawing out or assisting the expulsion of residues, whether of one particular sort of residue present in excess or of an overall 69

See San. Tu. II.9, 61,31–34 Ko. (VI.138–139 K.); and for further texts elaborating this view, Singer (2017). 70 For an excellent overview of Galen’s understanding of human health and of healthy individuals and lifestyles in practice, see Wilkins (2016).

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build-up (plēthos) of residues in general. This process of bringing about the removal of residues, in suboptimal, dangerous or unstable states of health, is a major preoccupation of the healthfulness practitioner (discussed for example in San. Tu. II.2 and II.6). The means by which this is brought about are partly those already mentioned – certain foods, exercises or baths may have this particular function – and partly certain types of massage, which play an especial role here. 5.2 Classification of the modes of health preservation: the four materials of remedies; the six things necessary or non-natural Galen himself offers a number of classifications of the varieties of factor relevant to the preservation and destruction of health. A potential cause of the loss of health arises from the constant ‘flowing-away of substance’ already mentioned; here, however, one must distinguish between this kind of harm itself, which is ‘inescapable for any generated body’ and ‘those others which follow from it’, which can be avoided through care or foresight – that is, by making the correct dietary and lifestyle choices.71 There is also a distinction between extrinsic and internal causes affecting our health: the former, which would include violent injuries or some kinds of epidemic disease, may be outside our power to control; but through proper dietetic practices we may avoid all others, those which he defines as ‘arising from within the body’.72 In broad terms, Galen says, there are four classes of material (hulē) of relevance to prescriptions for health: (1) things taken; (2) things done; (3) things evacuated; (4) things that come into contact with us from the outside. These can be further specified as (1) food, drink, drugs and inhaled air; (2) exercises and motions, including such ‘passive exercise’ as chariot or horse rides; also sleep, waking and sexual activity; (3) excreted or expelled residues, as discussed above; (4) the ambient air, baths, ointments, the dust of the wrestling-school, and externally applied drugs. 71

San. Tu. I.2, 5,16–18 Ko. (VI.6 K.). The avoidance of violent accidents or injuries, Galen suggests, while of great relevance to the preservation of health, does not belong properly to the art of healthfulness: San. Tu. I.7, 16,9–10 Ko. (VI.32 K.); cf. I.3, 7,9–21 Ko. (VI.10–11 K.) and Thras. 17, 54,12–55,3 H. (V.835–836 K.). For the distinction of the category of disease ‘of the sort that arises within the body’ see San. Tu. V.1, 136,14–35 Ko. (VI.308–309 K.), with n. 5: in this passage Galen says that he himself has managed to avoid all but a very few of such diseases since the age of 28, through attention to the correct health precepts, in spite of not having been endowed with a naturally healthy constitution; and that if he had been free of professional obligations he would have been able to avoid them completely.

72

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In adopting this fourfold classification Galen is following ‘the most reputable recent doctors’.73 By Galen’s time several medical writers – including Asclepiades, Athenaeus and Soranus – had written works with the title ‘On Remedies’ (Peri boēthēmatōn, Latin De remediis). More specifically, the neōteroi upon whom Galen is drawing here seem to include Antyllus and Herodotus, both authors of a period either shortly before or overlapping with his own, whose works apparently actually organized the material under these four headings.74 It is worth noting that the generic term used here, ‘material’ (hulē), especially in conjunction with ‘remedies’ (boēthēmata), in Latin becomes the familiar materia medica; however, while that phrase later comes to be associated exclusively with the materials (mainly plant, but also animal and mineral) used to make pharmaceutical preparations, we see that in this usage – that of both Galen and the neōteroi whose scheme he adopts – it refers to ‘materials’ employed in a much wider sense (including e.g. exercise). In a related development, Galen identifies a set of causes relevant to or necessary for health – a set which was later to become known as the ‘six things necessary’ or ‘six non-naturals’. It will be worth considering what Galen says about this set of factors, which was to have a major afterlife in mediaeval and early modern medical theory, in some detail. Let me note here at the outset that the situation here – both the details of Galen’s own views, and the relationship of these to the later medical tradition – is complex, and its explication inevitably involves a rather intricate survey and analysis of a range of texts. The reader who is interested in the conclusions of this survey, without wishing to follow its every twist and turn, may possibly prefer to pass over the next few pages and find those conclusions summarized at the end of the section, at pp. 42–43 below.

73

See San. Tu. I.15, 36,3–13 Ko. (VI.78 K.) and V.10, 154,34–155,3 Ko. (VI.358 K.). In the former passage, the fourfold distinction is embedded within a threefold one between bodies, causes and signs (which appears also at Ars Med. 1b, 276,10–14 B., I.307 K.): each of the four is in fact a kind of cause of health. In the latter passage, meanwhile, it is specified that the four are materials of remedies (boēthēmata). 74 The fourfold distinction is attributed to Antyllus by Stobaeus, Anthology 4.37.27 (V.895,22–896,6 Hense) (where there is some doubt there regarding the precise sense of the terminology, and in particular as to whether the third term refers to items causing evacuation, or, as Galen seems to take it, evacuation in general); and a number of remedies given by Oribasius are cited as deriving from the works by Antyllus or Herodotus with titles based on this division. For example, at Collectiones Medicae VI.1, 155,3–4 Raeder, we have the section heading ‘On lying in bed, from Antyllus, from his fourth book on remedies [involving] things done’). Further on the genre of De remediis literature, see Leith (2007).

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First, we should clarify that the conception is not fully or clearly formalized in these terms within the texts of Galen themselves, where we do not find a clearly and consistently identified defined set of six such factors, let alone the mention of the number 6. Nor do we find – as we do from early on in mediaeval Galenism – a clear and explicit connection between this group of factors and the categories of both the ‘necessary’ and the ‘non-natural’. Rather, in one of the two main passages which presents the Galenic ‘prehistory’ of this concept, in The Pulse for Beginners, we find the terminology of ‘non-natural’, or more literally ‘not by nature’ (ou phusei), in the other, in The Art of Medicine, that of the ‘necessary’. The list does, however, appear, essentially in the ‘classic’ form known to us from the later tradition, in that latter passage: ‘contact with the ambient air; motion and rest; sleep and waking; things taken; things evacuated; and affections of the soul (or, emotional disturbances)’.75 (On the significance of the last of these categories in particular, see further section 6.2 below.) Both terms, ‘necessary’ and ‘non-natural’, require some elucidation, and indeed are not entirely straightforward in their interpretation in the relevant Galenic contexts. Under the heading ‘necessary’, first of all, while one may think that what is being given is a list of those factors which are necessary for health, it seems, more precisely, that what is meant is that each of these factors is inevitably – necessarily – encountered in life in some version, and that the peculiarities of the version in which they are encountered have an effect on the individual’s health.76 The sense of ‘non-natural’ or ‘not by nature’, meanwhile, is rather less clear, and perhaps less univocal in Galen’s various uses of it. A clarification should be made here at the outset, one which has not been noted in previous scholarship. When referring to the distinct third category which 75

Ars Med. 23, 346,10–347,1 B. (I.367 K.). The former passage is at Puls. 10 (VIII.469–470 K.). At Hipp Epid. VI VIII, 484,3–7 WP, meanwhile, we find a similar though distinct list, which, however, is taken directly from the Hippocratic text there commented upon (‘Hippocrates’, Epidemics VI.8.23 (V.352 L.): ‘daily regime; habitation; sleep; exertions; sex; thought’). It may be significant that both these last mentioned works apparently belong to a late period in Galen’s output (indeed, The Art of Medicine, which gives the ‘classic’ formulation, has been thought by some to be a post-Galenic summary of his views: see Kollesch 1988). On the problems of Galen’s fluid usage in this conceptual area, as well as on the relationship of the Galenic concepts to the later tradition, see García Ballester (1993). It seems that the formalization (and equation) of the ‘six non-naturals’ and ‘six things necessary’ was established in Islamicate Galenism by the ninth– tenth century (ibid.: 107). 76 This is certainly the sense at Ars Med. 23, 345,17–347,2 B. (I.367–368 K.), where Galen contrasts causes of alteration to the body which it does not necessarily encounter – such as wild animals or swords – with those which it necessarily does encounter, and proceeds to the ‘classic’ list given above.

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is neither kata phusin (‘according to nature’) nor para phusin (‘contrary to nature’), Galen uses only the phrase ou phusei (literally, ‘not by nature’, usually translated ‘non-natural’), not the phrase ou kata phusin (‘not according to nature’), which by contrast is used as a virtual synonym of para phusin. True, the latter phrase is sometimes used rather as the negative of kata phusin, i.e. to denote anything which is outside that category, but still without any sense of a technical term suggesting a distinct, third category.77 (There are also passages which either affirm, or imply, that the terms kata phusin and para phusin do not exhaustively cover the whole field, but again they do so without invoking a distinct third category requiring its own technical term.)78 And the usual reference of the phrase – as of the phrases kata phusin and para phusin themselves – is a state of the body or some part of it, or the functioning of these. (Further on Galen’s use of these phrases, see section 5.4 below.) The phrase ou phusei, meanwhile, which occurs much less frequently, clearly does involve a more technical sense (or senses), and is used to invoke a third category, distinct from those denoted by the other two (much more frequently used) phrases. It is also the case that in several, although not all, of its instances it refers specifically to a type of cause relevant to health, rather than to a state. Even more specifically, in such cases, it in fact refers to causes of alteration of the pulse – the technical works on the pulse being those in which the phrase appears in such a discussion of causes. (This fact may make one suspect that Galen’s usage in such contexts owes something to the pre-existing medical tradition on the pulse.) Both in cases where it refers to a cause and in those in which it refers to a state, however, two separate core meanings of ou phusei seem to emerge: that of something’s being intermediate between the natural (kata phusin) and the unnatural (para phusin), and that of something’s being in some sense external to the human body, or additional to those features that exist by virtue of its innate constitution. Thus, in Causes in the Pulse, 77

Examples – to which many could be added – are: Caus. Puls. I.7 (IX.14 K.); Praes. Puls. I.5 (IX.258 K.); MM IV.1 (X.236 K.); MM VII.2 (X.461 K.); Ars Med. 21, 340,2 B. (I.361 K.) and 35, 381,7–8 B. (I.401 K.). (It is true that the mention of ou kata phusin in the former of these passages from The Art of Medicine comes in the context of a discussion of the ‘neither’, and concerns transitional states between health and sickness; nevertheless there seems to be no conceptual distinction between ou kata phusin there and para phusin a few lines later (21, 340,19 B., I.362 K.).) 78 See MM VIII.9 (X.589 K.), speaking of people whose state of mixture is neither ‘properly kata phusin’ nor ‘completely para phusin’, and MM XI.12 (X.771 K.) where kata phusin and para phusin are given as examples of terms which are according to Aristotelian usage antikeimena, not enantia.

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Galen divides the causes of alteration of the pulse into three classes: kata phusin, para phusin and ou phusei, explaining that the latter are ‘between’ the other two; and the way in which the last category is introduced in The Pulse for Beginners is similar.79 Moreover, when we reach the discussion of the para phusin causes of change in the latter text, many of those mentioned are of the same kind (e.g. food, exercise) as those which just appeared under the heading ou phusei; and it is explicitly clarified that ‘the quantitative excess of those same causes which we term “natural” and “non-natural” renders them “unnatural”’.80 So, the consumption of certain foods, or the engagement in certain exercises, may be – depending on the amount – kata phusin (natural/normal), para phusin (abnormal/ unhealthy), or between the two. In these contexts, then, the terminology of the ou phusei seems very similar to that of the ‘neither’, already encountered above: what is being individuated is a set of states or causes which are liminal between health and morbidity. And indeed, when we move to those texts which use the terminology of ou phusei in relation to bodily states, rather than causes, this connection is made explicit: in a passage in Withering (a passage which gives us our clearest indication of the source from which Galen derives such terminology, although unfortunately this is saying very little), we learn that some have thought that old age is a disease, others that it is unstable health, others something which is neither; and again some that it is kata phusin, others that it is para phusin, and here too others that it is something midway between the two, and neither of them, inventing a third term and stating it to be ou phusei. Marc. 4 (VII.680–681 K.)

If, then, we understand the ou phusei as thus essentially equivalent to the ‘neither’, it seems relevant that The Art of Medicine, which gives the most extended discussion of the latter terminology, does not make use of the former terminology – ‘neither’ there performing the same function that could also be referred to as ou phusei. (And we also see, then, that the notion of the ‘necessary’ causes in this same text bears no particular 79

Caus. Puls. III.1 (IX.105 K.). At Puls. 9 (VIII.462 K.) the kinds of change (tropē) of the pulse are divided into that which is kata phusin, that which is ‘not kata phusin, but not yet para phusin’, and that which is para phusin. 80 Puls. 11 (VIII.470 K.). The point is made also at Tum. Pr. Nat. 1 (VII.706 K.): τῶν οὐ φύσει διαθέσεων αἱ ὑπερβολαὶ παρὰ φύσιν εἰσίν (‘the excesses of the non-natural states are unnatural’).

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r­elationship with that of the ‘non-natural’ any more than it does with that of the ‘neither’.) On the other hand, in that same text with which we started in this discussion, The Pulse for Beginners, the ou phusei causes seem at their introduction to be distinct from the kata phusin in a more fundamental, conceptual way. What unites the causes of alteration of the pulse considered under the heading kata phusin (ch. 10) is that they are all causes that arise from the natural constitution – the particular phusis – of the individual; so, considered here are e.g. differences of internal heat and of physical bulk, as well as of gender – to which are then added differences due to time of life and to the seasons. The discussion of the ou phusei causes (ch. 11) by contrast introduces exercises, baths, food and drink – all things which may be regarded as external to the actual constitution, and which bring about temporary changes. Included within this second understanding, then, might also be the notion that factors which are ou phusei are not in themselves either healthy or unhealthy, but only so in relation to the particular individuals and circumstances concerned. And this would then, potentially, connect them with the category of the ‘necessary’ according to the interpretation given above – a connection which was, indeed, made in the post-Galenic tradition, but (let it be emphasized again) not by Galen himself. The second way of understanding the listing of causes as ou phusei would also seem to bring it closer to the list of causes of health already considered under the heading of boēthēmata. Let us summarize, however, finally, as follows. (i) There is a tension between two senses of ou phusei: that of something, whether a state or a cause, between the category of the natural and that of the unnatural, and that of a distinct type of cause, external to the body’s stable constitution, specifically including exercise, baths and food and drink (i.e., a specific type of remedy or boēthēma). (ii) the list of ou phusei causes of alteration of the pulse given in the specialist pulse treatises is not identical to such listings of boēthēmata, nor can it be equated with the list of ‘necessary’ causes in The Art of Medicine. The latter, indeed, includes factors actually mentioned as para phusin in The Pulse for Beginners. (iii) The connection between the two categories of the ‘non-natural’ and the ‘necessary’; the understanding of these categories as referring only to causes of health or interventions relevant to health (rather than

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also to states of the body); and the clear specification of six such causes – all these are developments which occur in mediaeval Galenism, but are not found in the discussions by Galen himself. 5.3 Diagnostic signs and skills It follows from Galen’s understanding of healthfulness, in conjunction with his detailed physiological views, that there is a range of signs relevant to the patient’s state of health, signs in the discernment (diagnōsis) of which the health-practitioner must train himself thoroughly. (As noted already, signs are one of the three items – alongside bodies and causes – constitutive of the study of healthfulness, as indeed of medicine itself.) These include the colour or complexion of the skin; its level of heat or cold and of moisture or dryness; the discernible qualities of the waste products, urine, faeces and sweat; the pulse; the observed state of the patient in terms of fatigue or energy; the patient’s own report of his experience, e.g. in terms of fatigue, inflammation or abdominal pain.81 Consideration of each of these signs, in conjunction with a preexisting knowledge of the patient’s natural constitution, age and circumstances, enables the trained practitioner to establish what imbalance of qualities, or what build-up of fluids, obtains in the body, or in some part of it, what danger attends the continuance or worsening of any such imbalance, and therefore what dietetic recommendation must be made to the individual, and for how long. 5.4 The individual focus The point just raised, of the importance of pre-existing knowledge of the patient, is worth exploring in more detail. As touched upon at section 4.4 above, Galen does not have a ‘one size fits all’ approach to health: what is healthful is a matter relative to the individual, both in the sense 81

See e.g. San. Tu. IV.4, 110–113 Ko. (VI.249–258 K.) for the attention to various waste products, as well as to the complexion. On Galen’s account of the ability of the trained practitioner to assess bodily mixtures by external signs, especially the touch, see Singer and van der Eijk (2018); van der Eijk (2015b); Singer (2022a). The use of urine as a diagnostic/prognostic indicator was developed much more fully in mediaeval times; on this see e.g. Bouras-Vallianatos (2019). It is worth noting here too that the pulse, which is a centrally important tool in Galen’s clinical work, appears minimally in Health, presumably because its use is associated with the diagnosis of disease proper (especially fevers) rather than with that of slight departures from the norm. (A similar observation applies to Mixtures, again a work about the human body and its states in general, not a treatise of nosology or clinical medicine.)

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that there are limitations and variations as to what version of health is accessible to different individuals, and in the sense that health prescriptions must always be made on the basis of the individual’s fundamental constitution, previous lifestyle, age and circumstances. Here it is important to consider the Galenic terminology of nature (phusis), and of what is ‘in accordance with nature’ (or ‘normal’: kata phusin) and what is ‘contrary to nature’ (or ‘abnormal’: para phusin). Both phrases were in widespread use in both medical and philosophical contexts. (In the latter, they are particularly associated with Stoic philosophy, the ethical ideal of which is sometimes characterized as to live a life ‘according to nature’.) They convey the sense of healthy biological functioning – of a state obtaining, or of the performance of vital activities, which corresponds to the natural requirements or norms of the organism in question. But while these terms may be used to refer to what is healthy or unhealthy for human beings quite generally, they too can also have a relative application – relative both to, for example, times of life or personal circumstances and to the different innate or acquired constitutions of different individuals. A level of daily exercise which might be kata phusin for the ideal case, or in general terms, may be para phusin in old age, or if one is not previously habituated to it. A striking example is provided by the consumption of milk: this can be highly beneficial, and indeed Galen recounts the case of a man who lived to an advanced old age using it as a main part of his diet. But it may also be extremely unhealthy: it will depend on particular features of the individual constitution. It is definitely contraindicated for those naturally prone to the build-up of fluids.82 More generally, many foods – those which are particularly ‘moist’, or productive of phlegm – may be healthful in youth, but unhealthy in old age.83 Similarly, the level of heat or moisture, the nature of the pulse, or the quality of the residues expelled, all vary from individual to individual, and in assessing her or his health what is relevant is whether or to what extent these features have departed from the kata phusin state for that individual, not from what is kata phusin in abstract for an imagined individual in the perfect or mean state (even though that imagined individual is important as a yardstick or conceptual centre point in relation to which all others are assessed). 82

For the general proposition of the relative application of the phrase kata phusin, see e.g. San. Tu. I.5, 11,16–33 Ko. (VI.21–22 K.). For the specific example of milk and its diverse effects, see San. Tu. V.7, 148,21–149,11 Ko. (VI.343–345 K.). 83 For the variety of meats and other foods unsuitable for the old but potentially appropriate at earlier ages see San. Tu. V.6, 146,28–147,6 Ko. (VI.339–340 K.).

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5.5 Times of life; old age In fact, considerable attention is devoted in Health to different times of life and their specific forms of health care, in a way which sheds vivid light on ancient approaches and practices, especially to infants and to the old. In Book I, chapters 7–11 of Health, there is discussion of the importance of the correct early care of children, which consists both in maintaining them at the right balance of physical qualities relative to their age and in avoiding distress and other emotional disturbances. The correct quality of the breast milk is of importance here – a choice which will sometimes entail difficult decisions as to a choice of wet nurse – as are the ‘passive exercise’ provided by hammocks or cribs, and music, both of which provide a soothing influence; and at a very early age the fragile body must be protected, including by the application of mineral powders, from extremes of temperature and other external dangers.84 As the child grows older, training and habituation of the appetites become important, by which processes the child learns to enjoy the foods and activities that are healthy for it, and at a later stage to follow instructions. Here as at other stages of life (and as we saw, for example, in relation to the social hierarchy of physical training, at section 3.2 above) Galen envisages a situation where practitioners with individual expertise and practical experience – in this case, nurses or nannies – are the primary care providers, but act under the overall supervision of a person like himself, with overall understanding of ‘the art that concerns the body’. The other end of life, too, involves its own specialism, the branch of the art which Galen refers to – again putting the term in quotation marks by attributing it to the neōteroi, but nevertheless apparently happy to embrace it – as ‘old-age care’ (gērokomikon). In fact, this branch even admits of a further division, into the care for the first part of old age and that for extreme old age. Old age provides a particular focus for much of the discussion in Books V and VI. As we have already seen, here long habituation is an important factor: it may be unhealthy to go against a dietetic practice that a person has become accustomed to over a long period, even if that practice would in other circumstances itself be considered unhealthy. More broadly, prescriptions for old age must take 84

Importance of avoiding distress and emotional disturbance: I.7, 18,11–18 Ko. (VI.36–37 K.); I.8, 20,31–21,3 Ko. (VI.42–43 K.); quality of breast milk and choice of wet nurse: I.9, 21,34–23,3 Ko. (VI.45–47 K.); use of soothing motions and music: I.7–8, 18,13–20 Ko. (VI.37 K.); protection of the newborn from environment: I.7, 16,14–28 Ko. (VI.32–33 K.); I.10, 24,25–25,2 Ko. (VI.51–52 K.).

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into account the overall physical state of the old, which is colder and drier as compared with that at earlier stages. Warming factors will be recommended in general terms at this age. In particular, wine is recommended – with, to be sure, further specifications as to the most a­ ppropriate varieties of wine for the old – whereas it was definitely contraindicated at a very early age (see in particular San. Tu. V.5). It is noteworthy, too, that while, as we have seen, this phase of life can be characterized as in a sense pathological, and as one of gradual decline, Galen is at pains to present concrete examples of individuals who have – through attention to healthful precepts – maintained a very high level of health up to an extremely advanced old age. It is, indeed, striking, that while there are only three individuals mentioned by name amongst the case histories of Health, two of these are examples of such remarkable old age: Antiochus and Telephus.85 A particular point emphasized here is the established habits of the older person. One must take these into account, and avoid making changes – changes which would in other circumstances, or in abstract terms, be changes towards a healthier state, but which in cases where a state or habit has been established which deviates from that theoretically healthier state, will in fact not be healthier, but will cause more harm than good.86 The broader analysis, or division, which Galen offers into different times of life (hēlikiai) is also of interest here, as this is important both for the understanding of ancient conceptions of the human life cycle in more general terms, and for the relationship of such conceptions to medical thought and practice. Although Galen never seems to lay out his views on the successive phases or times of life with complete clarity, and indeed seems to waver somewhat on the detail, the following is the basic picture that emerges. There are either four main stages of life (childhood, prime, post-prime and old age) or five (the same, with the insertion of youth or adolescence between childhood and the prime). This division into phases is partially correlated with a traditional Greek division of the life cycle into sevenyear periods (hebdomades), although these hebdomades are clearly of more relevance to earlier than to later stages of life. It is also correlated with a gradual diminution in both internal heat and moisture in the aging process, wherein, however, heat remains largely constant from infancy to 85 86

San. Tu. V.4, 143,16–144,12 Ko. (VI.332–334 K.). See e.g. San. Tu. V.10, 158,34–159,9 Ko. (VI.359–360 K.).

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the end of the prime (at least in optimal cases), but moisture begins to diminish from infancy onwards.87 It is also important to realize, as Galen is frequently at pains to point out, that old people’s bodies are drier, not wetter, than the prime – a fact which may be obscured, and about which some doctors are deceived, because at the same time there tends to be a greater build-up of fluids, such as phlegm, within those bodies. Thus, certain kinds of lifestyle practice and habituation are recommended during the first seven-year period (see above), which are continued in largely the same way up to the age of fourteen, with the addition of certain kinds of ethical and intellectual education.88 These two seven-year periods together constitute childhood. (A further subdivision may be added, as the category of brephos, infant, is sometimes discussed separately from that of the child, pais.) Fourteen is in some ways a pivotal age: from this point, over the third seven-year period, the training and education of different persons may diverge quite radically, depending on the individual character and expected role in life.89 The age of fourteen, or in some cases a little later, also corresponds to the beginning of the phase Galen calls hēbaskein – which could be translated as ‘to be youthful’ or perhaps ‘to reach maturity’. This would seem to correspond to puberty, although Galen is not explicit about the changes involved, nor does he focus on sexual development as central to changes in health care or lifestyle. It is also important to bear in mind, throughout, that Galen explicitly states that precise numbers cannot be put on the life phases under discussion.90 The period from fourteen/fifteen to twenty-one would seem to be, or certainly to include, that of the ephēbos (‘adolescent’) and the meirakion (‘youth’), with the prime then presumably beginning around twenty-one – although, as already mentioned, precise correspondences are not possible, and moreover the former, ephēbos–meirakion, stage does not actually appear in many of Galen’s summaries of the phases of life.91 If it is 87

On this particular point see San. Tu. I.12, 28,15–21 Ko. (VI.59–60 K.). The changes from infancy to old age are also discussed at length at Temp. II.2. 88 San. Tu. I.12, 28,12–31 Ko. (VI.59–60 K.). 89 See above, section 4.2, with n. 52. 90 See San. Tu. VI.2, 170,32–35 Ko. (VI.387 K.), both for this caveat and for the mention of hēbaskein. 91 Galen describes himself as prone to certain illnesses as a child, a meirakion and ephēbos at V.1, 136,27–32 Ko. (VI.309 K.), but in that passage is vague about the limits of the latter phases, contrasting his experience then with that after the age of 28. It is also true that in the passage immediately following that cited in the previous note, on hēbaskein, he proceeds straight from mention of that to mention of the post-prime, beginning around 30 or 35 (San. Tu. VI.2, 171,1–2 Ko., VI.387 K.) – as if to imply that hēbaskein, around 14, is indeed the beginning of the prime.

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omitted, then it seems that the ephēbos stage is assimilated within the broader category of ‘prime’. Where it is mentioned, it is in fact the stage of best mixture (although in general there seems to be little in Galen’s medical discussions which characterizes this phase differentially from the prime).92 If, then, it is not entirely clear when the prime begins, Galen states explicitly that the ‘post-prime’ begins in some cases at 30, in others as late as 35.93 What is clear is that post-prime corresponds to a loss of vigour, in relation to the gradual loss of moisture and heat which characterizes the aging process, and that these losses become still more marked as one proceeds into old age itself. It seems, also, that the numerical age at which one first becomes old (gerōn) is even less clearly demarcated than that of the onset of the post-prime – a reasonable acknowledgement on Galen’s part, one may think, of the individual variations in speed of the aging process. In a further refinement, given only very briefly, at the end of Book V of Health, Galen even individuates three further stages, within old age, involving different levels of feebleness as well as of coldness: ‘fresh’, ‘wrinkled’ and ‘proceeding’ old age.94 It should be mentioned, finally, that while the progress from childhood, and in particular from the prime, to old age, is seen as one of a gradual loss of vigour, Galen asserts a difference here between the quality of physical or natural (phusikai) and that of ‘soul’ or mental (psuchikai) In the Commentary on Hippocrates’ Nature of the Human Being, just a few lines before the mention of ephēboi and meirakia (on which see next note), Galen – albeit in commenting closely on a Hippocratic text – gives the fourfold, rather than the fivefold, division, childhood, prime, postprime, old age (HNH III.7, 94,26–95,1 M., XV.186 K.), but again without numbers. 92 ‘The best mixture of the body is that which it possesses at the time of youth (meirakia), while all others are inferior to this’, San. Tu. VI.2, 170, 28–29 Ko. (VI.387 K.); ‘the time between that of children and those in their prime, which is that of ephēboi and meirakia, should be that with the best mixture’, HNH III.7, 95,11–13 M. (XV.187 K.). Meirakia and people in their prime are classed together in terms of their heat, although apparently still regarded as separate categories, at Hipp. Epid. I I.12, 31,28–30 Wenkebach (XVIIA.54 K.), and at ibid. II.80, 90–95 Wenkebach (XVIIA.183–187 K.) there is discussion of a Hippocratic passage which considers the young (neoi), meirakia and those in their prime all together as prone to certain afflictions. At Hipp. Epid. VI III.28, 165,20–24 WP (XVIIB.77 K.), Galen mentions the stage of ephēboi and meirakia as transitional between that of the child and that of the man (anēr), making the point that such changes are gradual rather than sudden (but again does not relate either category to that of the prime). It is worth noting, finally, that at least one specific age corresponding to meirakion is given, namely that of 18 (at MM V.12, X.366 K. and MMG I.9, XI.28 K.). 93 Cf. n. 91. One might, again, wish to tie the beginning of the ‘post-prime’ very approximately to the conclusion of the fourth seven-year period, and incidentally (as again mentioned in n. 91) Galen does mention the age of 28 as in a sense crucial in his own development. 94 San. Tu. V.12, 167,17–19 Ko. (VI.379–80 K.). See the notes ad loc. for the latter two, which are unusual (and in one case disputed) terms in the Greek.

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activities: the former are at their best in childhood, the latter after childhood up to the post-prime.95 One might tentatively construct a table as follows, with the proviso that the relationship of meirakion/ephēbos to akmazōn, as well as the relationship of both to the actual cycle of years, involves both uncertainty and fluidity. MAIN STAGES

FURTHER OR SUBSIDIARY STAGES

Childhood (Pais)

NUMERICAL AGES 0–7 and 8–14

Infancy (brephos) Prime (Akmazōn)

0–2 22 (or 15?)–c.30/35

Ephēbos Meirakion

c.15–21 (?)

Post-Prime (Parakmazōn)

c.30/35–?

Old Age (Gerōn)

?–? Fresh Old Age (Ōmogerōn) Middle Old Age (Suphar) Extreme Old Age (Pempelos)

5.6 Limitations One should perhaps add a caveat or qualification, by way of coda to the above consideration of Galen’s nuanced consideration of different lifestyles, ages and circumstances, and of their different needs. There remains, as a constant presence throughout Galen’s work on health, the strong notion of an ideal bodily constitution and ideal lifestyle which together constitute the best candidate for health. This ideal, indeed, forms the structuring principle of the whole of Health: this optimal case is considered first, and all others are considered as deviations from it. Certainly, Galen wishes to be optimistic about the possibility that people who, as he puts it, are ‘in servitude’ to obligations of various kinds can indeed achieve a satisfactory level of health; this is much of the focus of Book VI. (He pays particular attention to people with similar 95

San. Tu. VI.2, 170,30–32 Ko. (VI.387 K.). While there is variation in the exact reference of the term psuchikos – which could, for example, include the capacities of sense perception – it seems that in this context Galen must intend the sense of intellectual, and possibly also of ethical, capacities.

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circumstances to his own – those who have obligations to patients or fellow-citizens, and, more broadly, those who work for a powerful person in society.) But it remains the case that the pursuit of health in his culture, and as he understands it, ideally requires precisely the opposite of that – ‘free[dom] from all servitude, so as to have leisure to devote to health alone’.96 To that extent, it is an elite pursuit. The limitations, not only on the social class but on the ethnic range of the persons to whom his discourse and his practices are available, are also matters of which he is well aware. As he writes somewhat dismissively, and perhaps flippantly, in the context of his account of the correct care of neonates: ‘We are not writing this for Germans or for any other wild or foreign people … but for Greeks and for all those who although foreign by race nevertheless emulate the customs of the Greeks’.97 Nor, he acknowledges, are people in general, rather than the highly educated or those from a narrow social group, likely to read his work.98 Relatedly, he subscribes to an anthropology, fairly standard in the ancient medical discourse, whereby the Mediterranean physical type is considered as a sort of ideal of the human condition, situated as it were at the mean between the physical and ethical imbalances arising in either more northerly or southerly climates – those of the Celts or Scythians, on the one hand, or of the Egyptians or Arabs, on the other, about whose physique and lifestyle this medical discourse tends to be dismissive. (In Galen’s particular version, it seems that the optimal type is, more specifically, found in the west of ancient Asia, in modern terms roughly the west coastal region of Turkey.) 99 Again, however, it should be noted that this exclusiveness is not – in theory, at least – racial in its nature, as the medical theories in question overwhelmingly hold the environment in which these various peoples live responsible for both their physical constitution and their habits.100  96

San. Tu. III.2, 74,27 Ko. (VI.168 K.). He describes his own lifestyle as involving such ‘servitude’ (douleia, also = ‘slavery’) to his art and to the demands of friends and fellow citizens at V.1, 136,22 Ko. (VI.308 K.); cf. VI.3, 173,26 Ko. (VI.394 K.). The term douleia is also used in its literal sense at San. Tu. II.1, 38,18.19 Ko. (VI.82 K.) and II.1, 39,4 Ko. (VI.83 K.).  97 San. Tu. I.10, 24,21–30 Ko. (VI.51 K.), with note ad loc.: it is, however, noteworthy that this ‘Greekness’ is something fundamentally cultural, and in principle available to people of any race.  98 San. Tu. I.10, 24,14–15 Ko. (VI.50–51 K.); VI.14, 197,14–15 Ko. (VI.450 K.).  99 See San. Tu. II.7, 56,28–57,1 Ko. (VI.126–127 K.), with note ad loc. For similar perspectives on ethnic differences in Galen see e.g. Temp. II.5, 68,18–69,5 H. (I.618 K.) and QAM 8; the Hippocratic text Airs, Waters, Places, on which Galen relies in the latter text (and elsewhere), is a central work in the earlier medical exposition of such anthropological views. 100 As emerges in detail from the theory expounded in both Hippocratic and Galenic texts, e.g. those cited in the previous note. The detailed analysis of these texts, however, and in particular their role in the history of ethnic stereotypes, are controversial topics. For further exploration of

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It should also be mentioned that amongst the constitutional or lifestyle differences that interest Galen, those of gender are largely absent. This seems even truer of his writings in this volume – in Health, women are mentioned explicitly almost exclusively in their reproductive and nursing role, rather than as possible candidates for health – than of his medical writings more broadly, which do interest themselves in certain pathologies and experiences that affect women in particular. The situation, in fact, seems rather pointedly different in relation to class or social role, and in relation to gender. As regards the former, while such people as artisans, farmers and labourers would undoubtedly never be amongst the audience or readership of Galen’s work, the text evinces some interest in their health, discussing, for example, how the everyday practices of their professions may function as exercises, and considering the foodstuffs available in rural areas. As regards the latter, Galen in Health shows no explicit interest in the distinctive health needs or lifestyle of women as differentiated from men, and it is also the case that a whole range of the lifestyle recommendations given – those involving gymnasium exercise, baths and massage – are things that are being offered exclusively to the male consumer.101 Such limitations should not, of course, surprise us, and are in a sense the inevitable concomitant of a work of the cultural and historical profile of Galen’s, a work transmitted to us through centuries of scholarship and elite medical culture, from an original context of composition at the highest level of Roman imperial society. But they need at least to be acknowledged, alongside those aspects of the approach to health in these works which we may find stimulating and challenging, or even at times strikingly ‘modern’.

this point see the discussion – itself, to be sure, far from uncontroversial – of Isaac (2004), who puts forward the term ‘proto-racism’ in characterization of many of the ancient Greek medical and philosophical views. 101 A slight qualification should be made to this statement, in that the Roman bathing, and even the sporting activities of the palaistra, could include women; see Yegül (2010): 16. For Galen’s remarks relevant to inhabitants of rural areas see e.g. San. Tu. II.8, 59,30–60,6 Ko. (VI.134 K.). On the question of Galen’s attitude to gender in relation to those of other ancient medical authorities, as well as on his own interactions with female patients, see Flemming (2000). On the one hand he mentions his interaction with a number of individual female patients; on the other he does so seldom, and shows little interest in specifically female complaints, or the domain of gynaecology.

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6 Soul and body 6.1 Soul–body parallelism We turn to a consideration of the important relationship of health of body and health of mind or soul in Galen’s view – a relationship both of parallelism or analogy and of mutual interaction. In some ways, the exclusiveness or idealism that we have seen in the context of Galen’s theory of bodily health is a feature also of his view of ethical excellence and the health of the soul. Here too natural endowments and early nurture – in this case, in the senses of both education of the intellect and the formation of ethically good practices through habituation and positive role models – are of vital importance. And here too we see the importance, even in adulthood, of constant attention to the continuance of the right practices, and to the avoidance of small faults, which if untreated risk becoming great and dangerous faults; and here too the necessity of intervention and supervision by a mentor. All these points are discussed in detail especially in Galen’s short work Affections and Errors. In both contexts, too, that of medical and that of ethical care, there is the converse phenomenon to that: self-sufficiency in cases of individuals who have achieved excellence, and will no longer need the intervention of an expert or mentor. This is true of the health of the body, as affirmed both in Health, where ‘nature itself discovers the correct measure in the best constitutions’ and ‘the healthy body finds out everything for itself, led by the impulses of nature, especially if it has been well educated in terms of its soul’, and also in Thrasybulus, where ‘a body which is in perfect health, provided that it follows its normal appetites, will make no error with regard to food, either in terms of its quality or in terms of the appropriate time of its use’.102 It is equally true of the health of the soul, which, when it reaches a state of temperance or self-control (sōphrosunē), no longer experiences a 102

San. Tu. II.7, 59,2–14 Ko. (VI.132–133 K.); Thras. 35, 80,23–26 H. (V.872 K.). He further states that if educated people read his work and ‘pay particular attention to this question: which factors benefit them and which harm them … they will have little need of doctors’, San. Tu. VI.14, 197,14–17 Ko. (VI.450 K.). The statement from Thrasybulus is connected to the view Galen attributes to Plato, that only the ‘physical training’ element of healthfulness requires a supervisor (and it is for this reason, Galen claims, that Plato refers to heathfulness as a whole by the name gumnastikē, ‘physical training’: on this claim see above, p. 6). For the proposition that bodies in the optimal state have appropriate desires and naturally regulate themselves without the intervention of a supervisor, see also Ars Med. 24, 350,8–15 B. (I.370–371 K.); cf. also San. Tu. V.10, 160,5–6 Ko. (VI.362 K.): ‘natures without being directed tend to choose those things which are appropriate to them’.

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conflict between good and bad urges.103 Of course, as the first quotation in the previous paragraph makes clear, the connection between body and soul here is far more than one of parallelism: having the soul (or the relevant functions of it) in the right state is, indeed, precisely what it is for a body to have the right desires. Galen is in this sense optimistic about human beings (and organisms in general): their propensity to seek their own good means that, in persons in the best state, the right practices come about by nature. However, he is pessimistic in the sense that this best state seems achievable only by the very few. There are, in fact, as Galen suggests in another work, The Doctrines of Hippocrates and Plato (in a discussion addressed at the rectification of Stoic misunderstandings in this area), two parallel hierarchies, whereby individuals may be classified according to their level of health, or lack of susceptibility to harm, in both soul and body. In both cases the terminology of pathos (harm or ‘affection’) and apatheia (immunity from harm, unaffectedness) is applicable. The position is complicated by the fact that Galen is here expressing his views by way of refutation of those of Chrysippus, who as a Stoic presumably accepted the actual possibility of complete apatheia in the case of the virtuous person. It seems, by contrast, that Galen would deny the genuine possibility of apatheia, in the case of both ‘soul’ and ‘body’. Still, both the hierarchical and aspirational model, and the way in which it presents a structural equivalence between health of soul and that of the body, are informative. The following is a summary, in tabular form, of the account Galen gives in that context, presenting five distinct levels of health, in terms of the insusceptibility or susceptibility to pathos of both souls and bodies, and suggesting that the two in fact mirror each other exactly in this respect.104 Health of soul

Health of body

Souls of the virtuous (σπουδαίων)

Bodies immune from pathos (ἀπάθεσι σώμασιν)

Souls of those making progress (προκοπτόντων)

Bodies in good-condition (εὐεκτικοῖς)

Souls of intermediate people (μετρίων)

Bodies in health but not in good-condition (ὑγιαίνουσι χωρὶς εὐεξίας)

103

See Aff. Pecc. Dig. I.1, 23,19–23 DB (V.34 K.), with Singer (2013): 267 n. 171. See PHP V.2, 296 DL (V.434 K.); and cf. San. Tu. I, n. 10.

104

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(Cont.) Health of soul

Health of body

Souls of the many/ordinary (πολλῶν τε καὶ φαύλων)

Bodies suffering disease on little provocation (ἐπὶ σμικρᾷ προφάσει νοσοῦσι)

Souls of people in grip of pathos (ἐν πάθει Actually diseased bodies (ἤδη νοσοῦσιν) τινὶ καθεστώτων)

This parallelism between health of body and health of soul, and the related one between the expertise of doctor and that of philosopher, were very well established in Graeco-Roman ethical thought, certainly since the writings of Plato, and appear especially prominently in a Platonic work which Galen cites several times in Thrasybulus, namely the Gorgias. If one goes back to the texts of Plato themselves, it is noteworthy that an important role is accorded to the expertise of the doctor, as that which aims for the true good of the body (health), in the same way that philosophy aims for the good of the soul, or of society (justice). While the structure of such Platonic arguments certainly involves the elevation of philosophy as the superior expertise, the use of the parallel also entails the clear views that there is an appropriate good of the body, that medicine (when properly conceived and properly practised) is a true art, and that it is the art which has this good of the body as its goal. The particular form that this parallelism takes in Galen is, indeed, strongly informed by that Platonic background (as already seen in relation to Thrasybulus, in section 2.2 above), as well as by the contemporary and recent tradition of ‘therapeutic’ philosophical writing – a tradition exemplified by such authors as Plutarch, as well as by many in the Stoic tradition (as indeed touched on in the above example), and one to which Galen himself actively contributes in his ethical works. But it is also informed by his medical theories and practice, and his keen consciousness of the reciprocal effects upon each other of body and soul. 6.2 Soul–body interactions For the parallel between health of soul and health of body operates not only in the sense just considered, that there is a strong structural parallel between the health of the soul and that of the body, and between the functions of their respective experts, philosopher and doctor,105 but also 105

It should be mentioned, as an aside to the present discussion (although it is a matter of considerable importance in Galen’s practical ethics) that the parallel as here stated is not an exact one. In Galen’s view, it is not, at least for everyday practical purposes, necessarily or even preferably a

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in the sense that health of body and health of soul tend to exist in parallel with each other – to go hand in hand. In other words, there is a strong causal relationship here, alongside the relationship of analogy. The one tends naturally to co-exist with or lead to the other; there are virtuous and vicious circles which co-involve the health of both. Within his health writings, Galen’s interest in the soul is focussed largely on precisely those practical or therapeutic considerations: in particular the ways in which emotional disturbances (‘the affections of the soul’, pathē psuchēs) may negatively affect the health of the body (or sometimes vice versa), or how, more positively – as we saw in the discussion of the cult of Asclepius in section 3.4 – interventions aimed at improving the emotional temperament (the state of the soul) may improve bodily health too. Emotional disturbances – or life experiences giving rise to emotional disturbances – which may have a negative effect on the mixture and thus on the health of the body standardly include sleeplessness, rage, distress and worry or excessive intellectual exertion;106 and lists of such dangerous factors recur at a number of points throughout Galen’s writings.107 A passage from Book I, chapter 8 of Health is particularly worthy of attention in this regard. On the one hand, in terms of formative or educative influences on the soul, it is stated that a child with the naturally best physical constitution will also automatically have a good character; but that this must be carefully preserved against attendant dangers: The character of the soul is destroyed by bad habits in food, drink, physical exercise, things watched and heard, and music as a whole. Indeed, the person who undertakes the art of health should be experienced in all these, and one should not think that it only concerns the philosopher to shape the character of the soul. San. Tu. I.8, 19,24–28 Ko. (VI.40 K.) professional philosopher who should act as ethical monitor to a person trying to improve in virtue, but rather a well-disposed lay person with the essential qualities of honesty and incorruptibility; see Aff. Pecc. Dig. I.3, 7,21–8,4 DB (V.9 K.). 106 The word phrontis covers both concentrated mental activity, of the sort especially associated with intellectuals or scholars, and more simply worry over everyday concerns; cf. Thras., nn. 95 and 101; also e.g. Temp. II.4, 60,15 H. (I.604 K.). The range of emotional activity covered by the term translated ‘rage’ is also slightly complex: thumos, related to the ‘spirited’ part of the soul, may include not just anger but more broadly ‘spirit’ or competitive mental activity. 107 See e.g. San. Tu. I.5, 14,15–20 Ko. (VI.28 K.); Thras. 40, 90,4–6 (V.885 K.). (There is, to be sure, considerable overlap between such factors and those discussed elsewhere under the heading of the ‘six things non-natural’, especially insofar as the latter include ‘thought’; see above, section 5.2.) For further exploration of Galen’s accounts of such effects of emotional disturbances on bodily states, see Singer (2017).

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Conversely, in terms of the potential negative effects of ‘soul’ upon ‘body’: rage, weeping, anger, distress and excessive worry, and poor sleep arising from these, provoke fevers, and become the starting-points of major diseases. So too, conversely, an idle intellect, mindlessness and a soul which is completely lacking in spirit frequently bring about poor colour and poor nourishment through feebleness of the innate heat. It is absolutely crucial that our connate heat be preserved within the bounds prescribed by health; and this is achieved by well-balanced exercises, not just in the body, but also in the soul. Unbalanced motions which arise as a result of desires, discussions and rages render the animal more bilious, when they are excessive, and more phlegmatic and colder when they are deficient. San. Tu. I.8, 19,31–20,7 Ko. (VI.40–41 K.)

And then further, more acute illnesses may follow from that. Indeed, Galen gives a number of examples in other texts of ultimately fatal consequences of certain instances of distress or anxiety.108 In a similar vein, we learn too that emotional disturbances – the pathē of the soul – are factors which may in some cases interfere with optimal performance of an exercise: the person undertaking the exercise should not be either spirited, so as to be still eager for exercise when his capacity is tiring, nor lacking in spirit, so as to give up when he is still capable of exertion. The person who is our present subject, then, will have these characteristics not just of body, but also of soul. Those who have cold fluids contained in their stomach or gathered in their whole condition are lazier in their motions. Similarly, those who are in a state of fulness and those who have been worn down by a recent exposure to cold are lacking in spirit and reluctant to move, and still more so are those who are rather cold by nature, and much more so still if some moisture also accompanies the coldness. San. Tu. II.7, 58,7–16 Ko. (VI.129–130 K.)

We have observed above, and will consider in more detail below, the Platonic background to Galen’s conception of the soul; we shall also note ways in which he seems to distort or at least strongly interpret the Platonic texts to adapt them to his own intellectual framework and 108

Most strikingly, in his account of the reaction of a certain scholar to the loss of his own writings in the great fire of 192 CE, at Ind. 7, 4,7 BJP; the story also appears, alongside a number of other cases of fatal consequences of anxiety or distress of various kinds, at Hipp. Epid. VI VIII, 485–487 WP.

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a­ rgumentative purposes. Here, however, the terms in which Galen describes the close interaction of soul and body, and relatedly of educative, including musical, and physical exercise components in the shaping of the soul, closely echo aspects of Plato’s account of the education and training of body and soul in the Republic. In particular, the discussion of the way in which the spirited soul should be either ‘softened’ or ‘hardened’, depending on its initial disposition, is closely paralleled by Republic III, 411a–412a, which also – in a way very similar to the passages cited above from San. Tu. I.8 – insists that music and exercise are of value for both body and soul, and indeed for the purpose of their becoming properly attuned to each other. Moreover, Galen believes, emotional disturbances may also interfere with the observable indicators of the bodily state: it may, for example, be important to be aware of an emotional state in order correctly to assess the significance of a patient’s complexion.109 In terms of the causal relationship, or interdependence, between soul and body, discussions in two other Galenic treatises seem particularly relevant: Mixtures and The Capacities of the Soul Depend on the Mixtures of the Body. In a passage in the former text, it is stated that the best state of balance or mixture within the body naturally or automatically coincides with the best dispositional or ethical state. After describing this best bodily mixture, the text continues: Such, then, is the best-mixed man in respect of his body; in respect of his soul, similarly, he is precisely in the middle between boldness and cowardice, hesitancy and rashness, pity and envy. Such a person will be cheerful, affectionate, generous, intelligent. Temp. II.1, 42,16–20 H. (I.576 K.)

The latter text takes the causal analysis further, insisting on a strong dependence of soul characteristics (ēthē) and capacities (dunameis) upon bodily mixture, which is in turn crucially dependent both on inherited features and on food, drink and the physical environment, and even positing an analysis in terms of some form of soul–body identity – that the ‘substance of the soul is a mixture of the body’ – although that analysis does not, in fact, seem to correspond to Galen’s final position on this 109

San. Tu. IV.4, 112,4–7 Ko. (VI.253–254 K.): ‘the colour will be that of the fluids, not that of the solid bodies in the animal, except in cases where the fluids retreat to deep within the living being – which happens in the case of cold, or rigor, or an affection of the soul, such as fear, violent distress or incipient shame’.

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matter.110 In any case, such theoretical or metaphysical analysis is beyond the frame of reference of Health. However, another passage in that work seems to offer a close parallel to the picture that we have been contemplating of the close interdependence and interaction between fluids and states of mixture, on the one hand, and ethical or emotional dispositions, on the other. It is from this [sc. an external] source … that faulty habits arise in the nonrational part of the soul, and false beliefs in the rational, as also, when we get our education from men who are decent human beings, true beliefs and good habits; while it is on the mixtures that depend, in the rational, different degrees of shrewdness and foolishness and, in the non-rational part of the soul, well-balanced or ill-balanced motions, also in different degrees. And the mixtures themselves are consequent on the original formation and on daily regimes involving good fluid, and these things mutually increase each other. So, to be sure, people who become sharpspirited because of the hot mixture then fire up their innate heat by their sharpness of temper; and those who are well-balanced in their mixtures, having well-balanced motions of the soul, are assisted towards good fluid. QAM 11, 78,19–79,9 M. (IV.820–821 K.)111

These accounts of the mutual influences – potentially involving both virtuous and vicious circles – of soul and body seem to fit well with, and complement, those already cited from Health: the picture is again one of close mutual dependence of ‘soul’ and ‘body’ characteristics.

6.3 The theoretical account of the soul Galen’s interest in psychology or soul theory in Health, then, is focussed largely on the question of how emotional factors or states may adversely affect those of the body, and vice versa, and in particular about ways in which certain cognitive or psychological interventions may improve the health of the body. He thus uses language which we may call ­‘pragmatically dualist’ – treating body and soul, and their health, as distinct domains 110

On the passage here cited from Temp., and its relationship with Galen’s ethics and view of the soul–body relationship elsewhere, see the discussion of Singer and van der Eijk ad loc. (2018): 106 n. 20. For the thesis in QAM see chs. 3 and 4 of the text, and discussion at Singer (2013): 335–369. 111 The translation is from Singer (2013): 408–409, with slight changes. (Note that the word translated ‘sharp-spirited’, oxuthumos, could also be translated ‘quick-tempered’.) There are some slight textual uncertainties in this passage, on which see Singer (2013) ad loc.

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from the point of view of practical or clinical interventions – without entering into the definitional or analytical question of the soul–body relationship which he raises elsewhere.112 More strongly theoretical, or philosophically analytical, discussions of the structure of the soul, or of its relationship with the body are (with some exceptions, partly already discussed and partly considered at sections 6.5 and 6.6 below) beyond Galen’s scope here. There are, however, illuminating parallels to the clinically based perceptions on these matters that we find in Health, in other works which do take the theoretical analysis further. First, on the structure of the soul: Galen is committed, on Platonic lines, to a clear division between rational and non-rational capacities or parts, and to a further division within the non-rational, between the irascible or ‘spirited’ (thumoeides) and the appetitive or desiderative (epithumētikon). This model of the Platonic tripartite soul is completely central – in Galen’s version or versions of it – both to his ethics and moral psychology and to his physiology. In the former context, it is crucial to understand the different forms of education, discipline and monitoring appropriate to each part. In the latter, each of the three is located within one of the three major organs of the body, the brain, the heart and the liver, and provides an account of (at least some aspects of ) their functions in the body.113 Although the tripartite structural model is not (in either of these versions) especially relevant to the subject matter of the health writings, nor prominent in its discussions, it can be discerned, as it were, in the background, and seems to underlie some of Galen’s accounts of, for example, early education, as we shall see in section 6.5. What I have called Galen’s pragmatically dualist language extends, in a striking passage (which comes directly between the first two presented in section 6.2 above), to the perception that: one should not think that it only concerns the philosopher to shape the character of the soul. Rather, it concerns the philosopher because of something greater, that is the health of the soul itself, but it concerns the doctor in the interest of the body’s not readily falling victim to sickness. San. Tu. I.8, 19,28–30 Ko. (VI.40 K.)

112

I discuss this ‘pragmatically dualist’ approach in Singer (2021a). The ethical and moral psychological model is laid out especially in Affections and Errors, Character Traits and The Capacities of the Soul Depend on the Mixtures of the Body; the same alongside the physiological, organ-based model in The Doctrines of Hippocrates and Plato.

113

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That last remark seems to concede – at least in theory – that there is a separate domain of the health or excellence of the soul, and that this domain belongs properly speaking to the philosopher. At a socio-intellectual level, it raises the question of the interaction, and possible conflict, between philosophy and medicine as disciplines in the elite Graeco-Roman world. Some sort of rivalry or debate over the competence of doctors and philosophers does indeed seem to have obtained in this milieu. We find evidence for this for example in Plutarch, whose Precepts on Health is a dialogue between a doctor interested in philosophy and a philosopher interested in medicine, while at the same time summarizing the views of their colleagues who were hostile to each other’s disciplines. Galen’s texts, as we have seen, give ample evidence of philosophers interested in medicine, and of intellectuals actively interested in both disciplines. A particular conflict may, indeed, arise in relation to the very question raised at the end of the previous section: at what point is the ‘health of the soul’ the concern of the doctor, and at what point that of the philosopher? Are emotional or psychological disturbances or states – because they are due to particular states of the body, innate or acquired, which in turn are understood in terms of such factors as, for example, an excess of black bile – primarily matters for medical intervention? Or do they at some point – and if so at what point – become an ethical concern, and thus the domain of the philosopher? Again, there is some explicit debate on such matters: for example Stoic philosophers, on the one hand, and the medical author Caelius Aurelianus, on the other, attempt to make a distinction between two kinds of psychic disturbance, along these lines.114 The further question then arises: if certain psychological or emotional states are the concern of the philosopher, what is the nature of this concern: how, practically, does the philosopher approach such cases? The ‘big-picture’ or strategic answer will be that implied by that last quotation from Health, above: ‘to shape the character of the soul … concerns the philosopher because of something greater, that is the health of the soul itself ’. The ‘health of the soul’ here must be understood as the person’s ethical excellence, his or her capacity to lead a good life, one which has the human good as its aim. The appropriate shaping of the character (ēthos) is a requirement, from the philosopher’s point of view, 114

See Ahonen (2018); also (2014). On the question of the conflict over competence more broadly, Polito (2016); relevant too is Coughlin (2018). Further on Plutarch’s ethical work see van Hoof (2010).

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insofar as it will conduce to such ethical excellence or capacity for appropriate moral action. From the medical point of view, meanwhile, it is a requirement simply because bad character traits also lead to bad medical outcomes. What does such ‘shaping’ consist in? Essentially, in a process of habituation to good practices, which is crucially focussed upon the control or elimination of the pathē (variously translated as ‘affections’, ‘passions’, ‘emotions’) – the notions of character (ēthos) and pathos being closely connected. The details of Galen’s conceptions – both in relation to ēthos and pathos, and in relation to the ‘big-picture’ question mentioned above, that of the human good or aim of life – are beyond our scope here. We may summarize, at least in the former area, by saying that there is a fundamental debate at this period between Stoics and Platonists/ Aristotelians, the former advocating the complete elimination of the pathē, the latter their control or moderation; that the two groups, however, share much in terms of their practical recommendations as to how such ethical ‘therapy’ should be conducted; and that Galen’s own conception of pathos – as well as of the nature of ethical therapy – is in a complex way indebted to both groups in the philosophical tradition.115 In this context, he devotes one of his own main ethical writings to the ‘diagnosis and treatment of the pathē of each individual’s soul’. The central point is that there is, in Galen’s time, a philosophical tradition, and set of techniques, of ‘therapy of the soul’, which exist alongside the practice of medicine. Philosophers, and ethical interventions, are conceived as functioning in a parallel way to doctors and medical ones – in terms of their close attention to and monitoring of the patient’s state and progress, in terms of the need to tailor prescriptions precisely to the patient’s needs, and above all in terms of the ultimate aspiration to cure the patient, to relieve suffering. Chief amongst the procedures in question are: dialogue with a person who will give an honest account of one’s perceived faults or shortcomings; regular self-monitoring; and a number

115

To summarize in very simplified terms: he adopts the Stoic (which is also in a sense the medical usage) whereby a pathos is an undesirable emotional response, and thus a purely negative event; he does not, however, advocate, at least as a practicable or achievable aim, the complete eradication of such pathē; Galen’s usage in relation to that of the previous tradition is discussed by Singer (2022b). Further on pathos and psychological therapy in Galen, see Hankinson (1993); Donini (2008); Singer (2013); Kaufman (2014); Devinant (2018) and (2020); Singer (2018); Gill (2018); and more broadly on the philosophical background to it (to take just a few examples) Nussbaum (1993), (1994); Hadot (1969); Hadot (1995); Graver (2007); Gill (2010); Singer (forthcoming).

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of repeated daily practices, including philosophical reflection and introspection, and recitation of appropriate mottos.116 It is important to the understanding of Galen’s work in this area to realize that, in relation to the above dichotomy, Galen himself plays a dual role. His own writings relevant to the ‘health of the soul’ belong within (at least) two strikingly different contexts and genres of work – broadly speaking, the medical and the ethical or moral-psychological. In talking of the philosopher’s interest in the ‘health of the soul itself ’, he could, indeed, be taken as referring to his own ethical works, in particular Affections and Errors, Character Traits and Avoiding Distress,117 in which he discusses the soul and its ‘therapy’, partly in theoretical but mainly in practical terms, as it were in the persona of a philosopher rather than a doctor. In a range of medical works, meanwhile, he considers the nature, and the treatment, of a number of medically defined psychological or (in our terms) neurological pathologies, which involve impairment of cognitive function, or mood, or both – for example mania, melancholia, paraphrosunē, phrenitis.118 In Health, meanwhile (and in The Capacities of the Soul Depend on the Mixtures of the Body), the two approaches are to some extent combined, as the interactions above as well as the incorporation of the discussion of soul health within a general programme of healthy upbringing and healthy living suggest. But it remains also the case that there is a clear hierarchy, in Galen’s view, according to which the domain of the soul – its activities and its care – is of greater value and moral importance than that of the body. It is a hierarchy which Galen invokes, not least by his very self-alignment with Plato and a range of relevant Platonic texts; moreover, he claims expertise in this ‘higher’ realm too. 6.5 Platonic background and the tripartite soul Platonic moral psychology functions as an important background to Galen’s thinking in his writings on health, even if, undoubtedly, it is less 116

On Galen’s techniques of therapy see Singer (2018); further on medical language in such ethical therapy, Singer (forthcoming). 117 These are his surviving ethical or psychological works (alongside the longer and more theoretically and anatomically based The Doctrines of Hippocrates and Plato); a number of further ‘occasional’ ethical works, now lost to us, are mentioned at Lib. Prop. 15. 118 For discussion of Galen’s range of discussions in different texts, and range of practical approaches, see again Singer (2018). Typical medical interventions for such conditions include purging of fluids, through emetics and other purgative drugs or in more severe cases through venesection.

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central in this area than it is in his specifically ethical, or indeed to some extent his physiological, works. Its relevance is illustrated by a number of passages in which the tripartite model – the fundamental division of the soul into rational, spirited and desiderative, along with (in Galen’s interpretation of this) the bodily location of each, respectively in the brain, the heart and the liver – seems in some way to underlie discussions or classifications he gives of the capacities or pathologies of the soul, or indeed of states and functions of the body.119 One may add, more broadly, that Galen’s use of thumos and related words relies on the Platonic understanding of the term; and one might, further, even see the classification of different lifestyles, already considered above (p. 29), as related to Platonic categories, especially those of the Republic, with its well-known division of philosophic/intellectual, military and other roles. 6.6 Aristotelian background and emotions as heat Galen’s account of the soul is also strongly connected to the Aristotelian background. In this connection, we encounter in Health one of Galen’s more striking and revealing statements, both of his view of the soul–body relationship and of his understanding of Aristotelian thought in this area. However, the remark – in a way not uncharacteristic of Galen’s most arresting philosophical contributions – is tantalizingly brief, and delivered in passing, in the context of a tangentially related topic, namely that of inner heat and physical exercise. Rage or anger, the emotion or ‘affection of the soul’ whose mention leads Galen into this theoretical aside, is relevant at this point simply because it is one of a number of ways – alongside exercise – in which the internal heat may become abnormally raised. The passage runs as follows: This [sc. increase in internal heat] is a common feature of all exercises; but it is not specific to them alone, since, to be sure, there also arises an increase in the internal heat in those experiencing rage, anxiety and shame. Now, rage is not simply an increase, but as it were a kind of seething of the hot in the heart; which is why the best-reputed philosophers state that this is its essence; for the appetite for revenge is an incidental feature, and not the essence, of the rage. The internal heat increases in those suffering shame too … San. Tu. II.9, 61,19–29 Ko. (VI.138 K.)

119

For examples see See San. Tu. I.6, 15,22–24 Ko. (VI.31 K.); I.8, 19,15–19 Ko. (VI.39 K.); II.11, 65,33–66,3 Ko. (VI.148 K.); III.4, 82,27–29 Ko. (VI.186 K.), in each case with the note ad loc.

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Here, the second sentence is a clear – though extremely individualistic, indeed tendentious – adaptation of a particular text from Aristotle’s De anima. As such, it demonstrates both Galen’s engagement with the Aristotelian intellectual tradition and his willingness to produce apparently improvised pieces of analysis, with potentially very large, but unexplored, theoretical implications, at various points throughout his work, almost by way of digression. While its theoretical implications could be understood in a number of ways, it is probably best taken mainly as a further assertion of the point made above, of the closely intertwined nature of emotional and bodily states, and of the relevance of the clinical significance of this in certain cases.120

7 Galen’s health writings as a source of information for aspects of Graeco-Roman everyday and intellectual life This overview of Galen’s health writings has so far concentrated on their relationship with ancient Graeco-Roman practices and debates relating to health and the body, as well as their contribution to a number of connected physiological and philosophical theories. These are, surely, the points of greatest interest that arise in these works for the historian, either of ancient medicine or philosophy, or of the later influence or transformation of these aspects of the classical tradition – or indeed for anyone interested in ancient philosophical and health-related debates and their potential to provide a stimulus or challenge to current discussions or conceptions. At the same time, it is worth mentioning the resource that these texts constitute, much more broadly, providing evidence in a number of areas concerning everyday and intellectual life in the ancient world. Galen is an extremely digressive writer, who often provides unexpected pieces of evidence or information on one particular topic, in the context of a discussion whose main topic or aim is something completely different; and nowhere is this truer than within the large, leisurely and somewhat rambling text of Health. As a result, this text functions as a veritable treasure trove of information on a range of often quite unexpected areas of Graeco-Roman attitudes and practices, including: 120

Of course, Aristotle himself in the relevant passage of De anima cannot correctly be taken to distinguish between the seething of the blood as the essence, and the appetite for revenge as an incidental feature, of rage. I discuss the context and significance of Galen’s transformation of the Aristotelian text in Singer (2014b); (2017); see also San. Tu. II, n. 59 below.

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• questions of Greek or Roman identity; • aspects of intellectual and educated life in ancient cities; • the everyday care of infants, including the practices, and the hiring, of wet-nurses; • the perception of certain ancient cities and their atmosphere as particularly dirty or polluted; • details of ancient practices within the gymnasium: exercise, massage and bathing; • a variety of everyday dietary practices and food choices, and relatedly food preparation, and the availability and use of different foods in different geographical and social contexts; • the use of and attitude towards a range of different wines; • the availability, relative value, and everyday use, of a number of herbs and spices, in homemade medicinal preparations; • attitudes to leisure and work, and issues of both time measurement and time management, for those with professional responsibilities and in particular for those directly employed in the service of Marcus Aurelius; • attitudes and expectations surrounding old age. Both Health and Thrasybulus also shed important light on aspects of ancient intellectual life. The latter informs us about the Graeco-Roman practice of public debate on a problēma, or ‘set question’ for debate, of which it is itself a particularly lively example, and of the relationship between oral and literary composition in this context. The text has its origin as an extemporized response to a question set in that public, competitive, and indeed antagonistic, context, which response is then transformed into a literary text which has the function of both reminding the reader of that original debate, and presenting the arguments that the author thinks most relevant in fully worked-out form. One function of – and reason for the demand for – such transcriptions of an oral presentation or lecture might be that they would enable another individual to conduct a debate against a similar opponent independently in the future, using the transcription as a template, or set of notes.121 The text of Health, meanwhile, also provides us with evidence for the gradual evolution of a medical treatise (see further below, section 8.1); and its remarks on the intended audience and likely readership are of 121

For a vivid Galenic account of how such competitive public debates or lectures proceeded, as well as for mention of this latter function of the transcribed text, see Lib. Prop. 1, 138,6–139,9 BM (XIX.13–14 K.), as well as the texts cited at n. 37 above.

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considerable interest for the question of the actual use and dissemination of such texts in this socio-intellectual context, and for the distinction between ‘technical’ and ‘non-technical’ texts. As already seen, Health is explicitly aimed at philiatroi rather than iatroi – a fact with two interesting consequences, from the socio-medical point of view. First, it ­indicates the presence (at least in Galen’s mind) of a substantial, nonprofessional elite in his Greek-speaking Roman milieu, to whom such a text will be of interest. Secondly, while presenting itself as a non-technical text ‘for all’, designed to assist the pursuit of health without the perpetual presence of a medical expert, this ‘non-technical’ nature has the somewhat paradoxical consequence that the text includes a considerable amount of detailed instruction on the home production of a number of quasi-medicinal preparations, precisely because it is their home preparation by lay persons, rather than the delegation of the drug preparation to ‘an expert in that area’, that is envisaged.

8 Composition of the texts 8.1 Problems of Galenic composition and dating: general We turn to the question of the date, and of the manner and structure of composition, of the texts of this volume. The two questions need to be considered in tandem. A number of Galen’s larger works represent projects that developed over a considerable period of years – a consideration which affects both our understanding of the structure of these works, and our assessment of their date. Even with works which do not have such a lengthy period of gestation, it may still be problematic to speak of ‘the date’ of the work in a straightforward way: a work may have its origin as an oral or lecture-style presentation, which is subsequently written up or circulated in note form; and there may then be a further distinction between such a provisional version and that finally worked up ‘for distribution’ (pros ekdosin), or even in some cases further revisions after such initial ‘publication’. It must be understood here that notions of book distribution and publication are very different in the Graeco-Roman world as compared with the modern world. There are different phases of composition and circulation of Galenic works, which may make it difficult to speak of a single date of composition of any given writing. A specific problem arises from the many cross-references which appear within his works, to other of his works ‘already written’.122 On the one hand, these constitute the 122

As already noted by Ilberg (1889): 216.

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best evidence we have for the dating (at least relative) of his writings. On the other, it seems completely clear that revisions or second versions of works were carried out, in the course of which further such cross-references were added, to works written since the first version. The inconsistent chronological picture that emerges from a consideration of all the cross-references can only be explained on this basis. It is also quite possible that a number of such cross-references arise from later scribal contamination of the text on the part of individuals who knew Galen’s work well, and were aware where other relevant discussions of a particular point occur. Such a procedure is by no means unlikely; asides of the form ‘as more fully discussed in my treatise on …’ can easily enough enter the text without altering anything else of substance. Moreover – and more fundamentally – a backward or forward reference of this sort should not necessarily, or not always, be understood in temporal terms, as referring to a past or future time of composition. Galen conceives his own works as having a thematic order, a correct order of reading, rather like reading materials for a lecture course (or series of lecture courses). Once this is understood, we see that the phrase ‘as we shall say in text X’ may refer just as much – or just as little – to a work already completed as the phrase ‘as was discussed in text Y’. Both texts, X and Y, may have already been written. Moreover, both may have been written in provisional and unstable form. Again, the parallel with the status or nature of modern teaching materials is helpful. Galen’s works have a paedagogic purpose and, very frequently, an original oral context. Text Y of the ‘back reference’ may be as liable to further revision as text X of the ‘forward reference’.123 Nor can inclusion or non-inclusion in Galen’s two works of ‘autobibliography’, which list his own writings, taken in conjunction with the supposed dates of composition of these, be used as a clear criterion. Again, it seems clear that some works were added, by way of updating, after those initial dates of composition; whichever work was originally written earlier, The Order of My Own Books omits some items included in My Own Books, and vice versa; and in general non-inclusion is not a conclusive proof of not having yet been written.

123

On Galen’s practices of self-distribution, self-editing and self-publicizing, and on the complex relationship between a theoretical order or curriculum of his works and straightforward chronological considerations, see Boudon-Millot (2009), Vegetti (2013) 31–57, Singer (2019b). For an attempt to identify the original paedagogic nature and context of Galenic texts through attention to linguistic features, see van der Eijk (2013). More broadly on the chronology of his writings, Boudon-Millot (2007), Introduction, following on the earlier work of Ilberg and Bardong.

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Let us turn from these general considerations to the specifics of the two texts of this volume. While, as we have said, the question of dating and those of the structure and composition of these texts cannot be addressed entirely in isolation from each other, the present section will concentrate on questions of dating, while the next two consider the works’ structure in more detail. Our two texts in a sense belong closely together: Health could be seen as an extended companion piece to Thrasybulus, to which it makes a number of references. The two works are also complementary, Thrasybulus offering a highly theoretical, as well as highly polemical, analysis of the nature of the expertise in question, and Health by contrast a much more pragmatically oriented account of the everyday practice of this expertise, full of details of foods and exercises, of lifestyles, and of diagnostic and prescriptive techniques. Many a reader will turn with relief from the logical and rhetorical tour-de-force of Thrasybulus to the more relaxed and practically informative pages of Health; on the other hand, the reader whose main interest is in ancient logic, dialectic and argumentative techniques may tire quickly of the medical and everyday minutiae of the latter work, and revel in the material offered by Thrasybulus. To conclude from this, however, that the two works are close to each other in date, would be quite speculative.124 Although (as we shall see further below), frequent cross-references from one work to another may in some cases be taken as contributory evidence to closeness in date, the close connectedness of the subject matter would in the present case provide sufficient reason for the three cross-references, which occur in the specific context of discussion of the definition and divisions of the art concerning the body. They do, however, seem to show that Health was written after Thrasybulus. As for Thrasybulus itself, as we have already seen, our text seems to be the written-up version of a previous oral presentation. Beyond this, little can be said about its likely date(s), except that the kind of competitive public display which provides its original context (on which see notes 37 and 121 above) is something with which Galen engaged very definitely in the earlier phase of his career. He states that he gave up participation in such public displays at a certain moment in his career; from that point of view it would seem plausible that the text – or at least the original presentation 124

As tentatively suggested by Ilberg (1896): 184–185.

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on which the final text is based – dates from before that moment, which is to say shortly after 169 CE at the latest.125 If that is right, there would be a gap of some years between the composition of the two works, even on the views of previous scholars (which I shall dispute) placing Health partly in the 170s. Health also seems clearly to have been composed over a considerable period. Questions of dating here are in some way related to questions of structure: Galen does not, in various ways, fulfil the plan originally laid out, and there is arguably also a different principle (including some haste) in operation in his composition of Book VI as compared with the earlier books. This in itself does not have to be a function of date; it may be simply a feature of Galen’s digressive and sometimes chaotic method of composition. We shall return to the question of the problematic structure and plan of Health in the next section; let us now proceed to consider the extrinsic evidence, both for this interruption between the composition of Books I–V and that of Book VI, and for the date of the treatise as a whole. Although, as we have already suggested, the use of cross-references by Galen in one work to other works, and vice versa, is a criterion that must be handled with great caution, it may – when it is so handled – help us with these questions. Earlier scholars placed the whole treatise in the earlier phase of Galen’s writing career, within the reign of Marcus Aurelius (who died in 180 CE). The only clear reason for doing so was a single passage in Book VI, apparently referring to the ongoing experience of working for that emperor. Once it was realized that, in the standard Greek edition of the work, a present-tense verb appeared in error in the passage in question, so that Galen should not be taken there as referring (or at least not as definitely referring) to a current state of affairs, there was nothing definitely tying the work to Marcus’ reign; and indeed that whole brief passage seems fairly clearly to refer to the past. 126 But the response to this 125

Galen claims to have given up public demonstrations at a certain point in his life, but precisely which point he means is liable to two different interpretations: either during his first stay in Rome, in his 34th year (i.e. 164 CE), or, more plausibly, early on during his second stay in Rome, i.e. shortly after 169. See Lib. Prop. 1,139,14–15 BM (XIX.15 K.), with the discussion of Boudon-Millot (2007): 188–189. 126 The earlier view was expressed by Ilberg (1889): 225, the error pointed out by Koch (1923): VII n. 1, following Hartlich. The passage in question is VI.5, 178,29–35 Ko. (VI.406 K.), describing the exercise regime of the emperor and its impact on the leisure of those in his entourage. The reading printed in Kühn was ὡς ἔξεστι (R), ‘so that it is possible’, whereas the preferable reading, that of M, ὡς ἐξεῖναι, may be translated ‘so that it was possible’. (Here the infinitive verb form is not tied to either present or past, so the tense implied must be deduced by the context; and the main verb of the sentence is in the imperfect tense.)

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r­ ealization was either (a) to move only the sixth book to a period after the death of Marcus, retaining a date shortly after 176 for the rest, or (b) to redate the whole work to the post-Marcan period – but, in either case, to a date immediately after his death (for Book VI or for the whole, as the case might be).127 And the justification for either of those positions, I shall argue, is weak, whereas there are quite good grounds to place it a decade or more later. Once the connection with Marcus Aurelius’ lifetime has been removed, the grounds for the early date are largely the problematic ones of crossreferences. Within these we may distinguish two varieties of argument: (a) those for a close chronological relationship with The Capacities of Foodstuffs and Good and Bad Fluid, which seem on such grounds to have been written between Books I–V and Book VI of Health; (b) those which purport to tie Health to other works which are taken to be of early date, on the basis of other cross-references between those works and Health. I note, first, that arguments which fall under heading (a) are for relative date, and would be consistent with – indeed would entail – Health’s having been written much later, if those two works themselves turned out to be of much later date; and that those arguments in previous scholarship which fall under (b) have not been innocent of the dangerous cherry-picking activities already warned of. I shall argue, in relation to (a), that there are in fact quite good grounds for placing those works on food later, and in relation to (b), that the particular set of references upon which they rely does not produce a consistent picture, so that in any case a choice must be made to accept some and disregard others. I shall argue, further, that a broader picture emerges, whereby the cross-references to Health appear overwhelmingly in works confidently believed to have been written in the reign of Septimius Severus (193–199 CE), and very seldom, if at all, in works written before that period; and that this provides much stronger evidence than these isolated, cherry-picked references. Evidence, that is, that Health as a whole was composed either in the Severan period or shortly before it, albeit with a gap of some sort between Books I–V and Book VI. That, then, is a summary of my conclusions on this question, the detailed justification of which now follows. As it is difficult to give such 127

The former is the view of Bardong (1942: 626), the latter that of Koch (1923: VII n. 1), given without any justification beyond that mentioned in the previous note.

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justification in concise form – or indeed, without a considerable volume of minute detail – the reader not interested in such minutiae may wish to skip the next paragraphs and rejoin the discussion at section 8.3. We have already suggested that the cross-references between works throughout the corpus must be handled with great caution, but that they may give us some assistance when they are so handled. An important distinction here is the following. Where we find an isolated reference to a work, X, in another work, Y, such a reference may in some cases be taken to derive from a later revision of work Y, and thus on its own gives little assurance that work Y is indeed (in its original or main phase of composition) of later date than work X. Where, on the other hand, a work Y repeatedly and insistently refers back to a work X, this makes it much more likely that the genesis of Y does indeed belong to a later period. We might also entertain the possibility, in the case of particularly frequent references of this sort, that they indicate that work X is particularly prominent in the author’s mind at the date of composition of work Y, and therefore perhaps that Y was composed fairly shortly after X, or even that the two are concurrent projects. Let us consider then the references to other works that appear within Health: most are to works dated with reasonable confidence to 169–76 (Mixtures; the works on the pulse; the works on venesection); and from this point of view a dating shortly after this would be perfectly possible, but also a dating considerably later. A particular question arises from the nature of the references to The Therapeutic Method. In line with the distinction explored earlier, Galen mentally divides up the material and subject matter of medicine between the two works, Health and The Therapeutic Method, as representing the two main branches of the ‘single art concerning the body’. So too, when he refers to a certain topic as ‘belonging within the healing pragmateia rather than that of health’, he is not always making a straightforward cross-reference to a work already written; he may rather be dividing the subject matter conceptually: pragmateia in Galen’s usage straddles the sense of a specific treatise and the broader one of a particular kind of study or subject area. From some of the references, it seems clear that The Therapeutic Method is an ongoing project in his mind, whatever state of completion it had reached. 128 Galen is perhaps referring to The 128

See such a mention of the pragmateia of healing at San. Tu. IV.10, 132,31–32 Ko. (VI.300 K.). The point that the two works were conceptualized by Galen in parallel was noted already by Ilberg (1889): 225.

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Therapeutic Method as a work in progress, or even as an existent, but not yet final, draft. Relevant here for example is the remark acknowledging the perceived need for an explanation of ‘the reason why I have now come to write about the composition of drugs, or indeed the testing of them, while I am not in the habit of doing any such thing in the treatise [or study] on healing’ (IV.5, 118,29–31 Ko., VI.269 K.). The use of present tense (more precisely, a perfect participle with present aspect, eithismenōi) to describe his current ‘habit’ in his work on therapeutics or healing is noteworthy. While this may indeed be a reference to the treatise in question, The Therapeutic Method, rather than to the topic or study more broadly, if so, it seems to be a reference to it as an ongoing, not a completed, project. Now, The Therapeutic Method itself is known to have been written in two phases, the first quite early, the second in the Severan period. From that point of view, such a reference to The Therapeutic Method as an ongoing project could be thought to make sense at any time over a very long period, although I shall argue that other evidence points to a particular temporal connection with the later books. I turn to the evidence for the gap between Books I–V and VI, and the relationship with the works on food There does seem to be some difference in approach in Book VI, as well as some differences in its manner of referring to other works. Structurally, as we shall discuss further below (pp. 82–83), it covers in one book – at least in stated intent – all the different suboptimal bodily constitutions, and suboptimal life circumstances, whereas five books were, in the event, dedicated to prescriptions only based on ‘the first assumption’, that is to say that of a person born with the best bodily endowments and continuing in the best possible circumstances. It starts, perhaps even with a hint of impatience with himself, with a summary of everything that has come before, and moves quite swiftly, as with the intention of finishing matters outstanding; and it certainly ends abruptly. Though such a conclusion is undoubtedly speculative, one gains the impression, at least, of a long-delayed attempt to complete an unfinished work. More concretely, Book VI refers to The Therapeutic Method in a quite different way from that already observed in Books I–V – namely, it refers to it straightforwardly as a work already completed. 129 Moreover, he refers to his works on both simple and compound drugs. 129

See e.g. San. Tu. VI.11, 191,28–29 Ko. (VI.437 K.): ‘a complete account … has … been given in my treatise on The Therapeutic Method’.

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Now, there are two further historical complications here: one is that Simple Drugs too was composed in two phases, a wide interval apart; the other that the books on compounds, although undoubtedly belonging to a much later period than the early 180s in their final form, had a first draft in the form of the first two books of The Composition of Drugs According to Place, which was composed before 192, then lost in the fire, and later rewritten. If, then, one takes these references to be – even if not added later – referring to the first books of Simple Drugs, and to the first draft of The Composition, respectively, they do not then constitute evidence for a late date for Book VI of Health. The fact remains that the phraseology of the references to both the therapeutic and the pharmacological work is radically different in Books I–V and in Book VI. We contrast with the above reference from Book VI such remarks as ‘it is not necessary … to have been trained in the pragmateia of the simple drugs nor in that of the compound ones’ (IV.5, 119,2 Ko., VI.269 K.), or the suggestion that specifications to do with venesection ‘belong more properly to the pragmateia [again, study or treatise] of healing’ (IV.10, 132,31–32 Ko., VI.300 K.). Neither is a clear or unambiguous reference to actual texts having been already written, any more than is the reference that we already noted, also from chapter 5 of Book IV. And there are no unambiguously backward references to the Simples or Compounds in Books I–V, either. I turn to the relevant evidence from the two works on foodstuffs, mentioned above. As again already noted by Ilberg, references in The Capacities of Foodstuffs to Health are only to discussions that occur within the first five books of the latter; and conversely Book VI of Health contains references to the former work.130 On this basis, it seems not unreasonable, even given the caveats about the possibility of individual references being added later, to conclude that the composition of those two works intervened between that of Books I–V and Book VI of Health. This, then, is evidence for the relative dating of The Capacities of Foodstuffs and Good and Bad Fluid in relation to Health – for their having been written between its two main phases. Is there any evidence, ­independent of Health, for an absolute date for the former works? In fact, as far as I can see the only such evidence internal to these former 130

Ilberg (1896): 187. At Alim. Fac. III.39, 382,23 H. (VI.744 K.) there is a mention of the treatise which seems to refer to San. Tu. IV.6, 121,26–34 Ko. (VI.275–276 K.) and V.5, 144,13–30 Ko. (VI.334–335 K.). The converse references are at San. Tu. VI.3, 173,6 Ko. (VI.392 K.) and VI.11, 191,12–13 Ko. (VI.435 K.). (There is also a reference at Bon. Mal. Suc. 2, 394,19–20 H. (VI.759 K.) to Alim. Fac.)

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texts – such as it is – points to a late date. The references to other works within these two treatises perhaps prove little. Apart from those mentioned to Health and to The Therapeutic Method (which given the two phases of this work would be inconclusive, although see further below on the apparent ‘pairing’ of these two works), there is one reference also to Readily Procured Remedies, and two to the Commentary on Hippocrates’ Regimen in Acute Diseases, which are of little value on their own.131 Of course, even if these references were to works written in the 170s – or even if they were disregarded altogether – this would not tell us that the treatises on foods should themselves be dated close to the 170s, merely that that would be a possibility. A further indication might be taken from Galen’s claim in The Capacities of Foodstuffs to have kept himself healthy ‘for many years’ after the age of twenty-eight – a claim which (as we shall argue in relation to a similar passage in Health) is more plausibly read as having been written at a later stage than his late forties or early fifties. Either on this basis or on that of the apparent references in the texts to later works, scholars committed on other grounds to a date of 182 or before for the two foodstuff works felt compelled to posit a Severan revision of works written much earlier. But once such a commitment is abandoned, we seem to be left, on the principle of Ockham’s Razor (albeit still on the tentative grounds of this mention of ‘many years’, in conjunction with some possible support from the cross-references) with a preferred Severan date for their composition as a whole.132 131

Alim. Fac. II.46, 314,10 H. (VI.634 K.); Alim. Fac. III.39, 382,20 H. (VI.743 K.); Bon. Mal. Suc. 7, 413,10 H. (VI.790 K.). Neither work is unproblematic in its dating. The former is of disputed authorship, although it should be said that if it is Galenic, it would seem to belong within the later phase of his pharmacological project. The dating of the Hippocratic commentaries is problematic; and it is much easier to give reasonably solid accounts of their order of composition than of their absolute dates. On this whole area see Manetti and Roselli (1994); Bardong (1942: 618–26); and Singer (2019b). More work is needed here, but it seems to me that Bardong’s absolute dates for the commentaries, most of which he places in the 170s, are in general too early. (This is demonstrably true of the Commentary on Hippocrates’ Epidemics VI, which on the basis of the extant Arabic portions, not known to Bardong, must now be dated after the fire at Rome in 192 CE. It is also a relevant consideration here that Galen is now generally thought to have lived beyond the date of 199, possibly until 210 or even 216, and if that is the case many of the ‘later’ works – plausibly including several of the commentaries – should plausibly be shifted later in time, at least to the reign of Severus, and possibly later.) 132 See Bardong (1942: 627–628), arguing against (while also apparently partially accepting) Siegfried Vogt’s argument for such a later revision on the basis of the cross-references. Bardong, without clearly addressing the arguments for a late revision, counter-claims that there is one passage in Good and Bad Fluid which cannot be either early or late, because it is tied to a moment precisely 25 years later than the completion of Galen’s 28th year (157 CE). This would give us the date 182 CE. But this (even if one is disposed to take such mentions of time spans in ancient autobiographical writing completely at face value, and as completely reliable) relies on a simple misreading of the passage in question, Bon. Mal. Suc. 1, 393,21–28 H. (VI.757 K.). Galen there

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I turn to what I take to be the most solid evidence (again, on the grounds of cross-references) against a date for Health in the late 180s or the 190s – evidence which will turn out to be in fact not very solid at all. This is the apparent closeness in time between Health (at least its earlier books) and the works Withering and Fulness, which are in turn referred to in The Distinct Types of Fever, a treatise which seems definitely to have been composed before 176. There are two legs to this argument, and a major uncertainty regarding each. First, while it is true that The Distinct Types of Fever mentions Withering, it is also true that Withering mentions The Distinct Types of Fever. Naturally Bardong, who was committed to a Marcan date for the first five books of Health, took the two mentions of The Distinct Types of Fever in Withering to be later additions, and the one in the other direction to be original. But it is equally easy to argue the opposite case – and then nothing would tie Withering and Fulness to a date near, let alone before, 176. Secondly, even if the reference in The Distinct Types of Fever is original, and the ones in Withering later additions, the closeness in date between Books I–V of Health and the two works Withering and Fulness is uncertain, too. Again, there are crossreferences in both directions – a fact which led Bardong to talk of an ‘intertwined’ relationship, with the works being written simultaneously. Book V of Health has a reference to Withering; but there is also a reference in the opposite direction; and the same reciprocal relationship exists between Health and Fulness.133 Bardong’s hypothesis is not implausible; states that he himself stayed healthy ‘for many years’ after the age of 28 through attention to his lifestyle, and that he was able to have a similar beneficial effect on ‘those of [his] friends whom [he] persuaded … some for 25 years, some for less’. There is nothing that ties that particular figure of 25 years, rather than the vaguer ‘many’, to Galen himself, nor anything to suggest that – in the case of those friends – the 25 are being counted from that same date of 157. (Indeed, the phrase ‘some for less’ arguably implies the opposite, namely that he is referring to a number of different friends that he persuaded to healthy lifestyles at different dates.) So on these grounds, too, the need to posit a date before 182 for the first five books of Health disappears on closer inspection. One may here also dismiss two equally flimsy arguments by Bardong for the placing of Health in and immediately after the Marcan period: one, that all major works of Galen should be placed before the commentaries ‘wherever possible’, on the grounds that he says he dealt with all the major branches of medicine before writing line-by-line commentaries; two, the lack of explicit cross-references to Hippocratic commentaries in Health. The latter consideration seems to have no real value for dating: there are, for example, no cross-references to the commentaries in (to take just one example) the later books of The Therapeutic Method either; and the former is clearly far too vague and too schematic to be taken seriously (even apart from the reservations about Bardong’s early dating of most of the commentaries, already mentioned). Indeed, some very major medical works – including Affected Places and the later books of The Therapeutic Method – are clearly to be attributed to the Severan period. 133 The references are: to Marc. at San. Tu. V.9, 154,22.27 Ko. (VI.357 K.); to San. Tu. book I at Marc. 3 (VII.676 K.); to Plen. at San. Tu. IV.1, 105,18 Ko. (VI.238 K.); to San. Tu. book IV at Plen. 8 (VII.552 K.).

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but of course it is equally possible to argue – as one is forced to in other cases of such inconsistent sets of cross-references – that one group of them has been added later. It might, indeed, plausibly though tentatively, be suggested that the closeness in date between Withering, Fulness and Health is a reasonably likely proposition, but that meanwhile the reference to Withering in The Distinct Types of Fever was added later. Moreover, a fairly convincing case could be made that the reference to Health in Fulness was added later: it is in a sentence which essentially consists of a whole list of other works which discuss the topic in question, and such a sentence could plausibly enough be argued to have been added later as a bibliographical note. In that case, if the reference to Health in Withering is also a later addition, nothing at all ties Health to the period of writing of those works, and the reference to them in The Distinct Types of Fever becomes simply irrelevant. Arguments may be mounted on both sides: the fundamental point here is that we have a set of data which are mutually contradictory, and can only be made to prove a case through a process of selection – a process wherein the choice inevitably risks being guided by what one already wishes to prove. The evidence in relation to Withering, Fulness and The Distinct Types of Fever, then, can prove nothing conclusively. Let us turn to references to the treatise Health in other works. If we put aside the isolated references from works just discussed in the previous paragraph, and those in the dietary works mentioned a little earlier, such references seem to come overwhelmingly from works which on other grounds are believed to have been composed in the latest phase of Galen’s career, that of the reign of Septimius Severus, or indeed beyond that. These are references in the later books of The Therapeutic Method, in Affected Places, in a number of the later Hippocratic commentaries, in The Art of Medicine,134 and in Venesection, Against Erasistratus. And, unlike the few isolated references that we have been considering so far, the references in a number of these works are recurrent.135 Particularly interesting are those in the latter books of The Therapeutic Method; there 134

There is a reference to the The Art of Medicine at San. Tu. V.11, 164,13 Ko. (VI.372 K.), which of course Bardong claimed must be a later addition. We are again in the realm of inconsistent sets; but it would be possible at least to entertain the notion that Health and The Art of Medicine were (in the way that Bardong imagined for Health and Fulness and Withering) actually ‘intertwined’ in their composition. 135 There are, for example, several references in both the Commentary on Hippocrates’ Nature of the Human Being and the Commentary on Hippocrates’ Epidemics VI; and three in The Art of Medicine. The other Hippocratic commentaries where there are references to the work are those on the Aphorisms and on In the Surgery.

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are none in the earlier books, thought to have been written in the 170s, whereas the references in the later books, of the Severan period, are frequent, one might almost say insistent. They indicate, it seems to me, not just that Health had been written previously, but that it was fresh in his mind at the time of writing – even that, as suggested earlier, the two projects were in some sense running concurrently in their conception and composition, albeit with the official completion of Health taking place before that of books VII–XIV of The Therapeutic Method. Of course, even if it is established, as I take it to be, that at least the overwhelming body of reliably acceptable references to Health elsewhere in Galen appear in works that he wrote in the Severan period, that is not conclusive evidence for a date either in that period or just before it. The absence of reference to a work over a period, even of many years, is an argumentum ex silentio. Still, the preponderance of references in very late works, in conjunction with the almost total lack of them in earlier works (or works we reliably know to be earlier) – and in particular in conjunction with the special position that such references apparently have in the later books of The Therapeutic Method – seems to me suggestive. We turn to another inconclusive criterion mentioned above, that of appearance or non-appearance in one or both of the ‘autobibliographical’ writings. As already suggested, any conclusion drawn from such considerations must be highly tentative. Its non-inclusion in My Own Books provides some evidence, at least, for a late date. Certainly, if it belonged either within the main body of his works which he attributes to the years 169–176, or, more generally, to those works which were written then or shortly after then and which constitute the main ‘curriculum’ of works on the human body and medical matters, then its ­omission from the listing of those in chapters 5–8 seems odd, or at best unexplained: the obvious place for its inclusion would have been in chapter 5. A further consideration – again, a tentative and speculative one, though to my mind fairly plausible – is that the one mention of the work that we do have within these texts, in The Order of My Own Books, looks rather as if it may itself be a later insertion. (On this mention, see above, section 3.3.) It is, finally, worth considering whether there may be some internal evidence that the text was written comparatively late in life. The focus on old age in general, and the attention paid to particular instances of old persons and their lifestyle, already considered above, are striking. Of course, it would be highly speculative to draw any strong inference from this as to the age of the author at the time of writing; but this feature of

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the work may at least be thought suggestive, in conjunction with the other considerations mentioned. There are, moreover, a couple of slightly stronger considerations in this regard. One, already touched on above, arises from Galen’s remark, in Book V, that he has remained largely free of illness ‘for very many years now’ (ἐτῶν ἤδη παμπόλλων), after being something of an invalid until the age of twenty-eight. Without giving excessive weight to the consideration, one might certainly think that such an argument – and indeed this specific word, παμπόλλων – would be more likely to have been employed by Galen in his late sixties or his seventies than in the 170s or even 180 CE, when he was approaching the age of fifty. One may, finally, consider a passage in which Galen gives a reflection on his previous professional life and responsibilities, which gives the appearance, at least, of a retrospective summary after retirement.136 To summarize, then: in an area inevitably fraught with inadequate evidence and tentative theorizing, it seems to me that the best such evidence and theorizing available to us point to a final date of completion of Health in the early to mid 190s, albeit with considerable doubt – even if this hypothesis is accepted – about the length of time over which it was composed, and also about the length of time separating Books I–V from Book VI. It may reasonably be asked: what, if anything, hangs on all this? The dates of composition of Galen’s works are fluid and extremely difficult to pin down, as has become abundantly clear; it could also be argued that they are not very important. It seems clear that not just the main lines, but nearly all the detail and substance of his philosophical, theoretical and clinical views were (with a few exceptions, which he occasionally mentions) solidified before the writing of the vast body of his works, the great majority of which after all were written after the age of forty. I suggest that two things of some value may emerge from these considerations. First, I take it that in the above I have provided greater precision than is available in previous scholarship, both as regards the methodology that may sensibly be used in the dating of Galenic works (and the problems attendant on it), and as regards some of the specific results that arise when one follows such a methodology; and that the above discussion may therefore be of use for further such investigations in the future.

136

The former remark is at San. Tu. V.1, 136,25–27 Ko. (VI.309 K.); the retrospective reflection at San. Tu. VI.7, 181,16–26 Ko. (VI.412 K.); on the latter see San. Tu. VI, n. 40.

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Secondly – in relation to some of those specific results – there seems to be something distinctive about the approach of Galen’s late-life works; something of value and interest in the perception of the doctor in his later years engaging in projects and enquiries more focussed on, and derived from, considerations of empirical and practical detail. We are undoubtedly, here, in the realm of generalizations, of broad overall shifts, rather than of distinct differences that demarcate one set of works from another. But it is possible to argue that works of this later phase are more open-ended and discursive than earlier works, more concerned with a wealth of everyday or empirical detail, even, more leisurely and less polemical in their outlook.137 (Although of course both of these are fluid categories: there was no point, even in his earlier writings, when Galen was not prone to digressions, nor is he ever without polemical targets, in the later ones.) But such is, in broad terms – and in somewhat different ways – a good characterization of a number of works known, or confidently believed, to belong to the period after 193: Affected Places; the latter books of Simple Drugs; the vast preponderance of the two works on The Composition of Drugs; the Commentary on Hippocrates’ Epidemics, Book VI. It also, of course, fits well with the works on food which I have above argued to belong to a similar period. And it is a good characterization of Health, too. The particular notion of Health as written alongside, or in close conceptual proximity to, the later books of The Therapeutic Method, suggested above, is something which might also be taken to fit with this picture. That specific theory – like, indeed, most of the above arguments in relation to date – will doubtless be ultimately unprovable, but may be worth considering as a working hypothesis for future study of both these works. 8.3 Health: structure and plan As already suggested, the gap between the plan stated at the outset of Health and the structure and content of the book as it develops is in some respects quite striking. There are, in fact, a number of subtly shifting accounts throughout the text, both of the intended future context, and of what Galen takes himself to have covered already; and all 137

The specific point about his comparative gentleness towards Theon, and towards the persona of the gumnastēs itself, here as opposed to in Thrasybulus, has already been made – though of course this can be understood as arising primarily from the works’ different genres or intellectual purposes, rather than simply from date.

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seem to stand in some tension with the content as it actually unfolds. Let us consider this in more detail. Early in Book I, an overall plan is outlined. The treatise will start with the health prescriptions for a person who is both born with the best kind of constitution and enjoys the leisure to follow the correct daily regime. This case is considered as a kind of benchmark or standard against which all others are assessed – the ‘A1’ case, as it were, optimal in both natural endowments and lifestyle opportunities. It will then proceed, successively, to consider the range of suboptimal natural constitutions, and the range of departures from the optimal daily regime. Here it is at least strongly implied both that this will be the overall organizing principle of the treatise, and that these different kinds of case will receive roughly equal treatment, each perhaps being the subject of a subsequent book.138 And this overall aim for the structure of the treatise is echoed several times later in the work too. In Book II, Galen is still avowedly dealing with the person of best constitution and the best possible life circumstances; its preamble mentioning also that whereas the first book dealt with ‘the chief points and the aims of the art’, we are turning now to individual detail; and that the second book will proceed from where the previous one left off, by proceeding to the third seven-year period, from the age of fourteen – thus explicitly introducing a secondary principle of organization of the text, which seems to have emerged in the course of the discussion, that of age.139 This secondary principle is reiterated retrospectively at the beginning of Book III: while both operating on the assumption of optimal constitution and lifestyle, Book I went from age zero to age fourteen, Book II from age fourteen to manhood. It is, however, admitted, in this same passage – in what seems already perhaps like a concession that the original plan has not exactly been followed – that the discussion was lengthened by a broader discussion, which covered the essentials of different kinds of massage and exercise, distinguishing them by type (eidos).140 138

See San. Tu. I.11, 28,8–11 Ko. (VI.59 K.): ‘My present purpose was to give an account of the best constitution of the body, in the best daily regime, as a kind of aim and standard. We shall distinguish in the books that follow this all those bodily constitutions which have an error in some respect, and the varieties of daily regime.’ Cf. the similar statements regarding the order, and the present subject matter, at I.6, 15,1–4 Ko. (VI.29 K.) and I.12, 29,8–23 Ko. (VI.61–63 K.). 139 San. Tu. II.1, 38,1–7 Ko. (VI.81 K.); the assertion that we are still on the subject of the optimal case is repeated at II.12, 69,12–13 Ko. (VI.156 K.). 140 San. Tu. III.1, 73,11–24 Ko. (VI.165–166 K.).

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And indeed this is the case. First massage, and then exercise, were the main subjects of Book II; and here no one particular age appears as a consistent guiding principle in the discussion – nor, indeed, does the assumption of optimal constitution and life circumstances. Then, the coda to Book II states as an aim for the next book that it will deal with ‘the number and identity of the departures from the natural state, and the way in which each of them should be discerned and treated’.141 But – as indeed stated in the continuation of that preamble to Book III – this book will in fact continue the discussion of the previous book, ‘proceed[ing] in the same way also with respect to all the other areas’142 – that is, it will give detail of further forms of exercise and massage, especially the ‘restorative’ form, before then going on to bathing, and – treated at particular length – varieties of fatigue or pain arising from exercise, and ways of treating these. Certainly, this last topic can be regarded as falling under the heading of ‘departures from the natural state’;143 but, as Galen also says several times towards the end of this book, he is deferring until later a discussion of ‘morbid symptoms’.144 Such a discussion is, indeed, the aim stated at the outset of Book IV, which begins also with a methodological discussion of where this topic should be situated more generally (on the category of the ‘neither’, see above, section 4.2). It is further stated in chapter 4 that the present topic is a young man of good constitution who has neglected some point of exercise or diet – that is, that we have now moved from the ‘A1’ case to that of optimal constitution in conjunction with suboptimal lifestyle.145 In reality, what follows in Book IV is to a considerable extent a continuation of the discussion of varieties of fatigue in the previous book, with further consideration of the use of certain oils for massage, and certain preparations to be taken orally (and even a brief discussion of venesection). There is, here, a focus on the build-up of unwanted, especially ‘raw’, fluids and the manner in which these should be evacuated. Certainly, Galen makes a close connection between these phenomena and faults in exercise or diet; and to that extent, the subject matter of the 141

San. Tu. II.12, 72,13–15 Ko. (VI.163 K.); the phrase ho ephexēs logos here could admittedly be taken more generally, to mean ‘the subsequent discussion’, but in context the expectation that this will be the subject matter of the next book certainly seems to be raised. 142 San. Tu. III.1, 74,4–11 Ko. (VI.166–167 K.). 143 And in San. Tu. III.5, 83,36–84,5 Ko. (VI.189 K.) the discussion is presented as being that of the rectification of errors that arise, on the grounds that even in the ‘A1’ case it is impossible that no error is ever made. 144 San. Tu. III.11, 97,29–30 Ko. (VI.221 K.); III.12, 100,13–14 Ko. (VI.227 K.); it is finally clarified that this discussion should follow in the next book: III.13, 102,21–22 Ko. (VI.232 K.). 145 San. Tu. IV.1, 103,7–18 Ko. (VI.233–234 K.); IV.4, 108,16–22 Ko. (VI.245–246 K.).

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book may be understood as that suboptimal lifestyle. But again, the discussion seems to address all the topics under discussion – varieties of fatigue, fluids and their evacuation, the use of various preparations to correct imbalance – in general, and on a broader basis than a focus on faults in diet or exercise would imply. (And one may note, too, that Book II included a detailed account of the evacuation of fluids.) We may also observe that there are plenty of remarks about suboptimal natural constitutions at various points throughout the work, even in the first books, and before this becomes the ‘official’ subject in Book V – which Galen begins with the claim, again, to have focussed thus far on the best natural constitution, and to have considered it, so far, up to the prime of life. What Galen will do in this book, he asserts, is (after summarizing what has gone before) move on to faulty natural constitutions, and then proceed to discuss old age.146 We thus see again something of a tension between the original stated aim and the subsidiary, a­ge-based, one. In the event, having mentioned the broader topic of faulty natures, at V.2, Galen proceeds straight to old age, which remains the focus for the remainder of the book. We turn, then, to Book VI. As already discussed above, it is probable that there was some lapse in time between the first five books and this one, and there seems to be some difference in approach, perhaps even some sense of haste in the manner of its composition, indicating an urgency finally to complete a project which has been a long time in the making. In fact, Book VI begins with a further inconsistency in, or retrospective revision of, the overall plan (VI.1). Now it is stated that all five previous books had as their topic the optimal case, and its preservation in its current state, and that it is only now that we will move, first to departures from daily regime in the best constitution, secondly to suboptimal constitutions. This preamble, then, tends to reinforce the impression that I have outlined above, namely that Galen has not in that previous discussion anywhere clearly focussed on the topic of suboptimal lifestyles. There is, perhaps, also something apologetic about the self-presentation here. Galen admits that the remaining subject matter – which should in principle include both all the suboptimal constitutions and all the constraints on lifestyle – is a much larger one than that so far treated. Nevertheless, he says, it makes sense for the following treatment of this larger subject area to be more concise, since the ‘capacities of most of the materials’ of 146

San. Tu. V.2, 138,6–15 Ko. (VI.312–313 K.).

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health interventions have already been communicated to the reader, who will be able to apply these by extension to the remaining cases.147 But the remaining, revised plan seems not to be very clearly followed, even within Book VI. While Galen reiterates the claim – after some theoretical distinctions regarding types of bad-mixture in chapters 2 and 3 – that he will proceed now to consider, first, the constrained life and then faults in natural mixture, that order is not followed up on in a very clear sense. Rather, after some remarks which are certainly relevant to the possible constraints on a perfect lifestyle – including the fascinating account of the ramifications of daily attendance on the emperor Marcus Aurelius, in chapter 5148 – the remaining chapters discuss various forms of bad-mixture, first those which are ‘even’ (i.e. obtain throughout the body), then those which are ‘uneven’ (i.e. affect some particular part differentially). Galen also states, at the end of chapter 8, that he is proceeding by adding examples to his account of the common and general features, in order to make his instruction complete – which, again, could be taken to be a different principle of organization from those mentioned previously.149 The final chapter, then, with its tacked-on description of a particular preparation of quinces – by Galen’s own admission appended here in response to the complaint by one of his followers that he had promised at a previous point in the text to include it, but had not kept the promise150 – certainly completes the impression of a final book completed somewhat in haste, and of the somewhat haphazard and ad hoc nature of the composition of the work as a whole. Digressions and departures from an original or stated plan are by no means uncommon in Galen’s work; indeed, they could be said to be intrinsic features of it. The text of Health, nevertheless, seems to constitute something of an extreme case, both in its departures from a stated programme (or programmes) and in the level of its digressions into a number of detailed areas – exercise, fatigue, fluids, massage, wine, old age, particular drug preparations, to name but some. It must remain, ultimately, a matter of speculation, to what extent these features arise from the position of the treatise outside the main curriculum of his paedagogic works, from its composition over a period of years, and perhaps at a fairly late date, or simply from the nature of the subject matter and 147

San. Tu. VI.1, 168,26–169,4 Ko. (VI.383 K.). San. Tu. VI.5, 178,29–35 Ko. (VI.406 K.). 149 San. Tu. VI.8, 184,14–18 Ko. (VI.419 K.). 150 San. Tu. VI.15, 197,18–24 Ko. (VI.450 K.). 148

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Galen’s approach to it – a subject matter and approach which oblige him to include a wide variety of information gathered from a wide range of contexts and many years of clinical experience. The argumentative structure of the work may, however, I think, fairly be characterized as a frustrating one to attempt to follow, fascinating though the text is from other points of view – in its wealth of detailed information and the content of its individual arguments. 8.4 Thrasybulus: structure and design of the text Thrasybulus presents itself as the written account or transcript of an enquiry into and solution of a problēma, that is a set question on a particular topic for intellectual enquiry, previously given orally in a public context. The treatise thus provides important evidence – as already mentioned above – for the conduct of such public debates. It also in itself represents an exemplification of such a problēma enquiry, and of Galen’s dialectics in practice. In this sense, it is a virtuosic display, marshalling a series of arguments, which rely on Aristotelian-based terminology and techniques of analysis, to defeat the opposing view that the art in charge of hugieinon is gumnastikē. Central to the structure of this argument is the fundamental proposition – which we noted in a different context above – of the oneness of the good of the body, and the concomitant oneness of the relevant art. Alternative views, positing more than one art, are refuted by reductio – on any other principle of organization, we find that we would end up with an absurd number of separate arts. On a true analysis, by contrast, it is found that gumnastikē, so far from being the art in charge of healthfulness, constitutes no more than a small part of the relevant expertise. At one level, Galen is here showing off his skill in the art of division, while also establishing dialectical credentials that his philosophically uneducated rivals, the physical trainers, could never aspire to. (Further on Galen’s procedure of subdivision of the medical art, and on the solutions it arrives at, see Appendix.) 8.5 Aristotelian and Platonic background in the composition of  Thrasybulus Relevant to the structure and progression of the argument is also the role of both Platonic and Aristotelian background in the text.

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In a sense its engagement with Plato is stronger, and certainly easier to trace, than that with Aristotle: Galen makes explicit references to, and indeed verbatim quotations from, the former, and the influence of specific texts and their arguments is very clear. However, the Aristotelian background informs the work in profound ways. In a sense, the project and manner of proceeding in the work can be read as Aristotelian. Galen identifies a problēma for solution – something which can be understood in broad terms as a ‘question set’ for discussion, but which also has a distinct Aristotelian heritage, whereby it refers specifically to what can and cannot be correctly predicated of an object, or to the precise terms of a proposition to be subjected to enquiry. Then, his technique of argument towards the solution of this problem employs a fundamentally Aristotelian logical terminology and approach. Both these points have been made, and the question of the precise nature of the engagement with and response to Aristotelian modes of argument further explored, in a recent study by Matyáš Havrda.151 On his view, the text can fruitfully be taken as an exemplification of techniques of argument presented in theoretical form in Aristotle’s Organon. Central to Galen’s approach, as the argument develops, is a process of logical division aimed at situating the terms under discussion – healthfulness, medicine, physical training – in the correct relationship to each other. And central to that enterprise is an analysis – again, Aristotelian in its influence – in terms of the aim or telos of the items in question, as well as related discussion which seeks to give appropriate analysis in terms of causes and in terms of the relationship (again in Aristotelian language) between the ends (telē), activities (energeiai) and states (katastaseis, diatheseis). I turn to the role of the Platonic background, and the use of Platonic concepts and explicit textual citations, which also have a considerable structural importance to the overall argument. We considered above in broad terms the way in which the text draws upon and responds to both Hippocratic and Platonic authority: Galen is exercised to have both of these palaioi on his side, even though what they say – or do not say – about gumnastikē seems, on the surface at least, to conflict with his own view of it. The way in which Galen argues from these authorities – including the climactic way in which he builds to quotation of the texts which seem most important, or which he most wants on his side – can be 151

For Galen’s use of problēma to refer to a topic for public debate, see Thras. 2, 33,16 H. (V.807 K.), with Thras., n. 2; and cf. n. 37 above with texts cited there. For the connection with the more technical Aristotelian sense see Havrda (2022); also (forthcoming).

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paralleled from other similar ‘display’ pieces, most notably The Capacities of the Soul Depend on the Mixtures of the Body.152 In his attribution to Plato of his own view that ‘healthfulness’ falls within the domain of medicine, Galen focusses on the Gorgias in particular. The focus seems a significant one. Galen gets more from this text than just the specific propositions (as he interprets them) about the nature of healthfulness and its relationship to medicine. Essential to Galen’s rhetoric in this work is the contrast between true arts (technai), represented by medicine, and bad or perverted arts (kakotechniai), of which athletically oriented physical training is a prime example. This dichotomy is inextricably linked with the notion of a true art as that which aims at the good for the object with which it is concerned, and the perverted art as being a form of ‘flattery’ (kolakeia), which aims rather at pleasure. Examples Galen gives of this kind of flattery, aimed at pleasure rather than the good, are cookery and cosmetics. Now, Plato does not in the Gorgias use the actual term ‘perverted art’; nor does Galen quote those passages where he uses the term ‘flattery’. However, the latter term does occur frequently in the Gorgias, where it is specifically linked with this exact notion of the false art which aims at pleasure rather than the good. Indeed, kolakeia not only appears significantly in the Gorgias; it does so overwhelmingly more than it does anywhere else, thirteen times as against six in the rest of the Platonic corpus put together. Mention of this term cannot but throw the reader of the Thrasybulus who has any Platonic background straight into the world of that text. There, its chief application is to rhetoric, understood as flattering the soul and aiming at its pleasure, by contrast with the true art, philosophy, which aims at its good. However, Plato also uses it in relation to the discussion of the body and its relevant art, and at that point uses those very same examples of cookery and of cosmetics. So, Galen’s use of Plato functions to some extent subliminally, and without explicitly quoting the passages which his argument is echoing and on which it partially relies. He seems in a way to rely on prior knowledge of, and adherence to, the Platonic text and its commitments, on the part of his readers. By speaking of false arts, of flattery and its aim of pleasure, and of the examples of cookery and cosmetics, Galen is summoning up the dichotomy between true arts and false arts that runs through the Gorgias, and – for those readers who can recall that text, at 152

For discussion of Galen’s argumentative strategy in The Capacities of the Soul Depend on the Mixtures of the Body, and in particular its relationship with the authorities that he draws upon, see Lloyd (1988); Singer (2013): 335–369.

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least in part – directing their minds to all the arguments there that reinforce that dichotomy, and above all to the attack on the sophists as purveyors of a false and deceitful, though seductive, version of wisdom. In the process he is also associating his opponents, the physical trainers, with those sophists and their erroneous reasoning, and himself with the figure of Socrates and the pursuit of the one true good. We may summarize the role of the Platonic background, and Galen’s exploitation of it, in terms of the central propositions that are most important to him, under the following heads: (1) the singleness of the good for the body (health), which in turn entails that the art concerned with it is single; (2) the clear distinction between true arts, which aim at such a good, and perverted ones (like cooking or cosmetics) which aim at pleasure; (3) the high epistemological requirements for the pursuit of arts in general, medicine in particular; (4) the priority of soul over body.153  Here as in other texts, Galen presents himself as, while no sectarian, an enthusiastic admirer of Plato, and in a sense one who follows in his footsteps, both ethically and epistemologically.154 In this sense, it seems that Galen adopts the Platonic rhetoric of knowledge and a Platonic self-presentation, with certain moralistic connotations. Finally in this summary of Galen’s use of and response to Plato in this text, let us devote a little time to consideration of the way in which he draws upon another dialogue, the Republic. Galen quotes two very short passages from Book III of the Republic, which are critical of a certain kind of athletic excess or misguided approach to bodily health or training. These are embedded in a substantial and important Platonic discussion of the appropriate training of the young, as well as of medicine more generally; and the way in which Galen selects his texts and uses them – in his interpretation of Plato and for his broader argument – is worthy of attention. 153

This notion seems strongly implied, not least by the text’s very invocation of both Gorgias, with its soul–body parallelism, and Republic. It is worth noting here that the statement at Rep. 403c–d – which appears in the text very close to the passage he actually quotes in Thrasybulus – to the effect that a good soul is the agent of improvement of the body, both reinforces this conception of the superior role of the soul within the soul–body complex and could be taken to be of a piece with the quotation from Health given at the end of section 6.3 above: a healthy soul will conduce to physical health, and is to that extent the concern of the doctor. 154 Galen’s self-alignment with, or appeal to the authority of, Plato has cultural and moralistic connotations which go beyond the question of the agreement between the two on any particular question of doctrine; on this aspect of Galen’s Platonism see Singer (1991).

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As we have seen, Galen asserts that Plato shared his view on ‘healthfulness’ and its role, but simply referred to it, by synecdoche, as ‘physical training’ (gumnastikē). At one level, this seems to be a valid interpretation: Plato does sometimes use the term gumnastikē to refer to a range of dietetic practices, not just those aimed at athletes or performed in the gymnasium, and seems to speak of this art as having a broad scope, with a parallel function to that of medicine. True, too, that Plato seems contemptuous of athletes and the version of physical training that they represent (403e–404a). It is also true, however, that the main context of Plato’s discussion of gumnastikē is the early training of boys and young men, with a specifically militaristic purpose (Republic 403c–d; 404a–b). Moreover, as the argument proceeds, we find that what is especially horrifying to Plato (or to Socrates in Plato’s characterization) is precisely the notion that citizens should need the supervision of a doctor in everyday life (405a– b); that they should need medicine ‘not because of wounds or some temporary illnesses, but because of the kind of idle daily regime at which we have arrived’ (405c–d); or that the ‘sons of Asclepius’ should be forced to find names for diseases which arise from this lifestyle. All this is the ultimate sign that early training and education have gone to the dogs (405a–b). Of course, Galen also appeals to a nostalgic view of the progression, or decline, in human affairs, whereby we stand in an inferior position to ‘the ancients’, and certain medical interventions were not discussed because they were not yet needed in the state of health that existed then. In Plato’s version of this nostalgic picture, however, as outlined in Book III of the Republic, it is the very inclusion within medicine of gumnastikē (including, as Galen suggests, what is later understood as ‘healthfulness’) that is a crucial part of the decline. The ‘combining’ of gumnastikē with medicine, attributed to Herodicus, is seen as a negative development, leading to long-drawn-out deaths and the prolongation of unhealthy and useless lives. This form of medicine, whereby unhealthy people are kept alive and there is a constant need for the doctor, is taken to be a perversion of true medicine – something that Asclepius would have had nothing to do with. And related to this is the need for everyone to fulfil a useful function in society: ‘there is no leisure for anyone to be a patient throughout his life’ (406c). The practitioners of crafts should surely prefer to die if they cannot carry on with their usual lifestyle (406e) – a perception that Socrates would like to extend to the rich, too, in cases where they

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become perpetual patients, even though the rich are not dependent on a profession. Indeed, at 409e–410a Socrates goes further, affirming that naturally unhealthy bodies should be left to die, medicine only concerning itself with the naturally good and healthy. It is this discussion which provides the context immediately preceding 407b, the passage quoted by Galen in chapter 36 (82 H.); the criticism of the ‘superfluous care of the body’ there follows straight on from the criticism of the inclusion of gumnastikē or lifelong health provisions within medicine altogether. It would be possible for Galen to argue that in this passage Socrates goes beyond that general point, and is focussing on the exaggerated gymnastic practices associated with physical trainers in particular; but certainly the broader context of Plato’s remarks, both before and after the passage selected for quotation – remarks which are tendentially highly hostile to the kind of lifelong and leisured pursuit of health advocated in Health – has been passed over. True, Galen acknowledges that Plato ‘did not see a need for daily regime in general in the case of healthy persons, but only for physical training’ (Thras. 39, 87.11–13 H., V.881 K.); but in spite of that acknowledgement he is very far from doing justice to the radical opposition to valetudinarianism within which it is embedded.

9 History and reception of the texts 9.1 The textual tradition of Thrasybulus and Health The Greek editions on which the translations in this volume are based are, for Thrasybulus, that of Georg Helmreich, in the Teubner Claudii Galeni Scripta Minora, volume III, in 1893, and, for Health, that of Konrad Koch, in volume V 4,2 of Corpus Medicorum Graecorum, in 1923 (also at that time published by Teubner). In each case I discuss individual difficulties in the manuscript readings (on the basis of these scholars’ collations and apparatus criticus) as they arise, and mention any departures from the text which they print, both in the notes and in a dedicated appendix. Helmreich relies for his text of Thrasybulus largely on the manuscript Laurentianus plut. LXXIV,3 (L), which he finds to be greatly superior to the others. Few significant points of difference arise, although there are some interesting questions, especially in relation to Galen’s quotations from Plato in the treatise, both as to the divergences between the text of Plato read by Galen and that of our modern editions, and as to the

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­ ossibility that his readings may in a few cases be superior. (These quesp tions are discussed where relevant passim.)155 The nature of the textual tradition of Health, both direct and indirect, is discussed by Konrad Koch in the preface to his edition.156 Without reproducing all the information given there, it will be worthwhile to give some summary of it, as well as some additional or complementary remarks. It should be mentioned at the outset that the manuscript tradition of the text is not highly problematic, and that there are few cases – in spite of what will be said in the following – where divergences between its different branches or different individual manuscripts involve matters of great moment, and still fewer where it is difficult to make sense of the text on the basis of the versions transmitted. However, the popularity of the work led to a large number of manuscripts being produced in mediaeval times, something which, as Koch points out, brought about some confusion and shortcomings in the manuscript tradition. On Koch’s analysis, there are two major branches of the Greek manuscript tradition, a and b, the former corresponding to the ‘older ­recension’, which, however, is only represented by one surviving Greek manuscript, itself in part severely damaged, the Marcianus 276 (M), thought by Koch to date to the twelfth century. This manuscript, then, is in general (and where not lacunose) Koch’s preferred source for the reconstruction of Galen’s text. The two other most important manuscripts, Reginensis 173 (R) and Marcianus 282 (V), both of the fifteenth century, belong to branch b. The first printed edition of the Greek text, the Aldine of 1525, was based on R; and before Koch all subsequent printed editions, up to and including that of Kühn in the nineteenth century, similarly relied on manuscripts of branch b. Apart from a large number of smaller errors which Koch detects as due to this reliance on the inferior branch, there is one which is particularly striking, namely the transposition of a substantial section of Book V of the work (appearing on pages 321–329 of Kühn’s edition, but properly belonging later in the book, and thus restored by Koch to their rightful place on pages 155–158 of his edition; see San. Tu. V, nn. 22 and 47). There are also some further, indirect, sources for branch a which supplement (or in some cases seem to confirm) the evidence of M. Chief amongst these is the translation by Niccolò da Reggio (N) in the 155 156

See various notes to chs. 35 and 36 of Thrasybulus. Koch (1923): VII–XXVI.

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f­ourteenth century, who seems to have had access to a number of manuscripts, including at least one of that branch. There are also some marginal notes made by the sixteenth-century French scholar Joseph Scaliger – who, Koch surmises, had access to a twin manuscript of M – in his copy of the Aldine edition (now preserved in the Herzog-August Bibliothek in Wolfenbüttel). Moreover, some sixteenth-century Latin printed editions add a considerable amount of editorial annotation to the translations they print, based on the researches of humanist scholars with access to further manuscripts; this is true in particular of the Venetian Juntine editions from 1541 to 1565, edited by Agostino Gadaldini, which, while using the translation of the humanist Thomas Linacre, itself based on a b-branch manuscript, include copious editorial annotations and suggested improvements, some of them based on manuscripts of the a branch. Meanwhile the earlier mediaeval Latin translator, Burgundio da Pisa, in the twelfth century, translated only the sixth book in its entirety; an excerpted version of the first five books which accompanies this translation in the manuscripts is probably not by him. (Niccolò, conversely, who consulted Burgundio’s work, translated the first five in their entirety and excerpted the sixth.) It seems that the translation and epitome attributed to Burgundio both rely on a manuscript of branch b. So much by way of précis of Koch’s summary. I add a few supplementary remarks, based on my own work on the text. (1) Koch’s reliance on M, and comparative scorn for V and R, are not always well founded. While the general policy of preferring M when the two branches differ may be sound, there are a number of cases where V and/or R give a better reading, and where Koch’s prior commitment to M leads him to make unjustified or perverse choices. Suspicion of Koch’s clear distinction between the two branches in terms of the greater antiquity represented by a is increased by the two facts that more recent scholars have cast doubt on the early date attributed by him to the manuscript itself, and that some – admittedly very brief – papyrus fragments of the treatise have been found which in particular instances transmit a reading agreeing with V and R and disagreeing with M.157 157

Cavallo (1980) and Mioni (1981) date it to the fourteenth century, not the twelfth; and while Wilson (1987) thinks it somewhat earlier than that, he does not commit himself to a precise date; it seems in any case that Koch’s assertion that M consists of two codices bound together, that of Health being much older than the other, is unfounded. In editing Papyrus Oxyrhynchus 5228, of the sixth century, in 2014, David Leith found several cases where the text of the papyrus, which

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(2) The situation regarding the editorial improvements or alternatives printed in the margins of the sixteenth-century Juntine editions of the Latin translation of Linacre, mentioned above, which are copious and include substantial information from another manuscript, or manuscripts, seems a complex one. The preface to the Juntine edition of 1565 mentions the use made by its editor, Agostino Gadaldini, of ‘veterum exemplarium graecorum’; and at other points there is marginal reference to one particular ‘vetustissimo optimoque exemplari’. The identity and range of sources used here would seem to be a matter for further investigation.158 (3) The marginal comments of Scaliger, which seem to consist of a mixture of his own emendations and readings from a different manuscript, and to which Koch pays considerable attention, seem seldom to be of great value in improving the text. (4) Potentially of greater significance than all the above in relation to future work on the text is the Arabic tradition: the work was translated into Arabic at least twice in the course of the ‘translation ­movement’ of the ninth century CE, and there are several extant manuscripts.159 This branch of the tradition – involving translations made from Greek manuscripts at a very early stage in the tradition – has not yet been taken into account by editors of the treatise; and I have not had the time or opportunity to consult Arabist colleagues interested in this material in the preparation of this volume either. Although councils of perfection might perhaps have pointed in that direction, such a may originally have been an abridged version of, or series of quotations from, Health, agrees with V and R against M (and only one clear case – that almost certainly due to the later introduction of error in the b branch – of the opposite phenomenon). Although the cases are all trivial, on the basis of this evidence alone the greater antiquity of branch b would seem to be supported as opposed to that of branch a. Examples of such agreement between the papyrus and VR are ἐστιν ἐν αὐτοῖϲ  (ἐν αὐτοῖς ἐστιν  M), V.3, 142,9 Ko. (VI.329 K.); κενωθῶσι(ν) (ἐκκενωθῶϲι M), V.9, 154,4 Ko. (VI.356 K.); κατὰ χειμῶνα (κατὰ τὸν χειμῶνα M), V.9, 154,6–7 Ko. (VI.356 K.). The papyrus is published in Hirt, Leith and Henry (2014), at 29–32. I am grateful to David Leith for sharing these observations which were made by him during research on the papyrus, but which did not appear in the final publication. 158 As suggested also by Fortuna (2012: 401), who discusses the history of the Latin editions of Galen’s works, and the role of Gadaldini in particular. (Further on the Latin translations see also n. 2 above.) Gadaldini described the nature of the intensive and collaborative scholarly input to the new editions in letters to the reader which appear in the editions of 1541–1542 and 1550, while the level of scholarly annotation based on this humanist research (much of it Gadaldini’s own) reached its peak in his final, 1565 edition (Fortuna 2012: 400–402 and 410–412). Koch (1923: XXI) suggested that the MS Gadaldini refers to as the ‘most ancient and excellent Greek manuscript’ is, in fact, M; and certainly most of the readings that he produces on this basis do not add anything to what we know from M. But it seems that there remain at least a few cases of suggested improvements which are not explicable on that basis. Cf. Book III, n. 47 and Book IV, n. 53. 159 See Sezgin (1967): 122.

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process would have involved a considerable further outlay of time on a project which had already been several years in the gestation. It will, however, be of interest to see what new findings may emerge, if and when those manuscripts are taken into account. 9.2 The title of  Health A little should be said about the title of the main work translated in this volume. As already mentioned, this appears in a number of slightly different forms in Galen’s own references to the work; moreover, the question of translation in the case of the most frequently occurring form is not entirely straightforward. It should be understood here that Galen’s manner of referring to his own works by title across the corpus is in general somewhat fluid: there is no felt need to fix on an absolutely firm and unchanging form to be used in all mentions of a given work.160 A simple solution, in English, would be to adopt the form of the title that appears in M, namely Galēnou technē hugieinē – ‘Galen’s healthful art’ or ‘Galen’s Art of Health’. The problem is that – whatever the reliability of this manuscript more generally – that form is attested nowhere else amongst Galen’s many mentions of the work, and must surely be taken to represent a later version of the title. The other manuscripts, meanwhile, give as the title a form of the word hugieina – either ‘first book of the hugieina’ or ‘first book concerning ta hugieina’.161 A second option is provided by a dozen or so instances in which Galen refers to the work as hē hugieinē pragmateia. This may be translated either as ‘the study of health’ or ‘the treatise on health’;162 and the latter would, indeed, provide another simple solution to the problem of the best English choice for the title. 160

The fluidity is part of a more general fluidity regarding titles in the ancient world. For example, when an author refers to a work as that ‘concerning (or ‘on’, peri) NN’, he may be taken to be referring to the content of that work, rather than necessarily citing a title verbatim. Subsequently, and in the versions still commonly used, the peri (in Latin, de) has come to be fixed and formalized as part of the title, but it is arguable whether this is correct, from a linguistic/historical point of view. When Galen says, e.g., that he has said something ‘in my work peri kriseōn’, it seems more correct, historically, to translate this as ‘in my work about crises’, than as ‘in my work, On Crises’. 161 The readings of V and R respectively (although in the latter the whole title, apart from the words ‘Galen, book one’, is apparently added by a later hand); the translation of Niccolò da Reggio, meanwhile, gives the form ‘sanativorum’, clearly a direct translation of the genitive form of ta hugieina. 162 On this dual sense of pragmateia, cf. above, section 8.2; and I.2, 5,33 Ko. (VI.7 K.), with n. 20.

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Ta hugieina is, however, the form of the title that appears most frequently in Galen’s references to the work.163 How should this be translated? Almost certainly, this combination of definite article with neuter plural form of the adjective should be taken as a virtual abstract noun, meaning something like ‘things to do with health’ or ‘matters of health’ – a sense, that is, whereby it would refer to the study of this branch of the art in general, and would include all interventions and practices that fall within it. An alternative interpretation, however, would be to take it that a word for ‘writings’, in particular hupomnēmata, should be mentally supplied, in which case it would instead mean ‘writings on health’; and this interpretation is supported by a number of instances in which Galen does indeed refer to the work in this form, saying something has been discussed not ‘in the hugieina’ but ‘in the hugieina hupomnēmata’ – ‘in the health(ful) writings’.164 But the existence (already discussed above) of a previous tradition, traced back to Diocles and Erasistratus in particular, of works with the title ta hugieina, apparently without that title involving any implied term for ‘writings’, would suggest that the abstract sense is the primary one for Galen, who is not only well aware of this tradition, but consciously placing his own work within it. Moreover, two further variations on the form of the title, whereby it is referred to as hē tōn hugieinōn pragmateia (the treatise, or study, of ta hugieina) or ta tōn hugieinōn hupomnēmata (the writings of ta hugieina),165 again argue for the interpretation of the word hugieina itself as referring to a subject matter, not a set of writings. Some such English translation as ‘Matters of Health’ would in many ways seem appropriate; but here we run into a potential confusion with Galen’s terminology of ‘materials’ or ‘matter’ (hulē) (discussed above, and rendered in Latin by the well-known materia), and it seemed good to 163

Some twenty times (including most of the references to the work, noted above (section 8.2), in The Therapeutic Method). A full list of references, in all the various forms, to the work in the Galenic corpus is given (with a couple of inaccuracies) by Koch (1923: VII, n. 1). 164 E.g. ἐν τοῖς ὑγιεινοῖς ὑπομνήμασι, MM XIII.6 (X.892 K.), Hipp. Epid. VI I.3, 16,3 WP (XVIIA.817 K.); Hipp. Off. Med. III.29 (XVIIIB.880 K.). Moreover, he similarly refers to things written in The Therapeutic Method (or in others’ writings on therapy) in the same way as ἐν τοῖς θεραπευτικοῖς, both with the addition of ὑπομνήμασι – MM III.3, (X.181 K.) – and without it – Caus. Symp. III.11 (VII.263 K.); Hipp. Epid. I II, 75,4 Wenkebach (XVIIA.145 K.); Hipp. Epid. VI II.2, 61,7 WP (XVIIA.898 K.); Hipp. Epid. VI II.32, 95,28–96,1 WP (XVIIA.961 K.) – and indeed has a conjoint cross-reference to both works (ἐν τοῖς ὑγιεινοῖς καὶ τοῖς θεραπευτικοῖς ὑπομνήμασι), at Hipp. Epid. VI V, 272,3–4 WP (XVIIB.249 K.). Such usage would seem to suggest that the word hupomnēmata is in general to be mentally supplied whenever we find ta therapeutika in such references, and it might then be thought that the same applies by extension to ta hugieina. 165 The former some dozen times, the latter at HNH III.7, 96,9 M. (XV.189 K.).

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avoid such confusion. For these reasons – in conjunction with those already mentioned above (section 2.1) against the choice of ‘Hygiene’ – the simpler title ‘Health’ has been preferred. 9.3 Reception and appropriation As remarked at the beginning of this introduction, Galen’s work on health was to have a high profile, and to be of considerable significance, in subsequent centuries, over a very long time span, both in Europe and beyond. This is true both of the influence of the treatise Ta hugieina itself – as evidenced for example by the presence of substantial extracts from the work in the compilations of the Byzantine ‘encyclopaedists’ Oribasius, Aëtius of Amida and Paul of Aegina – and, more broadly and perhaps even more importantly, of the tradition and approach to the ‘preservation of health’ which it embodies, and of which it is, as far as the ancient world is concerned, our fullest and richest source. This is not the place to explore that Nachleben in depth; we should observe, however, that such influence may be found in texts and discussions that extend far beyond the confines of narrowly medical literature, and in literary and intellectual cultures as diverse as twelfth-century Andalusia and sixteenthcentury Italy and England – as well as being in some way reflected, in times closer to our own, in the notion of the ‘valetudinarian’, prevalent in eighteenth-/nineteenth-century English literary usage. One ramification of the work’s prestige, in the early modern context, was that it was the focus of intensive scholarly activity on the part of two of England’s foremost humanist-physicians: Thomas Linacre (founder of the Royal College of Physicians), who dedicated his Latin translation of the work to his patron, King Henry VIII, in 1517, and John Caius, who presented his new Greek edition of the work to his heir King Edward VI thirty years later. It might be said that this high profile of Galen’s work – his work on health in particular – in mediaeval and early modern times has been matched only by the insignificance and neglect – again, of his writings in general, but especially of his work on health166 – in modern debates and in modern scholarship. 166

There has been a very considerable revival of scholarly interest in Galen over the last forty or so years; but this has (with some exceptions) tended to focus very strongly either on his work on anatomy, which is perceived as having a valid and respectable role in the history of medicine, or his work on philosophy (chiefly his logic, epistemology, ethics and philosophy of mind), which is perceived as making distinctive and original contributions within the ancient philosophical

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Our present age has seen an increased interest in and discussion of healthy lifestyles, and an increased discontent with the conception of medicine as an expertise concerned with acute, or at least clearly defined, disease entities at the expense of overall or ongoing bodily states; with parts of the body at the expense of persons; with drugs and other invasive procedures at the expense of a broader range of lifestyle prescriptions that would include diet, exercise, leisure activities and environmental factors. There is a very obvious sense in which Galen’s great work on health seems to speak to such an age, to offer discussions and materials relevant to these concerns and to this debate. His theoretical discussion of health too – as touched on above – raises definitional questions which have been at the forefront of arguments in the philosophy of medicine. How directly, or usefully, we find it to speak to us will, ultimately, be a question of individual disposition as well as of methodological approach. But whether one takes the Galenic work as a challenge to – even potentially a positive influence on – contemporary medical culture,167 or rather as an extraordinarily diverse source – for Graeco-Roman everyday life and social history; for the development of medical theory and practice; for particular debates within ancient philosophy and medicine, and at the interface of the two disciplines; for the origins or prehistory of similar debates in later times – it is on either count a severely neglected body of work, richly deserving of our attention. discourse. There has, by contrast, been comparatively little serious work on the Galenic discourse on health. Significant contributions to such discussion have, however, been made in more recent times, especially by Wöhrle (1990), Grimaudo (2008), Singer (2014b), Wilkins (2016), Lewis, Thumiger and van der Eijk (2017), alongside some recent work focussed more narrowly on Galen’s work on food and diet (Powell 2003; Wilkins 2013). 167 Such an approach was followed in particular by the ‘Galen Project’ run by the Classics Department of the University of Exeter in 2012, involving discussions with health practitioners and a related blog. The results of that research project are summarized in Dieppe, Gill and Marsden (2014).

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Thrasybulus. Whether healthfulness belongs within medicine or physical training*1

Statement of the question; the original oral context of its discussion; the correct methodological approach to its solution V.806 1. My arguments in the writing up of these notes, Thrasybulus, will be 33 H. K. exactly the same as those I gave extempore when you set me this enquiry.2 As you are surely aware, if the subject is the same my treatment 5 of it is the same; and I never embark3 on an argument without having both learnt the procedure relevant to that argument, and trained myself in it. * The page numbers in the left-hand margin refer to the Kühn (1823) edition (abb. K.), while the page and line numbers in the right-hand margin refer to the Teubner Scripta Minora edition (1893) by G. Helmreich (abb. H.), which is the basis of the present translation. 1 As Helmreich points out, both the more reliable MS and the references to this work elsewhere give the title in this form, rather than as ‘To Thrasybulus …’; it seems therefore that, however unexpected, this plain form is to be preferred. For the translation ‘physical training’, see n. 6. 2 The work is presented as the written version of an oral presentation or discussion. ‘Notes’ translates hupomnēmata, which has an original sense of ‘aide-mémoires’ and is used specifically for lecture notes or, as here, transcript (cf. ‘transcripts’ below, 4, 36,1 H. (V.810 K.), and also came to be the term used specifically for ‘commentaries’; but Galen also uses it much more broadly, without those specific connotations which it retains here. (Further on Galen’s accounts of his own writings, see Singer 2019b.) ‘Enquiry’ translates zētēma, cognate with the verb zētein, ‘to seek’, but standardly used in logical or dialectical contexts in this intellectual sense; and ‘object of enquiry’ below translates the present passive participle of that verb, zētoumenon (i.e. literally, ‘what is sought’). The participle so translated may refer both to the topic or question under enquiry, and to a fact or proposition which has to be discovered, which will constitute the answer to the zētēma or problēma set. The process of dialectical investigation is thus conceived as that of ‘discovery’ (heuresis) of ‘what is sought’, ‘the object of enquiry’ (zētoumenon). The verb translated ‘set’ is proballein, cognate with problēma (translated ‘set question’): both are used to refer to the formalized setting of a topic for debate in a public, competitive context; for Galen’s own accounts of such contexts, see Introduction, n. 37. For further discussion of the terminology of both zētein and problēma in Galen, considered in relation to its Aristotelian background, see Havrda (2022), who emphasizes the sense of the latter as ‘a question about … a relation between a subject and things ­predicated of it’. 3 The straightforward sense of the verb epicheirein is simply ‘attempt’, but it is cognate with the noun epicheirēma, which (again in Aristotelian terminology) refers to a particular kind of dialectical argument, inferior in status to a demonstrative syllogism; cf. below 5, 37,7–8 H. (V.812 K.).

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Now, as with every other investigation, the starting-point for its discovery 807 K. must be a knowledge of the object of enquiry. And this knowledge 10 is of two kinds: we may merely have a notion of the thing, or we may know its actual essence.4 (This difference has been discussed more fully in my work on Demonstration,5 in which we also set out all the other procedures; in what follows, too, the distinction should become evident from 15 its employment in practice.) 2. The set question was as follows: does what is known as ‘healthfulness’ belong within medicine or within physical training?6 You desired to hear my opinion on this question on the grounds that you had frequently been present at such disputes between doctors and trainers; and I asked to hear first from you, what notion you had of each of these terms: medicine, physical training, healthfulness. Otherwise there would be a danger that while you desired to hear about one subject my discussion would be about another, and thus that our argument would be addressed only to 808 K. terms, not to facts. Now, you refrained from answering this question, believing that I ought to cover all aspects of all these questions – which is simply wrong. If this were the case, then the question you set me would have in fact been many questions: first, the identity of medicine; secondly, that of physical training; and on top of that, thirdly, that of healthfulness, as well as this actual question which has been especially set, namely to which of these healthfulness belongs. Indeed, even this fourth question, as I 4

The distinction between a looser or more preliminary definition, the ennoēmatikos horos, based on something’s conception or notion (ennoia), and another, ousiōdēs horos, which communicates its essence (ousia), is discussed at Diff. Puls. IV.2 (VIII.704–708 K.) and IV.9 (VIII.741–743 K.) and at Ars Med. 1a, 275,4–15 B. (I.306 K.). Cf. also San. Tu. III.5, 84,13–14 Ko. (VI.190 K.) and III.7, 89,6 Ko. (VI.201 K.). On the term ousia in Galen more generally, see further San. Tu. I, nn. 53 and 55. 5 Galen uses the term ‘demonstration’ (apodeixis), in a way related to the Aristotelian tradition, to refer to an epistemically reliable form of argument with particular formal and logical features; he refers here to his lost work on logical and argumentative method, which he habitually recommends to students as a desirable foundation for their training in sound argument. Cf. Introduction, section 2.2, with n. 8. 6 On the linguistic form and usage of to hugieinon, see Introduction, section 2.1. I adopt the translation ‘physical training’ for the single term gumnastikē (a feminine adjective, with the noun technē, ‘art’, understood), and ‘trainer’ (sometimes ‘physical trainer’) for the related noun gumnastēs. Essentially what is meant is instruction in physical exercise (gumnasia), especially of the sort performed in a gymnasium (gumnasion) or wrestling-school (palaistra). There is a close relationship between this profession and the activity of the ‘athlete’ (athlētēs); on all these terms and their cultural context see Introduction, section 3.1. But while Galen’s attitude to athletes themselves, and their form of training, is wholly negative, he approves of gumnastikē, provided that it is carried out in the proper way, under medical guidance, and that it functions in the interests of true health and not the athletic state.

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pointed out, should not be set in this simple form, without a preliminary qualification: does one mean to which of these healthfulness is specific, to which it properly belongs, of which it is a part – or whichever other formulation one may prefer. And this too would present a starting-point for discovery of the object of enquiry. Say, for example, that the question is set in full, and indeed put to one, as follows: ‘Does healthfulness properly belong to medicine or to physical training?’ Then as well as stating the meaning of each of the three terms ‘medicine’, ‘physical training’ and ‘healthfulness’ we shall also have to explicate that of ‘properly belong to’, and the standard of its discernment.7 This last point is that which is specific to the actual set question. The 809 K. explication of the identity of ‘medicine’, ‘physical training’ and ‘healthfulness’, although it is not specific to the set question, must nevertheless be agreed upon. Since, therefore, you were willing on that occasion to go through only that one question that you had set me, and since I observed your reluctance to trust yourself in question and answer,8 I decided to take as my interlocutor a philosopher who happened to have turned up at the discussion, one who was well trained in logical theory. He undertook the task with enthusiasm and answered each question correctly; and so, as you know, the set question was easily resolved.

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3. The delight you took in the procedure followed in that argument was evident even then; for indeed, the object of enquiry was discovered more quickly than expected. Later, you were constantly wheedling me and 15 gently putting on pressure to force me to write the argument up, much against my own wishes. I felt it inappropriate to preserve in writing the correct solution to this one single set question; on the other hand, I had no leisure to give a similar treatment of all related matters. I therefore 20 considered that it would be sufficient for you, my friends9 – according to 810 K. my own previous practice on my own account – to show you the 7

For Galen’s use of the term kanōn, ‘standard’, see San. Tu. II, n. 4 and for the term diagnōsis see San. Tu. II, n. 49. Literally, ‘in the responses’ (apokriseis): Galen refers to a formalized series of questions and answers which would have been part of the procedure leading to the solution of the problēma. 9 Galen more often characterizes the addressees of his writings as hetairoi (‘followers’ or ‘associates’, on which term see San. Tu. V, n. 79, and further Singer 2019b) than, as here, ‘friends’ (philoi), although he sometimes does that too, and perhaps tends to use the words somewhat interchangeably. But the term hetairos suggests a closer professional affiliation, or student–teacher relationship, while philoi may have been a broader group, and he does distinguish the two groups explicitly at HNH III.21, 104,6–7 Mewaldt (XV.205 K.), speaking of his ‘discourses with my hetairoi and with other friends’. 8

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method, the employment of which will lead one to the solving not just of this but of all other set questions. 4. What is known among philosophers as logical theory enables one 25 who sufficiently cultivates it to undertake any enquiry with equal success. One who reads the transcripts of [discussions of ] set questions without 36 H. this logical theory is simply wasting his time: he will neither know how to assess which statements in them are true and which false, nor be able to recall all the arguments written down. Since, however, I have now 5 embarked upon the discussion of this set question, we must begin from the point which the argument had reached a few moments ago.

Some question-begging assumptions and some undesirable conclusions 5. Now, of course, one answer that one might give to the question, ‘what is medicine?’ would be: ‘the art of healing the sick and preserving health in the healthy’. This would appear to have assumed the [identity of ] 811 K. object of enquiry from the outset, declaring healthfulness as a part of medicine. Similarly, one who states the definition of medicine as merely ‘the art of curing patients’ takes the object of enquiry as assumed in the opposite sense, removing healthfulness from the domain of medicine. So, too, one who states physical training to be ‘the art of preserving health’ also takes the object of the enquiry as assumed in advance; as, also, one who declares it to be ‘creative of good-condition’ posits the object of enquiry as something already agreed. In attempting to give a definition, or even characterization,10 of the art, one must not make a denial or affirmation concerning the object of enquiry without offering a demonstration, but rather attempt a demonstration by starting from other, generally-agreed, positions. Is it then preferable to state that medicine is the art whose goal is health, and physical training the art whose goal is good-condition,11 and use these characterizations as starting-points in our enquiry? But in this case too we are removing healthfulness from physical training, while leaving it uncertain, and still an object of enquiry, in relation to ­medicine: 812 K. for if health is the goal of this art, our statement might be vulnerable to a distinction on the grounds that it posits as the goal the ­production 10 11

The word hupographē indicates a rough outline or sketch as opposed to a precise definition. Euexia (‘good-condition’) is a term of art in Galen’s theory of health, referring to the excellence of hexis (‘condition’); cf. Introduction, section 4.1. As Galen mentions below, the derivation of the word is indeed by the addition of eu (‘good’ or ‘well’) to the noun hexis; cf. also n. 18 below.

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or creation of a [state of ] health which did not previously exist, not the preservation of an existing one. There is then scope to argue on either side by using analogies. If, for example, we wished to show that producing something which was not there before belongs to the same art as preserving it when it is there, we would point to the arts of housebuilding, shipwrighting, carpentry and metal-working; if we wished to argue the opposite case we might point to the distinct activities of weaving and stitching, and of shoe-making and ‘sinew-stitching’ (as the art of repairing worn-out shoes is known). For it appears that it is the job of one practitioner to make a shirt, another to repair one that is torn; and similarly it is the task of the shoe-maker to create a shoe, but that of the sinew-stitcher to repair a worn one. Now, it has been shown in Demonstration that analogies should not be used in the context of scientific demonstrations; and anyone who has 813 K. schooled himself in that work will turn his nose up at this kind of procedure, and look for a better one. The person who is not so schooled may choose whichever of the above options he wishes, and argue the toss all day. 6. Those who posit that the goal of medicine is the production of health, but not its maintenance and preservation, while that of physical training is good-condition, will find themselves faced with a considerable further enquiry, in addition to those just mentioned. They will be compelled to show, in both the case of health and that of good-condition, that the art that creates it is different from that which preserves it. But in this case we shall also have to enquire into two other arts: a separate art of preserving health alongside medicine, and a separate art of maintaining good-­ condition alongside physical training. And since there are two kinds of good-condition, as has been demonstrated elsewhere, it will be difficult to determine which of the two physical training creates: the normal12 variety or that of athletes. We would obviously then have to pursue the enquiry into two further arts, making the total six: three arts creative of 814 K. goals and three preservative of these goals. The three underlying goals of health, normal good-condition and the good-condition of athletes would necessarily give rise to that number of arts. If, however, different types of good-condition and health require different arts, we shall need two arts for health as well, since that known as stable health is different from that 12

‘Normal’ translates kata phusin, more literally ‘in accordance with nature’. Both translations have been used, in different contexts. On Galen’s usage in this area see Introduction, sections 5.2 and 5.4.

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known as unstable health.13 (For it is not the case that good-condition is superior to stable health to a lesser degree than the latter is superior to unstable health.)14

Distinctions within health: unstable health, stable health and good-condition 7. You will achieve a clear understanding through a careful investigation; and the investigation should be conducted in the following way. Consider a type of patient you have frequently seen, one who has been suffering from a severe illness but has recently recovered, and is so thin15 and incapable of motion that he requires help to get about. Such a person no longer needs a cure, as he is no longer sick; but he does need a kind of building up and a vigour, so as to become strong enough to perform his 815 K. normal activities and capable of tolerating external influences. Obviously a person who is in such a state16 immediately subsequent to the removal of his sickness will not be able to endure heat or cold, poor sleep, or failure to digest. He will very easily fall ill again, since he has not yet acquired a healthy disposition which is solid or secure. Even if it then does become well established and stable, that still does not constitute ‘good-condition’, this latter term becoming applicable precisely through

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Literally, health ‘in hexis’ and health ‘in schesis’ (cf. again Introduction, section 4.1). The former is Galen’s regular term for ‘condition’, in the sense of a stable or enduring state of the body; the latter treated as a synonym for the more usual diathesis, ‘state’ (cf. n. 39 below). The phrases seem to be derived from technical philosophical, especially Stoic, terminology, although used here in a different way. The Stoics contrasted kinēsis, motion, with both schesis, a static condition, whether stable or not, and hexis, which is an important technical term in their physics; and an opposition between kata kinēsin and kata schesin is similarly found in the Peripatetic text Anonymus Londinensis. See e.g. SVF III.244; and cf. Plotinus, Enneads III.1.7; Anon. Lond. 1–3. Cf. San. Tu. V.4, 142,25 Ko. (VI.330 K.), where Galen attributes it to ‘doctors of more recent times’ – on his relationship with whom see Introduction, sections 2.3 and 4.2, and further below, ch. 7. Helmreich suspected the whole of the sentence given here in parentheses as spurious. I have retained it, but with the conjectural insertion of αὕτη before (or ἡ καθ᾽ ἕξιν after) the phrase τῆς κατὰ σχέσιν. This seems at least to give sense consistent with Galen’s views as stated elsewhere. (As it stands in the MSS, the sentence would mean rather: ‘For it is not the case that good-­ condition is superior to stable health to a lesser degree than it [i.e. good-condition] is to unstable health.’) For the proliferation of arts here warned against, see figure 3. Ischnos could also be translated ‘feeble’; while that might seem a more appropriate option in the present context, Galen’s view seems clearly to be that the kind of illness in question typically leads to a thinning or diminution of the body, and the core reference of ischnos in his usage in general seems to be thinness, rather than feebleness. ‘In such a state’ translates houtō diakeimenos, literally ‘thus disposed’; it should be noted that the word ‘state’ in this translation sometimes corresponds to such verbal phrases, rather than always to such nouns as diathesis; cf. n. 36 below.

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the addition of the quality ‘good’; yet it has ceased to be a faulty or poor state. A faulty or poor state17 consists in an inability adequately to perform the activities of life, and in ready susceptibility to harm. Where one’s performance of life activities suffers no hindrance, and one is not readily susceptible to harm, this is stable health. It is distinct from the faulty version involving poor performance of the activities of life, but has also not yet achieved the fully desirable [state], which will obtain if the activi816 K. ties are not only no longer weak, but actually endowed with some considerable vigour. In terms of the performance of the activities, stable health lies halfway between unstable health and good-condition. In unstable health, the activities are feeble, while in good-condition they are vigorous; in stable health they are not yet vigorous, but no longer feeble. It is thus obvious that, although the position of stable health is a middle one, and it is superior to unstable health in its value for the performance of all the activities of life, it does not involve excellence,18 which belongs only to good-condition. One should imagine a column,19 which starts with the harm to activities which obtains in sickness; then we have what obtains in unstable health, which is free from such harm, although the weakness renders performance poor; thirdly stable health, which is distinct from this weakness, while still not achieving vigour; and fourthly good-condition, which is a kind of excellence of the functions. (And the peak and perfection of these is the peak [form of ] their goodcondition.)20 817 K. Now, the art which leads a man to a healthy condition will clearly be separate from that which cures him of illness, if it is once agreed that different goals require different arts, and that in the case of each goal there must be two, one to bring it about and another to preserve it. It is thus obvious that our notion concerning goals embraces the entire 17 18 19

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For the terminology of diathesis, ‘state’, see n. 39 below. Cf. n. 11 above; here the addition of the noun ‘excellence’ (aretē) is taken to have the same function as the addition of the adverb eu. I read στοῖχον, which seems to have better MS support, that of L, as opposed to στίχον, ‘line’ or ‘row’, P2. The former word, stoichos, is used elsewhere by Galen for a column in a table within his text: see San. Tu. II.4, 50,32 Ko. (VI.112 K.), with n. 30, and cf. Book III, n. 62. We are thus envisaging an ascending column, with ever better stages of health. The grammar is odd, the repeated neuter singular definite pronoun to being used to refer to points on this column, without a clear reference (leading to a slight paraphrase in the translation); one suspects that some noun has fallen out which referred to points or markings on this column. Helmreich suggests the deletion of the sentence in parentheses; but the statement seems consistent with what is said later about ‘the peak of good-condition’, even if it seems to add an extra category in addition to those usually mentioned.

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enquiry now before us, and for this reason all definitions which are 41 H. derived from the goal give rise to considerable confusion.

Definitions of health 8. Perhaps, then, it would be better to proceed straight to the actual essence of the art, and to make this the starting-point of our enquiry. What is medicine? Someone might say: ‘the knowledge of things healthful and morbid’. But here too it would seem that ‘the healthful’21 has been prejudged at the outset to be part of medicine. Which is why, I suppose, some of those who posit the contrary view will affirm that it is the knowledge of things morbid only. Yet such people are first of all ignorant of the fact that the knowledge of opposites is always one, so that anyone with an understanding of things morbid cannot possibly be ignorant of those healthful. Well, this point may be beyond them, so let us 818 K. pass on to consideration of a second point of which they are ignorant, but which they may conceivably be able to follow. It is that the object of enquiry is not necessarily included in the definition of medicine. For somebody might distinguish different senses of the term [healthy], and proceed to show that medicine is the knowledge of bodies possessing health, of signs indicative of health and of causes productive of health, but not of factors preservative of health, and thus aim to address the set question by opposites.22 Those who engage in such sophistry seem not to have an accurate knowledge of the object of enquiry, nor of the fact that we speak of a ‘healthful sign’, meaning something arising in a sick person which is an indicator of health about to come into being; similarly of a ‘healthful cause’, meaning something administered to the patient which is productive of health, including of course all remedies in general; and that we also call that body which receives health a ‘healthful body’.23 The doctor must have knowledge of all these matters, even though they have nothing in common with our set question except verbally. For indeed, whether the supervisor of the preservation of the healthy is the doctor, or whether this sort of thing is the specific province of the trainer, was the initial subject 21 22

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The neuter adjective is the same as that also translated in this text as ‘healthfulness’; cf. Introduction, section 2.1. Galen’s point here relies on the fact that each of the phrases in italics could, in Greek, be replaced simply by a form of the adjective ‘healthy’ or ‘healthful’ (hugieinos). An alternative translation of kata tanantia, ‘by opposites’, might be perhaps ‘from opposite ends’. Cf. San. Tu. I.15, 36,3–4 Ko. (VI.78 K.), with n. 121, for the proposition that ‘the study of health (as also that of healing) consists in these three classes primarily: bodies, causes and signs’.

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819 K. of our enquiry; and this, as we have just now shown, must be decided by means of the enquiry into goals. Is health tout court the goal of medicine, 10 in which case both the production of previously non-existent health and the preservation of existing health are included, or is its production alone the province of medicine, while its preservation belongs to physical training? Similarly with physical training: is its goal good-condition, or 15 health, or the production, or the preservation, of either of these?

Divisions within the art concerning the body; the Hippocratic view of athletes 9. It has emerged from our argument that there is a danger, if we go beyond one art concerning the body, of producing seven. The first, which is the clearest and probably only undisputed one, is the art of curing disease; then there are two others, that of bringing someone from 20 unstable health to stable health, then that of keeping a person in health; then two more which perform the same role in relation to good-­ condition, that of creating it and that of preserving it; and then an additional two for athletic good-condition. If we use the term good-condition 43 H. on its own we refer to normal good-condition, whereas the athletic kind, 820 K. which is not normal, is not referred to by the term used on its own, but always with some addition, as for example by Hippocrates, when he says: The athletic state is not normal; better a healthy condition24

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and again: In [bodies] involved in physical training, the extremes of good-condition are dangerous.25

… here referring to bodies which are athletic and involved in physical training. For by ‘involved in physical training’ he must here be understood to refer not just to any kind of exercise – digging, for example, or 10 rowing, or harvesting, or any other normal human activity26 – but to exercise undertaken for its own sake, in the attempt to acquire a strength which will overthrow one’s rivals. 24 25 26

This favourite quotation of Galen’s comes from the ‘Hippocratic’ text Nutrition (De alimento 34, IX.110 L.), which is now thought to be a late work. Aphorisms 1.3 (IV.458 L.). It seems that some words are missing immediately after this quotation, and we are left with an incomplete sentence. For Galen’s view of everyday activities as a form of exercise, cf. San. Tu. II.8, 59,30–60,6 Ko. (VI.134 K.).

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The reason why this kind of state is not normal has been explained elsewhere; the part of that discussion which is of use for present purposes is the point that was made just now, that once one goes beyond one art concerning the body one ends up with seven – or indeed nine, for heaven’s sake: after all, why should we not then add a further two, one of 821 K. creating the peak of good-condition and another of preserving it? The peak of the good-condition of ‘exercised’ bodies should be avoided strenuously, as Hippocrates has stated very clearly; but equally, the peak of good-condition in straightforward terms – that is, of normal good-condition – should not only be preserved where it exists but energetically pursued. And so the total number of arts concerning the body comes to nine, seven of which are laudable, the other two being perverted arts,27 like that of the beautician.28 Well, we may perhaps prefer to leave these last two to one side; let us consider again the seven: first of all, the art of curing diseases, then, following on from that, two which regard health of the condition, two which regard good-condition, and two more which regard the peak of good-condition. Now, from these considerations it is quite obvious that if one does not posit [a single]29 art, which thus also has a single goal, one must go up to seven arts; and that this single goal is nothing other than health.

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Perverted versus true arts 10. Perhaps it would be better to approach the argument in a more accurate way, with a reminder, first of all, of a fact known to everyone: that 20 822 K. the perverted arts provide an apparent good in each area with which they are concerned, whereas the arts proper provide that which genuinely exists in that area. We should further state that, if what is known as the art of the beautician creates a false kind of beauty, it must be regarded as a perverted art and a form of flattery.30 There must be some other art 25 which is constituted31 in relation to authentic, genuinely true beauty, that 45 H. beauty which consists in good colour and good flesh, and good balance 27 28 29

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Kakotechniai: for this term, which for Galen clearly has a Platonic background, and is closely related to the notion of ‘flattery’ (kolakeia), see Introduction, section 8.5. Or, ‘that of embellishment’ (kommōtikē). I have supplied ‘a single’ here, and I suspect the word μίαν has fallen out before τέχνην: its presence seems to be implied by the ‘also’ (καὶ) attached to the other word for one, attached to ‘goal’ (τέλος): that is, Galen is affirming the correspondence between a single (μίαν) art and a single (ἓν) goal. The use of the term ‘flattery’ (kolakeia) in this sense is strongly Platonic, with specific echoes of the Gorgias; on this point see Introduction, section 8.5. For this usage see San. Tu. I, n. 38.

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of the parts – which are characteristics of normal good-condition. We have distinguished this art from that of physical training in another work too; but perhaps it will be no bad thing to restate the essential points 5 here too: let us begin this discussion now.

Health as normal performance of activities or normal constitution; the indissociability of health and good-condition (excellence) as aims 11. Either being healthy is the normal performance of the activities of each part of the body, or else such normal performance is a necessary consequence of the normal constitution of the body, while being healthy is this normal constitution itself. You may posit health as either of these two things; it makes no difference for present purposes. Now, pay careful attention to the next stage in the argument. 823 K. Which is it that we actually require: is what we require to be endowed with a normal constitution in each part of the body, or is it rather the normal [performance of ] each part’s activity? Surely everyone would agree in not wanting any part unable to perform its activity – eyes unable to see, for example, or nostrils unable to smell, or legs unable to walk, or, in general, any part which either does not perform its activity at all or performs it badly. In fact, quite generally, none of the things which we require do we require in an imperfect32 version; this applies equally to a house, a shoe, a couch or a garment. In requiring any of these things we also require them to be perfect.33 Similarly, then, we do not require to walk in a weak and feeble manner, nor to have dull sight or hearing; nor do we desire any other activity in its deficient form. Who would have it as an aspiration to acquire a deficient version of good colour, good flesh, beauty of the body in general, or bodily vigour? And if we require not a deficient performance of our activities but a perfect one, nor, then, shall we require a deficient constitution of the body with which we perform them. Now, [as we saw,] health was one of these two things. It is there824 K. fore obvious that no one requires an imperfect version of health; we all require the most perfect variety possible. 32

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The word atelēs, ‘imperfect’ is a negative adjective derived from the noun telos, ‘goal’, ‘end’, ‘purpose’, which also has a related adjective teleios, which may mean ‘perfect’ as well as ‘complete’ or ‘full-grown’. Atelēs thus has connotations not just of imperfection or non-completion but also more specifically of lack of fittedness to a goal: something which is atelēs will not fulfil that thing’s telos. ‘Perfect’ translates teleios, which again (see previous note) has the further connotation of being fitted to the goal or telos.

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12. Now, if good-condition is thought to be something other than perfect health, then one should seek a different art in the case of goodcondition and in that of health. If, however, they are one and the same thing, then the art must also be one. In what circumstances, then, would good-condition be the same as completely perfect health?34 First, if we have been persuaded35 that the constitution of the body which is the cause of the latter is also the cause of the former, then they will both be the same. The second consideration regards its actual essence. Goodcondition is nothing but condition in a good way;36 and a condition is a permanent state; so that to which a condition belongs must also be that to which a good-condition belongs; and both consist in a relation.37 So, too, one may be said to have a ‘condition’ in language and literature, in mathematics, in geometry, or astronomy, or in any other subject:38 when a state is established, it is called a condition. (For present purposes it makes no difference whether one says ‘state’ or ‘disposition’.)39 If, then, 825 K. that to which a condition belongs is the same as that to which a goodcondition belongs, and a condition is of someone, then obviously the good-condition is of the same someone as the condition is. But we are not here considering a ‘condition’ in geometry, music or in language and literature; we are considering a healthful condition. When, therefore, we speak of good-condition, we speak not of a musical or geometrical good-condition, or one in language and literature, but of the 34 35 36 37

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Literally: ‘How is good-condition the same as …?’ We might also translate ‘have grounds to believe’: the verb is a perfect-tense form of pisteuein, cognate with pistis, a proof or something on which one relies for (justified) belief. ‘In a good way’ here corresponds to the verbal formulation, eu echousa (cf. n. 16 above). Literally, ‘both [are] in relation to something (pros ti)’. The terminology, which is employed by Galen in a number of contexts, especially to characterize ‘relative’ as distinct from ‘absolute’ uses of qualitative terms such as ‘hot’, is from Aristotle, Categories 7. The fundamental sense of the category there is to distinguish things which are ‘of ’ something or someone, and exist only in relation to them, from things which exist independently (ousiai). See also San. Tu. II, n. 8. I have preserved the translation ‘condition’ here to preserve the sense of Galen’s sentence: the same term may be used in Greek to refer to what would more naturally be translated as an individual’s ‘level’ of ability or intellectual accomplishment. (Galen for example mentions that certain of his writings are tailored specifically to the hexis of the individuals for whom they were written: Lib. Prop., praef., 136,5–6 BM (XIX.10 K.); or the necessity of ‘gaining a certain hexis in the necessary basics’ before reading a certain work, Lib. Prop., praef., 136,11–13 BM (XIX.11 K.); cf. ibid. 1, 139,24 BM (XIX.15 K.) and 9, 160,20–21 BM (XIX.35 K.).) Grammatikē, here translated ‘language and literature’ (and sometimes ‘scholarship’), refers to the fundamental early training in grammar and literature that was central to Graeco-Roman elite education, and also to the profession of literary or textual criticism. It is cognate with grammatikos, on which see San. Tu. V, n. 28. ‘State’ translates diathesis, ‘disposition’ schesis. The former is Galen’s more usual general term for a bodily state – although, as indeed suggested here, he uses others synonymously, including schesis and more often katastasis. The key contrast is between the temporary state to which all those terms may refer and a hexis, which involves the addition of stability or permanence.

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healthful good-condition. This very point is overlooked by many, who believe the word ‘good-condition’ to be equivalent to the term ‘health’. The term ‘health’ applies to a certain state, while the term ‘good-­ condition’ indicates not the state tout court, but excellence and permanence within that state. For good-condition is the best condition of that state which we call ‘health’. Thus the term ‘good-condition’ is not indicative of a state, a constitution, or an activity; nor indeed is the term ‘condition’. (It seems that one must repeat the same thing over and over again, if one is to root out the inveterate ignorance of the majority.) The 826 K. term ‘condition’ refers only to the stability and established nature of the state, and the term ‘good-condition’ merely adds excellence to this. Indeed the latter term, ‘good-condition’, is composed of the word ‘condition’ with the addition of ‘good’; and we habitually apply it as a term of praise to any object which is in a good state and in possession of its own proper excellence. What is it, then, that we desire, and what do we want constantly to be the case for our bodies? Is it only to have a healthy state? Or is this not rather like enquiring whether we require a house which is faulty, practically on the point of falling down, or rather one which is in the best possible state in relation to the function for which it was created, and also as long-lasting as possible? No one wishes to be in good health only deficiently, or for a short time. In fact, no art, quite generally, has as its aim the lesser or the less long-lasting; every productive art has as its aim that which will be best and longest-lasting on the basis of the same material. Nor is the goal anything other than the achievement of the aim; and 827 K. so it is obvious from what has been said that there is both one goal and one aim of the art which concerns the body. It is not necessary for us at this point to distinguish whether this aim should be called soundness, good-condition, health, the normal constitution of the body, its normal activity, or the state or constitution on the basis of which we perform these normal activities perfectly.

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Each thing has a single goal, which is its good; the relevant arts aim at those goals 13. I have one task before me, namely to show that every art has an aim and a goal towards which it is directed. And there is one goal for each 15 existent thing, which is nothing other than the good within that being. The perfection of, say, a vine is no different from the good for that vine; nor would there be any subject apart from this to be investigated by the

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art concerned with vines.40 Similarly with the art concerned with olives: this too has as its aim the perfection of the olive’s nature. The body of man is one such existent thing; it too has an overall perfection; and both 828 K. the preservation of this, when present, and its recovery, when absent, are the task of some art. Whether we should posit some other goal of this art, at a lower level, is a point that our previously stated argument will take up.41 For there will be one art which creates good-condition, one which creates the peak of good-condition, another the healthy condition, fourthly the healthy disposition and, set apart from all these, a fifth which creates the athletic version of good-condition. And if we are to allot the business of creation to one set of arts and the business of preservation to another, then we shall have to seek out and constitute not just these arts concerning the body, but as many again alongside them. 14. It is obvious from this that we should not posit many goods for the body, nor should we posit a separation between the creative and preservative arts. One who is able to investigate the whole matter on the basis of the essential points will need no further argument. One who lacks this ability or, indeed, requires to have everything erased from his intellect that follows from a number of faulty assumptions will, I believe, still need a considerable amount. Some have wrongly believed that the good of the body is not one, but is divided into health, vigour and beauty, and that there may be a separate 829 K. creative and preservative art for each of these. These views, and whatever other misconceptions follow from them, must be refuted. First it will be advisable to explain that there is, in the primary and proper sense, one good of the body, by reference to which all other goods are so called. The other goods of the body acquire that name either by being parts of that good, by being causes of it, or by being what we may term its fruits. Beauty is constituted by good colour, good flesh, good balance and certain other factors; why should it not be the case, similarly, that the good of the 40

41

‘Being’ corresponds to ousia, a word with an Aristotelian heritage, usually translated ‘essence’ or ‘substance’; for Galen it seems sometimes to mean simply ‘existent thing’ or ‘being’. (On his usage see further San. Tu. I, nn. 53 and 55.) ‘Perfection’ translates teleiotēs: as with both telos and teleios (cf. nn. 32 and 33 above), this abstract noun is crucially related to the notion of the completion or achievement of a goal, and, in biological contexts, to that of an animal or plant achieving its full growth. The Greek as given in the MSS is odd: the verb translated ‘take up’ (ἐκδέξεται) has ‘us’ (ἡμᾶς) as its object, which seems impossible. We should perhaps emend to ἡμῖν, ‘by us’ (i.e. ‘the argument stated by us’), but this does not entirely solve the problem, as the normal usage with this verb in such contexts has ‘argument’ (logos) as the object, not the subject: one ‘takes up’ a logos, rather than the logos doing the taking up.

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body is constituted by health, vigour and beauty? Alternatively, why should it not be the case that health is the good of the body itself, and 50 H. beauty and the activities its fruits? Or why might not the activity be the first good of the body, and health its cause? For the causes of genuine health in a body will be no different from those of its strength or beauty 5 […]42 if something is going to make our body strong or beautiful it will automatically also make it genuinely healthy.

The inextricability of health, good-condition, strength and beauty as aims of the art 830 K. 15. For this reason too, then, there is only one art concerning the body. The same actions bring about strength of the activities, make us better to look at, healthier and more fully endowed with good-condition, just as, conversely, if there is some fault in our management of the body, the vigour of the activities will be lost, the beauty impaired, good-condition destroyed and health diminished: it is appropriate that all these grow and dwindle simultaneously. Now, the normal performance of the activities requires the normal constitution of the body: it comes about from that constitution, which stands in the relationship to it of a cause. It is therefore not possible for one of them to precede the other; both must be present if one is. Moreover, they grow or diminish simultaneously. And as they increase in quality, the one is called ‘good-condition’, the other ‘vigour’; vigour has the same relationship to performance of activity as good-condition has to health. Each comes about through the other, and vigour, like good831 K. condition, is of someone. Good-condition, then, is an excellence of the normal constitution, or if you prefer, state, of the body, and vigour an excellence of the [performance of ] its activities. (Excellence is the same thing as perfection, which is the same as the good for any particular existent thing, that is what is called its good in the primary, unqualified sense.) Both also deteriorate through the same causes. The healthy state may, in the circumstances discussed above, gain the appellation of goodcondition; if, on the other hand, performance of the activities is weak, this is feebleness and weakness of the vigour. Similarly, beauty is a necessary consequence of the former set of conditions, ugliness of the latter. All these things grow and decrease, and reach their perfection or destruction, in conjunction with each other; what harms or benefits any 42

According to Helmreich, some words seem to be missing at this point.

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one of them automatically also harms or benefits all the others. It is obvious for this reason too that there must be only one art which concerns them all. Which of the above is the first good of the body, the good in the unqualified sense? There is no urgent need to state this for present 832 K. purposes; but I shall do so for the sake of completeness. The unqualified, primary good of the body, that which we most need, is the perfection of [the performance of ] our activities. (This is sometimes referred to incompletely as vigour or strength: one should not use those terms on their own, but rather add ‘of the activities’.) Next after this there is a secondary good of the body, which is not its good in this unqualified sense, nor in itself, but by virtue of the fact that that primary good, the good in itself, is completely dependent on it for its creation. And this is the goodcondition of health. (This, again, is sometimes referred to incompletely as simply ‘good-condition’, without the addition ‘of health’ – a usage which lays the way open to sophistic arguments. For while one should say ‘good-condition of health’, people say rather simply ‘good-condition’.) A necessary consequence of this, in turn, is beauty, which is the third good of the body. Thus, the goods of the body are not all of the same class, any more than are the goods of the soul, nor do they all have the same logical status. One is the first good, the good in itself; another is the cause of this good; another its necessary consequence. So, which of these three does the art concerning the body primarily 833 K. create? Health, activities, or beauty? It has already been made quite evident that it necessarily benefits and produces all three if it benefits any one: if it benefits the activities, it necessarily benefits health and beauty too; for the activities cannot come about without the cause that produces them, while beauty necessarily follows. Similarly, if it benefits health, it automatically benefits the activities and beauty, because both of these are results of that. If, finally, it produces beauty, then it must without question already have produced health, and if health, also the activities.

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Health as the primary goal of the art, from which both the performance of activities and beauty follow 16. But the question our argument sought to track down was: what is the primary result of the practitioner of this art? And it is already clearly apparent from previous statements that the art brings about health, while 25 the activities and natural beauty follow as necessary consequences of that.

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The point at which the practitioner of an art ceases his primary activity43 is the same as his goal; and in this case that point is the bringing-about of the normal state, on the basis of which we perform our activities. And 834 K. this is health. When he has brought this about, he exerts himself no further upon either the activities or beauty; these will follow of necessity, even if the practitioner did not desire it. Once he has brought health about, the practitioner is powerless to prevent these consequences; it is, however, in his power to prevent health itself. And again, if he does in some way destroy health, it is not within his power to give rise to normal activities, or to beauty, in the body. Whatever, then, is the identity of the art concerning the body, it must be stated that it exerts itself, primarily and in itself, upon health, and subsequently and incidentally upon the activities and beauty – and not upon any of these in imperfect or deficient forms, but rather those which are perfect, full and at their peak. We have now sufficiently shown the sense in which the goods of the body are many and the sense in which there is only one, as well as the fact that the art which concerns the body is not occupied with all these goods equally, but with one in itself, with the others only incidentally.

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The identity of productive and preservative arts 17. I shall now attempt to show why it is not admissible in any material44 for there to be a different art that creates the goal from that which 835 K. preserves that goal. I will first show that this view is not supported by their own given example, and secondly that it is not supported by the nature of the facts either. Even if it is true that the production and the repair of shoes are the tasks of different arts, still they have not shown us a third art, that responsible for the shoe’s preservation. In the case of clothes, similarly, even if repair and creation belong to two different arts, what the third, preservative, art is, they are not able to tell us. Now, if we turn to our bodies, and to those controlled by nature45 quite generally, we may say that Nature is the craftsman, in a way analogous to the weaver or shoe-maker, while the rectification of what has suffered damage is the work of the farmer or doctor, whose roles are, 43 44

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One could also translate the phrase more simply, ‘where the practitioner … first stops’. Though it might be more idiomatic here to translate ‘subject’ or ‘subject matter’, I preserve the usual translation of hulē, to make clear the connection with discussions elsewhere; cf. Introduction, especially section 5.2, on the ‘materials of remedies’. The verb is dioikein; for this usage and Galenic conception see San. Tu. II, n. 76.

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again, analogous to those of the man who stitches clothes and the one who repairs old shoes; but the preservation of a piece of clothing or a shoe that is stored within the house, to prevent its theft or its being eaten by mice, would appear to belong to no art at all: it is simply a question of 836 K. carefulness. If one insists on the existence of an art of preservation of these things, then it will be an art of the same kind as generalship or that concerning civic affairs,46 or also of gate-keeping and other kinds of guarding. It is to avoid being at the mercy of enemies, malicious individuals and wild animals that we have built houses and cities, surrounded them with walls and appointed generals and magistrates; but this is not the kind of art we are looking for as the preserver of health. Our candidate must rather be one which is actively involved in some way with the human body, not incidentally but for its own sake, thus rendering it safe47 and healthy. None of the arts just mentioned is in itself a guardian of health. It happens incidentally that one who is not murdered, or eaten by a wild beast, preserves his health, and indeed his life as a whole; only in this incidental sense, not primarily nor in virtue of its specific definition,48 does any such art come to be a guardian of health.

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The distinction between necessary and non-necessary or incidental causes of health and disease, the former being the domain of the health-practitioner 18. In what, then, will consist the study49 of the art which preserves 837 K. health in virtue of its own definition? It will not, surely, consist in those 5 things which do not necessarily come into contact with the body, nor50 46 47

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The Greek word is politikē, which certainly could also be translated ‘politics’; but the adjective politikos can have a much wider semantic reach than the English cognate; cf. San. Tu. V, n. 68. Or ‘saving it’: the verb sōizein, of which the adjective sōos here is a cognate, is usually translated ‘save’, but can carry the sense of medical ‘saving’ or healing, as well as those of rescuing and keeping safe (and, especially in Christian writing, that of spiritual salvation). Cf. the use of the same phrase at San. Tu. VI.2, 170,6 Ko. (VI.385 K.). The distinction is between a property that belongs to something essentially, as a function of its true nature, and others that may or may not arise ‘incidentally’, kata (ti) sumbebēkos. The phrase, of Aristotelian heritage, is traditionally translated ‘accidentally’; on Galen’s use of the term, and his opposition of it to ousia, see San. Tu. I, n. 53. For pragmateia, translated both ‘study’ and ‘treatise’, see San. Tu. I, n. 20. The MSS repeat the phrase ex anankēs (‘necessarily’) at this point, which I follow Helmreich in omitting. If the phrase is to be repeated, it is out of place here, and should come rather later – ‘those which do not necessarily affect it’ – but it seems likely that it was repeated in error, and that Galen is making two separate points, one about whether things necessarily and always come into contact with us, and the other about whether such things actually have an effect, beneficial or harmful, on the body. For Galen’s discussion of external causes of health or sickness, and of the category of the necessary in this context, see Introduction, section 5.2.

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in those which do not affect it in any way; rather, it must concern itself with those factors with which the body continually interacts, whether we like it or not, and, within those, with those which have the capacity to benefit or harm it. Swords, wild beasts, cliffs or nooses, for example, are items with which the body does not necessarily come into contact. The ambient air, on the other hand, is necessarily encountered, and in two ways: as something that constantly surrounds the body and as something that is drawn in through inhalation. Sleep and waking, too, and rest and motion belong in this category: one cannot but be either asleep or awake, and either in rest or in motion; as, similarly, one must either be hungry or eating, thirsty or drinking, or in some disposition between the two. The different varieties of bed, on the other hand, or of clothing, do not come under this heading of ‘necessary’: an ivory-footed bed has no posi838 K. tive or negative effect on health, nor does a cheap camp bed;51 nor does the use of cheap or costly garments, or of utensils made of glass, wood, gold or silver; or whether one has pretty or ugly boys to serve one, or indeed has none at all and looks after oneself.52 All these factors are such as to have neither a positive nor a negative effect upon us, either primarily and in themselves, or incidentally. Hot or cold air, food and drink, rest and motion, waking and sleeping – these are the factors that necessarily benefit or harm us, by virtue of their intrinsic capacities. A worn-out shirt in winter, meanwhile, or a heavy, stifling one in summer will cause harm, not in a necessary but in an incidental manner, giving assistance to the cold and to the heat respectively.

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The means by which the health practitioner maintains health, considered as a constant process of repair or restoration of small losses 19. It is these factors, then – the ones which have in themselves a potential to do harm or good – which the person who is to provide for our health will consider. How, and in what manner, will he do that? By 10 giving instruction to eat, when the body has undergone considerable evacuation, so that there is a risk of perceptible damage, and prescribing 839 K. drink when it is more dried out than appropriate, which again gives rise to the risk of damage; and similarly by subjecting the body to exercise 51

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The word skimpous may also be translated ‘hammock’; cf. San. Tu. I.8, 18,20 Ko. (VI.37 K.), where it definitely refers to some kind of suspended bed used for children, and Praen. 7, 106, 10–108,14 N. (XIV.636–639 K.), where it refers rather to a makeshift bed of some kind. ‘Boys’ (paides) in this usage refers to household slaves.

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when he wishes to invigorate the capacity that controls us, as well as cleaning out the fine pores, but commanding rest when he sees that the body is either tired by the exercises or dispersed more than is appropriate. He will also empty the stomach, if there is retention, and hold it in if it is suffering from upset; and will attend to all other matters in the same manner, his chief concern always being to make no innovation so long as the body is completely healthy, but whenever there is any departure from perfect good balance, immediately to introduce whatever is missing, before the deviation towards the abnormal becomes a large one. The approach is similar to that of a person whose task it is to deal with the threads that come loose from a garment: the repair is not carried out on all of these threads at once, in a situation where they have all come loose together, but rather it is done day by day, in a process involving constant attentiveness; and thus the rectification remains so small as to escape general notice. The practitioner in charge of people in health must be 840 K. similarly able both to perceive and to rectify small instances of loss and damage. If our bodies remained completely immune from harm, just as they were left by the skilled practitioner who made them, then there would be no need for this constant intervention of repair. In reality, though, they are subject to flux and decay;53 and therefore some supervisor is required to keep watch, who will both recognize the nature and quantity of the substance being voided and immediately cure the loss by introducing the same amount of a similar substance. Say that the normal moisture flows out from a body: one must irrigate, providing the same quantity of moisture through drink; say that the hot is dissipated: the same quantity of this must be reintroduced; say that the dry is being evacuated: now is the appropriate time to give nourishment. In short, any dispersion or loss in the body must be rectified quickly, before it becomes widely perceptible.

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20. Imagine two large jars which have been pierced in many places, both full to begin with, and both being emptied by the outflow at an equal 25 rate. One has a supervisor who takes care always to replace an amount 841 K. equal to that lost; with the other, no one is present until the loss is 58 H. considerable, at which point someone suddenly takes control and replaces it all at once. Obviously most observers would not even say that the former jar was ever emptied or filled, but they would certainly 5 comment on both these processes in the latter case. So it is also with 53

Cf. the discussion at San. Tu. I.2 and I.4.

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healthy and sick bodies: there is one art which corrects both, through the single means of introducing what they lack. The difference is merely in 10 the amount, not in the quality, of the rectification.

The single nature of the art of rectification, irrespective of the size of the repairs 21. Yet such quantitative differences within the world of change belong to a single art: to belong to a different art would imply a change in the quality of the process too. If you imagine that, just because in the one case there was a considerable loss before the arrival of the practitioner, while in the other, because of the fortunate presence of an overseer, the level was constantly maintained, there must be two types of rectification, you are mistaken. It is not the job of one art to replace one thread that 842 K. has come loose, and of another to replace three or four, or for that matter five hundred; nor is it the case that one art carries out minor repairs on a wall, while more severe damage to it requires a different one. In quite general terms, the manner by which each existent object came about in the first place is also the manner in which a loss to it is rectified. The woof is woven into the warp to make a garment. Now, is it possible for that garment to sustain damage, or for that damage to be put right, in some way which does not involve those two elements? If it sustains damage of any kind at all, it cannot but be damage to the warp, or to the woof, or to both together; and, similarly, there is only one kind of cure: an interweaving of woof and warp which mimics the original process of its creation.

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22. But most people are unable to observe this overall point, being 5 deceived by the individual activities. Such matters belong within the domain of logical procedure, a subject in which these people who have the audacity to speak on set questions on a daily basis have absolutely no education nor training. If they did have any knowledge of logic, they would have been better advised to teach it to their students once and for 10 all, rather than solving thousands of such set questions individually. One who has learnt that procedure no longer has need of those thousands of discussions; for he is able to make all distinctions correctly for himself. 843 K. One who lacks this knowledge not only does not know whether such discussions are badly conducted, but is also at a loss with regard to any 15 of those very many set questions that he has not previously heard discussed.

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This is something of a digression, but let it stand as an attack on those who every day speak on set questions to their students without themselves knowing what they are talking about, being as they are quite untrained in logical theory, and deceiving their pupils through ignorance of the principle of assessment.54 In this particular case, for example, they simply do not investigate the question of how one should separate the different arts from each other – whether it should be on the basis of the individual or of the overall activities; or on the basis of neither of these, but rather of the aims and goals; or, again, of the materials, instruments, starting-points and the theoretical study. They thus make vacuous pronouncements on subjects of which they are ignorant. And so it may perhaps be advisable for me – since I have given you my undertaking to complete this ordeal55 – to give as good an account as possible in a very brief compass of all these statements that are made. Let us begin, again, with the individual activities.

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The plurality of individual activities within medicine; the fallacy of reasoning from this plurality to a plurality of arts 23. There is, then one individual activity by the use of which we sew up 844 K. eyelids; another, quite dissimilar, by which we couch cataracts; a third and a fourth, which are similar neither to the first two nor to each other, 10 by which we, on the one hand, cut fractured bone out of the head, and, in another part of the body, such as the upper arm or forearm, set fractured bone, by stretching, shaping and binding. All these activities are quite unlike surgery for ruptures, which in turn is unlike surgery for enlarged veins; and surgery for bladder stones is quite unlike all the 15 above.56 Most of the above activities are performed with a scalpel. But then there are the activities of applying ointment to the eyes, reducing a dislocated joint, applying plaster to a part, using a catheter correctly, or applying a cupping vessel, all of which are performed without a scalpel, 20 but which all differ widely from each other, as well as from those 54

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Kritērion: cognate with krinein, to assess, distinguish or separate, and used as a technical term to refer both to an epistemological item within logical or demonstrative procedure and to an internal mental capacity. The word athlos (cognate with the word for ‘athlete’) carries the connotation of a competitive and arduous activity. Galen refers to a number of well-known ancient surgical procedures. Some of these, as suggested in what follows, would have been performed by distinct ‘specialists’; cf. Introduction, section 3.2 with n. 34.

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­ reviously mentioned. So, too, the cutting of veins, dividing of arteries, p the scratching57 of the skin and the tapping of patients with dropsy: all these, too, differ both from each other and from all the above. These 845 K. surgical operations, and countless others besides, are performed by the hands.58 But there is then the whole other class of pharmaceutical activities, which are again quite different from each other as well as from the surgical ones. The drinking of hellebore, for example, or the eating of food, or fasting, are quite dissimilar to enemas, as is massage to bathing. Still more different from all these are the cleaning and purging of a wound, the application of a wet drug, the use of passive exercise and walking once it is dry again, or wrestling, or the drinking of scammony or honey-mixture. And the discernment of the pulse and the heat is again entirely dissimilar to all these, although performed by the extremities of the hands, as is the discernment of types of fluid contained in abscesses, of dropsical lumps, or those of ganglia, atherōmata, melikērides and steatōmata.59 For we do not employ the same applications and motions of the fingers, or the same manipulations or pressures in each of these cases; indeed, they are sometimes widely divergent. One could, it would appear, spend the entire day simply setting out the different types of activities, so great is their number.

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846 K. 24. It should be sufficiently plain from the above how great is the error of those who believe that arts should be separated according to individual activities. For surely no one would be so foolish or senseless as to remove 20 the above activities from the art of medicine and set up a separate art for each – the art of herniotomy, for example (a term which is nowadays employed in some quarters), of lithotomy or of tapping. Even if someone 25 may have the particular reputation of being a ‘herniotomist’, or a ‘tapper’, or a ‘lithotomist’, all are still called doctors. So too are those who 62 H. are named for the particular part of the body for which they exclusively take care: they are known as ophthalmic doctors, or doctors of the ears or 57 58

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The verb is aposchazein, on which see San. Tu. IV, n. 16. Helmreich supplied the words ‘the hands’ (τῶν χειρῶν), which seem required for sense, pointing to the parallel with HVA I.5,120,19 H. (XV.425 K.), where the connection is made between ‘surgery’ (cheirourgia) and what is done ‘by the hands’ (dia tōn cheirōn). The terms refer to a variety of kinds of abnormal growth or tumour. A ganglion was a knot-like growth, after which our modern ganglia are named; atherōma is named for the resemblance of its substance to porridge or gruel, melikēris for a resemblance to the honeycomb and steatōma for its suet-like nature.

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teeth; and still others are called after the materials they employ: dietetical, pharmaceutical or, indeed, botanical. Some have even been called ‘winegiving’ or ‘hellebore-giving’ doctors, because of the frequency with which they have been seen to employ these materials. 847 K. All human beings, I believe, are naturally endowed with rational principles, and so they know – some to a greater extent than others – that there is something which is the same in all the activities, and something which is different. The object for the sake of which they are created is the same (health being the aim in all cases);60 but the manner in which they are performed is not the same in each case; indeed, there will be a very great number of these. Now if, as indeed Plato does, one were to set up one art in relation to the manner and the overall aim in each case, and then divide this into forms and different types, and call each of these divisions an art, and so wish to use the terminology of a dietetic art, a pharmaceutical art and a surgical art, I have no objection to that.61 I would, indeed, have no objection if one were to impose further subdivisions on each of the above, so that dietetics would be broken down into things taken, things evacuated, actions performed and things that come into contact from outside, and one would set up a specific art for each of these. Nor, even, would I prevent still further multiple subdivision, right down to the individual activities, according to which, within the domain 848 K. of things taken, there would be one art for drugs, one for food, one for drink; and indeed I could even concede a specific art for each individual food, drink and drug. What I cannot accept, however, is the suggestion that these arts differ from each other in the same way as mathematics from rhetoric, or rhetoric from house-building or carpentry. These arts do not share a common aim; those which we considered just now all have the common aim of health. Rhetoric provides a parallel case: it is a single art, but within this single art I am happy to concede that there are different arts for the preamble, 60 61

Helmreich suspects the phrase in parentheses of being a scribal addition, it seems to me with insufficient grounds. Plato elaborates a method of division in the Phaedrus and also – with specific reference to different kinds of art – in the Sophist and the Statesman. Galen probably has those discussions in mind here, alongside the texts he actually cites, Gorgias and Republic; although he does not mention the Sophist or Statesman in this text, he does so in a similar context at Part. Med. 9, 129,9–12 Schöne. The Greek of the clause introducing the procedure attributed to Plato is not entirely straightforward: both the ‘manner’ (tropos) and the ‘aim’ (skopos) are objects of ‘set up’, so literally the phrase means ‘set up the manner and overall aim as an art’; and the word translated ‘in each case’ (ἑκάστου) means literally ‘of each [masculine]’, where it seems unclear what noun is referred to. (‘Forms’ and ‘distinct types’ correspond to the nouns eidos and diaphora; these are familiar terms of Aristotelian heritage, conventionally translated ‘species’ and ‘differentia’.)

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the narration, the proofs and the peroration,62 provided this only is admitted, that they are all different forms or, if you prefer the term, parts, of a single art. So too with medicine: I can speak of different arts of surgery, dietetics and pharmacy, provided only that it is accepted that all 849 K. have the same aim, by virtue of which they must of necessity be parts of a single art. This aim, indeed, appears to bring together the most diverse activities, binding or constraining them in such a way that all contribute to one single art. Consider the action of excising or cutting away a part which has become septic, by contrast with that of building up and fleshening up one which is hollow. The two actions are apparently opposites, different from each other in every way: the activities themselves are quite different, and the results are opposite. The one removes something which is present, the task of the other is to generate some substance which does not yet exist. But the excision or generating of something does not in itself constitute the practitioner’s purpose; similarly with cauterizing or cutting, one does not engage in these activities for their own sakes, but only because without them it is impossible to achieve health. It is this with which all these practitioners are urgently concerned, although they employ different methods. Because of this common aim all are called doctors, even if by virtue of their different activities, materials or parts of the body they receive different titles: ‘surgeon’ from the particular activity, ‘pharmacist’ from the material employed, ‘ophthalmist’ from the part of the body. 850 K. For it is by virtue of the fact that the parts to be treated are very different from one another, and of the fact that those treating them employ different operations and materials, that different names arise, some taken from the operations, some from the parts and some from the materials – ophthalmist, surgeon, pharmacist – yet nevertheless, on the basis of the goal, all are equally called ‘doctor’. It was shown earlier that all arts aim at the good of the being with which they are concerned, there being a primary good in each case. Now, it may be that one who is good at sewing up eyelids is bad at pharmacy; or that one who is outstanding in pharmacy has a poor understanding of dietetics; or that one who has cultivated that discipline has no manual training. But if on this basis we were to conclude that these were entirely different arts, we should end up, not just with three, but with three hundred. One man is good at using catheters, another at using enemas, another cuts veins well, another 62

Prooimion, diēgēsis, pistis and epilogos are technical terms from ancient rhetoric, representing the successive phases into which a forensic speech was divided.

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arteries; but then, when one comes across a single person who is good at all these, the arts will become one again. 851 K. Surely either procedure would be equally flawed – to chop up the art into lots of different ones just because of the incompetence of its practitioners, or to bring the many different arts under a single heading just because of their excellence. The former argument would preclude rhet- 10 oric from being a single art, not to mention mathematics, geometry, music, or indeed any other of the major ones, which are too large for the majority of those engaged in them to learn in their entirety. The latter argument, on the other hand, would in some cases make one art out of arts which have nothing in common at all; if the same man happened to 15 be a mathematician, a scholar63 and a philosopher, then it might be supposed that these were all parts of a single art.

Arts are defined by overall aims, not by individual activities or individual practitioners 25. We should not, therefore, distinguish the arts on the basis of the number of persons involved, but rather in accordance with the aims which an art has as its task; and we should consider here the overall activities, not the individual ones. For in each art you will find some point in common between all the individual activities; and it is in virtue of this that there is no obstacle to their being parts of a single art, even if they may appear to differ very widely. To weave a garment, for example, is 852 K. nothing other than to interlace warp with woof. Is sewing any different from this? No: here too woof is interlaced into the warp. If one made a decision from the outset to interlace woof and warp in a different manner, without employing the activity of weaving – either in the same way that torn clothes are in fact mended, or in the manner in which people make wicker baskets, food-baskets or nets – one would still be making a garment; it is just that it would take a great deal longer. It was through not just aiming at the goal, but at the speedier arrival at that goal, that the conception of the art of weaving on a loom came about; and it differs from the above-mentioned types of weaving not in an overall, but in an individual, sense. And so too with medicine: one might almost say that the individual operations are innumerable; but considered in overall terms, there is a common task of all of them. The one who removes something which is 63

See above, n. 38 and San. Tu. V, n. 28.

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superfluous from the body and the one who adds something to it which is missing are both engaged in the same overall task of rendering to the 15 body its normal good balance; and this balance is health. And those who heat, cool, dry or moisten the body are engaged in the same task.

The fundamental congruence between the creative operation of Nature and the ongoing maintenance or restoration of living beings 853 K. 26. Thus, if it were possible for us to carry out the generation of an animal from the outset, the principles involved in that initial creation would be no different from those involved in its restoration. So too, as things are, where we are not primarily responsible for either of these tasks, but it is Nature who first creates the animal and subsequently cures it when it is sick, it is not the case that the way in which it created flesh in the first place is different from the way in which it does so now, nor that the way in which nourishment is drawn in the embryo is different from the way in which this is done subsequently. Rather, all these, along with nutrition, separation, expulsion and, in short, all the activities, are performed in the same way now as in that initial creation. That the doctor is the servant of Nature;64 that the motto ‘Nature is in all sufficient to all’ is a fine one; that Nature itself brings diseases to their crisis and that natures are the healers of diseases – all these things have been quite adequately stated by the ancients.65 Why should I expand on them? Let me confine myself to a reminder of the single point which is of use for our present discussion, namely that making something and 854 K. repairing it when damaged do not belong to different arts, but to one and the same art. Or, even if they do not belong to the same art, nevertheless we have shown that medicine, although it does not bring into being something which did not previously exist, as does the tailor’s art, nevertheless resembles the art of repairing worn garments. We have also shown that the ‘preservation’ of any item has a twofold sense: there is one class of preservation (to which belongs our present subject, healthfulness) which consists in gradual, ongoing correction of wear and tear; and the

64 65

I have followed Helmreich in omitting the phrase οὐδὲ πρώτη τέχνη τις ἐκείνης, which (though it is odd Greek) would mean something like ‘and there is no art before it’. The motto is quoted from the Hippocratic De alimento 15 (IX.102 L.). In ancient medical theory the krisis is a decisive moment in the course of a periodic disease, especially a fever – a moment of intensification or paroxusmos followed by a period of relaxation of intensity, or in some cases by death.

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majority of people fail to appreciate the difference between this and the 20 other class, namely healing.

The relationship between activities and goals; the distinction between productive and merely active arts 27. Now, it may be thought that a goal consists precisely in the activity of making, whether it be a house, a garment, a household utensil, or health. This error arises from an inability to separate the actual goal from the activity that precedes that goal. It is not the building of a house that is the goal of house-building, but the house itself; not the weaving of a garment, or the construction of a ship, or a couch, or any individual article, but the article itself that is created – the thing which remains after the cessation of the craftsman’s activity. And this is a difference between the 855 K. productive arts and those which are merely active.66 With the latter, the goal ceases to exist when the activity ceases. Dancing, for example, has nothing to show other than its actual activity; by contrast carpentry can present a camp bed, house-building a house, medicine health. Thus, house-building is not the goal of the house-builder in the way that dancing is the goal of the dancer; the goal is the house, which is something separate from the activity. The goal of the weaver, similarly, is not weaving, or to weave, or the production or creation of a garment, but the garment itself. Nor is the production, creation or restoration of health the goal of medicine; these constitute the overall activity of the practitioner (the individual activities being cutting, cauterizing, setting joints and limbs, as well as reshaping and binding them; or, at a higher level of generality, surgery, pharmacy or dietetics); no, the goal is health, an item which is still there to be observed after the cessation of the practitioner’s activity. Nor is the preservation of health a goal, nor its restoration, nor, quite generally, to make healthy. All these are the activity; the 856 K. goal is health. The generic goal which is common to all the individual activities may be referred to in different ways by different people, while all indicating the same thing: ‘to make healthy’, ‘to produce health’, ‘the production of health’, ‘healthification’. In the same way people use the terms ‘cure of disease’, ‘healing of disease’, ‘activity of healing the sick’; or, indeed, ‘to cure diseases’, ‘to knock out diseases’, ‘to reintroduce health’, ‘to perform 66

This logical distinction between activity (praxis) and production or making (poiēsis) seems Aristotelian in origin; however, Aristotle defines all art as productive (poiētikē): Eth. Nic. VI.3, 1140a1–23.

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the needful’, ‘to remove the causes productive of disease’. All these refer not to a goal but to the activity that precedes that goal, as if the art 10 concerning the body were a merely active one in the sense of dancing or acting.

One should not use the different materials employed as a basis for the definitions of arts 28. We have presented a variety of demonstrations that arts should not be divided according to individual activities, but rather referred to their overall ones, with their proximity to their goal, after which one should attempt to distinguish the goals of those individual activities themselves. 857 K. Let us next consider whether the same applies to their materials. Now, it is apparent that there are many cases where one material underlies many different arts, and also cases where one art employs a wide variety of materials. Wood, for example, is the common material for shipwrights, carpenters, engineers and builders, as well as countless others; clay, too, is the material of many crafts; and so are stones and all other such things. So too the art of medicine, which is single, has a huge number of materials: the body itself which is the vessel of health; food and drink; all types of drugs; daily regimes. These latter, in fact, are really the doctor’s materials, while the body is that from which the goal comes about, or that in which it is realized.67 It is therefore obvious that materials should not be used as the basis for the division of arts. Some might posit a distinction between ‘common’ materials, which could be considered to be only incidentally the materials of a particular art, and others which belong properly, or are proximate, to each of the arts, and argue that our bodies, considered as natural bodies, are the material of natural science, considered as subjects of health, the material of medicine, and considered as ‘euectic’ or receptive of good-condition, the materials of physical training.68 Even then, however, one would still be separating the arts 67

68

The phrases ‘from which’ (ἐξ οὗ) and ‘in which’ (ἐν ᾧ) are used to indicate the material cause as opposed to final cause, understood in terms of the telos or goal. The distinction between types of cause traces its origins to Aristotle, though it was further developed in the Aristotelian and Platonic traditions. Although Galen does not elaborate the full scheme of four (or five) causes here, he does so elsewhere, at UP VI.12, i.339,7–18 H. (III.464–465 K.), also using such prepositional phrases. In the present text Galen seems to understand two different kinds of material cause, the body itself which is the recipient of health and the materials used by the doctor upon that body. ‘Natural science’ translates phusikē epistēmē: this is the knowledge involving study of the natural world in the broadest sense, including both ‘micro’ and ‘macro’ levels. The adjective euektikos is derived from euexia, ‘good-condition’, and refers to a body, branch of the art, etc., related to this

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858 K. on no other basis than that of the goal; for in saying that a certain body is 10 the subject of health one is already acknowledging a goal. Nor, even if one wished to separate the arts on the basis of their theoretical principles, would one be using a different starting-point from that which is, in effect, the goal;69 for it is the goal that demarcates and distinguishes the theoretical principles properly belonging to each art. Thus, the ones 15 properly belonging to an art are those through knowledge of which one is assisted towards that art’s goal. In scholarship, music or carpentry – as in any other art – anything which is able, either directly to bring about the goal, or to conduce to its better or speedier attainment, properly belongs to that art; anything which does not assist the production of that goal 20 does not.

Recapitulation: arts should be divided on basis of goals, from which further theoretical distinctions are derived 29. From every point of view, then, the argument dictates that we should go to the goal, and divide the arts on the basis of that. The differences in overall activities, theoretical principles and starting-points all derive from this. For indeed, these latter differ in relation to the goals of the arts. 71 H. 859 K. Health is the goal; it consists in hot, cold, dry and wet. Obviously the material starting-point lies within these, and the theoretical startingpoint is related to the knowledge of these. But these starting-points do not function in the same way for a doctor and for a natural philoso- 5 pher.70 This very feature – the difference in the way in which each science is derived from its goal – has been recognized and distinguished; and our argument always in an appropriate manner discovers the goal, as the standard and principle of assessment of all matters within the arts. The constitution of each art71 takes its starting-point here. No one 10 would wish to constitute an art of medicine without first having a desire for health, no more than one would wish to constitute an art of building without a prior wish for a house, or an art of weaving without one for clothes. The art which constitutes all arts, indeed, also takes its

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latter concept. Here and at subsequent occurrences I have rendered this technical adjective by this transliterated form, as it is difficult to find any close equivalent in English. I follow Chartier’s ἢ τοῦ δυνάμει, in place of τῇ δυνάμει. The sense of dunamis (‘capacity’) in the latter phrase is difficult to construe within the sentence, whereas in the former version dunamei (literally, ‘in capacity’) can be idiomatically taken to mean ‘virtually’, ‘in effect’. Phusikos, also translatable ‘student of nature’ – someone whose study is the ‘natural science’ just mentioned. Cf. San. Tu. I, n. 38.

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starting-point here. And we have shown elsewhere the correct procedure 15 for discovering the relevant art on the basis of a given goal. Anyone who wishes to follow the present argument properly should first school himself in that discussion.72 Then it will become quite evident to him that both parts, ‘healthfulness’ and ‘healing’, fall within one and the same theoretical study. If I were to transfer into the present work every matter 20 860 K. which has been discussed fully and in detail elsewhere, I would find myself exceeding the works of Menemachus and Menodotus in length.73

The single art concerning the body and the subdivisions within it 30. I believe, however, that the proposition that the art which concerns the good of the body is definitely single has been adequately shown by our argument thus far; it will be no less adequately shown in what follows. We have not yet, however, stated the appropriate name for this art. It is after all possible that it is neither medicine nor physical training but something else. It might be, moreover, that there is no name for this art, as is the case with many others. This point will be considered shortly; for the present, I affirm the truth of this above all propositions: that whatever the good of the body, it is a single thing, just as the good of every other being is single; that there is one art corresponding to it; and that the same procedure belongs to both the good and the art. Let us then investigate all the parts of this single art related to the good 861 K. of the body; we should surely in the process be able to identify the capacity of the part known as healthfulness. And so that there may be some [correct] procedure in our division in this case too, let us consider to what class the art concerned with the body belongs. Obviously its aim does not consist, as in the case of mathematics, astronomy or natural science, in contemplation alone; it also has a practical function in relation to the body. It is equally obvious, on the other hand, that its aim does not consist in the activity itself, as is the case with dancing, an art which has nothing to show once the activity has ceased. Evidently, then, it belongs in the class either of the productive or of the acquisitive arts, 72

73

While logos may here refer to a discussion in more general terms, it seems likely that Galen here has a particular book (which may also be referred to as logos) in mind: The Constitution of the Art of Medicine. Menemachus and Menodotus were well-known doctors of recent times, the former a representative of the Methodist school and the latter of the Empiricist. It seems that as authors they were notorious for the length of their expositions. On Menodotus see Perilli (2004).

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since we have found that it belongs among neither the theoretical nor the active. But it is not one of the acquisitive arts, such as angling and fishing, or hunting in general. These take control or possession of some existent thing; they do not produce something which was not in existence before. It remains, then, that the art concerning the human body must belong among the productive arts. Here, too, there is a twofold division, in terms of their tasks: a produc862 K. tive art may produce an entire object which was not previously there, or may repair some part of it which has suffered damage. Now, the art which we are at present investigating has no power to produce a whole human body; but it is able to repair its parts, like the art of mending garments; but here too there is a distinction in the manner of the repair. It is Nature which both makes the body and repairs it when it is damaged, and is in this way similar to the art concerned with clothes. The art into which we are enquiring is one that is subservient to Nature. For the sake of argument let us call this art ‘restorative’. Now, the restoration in question must either be a large one or a small one. Let that part of the art producing large restorations be called the ‘medical’ or ‘healing’ part; and that part producing small ones the ‘preservative’. Now, there are many further divisions within the former part, that involving large restorations: for every quantity admits of infinite subdivision. Since, however, it is not our purpose here to speak of these, let us leave this part to one side, and concentrate on the division of the latter. And it would appear that this is, in fundamental terms, tripartite. One may start with a subject who is at the peak of perfect health, and main863 K. tain him at that level; this division of the art is known as euectic. Then there is the art of building up the health of subjects who have just recovered from illness, which is referred to by some recent doctors as ‘recuperative’.74 Between the two lies the art which these same practitioners refer to specifically as ‘healthfulness’, whereas in a more general sense both the terms ‘preservative’ and ‘healthfulness’ are applied to it. These three parts of the preservative art, then, the recuperative, healthfulness and the euectic, all belong within that section of the art involving small restorations, which, however, differ in degree. The euectic involves the smallest restorations, while healthfulness involves restorations which are not quite so small, and those of the recuperative are larger again. Some would add a fourth division within the preservative art, giving it the specific name of ‘prophylactic’. The effect of this is the converse of 74

Cf. San. Tu. V.4, 142,22 Ko. (VI.330 K.).

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that which concerns itself with patients recently recovered from diseases. And, obviously, both these divisions have a kind of intermediate position between the two opposite parts of the art as a whole, that is to say that 10 involving large and that involving small restorations. For it is quite 864 K. evident to anyone that the healing art involves large restorations; and it should be obvious too that the euectic and healthfulness involve small ones. But those known as recuperative and prophylactic lie between the two: the restorations they employ are not small by comparison with those 15 of healthfulness, and not large compared with those of the healing part. It is my opinion, in fact, that the view of those who employ the appellation ‘neither’ for both these parts is not a bad one. But that is a different discussion.75 31. For the purposes of our present investigation, let us assume three 20 divisions of the preservative branch of the art concerned with the body: one directed towards patients who enjoy unstable health, one towards those who enjoy stable health, and one towards those who are in goodcondition; and let us call the first ‘recuperative’ (it is not worthwhile at 25 this point to engage in a dispute over terminology), the second ‘healthfulness’ and the third ‘euectic’. The first two have the function of 75 H. improving health, while the last maintains the existing condition.

Recapitulation of the original question; summary of the fundamental distinctions within the art This being the case, let us remind ourselves of the actual investigation 865 K. before us. It was, I believe, along these lines: ‘Is what is known as “healthfulness” a part of medicine or of physical training?’ Now, we quite 5 reasonably commented at the outset that the whole enquiry is concerned with definition. If we knew what medicine was, and what physical training was, we would then have no difficulty in discovering to which of them healthfulness belongs. As for healthfulness, I believe that its defini- 10 tion has now been stated quite clearly: it is either identical with the preservative as a whole, or else it is the middle one of the preservative’s three parts, that which is directed towards stable health. Any further enquiry would seem to be purely terminological, since the facts themselves no longer admit of dispute, provided that the proposi- 15 tions demonstrated above are agreed and remain established. Let me then 75

On the category of the ‘neither’ and Galen’s discussions of it, see Introduction, section 4.2.

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run through the chief points of that above demonstration, before turning to the terminological discussion. I state that, just as is the case with clothes, houses or shoes, so with the body, there is an art which although it is single has two parts, the one 866 K. creative, the other restorative; and that both of these [functions] belong to nature primarily, but that the second of them, the restorative, is assisted by a human art, which itself is divided into two parts, the healing or medical and the preservative. The preservative is also called healthfulness, and has three divisions, the recuperative, the euectic and that which is known by the same name as the larger entity: healthfulness. If, then, one wishes to enquire, either of the preservative as a whole, or of that part of it, whether it belongs within the art of medicine or that of physical training, one must go through the whole matter as I just have. You will then have to state that there is one art concerned with the body; and this you may, if you wish, call ‘medicine’, or if you object to that, ‘physical training’; or you may even state that the art as a whole has no name, but call one division of it medicine and the other physical training; or, if you do not like this either, you may have (in contradistinction to the art of healing) an art of healthfulness, which, if you so wish, you may further 867 K. divide into a dietetic part and a ‘physical training’ part. If you give a full account of each of these terms, then everything else will fall into place.76

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The arbitrariness and conventional nature of terminology 32. Wait a minute, I hear some of you say: terminological distinctions should not be made on the basis of personal whim, but of what is correct. Well, my reply, again, must be as follows: if you are going to say that this is no longer an investigation of the facts, and the question you have set me consists merely of an account of terms, then I do not shrink from such a discussion. But I must state that I have nothing clever to say, either about the terms used in the present enquiry, or about terms in general. My view is simply that if the term is from the language of the Assyrians, one must learn from the Assyrians the identity of the object to which they apply that term; if it is from the language of the Persians, Indians, Arabs or Ethiopians, or indeed any other people, one must learn it from them. An uttered term indicates nothing in itself. Now, that is my view. There are, however, some who claim that a term 868 K. does in itself indicate something to them. I have presented such people 76

Literally, ‘the whole will follow’.

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with large numbers of words collected from the Celts, Thracians, Mysians and Phrygians, and demanded that they state what object is revealed to them in each case. Their response at this point was that their ability was confined to the Greek language. I then presented them with the word limēn.77 When they replied ‘where ships are moored’, I mentioned that the Thessalians use the term for what we call ‘market-place’ [agora]. They then said that they had no knowledge of the Thessalian dialect – as if that were not to admit my initial claim, namely that the only way to learn the application of a term is from the people who apply it. I have written a separate treatise addressed to those who are so stupid;78 for those whose especial and primary concern is to learn about actual things, on the other hand, and whose efforts are engaged on that useful task, desiring to learn the terms applied to those things purely for the purpose of communication, I shall offer an account of the usage of the Greeks – and not that of all the Greeks, nor with respect to all words, which would be a matter of 869 K. linguistic or scholarly research. But I do claim some experience of Attic terminology, in particular, and secondarily also of Ionic, as well as of Doric and Aeolic. In these latter dialects, however, I am ignorant of the majority of words and know only a minority, while in the case of Attic that situation is reversed.79 If you do want a discussion of terms, consider what Homer says: Your doctor is a man worth thousands of others: Arrows he cuts out, he lays on soothing potions.

or again: Drugs, many fine in the mixing, many are baneful; Every doctor knows them all, of both kinds.80 77 78

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The standard classical Greek word for ‘harbour’, which, however, as Galen explains, had different senses in different Greek dialects. It is not clear which of his works Galen means here, but in My Own Books amongst the titles he gives (of works now lost) are Words Used in More than One Sense, Correctness of Terms, Against Those Who Interpret Words Maliciously and The Enquiry concerning Word and Meaning (ch. 14); and he also wrote a number of works dedicated to the vocabulary of various classical Greek authors, a subject he considered important for the elucidation of particular terms, the reference of which had shifted over time (ch. 20). Attic was the central dialect of classical Greek literature. By Galen’s time this literary dialect was the basis of formal Greek linguistic and literary education, as well as, in less formal and ‘high’ form, of the dialect spoken widely throughout the Greek-speaking world, known as koinē. There were literary-ideological debates as to how ‘Atticizing’, i.e. how puristic in the attempt to emulate classical Attic usage, writers should be. Galen takes a somewhat ambiguous position, on the one hand claiming to have no interest in such purism, and (as in the present discussion) to regard all linguistic usage as conventional and arbitrary, on the other strongly classicizing in his own ­vocabulary and syntax, and at times keen to parade his superior knowledge of Attic usage. The first pair of lines quoted are Iliad XI.514–515, the second Odyssey IV.230–231.

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indicating that it is the doctor’s art which cures the sick by both drugs 15 and manual operations.

Absence of gumnastikē as a branch of medicine in Homer and Plato; Hippocrates’ and Plato’s views on athletes and training 33. Now, whether in Homer’s time there was also a third branch of medicine, the ‘dietetic’, I would not like to conjecture; but one who is my elder and may be better trusted for his knowledge of Greek affairs, 870 K. the philosopher Plato, claims that the ancient sons of Asclepius81 did not engage in this part of the art at all. That there are these three branches, however, and that the art of treating bodies which are not in an abnormal state is called medicine by all Greeks, can hardly be denied. There was not yet a term for the art of physical training in Homer’s time; nor is there any individual called a ‘physical trainer’, as there is a ‘doctor’; and indeed, even in Plato the term ‘physical training’ occurs rarely, as he prefers to call the practitioner of this art ‘child-rearer’82 rather than ‘physical trainer’. The art of the physical trainers began a little before Plato, at the same time as the practice of athletics. In ancient times you would find a single man who was genuinely euectic in relation to the performance of all normal bodily activities. In competitions such a person would not just wrestle but also race; and it was not uncommon for one man to win in both these categories, as well as in javelin, archery, discus and the chariot-race. Only later were these different skills separated; and everyone became like Homer’s Epeius, in last place when it comes to any 871 K. normal activity, but good at boxing, the only use of which is

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The term ‘Asclepiads’, with the literal sense of sons or descendants of the god Asclepius, came to be used to mean doctors in general. The word’s implication of a family or clan is significant also in the sense that doctors in early times seem to have functioned in such family units, involving closeknit groups and successions and heirs, whether biological or adopted. Paidotribēs: the term lost the sense of its etymological connection with children (paides) quite early on, and elsewhere I have translated it ‘instructor’ (cf. Introduction, section 3.2 with n. 33); I here preserve a more ‘literal’ translation, since Galen’s discussion here is ‘about terms’. If the text here is correct, Galen is not exactly right about Plato’s usage: the abstract noun gumnastikē occurs quite frequently to refer to this art (85 times according to a TLG search). When it comes to the name for the practitioner, however, it is true that Plato seldom uses the term gumnastēs, and seems to prefer paidotribēs in a similar sense. But in the subsequent discussion, from ch. 34, Galen is not only aware of Plato’s use of the term gumnastikē, but indeed claims that he uses it to refer to what Galen means by hugieinē or to hugieinon. It seems therefore that Galen is either being forgetful or vague here, or possibly that the text should be emended to read τοῦ γυμναστοῦ for τῆς γυμναστικῆς, so that the claim would apply to Plato’s use of word for the practitioner, not the art.

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­c ompetitive. 83 Like him, they would be unable to sow, to dig, to complete a journey or to perform any other peace-time task, still less any of the actions of war. 34. This kind of ‘good-condition’ has already been the subject of our criticism, as has the art which supervises it, that of physical training. In opposition to this we have proposed a different good-condition, which is not only safe but of positive value for all the normal bodily activities. There are two types of material which produce and maintain this goodcondition: that known as the daily regime for health,84 and exercise. There are in all four classes of material which cause change in the body: manual operations, drugs, daily regime and exercise. One is useless to the sick, and two are useless to those in a normal state. The sick person may have all kinds of need of drugs, surgery and daily regime, but will have none of exercise; while the person who enjoys perfect health will have some need of exercise and daily regime, but none of drugs or surgery.

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872 K. 35. So physical training is a part of the healthful art; and Hippocrates has given us adequate instruction on both. He has given a full and most accurate account of the knowledge one must have of airs, places, waters, winds and seasons, and also of food, drink and daily practices. These are the elements of which daily regime consists. Similarly, Hippocrates has given a sufficient account of the appropriate time, quantity and quality, not only of exercise but also of massage. Plato appears to have used the term for one part of the art to refer to the whole: he speaks of an art ‘of physical training’ rather than one ‘of healthfulness’. The reasons for this would be that physical training is the par excellence activity of the healthy (it is not employed by the sick at all), and that he considered this part alone to require a supervisor. A body which is in perfect health, provided that it follows its normal appetites, will make no error with regard to food, either in terms of its quality or in terms of the appropriate time of its use. (This, however, is a separate discussion.) But that Plato regarded the physical training which is a part of the art concerned with the body as different from that which enjoys

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The character mentioned features in the twenty-third book of the Iliad; see especially XXIII.664– 669. (Somewhat confusingly, his name is shared by another character, who, so far from being ‘last at any normal activity’, was such a skilled craftsman that he built the Trojan horse.) For the terminology and tradition of the ‘daily regime for health’ (hugieinē diaita) see Introduction, section 2.2, with n. 11; Galen has in mind here, and in the following reference to particular Hippocratic texts, specifically the works Airs, Waters, Places and Regimen (as clarified further below, ch. 39, 87,9–11 H. (V.881 K.).

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873 K. popularity these days, will emerge quite clearly from what follows. Let me transcribe some quotations of his.85 First, one from the Gorgias, 81 H. which goes like this: Since there are two things in question, I say that there are two arts: the art regarding the soul I call ‘political’; for that regarding the body I cannot furnish you with a single name in the same manner; I shall say rather that 5 the healing of the body is a single [art], and that it has two parts, physical training and medicine.86

Here Plato indicates quite clearly that there is one art of healing, and that it has two primary divisions, also that the parts have names while the art 10 as a whole does not. The further propositions that this art aims at the best, and that this best is good-condition, are evident from exchanges such as the following (each of these propositions is laid out in the same book): ‘You agree that there is something called body and something called soul?’ ‘Of course.’ 15 ‘And you believe that each has its own good-condition?’ ‘Certainly.’ ‘And is there such a thing as an apparent but not real good-condition? What I mean is: there are many whose bodies appear to be in a good state, and of whom it would be difficult to detect the fact that they are not so, unless one happened to be a doctor or some sort of expert in physical training?’87

874 K.

And Plato goes on to explain that the aim of these practitioners is that 20 which is best [for us], while the aim of cooks and beauticians is that which is most pleasant. 36. The physical training practised by those who train athletes is a perverted art, which they attempt to dignify with a respectable name. In Plato’s time, it had not yet departed so far from normal practices as it has 82 H. now, but it had already begun to aim at something other than that which 85

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For analysis of Galen’s manipulation of the Platonic texts that he cites here, especially the Republic with its apparently strongly hostile attitude towards dietetics, see Introduction, section 8.5. It should be noted that in Galen’s quotations from Plato, as from other authors, minor differences appear in relation to the text we know from the independent MS tradition and editions of Plato’s works. These are almost always trivial, and by no means all will be mentioned; however, as an editorial principle I aim to preserve what Galen wrote, rather than correcting it in the light of the received text of Plato (as Helmreich tends to). Plato, Gorgias 464b. Plato, Gorgias 464a. The term so translated is not the regular gumnastēs but the vaguer adjectival form gumnastikos.

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is best; and Plato criticizes it on these grounds, as a form of strength aimed at overcoming one’s antagonist, in the third book of the Republic, 5 as follows: ‘And indeed,’ he said, ‘above all this superfluous care of the body, if it goes beyond the dictates of physical training.88 It causes problems for the management of a household, for military actions and for the stable conduct of civic offices. The biggest problem, though, is that it impedes 10 any kind of learning, contemplation or private study; for it is always accompanied by the fear of some strain or swimming in the head, the origin of which is then attributed to the practice and trial of philosophy; so that it is an absolute hindrance in any context where virtue is so cultivated and attempted. It gives one the impression of being a permanent 15 invalid, and in constant bodily pain.’89

875 K.

A subsequent passage indicates even more clearly that Plato does not consider the goal of physical training to be strength in competition, but rather the function of normal activities: He will undergo actual exercises and exertions with a view to the spirited part90 of his nature, and to stimulate that, rather than for the sake of his 20 strength – unlike the other athletes, who employ food and drinking 83 H. parties for the acquisition of bodily vigour.91 88

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Although Socrates here refers to the excesses of physical training – what goes beyond physical training – he may also, in context, be making a broader point about gumnastikē and/or healthfulness; see next note. This sentence contains some minor deviations from the received text of Plato: for the first word, the Galenic MSS have ‘and’, καὶ, against the Platonic MSS’ ‘yes’, ναὶ; and ‘if it goes …’ translates εἴ γε, whereas the Platonic MSS read ἥ γε, ‘which goes …’. At l. 13, however, the MSS seem to offer impossible readings, and I follow Helmreich in correcting to ὅπῃ ταύτῃ ἀρετὴ. Plato, Republic III, 407b4–c5. On the context of this passage within the Platonic text, in relation to Plato’s views on medicine and its relationship with gumnastikē, see Introduction, section 8.5. On the ‘spirited’ (thumoeides) and the Platonic tripartite soul, see Introduction, sections 6.3 and 6.5. Plato, Republic III, 410b5–8. The subject of this sentence, as provided by the immediate context in the original text, is the mousikos, or person with the correct early cultural training (the term mousikē has a broader application than to music alone), which, as characterized by Socrates, should above all be simple, and non-luxurious, in nature, and geared to the development of (especially militaristic) virtue. A contrast is thus being made between the form of gumnastikē that this properly trained, healthy and virtue-oriented person will engage in, and that of ‘the other athletes’. Within this passage there are four variant readings offered by the Galenic textual tradition as compared with the direct MS tradition of Plato. I adopt these variants as likely to represent Galen’s version of the text. Two have been accepted into the text of Plato by at least some editors; a third is unimportant; a fourth – although it is a much more significant variant than the others, and in my view stands a good chance of being the correct Platonic reading – seems to have been universally ignored. (1) For the first three words the Basileensis edition reads αὐτά γε μὴν for αὐτὰ μὴν: here the γε (accepted by most editors of Plato) has an emphatic sense, highlighting that it is actual exercises (which incidentally are mentioned here for the first time in the discussion) that are undertaken, not something else. (2) For ‘to stimulate that’ Galen reads κἀκεῖν᾽ ἐπεγείρων as

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From all this it is evident that Plato keeps precisely to Hippocrates’ view92 on this type of physical training, the goal of which is the goodcondition of athletes. He criticizes it as being of no use for the affairs of 5 the city, a point asserted by Hippocrates too, in the following summary form: ‘The athletic state is not normal; better a healthy condition.’93 The 876 K. fact that the extreme of this athletic state, which they are eager to achieve, is actually dangerous to their health, as well as the fact that both 10 Hippocrates and Plato were aware of this, has been stated in other works too.94

The unhealthy practices of athletes 37. Since, however, I have now embarked upon this task of exposing the bad version of good-condition and physical training, I shall restate this 15 point too, in as brief terms as possible.

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opposed to κἀκεῖνο ἐγείρων; this makes practically no difference to the sense. (3) In place of the Platonic MSS’ singular form of the verb ‘employ’, μεταχειριεῖται, Galen reads the plural μεταχειρίζονται: this seems more idiomatic, and has been accepted by some Platonic editors and translators (and in this case also by Helmreich). (4) The Galenic MSS read πότους, ‘drinkingparties’, for the Platonic MSS’ πόνους, ‘exertions’, in the last line. Editors of Plato – and indeed Helmreich – have taken it that the Galenic MSS are clearly wrong, and that Plato must be repeating ‘exertions’ (πόνους) from the first part of the sentence. The grounds for this are presumably that Socrates must be understood as focussing purely on the two different motivations or principles underlying the use of ‘exertions’ by the mousikos and the other athletes – the stimulation of the spirited and the acquisition of strength or vigour, repectively – rather than suggesting that the two sets of activities are radically different in kind, let alone that the latter do not actually involve exertion or exercise. Yet the two sets of activities are substantially different, even without the adoption of the reading πότους: exercise (γυμνάσια) is not actually mentioned in the second case, and food (σιτία) is not mentioned in the first, appearing rather unexpectedly in the mention of ‘the other athletes’. Stylistically, the pairing σιτία καὶ πότους is natural enough, and would contrast strongly with the earlier τὰ γυμνάσια καὶ τοὺς πόνους – whereas the partial variation between the two pairs, whereby one term in each, πόνους, is repeated while the other two diverge, seems stylistically awkward and offers a much less clear contrast. If an emendation to the text of Plato on the basis of the Galenic MS reading were accepted, then Socrates would not at this point be describing ‘the other athletes’ as engaging in exercises at all. (Point 1 above is relevant here too: the way that ‘exercises’ are suddenly introduced in the text as the practices that, specifically, the mousikos engages in.) Rather, he would be offering a scathing characterization of athletes, focussing – in a way which would prefigure Galen – on their unhealthy ‘stuffing’ of themselves. It should be clarified that this discussion in the Republic gives little more detail, beyond this passage, on actual physical training or athletic practices, making the issue difficult to decide on that basis. Galen argues at length, especially in The Doctrines of Hippocrates and Plato, for the agreement of those two authors on a number of fundamental doctrines; and there he states the further view, echoed also by the language here (literally, Plato ‘preserves Hippocrates’ view’), that Plato is in such contexts adopting or following Hippocrates. Cf. n. 24 above. Galen perhaps has in mind his Exhortation to Study the Arts, which also contains a virulent attack on the lifestyle of athletes.

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Health is situated as a certain kind of good balance, whereas this form of physical training creates imbalance, by increasing the amount and the density of the flesh, and producing a build-up of blood which is extremely viscous. For its aim is to increase not only the strength, but also the volume and weight, of the body, as these too assist in the overpowering of one’s opponent. It is therefore not a difficult discovery that the practice is for this reason useless from the point of view of the normal activities, and in other ways dangerous. Within every genuine art, the greatest achievement must be the maximal realization of that art’s aim; but in this case such an achievement turns out to be the worst thing of 877 K. all, as the art establishes not a natural state but, as Hippocrates says, one which is ‘not normal’. Natural goods grow better by progress, increase or augmentation; those which are not natural become more problematic the greater they are. Thus it has happened that some of these people have suffered a sudden loss of voice, others of feeling or motion, or even complete paralysis, as a result of this abnormal volume, and of the build-up, which extinguishes the innate heat and obstructs the pathways of exit for the breath. The least violent damage that they will sustain is to rupture a vessel and then vomit or spit blood. Let us now, then, escort from this writing, once and for all, the artificers of this type of good-condition, who are responsible for the extraordinary compositions currently being touted by people with severe damage to their ears. You will yourself be aware, my dear Thrasybulus, that I consider them not even deserving of a response. These are people who yesterday or the day before were indulging in unnatural stuffing of their bodies and sleep, yet who then have the incredible arrogance to expound shamelessly and at length on matters on which even 878 K. persons who have undertaken considerable training in the discernment of whether propositions are in logical agreement or conflict are unable to make a ready declaration. What would be the gain from such an exchange? What would such people learn if they heard some theoretical principle of great profundity, wisdom and accuracy? In this type of theoretical study, even those trained from childhood by the best teaching do not always make good judges. It would be remarkable if persons who were trained to win competitions, but who had so little natural talent that they failed even there, before at some point later announcing themselves as physical trainers, were the only individuals endowed with such extraordinary understanding. The reality is rather that it is wakefulness, and mental exertion informed by learning, not sleep, that are conducive to sharpness of ­intelligence;

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and it is an almost universally approved proverb – simply because it happens to be perfectly true – that ‘fat stomach begets not fine mind’. Perhaps, then, it is the dust that has presented them with their great wisdom?95 It would, however, be a little difficult to imagine mud as the 10 artificer of wisdom, when one observes that it is the habitual abode of hogs. Nor, on the other hand, would it be reasonable to suppose the lava879 K. tories, in which they pass so much of their time, a fertile breedingground for mental brilliance. And yet, they had no previous activities 15 apart from these: it has been plainly observed that they spend their entire lives in a perpetual round of eating, drinking, sleeping, defaecating or rolling in dust and in mud.

An appeal to the health tradition of Hippocrates and his successors 38. We may, then, dismiss these individuals. Our purpose from the outset was the investigation of arts, not of perverted arts. We should summon instead those who are experts in true physical training: Hippocrates, Diocles, Praxagoras, Philotimos, Erasistratus, Herophilus and all those who have thoroughly learnt the whole of the art related to the body. Now, you have just heard Plato’s opinion, that the art has no specific name of its own; do not then go looking for a single term to apply to the whole of the art related to the body, for you will not find one. If you ever find yourself in the position of having to speak about this art, it should suffice you to take a leaf from Plato’s book and to explain that you state that there is one art of healing the body, and that it has two parts, physical training and medicine – the former, obviously, regarding healthy 880 K. people, the latter the sick. What is more worthy of investigation is that Plato did not create an opposition between the art of healthfulness and that of medicine, as did all the above-mentioned individuals. Let me illustrate this by reference to one of them – since indeed his compositions are readily available to all of us. In the first book of his work on Healthfulness, Erasistratus writes as 95

‘Mental exertion’ translates phrontis; see Introduction, n. 106 and below, n. 101. The proverb quoted is a verse line, cited by several authors after Galen’s time, and also by the Anonymus Londinensis (XVI.3) before him; it seems to be by a comic poet, but of uncertain identity and date (Kock III.1234). For the negative associations of mud as applied to athletes, cf. their comparison with pigs in ch. 46 below; and cf. Protr. 11, 106,3–11 B. (I.27 K.), quoted in the Introduction, section 3.1, with n. 28 citing the similar anti-athletic satire of Lucian, which also focusses on the accumulation of flesh and the rolling in mud.

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follows: ‘It is impossible to find a doctor who has dedicated himself to the study of healthfulness.’ And later: ‘Indigestion in conjunction with an ailment, and the treatment of such indigestion, belong within medicine, not within the study of healthfulness.’ Further on he says: ‘If there is some malaise in the body which causes everything taken to decay, so that there is a return to the pre-existing bad fluid, it is for the doctor, not the health-practitioner, to dissolve such a state.’ And again later: ‘It is for doctors, not practitioners of healthfulness, to discuss and dissolve such states.’ It is thus apparent that Erasistratus not only used the terminology ‘of healthfulness’ with reference to a particular kind of art (this he has in 881 K. common with all the others), but that he also calls its practitioner a ‘health-practitioner’, in just the same way that one names the practitioner of medicine a doctor.96 So, then, the art of healing the body, which has no specific name amongst the Greeks, is divided into two primary parts; and just as we term these the arts of medicine and of healthfulness, so too we may term the practitioner of each doctor and health-practitioner. Many other doctors, too, have also used this terminology.

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The absence of a specialized category of the ‘healthful’ in Plato and Hippocrates 39. It seems likely, however, that in Plato’s time neither of these ‘healthful’ terms – neither that for the art nor that for its expert – was an established part of Greek usage. Even Hippocrates’ work on healthfulness is not actually entitled ‘healthfulness’; rather, one of them is entitled 10 Regimen and the other Airs, Waters, Places. It is possible, as I mentioned earlier, that Plato did not see a need for daily regime in general in the case of healthy persons, but only for physical training. Perhaps, too, he did not see the recuperative and prophylactic parts of the art as belonging 15 to this physical training; these, as was stated above, have an intermediate status, and can be regarded as part of whichever of the primary divisions one wishes. 882 K. If, however, one does allot these branches to the doctor, there will be rather little left for healthfulness, which will then only include the consideration of airs, waters, places, exercises and foods. Nor, indeed, of 20 all foods, but only those which are suitable for the healthy. Perhaps, 96

Cf. San. Tu. I, n. 121.

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indeed, since the subject of airs, waters and places was already well known to doctors – the healing part of the art having been the first to be constituted – nothing was still left to be learnt, from the point of view of 25 becoming not just a doctor but also a health-practitioner, than the art which concerns itself with exercise. It is therefore not implausible that the 88 H. whole should have been named by reference to this part.97 But this is a terminological, not a factual, investigation.

The correct methodology of division 40. As was stated previously, however, if someone, in spite of realizing that the question is a terminological and not a factual one, still requires me to make some statement on it, I will say that it is preferable for those who state that there are these two primary parts of the overall art to term them healthfulness and healing – since, indeed, we have learned in our 883 K. study of the procedures of division to place in contradistinction to each other items belonging to the same class. If, for example, someone were to state that some animals are ‘of the air’ and others ‘of the water’, it would clearly be incongruous to add to these a third class of ‘rational’ animals. The former distinction requires, rather, the addition of the classes ‘of fire’ and ‘of earth’, for these are analogous to those of air and water, while the latter requires ‘rational’ to be placed in contradistinction to ‘nonrational’, just as mortal requires immortal, wild tame, and pedestrian to both flying and swimming. It would be the height of illogicality to say that some animals are immortal, while others go by foot and still others are bipeds. It is the same with the art concerning the body. If one wishes to discover the parts of it by a process of division, one will state that the cure of the sick belongs to the art of medicine, while to take care of the healthy belongs to the art of healthfulness. Still better than this – as stated earlier – would be to say that there is a restorative art in relation to the body, and to call the part of this that makes large restorations ‘curative’ or ‘medical’,98 and the part that makes small restorations, of a sort 884 K. which are not even noticed if done early enough, ‘preservative’. Still 97 98

The connection in Greek is of course clear between ‘exercise’ (gumnasia) at the end of the previous sentence and ‘physical training’ (gumnastikē) here; cf. n. 6 above. The two words are closely related in Greek. That translated ‘curative’ is iatikon, a less common form than that translated ‘medical’, iatrikon; both, however, are derived from the same root, which also gives the forms iasthai, ‘to cure’ and iatros, ‘doctor’.

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better would be to name them from the materials with which they are concerned: the one ‘unhealthy’, the other ‘healthful’. And if you want a further division of the healthful or preservative part (it has already been stated that either of these terms may be used), you will divide it into three on the basis of the underlying materials, as mentioned above: that known as the recuperative, healthfulness in the particular sense, and the euectic. Each of these has its own specific material: the first, the body with unstable health; the second, that which has stable health; the third, the so-called euectic body. For it happens that the bodies in question have the same names as the parts of the art.99 And if you wish to make distinctions according to the different materials of the remedies, then you will make a fourfold division of this preservative or healthful art.100 For the art will then consist in those directed to: things taken; actions performed; things evacuated; and things that come into contact externally; these are the factors by which health is preserved. The part of the art which consists in ‘things taken’ is the 885 K. knowledge of which foods and drinks conduce to the preservation of health; that which consists in ‘things evacuated’ is the knowledge of sweats, faeces, urines and in short all things which need to be evacuated from the body; that which consists in ‘things that come into contact from outside’ is the knowledge of air, of water, of the salt water of the sea, of oil and of all other things of this kind. The fourth and remaining area, that of actions performed, consists in exercises and in daily practices. Waking, sleeplessness, sleep, sexual activity, rage, worry,101 and bathing also belong in this class; and the health-practitioner must discern the correct quantity, quality and appropriate time for each of the items mentioned.

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Galen’s use of the term ‘materials’ (hulai) here seems to be distinct from his usual usage, based also on that of the previous medical tradition (see Introduction, section 5.2), where the reference is to the materials of remedies (boēthēmata), that is the various means by which cures are brought about. Here, by contrast, he takes the body which is the subject of health to be the ‘material’. 100 On this fourfold division, and its sources in the previous tradition, see again Introduction, section 5.2. 101 The range of mental or emotional activity covered by these two terms is difficult to capture in English: thumos, related to the ‘spirited’ part of the soul in Platonic language, may include not just anger but more broadly ‘spirit’ or competitive mental activity; phrontis may include concentrated mental activity, especially that of the intellectual or scholar (cf. n. 95 above), as well as more simply ‘worry’. On the significance of psychological factors for bodily health, as well as the presence of the Platonic tripartite soul in Galen’s work on health, see Introduction, sections 6.2–3.

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The position of exercise within healthfulness 41. The knowledge of exercises thus constitutes a very small part of the art of healthfulness; for it seems right to use the terminology of ‘art of physical training’ for the knowledge of the effects of all kinds of exercise, of which those that actually take place in the wrestling-school are an extremely small part, and indeed the least useful.102 For example, rowing, 886 K. digging, reaping, spear-throwing, running, jumping, riding, hunting, armed combat, chopping and carrying wood, farming – the normal performance of these and all such activities is superior to exercise in the wrestling-school. You may thus see, not only how small a part of the art of healthfulness is physical training, but, further, how minimal a part of physical training is that which takes place in the wrestling-school – and, moreover, the fact that the practice of athletes is tangential to this minimal part. It brings about an abnormal state, and has a perverted art as its supervisor – one which pretends to the fine goal of good-condition, but in fact produces anything but that.103 Yet people who have been unsuccessful as athletes suddenly present themselves as experts in this kind of perverted art. The genuine experts in physical training, however, are Hippocrates and the band of associates mentioned in connection with him above. Of course, as in the context of medicine, so too with exercise, not every statement by each of those individuals is correct. But it is no part of 887 K. my present purpose to refute their errors. I am attempting rather to give an account of the term ‘physical training’, and to explain that it is a knowledge of the effects of exercises, just as pharmacology is a knowledge of the effects of drugs;104 both these parts take their names from their materials, in the same way as the other parts mentioned just now. 102

Again, one must have in mind the linguistic and conceptual connection in Greek between the terms translated ‘exercises’ (gumnasia) and ‘physical training’ (gumnastikē); cf. n. 97 above. For detail of the activities that take place in the wrestling-school (palaistra), see San. Tu. II, especially chs. 9–10. 103 There are two participles in parallel here, translated as ‘pretends to’ and ‘produces’; but in the MSS the first appears with a feminine ending (ὑποδυομένην), thus referring to the action of the feminine noun κακοτεχνίαν, ‘perverted art’, the second with a neuter ending (ἐργαζόμενον), thus qualifying the ‘practice’ (ἐπιτήδευμα) of the athletes, and it seems that one must emend one or the other. While Helmreich changed ὑποδυομένην to ὑποδυὀμενον, it seems to me preferable to take both participles as referring to the action of the ‘perverted art’, which is better understood as ‘pretending’ or ‘insinuating itself ’ in this way: the verb has connotations of mask-donning. I thus retain the MSS’ ὑποδυομένην, but emend ἐργαζόμενον to ἐργαζομένην. 104 Alongside the Greek etymological connection between gumnastikē and gumnasia, already mentioned (cf. nn. 97 and 102), Galen relies here on that between pharmakeutikē (­pharmacology) and pharmaka (drugs).

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False and correct classifications and interrelationships of physical training, medicine, preservative, etc. 42. It is obvious from the above that those who place physical training in contradistinction to medicine are in error; the former takes its name from the material employed, the latter from the overall, general activity. The first level is that of the individual activities – purging by hellebore or scammony, for example, or cutting a vein, excising a piece of bone, giving instructions to fast, or prescribing nourishment. Above these comes a level of more general, and indeed overall, activities: those of pharmacology, of manual operations and of dietetics; and common to all these is the activity of curing, just as, surely, the activity of preservation is common to all the activities that are performed in relation to healthy bodies. If, on the other hand, one places the preservative in contradistinction to the medical part, one is making an opposition between objects within 888 K. the same class. Both are called after an activity, just as unhealthy and healthful are both called after the underlying material, and pharmacology and physical training after the material of the remedy (while the former belongs to the unhealthy or medical part of the art, and the latter to the healthful, preservative part).

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Subordinate and directing arts; the position of wrestling-school exercise in relation to the healthful art as a whole 43. But here we must pay careful attention, and consider whether we are 10 not without realizing it demonstrating the supervisor of wrestling-school exercise to be the same as the expert in physical training, and producing another division of physical training as a whole, which we might term ‘expertise in wrestling-school exercise’.105 For the person who knows how to perform all the wrestling-school exercises, and all the individual 15 actions involved in each type of massage, is analogous to a baker, cook or house-builder: these are people who know how to create bread, food or houses, but have no understanding or knowledge of which of those objects is useful or not useful, or of what effect each has in the context of 20 health. Now, the art which takes care of our bodies is, as we have stated 889 K. repeatedly, one; these other arts provide it with its materials. The shoemaker is not the expert on whether a person should wear shoes or go 105

Galen uses the word palaistrikē, derived from palaiein, ‘to wrestle’ or palaistra, ‘wrestling-school’.

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unshod, nor on which particular type of shoe a particular person should wear. Hippocrates is an expert in this area; he prescribes mud-treading boots for one particular patient,106 but he is not about to craft these boots himself, any more than a general will craft a helmet, armour, spear, shield, dagger or greaves. A house-builder knows nothing of the effects of habitations built on high or low ground, of east- or west-facing, of those which point north and are cold or point south and are hot; of dark or light; of basements or top floors; damp or dry.107 He has no idea at all of the benefit or harm caused by any of these factors. No more does a baker know who should be given pure bread and who mixed bread, or who a lot and who a little, nor at what time; but he can still prepare them perfectly well. 890 K. Similarly, a cook may be competent to produce dishes of lentil, barley, groats, beet and so on, but will know nothing of their different capacities. These types of art provide all the materials for the art which heals the body, just as they in turn derive their materials from others. The baker is provided with grain by the farmer, with an oven by the oven-maker, with wood by the wood-cutter, with his slab by the carpenter; and the carpenter in turn is provided from various sources with his axe, his line and his wood. And in the same way the art of the smith gives the shoemaker his knife, the art of the tanner his hide, that of the carpenter his last. The house-builder is served by masons, stone-cutters, brickmakers and carpenters, who provide his stones, bricks and wood fittings. Such arts as these depend on each other, as well as providing the higher-level arts with those materials on the basis of which they achieve their goals and the serviceable tools with which to perfect those materials.

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44. But it is the art of healing the body which stands over them all like a 891 K. kind of director of works,108 requiring from the house-builder the production of a particular kind of house, from the shoe-maker a shoe, from the baker a loaf, from the cook a dish, and so on with all the others, 10 according to their particular nature. 106

See Joints 62 (IV.268 L.). The orientation of dwellings is a theme of the Hippocratic Airs, Waters, Places 5–6 (II.20–24 L.), as discussed by Galen e.g. at QAM 8, 57,14–21 M. (IV.798 K.). 108 More literally, ‘like a master craft’ (architektonikē). The term refers to the profession of the architect, engineer or master builder (apparently the profession of Galen’s father), but also more broadly to a higher-level or supervisory master art. On Galen’s conception of a hierarchy of arts or specialized skills, the subordinate ones serving the higher, see Introduction, sections 3.1–2, with nn. 33 and 34. 107

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And yet we saw that the art of healthfulness was one part of this art of healing of the body, that it was in turn divided into four parts, and that physical training was a part of one of these parts. Physical training will therefore itself be a kind of director of works of the relevant number of 15 arts – of horsemanship, when riding is required, in which case it will give instruction in the correct amount, the appropriate time and the quality; hunting with hounds, and indeed hunting in general, when these are called for; and in the same way digging, reaping, wood-cutting, rowing, dancing and in short all physical activities in which people engage. These 20 too it will direct, control and instruct. 45. And among these arts, too, is the one concerned with wrestlingschool exercise. Call it, if you will, the art of the ‘instructor’;109 it has no understanding of what will benefit or harm the body, but – in just the same way as the art of dance – merely discovers holds and motions which are, for example, elegant, complex, designed to throw down an opponent 892 K. or involving minimal effort or pain. And yet dance is not an art which lays any claim to expertise in the healing of the body; but this art of the instructor seems somehow to have fallen victim to some extreme form of derangement, like a crazy servant wantonly rebelling against a good master – the master in question being physical training. It is as though an armed fighter, a horseman, archer, slingsman or spear-thrower were to countermand the instructions of his general, when the latter was drawing up his men, ordering them to arm, leading them into battle, or calling a halt. Imagine a soldier who called upon his general to perform one of these individual specialisms, and then, on finding his own skill superior to the general’s, on that basis thought himself fit to take a share in the command, or alternatively declared his own skill to constitute a branch of the art of generalship. You would consider that such an individual had taken leave of his senses. Equally mad, in my opinion, is the instructor who wishes to claim a share in the art of physical training, or who believes himself to be in possession of a part of it. Just as the role of the soldier is purely subordinate to the art of generalship, so too that of the instructor, to the extent that he is engaged in providing exercise, is subordinate to that of physical training. To the extent that he cultivates the art of wrestling-school exercise, his role is subordinate to another kind of 893 K. practice, which I would call the art of overthrowing, although this is not

109

Literally, ‘child-rearer’, but see n. 82 above.

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the name preferred by the trainers of athletes, who refer to themselves as physical trainers. In reality, there are different varieties of the instructor’s art, as there are of that of archery: it may aim at overthrowing, as does generalship, or at physical training, as does medicine; and so each such art is the servant of two possible supervisory arts. For even the shoe-maker’s art may be instructed by a general to produce a good shoe for a particular soldier, or alternatively by the art concerned with the body to produce one conducive to health. Similarly, the art of cookery will produce a healthy dish at the instructions of the doctor and health-practitioner, but a dish designed only for pleasure at the behest of something which is not even an art, but rather a type of flattery, the goal of which is not health but pleasure. So, even expertise in wrestling-school exercise110 is of service to health, for health-practitioners and physical trainers, but also a service to the athletic state, for that perverted art which we have mentioned so often, which calls itself physical training but which is better referred to as the art of overthrowing. The Spartans, in fact, do refer to it by the equivalent to 894 K. that term in their dialect; and they describe those who are trained in it as becoming ‘more overthrowing’, rather than ‘stronger’.111

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The abuses of athletes 46. Therefore the healthy city loathes and abjures this practice, as disrup- 20 tive of every useful kind of strength and productive of a poor bodily state. Even I have frequently proved myself stronger than athletes with the greatest reputations, men who have carried off many a victor’s crown. For they all turned out to be useless at any kind of walking, similarly in 25 the actions of war, and even more so at anything to do with the affairs 97 H. of the city, or farming. And if ever they are called to assist a friend who is sick, they are the most useless people in the world, whether at giving advice, or at assisting in plan or action – just as useless, in fact, as pigs.112 110

I give the same translation here as for the word palaistrikē (on which see above, n. 105), although the form in the MSS is the minutely different palaistikē (παλαιστική). Given the apparently identical role in the argument, I am doubtful that Galen used the different word (which might be taken, more specifically as ‘expertise in wrestling’), and would be inclined to read παλαιστρική throughout. 111 The terms actually used are kabbalikē, a Spartan dialect equivalent of katablētikē, the word for ‘overthrowing’, and a comparative adjectival form of that. 112 Cf. n. 95 above.

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Nevertheless, the most unsuccessful of these individuals, those who have never won anything, have no hesitation in giving themselves the name of trainers; after which they squeal – again just like pigs – in a 895 K. discordant, barbarous voice. Some of them even attempt to write, on massage, good-condition, health or exercise; and then even dare to take part in arguments in which they attack people of whose works they have no knowledge. This was the case recently, for example, with someone who found fault with Hippocrates’ allegedly false assertions on massage.113 When I arrived on the scene, some of the doctors and philosophers present asked me to give them a full exposition of this subject, after which it became apparent that Hippocrates was the first to give a truly excellent account of it. At this point our self-taught physical trainer stepped forward, stripped a boy and demanded that we demonstrate our practice of massage and exercise on this boy, or else keep silent on those subjects. And then he began to shout: ‘Where was Hippocrates’ sandpit? Where was his wrestling-school? He probably never even knew how to apply oil.’ Well, this fellow screamed away, and in fact could not even be quiet for long enough to follow the discussion, while I calmly set about explaining matters to the assembled company. I showed how that benighted individual was behaving exactly like a cook or baker who had the audacity to 896 K. give a lecture on barley-gruel or bread, and then to make the remark: ‘When did Hippocrates ever spend time in a kitchen or in a mill? He should jolly well prepare some cake, bread, soup or pudding before he starts discussing them in this way.’

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The use of the term ‘doctor’ to indicate expertise in the whole art concerning the body, not just medicine; Hippocrates and his successors as experts in this art 47. Why, then, you may say, do we call Hippocrates and his successors 5 ‘doctors’, when that term refers not to the entire art which concerns the body but only to that part of it which cures the sick? For it is quite apparent that these people do undertake the entire art, in such a way that 10 they do not even omit the part of it that involves exercise. The reason is that healing was the first part of the entire art to be constituted, because 113

Though no name is given here, there is a strong similarity between the criticism here and what is said about Theon in Book III of Health; cf. the reference to Theon in the next chapter.

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of the greater urgency with which it is needed. What we call the preservative or healthful part was added later, in a more leisurely fashion; and so it came about that the whole art took its name from one part of it. This is in fact quite a common phenomenon. We use the name ‘geometer’ for experts not only in two-dimensional shapes, but also in solid bodies; we do not bother to say that someone is a geometer and a stereometer – the latter term simply got omitted. 897 K. So it is too, in our context, with the term hugieinos – by which I mean this term used [as a noun] to apply to the ‘health-practitioner’, that is not to ‘healthful’ bodies or daily regimes, but to the people with knowledge of these, those who were distinguished from doctors by Erasistratus. Consider, too, the term ‘trierarch’: in ancient times this was applied to the captain of a trireme, but now it is used indiscriminately for any commander of a sea-vessel, trireme or not. What happened in the case of medicine and doctors was similar to this: the whole of the art concerning the body came, in the course of time, to be named after the first part of it that was constituted, and so we have the term ‘medicine’ for the art, and ‘doctor’ for the expert in it. And so it is now not unreasonable, if asked what art healthfulness is a part of, to give the reply ‘medicine’. For the application of the latter term has been extended from a part to the art as a whole; so that it is quite proper to refer to Hippocrates, or to any present-day practitioner, as a doctor. Such a practitioner has knowledge of two primary divisions of the art, the healing and healthfulness. And within the latter part – as has already been shown – they also have 898 K. knowledge of physical training. Thus, in the same way that Hippocrates, Diocles, Praxagoras, Philotimos and Herophilus were experts in the entire art related to the body, as is shown by their compositions, so the followers of Theon and Tryphon are equally clearly shown by their compositions to be engaged in the perverted art which concerns athletes. The latter individuals have such names for their exercises as ‘preparation’, ‘partial’, ‘complete’, ‘restoration’;114 and they discuss whether an athlete should be trained and exercised in a ‘circuit’ of a certain kind or in another manner. And I must say it amazes me when I hear these people who train athletes nowadays claiming in a dispute that healthfulness is a part of their own art. In fact, 114

Galen himself speaks of ‘preparatory’ exercise at San. Tu. III.11, 97,34 Ko. (VI.222 K.) and of ‘restoration’ (apotherapeia) – something like ‘warming-down’ procedure after exercise – at length at San. Tu. III.2. At San. Tu. III.2, 75,1–3 Ko. (VI.169 K.) he mentions ‘the most complete form of exercise, which [athletes] also call the “building-up” (kataskeuē)’; see also San. Tu. III, n. 8.

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it is not even a part of the genuine art of physical training, but vice versa; so how could a claim be made for the perverted form of that art practised 5 by those individuals, which is not even a part of the art concerning the body, and which governs a practice held in contempt, not only by Plato or Hippocrates, but by all other doctors and philosophers?

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HEALTH* 1

* The page numbers in the left-hand margin refer to the Kühn (1821) edition (abb. K.), while the page and line numbers in the right-hand margin refer to the Teubner edition (1923) by K. Koch (abb. Ko.), which is the basis of the present translation. 1 On the form of the title, see Introduction, section 9.2.

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Book I

The two branches of the art concerning the body VI.1 K. 1. The art that concerns the human body is a single one, as has been 3 Ko. shown in another work;2 but its primary and most important parts are two in number. One of these is called ‘healthfulness’, the other ‘healing’,3 and they are opposite to each other in terms of their activities, since the 5 task of the former is to preserve the disposition of the body, and that of the latter to alter it. Since health is prior to sickness both chronologically and in status, presumably we, too, need first to investigate how one may 2 K. preserve the former; and then subsequently also how one may best thoroughly cure the latter. But the path of discovery is common to both – to 10 learn4 what kind of state of the body it is that we term ‘health’. For we would not be able either to preserve it when present, or to regain it when it is being lost if we did not have any idea at all what it was. We have written about this elsewhere,5 too, and shown that, while the health of what are known as the ‘uniform’ parts consists in some kind of good 2

Galen refers here to Thrasybulus; see further n. 31 below. The two words in quotation marks could here more literally be translated as adjectives (‘the healthful [part]’, ‘the healing [part]’) – with the word morion, from the previous sentence, taken as implied – but Galen regularly treats the former term, in particular, as a noun, which refers to the branch of medicine concerned with the maintenance of health – indeed, to the subject of the present treatise. See also Introduction, section 2.1. 4 The logical relationship of this phrase – literally, ‘if we are to know …’ – to the previous one seems ambiguous: probably, and as here translated, the conditional clause is an explanation of what the ‘path of discovery’ consists in. But it would also be possible to interpret the clause as referring to an intended consequence of following that path: so, ‘if we are to find out …’. 5 For Galen’s definition of health and relevant discussions elsewhere in his works, see Introduction, sections 4.1 and 4.4: particularly relevant are those in The Distinct Types of Disease and in The Art of Medicine. On the originally Aristotelian distinction of bodily parts into uniform (homoiomerēs, e.g. cartilage, bone, flesh) and organic (e.g. heart, liver, spleen, but also including limbs), see Introduction, section 4.5.1. The underlying physical distinction is in fact a three-level one – elements, uniform parts, organic parts – as summarized also succinctly below, VI.9, 184,21–26 Ko. (VI.420 K.). 3

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balance of cold, hot, dry and wet, that of the organic parts is brought 15 about from the composition, quantity,6 magnitude and shaping7 of the uniform ones. So, too, the person who is capable of preserving these will be the good preserver of health. And he will preserve it by first finding out all the ways in which it is lost. Just as surely as we would not have had any need of a specialized skill8 which would take care of 9 the body, if this were completely incapable of being affected, so, as things are, since 20 it is affected10 in many ways, it is necessary that some specialized skill be in charge, which both recognizes all the kinds of harm that befall it and 4 Ko. is able to provide protection. 6

The term posotēs here seems to correspond simply to what is referred to as arithmos, number, in other similar discussions; cf. I.4, 7,32 Ko. (VI.12 K.). 7 Diaplasis, also translatable as ‘formation’ or ‘construction’. Galen uses the term especially in the context of the development of the embryo, especially in The Shaping of the Embryo, which is an enquiry both into the sequential details of that process and into the identity of the power (dunamis) responsible for it, conceived in teleological terms. He also raises the question of the causal relationship between the ‘shaping power’, understood in such teleological, or even divine, terms, and the ‘bottom-up’ causal powers of the fundamental elements or mixtures in the body: see especially Temp. I.9, 36,23 H. (I.567 K.); and cf. ibid. II.6, 79,24–25 H. (I.636 K.). More generally, as here, diaplasis may refer to the formation or structuring of the parts of the body as opposed to its lower-level components, or to the structure of the body as a whole. 8 Technē, the same term translated ‘art’ in the first sentence, above. (Both translations are used in what follows.) The term refers to particular kinds of expertise, and has specific connotations in terms of the status and knowledge claims implied for those kinds of expertise. See Introduction, sections 3.1 and 8.5; and see especially the Exhortation to Study the Arts for Galen’s elevation of the concept of technē, and his construction of a hierarchy of technai, with medicine placed prominently in the ‘inner circle’ alongside e.g. mathematics, philosophy and astronomy (Protr. 5, 88,21– 89,2 B., I.7 K.). 9 ‘Take care of ’ is one meaning of the verb pronoeisthai (and cf. the related noun, pronoia, ‘care’, e.g. at I.4, 6,33 Ko., VI.9 K. below); it also has further medical connotations, both of prediction and of prescription; cf. e.g. I.7, 17,25 Ko. (VI.35 K.) and I.10, 23,26 Ko. (VI.49 K.) below. Galen explicitly discusses the semantics of both noun and verb at Hipp. Prog. I.4, 201–202 Heeg. (XVIIIB.7–10 K.): the discussion there arises from the Hippocratic usage of pronoia as a virtual synonym of prognōsis, but Galen identifies a semantic range, including: care and attention; ‘foresight’, in the senses both of preparedness and of foreknowledge; premeditation; and divine providence. (Both the sense of care, for one’s own self or soul, and that of divine providence are in evidence in Affections and Errors, the former at I.4, 11,24 DB (V.15 K.) and I.4, 15,6.11 DB (V.20 K.), the latter at I.4, 11,26 DB (V.15 K.).) 10 The adjective apathēs (‘incapable of being affected’) and the verb paschei (‘is affected’) are cognate. They are used both in relation to bodies (including elements or particles: see chs. 2–3 of The Elements According to Hippocrates), in which case what is at stake is whether a body is liable to change, but also in an ethical context, where the question is that of undergoing pathos (‘affection’ or ‘passion’), as against the ‘unaffectedness’ (apatheia) particularly associated with Stoic philosophy. (In fact, according to Galen both human bodies and human souls may be similarly graded in terms of their level of affectability: see Introduction, section 6.1.) But one should be aware that the noun pathos itself (or its synonym, pathēma) also has a traditional medical sense (which probably predates the technical ethical sense), whereby it refers to illness or pathological manifestation. In what follows, in ethical or psychological contexts the noun is given the traditional translation ‘affection’, in medical contexts usually that of ‘ailment’.

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2. There are two classes of harm and decay in our bodies: some are unavoidable11 and connate, having their root, as it were, in the sources of generation;12 the others are not unavoidable, and do not arise from our own selves, but are no less destructive of the body than the other kind. We shall now distinguish each of them. Blood and semen are the sources 5 of our generation: while blood is a kind of material which is well-fitted and readily obedient in every way to the craftsman, semen has the role of craftsman.13 Each consists of a mixture of the same elements, in terms of their class: wet, dry, hot and cold – or, if one wishes to use the terminology, not of the qualities but of the substance, earth, water, air and fire 10 (this has been demonstrated in the Elements according to Hippocrates)14 – but they differ in respect of the quantity in the combination. For within semen there is present more of the fiery and airy substance, in blood more of the earthy and watery substance. Now, certainly, in the latter too there is a dominance, on the one hand of hot over cold, and on the other 15 of wet over dry, and because of this latter dominance it is not said to be dry, like bone and nail and hair, but wet; semen, on the other hand, is drier than is the case with blood, but is itself also flowing and wet. So, 11

The term is anankaios, literally ‘necessary’, and also used in a logical sense; but in this text Galen often uses the term in this more concrete and practical context, for which ‘unavoidable’ seems a more natural translation. 12 The term archē, translated ‘source’, may refer to a starting-point or principle in a more abstract explanatory sense, or to a physical substance which provides something’s initial materials; the sense here is the latter. ‘Generation’ translates genesis, which has a very general sense of cominginto-being (including being born), as well as distinct philosophical, especially Aristotelian, connotations, where the physical or biological world, with the kinds of change that take place within it, is conceived as the world of ‘coming-into-being and passing-away’ (genesis and phthora). 13 For this phrase cf. Sem. I.5, 80,21–22 DL (IV.529 K.). The terminology of ‘craftsman’ (dēmiourgos) within teleological accounts of creation or formation has a heritage reaching back to Plato’s Timaeus, and Galen’s usage at least evokes that heritage, though he is here explicitly attributing the ‘craftsman’ role to semen, not to a hypostasized ‘Craftsman’. Galen’s own teleological accounts of human formation and of embryology, while drawing on the Platonist background, and while at times overtly anthropomorphic in the description of the role of the Craftsman, are also closely indebted to Aristotle in the understanding of active and passive physical principles, and (although also with criticisms of Aristotle) of the roles of semen and blood. See further the discussions in Semen and The Shaping of the Embryo, and on the Craftsman see UP X.13 and XI.13–14. 14 On the term ‘substance’ (ousia) cf. n. 53 below. The work here mentioned is (alongside the Commentary on Hippocrates’ Nature of the Human Being) Galen’s most detailed account of his own element theory or ‘physics’; one of its central claims is that the analysis of bodies in terms of the fundamental qualities – the hot, the cold, the wet and the dry – can in principle be translated into an analysis in terms of the fundamental elements – earth, air, fire, water (and that Hippocrates also subscribed to this view). See Introduction, section 4.5.1.

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then, the source of our generation is on both sides from a wet substance, which, of course, should not preserve its wetness, since, after all, it is to become nerves, arteries, veins, bones, cartilage, membranes and all other such things. In fact, right from the first [phase of ] generation, it is necessary for the drying element in the mixture to have been laid down more strongly in the foundation. It is fire that has this nature most; but also earth: this, too, is a dry thing. It was not, however, possible for there to be more earth in the combination, since the sources must be wet; but there is nothing to prevent there being a larger amount of fire in it; and in both cases [i.e. blood and semen] as much more has been put in the mixture as will cause sufficient drying without roasting or burning. This high level of hot was also sufficient to produce the readiness to motion. It is from this, indeed, that the embryo in the first phase gains consistency and acquires some slight solidification. After this, in the process of its becoming increasingly dried, it acquires some sort of outlines, and faint patterns, of each of the parts. Then, as it has been dried still further, it gets not just the outlines, nor just faint patterns, but the precise form of each. And indeed, once born, it constantly continues to become drier and stronger, until it reaches the prime.15 But at this point [the factors producing] increase come to a halt; the bones no longer grow because of their hardness, and each of the vessels is inflated to [its full] width, and thus all the parts are powerful and attain their peak of strength. From then on, as the organs start to become drier than they should be, their activities are performed less well, and the living being becomes less well-fleshed and thinner. When it is even further dried out, indeed, it is made not just less well-fleshed, but actually shrivelled, and the limbs are lacking in power, and unstable in their motions. And this kind of state is called ‘old age’, being analogous to the withering of plants. For that, too, is old age, for plants, and comes about through excessive dryness. This, then, is one necessary cause of decay for every generated body: that which is connate to it. A second, which applies especially to animals, is the flowing-away of their whole substance, brought about by the innate heat.16 15 16

For Galen’s views on the ‘prime’, and on times of life in general, see Introduction, section 5.5. Galen seems to distinguish here between a kind of decay or aging process which is undergone by all living things, i.e. plants and animals, and a second which is specific to animals: the innate heat, responsible for this latter one, was conceived as a distinctive characteristic of animals. For dryingout in animals as a feature of the aging process, parallel to the withering of plants, cf. Temp. II.2, 46,10–11 H. (I.581 K.), with its apparent reference to Aristotle, Resp. 17, 478b27–28 (‘[dying] is called withering in plants, in animals it is called old age’).

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Now, this kind of harm is inescapable for any generated body; but it is possible with foresight17 to avoid those others which follow from it. The origin of these too is [sometimes] the attempt to rectify the unavoidable kinds of harm. As the substance from which all animals are put together is in flux, unless one introduces something else similar to that which is flowing away, the whole body will in this way be destroyed and dispersed.18 It is for this reason, surely, that Nature has given not just to animals but also to plants, at the very outset, connate capacities that are desirous of whatever is in any case lacking. For we are not taught by anyone to eat, drink, or breathe, but from the beginning have in our own selves the capacities that, without instruction, will bring all these things about. Through eating we replenish whatever drier substance has flowed out, and through drinking we introduce whatever of the wetter substance has been evacuated, in both cases restoring the previous good balance. So, too, we preserve the good balance of airy and fiery substance through respiration and the pulse. These things have all been demonstrated specifically in other works;19 and I consider it appropriate to the present discussion to take the things shown in those as assumptions for the purposes of the treatise20 of health; and so to proceed to what is next in order.

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3. Since in all animals a large part of the substance flows away each day because of the innate heat, and we require food, drink, respiration and 6 Ko. the pulse for the sake of preserving the good balance of the latter, the 17

The phrase ‘with foresight’ translates the verbal form promēthoumenon, which has a similar sense to pronoeisthai (cf. above, n. 9). 18 By ‘attempt to rectify the unavoidable kinds of harm’ Galen means the process of replenishment of the substance which flows away, a process which inevitably gives rise to residues. (The progress of the argument is not at once clear, this point being taken up again only at the beginning of the next chapter; cf. also n. 21 below.) For the physiological model see further Introduction, section 4.5.2. The precise phraseology of the words translated ‘the substance … in flux’ (ῥεούσης … τῆς οὐσίας συστάσεως) seems slightly odd: I have translated it with the second noun dependent on the first (literally ‘substance of constitution’), but this sense is arguably difficult on the basis of the Greek as it stands, and the succession of the two nouns with very similar senses may seem suspect. The MSS V and R omit οὐσίας, which is syntactically easier, but would leave us with the proposition that the constitution of the bodies is in flux, whereas Galen typically (as indeed just on the previous Koch page) speaks of the flow of substance. But the sense is at least reasonably clear. 19 For Galen’s views on nutrition, the maintenance of the heat, and the role of respiration and the pulse, and the texts that discuss these in detail, see Introduction, especially sections 4.5.2 and 4.5.4. 20 Pragmateia: the term combines the senses of ‘treatise’, the actual written work on a particular subject, and, more abstractly, of the body of knowledge or ‘study’ that that particular subject involves: I have used both these translations at different points throughout this text.

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necessary consequence of this is the generation of residues. For if we were able to add on something else which was precisely of the same sort as that which had been evacuated, throughout the whole body, this would be the best thing, and the most healthful. But since that which flows from each part is of the same nature as the part itself, while none of the things eaten or drunk is precisely so, it became necessary for Nature to subject them first to a preliminary change and coction, to a preparation that would make them as nearly as possible of the same sort as the body that is to be nourished. And, during this, that which is not thoroughly processed nor assimilated is not added on to the body but, being superfluous, moves around the open spaces within. This indeed is why the name ‘residue’ has correctly been given to it by our predecessors.21 So, since eating and drinking are necessary for animals, and the generation of residues is a consequence of these, Nature both produced organs for their separation, and placed in those organs capacities – capacities by the motion of which they either attract, move on or expel the residues.22 One should not, then, either be obstructed in any respect, or be feeble in one’s activities, so as to preserve the body always clean and free of residues. And the argument has already laid out before you these two aims, for the purposes of the healthful daily regime23: one is the replenishment of things evacuated, the other the separation of excess products. The third – that which concerns the animal’s avoidance of speedy aging – follows necessarily upon those mentioned. If no error is made either in terms of replenishment of what is evacuated, or in terms of the residues not remaining within, the animal will then be healthy, and will enjoy its peak for a very long time. More will be said about this again later, as the argument proceeds.

21

The noun perittōma (‘residue’) is derived from the adjective perittos, ‘excess’, ‘redundant’, ‘superfluous’. Prominent amongst the ‘predecessors’ who used this terminology was Aristotle; for the conception see further Introduction, section 4.5.3. Galen’s view is that the balance of stuffs being introduced to the body, which is ultimately reducible to some combination of the hot, the cold, the wet and the dry, will never perfectly match what is required by the body; but also, perhaps, that there are simply some stuffs within any food ingested which cannot be transformed into food. 22 Galen is working here within the framework of his doctrine of the four ‘natural capacities’ (also known as ‘natural faculties’, phusikai dunameis), those of attraction, repulsion, assimilation and expulsion, which he takes to be fundamental to the functioning not just of animals but also of plants. See again Introduction, section 4.5.2. 23 Diaita: a general term, crucial to the understanding of the preservation of health from Hippocratic times onward, which covers especially diet, but also exercise, baths, environment, etc. On Galen’s relationship with previous writings on diaita see Introduction, section 2.3.

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4. Let us add what remains of the distinctions that we set out to make at the outset, so that we will have produced a clear definition of the aims related to health, in respect of both kind and number. We stated that, if the body were incapable of being affected, like diamond or some other 30 such stuff, it would need no specialized skill to supervise it; but since in fact there are two kinds of cause of its decay – those from within its own self, and those which befall it from outside – it follows that it requires a 10 K. considerable level of care.24 Now, the decay of the body from its own self was shown to take place in two ways: either because of old age moving 7 Ko. onward towards death, or because of the constant flux of its substance; but there is then the other way, following from what is eaten and drunk: that which arises from the generation of the residues. Now, decay from within takes place as described; as for what befalls it from outside, there is one factor which is inseparable [from us] and 5 constantly present, so that one might almost call it connate: the surrounding air. The others are not unavoidable, but only come into contact with the body at certain times, in an irregular way. Of these, some cause harm, as the surrounding air does, by immoderately heating, cooling, drying or moistening; others by crushing, tearing apart, piercing or making something dislocated. Now, there is a theoretical enquiry that 10 arises here, which may be argued on either side: some say that the safeguarding against all these belongs to the art concerning the body, others that this is only true of the things which immoderately25 heat, cool, moisten and dry, on the grounds that if something that crushes or 11 K. pierces, or does something else of that kind, takes us out of our normal state,26 it does not belong to any specialized skill either to recognize or to 15 guard against such things. It is not my task now to make distinctions that concern set questions27 of this sort; rather, I shall take as assumed what is agreed by both parties, and proceed to the task in hand. For it is agreed on both sides that factors that damage and destroy health by piercing, 20 crushing, and any similar action are universally recognized, whereas those that do so by heating, cooling, drying or moistening are not. Nor will we 24

Pronoia: cf. above, n. 9, for the connotations of this word and the related verb pronoeisthai. The adjective ametros and adverb ametrōs refer to an ‘imbalance’ (the opposite of summetros, summetria, which have regularly been translated as ‘well-balanced’, ‘good balance’); it seems more idiomatic, however, sometimes to translate them also as ‘immoderate’, ‘immoderately’. 26 ‘Normal’ translates kata phusin, more literally ‘in accordance with nature’, as the phrase is translated below. On Galen’s use of this phrase see Introduction, sections 5.2 and 5.4. 27 On the terminology of problēma (‘set question’), as well as that of the sophistika zētēmata (‘sophistical enquiries’) mentioned at the end of the paragraph, and on the argumentative culture to which they belong, see Thras., nn. 2 and 3, and Introduction, sections 7, with n. 121, and 8.5, with n. 151. 25

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ourselves,28 then, seem to be acting inappropriately if we pass over what is recognized by all, and move the discussion on to what is not so recognized. For it is not my task now to deal with sophistical enquiries, but to explain how one may best avoid illness. Let us then take the argument back to its proper beginning, with a still more precise reminder of its underlying assumptions. That health is not, straightforwardly, a good-mixture or balance of the elements from 12 K. which we have come into being29 (as practically all our predecessors have thought), but [that this is true] only of the health of the uniform bodies, has been demonstrated by us elsewhere;30 let it be taken as an assumption for our present purposes. Let it similarly be taken as a basis for the present discussion that – as also shown elsewhere – the health of the organic bodies consists in the shaping, number, magnitude and composition of the uniform ones. That, furthermore, the healthy constitution is assessed on the basis of the activities functioning according to nature, and that, within health, there is both an optimal form, which one might term perfect and complete health, and another form which is somewhat inferior, not perfect or complete, and that we state there to be a very broad spectrum within this latter form – let all these propositions, too, be taken as a basis in the present discussion. They have been previously demonstrated in other places, and will definitely be shown now too. But I would especially like the prospective student of the present writings to read the book in which I investigate the question, to which art healthfulness 13 K. belongs (it is entitled Thrasybulus 31), as well as that on The Best Constitution of our Bodies and that on Good-Condition.32 The latter are Reading αὐτοὶ, ‘ourselves [seem]’, with the MSS, whereas Koch (unnecessarily, it seems) reads αὐτοῖς, ‘[seem] to them’. The verb gignesthai, which may also mean simply ‘be born’, is cognate with the noun genesis, on which see above, n. 12. 30 Cf. n. 5 above. 31 In that text it is shown that ‘healthfulness’ (to hugieinon) is one of the two main branches of the ‘single art concerning the body’, which itself properly speaking has no name: see especially Thras. 30, 71,24–27 H. (V.860 K.); 31, 75,23–25 H. (V.866 K.); 38, 85,26–86,6 H. (V.879–880 K.); 38, 86,25–87,4 H. (V.881 K.); that single art has, however, come to be known loosely as ‘medicine’ (iatrikē), the term more correctly applied only to the other, healing, branch of this art: cf. Thras. 47, 99,2–14 H. (V.897 K.). See further Introduction, sections 2.1 and 8.5. 32 In these titles, ‘constitution’ translates kataskeuē, ‘good-condition’ euexia. The former term is used to apply to the endowments of the body in a more general sense, including the higher-level qualities of ‘shaping’ of the organic parts from the uniform ones, mentioned above; and throughout the present work Galen frequently speaks of the body with the best constitution, meaning that possessed from birth with the best possible qualities. Euexia (as explained especially in Thrasybulus) is defined as the excellence of hexis, which is itself a stable form of diathesis or katastasis, that is the state of the body, understood as arising from its mixture. A body which does not enjoy the best kataskeuē may nevertheless enjoy euexia, as the latter term may be understood as 28 29

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both very short books; and if one were to read them before embarking on the present argument, one would very easily follow what is being said 10 here. It has been stated previously that the book on Elements according to Hippocrates is necessary for present purposes; The Best Constitution and Good-Condition follow on from that one.33

Health as a balance; different levels within health; pain and impairment of performance as criteria of ill health 5. With all this taken as a basis, we may start our study of health from this point. Since health is a kind of balance, and every balance may be brought about and defined in two ways – either reaching the peak, and genuinely being a balance, or slightly falling short of the precise form of that – health, too, must be a balance in some twofold sense. There is that which is complete, optimal and perfect – the peak version – and there is that which falls short of this, but does not fall short to such a degree that 14 K. the animal is distressed. Here, too, a theoretical enquiry arises, rather than one which affects the function of the art. There are those who do not concede the possibility that one individual may be more healthy than another, nor that there is a considerable spectrum within that state of the body which we term ‘health’, insisting rather on health as a single, completely perfected state, which does not admit of any division into ‘more’ or ‘less’ healthy. In my view, however, just as one ‘white’ body may appear less white and another whiter, so too with bodies enjoying health: one may seem to do so less, another more.34 There are two demonstrations of this. The first comes from changes due to age. From the moment that the animal is born, the mixture necessarily changes, as we showed above; if, then, health consists in the quality of the mixture, and this quality does not remain the same, it is not possible that the same health is preserved. The second demonstration relative to the individual: each of us has his or her own euexia, the best possible condition for us given our own constitution. (The works mentioned are indeed very short (IV.737–755 K.), being confined essentially to laying out this conceptual and terminological framework.) 33 Of the works here cited, Thrasybulus pays particular attention to different varieties or levels of health, and to the notion of ‘peak health’ (as well as the problematic notion of the ‘peak of health’); see also Introduction, section 4.1. In his listing of other works here Galen is alluding to his own conception of the correct didactic or paedagogic order of his works, outlined in detail in his two ‘auto-bibliographical’ works, My Own Books and The Order of My Own Books, and mentioned at a number of other points passim in his works; on this see Boudon-Millot (2009); Singer (2019b). 34 For discussion of Galen’s argument here on degrees of health, and the intellectual context to which it is responding, see Introduction, sections 4.1 and 4.2.

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comes from differences in activities. Not all healthy people enjoy the same level of eyesight: some see better than others. So too with hearing: 15 K. there is a very great range of levels. Nor does everyone have the same ability to run with their legs, or to grasp with their hands; nor the same level of activity in terms of all the other organs, either: some perform better than others. Since, then, the differences in activities are consequent upon differences in mixture, it follows that there are as many differences in mixture as there are in the activities. And if someone prefers the terminology of ‘constitutions’ rather than that of ‘mixtures’ – so that the argument may be applicable within all the sects – he will still reach exactly the same conclusion. For health is definitely a balance of some kind, according to all the sects; it is just that in our view it is a balance of wet, dry, hot and cold, while others hold that it is a balance of bulks and channels, others a balance of atoms – or of [things] ‘unjointed’, or ‘partless’, or homoiomeries – or any such primary element.35 But certainly all agree that it is through the balance of these that we perform our activities with the different parts of the body. If, then, we perform these activities differently, the balance of the elements is different in each case. And this balance was agreed to be health. 16 K. Indeed, the argument may proceed even without mention of elements, as follows. If the activities are consequent upon the constitutions of the 35

Galen here aims to present his understanding of health as something which, in its essentials, commands assent across the various sects. In doing so, he claims that all sects agree that health is a balance – of whatever constituents they believe the body to be composed of – but admits that not all will take it to consist in a mixture. He then proceeds to list the different candidates for those constituents, according to different philosophical and medical schools. On this arguably tendentious Galenic argument, see Introduction, section 4.4; and see also MM IV.4, X.267–268 K., where Thessalus is said to follow Asclepiades in the basic view that health is a ‘balance of channels’, but also to introduce some innovations to that theory. Further on poroi see Introduction, n. 58. I depart from Koch’s text in two ways: first, I follow VR in omitting from the list ἀνομοιομερῶν, ‘non-uniform’, which seems to have been introduced to form a pair with ὁμοιομερῶν; secondly, I emend the reading ὁμοιομερῶν itself to ὁμοιομερειῶν. Τhe former would be the ‘uniform [parts]’ already encountered in the discussion above, but these were not fundamental elements according to anyone; the latter, ‘homoiomeries’, are the fundamental elements attributed in some sources to Anaxagoras of Clazomenae. It seems that the former word (much more common in Galen, and differing by only two letters) has been substituted by a scribe for the latter. ‘Bulks’ (onkoi) and ‘channels’ (poroi) and ‘unjointeds’ (anarma) are central to the physical theory of Asclepiades of Bithynia, who was followed in certain respects by the Methodists, although most other sources speak of the anarmos onkos (‘unjointed bulk’) rather than simply the anarmon. (On this point, and for the interpretation of Asclepiades’ views in this area, see Leith 2009.) Atoms are central to the theory of Epicurus and the Atomists; the notion of things ‘partless’ (amerē), i.e. the smallest units of matter, beyond which it cannot be divided, was that of Diodorus Cronus. On Galen’s own theory of the hot, the cold, the wet and the dry and its relationship with other element theories, see Introduction, section 4.5.1.

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parts, then there will be as many distinct constitutions as there are distinctions in the activities; now, the activities are consequent upon the constitutions; therefore it follows necessarily that there are as many distinct types of constitution as there are distinct types of activities. And the distinctions in the activities are manifold; so, too, then, are those in the constitutions. If, then, in all healthy persons the constitutions of the parts are balanced, and the constitutions are different (because the activities are different), there will be many good balances of the constitutions, and so, too, many ‘healths’. Now, if the individual ‘healths’ differ from each other, they must differ either in respect of the form which is common to all, that on the basis of which they are called ‘health’, or in degree; but, they do not differ in respect of the form which is common, for there are no different items which are actually health;36 therefore they differ from each other in degree. For just as the whiteness of snow does 17 K. not differ from the whiteness of milk, insofar as it is white, but does differ in degree, in the same way the health of Achilles, let us say, is the same thing as the health of Thersites, to the extent that it is health – but is different in another sense.37 And this sense is, in fact, that of degree. It is not possible to say either that we do not perform our activities differently, or that this inequality is due to something other than the constitution on the basis of which we perform them. If, however, someone states that only those individuals are healthy who perform at the peak in respect of all their bodily parts, and that the rest of us, who are in a worse state than they, are not healthy, such a person should be 36

Or, more literally, ‘healths are without distinction’. The proposition seems on the face of it in contradiction with the discussion of different levels and varieties of health thus far. The best interpretation is perhaps that the statement could be clarified as saying: ‘health admits of no distinctions insofar as it is health’, that is to say that there is not more than one conceptual item, ‘health’; see also next note. The text here is slightly problematic. I have preserved ‘form’ (εἶδος) at its second appearance, in l. 29, where it is omitted by M but otherwise seems to have good authority, and makes good sense. I have omitted the phrase ἀλλήλων διαφέρουσιν at l. 28, which seems to have been repeated in error from its appearance below, l. 30; in this I follow VR, who, however, also have a lacuna of about a line’s length immediately after this phrase. (As David Leith points out to me, Koch’s apparatus misrepresents the situation in these MSS: it makes better sense to understand them as omitting the first, not the second, occurrence, of the phrase, that is, the lacuna in VR comes directly after this phrase rather than before it.) 37 As they appear in Homer’s Iliad, Achilles is the ultimate exemplar of physical excellence, and Thersites the opposite of that. The latter is described as ‘the ugliest man who came to Troy: bandylegged, lame in one foot, his shoulders hunched over upon his chest, pointy-headed’ (Il. II.216– 219). He is thus not just exemplary of poor physical constitution, but actually deformed. The argument here is that to the extent that he partakes of health, this is the same ‘health’ that Achilles partakes of: he just does so very imperfectly. There is not more than one thing named ‘health’, although there are very different varieties and instantiations of it.

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aware that he is overturning the basis of the entire study of health. For if its aim is to preserve that health which we have acquired, and none of us is healthy, then it is immediately evident that we will have no one on whom to practise this specialized skill concerned with health which we are now aiming to constitute.38 In that case, then, we would have to cease 18 K. our enquiry in this area, fall silent and terminate the argument forthwith. So, then, the realization of the truth removes all such confusions. Health is not, and is not defined as, that which is indivisible alone, but also that which is inferior to this, but not so inferior as to have failed in its ­function. For we all – all human beings – require health both for the performance of the activities of life, which are impeded, interrupted or terminated by sickness, and also for the sake of an untroubled existence: when we are in pain, we are considerably troubled by that. Such a disposition, in which we are neither in pain nor impeded in the performance of life’s activities, we call ‘health’. If someone wishes to apply a different term to it, he will not gain anything from that – no more than those who introduce the notion of ‘perpetual pathology’.39 If their reason for introducing it were that every generated body, just as it possesses the causes of its generation, also possesses, connate from the beginning, the causes of its destruction – as we showed earlier – then we would approve of their respect for doctrines which are both true and ancient. But when they wish to establish that the disposition of bodies in 19 K. health belongs to the same form as that of those in sickness, we cannot then approve of them, nor accept their doctrine. They would have done much better to posit that health involves a broad spectrum, than that we are all in the grip of interminable disease. For even if they state that the seeds of sickness are present within us, they nevertheless themselves concede that these seeds escape our perception because of their smallness.40 38

The verb sunistanai, which may also be translated ‘put together’ (and in the passive ‘consist of ’), alongside its cognate noun sustasis is regularly used by Galen and others to refer to the intellectual process of ‘putting together’ or ‘constituting’ a technē, in the sense of establishing its nature and principles, as well as defining its parts. See especially Galen’s work, The Constitution of the Art of Medicine (where ‘constitution’ translates the Greek sustasis). 39 For discussion of Galen’s argument in relation to ‘perpetual pathology’ (aeipatheia) see Introduction, sections 4.2 and 4.4. It is not clear whom, specifically, Galen has in mind with this polemic; but see the next note for a possible Atomist connection. The noun aeipatheia itself seems only to appear in Galen’s own works, in contexts such as this, with no further attribution, and while the adjective form aeipathēs is attested elsewhere, the context of its appearance is almost always that of a cosmological doctrine attributed to early Pythagorean authors. 40 Galen is not hostile to the notion of ‘seeds of sickness’ in itself, which appears a number of times in his work: for detailed analysis of the history of the concept, as well as its significance for Galen, see Nutton (1983), who, however, misses at least two of the instances in the corpus, including this

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Well, let it be allowed, if they wish, that there actually is a painful state within us, but that it is so small and imperceptible, that it causes no distress to those who possess it. And let us allow fevers, too, if they so wish, which are so small that they give rise to no perception in us, and we are able to engage in public life, bathe, drink, eat, and perform all other actions as we require. For it is the unimpeded nature of the function41 that provides the better definition of health. Even the weakness of the activities – if stated in these straightforward terms – is not an indicator of sickness, but rather weakness which is contrary to the individual’s nature. For we all have poor sight if we compare ourselves with eagles, or with 20 K. Lynceus; nor, indeed, do we hear properly, if we compare ourselves with Melampus. And if anyone were to make a comparison with Iphiclus, or with Milo, then we would be feeble in the function of our feet and of our hands, respectively.42 In respect of each part, we would be considered close to being maimed, when compared with those who excel in that area. After all, which of us would think that his eyes were in a bad state one, and seems to overstate the relevance of the concept to the notion of contagion. In nearly all cases Galen seems to mean by it an internal cause or predisposition to disease: so at Parv. Pil. 3, 99,5–6 Marquardt (V.906 K.), Hipp. Epid. I III.7, 119,30–35 Wenkebach (XVIIA.239 K.) and Caus. Procat. 108,26 Bardong (in this last case, perhaps significantly, explicitly avoiding discussion of the precise meaning of the phrase). And a similar sense seems to be suggested by Plutarch, Quaest. conv. 731d–e. Only at Diff. Feb. I.6 (VII.291 K.) does Galen float the idea of ‘seeds of plague’ that may be carried in the ambient air, and it is unclear (as Nutton admits) whether he is really committed to that notion. In any case, he is evidently suspicious of a particular version or employment of the notion, whereby imperceptibly small seeds of sickness are constantly present within us; and it seems that this version is probably related to Atomist doctrine. Epicurus is reported as stating that the ‘starting-points of beings are bodies which must be theorized by reason’ (ἀρχὰς … τῶν ὄντων σώματα λόγῳ θεωρητά, Aët. 285.7 Diels); and the fact that Galen elsewhere pairs the notion of aeipatheia with the (it is implied, fruitless) quest for ‘theorized starting-points’ (using that same adjective, theōrētos) would seem to suggest that he sees the two views, that of aeipatheia and that of (Atomist) invisible theorized starting-points, as linked. See Di. Dec. I.6 (IX.798 K.): ‘If you want to investigate the theorized starting-points, you may well end up with the doctrine of aeipatheia.’ The fact, again explored by Nutton (1983: 9–11), that Lucretius speaks of seeds (semina) in his Atomist-based account of disease seems also to point to such a connection (although in this case the seeds in question seem indeed to be objects in the ambient air, and part of an account of pestilence: see especially Lucr. VI.1090–1102). 41 Albeit in a different context, in a discussion of pleasure, Aristotle focusses on the unimpeded nature of an energeia as the crucial characteristic: Eth. Nic. VII.13, 1153b9–12. 42 Lynceus, Melampus and Iphiclus are mythical characters. Lynceus, one of Jason’s companions in the quest for the Golden Fleece, was able to see even below the earth (Apollonius, Argonautica I.151–155). Iphiclus (or Iphicles) was the twin-half-brother of Heracles, who participated in the hunt for the Calydonian boar (ps.-Apollodorus, Bibl. I.8.2) and was presumably thus especially associated with speed (cf. Homer, Il. XXIII.636). Melampus was a seer, who according to one legend acquired the ability to hear and understand the language of animals (ps.-Apollodorus, Bib. I.96–97). Milo of Croton (6th century BCE) was the most famous wrestler of antiquity, his name a byword for exceptional strength. (Cf. Galen’s disparaging account of him, as a representative of athletic excesses, at Protr. 13, 112,15–113,17 B., I.34–35 K.)

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just because he were unable to see ants at a distance of two stadia? Or his ears, if he were unable to hear those at a distance of sixty?43 If someone could not correctly make out the letters written here in this book, on the other hand, then it would at that point be reasonable to be critical of one’s eyesight; but here again, the criticism would not be justified if that were the case at a distance of four cubits – except in the case of one who was by nature exceptionally sharp-sighted, so that he was able to make them out even at that distance. In that case, I suppose, the person would indeed criticize his eyesight and with justification state – in accordance with the remark which indeed is universal amongst men – that they cannot now perform such-and-such an activity which they did successfully perform in the past. We shall attribute such an experience to sickness of some kind, unless it is due to old age; indeed, there are those who say that old age itself belongs in this category. But in the case of all other individuals, who do not naturally have the characteristic of sharp21 K. sightedness, of acute hearing, or of being able to run fast, or of strength in any other particular activity, we shall not take it that they are in sickness, nor that they are at all in an abnormal state.44 For all sicknesses are abnormal, whereas these individuals are not in an abnormal state; nor, indeed, are the old. Vigour or feebleness of activity, then, should not be used in a straightforward way as the criterion of health and sickness; rather, one must add the term ‘normal’, when describing the healthy, and ‘abnormal’, when describing the sick, so that health is a normal state, which is productive of activity, and sickness an abnormal state, which is damaging to activity. Nor, then, is a normal state in itself health (for the blackness of the Egyptian, or the whiteness of the Celt, or the redness of the Scythian,45 is a normal state, but none of these is indicative of health, since health is not a matter of colour of any kind); nor is an abnormal state in itself a sickness (for in that case the blackness that comes from the sun, and the whiteness that comes from a long time spent in the shade, would both be sicknesses). The notion of health must 43

A stadion was a distance of 6 plethra, or just over 600 feet. There is perhaps a noun missing from this sentence, to correspond to the ‘ants’ in the seeing example (the Greek has just the article, τῶν, ‘those’, which on its own here would presumably mean simply ‘people’); but the sense of the example is not affected. 44 Literally, ‘contrary to nature’; cf. n. 26 above: the phrases kata phusin and para phusin are often used, as here, to indicate the state that is normal or not for that individual; cf. Introduction, section 5.4. 45 These are standard examples used in traditional Greek ethnography and anthropological theory, which tended to see the Greek constitution, or more precisely the constitution arising in the region of the Aegean, as a norm or ideal, from which other peoples, to north, south, etc., were supposed to diverge in both physique and character; see further Introduction, section 5.6.

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22 K. include the causal role in relation to the activity, and that of sickness must include damage to this activity. But this subject has been discussed more fully elsewhere;46 and for present purposes it will be sufficient to 35 take from that discussion this single point: that there is a considerable spectrum within health, and that we do not all have it in precisely equal measure. Now, there may be someone who feels that it is a violation to use the 12 Ko. term ‘good-mixture’ also in reference to that which is not absolutely perfect. Such persons need to be reminded of the way in which all terms are used in everyday life. Thus, we may speak of both a drink and a bath as being ‘well-mixed’. And we may do so not only in the sense that they may be so relatively to different individuals, but also because, even in 5 respect of the same individual, such a thing involves a spectrum. After all, if you put a small amount of something hot or cold into the drinkingcup while the drinker is looking the other way, it will escape his notice. Now, if what is well-mixed were so precise as to be something single and indivisible, the drink would no longer appear well-mixed when some23 K. thing hot or cold was added. In the same way, if someone puts a little of 10 something cold into a well-mixed swimming-bath, this will not immediately destroy its good-mixture. And we state that the surrounding air is well-mixed, too, even if it undergoes slight shifts in either direction. And why should it surprise us that the term ‘good-mixture’ is used by everyone in this extended sense, covering a considerable spectrum, when even in the case of good tuning, for a lyre, it is reasonable to say that, 15 while the most precise version is single and indivisible, the version in actual use involves a spectrum? For it often happens that a lyre which appears to be extremely well-tuned is then tuned more precisely by another musician.47 In all cases perception is our instrument of assessment for everyday purposes; and so we will assess good-mixture and ­bad-mixture, too, by our senses of perception. 46

Cf. n. 5 above; also n. 48 below. It is perhaps worth noting here the historical relationship between theories of mixture and those of ‘harmony’, going back to the Pythagorean harmonia theory of the soul discussed in Plato’s Phaedo, of which Galen’s suggested equation of krasis with the substance of the soul in The Capacities of the Soul Depend on the Mixtures of the Body is arguably the descendant. Specifically on musical tuning: Galen elaborates this point at Diff. Puls II.8 (VIII.620 K.), where he remarks that the musician can detect differences of less than a semitone, whereas the layperson may not notice much larger ones. In all specialisms, the expert will, by long and painstaking training, be able to discern much finer distinctions than the rest of us; on this see also Dig. Puls I.1 (VIII.768–769 K.), as well as van der Eijk (2015b) and Singer (2022a). An analogous situation, Galen is arguing, holds for the ‘good-mixture’ of the human body.

47

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In the same way, too, the damage to the activity, in the case of each thing damaged [in a way which leads to a state] contrary to what is normal, when this reaches a perceptible level, should at that point be considered by us ‘sickness’. Here, too, it does not for the present matter whether one says that the damaged activities are themselves the disease, 24 K. or whether we rather say that of the states by which they are damaged; nor, for that matter, whether one wishes to term these ‘states’ or ‘constitutions’. These distinctions have been made by us elsewhere, and it has been shown that health and sickness consist in the states and constitutions of the body, not in the activities and damages to activities.48 But for the purposes of preservation of health or healing of sickness, we derive no benefit from this verbal precision. It is enough to realize this alone: that the constitution of the body, having a causal role in relation to the activity, is the aim of the art of health and of healing. It is our task to preserve this, on the one hand, and on the other to create it when destroyed; and the activities follow of necessity: faultless ones follow if the constitution is good, faulty ones if they are bad. Thus, since what we are preserving and ourselves creating is a particular state and constitution of the body, and that of the activities follows this of necessity, we no 25 K. longer have to consider, for the present, whether one should place health and sickness within the class of activities or within that of constitutions. Let us, however, take it as an assumption that one must preserve those things in our normal constitution through which we perform our activities; and let us give a further reminder of the fact that the good-mixture of the uniform [parts], and the shaping, position, number and magnitude of the organic ones, are responsible for the activities, that these all involve a spectrum and that they are specific to each person; and let us proceed to what comes next. And here knowledge of this spectrum will be of very great use. For, since good-mixture is of two kinds, of which the former has a conceptual relevance, rather than one related to its stable existence in the animal body, while the latter both exists and is apparent in all those that are healthy, this actual, apparent kind must be further divided: there will be found within it a significant range of distinctions.

48

The logical status and relationship of these concepts are discussed in detail in Thrasybulus (again reiterating the point that these precise definitional points are unimportant in practice); see Introduction, section 4.1 with n. 47.

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You may learn the truth of this statement best of all from the stages of life.49 That of youths is best for purposes of the voluntary activities,50 26 K. while that of infants is worse, because of the moisture, and that of old men is worse because of dryness and cooling. With regard to the other activities which are termed ‘natural’, however, such as those of increase, coction, distribution [of nourishment] and nutrition, infants are better than those at other ages. And yet there is nothing to prevent all these individuals, at all the different ages, from being healthy. And you will find that, analogously to this distinction due to age, there is a remarkable distinction within the actual individual natures, as regards their mixtures; so, for example, if you take two children of the same age, you will find that one is much wetter than the other and, equally, that one is hotter and the other colder. In those bodies in which the excess of hot, cold, wet or dry is much greater than appropriate, the mixture is not faultless; but in those in which there is some difference with respect to the best mixed, but this difference is so small as not to be perceptible, we for practical purposes place such a body in the same position as the best. There are, thus, within the spectrum of health, both that version which 27 K. is well-mixed and faultless from the point of view of perception, and that which is somewhat ill-mixed and faulty. And the most manifest indicators of this statement are provided by the differences between bodies in terms of thinness and of abundance of flesh. For, of course, it is necessary that opposite conditions follow from opposite mixtures. Thus, just as we do not look positively upon either an excessively thin body or one which is too stout, in the same way we will not look positively on their mixtures, even if we see that, in each case, persons are, as much as possible, enjoying health. The conditions of those midway between these – those known as ‘well-fleshed’, being themselves well-balanced and 49

For fuller discussion of the different stages of life (hēlikiai) and their characteristics, see Introduction, section 5.5, with the texts cited there. In the next sentence ‘youth’ translates meirakion; cf. Book II, n. 19. 50 ‘Voluntary’ translates kath’ hormēn. The term hormē is usually translated ‘impulse’, and is especially associated with a technical sense in Stoic psychology and theory of action; Galen, however, uses the phrase kath’ hormēn (literally ‘in accordance with impulse’) interchangeably with kata proairesin (‘in accordance with volition/deliberation’) – as indeed stated explicitly at PHP VIII.1, 480,9–11 DL (V.649 K.) – to refer to voluntary motions, as opposed to the automatic or involuntary ones involved in the maintenance of life. For that other, equivalent usage see below, Book II.11, 65,28.35 Ko. (VI.148 K.) (with note) and II.11, 66,20 Ko. (VI.149 K.). See also II.7, 59,9 Ko. (VI.132 K.) on the ‘impulses of nature’. In the next sentence, ‘natural’ (phusikai) are those activities shared by all animals, and in some senses plants; the conception is closely related to that of the natural capacities, as laid out in detail in Natural Capacities; cf. Introduction, section 4.5.3 with n. 64.

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faultless in type – follow upon well-balanced and faultless mixtures.51 Now, as a really precise statement of truth, one would not say that even these kinds of nature were well-mixed – not, that is, in terms of an absolute, perfect good-mixture – but from the point of view of our perception, and for practical purposes, they should be considered faultless and optimal. The most manifest evidence that even these do not have the most 28 K. perfect good-mixture comes from the fact that they never remain exactly the same. First of all, they are subject to that change which is due to age: no age ever remains the same; rather, there is a constant movement towards greater dryness. Secondly, they are subject to that due to sleep and waking, rest and motion, and within motions, the different types, and also in addition to those, that which is due to being either hungry or thirsty, eating or drinking, being filled with food or being in need of drink. And in addition to all this, there are also baths; rages; worries; distress; and all such things which modify the mixture through pretty much their every shift.52 One should not, then, in a situation of such great change, seek the perfectly optimal mixture. For even if – in some optimal nature – this ever did arise, it certainly would not remain so, even for a moment. Indeed, I am actually amazed at these men’s belief, who think health and good-mixture to be a single item, admitting of no spectrum, and state that anything outside this is not health. For these people introduce the concept of ‘perpetual pathology’, without being 29 K. aware that they are constructing an argument that concerns something that either never arises in an animal body, or, if ever it does arise, does not remain even for the shortest imaginable time.

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Fundamental principles of health preservation; the nature of the best constitution 6. So, then, let us leave it to those people to preserve that phantom of health, while we turn rather to those kinds which actually appear. These 30 51

‘Well-fleshed’ translates the adjective eusarkos, which for Galen represents an optimal midpoint between being excessively ‘fleshy’ (polusarkos) and the opposite of that. The connection made here between this optimal bodily state and the underlying mixture, with fleshiness linked to excess moisture and superabundance of blood, is discussed further at Temp. II.4, 62,12–25 H. (I.607– 608 K.). 52 Note that thumoi could be taken to be ‘spirited’ activity or emotion (in the Platonic psychological sense) more generally, not narrowly ‘rage’. For the background of the Platonic tripartite soul in this work, see n. 72 below, and further Introduction, section 6.5; for further statements of the effects of psychological or emotional states on the body, sections 6.2 and 6.6.

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have a twofold essence,53 which indeed I have now finished discussing. Let us then convey the specific aim in each case: precise preservation, within the limits of perception, in the case of the faultless one, and that which is not precise in the case of the faulty one.54 We ought to rectify the healthy bad-mixtures, by making those natures which are drier than they should be wetter, and by drying those which are wetter; and, similarly, by reducing the excess of the hotter, and checking the imbalance in the case of those that are wetter, too. Which items of healthful daily regime one will use to do this, the continuing argument will show. First, I ought to give an account of how one may preserve the health of [people 30 K. with] the best nature; and, even before this, let us give a reminder of what in fact is the best constitution of the body. Such a constitution is, surely – if one is giving an explanation in terms of the actual essence of the thing 55 – that which is at the same time both best-mixed and endowed with a shaping of the parts which is precisely fitted to their activities, while also providing the overall number,56 size and relative arrangement of all of them, which are beneficial to the activities. In terms of its indicators, meanwhile, the precisely well-fleshed body is of the sort which I stated to be midway between thin and fleshy: it will make no difference whether one says ‘fleshy’ or ‘stout’. This sort of body is, similarly, also at the precise midpoint between the other excesses, so that no one can say that it is either hairy, or devoid of hair; nor that it is either soft or hard, white or black, narrow- or wide-veined, 53

Ousia: Galen uses this term both in a logical or metaphysical sense, to refer to the fundamental definitional characteristics of a concept or phenomenon (see e.g. Diff. Feb. I.1, VII.273 K., on the classification of fevers, where ousia is contrasted with sumbebēkos, or the discussion of the notorious problem of the ‘substance of the soul’ in The Capacities of the Soul Depend on the Mixtures of the Body, esp. 3–5), but also very frequently to refer simply to different kinds of physical stuff, as e.g. at Diff. Feb. I.6 (VII.289 K.) (‘the ousia itself of ambient air’), and within the present book at e.g. I.2, 4,10.13 Ko. (VI.3 K.); I.2, 5,14 Ko. (VI.6 K.); I.7, 16,2 Ko. (VI.31 K.). Cf. also n. 55 below. 54 I translate the text as in the MSS. But (a) it would seem more Galenic to emphasize once more that he means ‘faultless’ (ἀμέμπτου) only in the sense of what is perceptible (πρὸς αἴσθησιν), (b) the phrase πρὸς αἴσθησιν seems to go more naturally with ‘faultless health’. I therefore wonder if the phrase ὡς πρὸς αἴσθησιν is either out of place or should be repeated with both phrases, that is, that ‘within the limits of perception’ is a qualification which should be applied to both ‘precise’ and ‘not precise’. 55 Cf. n. 53 above. Galen elsewhere insists that the ousia tou pragmatos, ‘essence of the thing’, or ousia tou zētoumenou [pragmatos], ‘essence of the object of enquiry’, must be used as the startingpoint for valid scientific arguments or demonstrations; see Temp. II.2, 53,6 H. (I.592 K.); PHP e.g. II.3, 108,26–28 DL (V.219 K.) and II.3, 110,23–24 DL (V.221 K.); cf. QAM 5, 48,4 M. (IV.787 K.). On Galen’s use of this terminology in his accounts of logical demonstration, see Havrda (forthcoming). 56 Cf. n. 6 above: ‘number’ (arithmos) here seems to correspond to amount or ‘quantity’ (posotēs) elsewhere.

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spirited or lacking in spirit, prone to sleep or insomniac, dull in intellect, crafty, lustful, or the opposite of that. Moreover, if it is at the precise 31 K. midpoint of all excesses in all the parts, presumably such a body is also most beautiful to look upon, being well-balanced, and fit for all exer- 20 tions. It will also have all the other indicators of the good-mixture of each part, as has been said in the second book of Mixtures.57 For many bodies are well-mixed in, for example, the head, but badly-mixed in the chest, or in the parts in the region of the stomach and the reproductive parts. Some have a bad-mixture in their limbs, many have one in one of 25 the internal organs, or in one or more other parts; and similarly indeed some have a bad-mixture in respect of more than one internal organ. In many cases I have even found two mixtures existing in one of the organic parts, so that, for example, the rest of the vessel of the stomach all has one mixture – whether good or bad – while its mouth alone has another. These will be discussed amongst the bad constitutions of the 30 body.58 7. But let us now discuss the best one, that in which the entire substance 16 Ko. 32 K. of each part is faultless. Such a person will be fortunate if he is brought up in accordance with the art concerned with health, being supervised by this immediately from his birth; for he will thus gain some benefit for his soul too, since a good daily regime lays the way for good character 5 traits.59 And of course, if he comes to the employment of the art also at some subsequent stage of life, he will gain very great benefit in this way too. The way in which one may conduct such a person from the earliest stage, and render him healthy throughout his entire life (unless something violent befalls him from outside: this is irrelevant to the expert in 10 the art concerned with health) shall be discussed first; secondly, the way in which one may supervise a child in the case where the child is not newborn, but is still capable of education; and so too with the other stages of life.

57

See Temp. II.1 for an account of the person who is ‘well-mixed’ overall; there too the terminology of gnōrismata, understood as the diagnostic indicators by which one learns to discern the relevant bodily properties, is central. 58 Galen’s dedicated discussion of the suboptimal, and in particular uneven, bodily constitutions commences at Book VI, ch. 9. 59 On this claim cf. QAM 1, 32,9–11 M. (IV.768 K.), ‘we derive good-mixture of the body from our food and drink and other daily activities, and may then use this mixture to contribute to the virtue of the soul’, as well as the arguments of that text more broadly.

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Care of newborn and small children A newborn child – one which is faultless in its entire constitution – must 15 first be wrapped, sprinkled with well-balanced salts,60 so that its skin will 33 K. be firmer and denser than the internal parts. For during the gestation everything was equally soft, since no harder body came into contact with it from outside, nor did cold air come upon it, by which factors it could have been drawn together and compacted, thus becoming harder and 20 denser both than it was before and than the other parts. But when it is born, it is necessarily going to come into contact with cold and warmth and with many bodies harder than itself. Because of this it is appropriate that its connate covering be prepared by us in the best way for its protection against harm.61 Preparation by means of salts alone is sufficient for infants in a normal state. For those that require either a sprinkling with 25 dry leaves of myrtle or some other such thing are, surely, in a faulty state. And our task for the present is to conduct the discussion of those endowed with the best constitution. These, then, after being wrapped, as stated, should use milk as their nourishment, and baths of good water; for they need an entire daily 30 regime which is wet, since their mixture is also wetter than those at other 34 K. stages of life. And this point of enquiry should come first, in the context of what is necessary for the healthy daily regime. For there are those who think that the wetter natures always need to be dried, and similarly the colder to be heated, the drier moistened, the hotter cooled, since every 35 imbalance is increased by similars, and checked and reduced by oppo- 17 Ko. sites; and, in brief, ‘opposites are the cures for opposites’. 62 But these people ought to have read and mentioned not just this saying of Hippocrates, but also those where he states: ‘Wet daily regimes are 5 advantageous for all who have fever, but especially for children and others who are accustomed to this kind of daily regime.’63 For here it is obvious 60

Galen regularly uses the word for salt in the plural; it is not that other substances than salt are meant; what is at issue is the variety of different qualities or properties, and sometimes admixture of other substances, that he takes to be present in salt, depending on its provenance; on this see Note on translation, p. xxiii. 61 The term is duspatheia, which suggests that the body in question is not prone to being affected – slightly less strong than the apatheia mentioned above (see n. 10), which would suggest complete unaffectedness. 62 A standard Hippocratic notion; see e.g. Flat. 1 (VI.92 L.); Nat. Hom. 9, 188,3–10 Jouanna (VI. 52 L.), Aph. 2.22 (IV.476 L.), this last text being one that Galen very frequently cites. 63 Aph. 1.16 (IV.466 L.); cf. Galen’s commentary on the passage, Hipp. Aph. II.16 (XVIIB.425–428 K.). His reading seems tendentious here, since the Hippocratic text does certainly seem, through its ‘especially’ (μάλιστα δὲ) clause, to be talking about children and those with a certain diet as a subset of those with fever.

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that he places the three – disease, stage of life and customary practice – alongside each other, in succession, and regards disease as an indication for opposites, but stage of life and customary practice as indications for similars. In the case of fever (which is a hot, parching disease) wet daily regimes are beneficial; in the case of children (for they do not have a 35 K. disease: their stage of life is normal)64 what is most similar is the most beneficial. So too with customary practices, since these too bring about certain acquired natures in the bodies, the introduction of opposites is extremely harmful. And, reasonably enough, in the case of bodies in their normal state, their own condition must be preserved, while in the case of those in sickness, it must be altered and brought towards its opposite. Now, everything is preserved by similars, and altered by opposites. One must not, therefore, dry children, because their moisture is not abnormal, as it is in cases of sore throat, colds, catarrh and dropsy. Rather, in those who are wet by nature, one should give a daily regime consisting of naturally moistening things, thus preserving what is there by nature, with moistening daily regimes and baths of drinkable water (for those which manifest some drug-like quality, such as those containing sulphur, asphalt, natron65 and astringents, are all drying); and one should to the greatest extent provide nourishment and drinks which are extremely wet. Thus, too, Nature herself provided this in the case of children, preparing wet nourishment for them in the form of the mother’s milk. Now, mother’s 36 K. milk is perhaps the best thing for all other infants, too (except in the case of a sick infant), but especially so for the infant with the best mixture, who is now the subject of our discussion. It seems likely enough that the body of this infant’s mother will as a whole be faultless, and in particular her milk. While we are still in the process of gestation, our nourishment comes from blood; and the generation of milk is from blood, too, which has undergone a very small change in the breasts. And so all children who are nourished by mother’s milk are using a nourishment which is at once both most familiar and most appropriate to them. It is obvious that Nature not only has prepared such nourishment for infants, but also provided them, right from the start, with innate capacities for the use of I translate ἡ ἡλικία with the MSS, not ἢ ἡλικίαν with Koch. The latter ‘correction’ of the Basileensis, which would give the sense ‘they do not have a disease, but [it is] normal and in accordance with their age’, seems quite unnecessary, while the MSS reading gives the sense required. 65 For these mineral substances and their translation, and Galen’s account of their presence in various waters, see Note on translation, p. xxiii. 64

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them.66 For indeed, if one places the teat of the breast in the mouth of newly-born children immediately, they suck the milk and drink it down extremely eagerly; and if they happen to be in discomfort and wailing, the teat of the one nursing them placed in the mouth is a considerable 10 cure for their distress. Indeed, these three cures for children’s distress have 37 K. been discovered by nurses, who have been taught by experience: one is that just mentioned, the other two are a certain moderate motion and a melodious use of the voice, by constant use of which they not only soothe them, but also make them fall asleep. In this, too, one has an indi- 15 cation from Nature, that children are in themselves adapted for music and physical training; and therefore the person who is capable of employing these arts well will best educate both body and soul.67 8. So (for example) motions of children in cradles and hammocks, and in 20 the cradling of their own arms, have been discovered by nurses. And this further point of enquiry may arise, which is most necessary for the safeguarding of health, since Asclepiades has an absolute and quite manifest contempt for physical exercise, and Erasistratus, though he makes less bold an assertion, still demonstrates the same view as Asclepiades, while 25 practically all the other doctors approve them, not just for good-condition, but also for health.68 There are three primary classes of physical 66

Cf. the discussion of the extent to which newborn children and animals have an untaught ability to perform their appropriate bodily functions at Foet. Form. 6. 67 It is worth noting that what is being recommended here is the untaught music of nurses, rather than music carefully selected for its didactic or improving effects on the person, on the Platonic theoretical model, which Galen considers to be of great importance later in life: see PHP V.6, 330 DL (V.472–474 K.); the discussion of the effects of music below at I.8, 20,13–17 Ko. (VI.41 K.) is relevant to this too. 68 On the basis of our other sources for both Asclepiades and Erasistratus, this seems to be at least a considerable overstatement. Asclepiades is said to advocate passive exercise (Celsus, Med. II.14.1 and II.15.1) and for certain conditions even to prescribe the athlete’s daily regime, with much running and walking, and massage while the breath is held (Caelius Aurelianus, Tard. Pass. III.8.149, 768,27–29 Bendz). There is some evidence of his hostility to specifically athletic practices: Celsus, for whom Asclepiades seems to be a major source in this area, makes a distinction between normal everyday exercise and the athletic sort, rejecting the latter (Med. I.3); and Asclepiades is said to have ‘stated that the athletic condition is not safe’ (Caelius Aurelianus, Cel. Pass. I.14.113, 84,26–27 Bendz). But on this latter point Galen seems in complete agreement with him; see Thras. 9, 43,4–7 H. (V.820 K.), citing Hippocratic texts in support of a similar view. As for Erasistratus, while the few pieces of evidence we have for his views on ‘healthfulness’ (fragments 153–167 Garofalo) say little about exercise, he does seem to acknowledge its validity as part of a healthy daily regime, certainly if it is part of one’s customary practice, in fragments 161–163 (all of which are testimonies from Galen himself, the latter two representing the only extended verbatim quotations from Erasistratus in this area). Perhaps, as David Leith (to whom I am indebted for the textual references in this note) suggests to me, what Galen has in mind in this polemic is rather Asclepiades’ and Erasistratus’ teleological position than their detailed views on exercise. Galen objects to Asclepiades’ anti-teleological stance, and to Erasistratus, who in his view

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exercise, which is the same as the number of different types of motions: 38 K. for we are moved either by ourselves, from another source, or through drugs.69 The third kind of motion is in no way appropriate for the healthy; but motion from another source comes about in sailing, horseriding, carriage-riding and, as has just been mentioned, by means of cradles and hammocks and cradling in the arms. Now, newborn children have no need yet for such motion as arises through carriages, ships and horse-riding; but once they have reached the third or fourth year from birth, they may then undergo motion through carriages and ships to a moderate degree; and when they reach seven years of age, children tolerate quite vigorous motions, so that they may even adopt the practice of horse-riding. As for motions arising from themselves, children are first able to do this when they begin to crawl, and more so, when they begin to walk; but these things should not be forced before the right time, so that the limbs do not become distorted. Yet our nature shows, at this stage of life too, to what extent it is adapted70 to physical exercise. Even if you were to confine a child, you would not be able to prevent it from running around and skipping, just 39 K. as is the case with foals and calves. For nature is capable of implanting in all animals urges adapted towards health and preservation. But the followers of Asclepiades, having no conception of any of these matters, spend much time in the elaboration of sophistic arguments, attempting to show that physical exercise contributes nothing to health. Now, the relevant arguments will be addressed to them again later on, whereby

claims to have a teleological theory but departs from this in reality (for Galen’s discussion of Erasistratus in this area see von Staden 1997b). The view under attack might thus be that children could not, on such anti-teleological views, be taken to be naturally adapted to exercise, in the way that Galen has just argued. 69 Galen alludes here to a distinction made by Plato, Timaeus 88e–89b, between three types of motion in the human body: those arising from oneself, those arising from someone else, and those from drugs (pharmaka). The presentation here is somewhat confusing, with Galen explicitly equating the number of types of exercise with the number of types of motion, whereas the latter is – as indeed the mention of drugs, as well as the following sentence, makes clear – a broader category, including (what is usually referred to as) exercise as one of its types. The second type, also in that passage in the Timaeus (which mentions sailing and riding in carriages; cf. also Laws VII, 789d3) is that of ‘passive exercises’, which are mentioned here and at several other places in this book. 70 The word translated ‘adapted’ is a perfect passive form of the verb oikeioun, which is cognate with the adjective oikeios, ‘familiar’, ‘appropriate’ or ‘proper to’ (and also translated as ‘adapted’ in the next sentence). (It is also related to the abstract noun oikeiōsis, which has a technical sense, in Stoic philosophy, of a child’s gradually developing sense of itself as ‘belonging’, first to itself and its parents, and then to successively larger social groups.)

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their babbling may be finally refuted.71 The task before me now is not to refute the babbling of sophists, but to give thorough instruction in what is actually useful for health. Let me return to the topic of children who are endowed with the best bodily constitution. These will probably also be faultless in the character 15 of their souls, since those which are more spirited than they should be, or less spirited, or less perceptive, or more gluttonous, than is appropriate, must have had an incorrect mixture in those parts of the body with which we perform each of those things. (And more has been written about these in the discussions of The Doctrines of Hippocrates and Plato.)72 20

Relationship of body and soul; interventions related to the latter But the child who is the subject of our present attention is the one who is 40 K. best in all respects. This child will need no rectification in the character traits of his soul, but rather preservation, so that they are not destroyed. And everything is preserved by the same kinds of thing – in terms of their class – by which it is also destroyed. The character of the soul is destroyed by bad habits in food, drink, physical exercise, things watched 25 and heard, and music as a whole. Indeed, the person who undertakes the art of health should be experienced in all these, and one should not think that it only concerns the philosopher to shape the character of the soul.73 Rather, it concerns the philosopher because of something greater, that is the health of the soul itself, but it concerns the doctor in the interest of 30 the body’s not readily falling victim to sickness. For, indeed, rage, weeping, anger, distress and excessive worry, and poor sleep arising from 71

This promise does not appear to be directly fulfilled. Also, something appears to be wrong with the text of this sentence, which as it stands in the MSS has an awkward repetition (εἰρήσεται … εἰρησομένης) and would give a sense something like: ‘so that their babbling will be finally [or, completely] stated’. I take it that εἰρησομένης is wrong, and suggest that the correct reading must be ἐλεγχομένης (‘refuted’ rather than ‘stated’) – or something with a similar sense. It may be noted that Linacre’s translation has ‘taxanda’, which does indeed give such a sense. I note also that the phrase ἐπὶ τέλους does not occur elsewhere in Galen; it should perhaps be taken simply as an error for ἐπὶ τέλος (‘to the end’, i.e. ‘completely’). 72 It seems possible here too (cf. n. 52) to detect the model of the tripartite soul behind the three examples chosen: ‘spirited’ belonging to the spirited part, ‘gluttonous’ to the desiderative and ‘perceptive’ to the rational (even if the last connection is less clear than the others). There is, relatedly, much material in The Doctrines of Hippocrates and Plato relevant to the relationship of the three parts of the tripartite soul and their bodily location, though it does not seem clear what specific passages, if any, Galen has in mind here. On the correspondence between ethical or rational characteristics and bodily mixtures, cf. Introduction, section 6.2. 73 The question of the rival or overlapping competences of doctor and philosopher, and of the extent to which they should become expert in each other’s fields, constituted a live debate in Galen’s time; see Introduction, section 6.4.

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these, provoke fevers, and become the starting-points of major diseases.74 So too, conversely, an idle intellect, mindlessness and a soul which is completely lacking in spirit frequently bring about poor colour and poor 20 Ko. nourishment75 through feebleness of the innate heat. It is absolutely crucial that our connate heat be preserved within the bounds prescribed 41 K. by health; and this is achieved by well-balanced exercises, not just in the body, but also in the soul. Unbalanced motions which arise as a result of 5 desires, discussions and rages76 render the animal more bilious, when they are excessive, and more phlegmatic and colder when they are deficient. Moreover, in the former conditions fevers and all the hotter ailments come about, in the latter obstructions in the liver and internal organs, and epilēpsia and apoplexy and anything else of that sort – in 10 short, all diseases that arise involving catarrh and flow of liquids. In a considerable number of cases, we have restored health to people who were suffering for many years because of the character of their soul, by rectifying the imbalance of the motions. Our patron god Asclepius,77 too, is a significant witness to this argument: he has instructed a considerable number of odes to be written, as well as sketches of a comic 15 nature, and also the composition of certain songs,78 by people in whom 74

Galen expands elsewhere on the phenomenon of such ‘affections of the soul’ leading to concrete (including sometimes fatal) physical consequences; further on these Galenic discussions see Introduction, section 6.2. 75 What is meant by ‘poor nourishment’ (atrophia) is a failure by the body to absorb foods properly, to subject them fully to coction. There is a brief discussion of this problem and its management below, V.3, 141,28–142,6 (VI.320–321 K.). 76 Although the term thumos (here in the plural) also has the more everyday, non-technical sense of ‘anger’ or ‘rage’, the Platonist moral psychological background is again crucial here (cf. nn. 52 and 72 above). Once more, the three cases given here correspond to activities of the three parts of the Platonic soul, desire, reason and spirit. 77 Patrios theos could also have a local connotation, as Asclepius and his cult were particularly associated with Galen’s birthplace, Pergamum, and he was thus in a sense the ‘patron’ or ‘ancestral’ god of that place. But the main sense is surely that of Galen’s own personal affiliation to the god; for Galen’s account of this see Introduction, section 3.4. 78 ‘Sketches of a comic nature’ translates mimoi geloiōn. This seems to have been a standard phrase for a kind of comic performer or performance: cf. AA VII.16, 475,3–4 Garofalo (II.644 K.), and, in other authors, e.g. Demosthenes, Olynth. 2.19.7; Libanius 30.1.68.4; Progymnasmata 3.4.12.2. But mimos can refer to a sketch as well as performer, and this seems to be the sense required here, i.e. it is active writing, and presumably also performance, of such sketches that is part of the ‘therapy’ prescribed. In the syntax of the sentence, the phrase in question, μίμους γελοίων, seems to be in parallel with μέλη (‘songs’), and governed by γράφεσθαι: that is, both of these are things that the god has instructed ‘to be written’. It would also be possible to take the phrase rather as connected with the following verb, ποιεῖν, ‘create’ or ‘compose’, in which case the phrase could rather be understood as referring to the performer (‘instructed comic performers to create …’); but in that case we would have to take it that the object of the verb ποιεῖν had dropped out. The term melos could also be translated ‘lyric poem’; in either case, the item in question would be sung, and indeed it seems likely that the performance is an important element of the therapy

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the motions of the spirited had become too vehement and rendered the 42 K. mixture of the body excessively hot; and he has also instructed others – these too quite numerous – to engage in hunting with hounds, horseriding and armed fighting.79 And he specified from the outset the form of hunting that those whom he instructed should engage in, and the form of armed fighting, to those whom he ordered to take that armed physical 20 exercise. He did not just want to stimulate the spirited in them, which was feeble, but even stipulated the level of the physical exercise, by [stipulating] its type. For the spirited is not sharpened in the same way with the hunting of wild pigs, bears, bulls or some such fierce beast as with hares, deer or some such timid one; nor in the same way with light and 25 with heavy armour; nor in the cases of swift running and moderate motion, or of competition with others as opposed to on one’s own. So, too, there is no small difference between those who shout loudly, or urge [people] on and spur them on to labour, and those who are silent. But on 30 those matters more will be said in the subsequent books.80

Further discussion of upbringing of children, including use of milk, choice of nurse and avoidance of cold-water bathing and wine Small children who have the best mixture (this was our subject) require 43 K. considerable care so that no unbalanced motion arises in their soul; for when they do not yet have the use of language they indicate their discomfort by crying, shouting, raging and moving themselves in a disor- 35 derly way. And so we have to guess at what they need, and in each case 21 Ko. provide this before their distress grows and plunges the whole soul along with the body into too vehement and disordered a motion; for they cry and move unharmoniously, as though struggling, because they are experiencing some irritation from within themselves, because they are in discomfort because of some external factor, or because they want to defaecate, urinate, eat or drink. It can also happen that they desire 5 here. (The following phrase could also be translated, ‘for those …’, rather than ‘by those …’; but it seems clear that active participation is envisaged.) In attributing these instructions to the god Asclepius, Galen is doubtless describing activities in the Asclepieion at Pergamum, on which see Introduction, section 3.4. Galen’s brief remarks here may instructively be compared with our main literary source for the Asclepieion, the writings of Galen’s direct contemporary Aelius Aristides, on whom see further Introduction, section 3.4. Aelius indeed recounts – albeit with a religious rationale very different from that described by Galen here – the experience of composing lyrical poetry inspired by the god, in the context of his medical journey: Sacred Tales I (= Orations XLVII) 73, 393,13–18 Keil. 80 Galen discusses such precise distinctions within the functions of exercises especially in Book II, ch. 8. 79

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warmth when made uncomfortable by cold, or desire some cooling when disturbed by immoderate warmth, in some cases also because they do not tolerate the amount of clothing that has been put on them: for this too is a significant source of discomfort, especially in the context of the turning of the whole body and the motions of the limbs. But remaining still for too long is also a considerable source of distress. For no animal enjoys imbalance; all crave good balance. 44 K. And good balance is not a single thing for all; rather, all good balance is relative to something. Therefore one who is taking care of the upbringing of children has to be a precise estimator of what is good balance and what is appropriate to them, and to provide this in all cases [before the distress grows and plunges body and soul into an imbalance of motion]; but if the source of distress has in fact grown without being noticed, to attempt to rectify the distress, both by immediately providing what is desired or removing the source of discomfort, and also by motion in the arms and by the vocal production of songs, which are customarily employed by the cleverer nurses. On one occasion, when a child was crying, raging and throwing itself about vehemently and in a disorderly way all day, I discovered the source of its distress, when the nurse was completely at a loss. It did not settle, either when the teat was placed in its mouth or when the nurse encouraged it to defaecate or urinate; and it would not be consoled, not even when she tried to place it in her arms 45 K. and cradle it; but I observed that its bedding and wraps and clothes were too dirty and that the child itself was already dirty and unwashed, and instructed her to wash and clean it and to change the bedding, and to make all the clothing cleaner; and when this was done, it immediately ceased its unbalanced motions, and immediately slept, enjoying an extremely long and pleasant sleep. But to guess successfully at all the sources of a child’s discomfort requires not only astuteness but also constant experience in relation to the actual child being reared.

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9. And so I recommend that you concern yourself with all these things concerning the child, up to the third year from its birth, and in addition 22 Ko. to this take considerable care over the food, drink, sleep and sexual activity of the person nursing it, so that the milk may be of the best mixture. This will be so if the blood is of the best sort; and the best blood 5 is that which is neither bitter-bilious nor black-bilious nor phlegmatic nor mixed with some whey-like and watery moisture. Such blood is 46 K. generated as a result of well-balanced physical exercise, nourishment which is both of good fluid and taken at the appropriate time and in the

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right measure, and also as a result of well-timed and moderate drinking. There will be precise specification of all these in the subsequent books. I instruct women who are nursing children to abstain from sexual activity altogether: their menstrual emissions become irritated if they have intercourse with a man, and the milk no longer has a good smell. Moreover, some of them fall pregnant, and there is nothing more harmful than this to the child who is being nourished with milk. In that case the best of the blood is used up on the embryo, since this contains its own separate source of life within it, is controlled81 by this and continually draws to itself its proper nourishment, as if both rooted in the womb and inseparable from it, night and day. It is reasonable enough that the blood of the pregnant woman in such a case will become both smaller in quantity and worse; and because of this the milk gathered in the teats will be bad and small in quantity too. I would therefore advise that when the woman 47 K. nursing falls pregnant one find another nurse, examining and testing her milk precisely with regard to taste, sight and smell; for, indeed, the best milk will both be pleasant when one tastes and smells it and be seen to be white, even and in a middle state between moisture and thickness, when one observes it. Bad milk, on the other hand, will be either thick and excessively cheese-like, or moist and whey-like and blue-grey and uneven in its composition and colour; and, when one tastes it, will be very bitter and give an impression of saltiness or some other unpleasant quality; and this kind of milk is not even pleasant to smell. Let these be your indicators of the bad and good in milk; you may use them as evidence, when the need arises to turn to another nurse because of pregnancy or also of some disease affecting the mother,82 in making the assessment and choice of this person.

81

‘Controlled’ translates the verb dioikein; cf. below, II.11, 66,4 Ko. (VI.148 K.), with note. I depart from Koch’s reading, μαῖαν (that of one MS, V), and adopt μητέρα (MRV1). The former word does not have a specific sense of ‘wet nurse’, even in classical poetry, where its usage is vaguer, applied to persons considered as having some motherly or fostering function, and certainly not in later prose and medical literature, where it refers mainly to a woman with gynaecological expertise in general, and the role of midwife in particular: Plato, Theaetetus 149a; Soranus, Gynaecia, passim (where the wet nurse is indeed referred to by a different term, τιτθή): II.19 (66 Ilberg); cf. Galen, Praen. 8, 110,20 N. (XIV.641 K.). Galen’s point here seems to be precisely that in case of pregnancy or disease of the mother, if she would otherwise be nursing, one should find a wet nurse; and this fits with the fact that on the preceding page the feminine participle θηλάζουσα, ‘[woman] nursing’, is deliberately ambiguous between mother and wet nurse. That is, Galen is in this whole passage giving instructions which cover both the case where the mother would herself be expected to act as nurse and the case where the expectation would be to hire someone else.

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10. One should nourish the child with milk alone to begin with; when the teeth at the front appear, one should then in some way habituate it to 48 K. tolerate thicker nourishment, as women, taught by experience, in fact do – bread, first of all, then pulses, meats and all such foods which they first themselves chew, and then place in the mouths of the children. And one should massage the bodies of infants with sweet oil, again, just as most nurses appropriately do, straight away shaping the parts and adjusting their proportion. But in the case of the child which is our subject now, that with a faultless bodily constitution, the nurse ought not in any way to take excessive pains over the good proportion83 of the parts, but one should massage them to a moderate extent and wash them every day, as far as possible when there is not milk which has not undergone coction collected in the stomach; for there is a danger that this be taken in, before it has undergone good coction, into the whole body of the child. Especially so if one massages the stomach itself when full of milk: the body will fill with nourishment which has not undergone coction and it will fill the head. Therefore one should take great care that the child 49 K. should not have taken milk either before bathing or before massaging. This may be achieved by the nurse paying particular attention to the appropriate time, in cases of longer periods of sleep; for during this one will find either that the digestive cavity is completely empty or that it contains nourishment which has already undergone coction. One should not, as some nurses now do, set aside a particular time of the day, nor, like some others, provide for it when they themselves find they have some free time; because then it follows that the children will unavoidably often be harmed rather than benefited. The appropriate time specified by us will, on different occasions, turn out to fall at different times of day or night. For larger children, however, who are persuadable by means of blows, threats, rebukes and admonitions, there are two appropriate times for massaging and bathing.84 The first, and best, when the child rises from sleep in the morning, and then, after play, asks for nourishment. At that time especially one should impose a condition on them, at once training the body for health and for good-condition, and the soul for ready obedi50 K. ence and self-control, stating that one will not provide them with 83

‘Good proportion’ translates euruthmia, a noun cognate with ruthmizein, ‘adjusting proportion’, above; it refers to the correct balance or relationship between different parts. Cf. Temp. II.6, 71,14 H. (I.662 K.), and below e.g. II.11, 67,37 Ko. (VI.153 K.). 84 It is worth noting, as Sean Coughlin points out to me, the potentially controversial nature of Galen’s views here: Athenaeus, for example, rejected the use of physical punishment for children. For our non-Galenic sources for ancient views on child-rearing, see Introduction, section 2.3, with n. 16.

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­nourishment unless they eagerly submit to whatever massaging and baths we wish. But a carer who is in a hurry may give a moderate amount of bread and instruct the child to play for as long as it likes, and then call it again and at that point carry out the massage and the bathing. One should not, though, ever instruct them to drink before the bathing taken after food; for in that case there arises a distribution into the body of what is contained in the stomach. Care must be taken over this with bodies with faultless health. For the faulty states and constitutions of the body are those in which it is better to give food before bathing. Specifications about these will be made in the following books; for now, though, we should remind ourselves of our present subject, namely how we may conduct the daily regime of the child in the best state of body, so that the child is preserved in that state. In such a case it is better that bathing precedes food; and if the child is being reared in a place where there is no bath house – though perhaps people in such a 51 K. situation will not have contact with the present writings – the nurses wash the children in tubs, here too, until they reach the second or even the third year from birth; and when they get bigger, they oil and massage them, if not every day, then at least, say, every third or fourth day; and if the weather does not prevent it, lakes and rivers serve them for bathing, in the same way that the bath house does us. Amongst the Germans,85 children are not reared well. Still, we are not writing this for Germans or for any other wild or foreign people, any more than for bears or lions or goats or any other wild beasts, but for Greeks and for all those who although foreign by race nevertheless emulate the customs of the Greeks. For, amongst our people, who would tolerate an infant’s being taken to a flowing river immediately after its birth, while still hot, and there – as it is said is the practice of the Germans – simultaneously to make trial of its nature and to strengthen its body, by dipping it into the cold water like red-hot iron?86 For it is of course 85

Without speculating as to the likelihood that Galen may have had the opportunity to make observations about actual ‘Germans’ of his own time, it seems likely that this perception – like the image of Scythians below – derives largely from the literary, including scientific-medical, tradition. Further on Galen’s ethnic stereotypes see Introduction, section 5.6; and cf. next note. 86 Galen, a native of the Asian city of Pergamum (and at least possibly a Roman citizen) identifies himself as Greek; for him as for other intellectuals of this period, Greekness is fundamentally understood in terms of language and culture. Further on cultural Greekness see Introduction, sections 3.1 and 5.6. I translate the Greek barbaros by ‘foreign’, rather than by the more loaded ‘barbarian’ or ‘barbarous’ (but compare the usage at Thras. 46, 97,7 H., V.894 K.). Again, what is fundamentally at stake here is non-Greek language, and by extension the non-adoption of Greek cultural norms. Galen’s use of the phrase ‘amongst our people’ (par’ hēmin) in the next sentence is also of relevance here. He habitually uses such expressions to refer to the people or locality of

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52 K. immediately evident that if it withstands this and is not harmed, it has both shown its own natural strength and gained strength from the contact with the cold; but no one can be unaware, either, that if its innate heat is overcome by the external cooling, it will necessarily die immediately. And so what person of intelligence who is not completely wild and Scythian would choose to submit his own child to such a trial, in which the unsuccessful outcome is death – and that when he does not stand to make a great gain from the trial? While it may perhaps be a very great good for an ass or for one of the non-rational animals to have such dense and hard skin that it can bear the cold without distress, what is so great about such a thing for a human being, a rational animal? One could not reasonably say that extremely dense and hard skin was useful for health, speaking in absolute terms. There being two kinds of harm for animal bodies, one arising from external causes, the other from internal ones, those animal bodies whose skin is soft and porous are vulnerable to all external ones, and those 53 K. whose skin is dense and hard, to the internal ones. For this reason Hippocrates, in addition to his instruction given about what arises in us as a result of nourishment in many other contexts, also wrote the following statement: ‘Porousness of body is healthier in those in whom more is taken away in transpiration, more pathological in those in whom less.’87 It is thus better to avoid both sorts of excess, and neither make the skin so dense as to prevent it from good transpiration, nor so porous as to be readily harmed by every cause that befalls it from outside. Such, too, by nature is the body of the child which is now the subject of our discussion, being at the midpoint between all excesses. So, one must conduct its daily regime in such a way as constantly to preserve the excellence of its constitution. This will be achieved, during the first stage of life, by its being nourished on milk and washed in baths of fresh water, so that its body remains soft for as long as possible and acquires a great advantage for the purposes of its growth. In the next phase, when the child is able 54 K. to go to teachers, it is no longer necessary to use baths constantly, but it Pergamum or its immediate environs of Mysia, or more broadly (Roman) Asia; in this instance, however, he clearly refers again to the wider Greek cultural identity; cf. below, II.7, 56,29–30 Ko. (VI.126 K.) below, with n. 43. See also Introduction, section 3.1. In relation to the practice of cold bathing of infants, however, Galen’s condemnation was not universal within Greek culture: Aristotle, while also attributing it to barbaroi, speaks of it with approval as habituating the child to endure cold from early on (Politics VII.17, 1336a15–18). 87 The quotation is from the ‘Hippocratic’ Nutrition, thought by modern scholarship to be a late work, but cited quite frequently by Galen: De alimento 28 (IX.108 L.).

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is sufficient to continue palaistra exercise, 88 learning to engage in moderate exertions there, before taking food, but for the most part to abstain from bathing. But excessive exertion, which some instructors89 force on their children, is in no way good; because of the hardness at the wrong time, the body is rendered lacking in growth, even if it had a very 30 great impulse towards growth in its nature. 11. The child who is of this nature should not taste wine at all for as long as possible.90 For the drinking of wine both substantially moistens the body and heats it, filling the head with vapours, in cases of wet, hot mixtures – which is, indeed, the type of mixture of these children; and it is not good to fill their heads, nor to moisten and heat them excessively. 35 Their degree of moisture and heat is such that, if one increases either of 26 Ko. these even slightly, they are placed in a state of imbalance. And, while all imbalances are to be avoided, this type is particularly so, wherein the 5 55 K. harm penetrates not just the body, but also the soul. It is for this reason that the drinking of wine without appropriate measure is not good even for adults; for it provokes sudden rages and unseemly arrogance, and makes the reasoning part of the soul blunt and clouded. It does, however, have an appropriate function in the mixing, and at the same time the evacuation, of bilious residues. It is particularly useful, too, against dryness arising in the actual solid organs91 of the animal, and also because 10 of excessive exertions, and in some cases because of the mixture which belongs to the particular stage of life, in that it moistens and builds up92 what has been immoderately dried, and relieves the acridity of the bitter fluid, evacuating both by sweats and by urines. Children, since they do not accumulate such fluid but do have a great deal of their own moisture, 15 do not require the benefits that arise from wine, but only experience its harm. Therefore no one of intelligence will instruct children to use this 88

This is surely the sense here of diapalaien, although the ‘standard’ dictionary definition of the verb palaiein is ‘to wrestle’. The range of exercises carried out in the palaistra is discussed in detail in the next book. 89 The term is paidotribēs, the literal or original sense of which was ‘child-trainer’, but which had a much broader application, referring to people with a particular role in physical training: this role was apparently distinct from that of the gumnastēs, and below his in status and breadth of expertise; cf. below, II.9, 63,28 Ko. (VI.143 K.), and Introduction, section 3.2. 90 For age-related restrictions on wine, cf. QAM 10, 67,23–69,13 M. (IV.808–810 K.), where he quotes from Plato’s Laws in support of his views. 91 Galen insists on a distinction between the states of solid structures in the body and those of the fluids contained in them. See also below, II.2, 40,19 Ko. (VI.87 K.). 92 The word is anatrephein, literally ‘nourish up’; what is meant is a physical increase in the substance of the body.

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sort of drink, which, in addition to doing no good, has extraordinary harm potentially attendant on it.

Observations on good and bad water and air 56 K. Nor do I suggest that such children avoid cold drink completely, as some do; my instruction is rather that they should use it mostly after food, and in hot weather, when they will themselves be drawn to the cold93 – preferably, if possible, fresh springwater, which has no acquired bad94 quality, but, in the absence of this sort, some other. But water from a marsh, water which is muddy, malodorous, salty and, to put it simply, any which displays some particular quality in its taste, and also in its smell, should be avoided. It should be both very pleasant to drink, and completely clean. If it is passed quickly from the abdominal region,95 one should not look for any other water better than that: water which is clean, clear and not unpleasant to drink, but remains for a longer time in the abdominal region, must be considered halfway to being bad. My instruction is, further, to abstain from completely cold water, but not necessarily from hot water. Now, the safest thing is for such water to have been assessed by experi57 K. ence; but if one wishes also to predict96 the capacity of the water through indicators, then water the springs of which come out of rocks under pressure, with their flow towards the north, and away from the sun, should all be thought to be hard, and slow to pass: such water will automatically There is some doubt about the reading here. I follow Koch’s ὅταν ἥξωσιν αὐτοὶ, the reading of Oribasius and Scaliger, literally ‘whenever they will themselves have come’. Niccolò’s ‘bulliunt’ suggests that he is translating the Greek ἕψουσι (‘they will boil’), which also seems a possible reading, but it is then difficult to make sense of the rest of the phrase (for which Niccolò has ‘sicut in estate frigida’). If not the correct reading, ἕψουσι could also be an attempt to make sense of ἕξουσι, the reading of R, the only main Greek MS to preserve the phrase, which is missing in V (while several pages are here missing in M). 94 Koch proposes the deletion of the word ‘bad’ (μοχθηρὰν), taking it that what Galen wishes to insist on is the absence of any noticeable taste. It is true that in some contexts Galen does make such a stipulation, but in view of the immediate context – i.e. the list of bad tastes mentioned in the next sentence – and the lack of textual authority for its omission, I have kept it. 95 ‘Abdominal region’ here translates hupochondria, a technical term of Galen’s anatomy to which there is no precise correspondence in modern anatomy. It refers more specifically to a region below the chest; Galen speaks often of a pain or heaviness which arises in the ‘right hupochondrion’, by which he means an area on the right side of the body near to the liver; see e.g. below, V.7, 148,27–149,2 Ko. (VI.344 K.); VI.3, 172,33–173,1 Ko. (VI.392 K.). 96 Galen’s and others’ usage of the verb proginōskein can include the ‘prediction’ of a present state, i.e. to make a statement about it on the basis of inferential evidence, without yet having definite empirical confirmation: cf. the Hippocratic Prognostic I.2 (II.110 L.), with Galen’s commentary on it, Hipp. Prog. I.2, 198,7–23 Heeg (XVIIIB.3–4 K.). 93

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also have the property of being slow both to be heated and to be cooled. Water the springs of which break out towards the east, on the other hand, and are pushed through some channel or through clean earth, is heated and cooled very quickly; and this should be expected to be best for every stage of life. It is not the case, as it is with wine, food, physical 10 exercise and sleep and sexual activity,97 which should be experienced differently by people at different stages of life, also with water; the water which has just been stated to be the best should be used by children, young men and seniors. So, too, the best air is equally beneficial for all to breathe. What I mean by ‘best air’ is that which is completely clean; and this 15 will be that which is not polluted by vapour from either marshes or 58 K. swamps, or from caves which exude a poisonous fume, of the sort which exist in the vicinity of Sardis and Hierapolis, and in many other places on the earth. So, too, air which is polluted by a conduit taking waste water away either from some great city or from a large army encampment is 20 significantly bad. That which is contaminated with some putrefaction arising from animals, vegetables, pulses or faeces, is also bad.98 Air which is misty because of a neighbouring river or lake is not good; nor is that which receives no breath of wind because it is in a sunken place surrounded on all sides by mountains. This last is stifling and putrefying, 25 in the same way as that in certain houses which have been shut up, where mould collects as a result of putrefaction and lack of wind. Such types of air are injurious at all stages of life, just as completely clean air is good at all stages. The variety of air in terms of heat and coldness and also of dryness and wetness does not have the same effect on all; rather, well- 30 mixed air is best for well-mixed bodies, while for those which are domi- 28 Ko. 59 K. nated by some quality in excess, the air most opposite to that dominant quality is best: cold for a hot quality, hot for a cold one, and indeed dry for one which is too wet and, for a quality which is more parched than it should be, one which is wetter to the same extent that the dry quality 5 departs from the state of good balance. So much will be sufficient to know in the context of this discussion; how one may correct the harm from bad water and air will be stated in

97

For Galen’s lists of such factors and their effects, see further Introduction, section 5.2. The pollution or contamination that Galen here acknowledges as a potentially harmful feature of air, or water, is arguably not explained or calibrated by his fundamental explanatory physical schema of the hot, the cold, the wet and the dry. On this, and on the possible presence in Galen (and other ancient authors) of some form of contagion theory, see Nutton (1983).

98

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another book.99 My present purpose was to give an account of the best constitution of the body, in the best daily regime, as a kind of aim and standard. We shall distinguish in the books that follow this all those bodily constitutions which have an error in some respect, and the varie- 10 ties of daily regime.100

Care of children from age 7 to 14; relevance of different types of life 12. Let us then return in our argument to the child endowed with the best constitution, and let us give a thorough account of the stage of life from the first seven-year period up to the second, in terms both of the nature of its mixture and the items of daily regime it requires. Now, the mixture, as has been shown also in the discussions on Mixtures,101 is 60 K. equally hot [over this period], but not equally wet. Every living being becomes constantly drier from its birth onwards, but it does not become hotter or colder in the same way at every stage of life; rather, in those bodies which are endowed with the best constitutions, the heat remains roughly the same up to the prime, while in those which are wetter and colder than the best, the heat increases. But the present argument does not concern the latter. The person endowed with the best constitution should be kept to the daily regime already mentioned up to the stage of the fourteenth year, taking physical exercise neither to excess nor violently, to avoid restricting his growth, and bathing in hot rather than cold baths: he will not yet be able to tolerate the latter without distress. And one should shape the soul at this stage of life, especially through serious practices and through studies of the kind most apt to make the soul well-ordered: for good-order and ready obedience are the best preparation for the things which will be done regarding his body in the next stage of life. 61 K. After the second seven-year period throughout the third, if you wish to bring him to the peak of good-condition – say you want to make him into a noble soldier, a wrestler or some other kind of strong person – you will take less care of the goods of the soul, at least of those goods which  99

Koch suggests that Galen has in mind Book VI, ch. 6, of the present work, but the relevance of that seems rather tenuous. It seems possible that he is referring rather to a separate work, Good and Bad Humoral Fluid. 100 For Galen’s use of the term kanōn, ‘standard’, see Book II, n. 4. On the extent to which he keeps to the structure intended in this first book, see Introduction, section 8.3. For the translation of epallaxis as ‘variety’, see Book VI, n. 8. 101 For Galen’s views on the physiological changes at different times of life, and for the various texts (including Mixtures) in which he discusses these, see Introduction, section 5.5.

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lead towards some kind of knowledge 102 and wisdom; for matters concerning character should be addressed with precision at this stage of life especially. If, on the other hand, you choose to limit bodily matters to the strengthening of the parts, the acquisition of some sort of healthy condition, and growth, while your major concern is the improvement of the rational part of the youth’s soul103 – you will not require the same daily regime in both cases. And indeed a third and a fourth form of lifestyle may be found: that of those who engage in some manual specialized skill, which in turn may either involve the body in physical exercise or leave it unexercised, and that of those who engage in farming or business or some other such thing. So it actually seems quite difficult to enumerate all the types of life. Now, what the art of health professes is to 62 K. give to all human beings instructions for health, whether specific ones for each person or ones suited to all in common, or some which are specific and some common. It is not possible to give an account of all at once. One must first discuss how a person may extend his life to the greatest possible length while remaining healthy throughout; and such a person should, surely, be free of any imposed activity, and have the leisure to devote to the body alone. One should then work on the basis of a second assumption, of some specialized skill, activity, habitual practice or service, either of a political or private nature – or, in general, of some imposed lack of leisure. Our argument cannot be clear, or easy to remember, or methodically completed, without the above-mentioned ordering. Let us then return to the first assumption, and show how one with the best constitution of body, free of all things which conduce towards public activity in life, may live for himself alone, and may, as far as possible, 63 K. have no sickness, nor die before completing the longest possible span of life. After all, it is not possible to make that which is generated immune from decay, however much a certain contemporary philosopher has attempted to show the contrary, in that remarkable composition of his, in which he teaches the ‘Way of Immortality’.104 It is, however, possible 102

Epistēmē, usually, as here, rendered ‘knowledge’, can also in some contexts be more strongly translated, ‘scientific knowledge’, just as ‘scientific principles’ translates epistēmonika theorēmata below, II.4, 53,22–23 Ko. (VI.119 K.). For Galen’s views on the nature of true epistēmē or scientific knowledge see especially Frede (1985); Hankinson (1991), (1994a), (2008c); Havrda (forthcoming). 103 The verb translated ‘improvement’ is kosmein. It also has an aesthetic dimension, as well as connotations of order and regulation, being cognate with the term kosmos, which refers both to the universe and to ‘good order’. Alternative translations would be ‘the good ordering’, or ‘the adornment’, of the soul. This same usage, applied to improving effects on a person’s soul, appears at QAM 1, 32,7 M. (IV.767 K.), immediately before the passage cited at n. 59 above. 104 See Introduction, section 4.4, n. 57.

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to make the body of an animal continue for a very long time, especially the body of the animal with the best natural endowments. Some bodies have been endowed with such a bad constitution from the outset that they are unable to reach even the sixtieth year, even if you were to put 30 Asclepius himself in charge of them. But our present discussion does not concern them.

Physiology of the production and evacuation of residues Returning once more to the person endowed with the best constitution, let us give a reminder of what we demonstrated at the beginning, that it is necessary for us to eat and drink because there is a constant outflow from our bodies, and that because we eat and drink, it is again necessary to take care of the evacuation of the residues. But since there are many forms of these, some being residues of the nourishment with undergoes coction in the stomach, some of that which undergoes coction in the 64 K. liver, arteries and veins, some of the nourishment in each part, the evacuation, too, must be specific to each case, just as Nature herself has obviously brought this about from the beginning. For she has prepared for animals many organs, some which cleanse and separate out these residues, some which draw them onwards, some which collect them, some which expel them. And more has been said about all these in both the discussions on Natural Capacities and those on The Function of the Parts; for the present, these too will be taken as an assumption for the argument.105 The first residue is separated out and at the same time pushed on gradually through the whole of the intestines up to the considerable hollow of what is known as the ‘rectum’.106 To the outside of this hollow are adjoined muscles, which shut in the residue and hold it inside, preventing it from flowing out at the wrong time; but when a sufficient quantity has been collected and it is causing discomfort to the animal, at that point they allow it to be carried out, the muscles of the abdomen, along with the diaphragm, contributing to the speed of its emission. 105 106

On the four ‘natural capacities’ see n. 22 above, and Introduction, section 4.5.2, also for the relevant references to the texts mentioned here. I have here used the standard modern anatomical term for this lower part of the large intestine, which is in fact a direct Latin translation of the Greek term, apeuthusmenon (‘straightened’). In the next sentence the somewhat vague ‘abdomen’ translates epigastrion, which more precisely denotes the region around or in front of the stomach (gastēr). For such terms cf. Note on translation.

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The residue in the liver, meanwhile, is partially like the so-called ‘bloom’ on wine,107 and partially like the sediment. The former is attracted by the bladder, which adjoins this organ, the latter by the spleen; and having been collected in these, they are expelled, the one into the first part of the small intestines, the other into the stomach itself, and from these they then pass through the whole of the intestines along with the drier residue of the nourishment. The residue in the veins and arteries is like the whey in milk which is curdling, and the kidneys cleanse this and move it on to the bladder, which collects it in a manner very similar to that just mentioned for the dry residue. For a muscle is adjoined obliquely to this too at the point of outflow, closing its outlet so completely that nothing flows away to the outside. When this, too, reaches a sufficient quantity and causes the animal discomfort, the muscle ceases its control, releasing and slackening itself, and the bladder expels all that is superfluous, assisted in its speed, in this case too, as in that of the emission of the residues, by the muscles of the abdomen. 66 K. The remaining class of residues arises in each part from the fluid which nourishes that part.108 A portion [of these residues] is like some half-cooked remnant which cannot be assimilated to the body being nourished; the remaining portion (which was previously the vehicle of distribution, but has fulfilled that function) is wet and fine, like the whey-like substance mentioned above, and flows together into the bladder from the vessels. For this residue there is no channel especially set apart by Nature, but it is expelled by being carried through the soft bodies, which yield to its force, and especially when it is pushed by breath which rushes all at once, but also through all the small channels, of which the whole body and the entirety of the skin are full. Their 65 K.

107

The term anthos, literally ‘flower’, was used to refer to the froth or scum on the surface of wine. I read ἐκ τοῦ τρέφοντος αὐτὸ χυμοῦ, which seems to give the required sense, in place of the MSS reading, followed by Koch, τοῦ τρέφοντος αὐτὰ χυμοῦ, which would mean ‘[every part] of the fluid which nurtures them [sc. the residues]’). Cf. UP IV.15, i.235 H. (III.320 K.), where each organ is described as differently nourished by different forms of blood (thicker, redder, blacker), and where it is stated: αἱ τῆς σαρκὸς αὐτῶν ἰδέαι κατὰ τὸ τοῦ τρέφοντός εἰσιν εἶδος χυμοῦ (‘the types [or forms] of the flesh of these [organs] are in accordance with the form of the fluid which nourishes them’. This seems to provide a close verbal parallel to the present passage, and to show that it is the various parts of the body that Galen refers to as being nourished by different forms of fluid. (One should bear in mind that in such a context, chumos refers primarily to blood, but that this blood in Galen’s view always involves an admixture of the other chumoi, so that the fluid meant by chumos (both in the UP passage and here) is both blood and the other fluids that are (to different extents in different parts of the body) combined with it.) Further on this theoretical framework see Introduction, sections 4.5.2–3.

108

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generation has been discussed in Mixtures. 109 The finer residue is expelled easily, by being both dissolved by the innate heat into the form of vapour and wrenched out all at once by the violent motion; and what 67 K. is expelled in this way is called ‘sweat’. The other, which has no name, because it is not in fact recognized by most people, being invisible because of its fineness, has been called the ‘transpiration which is not evident to the senses’ by the very people who found out its existence through reasoning. Through this transpiration which is not evident to the senses, a part of the thicker residue is expelled too; but this needs both a stronger heat to drive it out and a stronger force to push it, otherwise there is a risk of its staying within the skin before arriving at outside. The origin of hair has been shown to be from this residue, and indeed also the dirt that is collected around the skin in all animals. We have thus stated pretty well all the necessary and essential points of the account of both the origin and the evacuation of residues: these have been demonstrated in other treatises, which I mentioned a little earlier, and will be [taken as] necessary assumptions in the discussions in which we are now involved. These residues have to be evacuated, since they are bad in their qualities, even if Asclepiades does not agree;110 and we should therefore first understand the causes of their retention, and next 68 K. after that attempt not to fall victim to them; but, if we do ever fall victim to them, attempt to rectify the mistake. Now, the avoidance of these causes will result from an understanding of whether the residues have been sufficiently separated off or not; but the rectification requires some other method in addition.

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Causes of retention of residues 13. Let it first be stated, by what causes each of the secretions mentioned is retained; secondly, how one may bring it out if it is retained. Retention of the residues in the stomach may happen either as a result of food and drink taken or as a result of [the state of ] the stomach and the intestines. 35 109

The reference is to Temp. II.5, 66–67 H. (I.614–616 K.), where Galen discusses these sorts of residue and their transpiration, and in this context also the way in which channels in the skin may either become closed up or permanently opened, the latter case being a function of dryness of skin in conjunction with pressure from the residues trying to escape. (In that passage he also gives a fuller account of his theory, touched on here, of the generation of hair from these residues.) 110 The theoretical position that ‘excretions of the stomach … are not alien’ to the body is attributed to Asclepiades by Caelius Aurelianus, Cel. Pass. I.14.114, 86,8–9 Bendz.

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It happens as a result of food and drink, because of the quality and quantity of those taken, as well as the order and the manner of their use: because of the quality, when it is sour, tart or dry111 in its consistency; because of the quantity, when it is more or less than appropriate; and because of the order, if what is astringent, rough or dry is taken first, and what is wet, smooth and sweet taken second; and because of the 69 K. manner of use if, when two meals ought to be taken separately, all the nourishment is taken at once. The cause of retention of residues related to the stomach and the intestines may arise both because of their nature and because of their acquired state. Those causes related to their own nature are causes of the bad constitutions of the body, as will be stated in the discussion of those; let us speak in this discussion about the acquired ones. There are eight different types of temporary state, all of which are in the class of badmixtures; four of these are simple bad-mixtures – heat, cold, dryness, moisture – and four composite bad-mixtures – heat together with dryness, heat together with moisture, cold together with dryness and cold together with moisture. And any one of these bad-mixtures would have to reach such a size as to make the propellent capacity manifestly weak – either that of the stomach alone, or that of the small intestines, or of the large ones, or indeed of all those mentioned together, or of some of them.112 Such bad-mixtures arise sometimes from things taken into the body, and sometimes from things which befall it from outside. The 70 K. former case is that where there is some sort of drug-like capacity113 in the nourishments or the drinks, so that the things taken have the effect of heating, cooling, drying, moistening, heating and drying at the same time, or acting in accordance with another coupling of properties. The latter is the case where the air which surrounds us immoderately heats, cools, dries or moistens us, or acts in accordance with some coupling of these; or may arise also from the water in which a person happens to have washed, or from some application of oil, or, in general, from any other 111

On Galen’s terminology of taste, see Note on translation, pp. xxiv–xxv. Galen’s theory of the four simple and four composite bad-mixtures is set out at Temp. II.2–4; further on his view of the role of mixture in the body see Introduction, sections 4.5.1–3. By ‘propellent capacity’ is meant here the function whereby these organs in their healthy state move the residues on towards their expulsion. 113 The distinction intended, which is explained elsewhere, especially Temp. III.4, 100,22–101,1 H. (I.669–670 K.), is between nourishment proper, which should in principle undergo a process of complete assimilation to the body it is nourishing, and drugs (pharmaka), which by their nature bring about some alteration in the state of the body. Further on this conceptual framework, see Singer (2020b). 112

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thing which comes into contact with the stomach from outside and has the capacity to heat, cool, dry or moisten it immoderately. Retention in the stomach, then, is due to these causes. Retention of bitter-bilious residue, meanwhile, is due to the feebleness of the capacity which attracts or expels it and to the narrowness of the organs that draw it onward and expel it. Feebleness of the bladder as a whole, which is to114 the liver, of the mouths which come from it to that 71 K. organ, and of the channels which discharge into the intestine may arise in the case of a temporary bad-mixture, in which case also, as was just mentioned, the propellent capacity of both intestines and stomach is harmed. Narrowness arises through inflammation, induration or obstruction, or through the compression of the parts that surround them or the closing of the outlets. Such compression in turn arises from the parts surrounding them, either through an immoderate build-up of the stuffs contained in them or through inflammation or induration. The closing of the outlets, too, is either because of one of these things or because of dryness. The cause of the dryness itself is stuffs that are vehemently astringent or ones that heat while also drying; the former bring about dryness by pushing out the moisture and drawing together, closing up and compacting the things [thus] constituted themselves, the latter by their dispersing effect. (But inflammation and induration are already manifestly diseases, so that they fall outside this study of health; they will be discussed again at a more appropriate time.)115 In the same way, the black-bilious116 residue sometimes also fails to be cleansed from the body. Here, the spleen has an analogous role to the 72 K. bile-receiving bladder, and the vein that extends to it from the ‘gates’ of the liver [is analogous] to the vessels that attract the bilious residue, while the vein that is borne from the spleen to the stomach is analogous to the channel which discharges bile. The residue in each of the parts of the animal which are being nourished will be impeded by the amount and 114

It seems likely that some participle has fallen out here, indicating the physical relationship or proximity of the bladder to the liver (the Latin translation of Linacre has the phrase ‘quae iecinori subicitur’, ‘which is positioned below the liver’). 115 Galen talks of the ‘inflammation-like fatigue’ (phlegmonōdēs kopos) extensively in Book II, and mentions inflammation also at V.12, 165,29 Ko. (VI.375 K.); but the reference here seems to be rather to clinical discussions, outside the present text. 116 Or ‘melancholic’; but the adjective melancholikos in Galen refers almost always, as here, to the fluid, or to a range of physical phenomena connected with it, rather than to the ‘psychological’ category of melancholy (melancholia), even though of course his theoretical account of the latter centrally involves this fluid. (In Galen’s treatise devoted to black bile, At. Bil., for example, the discussion is overwhelmingly of the physiology of this fluid and its connection to certain physical ailments.)

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thickness of this residue, and also by its viscosity, or by the feebleness of the heat which alters it and by the narrowness of the path of exit. Now, amount and thickness and viscosity arise either from the nature of the drink and food, or from some temporary feebleness of the alterative 25 capacity in the part being nourished; and the weakness of the heat which alters it is a product of lack of exercise. Narrowness of the path of exit arises because of induration, inflammation, obstruction, compression and closure; and the origin of each has just been mentioned. Some parts, however, have, in addition to these non-evident channels, certain other 30 73 K. clear and perceptible ones;117 examples are the brain and the eye. This 34 Ko. comes about through Nature, because of the importance of the part in question or because of the completeness of the activity, or because of the density of the bodies surrounding it. The brain is as it were a house for the rational soul and, being surrounded by a bone that covers it, is 5 cleansed by a great number of very large conduits, first of all those within the nostrils and the palate, secondly those within both ears, and thirdly those within the sutures of the cranium; and it is not unlikely that some superfluous stuff also flows from it into the eyes. The eye, while not at that same level of importance, nonetheless needs to be completely clean for the purpose of the complete exercise of its activity, and so all the 10 residue that is generated in it is evacuated by perceptible channels, within the nose and the eyelids.

Techniques for the evacuation of retained residues 14. Both the causes, and the organs, of the residues have now been stated. We should next discuss how one may evacuate them when they have been held in, beginning again from those in the stomach. The 74 K. common aim in all cases is to provide the opposite cause to that which 15 brought about the harm. Specifically in each case: if someone suffers 117

The term poroi (‘channels’) refers both to the imperceptible gaps in the skin through which transpiration was thought to take place (note that it is theoretically posited, invisible, channels which are in play here, not ‘pores’ in our sense) and also to any actual hollow anatomical structure through which fluids travel (or were thought to travel), e.g. blood vessels, nostrils, the optic nerve. V and R seem right, pace Koch, in omitting ἐκροὰς. If the word were included, the translation would rather be ‘certain other clear and perceptible points of outflow’. One might be inclined to prefer this vaguer term, ekroai, to poroi, to designate the disparate set of gaps in the structure of the skull that Galen proceeds to list; but in that case two further emendations would be required for the sake of grammatical agreement, which Koch overlooked: ἑτέρας for ἑτέρους and αἰσθητάς for αἰσθητούς, so omission is the economical solution. (Linacre’s translation uses only one noun here, meatus.)

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retention in the stomach after taking food which is small in quantity, and dry, one should administer food which is great in quantity and wet; if after taking food which is dry, to provide food which is wet, but not great in quantity; if after taking tart and sour foods, to feast it with sweet and smooth ones; if after taking food in a disorderly manner, to restore the correct order; if after taking food once instead of twice, to administer food not just twice, but frequently. In the same way, one should thoroughly cure temporary bad-mixtures by opposites, moistening if they are dried out, heating if they have become cold, and so similarly with the other qualities. The materials of these have been stated in the treatises we have written about drugs.118 When yellow bile has been retained, in the case of obstruction the thinning diet should be used (and the material of such a diet has been stated elsewhere, in one book)119; in the case of compression, if this is due to the immoderate filling of the bodies which are in contact with the channels of the bile-receiving [bladder], then if this is because of the thickness 75 K. of fluids, one should use the thinning diet, but if because of their amount, the evacuating diet. If the cause is an inflammation or induration, this already falls outside the scope of the study of health. If it is because of an incipient bad-mixture, one should introduce the quality which has been reduced. And one should heal the closing of the outlets in the same way: if it has arisen as a result of tart foods, one should instruct the consumption of smooth and sweet foods; if as a result of those which heat and dry, then the consumption of foods which cool and moisten. The material of such foods will be stated in the subsequent books. The manner of cleansing is the same in the case of retention of the third class of residues, which, as we stated, arise in every part of the animal. If the outlets of the channels are still closed, one has to rectify this by means of things opposite to those which have caused the harm, thoroughly heating the stoppages arising from the cooling causes, as also those that come about when we have become densified by the cold. 118

For this use of the term ‘materials’ (hulai) to mean the specific items used for medical remedies, in particular drugs, see Book II, n. 86, as well as Introduction, section 5.2 (and cf. the usage below at I.15, 35,33 Ko., VI.77 K.). On the varying nature of Galen’s cross-references to his works on drugs within the present work, and what they may tell us about the relationship or relative date of the different works, see Introduction, section 8.2. The fact that Galen does in this instance make reference to the pharmacological treatises, rather than to the dietetic work The Capacities of Foodstuffs, which might also seem relevant, is itself worth noting: this is presumably because of the ‘pathological’ context of the present discussion. 119 I.e. The Thinning Diet.

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Those that arise from heat and dryness require cooling and moistening, as 76 K. do those that are due to over-heating [from the sun]. So, too, those which have befallen someone because of something astringent, or of that kind of water which is astringent,120 demand smooth and soft massages, together with baths in fresh water. If, meanwhile, the channels have become obstructed through thickness, quantity or viscosity of residues, the thinning diet will be appropriate in this case, as will drugs which cut and heat – both those taken internally and those applied externally; and before all these things, exercise. For exercise too is capable of dissolving the residues and evacuating them through the channels, and it is superior to thinning foods and drugs to the extent that it is better that the residues be evacuated with no harm done to the body’s condition than in conjunction with the flesh being melted and the solid parts thinned. For this sort of harm is potentially attendant on the use of hot and thinning drugs; in the case of exercise, not only is there no such danger, but indeed the organic parts acquire vigour too, as the heat is rekindled in them, and the rubbing-together of the bodies against each other gives rise to a 77 K. certain hardness and protection against harm. It is not my task now to discuss how one may exercise oneself at the appropriate time and employ the appropriate measure and order and the necessary quality of the individual activities, nor, indeed, the appropriate time, measure, order and quality of nourishment, thinning foods and drinks, or drugs which cause alteration in quality. We have not yet discussed the use of any of these things individually, contenting ourselves with an account of the essential chief points. But in the subsequent discussions all these matters will be talked about at greater length.

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Summary; fourfold distinction of the materials of health 15. My intention for the present was to bring the whole study into summary form, so that no material related to health might be overlooked, in which the health-practitioner should be experienced. (It is no worse to call the person with knowledge of the whole art of health 35 ‘health-practitioner’ than it is to call the one who has knowledge of exercise alone a ‘physical trainer’;121 and indeed Erasistratus actually did use 120

Cf. n. 65 above. In Greek the two sets of terms are cognate single words: hugieinē – hugieinos; gumnasia – gumnastēs. (On the translation of gumnastēs and cognate terms see Thras., n. 6.) Essentially, Galen is making a claim for the independent status of an expertise which (in spite of his reference to Erasistratus) is not reflected by normal Greek usage. Cf. his discussion at Thras. 39, 87,6–11 H.

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78 K. the former term.) In our subsequent discussions we shall consider the appropriate time, quality, quantity and manner of employment of each of the materials mentioned, so that it becomes no longer just a material, but a cause of health. For the study of health (as also that of healing) consists in these three classes primarily: bodies, causes and signs.122 The bodies are the actual healthy bodies, which one must preserve in that state; the signs are features which arise in those bodies,123 on the basis of which diagnosis is carried out; the causes are those by which the safeguarding of health comes about. The most reputable of the more recent doctors have established a fourfold categorization of the materials: things taken, things done, things evacuated, and things that come into contact with us from the outside.124 ‘Things taken’ are food, drink, certain kinds of drugs which are taken internally and the air that is breathed in; ‘things done’ are massages, walks, chariot-rides, horse-riding and all kinds of motion. (And since not every motion constitutes exercise, but only the more vehement kind, exercise should thus be added alongside motion, so that things done are motions and exercises.) Counted within 79 K. this kind of cause, too, are waking, sleep and sexual activity. ‘Things that befall us from outside’ are, first of all, the air that surrounds us; then everything that has contact with the skin in bathing, the application of oil, or wrestling125 in dust; and any drug which does not go beyond the bounds of health, such as salts, natron, aphronitron, or one of the naturally-­occurring hot water sources.126 The material of ‘things evacuated’ has already been mentioned, a little earlier; it is not easy to make an assertion as to whether it is correct to distinguish this from the three kinds of cause previously mentioned. For perhaps it would have been better to state that the parts of the body are altered and transformed by things taken, done and befalling it from outside, and that their change happens in a­ ccordance with the quality and quantity; that, within the (V.881 K.), acknowledging the problem that neither the term hugieinē (for the art) nor hugieinos (for the practitioner) was used by Plato or Hippocrates. Further on Galen’s arguments in relation to these predecessors, see Introduction, sections 2.2–3; and further on Erasistratus, n. 68 above. 122 See Introduction, section 4.2, n. 51. On the terminology of ‘materials’ cf. Book II, n. 86; and further Introduction, section 5.2. 123 ‘Features that arise’ translates sumbebēkota, more usually translated ‘incidental features’, and traditionally rendered ‘accidents’ in translations of Aristotelian texts. In the present context this translation seems more appropriate. For further discussion of Galen’s use of the term, see Singer (2017). 124 On this and related classifications in Galen, as well as their origin, see again Introduction, section 5.2. 125 Cf. n. 88 above; it seems that activity in the wrestling-school is meant, in general. 126 On salt, natron, aphronitron and the various natural water sources with mineral deposits, see Note to translation, p. xxiii; cf. also n. 60 above.

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former, this happens in the process of being heated, cooled, dried and moistened; within the latter, in the process of being nourished and evacuated; and that this evacuation is itself twofold, being on the one hand of residues, which we discussed a little earlier, and on the other of the outflow of our own proper substance itself, which is opposite in nature to nourishment. And here, too, one should mention the ambiguity 80 K. which Hippocrates distinguished in his composition on Nutrition, in the following statement: ‘Nourishment is what nourishes, nourishment is also what is similar to that; nourishment is also what is about to nourish.’127 For the outflow of the substance ought to be placed in contradistinction to nourishment and coction in the first sense; haemorrhage and, in short, all evacuation of the blood, ought to be distinguished as an opposite to them in the second sense; and vomiting and passing of food undigested as opposite to them in the third sense. Well, let one posit what one wishes regarding these kinds of distinction. But it is necessary for one who undertakes the art of health to know the capacities of all the materials of health. For, indeed, the skilful employment of them develops from this starting-point – such skilful employment consisting in our discovery of the appropriate time and measure in the use of each. Let us then proceed to these matters, rather than continue in a refutation of faulty views. Since, however, my first book has reached a sufficient length, I shall draw it to a close at this point, and shall give a thorough exposition of the remaining points of the study in what follows. 127

De alimento 8, 141,5–6 Joly (IX.101 L.). The quotation appears also in the discussion of nutrition in Temp.: III.2, 95,4–5 H. (I.660 K.).

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Care of the naturally healthy child from age fourteen onward VI.81 K. 1. The previous book has stated the chief points and the aims of the art concerned with health; but we should attempt to give an account of all the individual points, beginning again from those with which the first book ended. Let the basis taken for the present argument be a child who is extremely healthy by nature, and who is embarking upon his third seven-year period; and let it be our task to shape and improve his body in the best way, to the maximum extent possible. First this should itself be defined: what exactly the attachment of the 82 K. word ‘best’ means for a statement.1 It is this. Just as it has been shown that there is a very great difference between bodies themselves, there are, in the same way, very many forms of life which we lead. It is not, therefore, possible for the best care of the body to come about in the case of every life that one has to deal with. It is possible to provide that [form of ] care which is best for each individual life; but not, in the context of all lives, that which is best in the absolute sense. For many, life is tied up with work obligations. It is unavoidable that these people are harmed by such obligations, and impossible to escape from them. Some find themselves living such lives because of poverty, some because of slavery, which is either imposed upon them from birth, or due to their having been taken prisoner in war, or captured.2 It is only such cases as these that most people term slavery; but in my view all those who, as a result either 1

This is clearly the sense of this phrase, although in what follows Galen seems to be elucidating the notion, not of ‘best’, but rather of ‘to the maximum extent possible’. The distinction here, such as it is, appears to be that aichmalōtos refers to a person taken prisoner in the course of war, while the verb harpazein may refer both to the seizing of prisoners during the sack of a city, but also, quite frequently, to other instances of forced abduction, especially of women. For Galen’s uses of the term douleia (‘slavery’ or ‘servitude’), both literal and metaphorical, see Introduction, section 5.6, with n. 96.

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of love of esteem or of some sort of desire, have chosen a life involving professional obligations, so that they have minimal leisure to devote to the care of their bodies, are also in slavery – a willing slavery, to bad mistresses.3 And so it is not possible in their case to prescribe the best 83 K. care of the body in the absolute sense. But in the case of one who is completely free, both by virtue of fortune and by virtue of his own choice, it is possible to instruct that person how he may enjoy health to the greatest extent, suffer sickness to the least extent, and have the best old age. And indeed the method of health, just like every other method, looks to this as the starting-point of its teaching. What is simple and faultless in every class demands to be placed, like a kind of standard,4 before all those items which are not simple and not faultless. In the case of bodies, that which is simple and faultless is the one which is endowed with the best constitution; while in the case of lifestyles it is that which is completely free. Let these two things then be conjoined in this book; next, let the free life be combined with each faulty bodily constitution; next, each life that involves some kind of slavery with the best bodily constitution; and, after this, let us combine faulty bodily constitutions with faulty lives, if our discussion is to be complete.

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84 K. 2. What, then, should one posit as the starting-point of the study of health, in the case of one who is endowed with the best bodily constitution and is embarking on the third seven-year period of his life, and who also has leisure to devote to his body alone, putting aside everything else 10 as irrelevant? Well, in my view it should be that stated by Hippocrates in his Aphorisms, where he writes: ‘Exertions should come before food’, and 3

Galen has a negative view of philotimia, literally a love of timē, that is, the kind of respect or esteem conferred by society, which leads to competitiveness and away from proper intellectual or ethical pursuits. See e.g. Aff. Pecc. Dig. I.9, 34,9–15 DB (V.51 K.) and I.10, 35,15–20 DB (V.53 K.): there too philotimia is characterized as one of a number of ‘tyrannical mistresses’ to which its devotees are enslaved; it is related to the underlying fault of insatiability. For Galen’s emphasis on the requirement of leisure for the pursuit of health, see again Introduction, section 5.6; and cf. the account of this requirement in relation to the time management of people in the service of powerful individuals, with particular reference to the emperor Marcus Aurelius, below, VI.5, 178,10–179,2 Ko. (VI.404–406 K.). 4 The term kanōn, which has a literal sense of ‘measuring stick’, is used by Galen frequently to indicate a standard, in the sense of a normative example against which a variety of physical states or features are measured; it may also refer to the famous Canon, the name of both a statue and a treatise by Polyclitus. Galen explicitly relates the two senses, discussing both the diagnostic use of a kanōn in the conceptual, paradigmatic sense, and the status of the Canon as exemplary of human physical excellence, at Temp. I.9, 33–37 H. (I.561–567 K.), with the notes of Singer and van der Eijk (2018) ad loc.

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in the sixth book of the Epidemics, in the following quotation: ‘Exertions, food, drink, sleep, sex: all in moderation.’5 For indeed, he has specified the quantity for all these, by the addition of the term at the end of the quotation: ‘in moderation’; and he has given us instruction in 15 their appropriate times, by the order of the words. For the purposes of the safeguarding of health, exertions should come first; food and drink should follow; next should come sleep, and then sex – in the case of those people who are in fact going to engage in sex. For all the other items are common to every stage of life, but sex belongs only to that of those who are in their prime,6 which is also the period proper to its function, since the times of life before and after that have the property 20 of not producing semen, or of producing infertile or weakly fertile semen.

Exertions, motions, exercise 85 K. But let the discussion of sex be deferred to its appropriate place. We should begin with exertions, and we must first make this distinction within them: whether exertion and motion and exercise are the same 25 thing, or exertion and motion the same, but exercise something different, or motion something different, with no distinction between exertion and exercise.7 It is my view, then, that not all motion, but only the more vehement kind, is exercise. But since what is vehement is understood in relative terms,8 the same motion may be an exercise in the case of one person, but not in that of another. The defining feature of ‘vehemence’ is 30 the alteration of respiration; for those motions which do not alter 5

In fact, both these quotations are from Book VI of the Epidemics, respectively from Epidemics VI.4.23 (V.314 L.) and Epidemics VI.6.2 (V.324 L.). Galen quotes the first one again (in very slightly different form) at both V.3, 141,12 Ko. (VI.319 K.) and (repeating the same misattribution) V.11, 163,3–4 Ko. (VI.369 K.). It is noteworthy that the verb Galen uses for these Hippocratic instructions in the next sentence, aphorizein (‘specify’) is cognate with the noun aphorismos, which provides the title ‘Aphorisms’. 6 For Galen’s views on the ‘prime’, in relation to the other times of life, see Introduction, section 5.5. 7 Galen’s main discussion of the role of sex and its relationship with the exercise regime is below at Book III, chs. 11–12. As regards the distinction here made between ‘exercise’ and other forms of motion: the usual sense of gumnasion is that of exercise deliberately engaged in for purposes of athletic or physical training or improving the health of the body; as becomes clear a little further on, the term – from which indeed we derive the English ‘gymnasium’ – is also associated with the public building in which such exercise typically takes place. On the institution of the gumnasion see Introduction, section 3.1. 8 Galen is here using Aristotelian logical phraseology (ἐν τῷ πρός τι), derived in particular from the tradition of the Categories; other possible translations would be ‘what is vehement consists in a relation’ or ‘the vehement is in the category of the relative’; cf. below II.4, 51,7 (VI.113 K.) and 51,37–38 Ko. (VI.115 K.), as well as n. 31; and cf. Thras., n. 37.

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r­ espiration are not known as exercises, but if one is compelled to breathe either a greater amount,9 or more quickly or frequently, as the result of a motion, such a motion will be an exercise for that person. Now this is the more general sense of ‘exercise’; the specific sense is that according to which everyone uses the term, ‘gymnasium’, to refer to a building 40 Ko. constructed in some public space of the city, to which they come also to 86 K. have an application of oil and to be massaged,10 to wrestle, to throw the discus, or to engage in some other such activity. And the term ‘exertion’ in my view corresponds to what is indicated by the term ‘exercise’ in that former, more general sense. For, within this meaning of the term, even 5 those who dig, reap and drive horses are both exerting themselves and taking exercise. Let us, then, make these distinctions regarding terminology, and let the whole of the subsequent argument be understood according to these meanings. If someone wishes to use the terms differently, I accept that. I am not here to conduct an investigation into the 10 correctness of terms, but one concerning the way in which one may enjoy the best health. It is because it happened to be useful to make distinctions about exercise, exertion and, collectively speaking, about motion in general, that I was compelled to make these specifications about the meanings of terms. Now, the functions of exercise have been stated also in the first book, 15 but it would be better to recapitulate them briefly now, too, since they happen to constitute both the aim and the standard by which to assess all 87 K. the individual things done in the art that concerns exercises. They were, then, twofold in terms of their class, differing in terms of their effect on the evacuation of residues, on the one hand, or the actual good-­ condition11 of the solid bodies, on the other. For since exercise is a vehe- 20 ment motion, it follows that these three things primarily arise from it in the body which is undertaking exercise: hardness of the organs which are rubbed against each other; increase of the innate heat; and somewhat forceful motion of the breath; and that there follow upon these all the I omit here ἢ ἔλαττον (‘or a smaller amount’): this does not seem to be a consequence of vehement motion or exercise, and the phrase was probably inserted as an apparently natural partner for μεῖζον (‘a greater amount’). 10 On the major role played by oil in this context, and the consequently vast consumption of it in the gymnasium, see Kennell (2001). The MSS have διατριψόμενοι, from the verb διατρίβειν, which normally means ‘to spend time’; I translate τριψόμενοι, which surely gives the required sense: massage, as we shall see, is a central part of the activities engaged in in such locations (and the prefix δια- will easily have been added in error, as the next verb begins with this too). 11 A broad theoretical account of the types and function of exercise was given at I.8, 18,26–31 Ko. (VI.37–38 K.) and I.14, 35,14–24 Ko. (VI.76–77 K.). On ‘good-condition’ (euexia) see Introduction, section 4.1, and the discussion of Thrasybulus, passim.  9

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other individual benefits that come about for bodies as a result of exercises: because of the hardness of the organs, their protection against harm and their good state of tension with regard to the activities; because of the heat, a strong attraction of the substances being distributed, readier alteration, better nutrition and flow of all the bodies, by which flow it happens that the solid bodies are softened, the wet ones12 are thinned and the channels become broad;13 and because of the strong motion of the breath it follows necessarily that the channels are cleansed and the 88 K. residues evacuated. If these are the effects of exercise, however, it is then not difficult to discover the correct time of their use. For since it conduces to distribution, there should not be a build-up of foods or fluids which are raw and have not undergone coction14 contained either in the digestive cavity or in the vessels; for there is a danger of their being attracted to all the parts of the animal before there is enough time for them to have become beneficial by undergoing coction. And because it cleanses the channels and evacuates the residues, it is better that it be undertaken before foods. For: ‘Those bodies which are not clean, the more you nourish them, the greater harm you will do’.15 It is thus quite evident from what has been stated that this is the best time for exercises: when the previous day’s nourishment has been completely processed and undergone complete coction, in the two coctive processes, that in the stomach and that in the vessels, and the time for fresh nourishment is in the offing. If you make the living being exercise before or after this, you will either fill it with fluids that have not undergone coction, or stimulate the pale yellow bile 89 K. to become greater in quantity.16 An indicator of such a correct time is the 12

Hugra (‘wet [bodies]’) could also be translated ‘fluids’; the term is used sometimes essentially as a synonym for chumoi. 13 I read εὐρεῖς (‘wide’) with the extant MS tradition (though in the absence of a reading from M for this passage), followed also by the early Latin translations (latiores), against Koch’s adoption of Scaliger’s reading εὐροῦς (‘well-flowing’). Broadening of the channels is part of the mechanism by which Galen believes that residues are evacuated, and there seems no very good reason to suspect the word. 14 For Galen’s theory of coction and nutrition, see Introduction, sections 4.5.2–3. 15 ‘Hippocrates’, Aphorisms 2.10 (IV.472 L.); cf. Galen’s commentary, Hipp. Aph. II.10 (XVIIB.466 K.) 16 ‘Pale yellow’ translates ōchros, which refers to an off-white, or a light shade of yellow (other translations sometimes used are ‘sallow’, ‘tawny’, ‘straw-coloured’). The colour term used for this variety of fluid, ‘yellow bile’, is much more usually xanthos; but Galen seems to consider the normal colour of the fluid to be in fact better characterized as ōchros (cf. below, IV.4, 110,21–24 Ko., VI.250 K.). As is clear from the discussion of urines here, and even more so from that of wines at V.5, 145,3–24 Ko. (VI.335–337 K.), a spectrum was recognized between leukos (‘white’, but also sometimes meaning ‘colourless’) and xanthos (‘yellow’), with ōchros in the middle and a number of shades in between. The terms, and the notion of points on this spectrum, are used

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colour of the urine: if it is watery, this signifies that the fluid distributed from the stomach and contained in the vessels is still uncooked; if it is reddish17 and bile-like, this signifies that it has been to a large extent processed; if to a moderate degree pale yellow, this signifies that the second coctive process has recently taken place. When the urine is not yet 15 tainted by bile, it appears watery and white, whereas when it receives more of it than appropriate, it appears reddish. It is when it appears either reddish to a balanced degree, or pale yellow to a moderate extent, that one should engage in exercises, having previously eliminated whatever residue is contained in the bladder and in the lower intestines. Otherwise, there is a danger that some part of these stuffs be introduced 20 into the condition of the body, caught up by the force of the heat involved in the exercises.

The function, use and varieties of massage Now, if someone proceeds to the more vigorous kinds of motion immediately on undressing, before softening the whole body and thinning the residues and broadening the channels, there is a risk of causing some tear or strain in the solid bodies, and also a risk of the residues obstructing 25 90 K. the channels by the force of the breath that sets them in motion. If, however, one undertakes a gradual preliminary heating, thus both softening the solid bodies and thinning the wet ones, in the process also broadening the channels, there will then be no danger to the person exercising, either of tearing any part or of obstructing the channels. The way in which this should be done is as follows. One should 30 perform the preliminary heating by rubbing the whole body moderately with linen and then massaging it with oil. (I do not advise the immediate use of fat,18 before the skin has been heated and the channels broadened and, in short, the body made ready for the reception of the oil.) Very 42 Ko. small movements of the hands, moderately fast and without pressure, are both in reference to these fluids and to the overall colour or complexion of an individual, used as a diagnostic marker; cf. IV.4, 112,2–25 Ko. (VI.253–255 K.), with note. See also next note. ‘Reddish’ translates purros: the word is often used to refer to a hair colour, and in Galen’s usage seems clearly to suggest a point further away from ‘white’ on the spectrum discussed in the previous note. The proviso should be made, in relation to both this and the previous note, that some research has suggested a radical problem of translatability of ancient colour terms into modern ones, arising from the extent to which the ancient ones seem to refer, at least partly or in some cases, to degrees of brightness or luminosity, rather than just to hue. See the discussions of Raina (2003); Sassi (2003); for further perspectives the essays collected in Borg (1999), Villard (2002), Cleland and Stears (2004) and Carastro (2009). 18 The term lipos more usually refers to animal fat, but here it clearly means fat generically. 17

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adequate for this purpose: the aim is the heating of the body without subjecting it to compression; for indeed, even when these are carried out, a reddish bloom will be manifest to you, spreading over the whole of the skin. It is at this point, then, that one should apply the fat, massaging with bare hands which are in a well-balanced state as regards hardness and softness, so that the body is neither drawn together and closed up 91 K. nor relaxed and slackened to a greater degree than appropriate, but rather preserved in a natural state. The massage should be gentle in its first applications, but should then increase gradually, and become more robust to the point where the skin is clearly undergoing compression, but not being crushed; and one should not continue massage at this strength for long, just once or twice to each part. We do not massage the child’s body in this way so as to harden it, when we reach the point of introducing the child to exertions, but in order to encourage the child towards the activities, to ratchet up the tension, and to close up the porousness due to the soft massage. For its body should be kept well-balanced and not be made either hard or dry, so that we do not in any way restrain its natural growth. In due course, when the child has become a youth,19 then we will use both harder massage and cold bathing after the exercises. 92 K. But we shall speak about these matters again.

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3. In massage which is preparatory to exercise, and has the aim of softening the body, a quality midway between the hard and the soft should dominate, and the whole should be patterned according to that. The manual applications and strokes of the massaging should be diverse 25 in form, not simply moving from high to low or from low to high, but also in sloping, oblique, transverse and up-slanting motions. By ‘transverse’, I mean the opposite of the vertical; by ‘up-slanting’, that which deviates slightly from the transverse at each end; that which departs 30 from the vertical slightly at each end I call ‘sloping’; and to that which is precisely midway between the transverse and the vertical motion, I apply the term ‘oblique’.20 And it will make no difference whether we 19

‘Youth’ translates meirakion, a term which seems to be used by Galen fairly interchangeably with neaniskos; further on his age terminology see Introduction, section 5.5. 20 The terms here used are plagios (‘sloping’), loxos (‘oblique’), enkarsios (‘transverse’), simos (‘up-slanting’) and euthus (‘vertical’). Each adjective has a variety of other senses, both general and technical; but Galen specifies their precise meaning here, in terms of angles between the vertical and the horizontal. Similar usage is found at UP V.14, i.287,16–288,1 H. (III.393 K.) – with which one may also compare the similar use of these terms in Anatomical Procedures, passim – describing the actual structure of muscles. There, of eight muscles over the stomach the first two are vertical; the second pair, at right-angles to these, are enkarsioi (wrapping around the peritoneum); the remaining two pairs are both loxoi, thus together forming an X across the front of the

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1 Some varieties of massage: diagram showing ‘vertical’, ‘sloping’, ‘oblique’, ‘up-slanting’ and ‘transverse’ massage (see Health, Book II, n. 20). From: Gadaldini (1565), p. 70.

use the word ‘massage’ or ‘massaging’, being aware that the term ‘massaging’ is more usual in ancient authors, and the term ‘massage’ in recent ones.21 The reason that I recommend that the manual applications and strokes be diverse in their forms is so that, as far as is possible, 35 93 K. all the fibres of the muscles be rubbed from every side. For to think that the transverse massaging, which some call ‘round’,22 hardens, densifies, 43 Ko. closes up and binds together the body, while the vertical one makes porous, slackens, softens and relaxes it, arises from the same ignorance as so many other statements made by most trainers. No one has 5 abdomen. Thus, here, loxos (oblique) refers to a motion which is at 45 degrees from the vertical or horizontal; and this leaves the plagios (sloping) and simos (up-slanting), which deviate slightly from the vertical and horizontal respectively, or are in between these and the loxos. Linacre’s translation, as printed in the Juntine edition of Gadaldini, contains a helpful and elegant diagram, in which each of the motions mentioned is presented as a diameter crossing a circle, each at a different angle from the vertical; see figure 1. 21 In Greek, the difference is between the noun tripsis and the same noun with the added prefix ana-, which has the connotation of ‘up’. No equivalent in idiomatic English would come close to reflecting this subtle – and, as Galen later remarks (II.11, 67,2–4 Ko., VI.150 K.), unimportant – semantic difference. 22 It seems natural that the enkarsios, while ‘transverse’ in the sense of the relationship of its direction to the ‘vertical’, conceived in two dimensions, will also be ‘round’ (strongulos) in the sense that such manual motions will not just move from side to side, but encircle the muscles being massaged.

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anything to add, regarding the capacities of massages, to what Hippocrates wrote in his In the Surgery, stating that bodies are bound by hard massage, but relaxed by soft massage, and that they are thinned by a long massage, but fleshened up23 by a moderate one. The quotation is as follows: ‘Massaging has the capacity to relax, bind, fleshen up and diminish: hard massaging, to bind; soft, to relax; long, to diminish; 10 moderate, to fleshen up.’24 There are, then, these four distinct types of massage in total, related to four capacities and functions. If, however, we include in our reckoning the ones which are midway between these, as being simultaneously 94 K. implied by those stated, there will then be six distinct types in all. What, then, is the reason that most of the recent trainers write of so many 15 distinct types of massage that one cannot even count them without difficulty? It is simply their complete lack of schooling in logical theory, as a result of which they, without realizing it, mention this or that extraneous feature along with those distinctions that are proper to massage, or include in their writings the causes that give rise to each massage, or 20 sometimes also mix up the genuine distinct types with those which they have incorrectly added to them. When they say, for example, that massages differ from each other in that some are carried out in the open air and some indoors, and others still in partial shade, and that some are carried out in a windy place and others in a calm one, or some in a hot one and others in a cold one, or some in the sun and others in the portico 25 of a bath house, or in the wrestling-school, and produce some list of this kind, they are not speaking of the proper distinctions within massages, but rather of certain [circumstances] which the person massaged cannot 95 K. be without.25 Certainly, he must be in some place within the inhabited world, and, in addition to that, at a certain season – winter, spring, or 30 one of the others. And when they say that some massages are carried out with more oil, others with less, or with none at all, or by the hands alone as opposed to with dust or linen cloths, and that the massages differ from each other according to whether these latter are hard or soft, they are 23

By the verb translated ‘fleshen up’ (sarkoun), Galen means that the actual substance of flesh is increased, as opposed to reduced or thinned. 24 Off. Med. 17 (III.322 L.); cf. Galen’s commentary, Hipp. Off. Med. III.26 (XVIIIB.871ff. K.). 25 Galen means that some such circumstances are necessarily present, but are not important for the definition or distinction of the massages. An oblique reference seems surely intended to Plato, Phaedo 99a–b, where a distinction is made between mention of the factors ‘without which not’ – the material conditions necessary for something to take place – and a proper or full causal account.

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producing an enumeration of the causes which bring about a hard or a soft massage. Within this category of cause is also the distinction as to 35 whether the hands of the masseur are hard or soft, and whether they press 44 Ko. vehemently or make contact gently. The third type is that which arises from those who think that there are many such distinctions of massage as a result of their mixing up all those stated with each other, using certain couplings. Now, in those cases where people mix up the external situation 5 or the causes of the proper distinctions with each other, the incorrectness of their understanding is more readily detected; but when they produce couplings within the proper distinctions, their mistake is less easily discerned.

Theon’s misrepresentation of Hippocrates on massage; the correct systematic account 96 K. There are even some who have acquired a reputation for wisdom, and believe that they have discovered something beyond the statements of Hippocrates. Amongst these is the trainer Theon, who believed that he 10 had a better knowledge of massage than Hippocrates. Hippocrates made the specification, in the quotation transcribed above, that there is a distinction of quality, in terms of soft and hard, and one of quantity, in terms of long and moderate; but Theon does not see fit to mention either quality or quantity individually. Rather, he writes, for example in the 15 third book of his Exercises: It will suffice, concerning massage, that we give the instruction that quantity must always be fitted to quality. These are in themselves both incomplete for the purposes of correct practice. For example, soft massage becomes productive, as regards quantity, of three end products. When 20 short, it releases the flesh to an extent and makes it tender; when long, it disperses and melts it; when sufficient, it fleshens the body up, with flaccid and flowing-together flesh. Similarly, hard massage produces the same number of end products, depending on quantity. When administered in long form, it closes up and binds together the body, and produces some- 25 thing similar to inflammation; when sufficient, it fleshens the body up, with flesh which is toned and of good outline; when short, it makes the surface reddish for a short time.26

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On Galen’s attitude to Theon as a representative of the trainers of his time, and for further references to him, see Introduction, section 2.3. The present quotation is the only substantial extant fragment of his work.

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He does not recommend that the trainer give any instruction regarding hard massage individually as such, but only to make its quantity fit that quality, if there is to be a correct completion of the practice of the art. In the same way, he does not consider that one should at this point set out any basic principles regarding soft massage, individually and on its own, on the grounds that a soft massage can never be carried out on its own, without its being also long, short or well-balanced. Then, he proceeds to give a thorough exposition, using couplings, of all their effects that they produce on our bodies, saying that that which is both soft and short ‘releases the flesh to an extent and makes it tender’. By this assertion he is merely using different terminology to communicate exactly the same thing stated by Hippocrates with the term ‘relax’; for what else is to ‘release’ the flesh and make it ‘tender’ other than to relax what is bound and drawn 98 K. together? He adds the phrase ‘to an extent’, not modifying the class of the activity, but specifying its quantity. For this kind of massage softens the body a little; thus, if it is carried out for longer, it will still soften, but more than before; but it is the fact that the short, soft massage does not slacken and soften bodies greatly, or considerably, but to a small degree, that he indicates by the addition of the phrase ‘to an extent’. He is not in fact at this point teaching anything that goes beyond the statements of Hippocrates; nor when he states that ‘when sufficient’ and soft ‘it fleshens the body up, with flaccid and flowing-together flesh’. It is because it is sufficient that it will fleshen it up; and it is because it is soft that it will release it, that is to say, soften it – which is the same thing as to make the body flaccid and flowing. This statement of his is correct; but when he discusses the massage which is both long and soft, he should not just have said that its nature is to ‘disperse’ and ‘melt’, but also what 99 K. quality it brings about in the flesh remaining. For it does not disperse and melt the whole substance, in the way that fire does, but of course also leaves something behind. He should surely then have added to the argument something about what is left behind, in terms of its physical form, rather than mention the specific task of the substantial massage and omit that of the soft. For the fact that the long massage disperses was also stated by Hippocrates previously; but Theon has not based his argument on the massage that is long, in simple terms, but has seen fit to In the last sentence ‘toned’ renders μεμνωμένῃ, the reading of M, which is difficult to understand, but perhaps corresponded to a technical usage of Theon’s; I have attempted a fairly neutral translation. The MSS VR, however, have μεμειωμένῃ, which would mean ‘reduced’, and is followed by Linacre’s Latin, ‘imminuta’; the word is much more usual and easy to understand, but the reading perhaps suspect for that very reason.

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teach by couplings, beginning with that which is short and soft, moving secondly to what is soft and long, next mentioning that which is both soft and well-balanced. He did not fail to refer to the action of the quality in the case of the first and third couplings; and he should not have omitted this in the case of the second one either. Here, too, he should have stated that the massage which is long and soft both disperses the flesh and makes it soft (unless one may accept the term ‘melt’ as standing for ‘soften’; the statement would then be true with that substitution too). 100 K. Not only does he not undermine the instruction of Hippocrates in any way; on the contrary, he confirms it. For if soft massage always makes the body tender, whether that massage is short, long or well-balanced, and there is no other addition in relation to quantity, to soften will be the inalienable property of the soft massage; and so too, surely, to harden, draw together, close up, bind, densify and make untender – or however else one may wish to communicate the same thing – will be the inalienable property of the hard massage. For the primary and proper name for flesh with this state is ‘hard’, just as that of the sort opposite to it is ‘soft’. It is, to be sure, also admissible to use any of the other terms, as I have said. As to the reason why it is possible to use so many terms for one thing, this will be stated later; for now, since this has been conceded, let us omit the cause for the moment. But the fact that it is a necessary consequence of a soft massage to make a body soft is immediately evident from what has been 101 K. stated. If you cannot ever make a body hard by the long, short or wellbalanced employment of such a massage, it is evident that it is its inalienable property to soften, just as it is that of the hard one to bind together and harden. In the case of this latter massage, too, whether you employ it in short, long or well-balanced form, you will never soften the body to any great extent. In all cases you will make it either more or less hard: more if you massage more, less if you massage less. Even if you content yourself with an extremely short application of hard massage, the hardness will appear then, too, though in proportion to that shortness of extent. One who is close to a fire is always heated, whether he is close to it for a long or for a short time, but more so if the proximity is long and less so if it is short, and least of all if he merely has a momentary contact with it. So too with massage: the body is in all cases made similar [to the quality of the massage], being softened by a soft one, hardened by a hard one, not, however, to the same degree in each case, but more so in the case of a longer one and less so in the case of a shorter one, and, of course, most of all in the case of the longest and least of all in the case of the shortest.

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Theon, in discussing the soft, long massage, says that it disperses and melts. Now if, by the term ‘melt’, he means to indicate evacuation, this does not mean anything more than disperse; in that case he will have said the same thing twice, having omitted the necessary addition of the state that arises in the body from soft massage. If, however, he means to indicate softening, relaxing, slackening, or whatever other term one wishes to use, then in that case he has omitted nothing, but it will turn out that he is saying all the same things as Hippocrates, albeit using a worse manner of instruction. Now, the fact that this manner of instruction is worse than that given to us by Hippocrates, we will show a little later; but this much is quite evident, that, if he has used the word ‘melt’ in place of ‘soften’, he is not saying anything beyond what Hippocrates says. For when that man says that a soft massage releases and a long one thins, it should be abundantly obvious for anyone of intelligence to infer that that 103 K. which is a composite of the soft and the long will both thin and soften. Theon, however, seems not to realize this. In the first book of his Physical Exercises, he uses one term (‘to thin’) for what he describes with two (‘to disspate’ and ‘to melt’) in the third. The relevant quotation from the first book is as follows: ‘By opposites, soft massage, when it is long, thins bodies; when sufficient, it fleshens them up, with a delicate and flowing flesh.’ Here, he manifestly states that massage which is both soft and long thins bodies. The necessity of mentioning what is specific not just to a long one but also to a soft one is indicated by Theon himself in the next quotation, where, in his instruction about hard massage, he states that a long massage closes bodies up and binds them together, and produces something similar to inflammation. For the massage, when extended, acquires even more of that property which it had when it was well-balanced in its quantity. Thus, all agree that a well-balanced hard massage fleshens up the body, with flesh that is hard, just as a well-balanced soft one also fleshens it up, 104 K. but with flesh that is soft. Theon, however, when he comes in his discussion to the massage which is both soft and long, appears to have completely failed to mention the task of the soft, and, when he comes to the massage which is both hard and long, that of the long. For if we are to take ‘melt’ to be the same as ‘evacuate’ and ‘disperse’, then he will have said something about the long, but nothing about the soft; and similarly, in his discussion of that which is hard and long, closing up, binding together and producing something similar to inflammation are stated about the hard, but nothing about the amount. And yet it was right to 102 K.

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say something also about quantity. So, for example, he asserts that if it is well-balanced in quantity, it thickens. What, then, will a long one do, 20 coming after a well-balanced one? It must certainly either preserve the action of that one, or alter it. If, however, it preserves it, then [the greater] amount of massage will not accomplish anything beyond its good balance, whereas if it does have a further effect, this must be either to reduce the fleshened-up state or to add to it. Now, if it takes away from it, it will thin it, and if it adds to it, it will fleshen it up. But it does not 25 fleshen it up; and so it follows necessarily that it thins it. And yet Theon 105 K. said nothing about the distinction in this respect; he was completely silent, making absolutely no assertion as to whether a hard massage, when extended, thins or thickens, or whether it preserves the fleshened-up state that came about from the moderate massage – but only that it closes up and binds together in a way similar to inflammation. He should not have 30 confined his statement to this, but added that it thins. 4. Evidently, then, he was either unable to understand Hippocrates’ specialized skill in this area, or unwilling to give credit to the man, who stated all the distinctions within massage in such a short quotation, and, as well as the distinctions, the activity and capacity of each of them. One’s immediate impression might lead one to think that he only spoke 35 of four; yet this is not true. In fact, he indicated two others which must unavoidably be conceptualized along with the stated ones: within the 48 Ko. distinction by quality, that which is midway between hard and soft – that is, the well-balanced – and in the distinction by quantity, that which is 106 K. short: for it follows necessarily that short is opposite to long. But the ancient manner of communication is so abbreviated27 that it often seems 5 to leap over in its form of expression much that follows of necessity from what is actually said. That, of course, is why we write notes on them, to give guidance to those who, through their lack of schooling, are unable to follow the speed of the ancient form of expression – as, indeed, we are doing in this present discussion.

27

It is a recurrent theme, central to Galen’s interpretive approach to Hippocrates, that the latter has a comprehensive knowledge, which, however, he expresses in an abbreviated manner (brachulogos, brachulogia), requiring exegesis from those who have studied his use of language and also understand the medical points at issue. The term hupomnēmata, ‘notes’, in the next sentence, could also be translated ‘commentaries’, and refers to such works of exegesis. On Galen’s attitude to Hippocrates see further Introduction, section 2.3, with literature there cited.

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If a hard massage has the capacity to bind, and a soft one to release, then all bodies which have been released beyond the point of moderation should be massaged with a hard massage, and all those which have been closed up should be massaged softly. And any body which is in a moderate state, should, quite obviously, not be massaged either hard or softly, but, as far as possible, in a way which avoids excess in either direction. But this extraordinary fellow28 Theon has blundered here at the outset, by never stating either the capacity or the function of the massage which is moderate in quality, but constantly bypassing it, as though it did not exist. We shall speak of this one a little later. Just as, within the distinctions of quality, we have not only the hard and the soft, but also the well-balanced, so too within those of quantity, there is not just long 107 K. and short, but also moderate. Why, then, did Hippocrates omit the middle one in his distinctions of quality, and the short one in his distinctions of quantity? One might think this an illogical procedure on his part: should one not, in an abbreviated form of instruction, make specifications by means of the opposed extremes, and omit the middle or well-balanced, as having its conceptualization unavoidably included along with the extremes? Well, I will try to give an account of this too, and to clarify the view of the ancient [author], not because it is necessary at this point (for we usually resolve these kinds of enquiries in our exegetical notes), but now that I have, in this book, embarked upon a defence of Hippocrates against the unschooled, and against their erroneous attacks upon his correct statements, I shall not shrink from making this further addition. One may make a broad distinction by class, between that which is productive and that which is produced. According to such a distinction, massage belongs to the ‘productive’ and the states that are brought about in our bodies by them 108 K. belong to the ‘produced’. It follows, then, that the oppositions are different within the class of massage and within the class of state. In that of massage, there are the soft, the hard, the long and the short; in that of state, there are what one might call the bound or released state of the bodies, and their thinness or fleshened-up state. Now, the former opposition in the states comes about as a result of the former opposition within the massages, but the second does not. It happens in this case that thinness comes about as a result of a long massage, while building up comes about as a result of a moderate one. A 28

The word thaumasios means literally ‘wonderful’, ‘extraordinary’, but is very frequently used ironically, especially in Plato’s dialogues, to indicate a reaction of surprise or shock at a person’s behaviour or statements – a usage which Galen is echoing here.

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short one is not yet capable of fleshening a body up, because for that outcome the body always needs a well-balanced supply of blood and a vigorous capacity. And both these things are brought about very well by a well-balanced massage, but neither is brought about, either to a considerable or even to a sufficient extent, by a short one. Since, then, the oppositions in the massages do not correspond to those in the states, and this abbreviated form of instruction compelled him to make his specifications through oppositions, he overlooked the less useful opposition and moved 109 K. immediately to the more useful one. And that within the states is more useful than that within the massages. The primary reason for this is that related to the goal of the art; for massages aim at the state of the body as their goal, and the goal is always more important than that which precedes it, to the same extent that that on account of which something comes about is more central than that which comes about on account of something. The second reason is clarity: on the basis of our having learnt the tasks of the long and the moderate massaging it is very easy to form a conception also of those of the short one; but the capacity of the wellbalanced massage is not equally easily grasped. Indeed, there is a third sense, for the purposes of our discussion, in which Hippocrates will be found to be giving the best form of instruction about massages. This is that the instruction of things that are manifestly accomplished should come first, and that of those which are unclearly accomplished should follow, whether one is writing something out explicitly or leaving it to the reader. And the action of the moderate massage is manifest in our conception of it, namely the fleshening-up of the body, while that of the short one is not manifest: for it does not appear manifestly to fleshen up, to thin, nor indeed to do anything at all, 110 K. unless it is to heat to a small extent. But to heat was the common property of all massage. Since, then, it does not manifestly accomplish anything, and even what it does appear to do is not specific to it, but common to all massage, it was reasonable to omit it. Now, the fact that it is the common property of all massage to heat is a proposition unworthy of a composition of Hippocrates; what each massage specifically accomplishes, on the other hand, was both necessary for Hippocrates to teach and useful for us to learn. He produced his whole instruction on the subject of massage by reducing the simple distinctions as it were to their elements:29 how you 29

For similar terminology, describing the fundamental concepts or distinctions relevant to an expertise as ‘elements’ (stoicheia), cf. Dig. Puls. I.1 (VIII.771 and 776 K.); I.9 (VIII.818 K.); IV.2 (VIII.934 K.).

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may build up, reduce, soften or close up the body. And the midpoints within the actions, and those brought about by coupling, automatically emerge along with these – the midpoints, when we choose neither to bind, to release, to fleshen up nor to diminish the body, and those by pairing, when, for example, we choose both to bind and to fleshen up. Anyone will be able to conceive that, when we choose to fleshen up a 111 K. body with hard flesh, a hard massage is to be employed in conjunction with a well-balanced quantity, just as, when we choose to do so with soft flesh, one which is soft and also well-balanced in its quantity, and so on with regard to the other couplings. Some of the trainers set these down as if they were their own discoveries, while at the same time criticizing Hippocrates. This is a very great wrong, both in that they deprive the man who first gave this instruction of the credit he deserves and, still worse, themselves appropriate his view, while attempting to malign him, and yet not even properly combining the simple distinctions with each other. One who wishes to proceed methodically to the individual couplings should surely not have made the total number six, as Theon did, nor have omitted some task within them which is specific either to quantity or to quality (as, for example, in the case of the massage which is both soft and long, he was shown to have omitted that of the soft, 112 K. and in the case of that which is both hard and long, that of long); but he should have added these too, and made the individual couplings nine in number. The three distinct types of massage, in terms of quality, combined with the three distinct types in terms of quantity, produce an end result of nine – the six mentioned by Theon in the quotation which I included a little earlier, and three others which he omitted, by passing over that which is midway between hard and soft. Yet it is not even possible to conceive either a hard or a soft massage without also conceiving a moderate one; and if he had coupled the three distinct types by quantity with this, he would have produced a total of nine couplings of massage, not six. I shall lay these out in a table,30 in which

30

The question of the status of tables or diagrams in Galenic texts is a slightly complex one. Frequently he uses schemes of subdivision which imply, or seem to require, a tabular presentation, and on a few occasions, as here, he explicitly refers to an actual table (diagramma) as appearing in the text. (On the use of the term stoichos, ‘column’ as a part of the table cf. Thras., n. 19.) Even in such cases, however, the MS tradition seldom preserves the table, often simply presenting the words that should have appeared in the table as continuing lines of text; and in some MSS it seems clear that there has been a later attempt to reconstruct the table, sometimes in the margin. In the present case, at least, the required manner of presentation seems clear enough. (But cf. Book III, n. 62.)

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the first column from top to bottom should be understood as referring 113 K. to qualities, and the second to quantities. 51 Ko. Qualities

Quantities

hard

short

hard

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hard

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short

soft

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Of the nine couplings shown in this table, Theon discusses the first six, without mentioning the remaining three; he thus plainly contradicts himself. For if there is a massage midway between short and long, which we call medium and well-balanced, there will, of course, be another 15 midway between hard and soft, to which we will apply the terms ‘wellbalanced’ and ‘medium’. And we must remember, in this whole discus114 K. sion, that all these terms are used relatively.31 What is a hard massage for one person could turn out to be a soft one for someone else, and a wellbalanced one a poorly-balanced for someone else, a short one long, or what is a long one for one person, again, a short one for a person in some different state. This is in fact Theon’s view too; and one who has over- 20 looked the massage which is well-balanced in its quality is surely making a very great error. The reason that Theon has tripped himself up, I believe, is that this was omitted in the Hippocratic quotation; from this, too, then, the man has been exposed as not having discovered anything of his own about massage, but rather as appropriating the views of Hippocrates – incorrectly. He did not begin his reading of the composi- 25 tions of the ancient [author] with teachers, starting from an early age. As he himself admits, he became an athlete first, and it was after abandoning that practice that he turned to the art of physical training. 31

Cf. n. 8 above. Further on the individual focus implied by Galen’s insistence that such adjectives are understood in relative terms, see Introduction, section 5.4.

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And, by the gods, I do not say all this to destroy the man’s character – in fact I regard him as the equal32 of any other trainer, including the best of them – but to indicate to the readers of this treatise that it is not easy to follow ancient books without recourse to those who give careful exegesis of them. I have already stated why it was in keeping with the 115 K. abbreviated manner of the ancient author to pass over, in the form of expression with which he communicates, the massage which is midway between hard and soft; and I have shown previously, and will show now, equally, why we should not overlook such things. If, then, both the existence and the conceptions of soft massage and of hard massage consist in a relation, it follows that that of a moderate massage will also consist in a relation. Now, take the case of a body which is of the same sort as that which we posited for the child under discussion in this book, that is to say one that enjoys complete health and is already wellbalanced in every respect, so that we do not want to make him either softer or harder, nor add anything to his fleshened-up state, nor take anything away. Should we, then, in the case of such a body, administer either a hard massage or a soft one, or a long or medium one? In my opinion, these would be quite inappropriate. By the hard massage such a body would be made harder, by the soft one softer, and, similarly, 116 K. thinner by the long one and thicker by the medium one. None of these things should be done; rather, the original state of good balance should be precisely preserved. We will not, then, massage him either hard or softly, nor with either long or short massagings, but with medium ones, bringing about nothing more than his preparation for exercise and, then, his restoration, when he has exercised sufficiently. (Let us too use this term, ‘restoration’,33 as the more recent trainers do, for that part of massage which takes place after exercise.) But Theon is not able to fit any of the couplings which he mentions within massage to such a bodily nature. He speaks of six in all, first of all three within the soft and secondly three within the hard. But it is obvious that such a body does not need any of the soft ones, nor any of the hard ones, but one which is midway between the two, which we should term well-balanced in terms of quantity and quality. The extent of Theon’s blunder, in passing over the massage which is midway between the hard and the soft, has become evident by now. So, in the case of the best constitution of the body it is 32 33

It seems that the correct reading for the sense must be ἥττον᾽, rather than ἧττον. The Greek term is apotherapeutikē, literally ‘after-therapy’, or ‘after-treatment’; it was clearly a technical term used by trainers for what might today be termed a ‘cool-down’ or ‘warm-down’.

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not possible to fit any of the couplings which he mentioned,34 either 117 K. when such a body is enjoying complete health or when it is in need of rectification. For if it is enjoying perfect health, it only requires the preparatory massage, which, as we have shown, is both short and midway between hard and soft; but if at some point it becomes either thinner or thicker than it should be, but nothing has been modified in terms of the quality of the flesh, which rather has been preserved at a precise midpoint between soft and hard, then we shall administer a massage which is both long and well-balanced in quality if we want to thin; one which is both short and well-balanced in quality if we wish to fleshen up; and one which is well-balanced in both respects (I mean quality and quantity) if we wish to build up [the body]. These last three couplings I laid out in the table a little earlier, as an addition to the six, to show how Theon omitted all these. Since, indeed, the argument has demonstrated not just that he omitted them but also that they are extremely useful, it may now be time to proceed to something which was deferred a little earlier, and to state, first, that instruction according to the elements of the [actual] facts35 is more useful than other kinds: for it makes the whole matter easy to grasp36 and helps consign it to the memory, so that one is easily 118 K. able to remember all the individual points and readily achieves facility in their use, since these are referred back to a few, defined elements. Anyone will easily be able to discover all the individual distinct types, functions and capacities of massage, by simply, first of all, learning the view of the ancient, and then having at his fingertips37 the quotation in which he instructed us that hard massage has the capacity to bind, soft massage to release, long massage to diminish and medium massage to fleshen up. By understanding and referring to this, we will first of all discover the two distinct types that were omitted in this quotation; then, subsequently, by connecting all with each other, we will get all the nine couplings, those presented just now in the table. It is not possible either to discover or to refer to these, unless the element-based instruction produced by Hippocrates has preceded [such discovery]. He reduced the I translate the reading of VR, εἶπε(ν), which seems to give the required sense, whereas M, followed by Koch, has εἶπον (‘I mentioned’). 35 Pragmata, more often translated ‘things’, but potentially referring also to states of affairs or events. 36 Literally ‘easily taken in overview’ (εὐσύνοπτον). 37 Literally ‘having ready to hand in the memory’ (πρόχειρον … τῇ μνήμῃ): the phrase is frequently used, especially in ethical contexts, to indicate thoughts or phrases that one should have constantly present to one’s mind to apply to one’s current situation; cf. e.g. Aff. Pecc. Dig. I.5, 18,4 DB (V.25 K.). 34

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whole discussion of massage to its first starting-points; from these, once they have been accurately discovered, we will be able to achieve not only 119 K. those things just mentioned, but also the ability to assess all the faulty forms of instruction. For the most specific feature of a method is this: to 20 be able to get from a short, element-based starting-point to all the individual points and assess everything that has been stated badly, using the scientific principles as a sort of standard with which to test all incorrect beliefs. Enough, then, on the fact that neither the trainer Theon nor any of the others has correct knowledge about massage (although his asser- 25 tions on the subject are superior to the others’), and that it is Hippocrates, and those who follow his teaching, that do have such knowledge.

Clarification of terminology relevant to states of body and massages; effects of different qualities of massage 5. It would remain to speak of one of the matters that have been so far deferred, concerning terms, so that no one be deceived by the multitude of these into thinking that the states are equal in number to the appellations. For the term ‘hard’ is properly applied to one particular state of the body, the nature of which requires no lengthy explanation from us now, since everyone is led to the matter in question by this word itself. And this is the case also with the term ‘soft’. The terms ‘porous’ and ‘dense’, 120 K. however, do not give such a manifest indication of the states of the body, because a certain duality of use of the terms has arisen here, whereby they refer to one set of things properly, and another set in an applied usage. What is properly speaking porous is that which is run through with large channels, just as what is dense is what is run through with small ones; but in a transferred or applied usage (or whatever one wishes to call it) the terms are used of what is flowing and what is compacted.38 It is, for example, in this latter sense that we speak of air and fire as ‘porous’ and of water and earth as ‘dense’, applying the appellations to the actual elements, which are unified and uniform in nature and not run through 38

‘Flowing’ translates kechumenou, of which a still more literal translation would be ‘poured’; in this context it would perhaps also be possible to render the sense by ‘dispersed’ or ‘spread out’. Galen’s claim here about the primary senses of araios (‘porous’) and puknos (‘dense’) help to clarify his understanding and use of them, especially in relation to the flesh or skin of the body. (Araios has also often been rendered by translators as ‘spare’, in such physical or medical contexts; it should be noted that another important sense of the terms is that relating to time, ‘frequent’ and ‘infrequent’.) Of course, Galen’s remarks here about the semantic stretch of the two Greek terms will not be applicable to any pair of English adjectives chosen for their translation, however carefully.

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with any channel. And the terms ‘closed up’ and ‘bound’ have departed much further still from their proper senses. Both are used in a transferred sense: ‘closed up’ for what is dense and for what is hard, sometimes in 10 their separate occurrence and sometimes when they coincide in the same object; ‘bound’, meanwhile, is used for these same things, but not through the same transferred usage. For since all things that are bound do not readily move, one uses the term also for things that have reached a 121 K. state of difficulty of motion, as a result of dryness, chilling, inflammation, induration, tension, filling or heaviness, and, for the same reason, 15 one uses the opposite terms for the opposite states, saying that they have been slackened, released or relaxed. One should not pay attention to the multitude of terms, but should consider there to be two classes of state in all, that which consists in the uniform bodies themselves, and is either hard or soft, and that which consists in the making of channels within the organic bodies, and is either dense or porous. These are the states 20 specific to the bodies themselves, and there are also acquired and, one might say, occasional ones, whereby the channels are sometimes filled with superfluous moisture and are at other times clean, and are sometimes dilated and sometimes closed. 6. But our discussion will address these states in the subsequent books;39 25 for the present, we should return to the task in hand and, first, make still 122 K. clearer specifications regarding massage; for example, that it sometimes brings about something beneficial for our bodies in its own right, but is sometimes subordinate to the effective actions, in a way similar to what Hippocrates said about binding: ‘Binding in some cases itself heals, in 30 some cases is subordinate to things that heal.’40 Now, the massage itself works by densifying what is porous and hardening what is soft (in the case, of course, of a hard massage), and by softening what is hard and widening what is dense (in the case of a soft massage). Thus, too, that massage which is employed for the sake of fleshening up the body, and that employed for the sake of thinning it, in themselves bring about 55 Ko. something beneficial. But that which is preparatory to exercise, and that employed after exercise, are subordinate to the exercise. The former [performs this function] by heating moderately, opening up the channels 39

For Galen’s structuring of the treatise and coverage of different topics in different books, see Introduction, section 8.3. Suboptimal bodily states are considered chiefly in Book VI. The forward reference to a further discussion of restorative massage, in the context of exercise, is probably to Book III, ch. 2, although there are other discussions in Book I and also Book V, ch. 10. 40 Off. Med. 8 (III.294 L.); cf. Galen’s commentary, Hipp. Off. Med. II.4 (XVIIIB.734ff. K.).

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of the body, causing the residues in the flesh to flow and softening the solid parts; and this sort of massage is called ‘preparatory’. The other has the appellation ‘restorative’, and is carried out with a larger amount of oil, simultaneously moistening by means of this fat, softening the solid parts and even, to an extent, dispersing that which is contained in the 123 K. channels. But there will be occasion to speak of this massage again, too, subsequently to exercise. The preparatory massage, however, which is employed in the case of the best nature, for the sake of thoroughly heating the body, should be carried out in the manner stated a little earlier: soft at first, but hard when the subject has already been introduced to exertions. For in this way it will best both soften the body and stimulate it towards activities, while also preserving the initial nature of the body. If, however, the body has a fault in some respect, then this should be adjusted somewhat in the direction of the hard. Slight excesses with regard to the state of good balance in the skin may be brought to an end without altering any of the internal properties; and the skin will be harmed less if adjusted in the direction of the hard and dense. For in this way it will have greater protection against harm. Thus, if such a body actually had the capacity for good transpiration, we would be making it extremely hard and dense. But, in the case which actually obtains, since it should be prepared well for both the transpiration of the residues from inside and the force of things coming into contact with it from outside, what is best will be what 124 K. is midway between each excess. And if in a particular case it happens that this is not preserved, then a harder, denser state is preferable to one which is softer and more porous. What is deficient in transpiration can be corrected through exercise; but the liability to harm from external causes, in the case of the other state, does not admit of any other ready rectification. Considerable harm also frequently arises in such a state through differences, not just in residues, but also in the nourishment itself. As regards the differences in quality, one should certainly err in the direction of the hard rather than in that of the soft; but as regards the distinction in quantity one should obviously err rather in the direction of the shorter, in the case of the nature and the stage of life now under consideration. This should be constantly borne in mind in the present discussion. We still wish such a body to grow, and to be dried out as little as possible. Which bodily natures and states should be massaged to a greater extent will be stated again later.

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Further specifications regarding bodily mixtures, constitutions, environment and approach to exercise 125 K. 7. Let us now, however, return to the subject of our present argument, and consider the measure of the massage in the same manner in which we recently considered its quality. And I have seen fit here, too, before specifying the measure, to make reference to another point of enquiry without which the measure cannot be correctly either specified or recognized. This point of enquiry is the mixture of the air surrounding the person being massaged. [The nature of ] this mixture can be shown in practice, but it is impracticable and completely impossible to give such a clear verbal account of it that such communication will not in any way fall short of manifest indication. It will, however, be sufficient if the argument does not fall greatly short of it. But here too there is another underlying assumption which precedes this argument, namely: in which region of the inhabited world the person about to undergo exercise is located. Only two specifications have been made about this person [so far], that of the bodily constitution and that of the stage of life; additional specifications have not been made as to the part of the world in which this person has been nurtured, or is going to undergo the exercise, nor as to the season of 126 K. the year, or time of day. Yet the measure of the massage is modified by all these. These additional specifications, then, must be made: they were stated by implication in the beginning of this work, but have not been indicated clearly through any explicit communication. For in saying that the person who is faultless in bodily constitution is being set out as a kind of standard for all those that are to be discussed subsequently, we will already, by virtue of this, in effect be making specifications as to the place. After all, it is not possible for a body to be born with the best mixture or the most faultless constitution in places which have an unbalanced mixture, as reason suggests and experience shows. In hot countries people are born dry, thin and, as it were, withered; and the inhabitants of cold places are uneven in their mixture, so that their external parts are colder than they should be and their internal parts and organs hotter.41 The best body, which is the subject of our present argument, is like the Canon of Polyclitus;42 in our own land,43 which is well-mixed, many 41

In relation to this claim, and the following remarks about different races, cf. Book I, n. 45, and also Introduction, section 5.6, with n. 99 for further textual references. 42 See n. 4 above. 43 By such phrases (‘amongst us’, ‘in our land’, etc.) Galen sometimes refers to the area immediately around Pergamum, sometimes to Asia, more broadly conceived: the Roman province of Asia

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127 K. bodies very similar to that have been observed, but among the Celts, Scythians, Egyptians or Arabs one could not even dream of seeing such a body. There is a considerable spectrum within our country itself, the most central part being that with best mixture. Such is the homeland of Hippocrates, which has the best mixture both in winter and in summer, and even more so in spring and autumn. Having, then, posited some such land for the body under consideration, let us in addition posit as the time of year the very middle of spring. And let it be, as nearly as possible, in the middle of that day on which we are first to put him to exercise, so that the natural capacity of his mixture is in no way changed by the surrounding air. For the same reasoning, the house in which he is going to undertake the exercise should also not be hotter or colder on that day than the general state of the air throughout the city. In winter and summer, on the other hand, one should add just so much (of heat in winter and of cold in summer) as will make the body completely well128 K. mixed at the time of the massage. For if it is either hotter or colder than it should be, it will, in the former case, sweat before it is sufficiently softened and, in the latter, not even be thoroughly heated in the first place, nor at any stage well softened, nor will it bloom with a red flush, nor will the body become raised up in volume.44 These, indeed, are the indicators of a well-balanced massage in well-balanced air, performed on a well-mixed condition of the body: redness and volume. For just as bodies in the first place become raised up in volume through the pouring on of hot water, which, however, subsides if that is increased to excess – for which reason, Hippocrates said of them, ‘At first they are raised, then they are thinned’45 – so too massage first raises up, but then contracts the included the whole of the western seaboard of Anatolia, as well as an area extending several hundred kilometres inland, and was bordered by Bithynia to the north, Galatia to the east and Lycia to the south. The historical Hippocrates was supposed to have come from the island of Cos, which could very loosely be considered to be in the centre of the region of Asia, provided that the Aegean islands are also taken as belonging to the province. Cf. Book I, n. 86. 44 The specifications of the optimal circumstances in which to conduct the exercise echo those of Mixtures, where, in particular, there is an insistence (in opposition to some rival medical views) on spring as the healthiest, ‘best mixed’ season of the year; see Temp. I.4, 10,4–16,23 H. (I.523–534 K.). ‘Raised up in volume’ translates eis onkon artheiē. The term onkos may refer to ‘volume’ or ‘bulk’, sometimes also ‘mass’, in a general sense (and cf. Book I, n. 35 for its technical use by Asclepiades), but also, in Galen’s specifically medical usage, to a lump or swelling, especially of a pathological kind (as in Galen’s dedicated work on the subject of ‘Abnormal swellings’, Peri tōn para phusin onkōn, Tum. Pr. Nat.). The notion is that massage has the effect of increasing the actual volume or bulk of the flesh. One could also translate ‘swollen up’, but this would be potentially misleading: the ‘swelling’ in question must be understood to be a healthy rather than a pathological appearance. On onkos cf. also Book IV, n. 29. 45 Off. Med. 13 (III.318 L.); cf. Galen’s commentary at Hipp. Off. Med. III.26 (XVIIIB.872ff. K.).

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body and reduces it. Now, with those who are being massaged for the sake of fleshening-up, one should stop at the point when the body has become raised up in volume and comes near to subsiding; but with those who are being prepared for exercise, one should not wait for that time, but stop much earlier, and especially so when they have the best mixture, 129 K. and are still at the stage of childhood. In this case their bodies are wet and soft, and are softened even by a short massage; and the aim and goal of the preparatory massage is that the solid parts be softened, the wet ones released and the channels widened. How great should be the amount of the massagings cannot be indicated verbally, but the supervisor, being skilled in such things, should use an imprecise estimate on the first day, gradually increasing its precision on the subsequent days, as he begins to gain some experience of the nature of that body. With exercise too, indeed, it is not possible to be precise about the measure on the first day, but on the days that follow it is very possible. Here, too, the indicators on the first day should be when the subject does not follow instructions with the same readiness, when ordered and encouraged, but his wrestling grips and motions are slower, more infrequent, less elegant and in general less intense. 130 K. Of course, the person undertaking the exercise should not be either spirited, so as to be still eager for exercise when his capacity is tiring, nor lacking in spirit, so as to give up when he is still capable of exertion. The person who is our present subject, then, will have these characteristics not just of body, but also of soul.46 Those who have cold fluids contained in their stomach or gathered in their whole condition are lazier in their motions. Similarly, those who are in a state of fulness47 and those who have been worn down by a recent exposure to cold are lacking in spirit and reluctant to move, and still more so are those who are rather cold by nature, and much more so still if some moisture also accompanies the coldness. These people distort the indicators of the correct measure in exercise, as, too, do those who are rather hot in their mixture, or who either through their own nature or through some acquired state are goodspirited,48 competitive and readier for activities than they should be. But 46

Further on Galen’s accounts of the relationship between states of ‘soul’ and those of ‘body’, and for the relevance in that context of the Platonic category of the ‘spirited’, see Introduction, sections 6.1–3. 47 Plēthōrikōs diakeimenoi: for the medical notion of plēthōra (‘fulness’), see below, IV.2, 105,1 Ko. (VI.237 K.), with n. 6. 48 This adjective, euthumos, is usually one with purely positive connotations and – cf. III.4, 82,27 Ko. (VI.186 K.), with n. 30 – it might be thought to indicate the correct balance between thumikos and athumos, which are usually the opposed terms in this context (as a few lines above,

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in those whose body is not too hot or too cold, and whose soul is not entirely lacking in spirit, nor competitive, desirous of esteem and spir131 K. ited, the indicators of the measure of exercise are precisely preserved, right from the very first day, but still more so as time goes on. Even if something has escaped notice in the beginning, this will be corrected by greater precision as one learns from experience. It is in this way, too, then, that one arrives at a precise estimate of the measure of foods, which cannot in any way be known at the beginning; but the daily experience and memory of the quantity of foods and exercise, on the part of a person in charge who does not ignore any detail but constantly recalls how the person subjected the foods to coction after a certain level of exercise, brings the process of discernment,49 in the course of time, close to precise scientific knowledge. Now all these are, in a way, common even to the worse constitutions of bodies, which it is not our task now to discuss. But the best nature, that which is under consideration now, has quite evident correct measures in all these, since it does not cloud nor distort any of the things stated either by the character traits of the soul or by the bad-mixtures of the body, but gives manifest indications of the correct measures of massage, exercise, 132 K. food and sleep; moreover, it tends to desist from each of these things when it no longer needs it, so that this, too, for the person in charge of such a body, is a significant indicator of the correct measure. I mean here the enthusiasm for each activity, since nature itself discovers the correct measure in the best constitutions.50 In the case of massage, too, those with the best nature leave off and turn to their exercise at the point when they have reached a sufficient level of both softness and heat in the whole body; and as for exercise, they will only start to be reluctant to continue when they have exercised sufficiently. Indeed, with food and drink, too, they will only desist when they are sufficiently filled. There is thus no danger that such a person will either exert himself excessively, or become II.7, 58,7–8 Ko., VI.130 K.; cf. I.6, 15,15 Ko., VI.30 K. and I.8, 19.16 Ko., VI.39 K.); one may compare also the usage of Plutarch’s Peri euthumias. In the present context, however, it seems to be taken to be synonymous with thumikos. Cf. also n. 50 below. 49 The noun diagnōsis, although in its ancient medical usage the ancestor of our ‘diagnosis’, for Galen refers to a process of accurate discernment or identification of a state of the body or of crucial differential features of such a state; typically the noun, and related verb, diaginōskein, do not (unlike their modern relatives) have a disease as their object. 50 The term for enthusiasm, prothumia, is cognate with the words athumos, euthumos, thumikos discussed in n. 48 above: it suggests a certain positive energy directed towards an activity. For discussion of the strikingly optimistic statement of the potential self-sufficiency of the body, and soul, in their optimal state, here and a few lines below (‘the healthy body finds out everything for itself …’), see Introduction, section 6.1.

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excessively filled, steered as he is by the impulses of nature. Nor does such 10 a person require the person in charge of him to have attained the highest level of scientific knowledge – unlike all those who will be discussed later, those with faulty constitutions. For the healthy body finds out everything 133 K. for itself, led by the impulses of nature, especially if it has been well educated in terms of its soul. For there are many who destroy good 15 natures through having had bad habits ingrained in them and adopting a daily regime which is rather undisciplined or lazy – just as, conversely, some who are naturally faulty in their body have rectified most of the shortcomings through a self-controlled life and appropriate51 use of tasks and exercise. But the entire subsequent discussion is dedicated to them; our task in this book is to give a thorough account of those who have the best bodily constitution, and who pay careful attention to preceptors of 20 health. And our discussion of these people had so far reached the point of the correct measure of exercise; we should next give a thorough account of the types of exercise.

Varieties of exercise 8. By types of exercise, I mean: wrestling, all-in wrestling, boxing, running and so on. Some are precisely this – simply exercises – while 25 others are not just exercises but also tasks. In addition to those already mentioned, exercises would include also ‘sweeping’, the diminishing 134 K. run,52 shadow-fighting, wrestling with the hands, jumping, throwing the discus or javelin, and exertion of the body with a leather ball, with a small or large ball,53 or with hand weights. Exercises which are also tasks 30 include digging, rowing, ploughing, vine-pruning, carrying burdens, reaping, riding, armed combat, walking, hunting, fishing and all the other individual activities engaged in by skilled and unskilled persons for functional purposes in life, for example building houses, metal-working, building ships, tilling the land or performing some other such action in 35 war or peace. Most such actions may also be employed as exercises.54 51

Or, more specifically, ‘appropriately timed’: the term, eukairos, is connected with the medical notion of the kairos, the opportune moment or appropriate time for an intervention. 52 These two forms of exercise are described in detail below, II.10, 64,4–12 Ko. (VI.144 K.). 53 Galen discusses in detail ‘the exercise with the small ball’, which he believed to have particular health benefits, in his short work of that title (Parv. Pil., translated in Singer 1997a); the identity of the game in question has been explored in detail by Boudon-Millot (2015). 54 There was a previous literary and medical tradition asserting the value of everyday tasks or activities as exercises, evidenced for example by Xenophon and Athenaeus of Attalia; cf. Coughlin (2018), and further Introduction, section 2.3, with n. 16.

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Their entire function is threefold: sometimes, they are undertaken as tasks alone; sometimes as training for the purpose of future tasks; and sometimes as exercises. Once, for example, when I was stuck in farmland during the winter, I was compelled, for the sake of exercise, to chop wood and to put barleycorns in a mortar and grind and de-husk them, things which the people on the farm were doing every day as tasks. 135 K. We shall make distinctions in the following discussion regarding the use of these as actual tasks; for now let us speak of their use as exercises. All such exercises are carried out not by persons performing them throughout the whole day, nor at any other time than before meals. One should of course attend to the correct measure in regard to the exercises themselves, as well as to what is known as the restoration. If, in addition, a person comes to the exercise after sufficient massage, then he will partake in all the [forms of exercise] that one can enumerate. One who undertakes the art of health, then, must have knowledge of all these, which indeed are known as types of exercise. This person, as I said before, may be called either the health-practitioner, the trainer or the doctor; the first of these appellations is the most proper, but the others may be used in an applied sense. For if all practitioners of arts are named by a term derived from the art that they undertake, it is immediately evident that the one who undertakes the art of health will reasonably be called ‘health-practitioner’, just as he who undertakes that concerned with physical exercise alone will be a trainer, and he who undertakes that 136 K. concerned with cures is a doctor.55 But if one wishes to call this healthpractitioner either a doctor or a trainer, one will be applying a term to the whole which is taken from a part; one will thus be using the term not properly, but in an applied, or extended, sense – or however one wishes to call it. The reason for this is that while the art concerning the body is single, there is no proper name that has been attached to that art as a whole. I have given a more extended discussion of this matter in a single volume which is entitled Thrasybulus.

55

The linguistic argument that Galen is here advancing is of course impossible to preserve perfectly in English: the Greek terms, closely etymologically related in each pair, are hugieinē (‘art of health’) – hugieinos (‘health-practitioner’); gumnasion (‘physical exercise’) – gumnastēs (‘trainer’) (on the translation of which pair see Thras., n. 6); iasis (‘cure’) – iatros (‘doctor’). See also Book I, n. 121. Galen here adopts a more neutral stance towards the gumnastēs than he does in the highly polemical Thrasybulus; or one might perhaps say that in the present discussion he considers the gumnastēs as a theoretical category, i.e. that of the person with the expertise most relevant to gumnasia, exercise, whereas in Thrasybulus he is concerned rather with the (misguided) practices of actual gumnastai, as he encounters them in Rome.

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So, the types of exercise are those stated. And their qualities, or ­distinctions – for here, too, either term may be employed – consist in: 30 swiftness and slowness of motion; good tension and, as we may call it, lack of tension; and also vehemence or faintness. The modes of employment of the types mentioned, together with their proper distinctions, are as follows. The motion is either continuous or intermittent. If it is continuous, it is either even or uneven; if intermittent, either regular or 61 Ko. irregular. These are the modes of employment in respect of the thing itself; those which accrue to it from external causes are as follows. The 137 K. exercise is carried out either in the open air or indoors, or in partial shade. In the same way, the place may be hot, cold, well-mixed, or also 5 completely dry, wet or medium. So, too, the manner of employment of exercise will be either with dust, of which there may be more or less, or with oil, which may also be greater or smaller in amount; or it may be without either. 9. Since, then, we have specified all those things in which the health- 10 practitioner should be experienced, it is now time to move on to the types of exercise, and to distinguish, first of all, what is common to all of them and what specific in each case; then, make specifications concerning the correct times of employment.

Increase in heat and its relationship to certain emotional states Now, it is common to all exercise that an increase in the heat of the living 15 being is produced by it. For our bodies are heated by baths, by washing in warm water, by hot weather in summer, by being heated by the sun or 138 K. warmed by a fire, and by hot drugs applied in massaging. But all these sorts of heat come from the outside, not the inside, nor are they kindled or increased by their own proper source.56 But in exercise, there is an 20 increase of the internal heat in the living being which arises from their own individual bodies themselves. This is a common feature of all exercises; but it is not specific to them alone, since, to be sure, there also arises an increase in the internal heat in those experiencing rage, anxiety57 and shame. Now, rage is not simply an increase, but as it were a 25 56

On Galen’s conception of the innate or internal heat of living beings, see Introduction, section 4.5.2. The verb translated ‘experiencing … anxiety’, agōnian, is derived from the noun agōn (‘contest’ or ‘competition’). This verb, and the related abstract noun agōnia, refer to the emotional response of stress felt as a result of concealing a secret, or in anticipation of some public appearance, performance or confrontation: for examples of Galenic accounts of this emotional state and its physical manifestation cf. Praen. 6, 102,17–104,15 N. (XIV.632–634 K.) and 7, 108,29–110,10 K.

57

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kind of seething58 of the hot in the heart; which is why the best-reputed philosophers state that this is its essence; for the appetite for revenge is an incidental feature, and not the essence, of the rage.59 The internal heat increases in those suffering shame too, as all of the hot first of all courses together to the inside, after that gathers deep down, and then increases 30 both because of that gathering and because of the continuous motion. For the breath is not at rest in people suffering shame, but is stirred about all over the place both from inside60 and about itself, along with all the 139 K. blood, just as it is in people suffering anxiety. More will be said about all such affections of the soul as the argument proceeds.61 For the present, I 62 Ko. (XIV.640–641 K.) and Praes. Puls. I.1 (IX.219 K.) and I.4 (IX.249–250 K.). Philostratus compares the experience of agōnian felt by a gladiator in anticipation of a fight with that of a public speaker (VS I.541). 58 Zesis is usually (including in the Aristotelian passage from which this derives, on which see next note) translated ‘boiling’. The sense of the term is, however, broader, involving both the notion of high temperature and that of the seething or bubbling associated with high temperature in various fluids; it may also refer to the bubbling associated with fermentation. Moreover, in the present treatise it does not, in most cases at least, mean actually ‘boiling’, as the references below to bathing in water which is zeon, and the related term zestolousia, make clear: III.4, 81,3 Ko. (VI.183 K.); III.8, 92,7 Ko. (VI.208 K.) and 93,8–94,8 Ko. (VI.210–213 K.). In fact, the mention of a cooking procedure involving zeon water, IV.8, 128,12 Ko. (VI.290 K.), is the only case where the translation ‘boiling’ could accurately be used. I have therefore preferred the present translation for the abstract noun, and ‘steaming’ for the related verb when applied to water. 59 The statement here echoes, while also significantly distorting, a very well-known passage from Aristotle, De anima I.1, 403a29–403b2; on this see Singer (2014a) and (2017). In that discussion Aristotle offers ‘seething of the hot around the heart’ and ‘appetite for revenge’ as parallel accounts of rage or anger, those respectively of the natural philosopher (phusikos) and of the dialectician, the former of whom is stating the ‘material’, the latter the ‘form and rationale (logos)’. He proceeds to state that a full account of the emotion must include both elements; nor does he use the language of ousia (substance) in the way that Galen does here, or suggest that the dialectician’s account could be understood as corresponding to an ‘incidental feature’ (sumbebēkos: further on Galen’s use of this term see Book I, n. 123 above). The verbal echo of this passage is, however, sufficiently close that it seems clear that Aristotle – or at least discussions in the Peripatetic tradition, based on this Aristotelian passage – are what Galen has in mind with his mention of ‘bestreputed philosophers’, and it does not seem that we should look for other candidates. Galen has thus significantly transformed the Aristotelian passage (or perhaps his half-remembered version of it) in a physicalist direction, insisting on the biological response as central and definitional in the understanding of rage – and, perhaps, by extension, of other emotions too, of which he also tries to give precise physiological characterizations. Further texts asserting a close correspondence between pathē psuchēs (emotions or ‘affections’) and particular physiological motions, especially those of the blood, heart or heat, are assembled and discussed in Singer (2017). 60 I tentatively adopt the reading ἔνδοθεν (‘from inside’, VR) in preference to M’s and Koch’s ἔνδον (‘inside’), as the former seems to bring the account closer to that given elsewhere of the physiological manifestations, although even so the account here does not make clear that a central feature of shame is the motion of blood both away from the surface and then back to it; cf. Caus. Symp. II.5 (VII.192 K.). 61 This promise is not really fulfilled, although Galen does mention them again below at IV.4, 112,6–14 Ko. (VI.253–254 K.) as a factor to be borne in mind in considering whether fluids have penetrated deep within the body or not.

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was compelled to mention them [just] because of the fact that a common symptom62 follows both from these affections and from exercise: I was showing how an increase in internal heat, arising from within, and from itself, is common to all exercise, but that it is not a property of exercise 5 only, but also of the affections just mentioned.

Specific functions of different exercises It is time now to move the discussion on to the specific features of each [type of ] exercise; we should make the point at the outset that within these too there are very many distinctions. Some at different times exercise one particular part more than another; some are performed in a state of rest, and others in very swift motion; some with good tension, some with lack of tension; and moreover some vehemently and some faintly. Now, I use the term ‘good tension’ for an exertion undertaken forcefully but without speed, and the term ‘vehement’ for one which has both force 140 K. and speed. (It will make no difference whether we say ‘force’ or ‘vigour’.) Digging involves good tension and vigour; so, too, the restraining of four horses at once with reins involves a considerable level of good tension, but is not a fast exercise. Similar to this is the activity of lifting a great load and then either remaining still or moving forward a little; up-hill walking is in this class too. In these, all the other parts of the body are lifted and raised up, like some load, by those organs which are moved first. Similarly, too, the activity of climbing up a rope, as in the exercise prescribed to boys in the wrestling-school to build up their good tension. Equally, one who takes hold of a rope or a piece of wood above his head and suspends oneself from it for a long period of time, is engaging in a vigorous, strong exercise, but not a fast one, as, also, is one who extends or raises his two hands in a clenched fist and holds them so for a long time. If one holds out one’s hands to one standing opposite, and gets the other person to pull them downwards while he resists, this will improve 141 K. the strength of muscles and nerves even more; for all these kinds of exercise are specific to these [parts]. Still more so [is the exercise] where one takes some weight in each of the hands separately, like the hand weights

62

Here and throughout, I have adopted the translation ‘symptom’ for its ancestor sumptōma, even though the match is in many ways an imperfect one, the Greek medical term referring, in a very general sense, to anything ‘contrary to nature’ that befalls the body: for the definitional account of sumptōma in relation to other general pathological terms, see Symp. Diff. 1, 198–214 Gundert (VII.42–53 K.).

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of the wrestling-school, and holds them still, with the hands either extended or uplifted. If, however, one also instructs someone to drag down or bend [his body] forcefully, while keeping himself motionless and unbent, not just in respect of his hands but also of his legs and spine, the person will be performing a substantial exercise for the good tension of his organic parts. It is said that even the famous Milo trained himself in that way, sometimes inviting anyone who wished to unbalance or remove him from his seat (though this would be more of an exercise for the legs), sometimes, if he wished to exercise his hands, instructing them to unclench his fist; or, again, they say, he would hold on to a pomegranate tree or some such item with his hands and offer anyone who wished to take it away from him.63 Now, these exercises involve both the display and the cultivation of very great strength, and they both exercise and strengthen the tension of the parts; so, too, when one either takes hold of someone round the 142 K. waist, or allows oneself to be taken hold of, and either tells the person taken hold of to unclench one’s hands and fingers, which have been interlocked, or oneself attempts to prize apart those of the person holding one; and in the same way also if someone bends forwards, and the person approaches him from the side and puts his arms round him, taking hold under the ribs, and both raises him up and carries him around like a load – and even more so if he tilts both downwards and upwards as he lifts him: for in this way one will completely build up the strength of the spine. So, too, those who lock their chests together and push each other backwards by force, and those who hang on to [someone’s] neck and pull down, are building up the good tension. The above kinds of exercise, however, can be performed even without a wrestling-school or deep dust, on any hardtrodden ground, provided one stands upright; but those which involve people wrestling against each other to cultivate their tension do require either deep dust or a wrestling-school.64 These are as follows: enfolding one of the opponent’s legs with one’s own two legs, then joining one’s 143 K. hands together, and forcing the one corresponding to the leg that has been trapped up towards the neck and the other towards the upper arm.

63 64

On Milo of Croton, cf. Book I, n. 42. Galen presumably means that the deep dust required would normally be found in a wrestlingschool, but might also be found in some other places too. For the use of dust, see also below, II.12, 72,3 Ko. (VI.162 K.); III.3, 81,32 Ko. (VI.185 K.); V.10, 158,9–10 Ko. (VI.328 K.); cf. also Book III, n. 67.

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One may also make the clench65 around the top of the head, and pull the other person backwards by force. Such wrestling-school exercises cultivate the good tension of both wrestlers, as do all those which involve wrapping one’s own legs around one of the opponent’s legs, or taking hold of 25 both of them at once. Both of these, too, build up strength. There are countless other such wrestling-school exercises for good tension; and the instructor66 has experience and familiarity in all of them. This is a different person from the trainer, in the same way that the cook is different from the doctor.67 Well, this, too, is likely to become a point of 30 enquiry for us; it has been discussed already in the book which we entitled Thrasybulus, and it will be discussed now also, as far as is necessary for present purposes, once we have first given an account of the different types of exercise. Those which contribute to good tension have already 144 K. been stated. 64 Ko. 10. It is now time to move on to those which are swift, but do not involve good tension or force. These include running, shadow-fighting, wrestling with the hands and exercise with a leather ball or with a small ball, when this is performed with the players at a distance and with running. In this category too are the diminishing run and ‘sweeping’. The 5 former exercise is that in which someone in a short course68 runs back and forth repeatedly, without curving, reducing the length slightly each time, and ending with one step. The latter is that where someone walks on tiptoes and stretches his arms out, moving them as quickly as possible in an alternating motion, one backwards and one forwards. This exercise 10 is very often performed standing against a wall, so that even if the person stumbles, he can easily right himself by grabbing hold of the wall; in this way, indeed, the person performing the exercise both conceals his blunders and becomes less prone to them. Other fast, but not forceful, 65

Cf. below, II.11, 67,16 Ko. (VI.151 K.), with n. 83, on this use of hamma, ‘knot’, to mean a clenching of the hands, in both wrestling exercises and massage. 66 On the role of the ‘instructor’ (paidotribēs) see above, Book I, n. 89 and Introduction, section 3.2. 67 The use of the derogatory term tribē, ‘familiarity’ or ‘knack’, paired with empeiria (‘experience’), has clear Platonic echoes, in particular of Gorgias 463a–b, where the kind of skill which consists only in a tribē is strongly contrasted with specialized skills or arts, technai, properly so called, and indeed cookery is put in the former category. It is noteworthy that Galen draws directly on the Gorgias and its account of technai in Thrasybulus (although he does not in that context mention a tribē, he does employ the pejorative term kolakeia, ‘flattery’). On this see further Introduction, section 8.5; and on the terminology of paidotribēs – which is etymologically a combination of the word for ‘child’ with a cognate of tribē – section 3.2. 68 A plethron was a length of 100 Greek feet (very roughly equivalent to 30 metres), or, as here, a course of that length.

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motions are those which are carried out in the wrestling-school by people 145 K. spinning swiftly in a circle, whether conjointly with others or on their own. One may also perform a swift exercise by engaging with an opponent, upright, and attempting to move his position quickly; and also with the feet alone, upright in one place, often springing backwards only, but sometimes raising each of the feet in turn in front of one. It is possible to perform a swift exercise with a similar motion of the hands, too, without holding hand weights, concentrating on both the frequency and the speed of the motions, moving the hands upwards and downwards69 either with or without a clenched fist. Such, then, is the fast exercise, which is [further] specified according to the types that we have mentioned. It is time to move to the vehement [kind]. This, as already stated, is a composite of that involving good tension and the fast. Those of the exercises which involve good tension have been mentioned; and I have added to them those fast motions which one may use as vehement ones. Vehement exercises also include digging, discus-throwing and jumping 146 K. continually without pausing; similarly, too, connecting the activity to70 throwing any heavy projectile, or exerting oneself swiftly while fitted with armour. Of course, those engaged in any of these forms of exercise tend to desist from them within a short time. You may already to some extent recognize also the distinction of exercise in terms of continuous and intermittent. All those just mentioned, indeed, are more usefully employed with intervals in between, especially those which are labours or tasks, rather than just exercises, such as rowing and digging. Those [types of ] exercise which are weaker tend to be performed without breaks; examples are long-distance running and walking.

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11. All these, then, are types of exercise; and in addition to the distinctions just stated, they also differ in that some exert the lower back more than the arms71 and legs; others exert the whole spine, the chest area alone, or the lungs. Walking and running are types of exercise specific to the legs; wrestling with the hands and shadow-fighting are specific to the 10 69 70 71

Or perhaps, ‘back and forth’; but this seems to give better sense here. Or perhaps, ‘making the activity more intense by’. The word cheir in Greek usually refers to the hand, but for Galen it properly speaking applies to the arm as a whole, including the hand, a usage he expounds in detail at AA III.2, 137–138 Garofalo (II.347 K.), where he says that akra cheir refers rather to the hand. Relatedly, ‘wrestling with the hands’ in the next sentence translates akrocheirismoi, literally ‘[uses of ] the ends of the cheir’.

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arms; specific to the lower back are: continually bending the body down147 K. wards and upwards; lifting a weight from the ground; or holding one up in both hands for an extended period. For example, an exercise some perform is to place hand weights in front of them, spaced apart at a distance equal to the length of their outstretched arms; then, from a standing position, to bend forward and pick them up, the one on the left-hand side with the right hand and vice versa, and then to replace each in its proper place, performing the action repeatedly without moving one’s feet. This motion exerts particularly the parts on the side of the spine, while that previously mentioned exerts those straight along it. The types of exercise proper to the chest and lungs are those involving very large inhalations; and, in addition to those mentioned, those which involve very great sound are proper to all the organs of the voice. A full list of them has been stated in the notes on The Voice.72 Since, however, we have reached this point in the discussion, it will be no bad thing to give an account of all the parts of the living being, both those which have manifest motions and those which have small, indistinct ones; and of which of them are moved of themselves and which by others. Such a distinction will provide considerable assistance to the trainer with respect 148 K. to the moving of all the parts of the living being, sometimes of themselves and by means of their own proper capacities, but sometimes from and through others. Now, all deliberate73 activities are motions specific to the muscles, nerves and tendons; if, additionally, they are performed with vehemence, they exercise the parts mentioned primarily and especially, but they also incidentally exercise the arteries; and they simultaneously move the veins, the fleshy parts, the ligaments and all the other parts of the animal equally with those mentioned.

Other forms of motion in the body The other motions of animal bodies, those which are performed not as a result of a common decision,74 but either as some kind of natural 72

A substantial early anatomical work of Galen’s, mentioned in his own list of his writings at Lib. Prop. 1, 137,24–26 BM (XIX.13 K.). The original text is lost, but testimonies for the text are assembled and discussed by Baumgarten (1963) and now by Nutton (2022). 73 The phrase here is kata proairesin; cf. Book I, n. 50, as well as the next note. 74 The term ‘decision’ here is the same translated as ‘deliberate’ in the phrase kata proairesin above (see previous note). While the earlier usage is a standard one used by Galen for deliberate or voluntary motions, by the unusual addition of the adjective ‘common’ (koinos) he apparently intends to highlight the fact that such deliberate motions, stemming from a central, shared source, affect the whole body, as distinct from the individual, involuntary motions of different parts.

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motions or in accordance with the affections of the soul, are of two 66 Ko. classes, being the actions either of the heart and the arteries or of the veins and the liver75 – of these, that is, primarily and especially, but secondarily also of all the other parts, since all parts are controlled by the four natural capacities.76 Now, the motion of the arteries and of the heart 5 never ceases at all, although it is intensified and relaxed, in terms of large149 K. ness and smallness, fastness and slowness, and also vehemence and faintness, for many reasons, all of which I have given an account of in my treatise on Causes in the Pulse. It will be sufficient for present purposes to 10 mention only the chief and primary points. One cause of the change in the pulse is the increase or lessening of the innate heat; another alteration77 is that in relation to quantity of the psychic breath;78 a third is that related to the vigour or feebleness of the capacity; a fourth, that related to the ailments of the organs. Now, however, is not the time to give instruc75

Galen’s verbal formulation in this passage (as also discussed in the previous note) seems slightly unusual in detail, but nevertheless essentially consistent with the view expressed especially in The Doctrines of Hippocrates and Plato, where the capacities of the soul are three in kind, voluntary (or, belonging to the leading-part, the hēgemonikon, of the soul, which is located in the brain, and functions via the nerves); involuntary or ‘vital’ (controlled from the heart, via the arteries); and nutritive or vegetative (controlled from the liver, via the veins); and moreover each of the latter two kinds of capacity, and organ, are related to a distinct part of the (Platonically based) tripartite soul – the thymoeidic or ‘spirited’, concerned with anger and competitiveness, in the heart, and the desiderative, concerned with food and sex, in the liver. (The significance of the ‘spirited’ has already emerged several times in the text; further on the presence of the tripartite soul here, see Introduction, section 6.5.) What seems distinctive in the present passage is the use of the term ‘natural motions’ (phusikai kinēseis), on the one hand, and the division of non-rational or nondeliberate motions into either ‘natural motions’ or ones ‘in accordance with the affections of the soul’, on the other. Galen may perhaps be taken to mean that the psychic or ‘soul’ affection and the ‘natural motion’ are both aspects of the same function; cf. the summary at PHP VII.3, 438,28–440,8 DL (V.600–601 K.). (It is also worth noting that the relationship of the liver and veins to a particular kind of ‘soul affection’, namely the desiderative, while implicit in the theory of The Doctrines of Hippocrates and Plato, is not clearly explored there.) 76 For the theory of the natural capacities, see Introduction, section 4.5.2. The verb translated by ‘controlled’ is dioikein: Galen’s usage is again slightly unusual here, as it is the verb he typically uses to describe the role of the three kinds of soul capacity within the body (see previous note), rather than the role of the natural (phusikai) capacities. The verb itself includes the connotations of both ‘inhabit’ and ‘govern’ (and is often translated by the latter). 77 I read ἀλλοίωσις with R, rather than ἀνάλωσις (M, followed by Koch) or ἀλλοίωσιν (V). Although ‘consumption’ (ἀνάλωσις) of psychic pneuma is indeed discussed by Galen – see next note – ‘another consumption’ seems to make no sense, and the alternative of reading this word as an accusative form (either with V or by changing ἀνάλωσις to ἀνάλωσιν) also seems impossible, as we already have an accusative word, ποσότητα, governed by κατὰ. 78 Cf. Caus. Puls. I.12 (IX.53 K.): ‘consumption of the psychic breath takes place in people who exercise or undergo dispersal, and in cases of internal flow – all of which things are observed by the doctor’; and cf. Caus. Puls. I.4 (IX.7ff. K.) on causes in this area more generally. For the role of breath or pneuma in Galen’s physiology, see Introduction, section 4.5.4; Singer (2020a); van der Eijk (2020).

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tion on this last type; for in those kinds of ailment the animal is necessarily already sick. All the other alterations of the pulse arise also in healthy persons: as regards increase or diminution of the innate heat, the alterations are a function of the season, nourishment, drink, baths, massage, sleep and waking, and also of affections of the soul and deliberate actions; as regards the consumption of the psychic breath, the alteration is a function of the distinct types of voluntary motion; as regards vigour and 150 K. feebleness of the capacity, of the good-mixtures and bad-mixtures of the actual body of the heart and of the arteries. The activity of the veins, along with [that of ] all the other organic parts which were brought into being by nature to deal with the management of nourishment, is altered in accordance with food and drink, distribution and coction, and nutrition (although a part of this79 too is in the arteries). Within those motions which are not activities, there is a threefold distinction: some arise in the living being of themselves, some befall it from outside, some are forced upon it by drugs. Those which arise of themselves I have already mentioned; those from outside are: sailing, horse-riding, passive exercises,80 both those provided by carriages and those provided by suspended hammocks, the rocking of cradles, or the arms of nurses, in the case of infants. Amongst motions from outside one may also include massaging (whether one wishes to use this term, as the ancients do, or without the addition of ‘-ing’, in accordance with more 151 K. recent authors; this makes no difference for present purposes).81 Some, however, are mixed motions, for example horse-riding. For, unlike the situation with carriages (especially those in which we recline at complete rest), it does not happen when riding a horse that one is moved about82 only by that which is carrying one, while performing no activity oneself: one has to keep the spine straight, to hold on to the sides of the horse properly with both thighs, to have one’s legs extended and to look out ahead. There is at the same time also exercise for the sight and exertion for the neck; but, above all, in this kind of exercise the internal organs are 79

‘Of this’ (ταύτης) must refer to ‘nourishment’ or ‘management of nourishment’ (τροφῆς οἰκονομίαν). In the phrase placed in parentheses Galen is reminding the reader, as it were as an afterthought, that while the veins, stomach and liver are the parts, according to his system, dedicated to the process of nourishment, there is one specific part of the nourishment process – that responsible for the nourishment of the lungs – that takes place in the arteries. 80 These forms of passive exercise are also mentioned at various points in Book I; cf. also Book I, n. 69. 81 See n. 21 above. 82 The Greek verb is seiein: one could also translate ‘shaken’.

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moved about. Now, they are moved about just as much in jumping, but less so during passive exercise in a carriage. If, then, one wishes to move the internal organs below the diaphragm more forcefully, one should resort to the exertions mentioned, and in addition to these, to massages applied by two hands clenched together.83 The person administering such massage should stand behind, and should move his hands around, now to the left, now to the right, the person massaged inclining his body in accordance with this motion. The internal organs below the diaphragm are also to some extent 152 K. moved by the most voluminous of inhalations and vocal utterances, as well as by exhalations, both those that take place on their own and those which involve also stopping of the breath, both in the case of the playing of the aulos and in that of the use of the voice.84 Stopping of the breath is indeed itself an exercise, for the muscles in the abdomen as much as for those in the chest. But we shall speak of this again later, since, alongside those functions just mentioned, it has another significant one, because of which we undertake it at the end of a session of exercise. Let us return to the subject now before us, namely that many of the motions that arise in a living being are not actions of its parts, nor are they consequent on such actions, but are accomplished by and through others, as is the case with passengers in carriages or at sea, with people undergoing massage and with those being purged by emetic or laxative drugs.

Exercise in relation to the expertise of the health-practitioner and trainer This last sort of motion, though, does not belong within the study of health. The others all do; and those which are performed by massage are 83

Literally, ‘the placing-round of knots’; cf. above, II.9, 63,22 Ko. (VI.143 K.). The term hamma is used, both in wrestling and in massage, to refer to the knot made by the clenching of hands. Here, the masseur stands behind the person massaged and exerts strong pressure, moving clenched hands over different parts of the abdomen. The same massage is also described below, III.2, 78,12 Ko. (VI.176 K.), with the phrase hammatōn periphorai (literally ‘encircling motions of knots’); cf. also Parv. Pil. 2, 96,5–6 Marquardt (V.903 K.), where the same phrase is used as here, but in the context of holds or clenches in contact sports. (In Plutarch, Alcibiades 1.8, Alcibiades bites the hands of the person who is pulling him down in such a clench, thus undoing the ‘knot’.) 84 The aulos was a double-reeded and (usually) double-piped wind instrument, broadly of the same family as the shawm or modern-day oboe, particularly used at parties and festivals and also as an accompanying instrument in some forms of dance and choral music. Its playing involved a high level of pressure, as evidenced by some vase paintings depicting aulos-players with their cheeks bound to maintain the tension. (For its traditional associations of ribaldry or decadence, as well as the distortion of the face caused by its playing, see Aristotle, Politics VIII.6, 1341a18–1341b8.)

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especially necessary for the health-practitioner to know. For it belongs to 153 K. this person’s art to understand the capacities of all motions, as it belongs to the actual specialists to understand85 all the individual matters; for they have the knowledge of the variety of the materials, 86 while the trainer has the knowledge of their capacities. If, for example, someone asked me to teach another person to carry out, in a well-proportioned manner,87 the motions involved in armed fighting, or indeed asked me to carry them out myself, I would not be able to perform any single one of them well; but if I were present while someone skilled in armed combat was performing them, I would know, more accurately than all of them, what capacity each of the activities had and which part in particular it exerted. Indeed, to be honest, the person skilled in armed combat would be able to say nothing of their capacity, while the one who understands the art concerned with exercise will discern them all, referring each to its designated aim.88 They are either forceful, heavy and productive of good tension; or light, fast and intense; or both forceful and swift. You will recognize these easily when observing them happening in the subject; and, in addition to these, also which actions exert the legs more than the 154 K. arms or chest, which the lower back, the head, the spine or the stomach, and which any other part in particular. An expert in armed combat will perform in a well-proportioned manner motions which are swift, or ones which are simultaneously productive of good tension and heavy, as the case may be; but he will not be aware that such motions densify and thin, nor that the slower ones fleshen up and make porous. In the same way, he will at times perform 85

The term technitai (‘specialists’) is cognate with technē (on which cf. Book I, n. 8 above), but here refers to people with individual or narrow specialisms as distinct from overall understanding of a technē in the larger sense; one might also translate ‘technician’ (cf. n. 88 below). Similarly, the word translated ‘understand’ is epistasthai, cognate with epistēmē, elsewhere translated ‘scientific knowledge’ (cf. Book I, n. 102), but again is here without the high-level epistemological connotations of the latter term. 86 ‘Material’ (hulē) refers in more abstract philosophical contexts to the matter or substrate which underlies something (and in specifically Aristotelian contexts, to ‘matter’ as opposed to ‘form’); in Galen’s medical usage it refers often to the ‘materials’ used for drugs or medicines (giving rise via Latin to the still sometimes used phrase materia medica), but also more broadly to any individual thing that may be used (exercise, massage, food, wines, drugs) in health interventions. To know the ‘material’ of all these is to know the identity of such individual items. See further Introduction, section 5.2. 87 Euruthmōs: the notion of euruthmia involves the precisely correct balance or relationship between parts; cf. Book I, n. 83. 88 Galen has a strong view of the hierarchical nature of arts or specialisms, whereby subordinate skills must work in the service of an overarching or organizing technē; see Introduction, section 3.2, with n. 34.

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motions which are productive of good tension, heavy and slow, but he will not be aware that these provide vigour and heaviness of body. A riding expert, similarly, will perform all his individual activities in the most well-proportioned way, and in that most fitted to their function, but will be completely ignorant as to which of them thin, fleshen up, bring about vigour or tautness, or render the body soft, hard, dense or porous; and in the same way, an expert with the ball understands all the throws and catches of the ball, but not which state each one brings to the body. Similarly, an instructor has understanding of all the activities of 155 K. the wrestling-school, but not of the nature of each one’s effects. So it is, in brief, with all persons, who perform bodily activities, whether they are specialists or not: they do not know the capacities of those activities. This would apply for example to dancers, sailors, carpenters, fishermen, farmers, metal-workers, builders, cobblers – in short, to all who carry out any task. The expert in physical training, however, proceeding from the basis outlined above, will not be ignorant of the capacity of any activity, even if he is observing it for the first time. Take the intense motions employed by dancers, for example, in their great leaps and fast rotations; in standing up from a crouch; in pushing their legs forward;89 or in separating them as widely as possible – in short, their swiftest90 motions. These make the body thin, muscly, hard, dense and also taut. In their relaxed, slow, soft motions, meanwhile, the body will not only not acquire those characteristics just mentioned, but change to the opposite state even if it was naturally muscly and taut. The point, then, that I was 156 K. making a little earlier – that the instructor is the servant of the trainer, in the same way as the cook of the doctor – has been shown here too. The cook prepares beet, lentils or barley-gruel in different ways at different times, without any knowledge of their capacities nor of which of the preparations is best; the doctor, on the other hand, is not capable of preparing any of these as well as the cook, but knows the capacity of each thing prepared. I omit καὶ διασύρουσι, following VR: the verb would, it seems, be used in an unusual sense, and its insertion would be fairly readily explained on the basis of a conflation of the previous verb, προσσύρουσι, and the following one διασχίζουσι. If retained, it would probably mean something like ‘and pushing their legs outward’. 90 I preserve the translation ‘swift’ here for the adjective oxus, as throughout this discussion of motions and exercise, although it does seem that ‘intense’ (which would usually be a translation of suntonos or eutonos) might here give a more natural sense. 89

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12. The trainer of the youth now under discussion – the one with the best constitution – understands the capacities of all the different exercises, and chooses, within each form of exercise, those which are well-balanced and midway between each imbalance. The best constitution requires not a swift or a slow exercise, but one which is well-balanced and at the midpoint; and, by the same token, neither a forceful, vehement one nor a relaxed, faint one; in this respect, too, the well-balanced one will be best. For one should not modify the best constitution of the body; one should 157 K. preserve it. If, then, the trainer of such a youth wishes him to take exercise through armed combat, he will take the person most experienced in the material of armed-combat activities, and ask for a demonstration of all of them; then he will himself choose, select and give instructions as to which exercises should be employed frequently, which less, which in a wellbalanced way, which not at all and which constantly. For he cannot fail to know which part receives greater exertion from each of these, nor what their qualities and capacities are. If, though, he wants the exercise to be with a ball, here too he will find out the type, the quality and the measure of the activities, taking on a ball-play expert in order to observe the entire material of the activities. The trainer – in his capacity as trainer – has no experience of the individual material of each specialized skill; but as soon as he observes them, he will immediately recognize their quality and capacity. Indeed, there are countless individuals in whom some parts of the body are weaker, in such a way that they are constantly liable to fall 158 K. victim to the diseases of those parts; and we have reinvigorated them through physical training alone, not by steering them away from their own forms of exercise, but rather by instructing them to perform the motions of their individual specialist skills – whether the person in question was a dancer, an expert in armed combat, in wrestling-school exercise or in anything else – and then choosing the most suitable of these, and giving prescriptions for their use, including time and amount.

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Summary of the principles and aims of daily regime, especially exercise I shall discuss rectifications of this kind as the argument proceeds, in that part of the treatise in which I give an account of faulty constitutions of 5 the body. Now, however, since our subject is the preservation of the best body in the best state, our task is to choose that which is well-balanced in every context: in massage, exercise, baths, nourishment, sleep. Through

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these we should make the bodily condition neither softer nor harder (for the former condition is vulnerable to motion from external causes, while the latter prevents increase), nor denser (whereby some of the residues within the flesh will be retained), nor more porous (whereby some bene159 K. ficial stuffs will flow away too). In the same way, one should not make it either thinner or thicker, since it is already in the best state; and one knows that that which is thinner is vulnerable to external causes, and the thicker to internal ones arising from the body itself. And it need hardly be said that one should not, either, render it hotter, colder, drier or wetter, since its mixture is faultless. There is, then, this single aim in the case of such a body: that which is well-balanced and moderate – that is, precisely midway between the imbalances – in all health-related materials. The way in which one may best achieve this aim has already been stated in the foregoing; but it is no bad thing to give many reminders of the most necessary points. On the first day, the estimate will be a broad one, but then successively more precise on the second, third and fourth and on subsequent days. On the first day, you should do everything in accordance with the aims mentioned above. Let the subject strip once the 160 K. urine has undergone complete coction, as Aigimios instructed.91 Then, the aim of the massaging is that the parts become softened; this will be indicated by the spread of the bloom over them, by the ease with which the limbs undergo softening, and by readiness for all kinds of motion. After that, it is time for the exercise to be performed, until such time as the body is raised up in volume, acquires a good bloom, and the motions become easy, even and well-proportioned. At the same time, you will also observe hot sweat mixed with vapour. The exercise should only cease at that point where one of the things mentioned begins to be altered. If, for example, it becomes apparent that the volume of the body is being drawn in, you should immediately stop the youth. If you exercise him further, you will cause the evacuation of something beneficial and so render the body thinner, drier and more lacking in growth. Similarly, too, if the bloom of the skin-colour begins to fade, you must stop; for by further exercise you will excessively cool down and disperse the body. You should also, of course, stop immediately when it becomes apparent that the readiness for motion, the good proportion or the evenness is diminishing 161 K. or receding in any respect, as indeed if there is some change in the 91

Little seems to be known about this individual. Elsewhere Galen mentions an Aigimios who wrote an early book on the pulse: Diff. Puls. I.2 (VIII.498 K.); IV.2 (VIII.716 K.); IV.11 (VIII.751–752 K.).

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amount or quality of the sweat. The sweat should continue to become larger in quantity and hotter as long as the motions are being rendered more vehement. When, then, it becomes either smaller in quantity or colder, in this case the body is already being dispersed, cooled, relaxed and dried more than is appropriate. One must, then, pay very precise attention to the body undergoing exercise, and stop it immediately when one of the stated signs starts to appear; one should not, however, immediately let the subject go and bathe, but should reduce the peak of the exercise and instruct him to stand (and also, if you wish, to expand his ribcage and hold his breath), and then perform the restoration, with application of oil. The nature of this ‘restoration’, its aims and its extent, and the motions and massages by which it is accomplished,92 will be indicated in the following book. For I believe that it is now time to finish the present book, which is sufficient in extent, adding only this point, that a completely well-mixed 162 K. bath, too, must be chosen for this age and nature. That is to say (if we recall), the third seven-year period after birth, in other words the age between the completion of the fourteenth year and that of the twentyfirst. During this, my instruction is that the youth should not yet take cold baths; in this way he will enjoy maximum growth. When his growth is completed, then we may consider cold bathing. Let us also consider more precisely, in the following book, those exercises performed using dust.93 For the present, it will be sufficient to state this, that the youth does not actually require dust, if the house in which he is undergoing the exercise has been prepared in the manner which I instructed at the outset. If, however, it happens that it is hotter than that, dust should indeed be used. Now, if he does use dust, he must definitely bathe. If he does not use it, it is possible not to bathe, especially in winter. All those estimates which the person supervising the youth should then make regarding nutrition, drink, sleep and walking, will be stated in 163 K. what follows. It is impossible for him to achieve these precisely on the first day. On the second, however, on the basis of a knowledge of the extent of the exercise and the nature of the regime, if it was apparent that he preserved his nature completely, then he will instruct the same extent of regime and exercise; if he did not preserve it, he will attempt to return I read ἐξ ὧν τε συμπληροῦται (‘and from which motions it is accomplished’, R) rather than ἐξ ὧν συμπληροῦνται (‘from which they are accomplished’, other MSS, followed by Koch), as seems required by the sense. 93 Cf. n. 64 above, with further references there. Here the use of dust applied to the body seems to be meant, rather than merely as a surface on which to exercise. 92

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him to that, by changing the amounts in accordance with the extent of his departure from those original extents. He will continue to do this until he arrives at a precise determination of the extent of the actions performed. As for the number and identity of the departures from the natural state, and the way in which each of them should be discerned and 15 treated, the next book will give an explanation of these.

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Importance of specification of health instructions on basis of different types of body and life circumstances; recapitulation of argument so far 164 K. 1. Of those doctors and trainers who have written treatises on health, some have produced a set of instructions of general application to all human beings, with no conception whatever of the specific differences within our bodies; others, while clarifying that there are considerable differences amongst us, have deliberately omitted them, on the grounds that it is impossible to deal with all. And a few, while attempting to make specifications by type and class, have got more things wrong than right. 165 K. We, meanwhile, indicated at the outset, in the first book, how many types of human body there are, and announced our intention to write instructions for health for each of them specifically.1 We began with the body which has a faultless constitution; and, since even this sort of human being is sometimes prevented, by the obligations to which he is voluntarily or involuntarily subject,2 from following a daily regime in accordance with the prescriptions of the art of health, we decided that it was best to take as our basis for discussion first of all the person who is completely free, with leisure to devote to the health of the body alone. In terms of the bringing-up of such a person, the first book gave instruction on the care extended up to the age of fourteen, the second indicated 1

Cf. especially I.12, 28,32–29,19 Ko. (VI.60–61 K.), and more broadly on Galen’s intended and actual structure for the work, Introduction, section 8.3. 2 For further discussions of this problem throughout the text, see Introduction, section 3.1, with n. 31, and section 5.6, with n. 96.

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how he should be reared into manhood. The discussion, however, was lengthened by covering the chief points of common application to the study of health, without which it would not even have been possible to give an account of each stage of life and nature under discussion. So, we enumerated all the distinctions within massage and exercise – not, to be sure, the individual ones, except in passing, insofar as they served our 166 K. purpose by way of example, but those specified in terms of type and class. In the case of massage, we gave an explanation of the hard and the soft and, before these, of that which has some well-balanced capacity; and, adding to these distinctions those of quantity, which are also three in number, we proceeded to show that, through coupling, there are nine in all, and stated the capacity of each. Within exercises, we explained which we term swift, or fast, and which dull, or slow, and which midway between the two and thus primary in terms of their actual nature. So too with those which are productive of good tension and those which are soft, and with the heavy and light, similarly, we gave an account also of those which are midway between these qualities, showing how in the case of the best constitution one should keep always – in massage, exercise, baths, nourishment and everything else in which the healthy daily regime consists – to those which are moderate and possessed of good balance, being midway between those which are unbalanced. In the case of massage and exercise, we organized the theoretical study3 into certain common kinds, so that the instruction would be both easy to remember 167 K. and methodical; and we promised to proceed in the same way also with respect to all the other areas – and to do so first, indeed, with what is known as ‘restoration’, this being next in order after those mentioned. For after indicating the point to which exercises should be extended and increased for their completion, for the purpose of health,4 we stated that what is known as ‘restoration’ follows upon them. Let us turn to this subject now.

3

The term theōria tends to refer rather to a body of theoretical knowledge (and sometimes to a treatment of that body of knowledge) than simply to a ‘theory’. 4 I translate πρὸς τὸ τέλειον, ‘for their completion’ (also translatable ‘for their perfection’), following Koch. The reading τὸ τέλειον may seem suspect here, since Galen is about to attribute this precise phrase to trainers as their nomenclature for a particular form of exercise (cf. n. 8 below), and it is perhaps odd for him to use the phrase here without making any explicit connection with that; the reading of VR, καὶ τὸ τέλος (‘and their goal’), could be argued for. But I take it that Galen here means ‘perfection’ in the sense of the ‘perfect’ form of health, discussed above in Book I, e.g. at I.4–5, 7,34–8,20 Ko. (VI.12–13 K.).

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Restoration (apotherapeia) 2. The first point is that there are two classes of restoration: it is in one sense a part, and in another a type, of exercise. Let us turn to the latter sense in due course, but first discuss restoration as a part of exercise. In any exercise which is performed well, the final part of it is called restoration; and there are two aims of this: to evacuate residues and to keep the body free from fatigue.5 Now, the former aim is common to the whole of the exercise (for here, too, we said that there were two aims in 168 K. all, namely to strengthen the solid parts of the living being and to evacuate the residues); but the specific aim of restoration is to impede and hinder the usual fatigue from arising after immoderate exercise. Now, in the case of athletes, and of those who carry out any task which is necessary in their life – digging, walking long distances, rowing and so on – fatigue comes about more readily, unless one employs restoration;6 but with the body which is the subject of our present discussion, that which is endowed with the best constitution and is free from all servitude,7 so as to have leisure to devote to health alone, the engendering of fatigue is rare. For those athletes who exert themselves most, fatigue is not potentially attendant on any exercise except that which they term the ‘complete’. By the same token those who live a free life, and undertake exercise only for the sake of health, will never suffer fatigue, because they never have need of such an exercise. In order to prepare their bodies for the exertions that arise in competitions, which are immoderate and 169 K. which in some cases go on for a whole day, athletes must sometimes undertake that most complete form of exercise – that which they also call the ‘building-up’.8 5

‘Free from fatigue’ translates akopos, the negative adjective formed from the noun kopos – which becomes a major topic of discussion in this book. (Cf. also the pharmacological usage discussed in n. 69 below.) In Greek (and indeed in Galen) more generally, the noun has the broad sense of tiredness or fatigue; but, as we shall see, in the particular context of exercise and massage, it may also refer much more narrowly to muscle pain or strain produced by physical exertions. 6 It seems noteworthy that here Galen puts athletes in the same class as a variety of different labourers, and attributes their suboptimal state of health to that circumstance; this is rather different from the terms in which he disparages their state of health elsewhere, especially throughout Thrasybulus. 7 The term, douleia, is the same translated ‘slavery’ above, II.1, 38,18.19 Ko. (VI.82 K.) and 39,4 Ko. (VI.83 K.), where the connection with that stronger, or literal, sense is emphasized; however, the word can also be used with a broader, or metaphorical, application, to indicate a life of obligation, or of limited freedom to act as one would wish; for further references to the latter notion within the text see Introduction, section 5.6, with n. 96. 8 The word, kataskeuē, linked here to the notions of the ‘complete’ or ‘most complete’ form of exercise, is the same word used for the construction or ‘constitution’ of the body (cf. Book I, n. 32). The term was presumably used by athletes and their trainers to refer to a form of exercise which

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For those who undertake exercise purely for the sake of health, however, it is neither necessary nor in any way beneficial to be led into excessive exertion; there is therefore no risk of falling victim to fatigue. One should, nonetheless, employ restoration upon their bodies, even where there is no expectation of fatigue, for the purpose of evacuation of the residues. Security from the risk of fatigue will thus accrue as an additional benefit. For even if the extent of the exercise in these people’s case is as far as possible such as to be free from fatigue, and the manner of the activity unforced, it is still possible for a trainer to miss something small, on either count, which, if overlooked, will bring about some fatigue – albeit not a large one, nor one of long duration – in the person exercising. Yet it is not appropriate for one who lives for himself and has leisure to devote to the health of the body alone to be harmed at any point, even to the smallest extent. It is therefore safest to employ restoration in every case. The kind of restoration to be performed will be indicated by the nature 170 K. of the aims. Our task is to produce the complete evacuation of those residues which still remain in the body, in the solid parts of the living being, after these residues have been heated and thinned by the exercise. We should, then, employ massaging performed by another person, while also tensing the parts being rubbed, and in addition also what is known as the holding of the breath. But since there is more than one type of both massage and the holding of the breath, it will be best to choose the most beneficial, in each case. It has been shown that hard massages bind together, that is to say, they render the body both denser and harder. These, then, will not be well suited to the present type of body, since, indeed, what is densified tends to stop [stuffs] within itself, but what is made porous encourages what is superfluous to flow away. So, too, to be hardened is completely contraindicated for those [bodies]9 which have been tensed, since it increases that state, while to be softened is most beneficial. Since, then, one should both dissipate the residues and soften those [bodies] which have been tensed, one should avoid hard massages. would substantially build up the body. Cf. below, III.8, 94,8 Ko. (VI.213 K.), which has the adjectival form of the word applied to exercises. See also Thras. 47, 99,22–23 H. (V.898 K.), attributing a number of such technical terms to trainers, including ‘preparation’ (paraskeuē) and (as here and also below, III.8, 92–94 Ko., VI.208–212 K.) ‘complete’ (teleios), although the term kataskeuē does not appear there. 9 Here and in the following lines I take it that ‘bodies’ is the noun to be supplied (the Greek has only a participial form of the verb, with the noun understood). It would be possible also to translate ‘parts’; but it seems that Galen is here considering the state of the body as a whole.

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171 K. Nor, in my view, are slow ones any less to be avoided. For when the body is no longer being moved of itself, there is a danger of its being cooled and densified, if it receives no external assistance to its warming. One should, therefore, employ a massage which is not only fast but also involves many hands, so that, as far as possible, no part of the subject of the massage be left bare. Since, however, the massage ought not to be either slow or hard, oil should be poured abundantly over the subject. This contributes to both the speed and the softness of the massage, while also bringing with it another very great benefit: it relaxes the tensions and softens the parts that have undergone exertion during the more vigorous activities. These, then, are the reasons for avoiding a hard massage. There are different reasons for avoiding a soft one, namely that it does not penetrate within the body, but causes relaxation only in the skin and in the flesh near to it; nor does it squeeze out the residues contained in the narrow channels. This, indeed, is why we employ the practice of tensing, on the part of the person undergoing the massage, and the holding of breath. Now, the massage which is midway between soft and hard – the well172 K. balanced – seems to avoid both the inefficacy of the soft massage and the forcefulness and harmfulness of the hard one. This will be performed by an application of the hands which is so vigorous that the compression from them will be in a way close to the hard massage, but sufficiently relaxed by the amount of fat and the speed of the motion that it becomes completely well-balanced. For fat is a considerable protection against the forcefulness of the application, while the brevity of contact means that the force is reduced to the same extent as is the time. We recommend that one at the same time tense the parts being rubbed, so that all residue between the skin and the underlying flesh be evacuated through the skin. For, if both are slack, it will be no more likely that the residues are moved inside than outside; but if the parts situated below the skin are tensed, all will be expelled, just as though it were being pressed upon by two hands, the one being that which has been laid on by the masseur, the other that of the parts tensed within. 173 K. For these very reasons, the retention and holding of breath is a considerable part of restoration. This is what it is called when we tighten and draw in all the muscles of the chest in the region of the ribs in order to retain our exhalation. For what happens then is that the breath which, under pressure from the ribs, is prevented from being exhaled because of

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the closure of the larynx, 10 is all pushed downwards towards the diaphragm; and, since the liver, spleen, stomach and certain other organs are situated below this, these are all moved outward together with the diaphragm. At the same time one should keep the muscles of the abdomen still, in a state of tension, so that all those parts that lie between are compressed by both these and the diaphragm – as if by two hands – and push out the residue contained within them towards the places which yield to receive them. Now, the parts that lie between are the liver, spleen, stomach, and the forward part of the colon and the small intestine; and the places that are ready to receive the residues that are pushed out are the entire open space of the stomach and the hollows of the intestines that lie in that area. If, however, you leave the muscles of the abdomen completely idle, you 174 K. will evacuate the residues of none of the parts mentioned, but will transfer those in the chest and lungs to below. It is better for them to be transferred there than to remain in those parts, inasmuch as the evacuation of residues contained in the digestive cavity happens more readily than that of those in the lungs and chest. The former are in part easily vomited or excreted as faeces, in part expelled with intensity and force by coughing. If, however, one tightens the muscles of the abdomen in the same way as the diaphragm in one’s holding of breath, the internal organs below the diaphragm will be more completely cleansed, but nothing will be transferred from the organs of breath to those of nutrition, the entire residue remaining in the chest and lungs. I do not, therefore, advocate such holding of breath; and still less so when someone either fails altogether to tighten the diaphragm strongly and forcefully, or draws in the muscles of the stomach area a little. In this case it follows unavoidably that all the vessels and parts within the neck are filled with blood and breath, and that the residues are all carried upwards towards the head, not downwards towards the stomach. 175 K. This may be observed also in aulos-players,11 or when people vocalize either at a very loud volume or at a very high pitch: the whole neck is widened, the face becomes swollen and the head vehemently filled. In this activity, too, the muscles of the abdomen are tightened while the diaphragm gives way to them. All this sort of activity – as was demonstrated in my work on The Voice – is a combination and composite of 10

It should be borne in mind that (as pointed out by Boudon-Millot (2007): 147 n. 1) the Greek term larunx is less anatomically specific than our ‘larynx’, and may include also the pharynx; the same may apply, vice versa, to the Greek term pharunx, below. 11 Cf. Book II, n. 84.

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very great exhalation and of holding of breath. When a great deal of breath is let out all at once, there is very large exhalation, following upon the most vehement tightening of the muscles in the ribcage as well as those of the abdomen, while, in the case of the holding of breath, the same tightening takes place in both sets of muscles, but nothing is exhaled; and in the case of aulos-players and those vocalizing at a high pitch, the muscles are tensed in the same way, but the exhalation is neither completely retained nor carried out all at once, but has a middle disposition. Thus, the tension of the muscles is common to all three 176 K. activities, while what is specific in the exhalations that are carried out all at once is the fast motion of the breath; and what is specific in the holding of breath is the retention; and, in the case of aulos-playing and vocalization, a well-balanced evacuation. The cause of the difference between the three activities is the pharynx, which is opened to the maximum extent when much is exhaled all at once, completely closed when the breath is held, and in a middle disposition in the case of aulosplaying and high-pitched, loud vocalization. Now, it will be necessary to speak of these matters again at a later stage, in our discussion of voice projections.12 The form of it that is suitable for restoration moves the stomach outwards while all the muscles of the chest are under tension, but those in the stomach area and the diaphragm are released; for it is thus that the residues will be carried downwards. The second place, with regard to the restoration of the internal organs below the diaphragm, is occupied by that which tightens the muscles of the stomach area moderately. For the same purpose, too, one should employ those encircling motions with hands clenched which masseurs make around the entire 177 K. stomach, while standing behind the person undergoing massage; 13 another sort are those made around the broad of the back, while standing in front of the subject, with both hands; and yet another those which involve the lungs, spine and sternum of the person massaged undergoing a kind of twisting-together. Similar clenches and circular motions may be used on the lower-back region. All of these bring about tension in the subject, but not all bring about the twisting-together. For

12

There is a very brief further mention of the exercise known as ‘voice projection’ (anaphōnēsis), and of its benefits for the young, growing body, below at V.10, 158,19–34 Ko. (VI.358–359 K.); but one suspects that this is a case of an intention not fulfilled. 13 Cf. Book II, n. 83.

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the motions performed during restoration14 should no longer be continuous, nor vehement; some motions should be performed, but interspersed with massage. Continuous, vehement massages are specific to the ‘building-up’ exercises; those which are neither continuous nor vehement are proper to restoration. So, the person should frequently be rolled up and frequently be stretched out, and frequently also change the person assisting him in the exercise;15 and he should also frequently lie on his back, with each leg in turn folded around the training assistant,16 with a certain degree of tightening, but not a heavy one, and undergo massage from others applying a gentle touch at appropriate 178 K. moments. In this way he will best preserve the heat that has been increased in the course of the exercise, and expel the residues simultaneously with the specific tightenings and motions. And this process is, in my view, greatly facilitated by the holding of breath. For the breath is pushed from all sides and forced to go down into the fine channels, and if it is further subjected to compression and pushed onwards, it finds its way through all of them, at the same time carrying with it some part of the thinned residues. Craftsmen may often be observed in a similar way cleansing out the fine passages in their instruments by blowing into them vehemently. To the extent that this breath is carried forward by the compulsion of force, to that extent, too, things are either pushed forward or swept along by it as it aims17 to pass through the whole pathway: those things in front of it are pushed forward, those to the side are swept along, both being Reading ἐπὶ τῆς ἀποθεραπείας for ἀπὸ τῆς θεραπείας, with Oribasius. The latter reading would mean ‘from the treatment (therapeia)’; it seems clear that apotherapeia, not therapeia, is what is under discussion. 15 It should be noted that the text is somewhat uncertain here, and each of the activities mentioned unclear in detail. The first two verbs, ἐνανειλείσθω and διανωθείσθω, are hapax legomena if taken as they stand, and there are a number of MS variants. But it seems clear that Galen is using words to indicate the rolling up and stretching out of a body. The participial verb translated ‘person assisting him in the exercise’ (προγυμναζόμενον) is cognate with the noun progumnastēs (on which see next note), and must presumably refer to the same person or professional role. Galen clearly envisages a number of different individuals simultaneously assisting with the different forms of both exercise and massage. On this point cf. above, III.2, 75,34 Ko. (VI.171 K.) and below, III.6, 87,19 Ko. (VI.197 K.), where it is mentioned that a number of different people are performing the massage. This picture is indeed made even clearer by another text, Puer. Epil. 3 (XI.364–365 K.), which mentions five people performing a massage; and cf. Alexander of Tralles I.15, 557–559. 16 The progumnastēs  was a slave who assisted his master in performing his exercises; cf. Seneca, Epistulae morales 83.4. The role is mentioned again below, III.4, 82,32 Ko. (VI.187 K.). 17 I follow the reading of M, ἐφιεμένου: that is, it is the breath that aims to pass through. The other MSS, followed by Koch, have ἐφιέμενα, making the participle qualify the ‘things’; this seems to me to obscure the distinction intended between the breath, which is as it were the agent, and the other things, which are pulled or drawn along in its wake. 14

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compelled by the force of the motion. So, too, the best trainers employ 179 K. the holding of breath, as well as the above-mentioned restorative massage, between the actual exercises, thus both resting them when they begin to tire and providing a brief cleansing-through of the channels, so that the body may be both well-breathed and clean for the next exertions. 15 There is, indeed, a danger that a trainer who has taken no care of such matters will obstruct the channels rather than cleanse them. Extremely vehement motions of matter have opposite effects when carried out at different times and in different ways: the effect of obstruction, when the matter subject to motion is thick, large in quantity and moved all at the same time; the effect of cleansing, when it is small in quantity and fine in 20 consistency18 and when it is not under pressure and compulsion causing it to be evacuated all at once. This effect is apparent also in all instruments19 in the outside world, and wicker baskets: all superfluous stuffs are washed away and removed from them, not when, while those previously present are still coming out, other stuffs are forcefully brought up against them – in that case there is a risk that the stuffs coming out will 25 become wedged and forced up against each other and so obstruct the pathway – but when those previously present have already been evacu180 K. ated and others are evacuated in turn. Why, indeed, should one be surprised at these small-scale effects, when even people coming out of a theatre all at once are held up at the exits? On these grounds, then, I 30 approve of those who employ restoration in the middle of the exertions, and especially so in the case of those who are training for the ‘heavy’ contests, as they are known. We shall, however, return to these matters. The person who is our subject at present has as his aim not the athletic form of good-condition, but simply health. This person, then, has no need to perform a large number of exercises, nor to eat under compulsion, nor, indeed, to eat a large amount of pig meat, or of such food as is eaten by the heavy 80 Ko. athletes. For all these reasons, there is no danger that such a person’s channels will become obstructed, if his preparation is carried out well – that is to say, with the appropriate massage and with exertions continuing 18

Literally ‘fine-parted’ (leptomerēs): for Galen this is an important quality of stuffs applied to the body, enabling them to penetrate it more readily; on this mechanism see especially Debru (1997b). 19 I read κατά τε with VR (= ‘also in the case of ’) for Koch’s κατά τι (‘in some part/aspect of ’); but it seems that something else must have gone wrong in the MS tradition: ‘all instruments’ seems far too broad for what Galen intends, especially when coupled with the very specific ‘wicker baskets’. It seems likely that either some word specifying more precisely the instruments or utensils meant has dropped out before ‘all instruments’, or the word ἁπάντων (‘all’) is itself a ­corruption, concealing the original word referring to these utensils.

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at a low level and at short intervals. For the heavy athlete, meanwhile, there is a danger, because of both the quality and the amount of the 5 foods, that if everything is not carried out perfectly the channels will be 181 K. obstructed rather than cleansed in the course of the exercise.

Bathing 3. Enough, then, on restoration. Let us move next to bathing – with just one further word on the present subject. That is, that anyone who can communicate these matters in fewer words may accuse us of verbosity. If, however, someone believes himself to have made his account concise, while he has in fact passed over some absolutely necessary theoretical principle, or a demonstration which establishes such a proposition, he should be ashamed rather than delighted by that kind of concision. Now, I could have written a whole book on the subject known as restoration, but did not think it right to do so, preferring to cut down the length of this treatise as much as possible. If I had embarked upon the enterprise of refuting all the false statements made by the majority of writers, I would have ended up with something pretty substantial and impressive, in terms of word-length. I believe, however, that – from the point of view of any person of intelligence – I have provided the necessary materials, in what has been demonstrated above, on which to base such a refutation. When, for example, Asclepiades says that the holding of the breath fills the head, it is possible, by proceeding from the specifi182 K. cations which I made a little earlier, showing the distinctions within the holding of breath, for anyone who so wishes to produce his own refutation. Similarly in the second book, it would certainly have been possible for me too to give a thorough exposition of all the individual exercises, and so to extend the length of the discussion – as certain others have done, in particular the one who dealt with this whole study best of all, Theon of Alexandria. Theon wrote four books about the individual exercises; and I could have discussed all those ones too, and would have been able to communicate them better than he did, while also mentioning many other exercises which are common to tasks. His concern was with how best to instruct athletes in exercise, and so he spoke at great length on the exercises performed in that context, whereas one might also, if one wished, give an account of all the exercises performed in the context of all the specialized skills. Let this, then, be my response to anyone who may be irritated by the length of the treatise.

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4. It is now time to give a thorough account of baths, first, of those 183 K. which consist of heated fresh water, since the use of these is the greatest; next, of those consisting of cold water, and then of naturally-occurring waters, as they are known, of which some are well-mixed, some steaming, some tepid and some completely cold.20 The capacity of hot fresh water, when this is well-mixed,21 is wet and hot; when it has become tepid, wet and cold; when it has been made hotter than appropriate, hot but no longer equally wet. It causes bodies to shiver, and their channels to be densified, so that they do not benefit from the external moisture, nor are any of the internal residues evacuated. But let us start with the well-mixed ones. In themselves, these in all cases moisten and heat;22 sometimes, however, there is some incidental feature, which causes them to disperse the fluids,23 to fill the parts of the body with some superfluous flow of liquids, to soften, to subject to coction, or to invigorate or destroy the capacity.24 Here their quantity, too, is a very significant factor. It is possible to list many other effects of well-mixed baths of drinkable 184 K. water, consequent upon those already mentioned. Let us discuss those relevant to the present treatise in the briefest terms possible, deferring, for the present, their function in disease. As regards their use in the context of health, then: the young man who is our subject in the present discussion should first have exercised in the manner already mentioned. In his case, in fact, there is little benefit from bathing; for he has already gained everything from the well-balanced exercises and from the restoration mentioned. If, however, bathing is employed well, it too may form part 20

‘Steaming’ translates zeonta, which can also mean ‘boiling’ (but see Book II, n. 58), and in the context of natural springs may refer to their ‘bubbling’; for hot ones see above, I.15, 36,20 Ko. (VI.79 K.), with note. On naturally occurring springs and their various properties, cf. Note on translation, p. xxiii. 21 I preserve this literal translation for eukratos, though it risks giving a misleading impression in English: what is meant is the good balance between the fundamental qualities (hot, cold, wet and dry), understood by Galen as a blend or mixture (krasis) in the sense of the balance. The conceptual framework of mixtures, and of the kind of effects of bodies upon each other described here, is elaborated especially in Mixtures. 22 For sumbebēkos ‘incidental property’ cf. Book I, nn. 53 and 123. 23 The word here is hugrotēs, literally ‘moisture’. This, and the cognate hugra (‘wet [things]’), are sometimes used by Galen synonymously with chumoi, his more usual term for the ‘fluids’ that occur in the body. Cf. e.g. below, IV.2, 105,27 Ko. (VI.239 K.). (Further on fluids see Introduction, section 4.5.3.) 24 The word translated ‘flow’ (rheuma) may have a very general application, but is typically used by Galen to refer to the sort of fluids built up in old age. The term dunamis here refers to the strength or ‘capacity’ of the body as a whole, rather than in the more usual technical sense encountered so far (on which cf. Introduction, section 4.5.2 with n. 64).

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of the restoration, softening the hard parts which have undergone tension and dispersing any residue or secretion25 retained inside, close to the skin. But the person who is our subject in this discussion is unlikely to need either of these; for no secretion of soft flesh or fat is likely to have arisen during his exercises. Such things tend to follow from unbalanced, vehement motions; and all his residues have been evacuated, and his hard 185 K. parts softened, during the time of the restoration, so that he needs to wash off the sweat and the dust (if indeed he has used this), rather than to be heated in the bath. He requires, therefore, only to walk as far as the water tank, not to spend time in the baths26 like those who intend to heat themselves without having exercised. Nor, indeed, need he spend much time in the pool, but, after washing himself off, as stated, he should move straight on to the cold water. This, too, should be well-balanced in keeping with the well-balanced nature of the body. The circumstances requiring use of very cold water, or of tepid, as it were sun-warmed, water, will be discussed later.27 As regards the body with the best nature, it has already been stated that one should not wash it in cold water so long as it is still growing,28 in order to avoid impeding its growth; when, however, it has grown sufficiently, one should accustom it to this too; for it strengthens the whole body and makes the skin dense and hard, and this is the strongest protection against harm from external sources. One ought to know, above all, how a person may begin the process of 186 K. cold bathing without receiving any harm from the sudden change. For there are many who because of a bad start have been put off the whole practice of cold bathing to such an extent that they cannot bear to entrust themselves to people who employ it, even when these people do 25

Suntēgma is literally a product arising from suntēkein, melting or liquefaction in the body; it is conceived as similar to perittōma, a residue or superfluous stuff requiring expulsion from the body (on which see again Introduction, section 4.5.3). See e.g. Nat. Fac. I.13, 130,22–24 H. (II.41 K.) and PHP VIII.6, 522,30–32 DL (V.701 K.) and cf. also e.g. Aristotle, Gen. an. I.18, 724b26. The cognate verb is also used, reflexively, for ‘wearing oneself out’: see Book VI, n. 28. 26 ‘Water tank’ translates dexamenē, literally ‘receptacle’ or ‘vessel’, but in context used to refer to the water tanks of different temperature in a bath house (cf. MM VIII.2, X.536 K., where immersion in both the hot and the cold dexamenē is mentioned). ‘Baths’ translates balaneion, the term used standardly both for the bath house and more generally for the activity of bathing. By ‘walk as far’ as the water tank Galen would seem to mean to indicate a quick dip, rather than literally only approaching the water, especially since the kolumbēthra (translated ‘pool’) in the next sentence appears here to be synonymous with dexamenē. (Cf. MM VII.6, X.473 K., where kolumbēthrai are favourably compared with pueloi, apparently small bath tubs for domestic use.) Cf. below, n. 67 and fig. 2; and for more detail on Roman bathing practices see Yegül (2010). 27 This appears to be another unfulfilled promise. 28 Cf. the mention of this as a practice of the Germans at I.10, 24,21–34 Ko. (VI.51–52 K.).

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so quite safely. Now, the appropriate time is the beginning of spring, so that there may be a substantial habituation over the whole period between then and the winter. Furthermore, the day on which one starts should be as windless as possible, and also the hottest kind of day for that time of year. One should of course also choose the hottest part of that day, and the gymnasium29 with the best mixture. Such, then, is the preparation, as far as external factors are concerned. As for the actual body which is to employ the cold [water], this should have the following preparation. In terms of age, it should be roughly in the middle of the fourth seven-year period, and should not have been altered in any way through any temporary cause on the day in question or on the night before that, but rather should be in the same healthy disposition in which it was initially. As regards his soul, too, the young man who is about to use the cold should, at this time more than ever, be good-­spirited and confident.30 187 K. Let him then first be massaged with cloths, for a longer time than previously; and let the massages be more vehement than before, and performed with harder material. It will be no bad thing, also, if the training assistants carry out the massage wearing stitched gloves, so that the action becomes more even. Next, he should be massaged with oil, in accordance with his previous custom; then, engage in the same exercises as before, in terms of amount, but with greater speed; then, he should enter the water while quickening, rather than slackening, his motion, or indeed jump in all at once. In either case his aim should be that, as far as possible, the water cover all parts of the body at the same time; to come into contact with it just superficially leads to shivering. The water should be neither tepid nor unbearable and ice-cold. The former will fail to produce the recall of the heat, while the latter will cool and shock those who are not used to it. In due course, our young man may at some point

29

The term here is gumnastērion, a rare variant for gumnasion. But in fact Galen seldom uses the term gumnasion in any case to refer to the building or institution, as opposed to exercise in general; cf. II.2, 39,35 Ko. (VI.85 K.) above, discussing the term itself, a rare exception. On the institution of the gumnasion see Introduction, sections 3.1–2. 30 The term euthumos (‘good-spirited’) is cognate with thumos (‘spirit’ or ‘rage’) and thus usually (but cf. Book II, n. 48) connotes a good, but not excessive, operation of that competitive, energetic part of the soul within the Platonic–Galenic tripartite model. (On the presence of the tripartite soul throughout the text, see Introduction, section 6.5.) The less common term phaidros (‘confident’) may refer both to the brightness or sparkle of a gaze (Protr. 3, 87,10 B., I.5 K.) and to a positive, optimistic expression or outlook (e.g. Praen. 3, 84,16.26 N., XIV.615–616 K., describing a doctor’s attitude in relation to a prognosis; cf. Aff. Pecc. Dig. I.10, 36,3 DB, V.54 K.). ‘Serene’ or ‘radiant’ would also be possible (less prosaic) translations.

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use even this latter kind of water, if necessity dictates; but on the first day 188 K. he should completely avoid anything which is excessively cold. On coming out of the water he should be further massaged with oil, until the skin is thoroughly heated; after this, one should administer more food than usual, but less drink. In fact, even if you gave no such instruction, he would do this of his own accord, if everything has been carried out correctly. People have greater appetite after cold bathing, subject food better to coction, and are less thirsty. They also arrive for exercise on the next day clearly better-conditioned:31 the volume of their body is the same as it was previously, but it is closed up, more muscly and taut, and the skin harder and denser. He should, after this, perform everything in the same way on the second, third and fourth days. Then, in due course, we will instruct him to get into the cold water a second time, after the massage which is carried out after the first bath, in the way previously mentioned. I do not, however, recommend that he do so a third time too, as certain individuals have been known to instruct. The second bath is indeed quite sufficient, in my view, especially since we may instruct him 189 K. to remain in it as long as we wish. Here too the limit of the time spent in the water must be derived from one’s day-by-day experience. If, after coming out of the water, the subject quickly acquires good colour when massaged, then he has remained in the water for a moderate time; if he remains difficult to heat and lacking in colour for a longer time, he has had an immoderate contact with the cold. By paying attention to the indicators of flesh colour, you will easily find out whether he ought to spend the same amount of time again in the cold [water], or whether this should be either increased or decreased to any extent. Enough, then, on the subject of cold baths for the person with the best nature.

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Rectifications of errors; fatigue states 5. It is now time to give a thorough account of how best to bring about 84 Ko. rectifications of the errors that arise: for even if someone has the most faultless possible bodily constitution and is removed from all life’s concerns and lives for himself alone, nonetheless it is quite impossible that neither he nor his supervisor ever makes any error at all. It is 5 190 K. certainly likely that a young man focussed on physical training32 will fall 31 32

I.e., more in a state of euexia: this is the comparative adjective cognate with that noun. The term is gumnastikos, which may have the negative connotations which Galen associates with athletics, especially in Thrasybulus; but it seems possible here that he is also thinking of this as one of the possible legitimate lifestyle choices outlined above, I.12, 28,32–29,19 Ko. (VI.61–62 K.).

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victim to an error such as fatigue sooner and more often than others – and also on a constant basis. About fatigue many statements have already been made, not just by doctors or trainers, but also by philosophers: even Theophrastus, for example, has a whole book on the subject.33 Here, too, in the interests of economy of space, I have decided to pass over some people’s false statements, but to give a thorough account of the matters most necessary for health-practitioners, together with the appropriate demonstrations. First among these is an account of the notion; for it is right to begin with the notion, and so proceed to the essence.34 Some hold that the notion of fatigue consists in one’s impression, either in all the limbs or only in those which have been exerted, that they have been burnt and undergone tension; some that it consists in the fact that people acquire some uncomfortable and unpleasant sensation of themselves in their motions, a sensation which some have stated to be inexpressible in words, while some have applied to it the term ‘wound-like’.35 There are, too, certain others who believe that we have the sensation that our limbs have been crushed and are inflamed. There are also some who make a 191 K. composite of these simple states: that of tension, the ‘wound-like’ and the ‘inflammation-like’; others make a composite of two of them, either of the wound-like with that involving tension or of the inflammation-like with either one of them, individually. The result is that there are in total seven beliefs concerning the notion associated with fatigue. All of them are true in part, but they are not so without qualification, and do not give the whole picture.36 Whether a wound-like sensation arises during motion, or an inflammation-like one, or whether people have the impression of burning or of tension, or whether certain of these arise in a pair, or all of them coincide – each of these states is termed fatigue. There are,

33

A short work on this subject by Theophrastus has survived; it has been edited by Sollenberger in Fortenbaugh, Sharples and Sollenberger (2003). 34 For this distinction, and the related one between ‘notion-based’ and ‘essence-based’ definitions, see Thras. 1, 33,10–11 H. (V.807 K.), with n. 4; and cf. below, III.7, 89,6 Ko. (VI.201 K.). On ousia in Galen see also Book I, nn. 53 and 55. 35 For Galen’s views on the terminology of pain, and for problems regarding its inexpressibility (and the inexpressibility of experience more broadly), see Reinhardt (2011); Roby (2016); Lewis (2022); Singer (2022a). 36 I follow (with something of a paraphrase) the text printed by Koch, τὸ σύμπαν δὲ οὐχ ἁπλῶς, although the phrasing seems slightly odd, and there are some variants and doubts: Koch suggests deleting ἁπλῶς (‘without qualification’), and there is a suggestion that the word ἀληθεῖς (‘true’) should be repeated at the end of the phrase; but perhaps all that is needed is to supply that ­repetition mentally to the phrase as it stands.

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therefore, seven distinct types of fatigue in all, three simple and four composite.37 The rectifications of bodies in these states are to an extent specific to each state and to an extent common to all. We shall speak about these in order, but let us first speak of the state which accompanies fatigue, which some are deceived into calling fatigue. The quality of this state, as well as its indicators, will be shown more clearly, if we first find the essence of 192 K. each of the fatigue states. So far, only the symptoms have been mentioned; the impression of burning and tension of the parts, as well as the arising of an inflammation-like or wound-like sensation during motion, are not states but symptoms. As to the states of the actual bodies – the states in the case of which such symptoms customarily arise – there are three simple ones, and four composite. Now, the wound-like state arises in the case of build-up of residues which are both fine and acrid; and there are two causes of the generation of these during exercise: either because of the thicker residues being dissolved and thinned, but not completely expelled; or through the melting of some fat or soft flesh. The skin and the flesh are inevitably pricked and, as it were, pierced by such fluids, being, as they are, fine and acrid, so that this sometimes even gives rise to shivering and rigor, in cases where they are markedly acrid, and also large quantity.38 This, then, is the basic nature of what is known as the ‘wound-like’ fatigue. When, however, the parts seem only to be under tension, but there is 193 K. no wound-like sensation, in this fatigue there is no residue worth mentioning contained in the bodies, but a certain state is brought about in the muscles and the nerves, arising after the more vehement tightenings produced during the exercises; and this state indicates the capacity of the effective cause. For it happens during these more vehement tightenings that all the fibres of the muscles are tensed, but that not all of them tire equally. Those which are in alignment with the tension do so most; but those which are at a more oblique angle to it are straightened out less by the tension. In the case of these latter, then, there is no potentially attendant danger, whereas in the case of those which have been extended to a greater degree, so that they come close to being torn apart, there 37

Galen seems to say that each of his predecessors in this area acknowledged as ‘fatigue’ only one of the seven types of kopos which actually exist – the wound-like, the tensed and the inflammationlike, and the four further types which arise from the combination of any two, or all three, of them. See below, II.9, 95,18–36 Ko. (216–217 K.) with n. 62. The three simple kopoi here correspond to the first three listed there. 38 Galen associates the action of ‘acrid’ (drimeis) and biting fluids, at a certain level of intensity, with shivering and rigor; see Book IV, n. 8.

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remains a certain state similar to that which arises during the activity: they still give the impression of being tensed, even when this is no longer the case. The third distinct type of fatigue, in which we have the sensation that the parts of our bodies are being crushed or suffering inflammation, usually 30 arises when the muscles, having undergone considerable heating, draw to themselves some of the residues surrounding them. If, further, this 194 K. same state arises in respect of the tendons or nerves, this ailment people call ‘bone fatigue’, referring the sensation, because of its depth, to the 86 Ko. parts lying deep within. For the skin is on the surface, while the muscles, which envelop the bones, have second place, and the tendons are conjoined to the bones; it is therefore natural that when the tendons undergo one of the stated affections the state seems to be occurring deep 5 within, and to affect the bones. These, then, are the three simple distinct types of fatigue; there are, as previously stated, four composite ones arising from them; and of these we shall speak next in order, once we have completed our account of the simple ones. For there is actually also another state, which deceives some into considering it a form of fatigue. This arises from the excessive drying of 10 the muscles, so that the entire body appears parched and drawn in and is slightly reluctant to move, but there is none of the other experiences previously mentioned – the sensation of a wound or of tension, still less that of inflammation. The visual appearance of this latter and of the state 15 195 K. now under discussion are quite opposite. This one makes the muscles parched and drawn in, while in the inflammation-like fatigue they appear in greater volume even than that which is normal. There are, then, four 20 states in all, each requiring its own proper rectification.

Causes and treatments of the four fatigue states 6. Let us then start with that kind of fatigue which brings with it the ‘wound’ sensation – that which, we said, comes about through acridity of residues. This kind of fatigue arises especially in the case of bodies with bad fluid, which are full of residues. It may also result from a recent lack of coction, in cases where a person has exercised rashly or spent time in the sun. It is not, however, impossible in some cases for it to arise in a 25 body which enjoys good fluid, and with no lack of coction, through an excess of unbalanced exercise. It is also typically brought about by motions which are swift and numerous. In people undergoing this kind

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of fatigue the skin appears thick and prone to shivering, and they agree in experiencing, during motion, a pain similar to that of a wound – some in the skin only, others in the flesh beneath it. The cure of this consists in 196 K. what is opposite to the state: one must disperse the residues, and then the ailment is at an end. This will be achieved by soft massage, large in quantity, applied with an olive oil which has no astringent effect (Sabine oil, for example, in particular). Most contraindicated for this state is that from Spain or Iberia, which is known as Spanish, as well as that known as unripe or raw-pressed.39 In brief, any tart olive oil is not suitable: you may discern its capacity by taste, even if you have no previous experience of it.40 So, for example, in Macedonia I once tasted the olive oil which is produced in the region of the Aulon around the Strymon, and recognized it as having the same capacity as the ‘Hispanic’.41 Moreover, you will also recognize the capacity of the other oils in the same way – both those which are so called by extension and those which are prepared using flowers, roots, herbs, leaves, shoots or fruits.42 Enough has been said about these in my treatise on drugs; and it will be stated again in the present work, at the appropriate time. 197 K. Now, however, it is sufficient to state simply this, that the sweetest oil that there is is the most suitable for present purposes. This should be used abundantly, with a large massage, on the first day, so that the suspected fatigue does not arise at all, and on the second day to dissolve such fatigue, if it has already arisen. And it is dissolved by the ‘restorative’ exercise, in which it is possible to perform motions which are wellbalanced in their amount and rather slow as regards their quality, with 39

Galen mentions Sabine and Spanish oil, as well as this ‘raw-pressed’ oil made from under-ripe olives, with similar remarks about their releasing or constrictive properties, elsewhere too; see e.g. MM XI.26 (X.790 K.), SMT II.16 (XI.498 K.) and VI.5 (XI.868–870 K.); and cf. Caelius Aurelianus, Cel. Pass. I.9.67–68, 60 Bendz. (On the possible overlap with Methodist thought in this area, see Introduction, section 2.3, n. 24.) 40 Galen gives an interesting discussion of the extent to which one may ‘recognize’ a taste on the basis of a verbal account of it, even when experiencing it for the first time (giving as one example his own first encounter with the famous Falernian wine), at Dig. Puls. I.1 (VIII.774–775 K.). 41 Galen mentions his investigation of plant and food properties in Macedonia and Thrace elsewhere too, e.g. at Alim. Fac. I.13, 236,18–237,19 H. (VI.514–516 K.) and SMT VIII.17 (XII.114 K.); and he explains, at SMT IX.2 (XII.171 K.), that he went by land through Thrace and Macedonia in the course of his second voyage from his homeland to Rome. Further on Galen’s voyages, and their (sometimes uncertain) chronology, see Boudon-Millot (2012): 103–119; Mattern (2013): 99–105. 42 The word elaion is derived from the word for olive, and thus etymologically or ‘properly’ refers to olive oil; but other oils were also so termed ‘by extension’, as in fact Galen explicitly discusses at SMT II.7 (XI.483–484 K.). Galen is making a distinction here between oils made from other fruits or nuts than the olive, and oils prepared by the infusion of some other plant. Cf. n. 68 below.

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frequent breaks, during which the person should be massaged by the simultaneous touch of several people, so that no individual part of him be cooled down, and so that the residues be dispersed very quickly. One who has a build-up of residues in and beneath the skin should have a very large amount of massage, whereas in the other kind of fatigue,43 in which there is a greater build-up in the muscles, the concentration should be on self-initiated motions; for in such cases massage alone is not sufficient to disperse the residues. For these require not just the pull44 of some external agent, but also the simultaneous push of another, internal, 198 K. agent. What pushes them, in fact, is the hot which is kindled during motions, as well as the breath which is simultaneously expelled,45 and the tightening of the muscles themselves, and, in addition, the capacity of separating-off that is within each of the parts. The second kind of fatigue, meanwhile, in which there is the sensation of tension, has as the aim of its cure what is termed by Hippocrates ‘slackening’; for this is opposite to tension, just as softening is opposite to hardness. This is why Hippocrates said: ‘Of hard skin, softening; of tensed skin, slackening.’ For what is soft is opposite to what is hard, and what is slack is opposite to what is tensed. There is a different method of slackening what is tensed in other states, which we have discussed in the fifth book of our work on The Capacity of Simple Drugs; but in the case where that state arises through exercise, this is achieved by a massage which is both soft and small in quantity, using sweet, sun-warmed olive oil, and with total rest, or lack of movement, or well-mixed baths and a considerable length of time spent in hot water; thus, even if you bathe the subject twice or three times you will do him considerable benefit. Such persons also require the application of oil after bathing, before they 199 K. dress; and, if the oil happens to get washed off by some sweat, they need a fresh application. They require an application the next day, too, on rising after sleep, and the massage should not be hard, nor should the oil used be extremely cold. Such fatigue befalls men with good fluid who have exerted themselves in exercises involving a good level of tension, rather than swift ones,46 43

Galen here means the ‘other’ of the two which involve residues, namely the third or ‘­inflammation-like’ variety of fatigue. 44 The verb helkein (‘pull’) here is taken as the opposite of ōthein (‘push’); it is also cognate with helktikē, usually translated ‘attractive’, the name of one of the four natural capacities within the body; cf. Introduction, section 4.5.2 with n. 64. 45 Sunekkrinomenon: Galen refers here to ‘expulsion’ through the channels (poroi) in the skin, not through exhalation; for his understanding of poroi see Introduction, n. 58. 46 Cf. Book II, n. 90.

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and it renders its sufferers terribly reluctant [to move], and stiff; but they do not appear dense and prone to shivering, as do those who were 15 mentioned a little earlier. On the other hand, they are seen to be no less drawn in and parched than those, and they seem to those who touch them hotter, not only than those who have the wound-like state, but also 20 than themselves when healthy. 7. The third kind of fatigue arises after extremely vehement motions; and it is the only one which raises up the muscle volume beyond what is normal, so that in these cases the state is similar to inflammation. By the same token, these people experience pain when touched, and are also rather hot to the touch; they also experience pain if they attempt to move through their own effort. This kind of fatigue generally befalls people 200 K. who are unused to exercise; but it has been known occasionally to occur in people who are used to exercise, in cases of large amounts of extremely vehement motion. Its cure involves three aims (and these are essentially the same in all cases of inflammation): evacuation of the residue, rest for what has been tensed and cooling of the fiery quality. A large quantity of lukewarm oil, soft massages and a very long time spent in well-mixed water are the cure for this kind of fatigue. If, indeed, the water is rather on the lukewarm side, it will be of even greater benefit. So, too, a considerable period of rest, constant application of oil, and all things which rest and soothe what has become tired, and which disperse what is superfluous. One might perhaps think that this kind of fatigue is not a simple one, nor a third in addition to the stated two, but that it is rather a composite of them both, consisting simply of tension of the nerve-like bodies and of the ‘wound’ sensation; for (the argument would be) heat is, in another way, a natural property of fatigues of this sort,47 as also of each of the 201 K. others already mentioned, but is not actually constitutive of the notion or the essence.48 Yet, in fact, the presence of abnormal volume is a peculiar property of this kind of fatigue alone, not of the others; and the quality of the sensation of pain is not the same in the ‘tensed’ kind of fatigue and I follow Koch’s ἄλλως μὲν; but Gadaldini’s Juntine of 1565 reports ἄλλοις μὲν as the reading of the antiqui Graeci; and this, though it would produce slightly unusual syntax in apposition to τοῖς τοιούτοις, may possibly be correct; the sense would then be: ‘heat is a natural property of some fatigues of this sort’. 48 Cf. above, n. 34 and Thras., n. 4 on the distinction between ennoia and ousia (which he here, however, seems rather to conflate). The term here translated ‘constitutive’, sumplērōtikos, literally ‘filling’ or ‘fulfilling’, is not common, but was apparently used by both Epicureans and Stoics in a sense similar to the present one. 47

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in this one. There, subjects believe that they are undergoing tension, while those in the grip of this kind of fatigue believe that all their nerves, even as far as the bones, are being crushed. So, in these respects it has a peculiar distinction from the other two kinds of fatigue, and is not simply a composite. There are, then, these three states, or dispositions – or whatever other term one may prefer – of the body. And there is a fourth one, too, which is similar to fatigue but is not in fact fatigue, in that it does not have either the state which is similar to a wound, nor that which is tensed, nor the inflammation-like one, nor indeed does it bring with it either any shivering or pain, nor reluctance to move, but simply thinness together with dryness. Now, this arises in bodies which enjoy good fluid and are involved in physical training, when they have engaged in immoderate exercise and have not undergone a good restoration. Thus the residues are dispersed, and what has been 202 K. tensed is slackened, and nothing else remains in the body except for dryness, which they have acquired from the immoderate motion. During the first day this body requires no change from what went before, except for hotter water, which will slightly draw together, heat, and improve the tension of, the skin; and, during the second day, a short, soft and slow restorative exercise, in terms of both motions and massage, and a water tank49 which is equally hot. These people should jump immediately into cold water, so that the tension, as well as the heat, remains in their skin. For they are dispersed still less in the subsequent period, and they take nourishment into flesh and skin easily; you will find nothing better for them than this, since they have no peculiar state apart from the thinness and dryness of the flesh. Such a body surely needs to be built up and moistened, and both these things are best achieved for it by moistening nourishment.

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203 K. 8. Now that I have mentioned the regime which follows upon bathing, it 90 Ko. will be no bad thing also to deal with matters related to fatigue states. Now, the wound-like fatigue, if it has undergone an adequate restoration, requires normal nourishment, or nourishment which is slightly lighter than that, or indeed both moister and smaller in quantity; if, however, 5 during the restoration it transmutes into the fourth kind of state (which in fact happens very frequently), in that case it requires both bathing and nourishment. The tensed state, meanwhile, requires a smaller nourishment to an even greater extent, and the inflammation-like kind requires 49

Cf. n. 26 above on the reference of dexamenē.

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the moistest and smallest nourishment of all, which should also contain some cooling quality. All persons suffering from fatigue have equal need 10 of nourishment containing good fluid, which, of course, is the sort which the young man who is our present subject would be using also while healthy. What is viscous in nourishment should be avoided both in the wound-like and in the inflammation-like kinds of fatigue, since this will hinder the dispersal of the residues. In tensed fatigue, however, such foods may be given, provided one diminishes their amount. It is no 15 204 K. wonder, then, that there is great dispute, not only amongst lay persons, but also amongst specialists, and between specialists and lay persons – all failing to agree on the subject of exercise, massage, baths and diet in the case of people suffering from fatigue. So, for example, one may hear people claiming that fatigue must be dissolved by fatigue; others claiming that a rest will cure the tiredness; others that sufferers from fatigue must 20 employ a reduced diet; others, that one should not only remove nothing from the usual diet, but in fact administer more, to exactly the extent of the person’s increase in exercise (on the grounds that the nourishment should be proportional to the exertion); still others, that one should neither add to nor reduce the nourishment. So, too, some bathe them in 25 well-mixed water, some in hot, some in lukewarm. Experience leads each person only to that which he happens to have frequently observed; but such theoretical statements – which, as was shown earlier, are incomplete from the point of view of each individual case – teach of only one fatigue state, passing over the others as if non- 30 205 K. existent, and give instruction in the rectification only of that one which they recognize.50 So, for example, it can even be true that ‘fatigue is dissolved by fatigue’,51 in those cases where it appears to be necessary to perform the same amount of exercise on the following as on the previous day; and also true that the cure of fatigue lies in rest. The former approach is obviously beneficial in cases of residue-based fatigue, and 35 especially where the residues are contained in the muscles, the latter in cases of tensed and inflammation-like fatigue. It is true, too, that sufferers 50

Cf. above n. 37, with related text, for Galen’s account of the incomplete nature of his predecessors’ accounts of fatigue, which he presumably takes to arise from the partial nature of their ­individual experiences. There is also an allusion here to the distinction between the purely ­experience-based approach of the Empirics and the approach which is also informed by theory (although his direct target here is those who use theory incorrectly, and with inappropriate generalization, rather than those who actually refrain from theoretical statements); cf. n. 64 below. (For Galen’s summary account of this distinction, see Sects for Beginners.) 51 It seems likely from the syntax here that Galen is quoting or paraphrasing a mantra that was in use amongst some trainers.

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from fatigue should have a reduced diet: this has been seen to be of benefit with inflammation-like fatigue. True, too, that one should give the usual diet: this has been observed to be the correct course in the case of wound-like fatigue, during restoration; and also true that one should take more food, in the case of the state which appears similar to fatigue, into which there is often a transition from the wound-like. It is true, equally, that one should bathe in well-mixed water in the case of residuebased fatigue; and true that one should not bathe in this in the case of 206 K. inflammation-like fatigue, which requires lukewarm water, nor in that of the state which is similar to fatigue, which requires hotter water.52 Some think such a state too to be a form of fatigue. Certain others refrain from saying what kind of state it is; but where there is some suspicion of the onset of fatigue, they advise the use of hotter water in the bath, adding as a reason – as we stated before – the claim that such a bath helps to bring about either distribution or nutrition. Yet they do not instruct us for what reason distribution and nutrition would be able to hinder the fatigue – nor, indeed, do they write what kind of thing the fatigue state is in the first place. So, most of them have said nothing on this point, but some who have dared to say something have declared it to be dryness. Now, to treat dryness with nourishment (and in particular with a moistening nourishment, although most of them do not even make this addition) is most correct; it is not, however, either a cure for or a prevention of fatigue. When, however (as has been stated), the parts 207 K. have been made drier, but there is no tension in them, nor fine, acrid residues, nor an inflammation-like state, then, to be sure, one should build up those parts that have been dried through evacuation with moistening nourishment; for if you do not build up such a person adequately, you will see the body become thinner and drier on the subsequent day. And some, taking this state to be a form of fatigue, believe that they have prevented its inception by a fairly hot bath and plentiful nourishment.

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Further on the treatment of fatigue; criticisms of Theon It does seem remarkable, though, that some, including Theon himself, fail to recommend the same cure for fatigue when it has actually come about. For if one takes the state which I just mentioned to be fatigue, 30 one should both dissolve it and prevent it from arising by the building I omit the negative, οὐ, from this last phrase, as seems surely required by the sense. (Linacre ­similarly translates with a positive statement: ‘hi namque calidiores volunt’.)

52

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up [of the body], while if one takes it to be one of the other, genuine, fatigues, the person should be nourished very sparingly in all cases – both cases of expected and cases of already existent fatigue. Nor is it possible to say that the fourth state, which is parallel to fatigue, is typi- 35 cally converted into one of the three, if it is not rectified on the first day through good nourishment. If its only actual feature is dryness, then no 92 Ko. 208 K. greater thinness will follow; but if some hotness is there too, there is a danger of fever. Fatigue and fever are indeed not the same thing, even if it is certainly the case that some of those who are in a state of fatigue do become fevered. It strikes me, then, as remarkable that Theon, in the fourth book of his account of individual exercises, in which he deals with the ‘complete’ 5 exercise, writes as follows: When, as very frequently happens, some fatigue arises on the next day in people who have undergone such exercise, steaming-water bathing53 averts the tendency to fatigue, firing up the surface, so that this, in the manner of a cupping instrument, draws in the nourishment that is taken and 10 cleaves it apart for the fatigued nerves.

Here the author has – apart from anything else – introduced some sort of riddle in the phrase ‘cleaves it apart’. This could be interpreted as follows: ‘so that the surface, in the manner of a cupping instrument, draws to itself the nourishment and provides a portion of it to the nerves’; but also in the opposite way: ‘so that the surface, in the manner of a cupping instrument, draws to itself the nourishment which is being carried towards the nerves,54 and divides it up’. According to the former state- 15 209 K. ment, then, the skin (this, I take it, is what he means by ‘surface’) by being heated is raised up in a way that conduces to the good-­ nourishment, by the nerves;55 on the latter, it conduces to reduction of nourishment.

53

Zestolousia is derived from the adjective zestos (‘boiling’, ‘seething’; cf. Book II, n. 58). It could more simply be translated ‘hot bathing’; but one must do justice to the facts (a) that zestos is more specific than just ‘hot’, and (b) that this is an unusual and technical term, extant only in Galen (apart from one later, derivative medical source), and attributed by him exclusively to Theon. Cf. also above, n. 20. 54 N.b.: I here use the standard translation ‘nerves’ for neura; but one should give the caveat that, even in Galen, the equivalence between neuron and what modern science identifies as nerves is not wholly straightforward, and that in earlier, and less anatomically expert, authors (very probably including Theon), it included also the sense of ‘sinews’. 55 It would also be possible to interpret this phrase as ‘for the nerves’; but the translation given seems to make better sense.

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Now, on the basis of this quotation alone, it is impossible to discover Theon’s opinion; from what he says elsewhere, however, especially in the third book of his Physical Training, he means that a smaller amount of nourishment should be given after the ‘complete’ exercise. Yet the actual reasoning underlying this advice has not been made clear. Less nourishment than usual may be given when the same amount is not needed, or when the subject is unable to subject it to coction. The first cannot be true in the case of people who have performed a great deal of exercise, while the second may be true in some cases, but not in others. If the coctive capacity is on the weak side, it will be true, but otherwise it will be false. Here, ‘coctive capacity’ should be understood as referring not simply to that in the stomach, or in the veins or liver, but also to that in each part of the body, in the present context, for example, in the muscles, which is the particular location of the state which we have been discussing. 210 K. These, having undergone excessive dispersal during exercise, become rather thin and dry. Now, if this happens to them to a small extent, they are capable of processing as much nourishment as they need; if, however, they depart a long way from the normal state, they are not capable of this. Theon had absolutely no conception of this point, and made no specification here. It was not, in the first place, on the basis of some reasoning, but from experience – as he himself concedes – that he observed hotter water to be useful after the ‘complete’ exercise. That is why in a subsequent passage he writes as follows: ‘If this has a supporting argument too, this is a matter of good luck; if not, is what is witnessed by actual results not to be admitted, if it does not have an accompanying argument to hand?’56 Now, if he had discovered the state in which hot water is recommended, while admitting ignorance of the reason, he could reasonably be forgiven for that; but when he states, in absolute terms, that ‘steamingwater bathing’ (as he calls it) is appropriate after the ‘complete’ exercise, whereas in fact many states may be consequent upon such an exercise, one may blame him for not proceeding to make the relevant further spec211 K. ifications. He is indeed himself aware that both the inflammation-like fatigue – in which the parts that have undergone exertion are raised up in volume beyond what is normal – and the other may follow upon such exercise; but he writes of both as though they were one, because of his 56

I follow Koch’s text here, but punctuate with a question mark; it seems required for sense to take this as a rhetorical question.

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attention to the common symptom, which is the opposite of abnormal volume.57 For people are rendered thinner in the other two kinds of fatigue, as also in the fourth state, with which our argument is concerned. It is not, however, the case that, just because there is one common symptom of these three states, so too the state is single. Now, in the case of that which arises from tension of the nerve-like bodies,58 one should not wash with water which is hotter than usual; nor should one do so in the case of that arising from residues; but with thinness which is not accompanied by these factors, it is beneficial to wash with water which is warmer than the well-balanced. This state arises when bodies have been dispersed to a large degree during exercises, as usually happens in long periods of fasting. Thus, the rectification of these involves the addition and refilling of what has been evacuated. But this 212 K. cannot happen so long as the skin remains porous. One must therefore first draw it together, densify and close it up, if any part of the abundant nourishment is to be beneficial; and it is drawn together and stopped up by both cold and steaming water. With cold water, however, there is a risk that the subject is harmed, when he has become both porous and empty after the large number of exercises; with steaming water, no harm arises in the skin, but a protective density, assisted somewhat by the residual heat within. One who bathes in this way, therefore, should not spend too long in the cold water. In fact, as Theon himself correctly warned: ‘Do not spend long in the cold, as this will destroy the benefit derived from the steaming-water bathing.’59 The reason for Theon’s blunder, in writing of what is beneficial for one state as though it were suited to all, is the condition of the bodies for whose exercise he was responsible. His training involved athletes who, after the ‘complete’ exercise, would readily fall into the fourth state, but rarely into the third. He therefore wrote up his frequent observation as if 213 K. it had universal application. If, on the other hand, he had trained subjects who were of bad fluid, of bad condition, unused to exercise, weak, or not young men, he would have observed that they rarely fall 57

The verb antikeitai could also be taken as ‘corresponds to’, but the sense of opposition seems rather to be required. The precise meaning of the sentence seems slightly unclear; but at any rate Galen is insisting that Theon has missed essential features of or distinctions between the fatigues in question. 58 Cf. n. 54 above on the ancient terminology of neura; bodies which are neurōdēs are those which belong under that general heading or share the physical substance of neura. 59 Unlike Koch, I have punctuated this as a direct quotation from Theon: as mentioned above, n. 53, the technical term zestolousia is only used by Galen in reference to Theon’s own views. (Also, the verb here translated ‘destroy’, analuein, seems not to be used otherwise by Galen in precisely this sense.)

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into this kind of state, but very frequently into the others. Perhaps, though, it is superfluous to state this; for he himself concedes that one should use steaming-water bathing after ‘building-up’ exercises;60 and these are practised only by athletes. The objection will be made that, while it is only practised by them voluntarily, and in a regular fashion, it 10 is also done by many others sometimes, as a result of necessity, or competitiveness, or for some other reason. With these kinds of case, however, after immoderate exercise, one or more fatigue states necessarily comes about. It is, then, only in bodies of good-condition that the fourth state arises – which will be the case with athletes who are well guided and with 15 the young man who is the subject of our present discussion. If one asserts, in absolute terms, that the use of hot baths is suitable after extremely vehement exercise, then one is making a statement that is true 214 K. for one kind of disposition, but false for the other three. Many other such false statements have been written, by doctors and trainers, throughout their whole study of health. The chief point in common 20 between them is the undifferentiated nature of the statement, whereby what has been observed in one state is attributed to many.

Combinations of fatigue states 9. There is also a fifth state, close to those already mentioned, which is called ‘stoppage’; I shall speak about this next, once the discussion of 25 fatigues is completed. There are three simple distinct types of fatigue, of which I have already spoken; if one takes them in pairs, there arise another three; and a seventh is that involving the simultaneous occurrence of the three. The discernment of these takes place on the basis of the coupling together of the indicators; and the aim of rectification is partly that common to all, whereby one pays attention to that which 30 dominates, without altogether neglecting the rest; but there is also the specific aim, in addition to the common one, which is taken from the individual states. Now, to go through all the pairings would be a long 215 K. process; for the sake of clarity, the discussion will be concluded by means of one example. If there is a [considerable] volume in the muscles, and, at the same time, these themselves give the impression of having being crushed, and 35 a ‘wound’ sensation, or inflammation-like fatigue, in conjunction with 60

The adjective is kataskeuastika, cognate with katasekeuē: cf. n. 8 above.

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a residue-based one, has taken hold of the subject, the restoration will be realized by aiming at both [states], but especially at the greater one. The nature of ‘the greater’ is not a single one for all things: there is its nature in terms of capacity and, as it were, status of the matter, and its nature in terms of its own proper substance.61 Now, as regards status and capacity, the inflammation-like fatigue is greater than the residuebased one; in terms of its own proper substance, each of them may become both large and small, as also in the case where each is present on its own. If both have departed from the normal state to the same degree, then the inflamed fatigue demands the main focus of the treatment, since this is dominant in terms of its capacity; if, on the other hand, the inflammation-like one has departed from it to a very small extent, and the wound-like one to a very large one, then one must consider whether the wound-like fatigue exceeds in magnitude to the 216 K. same extent that the inflammation-like one exceeds in capacity, or whether it does so less or more, and in this way find out which one is dominant. If they appear equal in strength, one should address both equally. Let this, then, be your method in the case of all complex states. Just as, on the basis of three types of fatigue, one arrives at a figure of four couplings, so, if one adds in the fourth state too, that figure will become much larger. You may understand what we are saying clearly with the help of a table.62 Let the first item in it be the wound-like state; the second, the tensed one; the third, the inflammation-like; and the fourth, that involving thinness. The first may come about in conjunction with the second, the third or the fourth; the second, again, in conjunction with the third or the fourth; the third in conjunction with the fourth. There are thus in total six couplings, if one takes the states two at a time; 61

Cf. above (Book I, nn. 53, 55 and 123) on Galen’s use of ousia and on the distinction between ‘in itself ’ and incidental properties (sumbebēkota). Here, slightly differently, it seems that ousia is referring to the actual physical substance, and dunamis to the discernible or external effect of this substance. There is an analogy here to foods or drugs, of different levels of strength: a large amount of a weaker one may be less, in its effect, than a small amount of a stronger one; and we should consider the inflammation-like fatigue as in this sense analogous to the stronger drug. 62 Cf. Book II, n. 30, on tables (diagrammata) in Galen. At that point in the text the table is a very simple one, and its actual layout described, in terms of two columns (stoichoi, on which term cf. Thras., n. 19). It may be significant that Galen in the present case does not precisely say that he is referring to an actual table, rather that ‘you may understand’ what is meant by the use of one. If an actual table, rather than a list of primary items followed by combinations, is intended, it is not clear exactly what form this should take. I have rather followed the layout of the manuscript tradition, which simply presents a list; the headings in square brackets, ‘simple states’ and ‘composite states’, derive from Linacre’s Latin translation (printed also in Kühn).

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but there are a further four where three states are combined together. The first may come about with the second and third, or with the second and 217 K. fourth, or with the third and fourth; then, the second with the third and the fourth. Last of all will be the state composed of all four combined together. The total figure is thus eleven; and there were, of course, four simple ones. In all, then, there will be fifteen. [Simple states:] A = wound-like; B = tensed; C = inflammation-like; D = thinness; [composite states:] AB, AC, AD, BC, BD, CD, ABC, ABD, ACD, BCD, ABCD. If, additionally, you combine the different types of stoppage with each other and with these fifteen, you will produce a very large number of combinations; and if you also combine with these the types of noncoction, or the types of disposition of body which arise from sex, heating, lack of sleep, or distress, it will not be an easy matter to count them all. Nor am I at this stage speaking of those of fulness,63 bad fluid, retention of the stomach, diarrhoea, vomiting, heaviness of the head or of some other part, or, in general, any which arise in the context of some symptom. We shall discuss all such matters later. I have mentioned them 218 K. here simply for the purpose of showing how great is the number of combinations. One may surely wonder at those who claim, in the case of assemblages of them, which they call ‘concatenations’,64 to have closely observed either the treatment or the prognosis of what will happen. There is only one way in which it is possible both to foreknow65 and to treat appropriately, as Hippocrates instructed us, telling us that we must understand the capacity of each of the simple things – as I have shown now with the four states. When each one comes about on its own, it will indicate a 63

Further on ‘fulness’ (plēthōra) see Book IV, n. 6. The attack here is on the Empiricist school of medicine: both ‘assemblages’ (athroismata) of symptoms and ‘concatenations’ (sundromai, literally ‘runnings-together’, from which is derived the modern medical term ‘syndrome’) are technical terms from this school, which believed in amassing large amounts of individual information, or case histories, from separately observed cases, rather than in reducing the phenomena to a set of common recurrent ‘simple’ elements, or to an underlying causal scheme, as advocated by Galen (and as here attributed by him to Hippocrates). See especially SI 2, 3,13–17 H. (I.66–67 K.), where Galen emphasizes the Empiricists’ use of the terminology of ‘assembling’ within his introductory account of their approach to the art; and 4, 7,3–5 H. (I.72 K.) where they are said to call a particular athroisma of symptoms a sundromē; and cf. below V.10, 159,25 Ko. (VI.361 K.); V.11, 161,12 Ko. (VI.365 K.). 65 ‘Foreknow’ (proginōskein) is the verb cognate with the noun ‘prognosis’. Galen here alludes to the Hippocratic Prognostic, which was an important text to him conceptually and on which he wrote a major commentary. For his detailed discussion of the Hippocratic use of the terminology of prognōsis and proginōskein, see especially Hipp. Prog. I.1–4, and cf. above, Book I, n. 9. 64

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simple rectification; but when combined with another, this will be in accordance with the method just described, regarding all the complex states.

Stoppage 10. Whenever, then, it is apparent that this is the case, one must [first] return again to the simple states, amongst which, subsequent to those mentioned, are those involving stoppage. This is the term I give to damage of the channels whereby the residues are prevented from being dispersed. This comes about through obstruction or densifying (which is also called closing) of the channels. Obstruction comes about when 219 K. viscous or thick residues surge all at once to the skin, and densification arises as a result of those which are astringent and cooling. It cannot, however, happen that the kind of body which is the subject of our present discussion falls victim to obstruction, so long as it is being guided in accordance with the form of care which has been described. It may, on the other hand, sometimes be densified, both by extreme cold and by astringent baths.66 It is also possible that, after bathing or sweating, or when the skin has become porous from some other cause, a breeze blowing upon the person may sometimes bring about some cooling and densification. The state here mentioned is discerned, as soon as the person undresses, by whiteness and poor colour, hardness and densification of the skin, and, during exercise, by the difficulty in becoming heated. In such cases people do not sweat as much as before, nor do they have such good colour, but, even if they are compelled, by the tendency of the exercise to produce good tension, to produce some sweat, this is smaller in quantity than usual, and also colder and less vaporous. The cure of such a state is heating; for this is opposite [in nature] to 220 K. cooling. One should, then, use exercises which are more intense, and hotter baths. It will be advisable, too, to roll on the floor in the first chamber, smoothly, with oil.67 This should be one of the slackening oils – 66

On the different qualities of different kinds of water, related to their mineral content, see Note on translation, p. xxiii. 67 Or, ‘with smooth oil’, reading λιπαροῦ with M, which seems easier. For the procedure of rolling on the ground after application of oil, cf. V.10, 156,9 Ko. (VI.324 K.); and cf. Book II, n. 64 for further references to the use of dust. The ‘first chamber’ is that with the cold bath, after which one typically progressed to the ‘middle’ and then the ‘third’ chamber: Galen uses this terminology (for frigidarium, tepidarium and caldarium) at MM X.10 (X.723–724 K.), in a passage which also discusses the use of oil in the bath chambers, and the spending of time in them outside the actual tub, and pays attention to the ambient temperature of each, and indeed to the temperature of the oil. There, on the other hand, he mentions oiling in the second chamber, and recommends that

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A = apodyterium (changing room) B = basilica thermarum (hall) C = caldarium (hot room) CPi = calida piscina (hot tank) F = frigidarium (cold room) N = natatio (swimming pool) P = palaistra (wrestling-school or gymnasium) S = sudatorium (sweat room) T = tepidarium (warm room) U = unctorium (massage room)

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2 Plans of the main types of Roman baths and bath-and-gymnasium complexes, showing the typical transitions between rooms of different temperatures, as well as the integration of baths with the palaistra. The larger-scale, ‘imperial’ type of complex is shown in the bottom two drawings. The shaded areas represent the actual pools. Redrawn from the illustration in Der Neue Pauly, ‘Thermen’, p. 415, by kind permission of Brill.

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in Italy, for example, Sabine oil is of this type – and it is preferable, in such states, that the oil be two or three years old, for then it is both finer in consistency and hotter. The amount of time spent in the cold bath should not be a long one, nor should the water itself be too cold. Further, when they are about to dress, such people should have an application of some oil which is moderately heating, which might be one of the kinds one finds in Egypt – of castor and radish – but elsewhere in the inhabited world, something sweet, fine in consistency and moderately old, or one of the perfumed oils68 – that made with lilies, those made with fresh young wine, with iris, or with marjoram, and the Commagene. That made with fresh young wine is a definite anti-fatigue [drug], and a slackening one,69 and is thus appropriate for those who have been substantially fatigued; that made with lilies is slightly hotter and more emollient; those of iris and marjoram and the Commagene have a still more marked 221 K. heating effect: these are beneficial also for chills specifically so called. Densification of the skin is sufficiently cured also by the oil made with dill, especially if the dill is green. Suited to these states, as also to cases of strong fatigue, is the anti-fatigue [drug] made with pine-nuts;70 and how one should prepare this will be stated in what follows. I believe that I have already discussed these matters in a way that goes beyond the scope of our present subject: in one with the best bodily constitution, who has entered upon a free life, makes no error himself and has the best supervisor of his health, any of the states verging on morbidity is highly unlikely to arise. one ‘use the chambers simply as a walk-through’, and enter the water only in the third chamber. See figure 2; and further also Yegül (1992): 33–40, with nn. 56–59. 68 For this usage of the term muron, and for different varieties of perfumed or infused oils, see e.g. SMT II.27 (XI.538 K.) (where a usage is specified according to which an oil is called elaion when no aromatics are infused in it, and muron when they are) and SMT VI.5 (XI.872 K.); and cf. e.g. Dioscorides I.42f. The word – and the specific infusions mentioned – were also used simply for perfumes, alongside the medicinal use Galen describes here. The items discussed here appear also in Galen’s works on drugs. Cf. Comp. Med. Loc. II.1 (XII.543 K.) and III.1 (XII.601–604 K.) (on Commagene: it is explained that this perfume is so called because it comes from Syria). Comp. Med. Loc. IX.1 (XIII.228 K.) has almost the same list as here, and again makes the same distinction; and one or more of those mentioned here appear also at SMT III.9 (XI.560 K.), V.9 (XI.739 K.), V.14 (XI.750 K.) (where it is noted that the sediments of all mura are thick in their consistency) and Comp. Med. Loc. I.3 (XII.448 K.). That with lilies and the Commagene are paired at Comp. Med. Loc. III.1 (XII.604 K.) as exotic or expensive preparations used by rich women. 69 Galen and others classified certain drugs under the headings ‘anti-fatigue’ (akopa) and ‘slackening’ (chalastika). See e.g. SMT V.11 (XI.741 K.) and V.14 (XI.751 K.), Comp. Med. Loc. VII.1 (XIII.6 K.), Comp. Med Gen. VII.9 (XIII.991 K.) and VII.11 (XIII.1005 K.); and cf. below, VI.8, 184,1–2 Ko. (VI.418 K.), where the former usage is attributed to ‘the more recent doctors’. 70 The ‘anti-fatigue’ effect of both dill and pine-nuts is mentioned also at Comp. Med. Gen. VII.11 (XIII.1008 K.).

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Exercise after sex 11. Let us, then, return once more to our original subject and, leaving aside over-heating [from the sun], cooling, lack of coction, diarrhoea and all such things – for it will be better to defer all these to a single book, namely that which will subsequently be written on morbid symptoms71 – let us now consider the question of exercise taking place after sex. For there is some dispute on this point, some thinking that the exercise performed in those circumstances should be of the same kind as that 222 K. called restoration, others that it should be of the same kind as the preparatory. The preparatory exercise is situated below the point of good balance, in terms of the quantity of the motions, but is more intense and swifter, in terms of their quality. Now, those who recommend restoration, similar to that after exertion, are concerned to avoid dissolution and dryness of the body, for we suffer both these after sex, and after a large amount of exercise, while those who recommend that one should employ preparatory exercise are concerned to avoid porousness and readiness to sweat, which are intensified by the restorative exercise, but corrected by the preparatory. I, meanwhile, approve both these schools of thought, since each has a partial view of the truth, and will combine their beliefs together. Both will agree that one should reinvigorate the capacity, bind up the porousness, and not increase the dryness. But there is one specification lacking on both sides, along the lines which we have already stated, in relation to all the complex states. Let us restate this again now. 223 K. Whenever more than one state coincide, if the treatment indicated is single in kind, then this must be intensified more than if each of the states had been single; if the states are opposed to each other, one must first carry out a rectification in accordance with the state which is dominant, while by no means neglecting the others. Now, in those who engage in sexual activity while they are weak, either because of their age or for some other reason, feebleness of state will necessarily dominate; in those who are strong and young – like the young man who is the subject of our present discussion – the bodily condition undergoes alteration in the direction of porousness more than the capacity does in the direction of feebleness. In such bodies the rectification is carried out not by means of things that make the body porous, such as the restorative exercise, but by means of things that draw together and close up, such as the preparatory exercise. If, additionally, some cooling arises after sexual activity, the preparatory exercise should be used from this point of view too, since it 71

The next book is meant.

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provokes hotness, both through the swift and intense nature of the motions and through the fact that it draws together and closes up the condition. That this, alone amongst forms of exercise, cures the porous224 K. ness, is agreed by all trainers, who have learnt it from experience. There is, then, nothing better for present purposes than this form of exercise. One may also make use of cold bathing, when the season of the year encourages this. One should give food which is little in quantity and moist in quality, so that the subject is able to perform good coction upon it and rectify the dryness arising from the sexual activity. The food should, furthermore, not be cold in its mixture, but either middling in type or hot. Since the body is rendered porous and cold, and also at the same time weak and dry, by sex, it seems obvious that what is administered should be densifying, heating, moistening and reinvigorating of the capacity, and that these are the aims in such cases. The fact that this is the capacity of sexual activity does not belong within the present discussion; our task here was to give an account of how the body in question should best be exercised after having engaged in sexual activity, and it was not possible to accomplish this properly without taking the quality of the 225 K. state arising after sex as an assumption. For the present, then, we state as an assumption, but later it will be stated with a demonstration, what the capacity of sexual activity is, whether or not it should be engaged in at all, and what is the nature of the benefit and harm it produces, in relation to bodily states, to seasons of the year, to places, and to all other such variables which one should also specify.72

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Exercise after lack of sleep and various emotional disturbances 12. After engagement in sexual activity, then, the form of exercise used should be the preparatory; but if lack of sleep, or distress, or both, are 20 also present, it should be the restorative – if, that is, these have arisen without lack of coction. In cases of lack of coction one should not take exercise at all. Experience, too, shows restorative exercise to be appropriate in cases of distress and lack of sleep: it becomes apparent that these people are harmed by the other kinds of exercise, as well as being unable 25 to keep to the instructions, if they are still in a state of distress. This is made evident by reason, no less than experience: since people who have undergone sleeplessness and distress visibly become thinner and more 72

It does not seem clear to which discussion Galen is here referring; there are several mentions in Book VI of the importance of abstaining from sexual activity for those of dry mixture.

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226 K. parched, as well as reluctant to follow instructions, one must consider that their bodies are dry. Such states are thoroughly cured by soft massages, performed with plentiful olive oil and well-mixed baths, and by slow motions, without strong tension, and interspersed with frequent rests. And this was the pattern of the restorative exercise. Dryness which arises from rage73 or which has come about through lack of drink should also be rectified in the same way. The rectification will be opposite in kind for wetness in this condition,74 whether this has come about through excessive drinking or through some other cause. In these states, then, the aim will be that of drying. Now, this much is common to all of them, but what is specific to each state arises from the individual differences. If the wetness has arisen from excessive idleness and immoderate and untimely use of moistening foods, it requires a longer form of rectification; if from excessive drinking on the previous day, without the head, or the mouth of the digestive cavity, having 227 K. suffered anything, it can be thoroughly cured within one day, by the administration of a great quantity of dry massage, and by fairly swift exercise and the use of rather little drink, and of drying foods. Of course, those [cases where] moisture is superfluous in the body, wherein the head or the stomach mouth has taken some harm from the wine, are not relevant to the present discussion: we will talk about these in the discussion of morbid symptoms. Those arising from an extremely long period of idleness will not come about in the first place, in the case of the state now under discussion; nor will those arising through an excess of foods which are wet in nature, such as most kinds of fruit and those vegetables which are not acrid. When they do come about, it is not possible to treat them all at once; for if the person engages in such exertions as to dry out the condition sufficiently, he will fall victim to fatigue and suffer fever, certainly for a day, and, if the forms of wetness happen to be bad ones, for many days. Rectification may be carried out, however, in the course of time, as will be stated later on, in that part of the discussion in which 228 K. we are altering faulty mixtures for the better. The care of acquired states is similar to that of natural bad-mixtures; and so we do not need to give a thorough account of them now. 73

Or perhaps, less specifically, ‘excitation of the spirit’; on thumos cf. Book I, nn. 52 and 76 and Book II, n. 48, as well as n. 30 within the present book. 74 The phrase ‘in this condition’ (κατὰ ταύτην τὴν ἕξιν) seems slightly suspect: it is not quite clear what ‘condition’ is meant, and in what follows Galen proceeds to discuss the rectification of wet states in general. (VR omit τὴν ἕξιν, ‘condition’, but that would still leave κατὰ ταύτην, ‘in this’, with an unclear reference.)

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Morning and evening massages 13. It remains, then, to give an account of massages applied in the morning and in the evening – and by this I do not, of course, mean the sort of account that Quintus75 is said to have given in response to some trainer who asked what is the capacity of the application of oil below, namely that it is has the capacity of removing one’s clothes. These are said to be the exact words of a trainer’s question to Quintus, and of his response. There is another similar saying of Quintus’ which is current, concerning urine, namely that learning about urines is the task of a fuller; and another on the hot, cold, dry and wet, to the effect that they are words for types of bath.76 Personally, I would be reluctant to believe that even Thessalus,77 let alone Quintus, would have made such utterances. They are all frivolous japes, completely unworthy of a man possessed of the knowledge of such a serious art. It is better, then, to conduct our investigation regarding the morning massaging for the body which is the subject of our present discussion in 229 K. the following manner. The body will either be completely faultless after sleep, or affected by one of the fatigue states, or by one of the other states of which I gave an account just a little earlier, subsequent to that of the fatigue states. Now, if it is faultless, it is superfluous to massage or apply oil, except in a case where it might be unavoidably exposed to extreme cold: in this case we shall prepare the person with massage in the same way as we would those who are about to engage in cold bathing. If, on the other hand, there is some sensation of fatigue, we have already stated how one should oil and gently massage the person in that case. Similarly, if he is drier than he should be, one should apply sweet oil – for this 75

The frivolous jokes attributed to Quintus, and Galen’s stated reluctance to believe them, seem interestingly indicative of an ambiguous attitude on Galen’s part. Quintus was a major anatomist of the period a couple of generations before Galen, who in a sense belongs within his school. Galen refers to him as a supreme expert in anatomy (Lib. Prop. 3, 145,10–11 BM, XIX.22 K.), and as a young man made great efforts to study with his pupils, especially Numisianus; on this history see Grmek and Gourevitch (1994); Boudon-Millot (2007), introduction; Singer (2019a). On the other hand, he accuses Quintus and his pupils of not having understood Hippocrates correctly (Ord. Lib. Prop. 3, 98,14–16 BM, XIX.57 K.). It seems possible, on the basis of these Galenic remarks in conjunction with the remarks attributed to Quintus here, to construct an, albeit very tentative, picture of a person fundamentally devoted to anatomical research, but sceptical about medical theory in its more formal or philosophical formulations, and perhaps also about the authority of Hippocrates. 76 In ancient times urine, because of its cleansing properties, due to the ammonia content, was an essential part of the fulling process. I read βαλανείων, ‘types of bath’, for the MSS βαλανέων, which would mean rather ‘types of bathhouse attendant’. 77 For Galen’s attitude to the Methodists, represented especially by Thessalus, see Introduction, section 2.3, with nn. 20 and 21.

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moistens the dry skin – and one should massage very little, but with a massage which is neither hard nor soft. For we need only to stimulate distribution, not to alter the condition of the skin or of the flesh, nor to disperse any of what is contained in them. Soft massage brings about both these things, while hard massage brings about one of them, since, indeed, this densifies the skin and makes it hard, while soft massage 230 K. disperses and renders the body porous and soft. If, on the other hand, we wish to rectify the densification of the skin, then if this has arisen from hard massagings and wrestling holds and from vehement exercise and a great deal of dust, we shall massage softly, using plentiful fresh oil; but if it has arisen from cooling, we shall restore such a subject to the normal state, first with massagings which are both dry and fast, and secondly with those which involve oil that is heating. When porousness has arisen from excessive bathing, soft massages and sexual activity, we shall cure this with a small amount of dry massage, and then with a small amount of massage using one of the astringent oils. Wetness arising from excess drinking is treated by dry massages alone, carried out with cloth, with gloves, or sometimes with bare hands, either entirely without lubrication or with a very small quantity of oil. The oil in this case should be fresh, so as to be liable to cause dispersal, and completely devoid of any astringent quality. So much, then, for the morning massaging. 231 K. That performed in the evening, on the other hand, must be suited to people who are substantially fatigued, or dried out, or who are experiencing poor nourishment. The symptom of poor nourishment, though, should be excluded from the discussion for the present, since it will be dealt with subsequently, along with all the other morbid symptoms.78 In the case of the nature now under consideration, when there is either powerful fatigue or some immoderate dryness in the body, let the evening meal be a small one, and the time between meals long; and they should remain at rest for the most part, but undertake short walks, so that the food goes down, as happens through the downward shaking that happens when someone walks upright. It is good, too, if they are able to defaecate. If all these are carried out correctly, it is safe to massage with fresh oil, while taking care not to touch the stomach at all; otherwise, there is a danger that the food itself will undergo poor coction, that some half-cooked fluid from it will be distributed, that the head will be clouded and the stomach mouth upset. So, it is best not to touch the 78

There is a brief discussion of poor nourishment and its treatment below, V.3, 141,28–142,6 Ko. (VI.320–321 K.).

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stomach at all; if, however, at some point there arises some sensation of fatigue, or excessive dryness, in the muscles surrounding it, one should 20 232 K. apply moderate [oils], with a very light touch. Anyone who wishes to hear the reasons for these statements must wait for the next book, in which we give an account of morbid symptoms. For I believe that the present book has already reached a sufficient length.

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Book IV

Morbid and healthful symptoms; the category of the ‘neither’ 233 K. 1. I shall not follow the practice of the majority of recent doctors, who waste their time on sophistical enquiries and either devote a very brief discussion to the most necessary points, or omit such discussion altogether. Rather, as set out at the beginning, I shall give an account of what is actually most useful, leaving for another time those things which involve a more theoretical investigation. With respect then to morbid symptoms, which are the subject of our account in the present book, there immediately arises a major question as 234 K. to whether this discussion belongs within a study1 of health or within one of healing – or within a third beside these, which some posit as lying midway between the two, and to which they give the term ‘neutral’.2 I knew, however, that I would attract equal criticism from the sophists whether I mentioned these in a discourse on matters of health or in one on healing; and I also realized that if anyone were to suggest to them that it should belong within a third treatise, entitled ‘states which are

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Cf. Book I, n. 20 on pragmateia; the same word is translated as both ‘treatise’ and ‘study’ in different contexts in the following sentences. This word oudeteros may be translated ‘neither’ or ‘neutral’ (or, in the grammatical sense, ‘neuter’, thus explaining the joke which follows); on the medical use of the term, attributed to Herophilus and his school and occasionally adopted by Galen, see Introduction, section 4.2. The sense and usage are, however, somewhat unusual in the present case, where it is the adjectives ‘healthful’ (hugieinos) and ‘therapeutic’ (therapeutikos) – here translated ‘of health’, ‘of disease’ – that are contrasted with ‘neutral’. The term oudeteros is usually applied rather to symptoms, causes or signs – these may be ‘of health’, ‘of sickness’ (morbid), or ‘neither’ – not to a separate kind of study or branch of the art. Galen seems to say that the subject matter of this book, the ‘morbid symptoms’, could logically belong within either a treatise of therapeutics or one of health, and thus in a sense belong actually in this ‘neutral’ category.

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neutral’,3 these persons would scoff and mock even more, asking what kind of treatise we will use to give our views on the masculine and the feminine. I have therefore decided to discuss them in the present book. It is impossible to escape the tongue-lashings of the sophists; but their criticism will be less if we follow this procedure; so that is perhaps the 20 best course. The sense in which they belong within the same common body of teaching will be understood on the basis of the theoretical study itself – if one pays precise attention to the discussion which now follows. The specialized skill which concerns exercise is a very large part of the 235 K. science of health; and to avoid fatigue is also a major concern of that same skill. It was shown previously that the prevention of future fatigue 25 and the rectification of fatigue that has already arisen are similar. One should not, then, give instruction in one place on the avoidance of fatigue and in another on the appropriate manner in which one restores an existing fatigue to the normal state. It is for this reason that our discussion in the previous book – the third of the whole treatise – covered fatigue arising from exercise, while also mentioning the states 104 Ko. similar to fatigue, some of which also arise very frequently after exercise. We shall proceed now to discuss, first fatigues themselves, in their presentation in the absence of exercise, and secondly those states which belong to the same type as these. 2. Now, fatigue which arises after immoderate exercise is a healthful 5 symptom, that which arises otherwise is a morbid symptom. Thus, Hippocrates’ dictum seems an excellent one: ‘Spontaneous fatigue means 236 K. sickness.’4 Now, the sensation of being wounded is a fatigue symptom; and the cause of its coming about is a fatigue state. But the cause by which this itself comes about admits a twofold distinction. Either it is 10 contained in the body of the living being itself, in which case it is called a preceding cause, or else it is not present within the body at all, in which case it is called an antecedent cause.5 There are thus three classes in all with which the present argument is concerned: the fatigue symptom, the 3

Or ‘neuter’ (see previous note). It is possible that the mention of ‘states’ here also contributes to the pun, as this term (diathesis) also had a grammatical sense, although this usually refers to verbal voice. 4 Aphorisms 2.5 (IV.470 L.). 5 In Galen’s technical account of causes of disease a ‘preceding cause’ (proēgoumenon aition) is a factor arising from the state of the body itself, an ‘antecedent (or procatarctic) cause’ (prokatarktikon aition) is a factor arising from external sources, such as ambient air, exercise or diet. (A third type, the ‘containing’ or ‘cohesive’ cause (sunektikon), accounting for the ongoing state or composition of the bodies themselves, is also mentioned by Galen, but is a much less significant part of his system.) His fullest discussion of his views in this area is in Procatarctic Causes; for analysis of the

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fatigue state and the cause of this state. Within each, there are also 15 certain distinctions of type: in the class of causes, as just mentioned, we have preceding and antecedent; in that of states, as was shown in the previous book, we have the wound-like, the tensed and the inflammation-like; and in the class of symptoms we have these same three again. It is possible to give them different names, if one wishes; but it is not 20 possible to mention or produce more [classes] than those stated here – if, that is, one wishes to speak the truth – nor to mention or produce more distinct types than these.

The wound-like fatigue; build-up of acrid residues; distinction between this and general build-up of fluids Let us begin with the wound-like fatigue. This brings with it a painful 237 K. sensation during the motion, as if the body is being wounded, either in the skin alone, in more moderate cases, or in the flesh below the skin, in more vehement cases, or in both, in very strong cases. This, then, is the fatigue symptom. The fatigue state, which gives rise to this, is the acridity of fine, hot fluids which eat into, prick and sting the bodies. It sometimes arises from immoderate motions, as was shown in the previous book, and sometimes from some bad fluid which has grown imperceptibly: Hippocrates calls such kinds of fatigue spontaneous. The other class of fatigue, the tensed, when this comes about spontaneously, follows what is known as ‘fulness’.6 In cases of fulness, the solid parts of the animal are extended, especially those which contain fluids. The third class of fatigue, the inflammation-like, results from fulness combined with the bad fluid already mentioned. For it is not every type of bad fluid, but only that in which there is a biting acridity, which brings about the wound-like fatigue; nor does even this one do so when it is thoroughly combined 238 K. with the blood in the veins, for in that case its capacity is not felt, since Galenic theory, as well as its relationship to the previous medical and philosophical tradition, see Hankinson (1994a). 6 The term plēthōra is closely related, both linguistically and conceptually, to plēthos, here translated ‘build-up’ – or, in the title of the work referred to below, ‘fulness’. Galen indeed gives his most thorough account of this condition, which consists in the build-up of excess fluids in the body, in that work, ‘on plēthos’ (Latin De plenitudine; in English the title has been translated as both ‘plethora’ and ‘fulness’). Both in that text (Plen. 11, VII.571 K.) and later in this one (VI.13, 194,1–2 Ko., VI.442 K.) he states that plēthōra is the term used for the specific form of plēthos in which there is an excess of fluids throughout the whole body; but it seems possible also to talk of a ‘plethoric’ part of the body (Plen. 5, VII.537 K.). Again as outlined below, Galen in Fulness makes an important distinction between plēthos, an excess of fluids in general, and kakochumia, a pathological imbalance whereby one fluid predominates (Plen. 11, VII.574).

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the bad fluid is both dissipated and overpowered by the good quality of the blood. But when the bad fluid on its own is moved and becomes lodged in the flesh and skin it brings on a wound-like state and sensation. Those who think that this kind of fatigue is the result of build-up are in error; for it is not the result of that kind of build-up which is also called fulness (the one that gives rise to the tensed fatigue), nor of that which makes the capacity heavy (for there is no biting nor sensation of fatigue); rather heaviness and impairment of motion are the symptoms of this kind of build-up, which weighs down the capacity of the soul, in cases where its effect on this is greater; or impairments of the pulse, when its effect on the vital capacity is greater. Enough has been said on these in my works on the pulse;7 and in my work on Fulness, too, the indicators have been stated of the natural capacity becoming heavy, as well as the indicators of both the others.8 Build-up, then, is not responsible for the fatigue which brings with it a sensation of wounding; rather, it is the 239 K. acridity of the fluids contained in the skin and in the flesh. For this sharpness, so long as it lies at rest, escapes one’s perception; but as soon as it is set in motion it is immediately noticed. This motion arises, primarily and especially, according to certain principles of its own, which we will proceed to discuss; but another kind of motion arises incidentally, when we ourselves deliberately move a certain part, or the whole body, and thus in the process also set in motion the fluids contained within it. This latter kind of motion, however, is very slight and brings on only the sensation of fatigue. The other, being more vehement, is a cause of rigor, while that which is between these in strength is a cause of shivering. (It has been shown in our work on The Causes of Symptoms that there is nothing to prevent even a hot cause bringing about shivering and rigor.)9 Here it will be sufficient to take the chief points of matters that were shown in that book and use them as assumptions for our present discussion. When, then, biting residues are inadvertently nurtured in the bodies capable of sensation, these are set in motion in two ways. The first is 7

The ‘weighing-down’ caused by build-up of fluids, and the effect of this on the pulse, is discussed e.g. at Caus. Puls. II.1 (IX.61 K.) and II.4–5 (IX.71–75 K.). 8 In Fulness there is a substantial discussion of the sensation and varieties of ‘heaviness’. It is noteworthy in relation to the account which follows here of shivering (phrikē) and rigor (rigos), and of their connection with the build-up of fluids or residues in the body, that Galen in Fulness expounds a fourfold distinction of different levels of intensity of ‘biting fluids’, referring there also to the ‘wound-like sensation’, and placing rigor and shivering respectively at the highest and the next-highest level (Plen. 8, VII.551–552 K.). 9 See e.g. Caus. Symp. II.5 (VII.188 K., VII.190 K., VII.194 K.).

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when they are pushed out by these bodies themselves, which have a 240 K. capacity to separate off things alien;10 the second is by the vehement motion brought about by exercise and by the spirit,11 or by the heat of the ambient air. Now, lukewarm, putrefying residues, when they are 5 vehemently set in motion, do not only bring on shivering or rigor, but also provoke fevers; those which are both cold and fine in consistency have the former effect but not the latter. There must, also, be some significant build-up in either case, if they are to have these effects. Those ­residues which are either biting, but very small in quantity, or larger in 10 quantity but not completely biting, when they reach the bodies capable of sensation, bring about the wound-like fatigue. These latter, then, must certainly be discussed in the present work; those which bring on fevers belong rather within the study of healing. On the other hand, those which bring about shivering, but do not provoke fevers, belong also 241 K. within the present study. 15 3. The cure for these is partially one based on aims which are common to both types, and partially one specific to each. That [element of ] the cure which is common to both will be discussed first. Whether the residue is hot or cold, one should evacuate or alter it. Not every residue is susceptible to alteration from its nature,12 any more than every foodstuff is 20 susceptible to coction in the stomach in the case of all animals. There has to be some kinship between the agent of coction and the stuff undergoing coction. Where the latter is completely alien, there is no means by which this can undergo an ordering [which takes it] away from its nature; one should, rather, attempt to evacuate it speedily, just as, also, it is best to evacuate by vomiting or by excretion those things which have undergone complete decay in the stomach. But it is not possible to evacuate 25 that bad fluid which has been absorbed into the flesh and in the other bodies as readily as that which is contained within the perceptible open spaces. Sometimes, too, the nature of the patient itself does not accept a remedy capable of bringing about speedy evacuation. 10

On the natural capacities of bodies, including those of separation and repulsion, see Introduction, section 4.5.2 with n. 64. 11 On thumos, ‘spirit’, see Book I, nn. 52 and 76, Book II, n. 48 and Book III, nn. 30 and 73. 12 One could in this case (and in that following a few lines below) perhaps also translate phusis as ‘natural state’. Relevant to the discussion here of the ‘kinship’ (sungeneia) that must exist between bodies in order for one to be able to alter the other, and of the alternative situation where the bodies in question are wholly alien to each other, is the account of the alteration that does or does not take place in the processes of nutrition and pharmaceutical action; on this see Introduction, section 4.5.2 and further Singer (2020b).

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There are, moreover, occasions when some other state resists and prevents such a manner of evacuation, and we shall speak of these in what follows, after first completing our discussion of the first division. For we have stated the common aims in the cure of residues: evacuation and alteration. Now, we must add the specific ones: there is no one single method by which to perform the evacuation or the alteration; rather, one must seek out the one which is appropriate to the source of distress in any given case. And what is appropriate is, stated in general terms, that which is brought about through opposites. In individual terms, it is that which acts in an opposite way in any given case. These, then, are the essential points of the argument; but we must give a fuller explanation of these, adding also the demonstration appropriate in each case. We shall take as our starting-point, within the spontaneously-arising fatigues, the wound-like state.

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Varieties of presentation of acrid fluids in the body 4. Since this kind of fatigue results from the bad fluid of acrid residues, one should first consider whether this bad fluid is contained only in the hard bodies or also in the hollows of the veins. We have no manifest or 243 K. clear indicator regarding the residues in the veins, except only that from 10 the urine, and so must make a conjecture on the basis of the following considerations. First, we must consider what daily regime the patient’s body has been employing; secondly, whether its natural habit was to accumulate bad fluid; one must also consider whether the usual secretions are being withheld; fourthly and lastly, whether the patient has become accustomed to evacuating the residues by exercise, purging, vomiting, passive exercise or the use of naturally-occurring waters, which 15 he has recently neglected. As regards the daily regime, one must investigate whether there has been a preceding lack of coction taking place more often, or to a greater extent, than usual, or whether a large amount of food of bad fluid has been introduced, or whether the patient has drunk fresh new wine instead of old wine, or wine which is thick or clouded instead of that which is fine [in consistency],13 or indeed whether he has moved entirely from the drinking of wine to that of water 20 – and, in each of these cases, whether he has made this error not once or twice but continuously over a long period. Secondly, as stated, one must 13

See further below, ch. 6, on the qualities of different wines.

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consider whether the patient is amongst those who have a natural tendency to accumulate bad fluid. This you may find out by enquiring whether any of the following has 244 K. especially arisen: an itchy, rough, hard or irritated state, or erusipelas, herpēs, elephas, ophiasis, alōpekiasis, a large number of spots, wound-like or night-time pustules14 – or, in short, any of the symptoms that are generated and increase as a result of bad fluid. We then added that one should investigate whether some accustomed secretion – through vomiting, haemorrhoids, some fistula, diarrhoea or, in the case of women, menstrual emissions – is being withheld; and then whether one who has had a consistent habit of cleansing himself out has now ceased to do so. There are those who evacuate their own residues every spring or autumn, but have now ceased: some do this with laxative drugs, some with emetics, diuretics or those which provoke sweat, or by use of ­naturally-occurring waters which contain sulphur, asphalt or natron;15 many, too, have neglected their customary practice of exercise, and some have completely neglected the practice of massage, baths, or, after bathing, of vomiting from the use of sweet wine. It is quite evident that this discussion does not just concern those with 245 K. the best constitution, but, by virtue of the exhaustive list which we are here giving of the causes of bad fluid, is relevant also to those bodies which naturally accumulate bad fluid; and we shall discuss these latter, in the context of bad bodily constitutions, in more detail in the subsequent books. These, then, are the factors on the basis of which one should make one’s conjecture as to the quantity of the bad fluid; and one should then proceed to discover the cure by a calculation made in accordance with this. If the bad fluid is small in quantity and has been accumulated in the skin alone, the cure will be a more moderate one; if greater in extent and located deeper in the body, it will be stronger. First, then, we shall state the cure for the milder type, contained in the skin alone; then, that for the case where the fleshy parts have been filled; thirdly and finally, that for the case where the blood is entirely unpurged and full of residues.

14

By ‘night-time’ pustules is meant those that continue to cause pain or irritation throughout the night. The other terms here refer to a variety of skin complaints, for which it has not seemed worthwhile to attempt modern equivalents. (In those cases where the term is still in medical use today, it should not be taken that the ancient disease category is equivalent to the modern one.) 15 On sulphur, asphalt and natron, and the waters containing them, see Note on translation, p. xxiii.

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The person of naturally good fluid after slight neglect of daily regime First, then, – returning to our original subject – I take the case of a young man who is naturally endowed with good fluid, who has previously enjoyed a healthy daily regime in all respects, but who now, because of a long time spent on travel for some unavoidable reason, has not engaged in his usual exercise or bathing, and has resorted to poor food 20 246 K. and drink, as well as being transported in a carriage after his breakfast or supper, or indeed for the whole day, and has also slept very badly in general. Let us assume further that this person has not made any error in the amount of the food and drink taken, and has therefore not been subject to any lack of coction. In such a case, the person cannot have 25 accumulated a large amount of bad fluid. There will thus be no need for a lengthy rectification. The restorative exercise of which we gave an account in the previous book will be sufficient; and the relevant daily regime was mentioned there too. There is therefore no need to extend this discussion here. Let us simply give a reminder that the aim in the case of bodies in such a state is the evacuation of the residues in the skin, 30 provided that the state, too, is confined to this region.

The person subject to excessive lack of coction, with wound-like sensation penetrating deep within Let us then proceed to the case where a person, in addition to those other factors, has also been subject to excessive lack of coction, and, moreover, where the wound-like sensation is not confined to the skin, but penetrates deep within, so that there is the suspicion that the whole body has been filled with bad fluid. In this case we shall not make the person 35 247 K. engage in exercise, or indeed in any form of motion; rather we shall 109 Ko. instruct him to rest and sleep; keep him fasting for the whole day; then, towards evening, apply oil smoothly, give a bath of hot, well-mixed water and a very small amount of nourishment of good fluid, in the form of a gruel. Nor shall we deny him wine; for wine, more than anything, brings 5 about coction of those fluids which have only half achieved this, as well as provoking sweat and urine and conducing to sleep. In such cases we must cause evacuation, through sweat and urine, of all that which is already actually bad, since the bad fluid is no longer capable of undergoing coction; and we must complete the coction of, and render ­serviceable, that which is as it were half-cooked.

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This is best achieved through rest and sleep. Now, if the symptom 10 settles down after these, one should gradually reintroduce the customary practices; if, however, it still remains on the next day, one should then consider the possibility of a stronger remedy, especially if during the night the person has experienced excessive fatigue, or nausea, or sleepless248 K. ness, or vivid and disturbed dreams. In such cases it is appropriate to 15 resort to one of two procedures, in cases of strong capacity: either venesection or purging; and one should make a determination as to which of these is preferable, as I shall proceed to explain. In cases of weak capacity, one should on no account cut, but should purge from below, in a moderate way. (What constitutes a moderate purging will be stated in what follows, after we have first made the necessary specifications that 20 come before that.) Where the person’s capacity is strong and the fatigue remains, one should consider whether the bad fluid causing the fatigue has arisen in isolation or in conjunction with a build-up of blood or of raw, uncooked fluids. If there is a build-up of blood, one must either cut or perform some other procedure similar in function. ‘Similar in function’ here means: to open up haemorrhoids in cases where their flow has 25 been withheld; in the case of women, to provoke the expulsion of the menstrual fluid; where neither of these is relevant, to scratch the ankles16 and then cause purging from below, with the drug which is most appropriate for the bad fluid [in question]. Where the bad fluid has arisen 249 K. alone, without a build-up of blood, one should proceed to the purging appropriate to the residue which is the source of the distress.17 This is 30 sometimes one which is either bitter-bilious or black-bilious, and sometimes phlegmatic, salty or sharp; each of these may, further, be either more whey-like or thicker in its composition, or midway between the two.

16

The verb is aposchazein, which may also have the technical medical sense of ‘scarify’. But Galen distinguishes regularly between temnein (‘to cut’), applied to a vein, and aposchazein, applied to the ankle; in this context the latter still involves a cut, but represents a milder blood letting procedure than venesection, ‘vein-cutting’, proper. Cf. Cur. Rat. Ven. Sect. 11 (XI.283–284 K.) and 18 (XI.303 K.), where the milder procedure is recommended for the provocation of withheld menstrual fluid, and Thras. 23, 60,23 H. (V.844 K.). 17 A key feature of Galen’s pharmacology (summarized e.g. at Prop. Plac. 9 and 12, and elaborated more fully in The Capacity of Cleansing Drugs) is that the purgative capacity of a drug is specific to the fluid that it is to purge.

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Discernment of the different residues present, and of different locations in the body; treatment in different cases Let us now discuss the [manner of ] discernment of these. If the fatiguelike state has arisen in conjunction with certain pustules, from these one may readily discover the kind of residue in question; if not, then in the case of a person who is naturally of good fluid, one may do so on the basis of the preceding foods, and of all other things that have happened to him; in the case of a person who is naturally of bad fluid, then something may be gathered from this very fact. More will be said about such mixtures later; let us now discuss the other factors on the basis of which it is also possible to infer the type of the bad fluid. In one who has had a fairly idle daily regime there tends to be an accumulation of phlegmatic fluid, whereas in one who has undergone greater exertions it tends to be either bitter-bilious or black-bilious, the former in summer, the latter in autumn. One must, however, also consider the 250 K. length of the exertions: the greater their duration, the greater the tendency towards the black-bilious. Further, if the exertions are accompanied by substantial sweating, they make the residue thicker, whereas if they are not they make it finer, as do those that take place in winter and, in general, in cold [atmospheric] conditions. One must, simultaneously, consider the amount of the urine – and indeed the quality of the sweat, for this may be vinegar-like, salty, or possessed of a clear odour similar to that of ordure or waste. And this may be investigated by means of the strigil, when they bathe. In many cases, for example, it appears completely bitter-bilious, like that separated off in jaundice. The discernment of this is easily carried out, even before tasting, from the colour alone; for its appearance is pale yellow, like that of the bile of that sort. In many cases, after extremely vigorous exertion and intense overheating, it is observed to be actually yellow. Sometimes, too, it is a combination of the two, as it were midway between pale yellow and yellow, just like the 251 K. fluid of bile.18 This may be seen also in the vomit and in the faeces: a colour which is either pale yellow or yellow or a composite of the two.

18

‘Midway between pale yellow and yellow’ translates ōchroxanthos, a compound adjective which Galen seems to have coined, and which occurs a few other times in his work, two of them within this text. (It is used only once outside the Galenic corpus, by Aretaeus, who also says that this is the colour of bile (IV.11, 80,7 Hude).) For these colour terms and their relationship to bile, see Book II, n. 16; and cf. also below, V.5, 145,3–24 Ko. (VI.335–337 K.), on wines.

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Whatever quality the fluid has when contained in the body, this will necessarily also be apparent in the liquid [secreted].19 Now, sweat is an indicator of the fluids which are in excess throughout the body as a whole, while urine is an indicator only of those which are 30 contained in the vessels. One should therefore omit nothing, but consider the sweat too, as just stated. Sometimes it is worth asking the patient himself to taste it, in the interests of more accurate discernment; and this tends sometimes to happen of its own accord, as sweat from the 111 Ko. brow and that area drips down into the mouth. One should also consider the consistency, as well as the colour, of the urine. Nor should one leave any of the suspended matter or the sediment in the urine uninvesti- 5 gated.20 For all such things give an accurate indication of the nature of the blood in the vessels. If this is bilious, it follows necessarily that the liquid secreted will also appear bilious (in accordance with either of the physical forms of bile) – and there will be an analogous consequence if it 252 K. is phlegmatic. If it is completely uncooked, the urine will be fine and watery, without any sediment or suspended matter; but when it is 10 subjected to coction, these will be in evidence, and a kind of fine mist will appear upon the surface, from above, similar to the scum or crust that develops on a soup when it is cooling down. If it appears cloudy, like that of beasts of burden, this will be an indication that the veins have become filled with what are termed ‘raw’ fluids, but that the [living being’s] nature is not at rest in relation to these fluids, but is vigorously 15 subjecting them to coction.21 If the separation takes place quickly, and the deposit is white, smooth and even, this indicates that the [living being’s] nature is just on the point of mastering all these fluids. If it is clear on urination, but then immediately becomes cloudy, this indicates a nature currently attempting to subject the raw fluids to coction; and if this happens not immediately but after a considerable time, this indicates 20 19

The term translated ‘liquid’ here is orros, more literally ‘whey’; that literal sense gives an impression of the kind of watery fluid that Galen has in mind here. 20 Galen distinguishes huphistamenon (or hupostasis), the sediment, or what is found at the bottom of a container of the fluid, from what is suspended, enaiōroumenon (or enaiōrēma) at the top. (The text as it stands seems suspect: one should surely prefer ὑφισταμένων, a participial form of the verb Galen regularly uses in such contexts, to the form with the additional prefix παρ-, which would be a hapax legomenon in his corpus. VR have that participle, though unfortunately in the wrong grammatical case, ὑφιστάμενα.) 21 The relevance of beasts of burden to coction and raw fluids seems to be that such beasts are understood, in general, not to subject their foods to full coction, although this is not for them a pathological situation. (This secretion of ‘raw’ fluids was perhaps taken to be connected with the raw nature of the foods that the animals in question eat.) In any case, the perception that such animals have ‘thick’ urine seems to have been traditional; cf. Hipp. Epid. VII.89 (V.446 L.), mentioning ‘urine thick like that of a beast of burden’.

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that such an attempt is not immediately present, but will take place in the future. You should use the separation – whether it happens quickly, slowly or not at all22 – as an indicator of common application in the case of all cloudy urines. If it happens quickly and the sediment is white, 253 K. smooth and even, this indicates that the [animal’s] nature is much stronger than the fluids which are being subjected to coction. If the sediment is good, but takes a longer time to appear, this tells one that its 25 nature, also, will take a longer time to master the fluids. If urination takes place either not at all or with poor sediments, then the nature is weak and requires some assistance for the coction of the fluids. Just as the urine indicates the state of the fluids in the vessels, so 30 sweating, and other things which are apparent throughout the condition of the living being as a whole, are indicative of what is happening in that condition. Here, an unaccustomed sensation of hotness arises when there 112 Ko. is a dominance of hot fluids, and a cold one when there is a dominance of cold ones. Moreover, the person appears to be more white when there is an excess of phlegm, more pale yellow where there is an excess of bile, and, if the latter is particularly unmastered, more yellow. For the colour23 will be that of the fluids, not that of the solid bodies in the animal, 5 except in cases where the fluids retreat to deep within the living being – which happens in the case of cold, or rigor, or an affection of the soul, 254 K. such as fear, violent distress or incipient shame; if none of these is present, the fluids will never retreat back to deep within. Similarly, the fluids will never burn the skin by rushing towards it forcefully unless the 10 soul is undergoing some affection, or the living being is being subjected to immoderate warmth from the outside. With people who have become violently angry or enraged, therefore, or when they are presenting what we may call the back-flow of fluids24 that results from shame, one should not pay attention to the colour; but in cases where there is no attack of 22

Diakrisis and the cognate verb diakrinein, both in this passage translated ‘separation’, may refer simply to the secretion of residues, or the process of urination itself (as e.g. below, VI.1, 168,19 Ko., VI.382 K.); but here it seems rather to refer to the process of separation within the urine itself, i.e. how quickly a sediment appears. 23 Here chrōma (or, more usually, as later in this paragraph, chroia) refers to the apparent colour of the person as a whole, i.e. what we would call the complexion; cf. III.10, 96,30–33 Ko. (VI.219 K.) above. It should be recalled that these three terms – white (leukos), pale yellow (ōchros) and yellow (xanthos) – are considered as points on a spectrum; cf. n. 18 above, with cross-references there. 24 The Hippocratic Humours has this same phrase (ampōtis tōn chumōn) in its first line: Hum. 1, 158,3 Overwien (V.476 L.). Galen is clearly evoking that text, but conceptually he seems to have in mind the notion that shame involves a flow of fluids away from and then back towards the surface; cf. Book II, n. 60.

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the surrounding hot or cold, and no affection of the kind just mentioned has arisen, then the discernment of the fluids on the basis of the colour of the living being will be infallible. So, then, just as the fact that a body has become whiter than usual indicates the dominance of the phlegmatic fluid, and the fact that it has become more pale yellow, or yellow, indicates the dominance of the bilious fluid, in the same way an increase in red indicates that there is more blood than normal, and an increase in black that there is more black bile. Sometimes the body may appear to you similar to lead in its colour, and sometimes like some combination of white and blue-grey; at 255 K. other times the blue-grey colour alone may be dominant, without the white. Such colours indicate the dominance of a raw fluid, which belongs to the phlegmatic type, but is less moist than that usually referred to as phlegm. In general there is no viscosity present; if it is present, this is the sort of fluid called by Praxagoras ‘glassy’, which is significantly cold, but less thick than that termed ‘raw’ par excellence. All such fluids are white and raw in the general sense, but within that they are given different appellations. This is not the appropriate moment to specify all of them; for present purposes all that concerns us is the common feature, which is that they have not been completely processed by the [animal’s] nature, but are still raw. For blood is at the boundary between bilious fluids and these ones, which as a class may be referred to by a single term, either ‘raw fluid’ or ‘phlegm’. The former are produced when the blood has been over-processed, the latter when that process has not yet taken place. The individual distinctions with each are limitless; 256 K. but some kind of specification has already been given by those who are skilled in such matters, using a manageable number of types. Not even all these are necessary for the present discussion; it is sufficient to place all under one main heading,25 which it is then appropriate to have as our aim in view in our practice. Some, before the nourishment has been completely turned to blood, are as it were half-cooked; some totally uncooked; some nearly achieving the form of blood; some at an extreme of blood-production, as a consequence of an imbalance of heat; and within these latter, some are closer Reading τὸ κεφάλαιον (with V and R) for Koch’s τὰ κεφάλαια (which would mean ‘place all the main headings [or, chief points] under one’): the sense is surely that all the types, not just the chief ones, are brought under one heading, and the term kephalaion is typically used in such cases to indicate a main heading or uniting feature for a range of items. In this case what Galen more precisely means is that there is one main heading for each of the broader ranges of phenomena. The same usage appears twice in a very similar sense at Temp. I.4, 15,5–10 H. (I.531–532 K.): εἰς ἓν κεφάλαιον ἀγαγὼν … εἰς ἓν ἅπαντα κεφάλαιον ἀναγόμενα.

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to and some further away from blood, and some very far indeed.26 In the case of those which are closer to it, on either side, one may confidently employ venesection; in the case of those which are further, one should do 10 so only with caution, and in the case of those which are very far from it, one should not do so at all. One should at the same time also attempt to consider the quantity, in each case. If, for example, there is very little good blood, but a large amount of some other fluid, one should refrain from venesection; if the latter is small in quantity while the blood is 257 K. abundant, one may cut with confidence. Then, in such cases, one should 15 empty the stomach from below, as already stated, paying attention to the amount and the nature of the fluid which is in excess. If, however, the patient refuses to submit to the doctor for any kind of removal of blood, because of either age or timidity, one should subject him to a very strong purging. If he is suspicious of this, too, one must evacuate what is superfluous in some other way. In the case of the type of nature presently 20 under discussion, it is not difficult to discover other manners of evacuation; in others, one should discover them by the use of more precise specifications. These we shall discuss further once we have completed our discussion of the nature which is endowed with good fluid.

Build-up of half-cooked fluids after fatigue following poor regime Let us take the case where such a person has become fatigued after a poor daily regime, and then, on the basis of the signs mentioned above, some 25 build-up of half-cooked fluids is apparent in the venous class of vessels, and in the body as a whole some build-up of those biting fluids which led to the fatigue; and let us take it also that there has been a certain concomitant increase in the blood. The main thing one must do, as 258 K. stated, is to remove from the blood and then purge that fluid which 30 appears to be dominant. If, however, the removal of blood is not permitted, one must increase the purging. If the patient refuses both, one should investigate the other means by which – if not quickly, at least over a longer period of time – one may best restore the person to his original bodily condition. Since, then, the first two aims of the rectification are common to all 114 Ko. such states, that is to say the coction of the uncooked and half-cooked fluids which are generated before the blood, and the evacuation of acrid, 26

The picture Galen is presenting is of a spectrum of qualities of fluids, arising in the digestive or coctive process, with raw and phlegmatic at one end and cooked and bilious at the other, true blood representing a perfect midpoint of the process; see further Introduction, section 4.5.3.

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biting ones which are secondary and subsequent to the blood, one should keep these patients from all vigorous motion, softly apply and rub oil in conjunction with the gentlest possible baths, and then instruct rest and fasting, and, if possible, sleep, in the clear knowledge that nothing brings about coction in those substances capable of it, and disperses bad fluids, so well as sleep after bathing. If, then, as was stated a little earlier, after an 259 K. attempt on the first day, where the fatigue subsides readily, we see that the person is still equally troubled, we should bring him to bathe and compel him to rest and fast on the second day too; and we should realize that, as on the second, so also on the third day, bathing while fasting is appropriate, and rest and sleep between bathing. For these persons, indeed, the bath itself is of considerable help also in bringing about sleep. People always become more prone to sleep after bathing, in the absence of some more powerful factor preventing it. Sleep, then, becomes both a good cause and at the same time also a good sign of the desired benefit, just as, conversely, the inability to sleep after bathing is the opposite of these. You may thus even, to a considerable extent, discern the excess fluids on the basis of sleep and sleeplessness. Cold ones lead to kōma and long sleep;27 hot and biting ones to a sleepless state, in which, even if the person does occasionally fall asleep, the sleep is troubled, with vivid dreams, so that the person quickly rises from them. As on the first day, so too on the second, we should give very 260 K. small amounts of simple gruel; to give more to those in need of evacuation is directly contraindicated, while conversely not to nourish them at all leads to nausea, and is harmful to the mouth of the stomach, destructive of capacity and productive of bad fluid. One should therefore give them a very small amount, especially, if possible, of the juice of a simplyprepared barley-gruel, or otherwise of that of groats,28 prepared in the same way as the barley – especially where we suspect a build-up of raw fluids either in the veins or throughout the whole volume of the body.29 27

By kōma Galen means a profound sleep or state of semi-consciousness. By ‘groats’ (chondroi) Galen apparently refers to a kind of coarse wheat grain, used especially in gruel preparation, which he takes to be of considerable importance in the healthy diet; cf. Alim. Fac. I.6, 225–226 H. (VI.496–498 K.). 29 For Galen’s views on the different grains used for bread and gruel, their relative values and various products, see Alim. Fac. I.2–17, 217–243 H. (VI.481–525 K.). Amongst wheat flours, he makes a fundamental distinction between the most dense (puknos) kinds, which are also the most nutritious (trophimos), and the most ‘pure’ or ‘fine’ (katharos) kinds, which give less nutrition in relation to their bulk, with a wide range in between. I retain the translation ‘volume’ for onkos throughout; ‘bulk’ or ‘mass’ would be alternative translations (cf. Book II, n. 44), which might seem to capture the sense more closely in some cases; but the conceptual distinction between volume and mass is not as clear-cut here as it is for 28

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For if the groat is taken without vinegar,30 then it is more viscous than appropriate for the present case, and will therefore obstruct the channels rather than cleanse them through, as is especially required in the case of thick, viscous fluids, such as, in general, all those of the phlegmatic type. Now, this [groat] has good fluid, and therefore has a moderating effect on the bad fluid. If, however, the viscous quality in it is not checked, by the addition of a moderate amount of vinegar and leek, then it will obstruct and nourish more than is beneficial for such persons. It is for 261 K. this reason that the juice of barley-gruel is preferable in such cases, since it gives a moderate level of nourishment and does not become retained in any of the narrower pathways, as does that of groat; rather, it comes through itself and at the same time also cleanses the channels ­thoroughly, in a process of cutting and dissolving all that is thick in the half-cooked and uncooked fluids. This, indeed, is why honey-mixture is suitable for them, too, as well as honey-vinegar, honey-preserve,31 pepper, ginger and all things which cut and dissolve what is thick without producing bad fluid. More will be said about these actual materials in what follows; for the purposes of the present argument, both those already mentioned and those which will be discussed may be taken as examples. Of pulses, the most suitable is barley; of vegetables, lettuce; of fish, those of the rocks; of breads, those which are baked in a terracotta oven, leavened, with moderately fine flour; of birds, those of the mountains; of drinks, honey-vinegar, honey-mixture, wine which is fine in quality and white – in short, all those things which have good fluid, are cleansing, 262 K. and are not viscous, thick in their fluid or excessively nutritious.32 For the us, and, while no one translation covers the semantic range perfectly, I have preferred at least to preserve consistency. Oxos is the standard word for vinegar, but it may also refer to the sharp wine (Latin poxa) which was very widely drunk in the Roman world. I have used the translation ‘vinegar’ throughout, but it should be borne in mind that Galen may in some cases have this more drinkable product in mind. 31 The three honey-based preparations mentioned are, respectively, melikraton, oxumeli and apomeli. The last is a preparation which is made by boiling the honeycomb, and then set aside, as described below; it is mentioned by Galen only a handful of times, including the three references in this text. Oxumeli, which is much more frequently mentioned, is a mixture of honey with oxos, vinegar (on which see previous note). Melikraton was a mixture of honey and water, used from classical Greek times, including in libations to the gods, and by Galen’s period a standard part of the repertory of home preparations with a medical application. Dioscorides describes the preparation of all of them at V.9. 32 The characterizations of individual foods can be closely paralleled from The Capacities of Foodstuffs; and there is a close correspondence between the choices made here and those recommended in The Thinning Diet. The classification of barley under ‘pulses’ looks odd: I have preserved this translation of ospria here for consistency, and indeed Galen elsewhere specifies that the word is applied to ‘those cereals (Dēmētria spermata) from which bread is not made: beans, 30

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circumstances under discussion, the substances known as diuretic cannot be countenanced, especially those which vehemently heat and melt the blood: in cases where good coction is about to take place, there is no need for such disturbance. All these things, then, should be done in this way on the second day, and equally on the third and fourth. In addition to this, if the fatigue-like state is being relieved, while the body acquires good colour, with ripened urine33 and good sleep, one may venture to give more massage and a very little exercise. If one proceeds in this way and there arises no sensation of fatigue, then one may swiftly return to the usual exercise regime; if, on the other hand, any of the previous symptoms or signs appears, then you must again direct your attention to this, and attempt to alter the individual features accordingly. If a recollection of the sensation of fatigue is the only thing that occurs, while all other signs remain good, then one should rectify this fatigue through 263 K. restoration; if, meanwhile, the signs are disturbed and, as it were, confused, but there is no presence of fatigue, then one should keep the person at rest for a longer period; if both circumstances occur simultaneously, then you should keep to the same form of care which you employed previously to make the beneficial progress that led you to risk a certain level of exercise. This, then, is the manner of rectification for the state mentioned.

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Fatigue involving small amount of good blood and large quantity of raw fluids 5. If the other circumstances are the same in the case of the person mentioned, but there is only a little good blood in the fatigued body, with a large quantity of raw fluids, then one should not cut, purge or exercise, nor engage in motion or bathing at all. For venesection will then evacuate the good blood, while drawing the bad blood, which is gathered 10 especially in the veins, in the liver and the mesentery,34 into the whole body. And purging, in such cases, produces twisting of the gut, biting sensations and fainting, while also not accomplishing a proper evacuapeas, chickpeas ...’ (Al. Fac. I.16, 243,2–5 H., VI.524 K.). But there is clearly a certain fluidity in classification, in relation to (in our terms) pulses and cereals. In line with the theory of coction and of raw and cooked fluids which Galen has been outlining, by this is meant urine in the right state, with the fluids appropriately ‘cooked’. 34 For Galen’s understanding of the mesentery (mesenterion or mesaraion), an anatomical body enveloping the veins, arteries and nerves in the region of the liver, and connected to the ­intestines, see AA VI.6, 373,28–374,11 Garofalo (II.563 K.). 33

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tion; for the raw fluids are all idle and difficult to move because of their thickness and coldness. So, they also obstruct all the narrow pathways, by 264 K. which the evacuated materials should arrive at the stomach in the process 15 of purging; they are therefore themselves not evacuated, and also impede the others. Now, this recommendation was also made by Hippocrates, in a very short statement: ‘Treat with drugs and move the cooked, not the raw.’35

Build-up of raw fluids in first veins; preparation of Diospolitikon and of three-pepper drug; honey-based preparations It is for the same reason that it is not appropriate to exercise or in general to cause motion in those who have a build-up of raw fluids in the first veins.36 All such motions set the fluids moving into the whole of the body. One must, therefore, keep them at complete rest, and give food, drink and drugs which thin, cut and process the thickness of the fluids, without noticeably heating; fluids which are very powerfully heated reach every part of the body. One should keep them to a diet mainly of honeyvinegar, giving also occasional small amounts of barley-gruel and of honey-mixture. For these subjects tolerate the thinning diet better than anyone, as they are able to use the build-up of raw fluids for the nourishment of the body, while also gradually subjecting them to coction. Since, 265 K. moreover, the abdominal region37 has been bloated and inflated by such [fluids], and whatever is taken will readily be aerated, it is best to give some long pepper with the nourishment. This dissolves the thickness of the flatulent air; and what has collected, unmoving, in the abdominal region is pushed away towards the lower [part of the] stomach, and removed along with [other foods] taken in the process of coction, in the same way as happened with all types of pepper. If the long pepper is not available, one should use the white; for this increases the tension of the mouth of the stomach more than the other two kinds. If the white is not available either, one should use the best of the black ones, which is the ‘heavyweight’.38 35

Aphorisms 1.22 (IV.468 L.). The word translated ‘cooked’ (pepona) may also mean ‘ripe’. Galen regards the liver as source of the veins; by ‘first veins’ he means those closest to, and growing directly out from, the liver; cf. V.8, 152,2 Ko. (VI.351 K.) and Book VI, n. 18. 37 Hupochondrion: see above, Book I, n. 95. 38 Galen refers to piper longum and piper nigrum, which were valued commodities in the ancient spice trade. 36

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It is preferable, too, to use the drug known as ‘Diospolitikon’. There are two ways of preparing this, one with equal amounts of cumin, pepper, rue and natron (this has a greater laxative effect on the stomach), the other in a combination with equal quantities of all the other ingredients, but half the amount of natron.39 The variety of cumin known as ‘Ethiopian’ is to be preferred as an ingredient, and either the ‘long’ or the ‘white’ variety of pepper; and the cumin should be soaked in extremely 266 K. acrid vinegar, then immediately pounded, or after having been previously moderately roasted in a terracotta vessel which has been fully fired in a furnace. (Those which have been insufficiently dried are more like clay than terracotta, and something of their quality gets rubbed off into the drugs being prepared.) The leaves of the rue, too, should have been moderately dried in advance. If they have been too thoroughly dried, they become acrid, bitter and hotter than appropriate; if not previously dried at all, they contain some residue-based moisture which has not been completely processed, and are therefore not entirely free from flatulence. One sometimes adds skimmed honey to these four ingredients, one sometimes adds only these ingredients on their own, set aside40 without honey, to the juice of barley-gruel, and to whatever other food seems most appropriate. This drug may also be taken on its own, both before food and after food. In the case of this kind of use, the one mixed with honey is the best, provided that the honey is completely skimmed; for then it is freest from flatulence. The honey itself, of course, should be the finest, if the drug is 267 K. to be as free from flatulence and as cutting as possible. Also suitable for those in such a state is the three-pepper preparation – provided that it has not been prepared as something highly drug-like and manifold, in the way that most doctors put it together, like some rich sauce or wild pig dish prepared by one of these show-off cooks. It is an important task for doctors or for those who take it to boil thoroughly the drugs that are added to it: ajowan, hartwort, lovage and all of that sort; for these are discerned to remain for a very long time in the stomach if taken raw and unchanged. These, then, must be removed from the drug, as must elecampane, spikenard and cassia (which some include). One should have two preparations ready, as is our own practice: a simple one, which should be given in the case of people who have performed poor 39

Cf. n. 15 above. Or ‘stored’ (apotethenta).

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coction, or those who have a recent advent of cooling or phlegmatic fluid in the stomach; and another, drug-like, one, which we use particularly 268 K. for the flow of liquids from the head into the chest. The manner of preparation of this latter one will be stated on another occasion; but the simple one – which we use also for build-up of raw [fluids] in the first veins – is as follows. Take fifty drams41 of each of the three peppers, and add to these no more than eight drams each of anise, thyme and ginger. This is the simplest – except for that without even ginger. Another is that composed of the same ingredients, but with sixteen drams each of anise, thyme and ginger added to the fifty drams of each pepper; this, too, we use especially for the cases now under discussion. If possible, the anise should be Cretan and the thyme from Attica, or at least from some high, dry region. The leaves should be added as well as the flowers, but with the woody material separated off. The long pepper should be healthy, and should not have been perforated, so too the ginger; for both become 269 K. perforated very easily. In addition to not having been perforated, the pepper should, of course, be true pepper, imported from foreign lands.42 There are two common fakes produced here: one a preparation made especially in Alexandria, the other the shoot of a particular herb. I shall explain how one may recognize these fakes; and let me first say a few words in order to forestall any surprise or question that some may raise as to the reason why I have now come to write about the composition of drugs, or indeed the testing of them, while I am not in the habit of doing any such thing in the treatise on healing.43 The reason is that in that work I am addressing only doctors, while here I am addressing all those to whom some have applied the general appellation ‘medicine-lovers’.44 The latter are people who, of course, have 41

For the system of weights used here, see Note on translation, p. xxiv. On this translation of the adjective barbaros, see Book I, n. 86; an alternative translation here might be ‘from outside the empire’, but the core sense is that of an area outside the Greekspeaking world, or world of Hellenized civilization. 43 On the varying manner of Galen’s references in this work to the ‘treatise on healing’, on what they may tell us about the dates of the works, and also on the question whether these are in all cases references to the actual treatise, rather than to the study or subject area more broadly (the word pragmateia covering both senses, cf. Book I, n. 20), see Introduction, section 8.2. 44 The term philiatros is a rare one, including in Galen, and little attested before Galen’s own time. It could also be translated ‘amateur of medicine’ – provided that one understands this in the more traditional, positive sense of ‘amateur’. He does not elsewhere offer any more detailed definition of it than that given here; but cf. Adv. Typ. Scr. 1 (VII.477 K.), where this quality in conjunction with willingness to work hard will lead the lay person to respect doctors’ distinctions between fevers. (A somewhat different sense appears at Comp. Med. Gen. III.8, XIII.636 K., where it is paired with philopharmakos, ‘drug-loving’: rich people who have both these ­characteristics will 42

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undergone an education in the fundamentals,45 so that their intellect has been trained. It is not necessary for such people to have been trained in 119 Ko. the study of the simple drugs nor in that of the compound ones; still less to understand the manner of preparation or the manner of testing of each of these. For the benefit of these people, it is advisable to write 270 K. down everything of this kind with precision, in the same way that I took 5 it upon myself just now to give a thorough account of the long pepper. One should taste it first, considering precisely whether it retains the quality of pepper; and after this one should put it in water. The fake product, when soaked for a whole day, is immediately broken down and dissolved. If, then, the substance does have the precise quality of pepper, and is not broken down when soaked, and furthermore has (as already 10 stated) not been perforated, you should take this to be the appropriate kind of long pepper. As for the black type, this should be neither short, nor shrivelled, nor thick-rinded; rather, one should select the largest and best growth of the type known as ‘heavyweight’. In the case of the white pepper, too, one should select the largest and best growth. Then, when all has been 15 chopped up and put through a fine sieve, one should very carefully mix in the finest skimmed honey. This should have a good smell, and be yellow, extremely sweet, but also extremely acrid; and should be neither thick in its consistency nor so wet as to lose its cohesion; rather, it should be such that if one puts one’s finger into it and then lifts it out, one 20 271 K. should see a very long downward drip of the honey, still retaining its cohesion. It is best to cook it on charcoal or on completely dry wood, the type known as smokeless. The drug should be administered not once or twice, but many times during the day; appropriate times are: first thing in the morning; before food; after food; and just before sleep. The dosage 25 should be a spoonful on each occasion: a small one in the case of small scorn to use cheap, rather than expensive, drugs.) Plutarch uses the verbal cognate, philiatrein, with reference to philosophers who take a serious interest in medicine (De tuenda sanitate praecepta 122d), to the interest in both theory and practice of philosophy attributed by Aristotle to Alexander the Great (Alexander 8), and also to the king Mithradates VI Eupator of Pontus (first century BCE), who was so ‘medicine-loving’ that people in his entourage submitted themselves to being phlebotomized and cauterized by him (Quomodo adulator 58a); on Mithradates’ medical interests see also Book V, n. 36. Galen’s remark here has a broader significance, however, attesting both to the active interest in medicine and drug preparations by non-professionals in his time, and to the distinctions between different intended audiences for his works. Cf. Introduction, section 3.3. 45 Or ‘elementary studies’ (literally ‘first lessons’, prōta mathēmata): Galen uses the phrase to indicate the essential preliminary education, especially in logic, needed to enable a person to follow and assess arguments, as opposed to other more specialized studies; cf. Aff. Pecc. Dig. II.3 49,14 DB (V.72 K.) and II.5, 60,24 DB (V.90 K.)

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bodies, a very large one for very large bodies, and, similarly, an appropriate size for the bodies between those. It is also beneficial to take ginger – the type that has been imported from foreign lands – soaked in vinegar. This is the root of a green herb, placed in vinegar immediately after harvesting. For the heat of such drugs is immediately quenched some- 30 where in the very first veins, and is not transmitted to the whole body, as it is in the case of certain other drugs – the catmint-based drug, for example, which will be discussed further shortly. 6. In this respect honey-vinegar, too, is extremely useful for them, as also 272 K. mentioned previously. This should be prepared in the following manner. The finest honey should be skimmed, over charcoal, and a sufficient quantity of vinegar added that it seems neither excessively sharp nor excessively sweet. It should then again be cooked over charcoal, so that the qualities become completely unified and the vinegar does not seem raw to the taste. One should then set it aside and add water to it on use, mixing the water in the same way as one does with wine. As long as the person drinking it does not complain of its being either excessively sharp or excessively sweet, one may proceed to use it all; otherwise, one should take what is left and boil it off again. I am not in agreement with the practice of those who prepare this mixture according to a single formula; this seems to me similar to the practice of those who recommend the same mixture of wine and water to all drinkers, failing to realize that some, who are accustomed to a more dilute mixture, will immediately suffer in the head if someone gives them an even slightly more concentrated one, while others, who enjoy the more concentrated mixture, will upset the mouth of their stomachs if they drink it more dilute. If, then, this happens with wine, which is such a familiar drink, it is reasonable to suppose that these consequences will follow all the more so in the case of 273 K. honey-vinegar, to the extent that it is less familiar, as well as stronger, than wine. It is therefore preferable to make one’s evaluation of what is well-balanced in accordance with the perception of the person taking the substance, not in accordance with our own perception. One should assume that what is most suited to the nature of the person who takes it is the most pleasant honey-vinegar, which will thus also be the most beneficial, while that which is least pleasant to that person will be the most opposed to his nature. The very first mixture of it, that which will suit the majority, should be made in the following way. One should combine two parts of honey – from which the scum has been removed –

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with one part of vinegar, and then boil on a gentle flame, until the qualities are unified; thus, too, the vinegar will no longer seem raw. Honey-vinegar may also be prepared by using water at the outset, as follows. The water, which should be the finest kind, should be combined in the proportion of four parts to one of honey, then boiled moderately, until the scum appears upon the surface. Poor-quality honey produces a very large amount of scum, so that it needs to be boiled for a longer period of time; the best honey produces a very small amount, in a much shorter time, and so does not require the same length of boiling. A very long boiling process leads to a reduction to a quarter of the original 274 K. amount of the mixture. One should combine with an amount of vinegar which is half that of the honey and then again boil until their qualities are completely unified and the vinegar no longer seems raw. The preparation may also be carried out by combining the three ingredients together at the outset. There should be one part of vinegar to two of honey and four of water; these should be boiled down until a third or a quarter remains, and the scum should be removed during the process. If you wish to make it stronger, you will put in the same amount of vinegar as honey. Honey-preserve is best prepared with water; and it is drunk throughout the whole summer as a cooling drink. It may, if desired, be usefully employed for the kind of state presently under discussion, and especially when it has been made sharper, something which very commonly happens, to either a greater or a lesser extent, in the course of its preparation not with rain-water (which one uses in the case of honeywater), but with whatever water is to hand. It is also possible to make it with rain-water, if one so wishes; and I might even recommend this procedure, if I actually thought rain-water advisable; but I do not think it advisable; moreover, it can be made sharper just as well [without], espe275 K. cially for present purposes. This sharpening takes place to a moderate degree provided that one is not entirely careless in one’s preparation. Here, care should be taken to ensure that the honeycomb is not of extremely poor quality, and that it be boiled for a long time in clear, pleasant spring-water. One should squeeze out the honey from the honeycomb and boil it in the water until scum ceases to appear. This, then, is one drink that should be used. Amongst wines, one should use those which have been slightly sharpened; of foods, those which thin without heating. The caper is in this category, if taken in honey-vinegar or oil-vinegar. Keep to this diet for two or three days, as already suggested. If at that point you are confident that the raw fluids

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have already been sufficiently thinned, then administer wine which is fine in its consistency and either tawny46 or white in colour: the one is good for good fluid and coction, the other for urine production. Amongst Italian 30 wines, the Falernian and the Sorrentine are in the former class, the Sabine, Alban and Adriatic in the latter.47 Amongst Asian wines, Lesbian and 276 K. Ariusian48 are in the former, Titakazene and Arsyenian in the latter. Let these be given as examples; there are many others similar to the above in 35 both Italy and Asia, and indeed amongst other peoples. One should 122 Ko. make one’s own choice of these, by reference to the aims stated, the colour and the consistency, and should reject thick or black wines as being productive of bad fluid and slow movement [of the fluids]. If the person improves on the stated regime, one should bathe him, 5 apply oil and massage gently, and as soon as the urines acquire some sediment, one should increase the massage as well as returning the person gradually to his usual exercises. During this period one should also use oils which have a dispersive effect (which I mentioned also earlier, and will discuss again). I do not, however, recommend the use of emetics in 10 such states, as suggested by some doctors and trainers who have, I believe, been led astray by their reading of Philotimos and Praxagoras49 277 K. on the treatment of such fluids. For these authorities do not in fact evacuate by emetics when the excess of such fluids is accompanied by a fatigue state,50 but in cases where those fluids are the sole source of 46

Kirros: this indicates a colour between xanthos (‘yellow’) and purros (‘red’, ‘fiery’); cf. Book II, nn. 16 and 17 and Book V, n. 33. For further information on the various wines of the ancient Mediterranean region, their perceived relative values and their use, including in medical contexts, see book XIV of Pliny’s Natural History, where several of the wines listed here are also discussed. He classes both Alban (from a city in Latium) and Sorrentine as next in quality after Falernian, which was grown in a particular region of Campania (XIV.62–64); and also discusses Adriatic wines (XIV.60–61 and XIV.67). He lists wines from outside Italy at XIV.73–76, prominently mentioning Ariusian (which was from Chios), Lesbian and that of Tmolus. The Arsyenian wine apparently also came from the region of Chios. Further on wines see book V, chapter 5, as well as Bon. Mal. Suc. 11, 420–425 H. (VI.800–809 K.). The Falernian was particularly famous; cf. Book III, n. 40 for Galen’s account of his own first encounter with it. 48 It is interesting to note that these two appear under the heading of ‘Greek’ wines below, V.5, 144,15 Ko. (VI.334 K.); of course, the Asian geographical location and culture Galen refers to here belongs firmly within the Greek-speaking world; cf. Book I, n. 86 and Book II, n. 43. 49 On the prominence of Praxagoras and Philotimos within the discourse on physical training and healthfulness, see Introduction, section 2.3, with n. 13. 50 I read κοπώδει διαθέσει for κοπώδεις διαθέσεις, an emendation surely required by the sense. The point is whether the fluids in question undergo a build-up (πλεονάζωσιν) in conjunction with the fatigue state (ἅμα κοπώδει διαθέσει) or alone (μόνοι): χυμοί (fluids) must be understood as the subject (supplied on the basis of χυμῶν in the previous line) throughout the phrase. The description of states, as opposed to fluids, as being ‘in excess’, and thus as the subject of πλεονάζωσιν, would be strange; and the fact that it is stuffs in the body, not states, that are the subject of this

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distress; for in this case there is no danger that some of the residues in the 15 flesh will be violently drawn inward in the reverse direction, as can happen when there is a simultaneous excess of both: raw ones in the first veins and biting ones in the solid parts. Either kind of reverse drawing of such residues is to be avoided, that is to say the drawing-outwards of the raw ones and the drawing-inwards of the biting ones. So, just as in the previous discussion we avoided the 20 drawing-outwards of the raw fluids, so we should avoid the drawinginwards of the biting ones. The chief [causes] of their being borne outwards are: exercise, massage, baths, warmth and warming applications of oil, and, amongst affections of the soul, sharp-spiritedness51 – and, to put it simply, all those which provoke the fluids deep within the living being to move from their place. The causes of their being borne inwards 25 are those which reverse the outward motion. These are cold and astringent stuffs brought into contact with the skin, as well as all other factors 278 K. which draw fluids or in any other way encourage their inward motion, among which are distress and shivering, from whatever cause this latter arises. (It has been shown that shivering and rigor may be due to a cold 30 or a hot cause, as well as to sounds or sights which shock and terrify the soul.) All such things, then, are to be avoided, whenever the person is in a fatigue state and at the same time also has veins which are full of 123 Ko. uncooked fluids. It is not a good thing either to draw the fluids which are on the outside inward, or vice versa. Those on the outside should be dispersed gently – for those things which bring this about too forcefully tend to attract some part of the ones from the inside, too – and those on the inside should be thinned and subjected to coction. If you attempt too vehemently to evacuate them, either by emetics or by the emptying of the 5 stomach from below, you will attract some of those on the outside to the inside. The followers of Philotimos should not be criticized for using such evacuation in cases where there is a build-up of raw fluids lying within the first veins, in the absence of any other state; rather, we should verb is further made clear by its further appearance in line 16, with ‘residues’ (περιττώματα) as its subject. 51 I preserve a rather literal translation of oxuthumia, to indicate the connection with the ­psychological–ethical notion of thumos (‘spirit’), which we have encountered several times before (cf. n. 11 above with further cross-references there); but the word could also be rendered simply ‘quickness of temper’ (on this, see von Staden (2011)). (The adjective oxuthumos occurs in this sense in a Hippocratic passage, Epid. II.5.16, V.130 L., which Galen more than once quotes in support of his view that Hippocrates supports his own Platonically-based psychology, as well as the distinction between veins and arteries e.g. at QAM 8, 63,4–5 M., IV.803 K.)

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ourselves make it our practice to follow the ancient writings more accu279 K. rately. Now, in cases where there is both a build-up of raw fluids inter- 10 nally and a sensation of fatigue externally, we shall cook hyssop with the actual honey-mixture and give this, not immediately, nor on the first day, but on those that follow. We shall, however, not advise emetics, because of the risk, already mentioned, of the reverse movement inward of some part of the external residues. Praxagoras and Philotimos, meanwhile, 15 quite reasonably adopt the use of emetics, after such honey-mixture, when they are treating raw fluids without a fatigue state.

Persons with build-up of raw fluids absorbed throughout; preparation of the catmint-based drug; variations in recipe 7. Since, then, enough has been said on this subject too, the appropriate moment has perhaps arrived to begin consideration of the remaining state, in which the veins contain good blood, well-balanced in quantity, but the build-up of raw fluids has been absorbed52 into the subject’s condition. The particular circumstances in which this tends to arise are those in which warmth or immoderate exercise carries off the raw fluids from the veins into the flesh, in the case of people who have not experienced a recent failure to carry out coction; if this does indeed also happen, the whole body will then be filled with raw fluids. The manner in which one should rectify such a state will be stated a little later. Since, 280 K. however, what is composite is secondary and subsequent to what is simple, it will be preferable to give a thorough account of the other state, which is simple, and to return after that to the composite ones. That one, too, however, should not be thought to be completely simple, only simple in the context of spontaneous fatigue. We may take the state which produces fatigue as the underlying situation, and then add in to it the others. It is because, within the resultant combination, there is sometimes a single, simple state, and sometimes a composite one, that we therefore call the state in question now ‘simple’. Let us take the case where there is a build-up of raw fluids in the solid parts of the living being, not in the veins, in conjunction with the presence of a wound-like state of fatigue in the same parts; for such was the initial basis of this discussion. In the case where the build-up of raw fluids was in the veins, especially the first veins, we avoided things which heat, because of the 52

Literally ‘taken up’ (analambanein).

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risk that such fluids would be absorbed into the condition of the person; in the present case, however, there is no such risk. One should, then, give such subjects whatever will extend the heat as 281 K. far as the skin, and one should apply massage for longer periods, with oil which is slackening, especially immediately on rising after sleep: such massage at once both subjects the raw fluids to coction and nourishes the volume of the body. After this, there should be a lengthy period of rest, if these outcomes are to be produced successfully. One will much more definitely achieve the aims which they have as their purpose, if the subject takes small amounts of food on the first day and drinks nothing after the meal but tawny wine, fine in its consistency. Nor is it beneficial immediately to engage in continuous, vehement exercise, for there is a risk here that we inadvertently compel the body to be nourished while the fluids are still uncooked. It is thus preferable to have a lengthy massage first thing in the morning, then to rest, to take a moderate walk, and again to employ a long massage, a bath which is moderately hot, and nourishments of good fluid which are also not viscous. The materials of these have been stated already: we recommended for such purposes barley-gruel, fish of the rocks and mountain birds. The thinning types of food – to which we have devoted a specific book – are suitable here too. One need not even avoid things which heat vehemently, and may also 282 K. take the catmint-based drug without risk. Its composition is as follows: twelve drams each of catmint, pennyroyal, parsley, hartwort; four drams each of celery seed and thyme clusters; in addition to these, also sixteen drams of lovage and forty-eight of pepper. The pepper should be of the variety known as ‘heavyweight’, the hartwort should be Massaleotic, the parsley should be Macedonian and, more specifically, Astreotic, the catmint and pennyroyal should preferably be from Crete, but otherwise from high, dry places; and so too the thyme. One should remove the hard, woody parts of the herbs and take the leaves for the drug, especially the finest and freshest growths from the tips of the plants, as well as the flowers, and with them the finest of the fruits. One should chop them all together, then push them through a very fine sieve; for drugs prepared in this way are best distributed through the whole condition of the living 283 K. being, as, conversely, those which are very thick remain in the stomach, incapable of entering the narrow mouths of the veins. It is for this reason that we usually prepare the drug known as Diospolitikon, which we mentioned a little earlier in the present work, in a coarser manner, if the requirement is for it to empty the stomach from below.

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Someone who was unaware of this, and who had made the drug in an extremely fine and powdery form, thus provoking no such evacuation but giving rise to a considerable quantity of urine, once communicated the fact to us, as he was perplexed by it and wanted to find out the true cause. He stated that he himself believed the cause of this feature to be some idiosunkrisia53 – this was the term he actually used – of the person. When he learnt that the specific cause was the form of the recipe,54 he prepared it again in a different way and achieved his aim. So, this precept should be borne in mind in relation to the composition of drugs in general; as for that presently under discussion, everything should be taken in a thoroughly fine form, to facilitate distribution and movement throughout the body. The best-quality honey, completely skimmed, 284 K. should also be combined with the ingredients prepared in this way. The drug should be taken after the early-morning massaging, before exercise and bathing. It may, however, also be taken dry, without the addition of honey, in the same way as salts55 that are added to food; and it is also possible to add it to barley-gruel or vinegar or some such thing, in place of pepper.56 The dry preparation, similar to salts, is beneficial; so too is that with honey, which can also be combined with foods and consumed with some of them, so that it will seem pleasant to the person using it. After nourishment, however, one should never take either this or any other drug which produces very powerful distribution: at that time what It seems that the reading of M, ἰδιοσυγκρισίαν, is correct here and, more broadly, that this form of the word, ἰδιοσυγκρισία, rather than ἰδιοσυγκρασία, is the authentic original one, while the latter – from which our ‘idiosyncrasy’ is derived – is a hypercorrect form based on a false connection with the notion of krasis (mixture). The term used here, which is attributed to someone else’s usage rather than owned by Galen himself, seems to be derived from sunkrisis, a word for ‘combination’ or ‘agglomeration’ used by previous authors in a number of medical and philosophical contexts, in particular by Atomists and Methodists. (On this cf. Book VI, n. 35 below.) The term idiosunkrisia thus literally means something like ‘specific combination’. Gadaldini claims to have read ἰδιοσυγκρασίαν ‘in vetustissimo optimoque exemplari’, which may be true; but Koch plausibly suspects (partly on the grounds that this ‘vetustissimum exemplar’ seldom if ever departs from M, partly because the form ἰδιοσυγκρασία was already known from other sources) that this was in fact Gadaldini’s own ‘correction’. (Cf. Introduction, n. 158.) V, R and N meanwhile all offer garbled forms of the word. 54 Koch wishes to delete both εἶδος (‘form’) and ἴδιον (‘specific’), with no MS justification, and both seem to make perfect sense here. The person is seeking a causal explanation, which turns out to derive from what is specific to the recipe, not the individual who took it, and the second use of idion picks up that adjective’s appearance in the noun idiosunkrisia, indeed correcting that person’s use of it (perhaps even with a slightly mocking tone). 55 Cf. Book I, n. 60. 56 The sentence could also be construed to mean: ‘it is also possible to put vinegar or something similar into a gruel in place of pepper’; but the translation given seems to give better sense in context. 53

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has been taken should be subjected to coction rather than to distribution. Those who require some external assistance for coction should, therefore, at this moment be given the drug whose composition I explained earlier, that is to say the simple three-pepper drug. Even pepper on its own, sprinkled over drink, is beneficial in these circumstances; or, if the 285 K. need is greater, the quince-juice drug: I shall give a complete explanation of both the composition and the capacity of this in what follows. For the case presently under discussion, however, the best drug known to me is that catmint-based one. It both thins what is thick and viscous and disperses it, as well as provoking urination and, in women, the menstrual flow. It is also very pleasant to use, especially if one takes it with more honey; in this case it should be cooked for longer. For those who reject sweet things and avoid honey (for one does sometimes come across persons of this nature), a small amount of honey should be added in the composition; and it is better in this case too to cook it for longer; for not only is it less sweet like that, but also less apt to upset the stomach mouth, in persons who by nature reject honey. All these considerations will be arrived at on one’s own, even without our advice, if one keeps one common aim in view in all cases, namely that the drug should be as pleasant as is possible – while preserving its beneficial capacity: I do not, of course, suggest that one reduce this in 286 K. one’s quest for pleasure. After a person has undergone this kind of preparation for the first, say, two or three days, there should be no problem in his engaging in his usual exercises, while checking both his good colour and the other signs which were mentioned in the previous discussion. If all seem to you positive, then allow him to exercise fully; otherwise, stop him before a moderate amount, and keep him to the stated regime and drugs for that day too, again attempting exercise on the next day, on the basis of the same signs and aims. Thus, once everything appears faultless, you may return him to the same daily regime to which he was accustomed before he succumbed to the fatigue-like symptom.

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Drug preparations for those with accumulated fluids throughout 8. It is also beneficial for those who have accumulated fluids in their flesh, and in the whole volume of the living being, which require coction or distribution, to employ the pine-based anti-fatigue drug. So it will perhaps be no bad thing to say something about the composition of this 35 287 K. too. The best season for the seed of the pine is around the rising of

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Arcturus,57 a time of year which is known in Rome as Septembrius, by us in Pergamum as Hyperberetaios, and in Athens as the ‘mysteries’. It may, however, be added to oil at whatever time of the year one wishes; there is no difference as far as that is concerned. It should preferably be crushed before it is added; in this way it will fill the oil more quickly with its own quality and capacity. The time allowed for this process should be at least forty days; we have frequently had them soak for three, four or even many more months, after which we take the seed, press the fluid out from the seed, discard the seed and filter the fluid through a linen cloth. The oil used should be of the slackening variety, for example, in Italy, Sabine oil; and to 25 cups of this one should add an Italian peck of the pine seed (the cups should be of Italian measure too, also known as pounds). Once the seed has been soaked in it, of course, the quantity becomes considerably reduced. It is well-balanced to add to the 288 K. remainder four pounds of honeycomb, and a third of a pound – which is 32 drams in weight – of pine resin. One should also add the same amount of the resin of the strobilos.58 If these last are not available, one may instead use that of the terebinth. Preferably, it should be cooked in a double vessel, or at least on a weak flame, such as that of charcoal, and this too in small quantity. This drug is highly appropriate for all forms of fatigue, both spontaneous and non-spontaneous. Beneficial, too, is that which is prepared from the flower of the black poplar. Its flowers should still be closed; and one should add an Italian peck of them to twenty-five pounds of Sabine oil. If Sabine is not available, the preparation may be done with some similar oil. As has already been stated above, there is a basic similarity between all those which are both fine in consistency and not astringent. The flower should ideally be 57

‘Rising’ in this sense refers to the moment in the year when the constellation in question first becomes visible in the night sky just before dawn; the date in question is the middle of September. Galen nowhere else mentions this Latin month name, nor indeed that which he attributes to his home city; he does, however, discuss the seasons, and their relationship to the rising and setting of particular stars, especially in his commentary on Book I of the Hippocratic Epidemics. For the particular connection between the rising of Arcturus and the beginning of autumn, see Hipp. Epid. I I.1, 12,21–22 Wenkebach (XVIIA.17 K.). 58 For the measures mentioned here, see Note on translation, p. xxiv. The pound (litra, Latin libra) may be used both as a measure of volume and as a measure of weight. An explicit equivalence is made between the volumetric measures cup (kotulē) and pound (litra), and this must refer to the volumetric litra or libra that was in use in Rome, alongside the litra as a measure of weight. The same seems to apply to the use of the pound measure in relation to pine resin, whereas the dram is apparently here simply a measure of weight. There is some unclarity arising from Galen’s unexplained transitions between the two kinds of measurement. It is clear that strobilos refers to a particular kind of pine tree (mentioned also by Dioscorides, I.69), not to a ‘pine cone’, the ­translation offered by LSJ. I am grateful to Manuela Marai for advice on this point.

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lightly crushed before being added to the oil. If, furthermore, it is stirred every day, especially when the sun is hot, and is kept in a warm dwelling, the quality and capacity of the poplar will in this way be transferred more 289 K. quickly into the oil, so that within two or three months you may press out the flower and discard it, and you will have an oil which disperses without any biting effect, just as well as that based on pine. One may, additionally, add the same amounts of honeycomb and resin as mentioned just now for the composition of the drug with pine. If the expressed fluid is on the thick side, then it will be sufficient to add not only a fourth-part, but even a fifth-part of honeycomb. I was even once known to add a sixth-part, in a case where the oil was becoming very thick and the person planning to use it was one who preferred a moister drug. There are those who are not prepared to wait a long time for the soaking of the flowers or seeds, and therefore need, on the one hand, to boil them, but on the other (if they have some foresight), to add water, in order to avoid the matter added being burnt, and the oil becoming rancid. A more careful procedure still is that of carrying out the heating 290 K. in a double vessel: this refers to the procedure whereby a smaller vessel, to which the oil is to be added, is placed in a saucepan containing steaming water. This, indeed, is a procedure that we use ourselves, not, however, for the heating of seeds or flowers – this is not necessary since we soak them for a long period – but whenever we attempt to soften either resin or honeycomb in fat for a drug preparation. If, however, one is compelled to make the above preparations quickly, one will need to perform this preliminary heating, and to add water or wine to avoid them becoming burnt. Water is more beneficial for the present case, while wine is more beneficial for gouty states and those of the joints in general. It will be sufficient to add whatever amount of water will be completely used up in the heating process. This will be as little as a quarter or a fifth of the total amount of the oil. These drugs, then, cause dispersal of those fluids in the flesh and the skin which are not extremely thick and viscous. So, too, does oil prepared with chamomile – either on its own, or with the addition of beeswax and 291 K. resin. In this case, too, a fourth-part of beeswax and a twelfth-part of resin will be sufficient. If, however, you cannot get access to the ingredients for any of these oils, the easiest thing for you to prepare will be dill oil. This, too, is a drug that causes dispersal, whether used on its own or with beeswax and resin. One should attempt to heat the dill oil in a double vessel; and the dill should preferably be green: if this is the case at

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the time when you use it, then it is ripe. Oil infused with marjoram will be suitable in winter, or in a cold place or climatic condition. This, too, should include beeswax and resin, if, that is, you want it to withstand the bodies which will have an application of it. You may, equally, heat the herb of rosemary in oil. If you do not even have this, then the root of white beet, that of the squirting cucumber, that of the marsh mallow and that of bryony have a significant dispersive effect: these add their own quality and capacity to any of the dispersive oils. If you wish to 292 K. add to any oil prepared in this manner either beeswax alone or some resin along with it, you will produce an excellent, stable ointment. It will in all cases be sufficient to add a fourth-part of beeswax and a twelfth-part of resin. If, moreover, you add two kinds of resin – that of the pine and that of the pine-cone – or even a third on top of these, that of the terebinth, or, in the absence of these, the fluid of pine-resin, then you will find that this drug too will cause dispersal. If you cannot even get hold of this last, you may use the wet pine resin from the potter’s workshop, or that known as burnt resin, but you should be aware that these are inferior to those previously mentioned, although not completely worthless.

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Combination of wound-like sensation with build-up of raw fluids; variations on the three-pepper drug 9. There remains the fatigue state in which, in addition to the wound-like sensation, a build-up of raw fluids is contained in the body as a whole; and something should be said about this one too. There is no difficulty in discovering its rectification, on the basis of what has been said already. For we have stated that where there is a build-up of raw fluids in the first 20 veins, one should cut these fluids and subject them to coction, avoiding 293 K. their distribution into the volume of the body, but where the build-up is in the furthermost veins, and within the overall condition of the living being, one should bring about both coction and dispersal. In a case where both circumstances obtain, then, one must carry out a combination of the two procedures. If you believe the disturbance to be of equal force on both fronts, then you should aim equally at both results; if one 25 or other is dominant, you should direct the treatment predominantly towards that, while not neglecting the smaller element. Since it will be of considerable value to give some examples to illustrate this point, too, let us now consider the manner in which this combined treatment is to be carried out.

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I have already recommended the use of the simple three-pepper drug for cases where there is a build-up of raw fluids in the veins, especially the first veins. Where the build-up is not just in these but in all the veins, and even in the flesh, then one should use the three-pepper drug at the beginning of one’s intervention, and this should contain the same amount of parsley as it does of anise, thyme and ginger. After the first day, and even more so after the second, one should mix in with it the 294 K. catmint-based one;59 then, after this, an equal amount of each; then, as time goes on, more of that with catmint; finally, this one alone. The same applies to the daily regime in general: when the states are equally balanced, one should combine together the rectificatory aims. To begin with, the cures relating to the first veins should be dominant; at the end, those relating to the flesh; and in the time between the two, both should be combined equally. This then concludes this part of the discussion, from which it should have become evident how one should rectify the errors in the fluids before they have reached the stage where the person is sick. On the basis of what we have said about the fatigue state when this is combined with some bad fluid, one may deduce what is relevant to each other state too, in cases where it arises on its own.

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Tensed and inflammation-like classes of fatigue; the need for venesection 10. We have, then, said pretty much everything relevant to the first class of fatigues, those in which there is a pricking sensation throughout the 15 whole volume of the living being, as well as to all the other excesses of poor fluids which arise in the body, both on their own and in conjunction with the fatigues. I proceed next to discuss the fatigue which we have called the tensed 295 K. fatigue. It was the view of a number of well-reputed doctors, not least amongst them the followers of Erasistratus, that when this fatigue arises in the absence of exercise, it indicates a build-up distending the solid 20 parts of the animal. We have, moreover, already stated that whenever there is a build-up of blood, it is best either to cut a vein or to scratch the ankles. But we must return to this argument again, for the sake of Erasistratus, who refused to resort to venesection for any state at all, 25 including this one.60 Now, we have already stated that it is possible to Reading τὸ for Koch’s τοῦ, which is apparently simply a misprint. For Galen’s account of Erasistratus’ view of exercise, cf. Book I, n. 68; for his views on venesection, see next note. On the distinction between cutting a vein and scratching the ankle, cf. above, n. 16.

59 60

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evacuate such a build-up by other means too, in the case of the healthiest type of nature, that currently under discussion. In the case of faulty natures, however, where the superfluous stuff is carried into the brain and the organs of respiration, how great an evil it is at this point still to employ other means of evacuation, without recourse to venesection, will, of course, be discussed in the subsequent books, in which we conclude our account of faulty states. (We have also discussed it previously, in our 296 K. work on Venesection, against Erasistratus.)61 Let us then not waste further words on this subject now, but rather move on to the remaining type of fatigue – the third type, in which it arises spontaneously, and which we previously referred to as ‘­inflammation-like’, because of the magnitude of the pain, and because it arises in conjunction with manifest heat, and simultaneously raises up the muscles in volume. This type of fatigue cannot be held in check even for a few hours – never mind the two or three days allowed by Erasistratus’ slowness – before leading to an extremely vehement fever, unless one immediately lets blood. For, indeed, the blood is extremely hot in such cases, and all those who fall victim to this type of fatigue require a very substantial evacuation of it. Many experience fever even if you do let blood. One should therefore not let up, nor remove only a small amount, but continue both very quickly and to the point of fainting, unless there is some contraindication. It is preferable, in fact, to remove the blood twice in one day, if possible; in this case, the first evac297 K. uation should be performed in such a way that the person does not faint, while the second should not resist that outcome. For one who collapses as a result of the first evacuation will not be able to endure a second, whereas one who experiences something of this sort in the second evacuation is easily restored.62 A person in the above kind of state who does not undergo venesection will only survive by good fortune – and will not survive at all, unless there is some evacuation by other means, through a flow of blood from the nose, or violent sweating. Before carrying out the venesection one should consider very carefully whether the tensions and the pricking pains are affecting the chest and the upper and lower back, or to a greater extent the head and neck. In 61

Erasistratus is against venesection, advocating in all cases slower, more gradual methods of the evacuation of residues. 62 The adjective euanakomistos has only one other occurrence in Greek literature: Plutarch, De cohibenda ira 458e7, where it refers to the recall of their ‘spirit’ (thumos) by Spartan soldiers. The precise sense is therefore not completely certain: being brought back to consciousness, or simply restored to the normal state, seem the likely possible senses.

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the latter case you will cut the Basilic vein,63 especially if the subject feels that his head is full and hot; in the former case you will cut the one within. If, on the other hand, the body is affected by the fatigue evenly all over, you will cut the one midway between the two. Now, if fever 25 results from the venesection, it is then the task of the method of healing to take care of these patients.64 If, on the other hand, they remain without fever, you should give only juice of barley-gruel or gruel of groats 298 K. on the first day after venesection, and on the second you may proceed to bathing, with plentiful oil, and allow a diet, even if bathing is taking place, of a very moderate amount of lettuce, if it is desired; and you may 30 also give bottle gourd, if it is available, as well as barley-gruel. Groats are excellent, too, whether one prepares them as a gruel seasoned with vinegar, or without vinegar. If bottle gourd is not available, then one may 132 Ko. use beet, monk’s rhubarb, or orach. If the person wishes to consume meat, too, then one should give fish of the rocks, or of the cod type, cooked well in a clear broth.65 What I mean here by a clear broth is one which is prepared without garum,66 and above all without any other rich sauce. One should add dill and salts to the water, with oil and a little 5 leek. It is better to avoid wine even on the second day. On the third, if the drinking of water is tolerated with good coction, one should still withhold wine, whereas if it is not tolerated, one should give honeypreserve, especially. This drink has a gentle cooling effect, which is itself called for by the inflammation-like fatigue. If honey-preserve is not avail- 10 299 K. able, one should give white wine of fine consistency and restore [the patient] along the same lines in other respects too, employing a daily regime which involves good fluid and is in no way heating. One should avoid above all things the building up of the person all at once. For in those who return immediately to their original daily regime after such evacuations, the condition becomes filled with uncooked fluids, which 15 are absorbed by the volume of the body before they undergo good coction in the stomach and in the veins. This, then, is the best form of care for the ­inflammation-like fatigue. 63

In Greek, the ōmiaia: what is meant is the most superficial vein in the arm; see Ven. Art. Diss. 3 (esp. 88 Garofalo, II.792 K. and 90 Garofalo, II.793–794 K.), where Galen describes the ōmiaia and all its connections and parts. 64 N.b. ‘the method of healing’ (ἡ θεραπευτικὴ μέθοδος) is the title of Galen’s treatise or study (pragmateia) of health; cf. n. 43 above. 65 Leukon zōmon: on the use of the adjective leukos to mean not just ‘white’ but also ‘clear’ or ‘colourless’, cf. Book II, n. 16; zōmos could also be translated ‘soup’ or ‘sauce’. 66 Garum was a fermented paste or relish made from various fish products and very widely used as an accompaniment to staple foods in the Roman world.

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The reason why we give instructions for the further removal of blood in this case, and not for filling all at once, may be adequately stated in empirical terms: the subject both derives greater benefit after undergoing such evacuation and experiences good health for a long period when following the daily regime stated. It is, however, worth adding also the indication based on the physical reality. There is in the inflammation-like fatigue an accumulated build-up of hot blood in the volume [of the body]; and venesection evacuates the fluids in the vessels. It is therefore 300 K. preferable to leave sufficient time after the earlier evacuation for some part of what is in the body to be transferred into the veins; this, however, should not be allowed to remain in them, since it is halfway to being bad in its quality, but should for the most part be evacuated. Thus, we carry out a further removal of blood on the second day, and sometimes also on the third, whenever it seems that it will be beneficial to produce this effect of drawing-back and transferral from the one to the other. All such specifications have also been discussed more thoroughly in my work on Venesection; and their mention is not appropriate here, since they belong more properly to the study of healing, and since we shall probably give a fuller account of venesection in this treatise, too.67

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Importance of not bringing about quick filling after venesection 11. It remains, then, before the conclusion of the present book, to give a brief statement of the importance of not bringing about any quick filling, after venesection. This discussion will also take as an assumption for its 5 establishment something which was previously demonstrated in Natural Capacities. In that work it was shown that there exists in all beings controlled by Nature68 an innate capacity which is attractive of the 301 K. proper fluids, by which the being is to be nourished; and it was shown, further, that when the being has no access to its proper, beneficial nourishment, it is forced to take up also some of those which are not benefi- 10 cial. To this category belongs that which is in the gastric cavity and in the veins that has not yet undergone coction. It is, then, unavoidable, whenever a person takes in more food at such a time, that he will take up a very large amount of raw fluid into the volume of the living being. This is so for a number of reasons: [a] because it achieves poorer coction in the 67

Galen apparently does not fulfil this rather tentatively expressed expectation. Further on such discrepancies between plan and execution, see Introduction, section 8.3. 68 For this usage cf. Book II, n. 76; more broadly on Galen’s theory of the natural capacities, Introduction, section 4.5.2 with n. 64.

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stomach and in the veins; [b] because more of it is drawn into that volume since there is more present; [c] because that which has not yet been processed is drawn in more quickly than it should be as a result of the coming-together of the stomach with the veins and of the veins with all the other parts of the animals – a coming-together which would not have taken place in the same way if the amount had been small. For it has been shown that the parts first themselves derive benefit from their proper nourishment, before then transmitting it to the other parts. The last, and most significant, cause of damage for people in this state is [d] that the parts throughout the entire volume of the living being, drawing 302 K. to themselves a large amount of half-cooked nourishment, generate a considerable build-up of residues from this. It is not possible for them to subject it all to coction, in the same way as they would with good nourishment, nor to add it on, nor to assimilate it; rather, they must fail in each of their proper tasks as a result of the poor, and plentiful, quality of the nourishment. For what inevitably happens to them is something similar to what happens to the stomach itself when it has taken a great deal of badly prepared foods. By ‘badly prepared’ I mean food which required some boiling or baking, but did not properly receive this. So, for example, it is impossible for bread which has been inadequately baked, or meat or pulses which have been incompletely boiled, to receive good coction in the stomach. The same relationship exists between foods which have been poorly processed in the stomach and the second coction, within the veins, as between foods which have been poorly prepared in the first place and the coction in the stomach. Moreover, the same relationship exists between those which have not received proper coction in the veins and the coction in the flesh as between the foods and the coction in the 303 K. stomach, and between what is transferred from this and that in the veins. The stomach, then, does not completely subject to coction what comes from outside it, nor do the veins do so to what comes from the stomach, nor the flesh to what comes from the veins, when these are not well processed. It necessarily follows that there is a build-up of residues in the body. This, then, has been a very brief summative account. Anyone who wishes to acquire precise knowledge of each of the matters stated, for the purposes of demonstration, must read Natural Capacities,69 where it has 69

For Galen’s theory of nutrition and the texts in which it is expounded, see Introduction, sections 4.5.2–3. Cf. in particular Nat. Fac. III.12, 233,26 H. (II.183 K.), where again the specific ­terminology of ‘alien burden’ (achthos allotrion) is used in the context of the expulsion of residues.

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been demonstrated, first, how the stomach takes in nourishment for its own sake, in order to derive benefit from it and replenish whatever it 10 lacks, and that it therefore enfolds the nourishment from all sides and takes hold of the whole of it, until it is sated; and secondly, how, when it no longer requires the nourishment, it then opens the pylorus, and squeezes and pushes downward whatever in the foods is superfluous, as an alien burden; then, how, in the pathway through the intestines, and 15 especially the smaller, the relevant veins take up the nourishment, which has been altered and has become more akin to the animal by the contact 304 K. with the gastric cavity. Then, within the veins, too, it is transferred from one to another in the same way as it was from the stomach to the veins. From that point, once it has been completely processed, it is attracted to each part of the animal, where it undergoes the third coction and is 20 assimilated to the animal being nourished. Anyone who reads through that discussion in the work mentioned will not fail to understand the reason why many who have undergone evacuation of their condition, if they do not build up [their bodies] to a moderate extent, accumulate a large quantity of residues throughout the condition as a whole, and suffer sickness as a result of these, to a considerable extent.70 70

‘To a considerable extent’ translates οὐκ εἰς μικρόν. I here follow the reading of VR, which seems clearly to give the required sense, whereas M’s οὐκ εἰς μακράν would mean ‘to a small extent’. (The precise phrase οὐκ εἰς μικρόν is perhaps not very frequent in occurrence, but it appears for example at Hipp. Epid. III III.76, 165,14 Wenkebach, XVIIA.744 K.)

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Book V

Justification of the length of the treatise; variety of individuals under consideration; the nature and transformative power of the true healthful art 305 K. 1. As I embark upon this fifth book of this treatise of health I wish first 135 Ko. to reassure anyone who may be irritated at the length of the exposition. This is not a legitimate complaint against me, but rather something arising directly from the very nature of the matter under discussion. I 5 could only be blamed if it were possible to give an account of a large theoretical study in a very short space without omitting anything useful; if that is the case, I have extended the length unnecessarily. Since, however, it is not possible to make statements at once very clearly and very quickly about the same subject, then it is not appropriate to blame 306 K. me – but rather those who omit a considerable amount of essential material. And amongst the most essential considerations in the entire study of 10 health – belonging, as it were, to its very foundations – is that there is a very large number of different human natures. This point is in fact generally agreed upon by both doctors and trainers; but most of them write about the scheme of conduct1 of health as if they were talking about one [type of ] human being. And they do so without ever showing us even 15 one example of a person who has been helped by them. It would surely be proper for them to commit their view to writing only if they were able to present to us not just one, but a very large number of persons who had previously suffered from constant sickness and were then kept free of it for many years as a result of their efforts. I, by contrast, have shown this in practice; and it is because I have kept 1

The noun agōgē covers the senses both of a manner of conduct of life and of a discipline or set of instructions for that.

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many people who were previously constantly sick free from sickness, through their obedience to my precepts for health, that I have undertaken to write about these individuals. Some I ordered to refrain from exercise altogether – that is, from exercise performed as a habitual practice – advising them to be content with the everyday activities of life; others I ordered to cut out the great majority of their exercises, so that the whole amount was reduced to a 307 K. very small level; and certain people I ordered simply to modify the character, order or time of their exercises, while still others I told to change their entire pattern. By giving instructions on bathing, too – to refrain from bathing altogether; to bathe more or less; to do so only before eating or also after eating; in water that was warmer than that used previously, or cooler, or completely cold water – I kept people free from sickness for very many years. Yet I would not have done any of these things if I had not understood the natural differences between bodies, and the daily regime for health which is appropriate to each one. There are some who write compositions on health, and also who give oral instructions on it without writings, and are unable to keep even themselves free from sickness; then, when they are mocked by certain persons who, among other things, apply to them that verse:

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Doctor of others, yet bursting with wounds!2

some attribute the cause to their lack of leisure, while others admit that they are sick because of their own lack of discipline. Well, in the latter 308 K. case, their defence is far worse than the original charge, at least if I am to 10 be the judge of it. Then there are those who attribute the cause to things that befall them in life. In this case, if they suffer an ephemeral fever arising from burning, cooling, fatigue or other such causes, they should be exonerated of the accusation; if they suffer some other fever, they should not. I myself have not remained entirely free from fever, but have 15 suffered fevers as a result of certain fatigues, while remaining completely free from all other diseases for very many years now – and this despite having suffered injuries to certain parts of the body, of a kind which in other people have led to inflammation in conjunction with swellings of glands,3 and so to fever, while I have suffered neither the swelling nor the 2

The verse fragment, from a lost play by Euripides (fr. 1086, p. 1012 Kannicht) seems to have been a well-known commonplace by Galen’s time; it was quoted four times by Plutarch, and then many times in late-antique Christian texts. It is not known which play it is from. 3 The term boubōn in Galen usually refers to a gland, especially one in the armpit, and then by extension to a swelling. When the reference is to a swelling, rather than to the gland itself, it seems

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fever. I have achieved this through no other means than the theoretical study of health, and this in spite of not having been blessed with a 20 healthy bodily constitution from the start, as well as not being able to lead a completely free life: I have been both in servitude4 to the demands of my art and obliged to perform services for friends, family members and fellow-citizens, very often having to remain awake for most of the night, because of either patients or – even more constantly – my pursuit of the fruits of learning. 309 K. In spite of all this, I have not suffered any disease of the sort that arises 25 from within the body for many years now – except, as I say, for the very occasional ephemeral fever resulting from fatigue. Yet during my childhood, and even my adolescence and youth, I fell victim to quite a large number of sicknesses. It was after the completion of my twenty-eighth year that I became convinced that there was such a thing as the art of 30 health and took to following its prescriptions;5 and I have continued to do so throughout my subsequent life, with the result that I never suffered any disease other than a very occasional ephemeral fever. These too, of course, can be avoided by those who choose a life free of obligations, as has become evident in what has been said previously and will be even 35 more so in what follows, to anyone wishing to pay attention. My claim is that it is not even possible for the swelling of a gland to 137 Ko. arise, in those whose self-preparation for health is complete, provided that their bodies are free of residues in respect of either class, that of 310 K. quantity or that of quality. This response should be sufficient for those present-day practitioners who claim to offer precepts of health, whether in oral or in written form. As regards those who did so in the past, and 5 who, from what one hears from other people’s reports, never succeeded in keeping either themselves or those who listened to them free from sickness, nor dared to make any such boast in their compositions – to these it is not even necessary to make a response. One may, rather, simply express one’s amazement at the claim that some of them have made to 10 encompass the whole of the theoretical study of health in one book. It is that it is to the swelling of such a gland specifically, not to swellings more generally. The sense is discussed at MMG II.1 (XI.77 K.). 4 The verb is douleuein, cognate with douleia, ‘slavery’ or ‘servitude’; for Galen’s literal and metaphorical uses of the words, see Introduction, section 5.6, with n. 96. 5 The terms translated ‘adolescence’ and ‘youth’ are ephēbos and meirakion; on Galen’s account of the different stages of life see Introduction, section 5.5; and further on this aspect of Galen’s autobiography, Introduction, n. 132. The realization of the validity of the ‘art of health’ on the account here would coincide roughly with his return to Pergamum after his years of study in Smyrna, Corinth and Alexandria, at the age of 28, whether or not any significance is to be attached to that.

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not, after all, that their writing on the subject is like that of Hippocrates, whereby the method is indicated by means of the primary and most general headings; they are undertaking to do the whole thing with precision, in the same way that I am. So, then, the cause of the length of these books has been stated. Anyone who is both devoted to the good and committed to the work involved in achieving the best aims6 should not baulk at the extent of the art of health, but rather revel in the immensity of what it offers. Are these not great and remarkable achievements on the part of this art: to keep 311 K. someone in very advanced old age in untroubled health in terms of his faculties of sense, consistently free from sickness and pain, and in a good state overall, provided that this person did not have a completely diseaseprone body from the start? Conversely, I have surely observed persons who were by nature healthy fall victim to a large number of diseases and finally, in old age, succumb to incurable ailments, when it would have been possible for them, on the basis of the natural condition of their bodies, to continue into extreme old age with all their faculties of sense unimpaired and with all the other parts of the body in good health too. Is it not a shameful thing that someone fortunate enough to have had the best natural endowments has to be carried by others because of gout, or is racked with pain because he suffers from the stone, has pain in the intestines or has an ulceration of the bladder arising from bad fluid? Or that [such a person] should be prevented by an extraordinary illness of the joints from using his own hands, and so need another’s help to put the food into his mouth, and to wash his own bottom off after stool? Anyone who is not completely spineless7 would prefer to die a thousand 312 K. deaths than to endure such a life. But even if someone, through his own lack of a sense of shame, or his own spinelessness, were able to overlook the shame involved in such a life, he could hardly overlook the pains that such people endure night and day, which are like the tortures inflicted by the public executioner. Yet all these may be blamed on either a lack of discipline, or ignorance, or both. Now, however, has not been the appropriate time to rectify their lack of discipline. What I do hope to accomplish through this treatise is to cure their ignorance of what needs to be

6

The phrase philokalos … kai philoponos epi tois aristois is a slightly unusual one; while the translation given captures what seems to be the intended sense, a more literal rendering would be ‘a lover of what is fine and hard worker in the case of the best [things]’. 7 Literally ‘soft’; but beyond the literal sense, applied to bodies, the adjective malakos (in ancient as in modern Greek) has connotations of moral weakness and also of effeminacy.

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done, and to set down a specific scheme of conduct of health for each 5 different bodily nature.8

Recapitulation of principles and methods 2. It is surely proper to start with the best nature, wherein the aim is not rectification, but preservation of what is present; and this is indeed the procedure that we have followed, devoting our discussion up to this point to this type of nature, in each of the stages of life except for that which is called ‘post-prime’, and of which the latter part is called specifically ‘old age’. And this too has its own specific division, as will be discussed later, in that part of the book where we address the part of the art known as ‘old-age care’. Now, however, after some recapitulation of 313 K. the most important points of the previous discussion, we shall move on to the faulty bodily natures, showing how each of them may best be preserved in health.9 The best body has the following aims, as regards quantity, quality and capacity: first, in terms of exercises, those referred to as ‘moderate’ and ‘well-balanced’, which should also be applied equally to all parts of the body; here, we should avoid all excess and, if any error is made at any point in any of the stated respects, rectify the mistake. As to the nature of the things eaten and drunk, with regard to their amount, quality and capacity, the aim here again is that of good balance: one should take neither more nor less than that amount which, after good coction, distribution and nourishment of the body – and, if required, in the case of those who are still growing, the addition of something well-balanced to 8

What underlies the remark here, and the dichotomy presented in the previous two sentences, is Galen’s ethical scheme, with its division between non-rational and rational capacities within the soul. Akolasia (‘lack of discipline’) and ‘softness’ belong to the realm of the non-rational and the pathē; that is, they are understood as shortcomings in the dispositional state of a human being, that which arises from his or her nature, upbringing and habituation, and are reflected in ingrained attitudes and behaviour. It is this area of his addressees’ moral character that Galen says that he has not had the occasion to address. (The use of the terms ‘rectification’, epanorthōsis, and ‘appropriate time’, kairos – a technical medical term related especially to the progress of disease and the correct time for intervention – reinforces the strong medical metaphor in play in Galen’s ethical approach.) Although he can do nothing about such ingrained moral flaws, then, he does, however, hope to be able to address their agnoia (‘ignorance’), that is, to persuade them through argument of certain propositions of reason. Galen’s approach to the rectification of both nonrational and rational psychological or ethical flaws is laid out especially in Affections and Errors. 9 On Galen’s intended order of topics in relation to the actual execution, see Introduction, section 8.3. Chapters 3–9 of the present book do in fact address problems of old age; as for the discussion of the faulty natures, this seems not to begin until Book VI, ch. 9. For his approach to old age see Introduction, section 5.5. The subdivision of old age into further stages is made at the end of the present book, V.12, 167,17–29 Ko. (VI.379–380 K.).

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the body – will leave nothing either superfluous or wanting. So, too, with regard to sleep and waking, baths, activity of the soul and all other such matters, one must, of course, preserve good balance; and, if there is ever 314 K. any error in any of these, rectify the mistake. Your common aim in all rectifications is the use of the opposite imbalance: if there was excessive exertion of the body on the previous day, you should reduce the number of the exercises, and if insufficient, you should increase it; similarly, if rather swift10 exercises were employed, you should moderately relax them, whereas if they were relaxed you should intensify. In the same manner, too, you should move from exercises more productive of good tension to softer ones, and from ones involving less tension to more vigorous ones, and also replace the feeble with the vehement and the vehement with their opposite. You should, in short, rectify any imbalance by means of the opposite imbalance; in this way you will preserve the person in health. In order to avoid any mistake in correction, one must first of all accurately discern the states of the body, and then bear in mind everything that happened on the previous day. For the states will provide you with an indication of what has been done wrong, while your memory of what has happened previously will suggest to you the extent to which any of the habitual practices should be changed. As regards the states, the imbalances are 315 K. such that the body will appear thinner, of fuller volume, harder, softer, moister, drier, more porous or denser than usual, as well as not completely preserving its normal good colour. Your memory of what took place before will indicate to you the error itself, and will also tell you its rectification, by a comparison with the present circumstances. If, for example, the body appears thinner, one should investigate and remind oneself whether the person has undergone more exertion than appropriate, or employed swifter motions, or had too much massage or bathing; next, one should consider whether he has experienced mental exertion11 or sleeplessness, or expelled much more than he should from his stomach; and also whether the house in which he has been staying is too hot, whether he has eaten or drunk too little, or engaged in sexual activity inappropriately. If the body appears to be of greater volume one should consider whether there has been massage or exercise which was

10 11

Cf. Book II, n. 90. The verb is phrontizein; on the related noun phrontis cf. Thras., nn. 95 and 101 and Introduction, n. 106.

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inadequate or too slow, excessive sleep, retention in the stomach, or a build-up of foods which have undergone faultless coction.12 316 K. If the body appears harder than usual, one should first remind oneself what massages there have been, then of any exercises productive of good tension involving a hard adversary, and also whether such exercises took place in dust, and then whether the dust was itself extremely hard and cold, and whether it took place without restoration. Then, one should consider the baths: were they extremely cold, or too hot? Is the house in which the person has spent time, both awake and asleep, cold? Then there is the question of dryness of foods and lack of drink. If, on the other hand, the body becomes softer than usual on the next day, one must first remind oneself of the massage – was it soft, with fat, or with gently lukewarm baths? After this consideration, one should turn to the exercises: were they slow, few, and involving an excessively soft fellowwrestler? Then, whether drink has been excessive; and after that whether food has been too great in quantity or moist in nature; then whether there has been too much sleep. Close to the soft state of the body is that known as wet – with the difference that the soft quality is that of the bodies themselves, while the wet quality is that of the wet things within them. The distinction between these is made by touch: the wet state is 317 K. accompanied by dampness,13 the soft state is not, although the soft body is, of course, also wet in terms of its own parts. For the sake of clear exposition, however, let this latter one be called soft, and the former wet. Now, the state which is immoderately dry automatically hardens the condition, while it is not necessarily the case that the wet one is accompanied by softness: it is possible for the flesh to be hardened, but for dampness or sweat to be brought up from the body. In the case of moisture, there must be a suspicion of untimely sexual activity, or of weakness of the capacity arising from some other cause, or porousness of the body resulting from immoderately soft massage, excessive bathing, or the fact that the air in the house in which the person has been staying is hotter than it should be. One should consider also whether drink has been excessive, whether there has been more sleep than normal, and whether the ambient air underwent a sudden change in the direction of wetness and heat; and similarly as regards nourishment. In the case of smoothness 12

I suspect that a negative is missing here: one might expect Galen to be speaking of a build-up of poorly digested foods, not perfectly digested ones. However, it is also possible that he is here referring to the sort of excess that arises, even in the case of perfect coction; and so I have left the MS reading unaltered. 13 The word ikmades presumably indicates an actual feeling of wetness to the touch.

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or softness (both terms are commonly used), whenever this occurs 20 without moisture, [one will suspect that14] there has been correct coction 318 K. of the nourishments, and nutrition of the body, but inadequate exercise. Conversely, in the case of hardness, that there has been a hard application of massage, or excessive exercise, with a hard body, in dust. Dryness of condition indicates a lack of drink or nourishment, sleeplessness, anxiety 25 in life,15 a long massage or immoderate exercise. By consideration of these things, then, you will be able to rectify the mistake day by day, before it increases to the point of becoming difficult to heal. Always keep in mind the principle that every imbalance is brought to rectification through the opposite imbalance; this is the common aim in all abnormal states. You should, then, by adding to this 30 the diagnosis16 of the bodies themselves whose care you are going to undertake, as well as the capacity of each of the remedies, acquire understanding of the whole of the art related to the body – that art by which you will not only preserve in health those who are healthy but also restore to the sick their original condition.

Suboptimal mixtures; old age 319 K. 3. The characteristics of the best body have already been stated. You 141 Ko. should, then, realize that that which falls short of this does so for one of three reasons: that it acquired a poor constitution from the beginning, in the process of gestation; because it was for some reason brought to an abnormal state later; or by reason of age. In all cases one must attempt 5 rectification through the opposing imbalance. Take old age itself: this is cold and dry, as has been demonstrated in our books on Mixtures,17 and its rectification is performed by means of those things which moisten and heat, such as hot baths of fresh water, the drinking of wine, those nourishments which are by nature both moistening and heating. It is best to 10 start with the consideration of exercise, massage and all motion, since, 14

I take it that the phrases that follow are to be understood as syntactically still dependent on ὑποπτευτέον (‘one must suspect’) in l. 14 above, even though no such word is actually repeated here. 15 The phrase is merimna biōtikē. The noun is a hapax legomenon in Galen, and also a rare word in prose texts until a later period, while on the other hand the two-word phrase itself becomes a common one later, in Christian texts. This perhaps makes the reading suspect, although it seems to enjoy MS unanimity. 16 I here translate diagnōsis as ‘diagnosis’ rather than, as elsewhere more usually, ‘discernment’; on this term see Book II, n. 49. 17 This is indeed an important theme of Mixtures; for Galen’s views on the different stages of life, and texts in which he discusses them, see Introduction, section 5.5.

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indeed, the motto that ‘exertions should come before food’18 is a good one; and here one should bear in mind also the following words of the Poet, which are at least partially correct:         but when he has bathed and has eaten, Let him then sleep softly; for that is the way of an old man.19

320 K.

That, to be sure, does not cover the case entirely; for old men require bodily motion no less than the young, as there is a risk of the extinguishing of their innate heat. In the case of bodies at their prime, certain natures are found which need rest – and of course these too are mentioned by Hippocrates20 – but no old man requires total rest, any more than he needs vehement exercise; for the hot in them needs to be fanned, whereas it will be confounded by very vehement motions. Great flames, on the other hand, have no further need of something to fan them, but are sufficient to themselves, in terms of both self-preservation and the mastering of the material for the flame. Those in their prime, then, do not even need to undergo massage after sleep, first thing in the morning, as do old men. The aim of such massaging, which should be carried out with fat, is twofold: either to heal the fatigue state, before it grows to the point where it provokes a fever, or to stimulate distribution when this is functioning feebly. We have, easily and within a short time, restored the well-fleshed quality of many who had been experiencing 321 K. poor nourishment for a long time, by turning them to this kind of massage. But what arises in others temporarily, and as a pathological state, obtains permanently in the case of old men. Their whole body is cold, and it is impossible for it to attract the nourishment to itself, to process it well and to be nourished by it. By stimulating the vital tension and heating moderately, massage produces speedier distribution and readier nourishment. Similarly, the application of pitch-plaster,21 which leads to fleshening-up in the case of many young men experiencing poor nourishment, is beneficial to all old men. Massage with oil should, indeed, be as 18

Epidemics VI.4.23 (V.314 L.) (here paraphrased in indirect speech rather than quoted verbatim); cf. above, Book II, n. 5. 19 Homer, Odyssey XXIV.254–255. It was standard in the literate culture of Galen’s time to refer to Homer as ‘the Poet’ (rather as it is in some contemporary English-speaking milieux to refer to Shakespeare as ‘the Bard’) – a usage which Galen in fact explicitly discusses at QAM 2, 35,13–14 M. (IV.771 K.). 20 As Koch suggests, Galen may have in mind Nat. Hom. 22, 218,6–16 Jouanna (VI.84 L.). 21 This kind of plaster, which was used for the medical reasons here described, also had a depilatory effect, and was employed by some also for cosmetic reasons; cf. Book VI, n. 45.

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it were the single exercise of old men first thing in the morning; this should be followed by walking and passive exercise which does not bring about fatigue. One should tailor these to the capacity of the old man;22 329,8 K. for there is a considerable difference here, some being completely feeble 10 as regards motion, even when they have not yet reached seventy years of age, while others are much stronger than this even after the age of eighty. The motion you should use with the weaker ones should be passive exercise, rather than walking, while you should use both with the stronger ones. The readiness with which you bring them to a second massage will 15 also not be the same in each case; this will be greater in the case of the weaker person. Amongst the most universal precepts that you follow 330 K. should be the following: in the case of a weak capacity, build up the body with frequent but small amounts of nutrition, and in the case of a strong one, with infrequent, large amounts. 4. Now, to state all this is very easy, but to supervise an old man in a way which preserves his health is amongst the most difficult things – as is also the case with those recovering from sickness. The latter part of the art is called by the doctors of more recent times the recuperative, while that which addresses old men is called old-age care. In both cases the states seem not to accord with the notion of health in its most accurate sense, but rather to be either in some middle position between sickness and health, or at least not to belong within that type of health which these doctors call ‘stable health’ but to that which they call ‘unstable health’.23 Whether, then, one should call old age a sickness, or a morbid state, or one midway between health and sickness, or unstable health – one need not concern oneself with such enquiries, which are purely verbal, but should understand the actual disposition of the body of an old man, which falls into sickness as a result of very small causes, and should thus 331 K. be kept to a daily regime similar to that of those recovering from sickness. It is very easy to say that it is preferable to apply fat, with massaging, to the old man first thing in the morning; but the appropriate performance 22

Pages 321,13–329,8 of Kühn’s edition appear below, at pages 155,4–158,17 of Koch’s edition: Koch has restored the original order, on the authority of M and the translation of Niccolò da Reggio, which both represent branch a of the MS tradition. The mistaken order crept early on into the other branch, b, which was followed by all the printed editions until Koch. Cf. Introduction, section 9.1. 23 Literally, health ‘in condition’ (kath’ hexin) and ‘in state’ (kata schesin); see Thras., n. 13, and for the elaboration of this distinction, Thras. esp. 7, 40,2–18 H. (V.816 K.). For Galen’s adoption of the terminology of ‘doctors of more recent times’ (neōteroi), see Introduction, sections 2.3 and 4.2 with n. 49.

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of the task is the most difficult thing of all. A massage which is slightly too hard will provoke fatigue, while one which is too soft will achieve nothing. Neither, indeed, will an extremely short one; and a long one will have the effect of dispersal rather than that of building up. Moreover, if the place in which the old man’s body undergoes exercise is too cold, then so far from achieving any beneficial effect, it will actually densify the body and cool it down. If, on the other hand, it is hotter than it should be, then in winter it will render the body of the old man too porous, and thus liable to chilling, and in summer produce dispersal and destroy its capacity. People who enjoy stable health do not undergo alteration of the body even as a result of any of the stronger causes; in the case of old men, even the smallest bring about a very great change. So it is also with the quantity and quality of the food: here, too, old men will experience considerable harm as a result of some slight transgression, while young 332 K. men will experience very little, even from very great errors. The safest procedure, in the case of weak old men, is to give little food, three times a day. This is the daily regime that the doctor Antiochus24 imposed upon himself; and he reached an age of more than eighty years, going every day to the public forum, to the place where the citizens’ council chamber itself was,25 and sometimes also making a long journey out of town to examine a patient. He used to make the journey from his house to the public forum – a distance of roughly three stadia – on foot, and in this way he would also visit those patients who lived nearby. If he was ever compelled to make a longer journey, he would do so either in a litter or in a carriage. There was a room in his house which was heated by a furnace in winter, but had well-mixed air, even without a fire, in summer. It was here that he would always undergo massage, both in winter and in summer, after first defaecating, of course. At the place to which he went in the forum, he would eat bread with Attic honey, around the third, or at the latest the fourth, hour;26 the honey would 24

Galen’s account of Antiochus, like the following one of Telephus and perhaps that of Primigenes a little later on, seems likely to be the recollection of a personal acquaintance from the time of his own youth in Pergamum. 25 I translate αὐτὸ (‘itself ’), the reading of VR, which seems more plausible than αὐτῷ (‘for him’, M). One wonders, albeit speculatively, whether the daily journey and the location mentioned are related to a similar medical–intellectual context to that described by Galen in the environs of the Temple of Peace at Rome (see Introduction, section 3.3); that is, did the area around the council chamber at Pergamum have an analogous function as a meeting-place and setting for public lectures or debates? 26 Galen refers to the standard Graeco-Roman system of time-keeping, dividing the day (from sunrise to sunset) into twelve equal hours; thus, the third hour is halfway between sunrise and midday (which is the ‘sixth hour’), i.e. some time between 08.30 and 10.00, depending on the

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usually be cooked, but occasionally raw. He would then continue up to 333 K. the seventh hour either engaging others in discussion, or reading alone, and then spending time in the public bath house, performing the exercises appropriate for an old man, the nature of which will be stated a little later. Then, after bathing, he would have his lunch,27 which would be a well-balanced one: first, he would take those things that empty the stomach, and after that mainly fish, both those of the rocks and those of deep water. Then, at dinner, he would refrain from the consumption of fish, but would take those foods which have the best fluid and which are not prone to decay: groats with wine-honey, or a bird cooked in a simple soup. By applying this old-age care to himself, Antiochus continued right to the end with his senses unimpaired and his limbs supple. Telephus the scholar28 reached an even greater age than Antiochus, living nearly 100 years. He would bathe twice a month in the winter, four times a month in the summer and three in the intervening seasons. On days when he did not bathe, he would have oil applied around the third hour, with a short massaging. He would then eat groats boiled in water, with the addi334 K. tion of the finest raw honey: this would be sufficient for him for his first meal. He, too, would have his lunch at the seventh hour, or a little earlier, taking vegetables first and then enjoying birds or fish. In the evening he would eat bread alone, soaking it in diluted wine.

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Use and choice of wines for the old 5. As surely as wine is completely contraindicated for children, so it is extremely beneficial for the old. The wine should be one of those which are hotter in their nature, such as Ariusian, Lesbian or that known as 15 ‘Mysian’, amongst the Greek ones (this last being not from the Mysia on the Istros, but from ‘Hellespontic Mysia’, as it is called, a place in our homeland of Asia, bordering on Pergamum)29 or, amongst the Italian ones, Falernian or Sorrentine. Next after them are, in Italy, Tiburtine and time of year; and the seventh hour is around 13.00. For some of the ramifications of this system, see VI.5, 178,29–35 Ko. (VI.406 K.). 27 The ariston was the first substantial meal, taken around the middle of the day. 28 The term grammatikos includes both the sense of a ‘secondary’-level teacher of grammar and literature and that of a scholar or literary critic. On these senses of the term in Graeco-Roman society see Morgan (1998): 155ff.; see further Marrou (1956/1982); Webb (2017). The latter aspect of the role is celebrated by Galen as a noble technē, e.g. at Aff. Pecc. Dig. II.7, 68,15 DB (V.103 K.) and Protr. 5, 89,2 B. (I.7 K.). Cf. Thras., n. 38. 29 Galen’s home city of Pergamum was within the region of Mysia, in northwestern Anatolia. He is here clarifying that this is the region he means by ‘Mysia’, rather than another region, more

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Signian, provided both have been aged.30 When young, these wines neither stimulate distribution [of nourishment] nor provoke urination, but remain for a long time in the stomach, where they produce upsets. In second place to these are the Adriatic, the Sabine, the Alban, the 335 K. Gaurian, the Triphuline, and all those Italian aminaios wines which are produced in the region of Naples and in the land of the Tuscans. 31 Mysian is of the same type of capacity as the Sorrentine, while the best of the Tmolite ones are of the same type as the Falernian; and the Titakazene and Arsyenian are similar to the Sabine and the Adriatic. Seniors who do not have very strong heads should drink these latter types, moderately aged; for those with strong heads the Falernian, Sorrentine, Ariusian, Lesbian, Mysian and Tmolite are suitable. It is obvious, then, that within every people, each person32 will be able to select the most appropriate wine from the examples just given, having as his aims, in the examination of wine for old men, the choice always of that which is finest in terms of its consistency and, in terms of its colour, that which Hippocrates used to call tawny, and which one may also call yellow. Pale yellow wine – a colour midway between yellow and white – is good, too.33 If you wish to mix yellow wine with white, the mixture which you will produce as a result will be pale yellow; yellow wine mixed 336 K. with water will also acquire this colour. Depending on whether you add more or less water, the wine may appear either pale yellow or as it were usually referred to as ‘Moesia’, in the southwestern Balkans and bordering the Danube (Istros). According to some, the two ‘Mysian’ peoples were ethnically linked. For a fuller Galenic account of wines and their different properties see Bon. Mal. Suc. 11, 420–425 H. (VI.800–809 K.). Cf. also Book IV, n. 47. 31 Aminaios refers to a type of grape, described by Galen as having a tart taste (SMT IV.8, XI.648 K.; Comp. Med. Loc. VI.4, XII.922 K.); both Asian and Italian (especially Neapolitan) aminaios wines are mentioned by Galen also at Bon. Mal. Suc. 11, 423,6 H. (VI.805 K.) and 424,2 H. (VI.806 K.); cf. also below, V.5, 145,28 Ko. (VI.337 K.). 32 I read ἕκαστος δυνήσεται σκόπους ἔχων ἐπὶ τῶν γερόντων ἐν τῇ τῶν οἴνων δοκιμασίᾳ, which is a mixture of the readings of M and VR, and seems to yield the required sense. Koch’s transposition of τῶν γερόντων to just after ἕκαστος (which would mean that ‘each old man’ was doing the choosing) seems to me unnecessary; it would also subtly shift the sense so that the patient, rather than the expert, is responsible for the choice. It is true, of course, as the above example of Antiochus in particular shows, that Galen envisages the possibility of an old man supervising his own health care; but it is also true that there remains a conceptual distinction between the expert and the subject. Throughout the relevant passages of the present text, Galen regularly addresses his instruction on diet and exercise to the expert – it is the diet and exercise that they will impose on the subject – rather than directly to the subject. 33 ‘Tawny’ translates kirros, a colour understood as between purros (red, fiery) and xanthos (yellow); cf. Book IV, n. 46. For the Hippocratic usage Koch cites Regimen in Acute Diseases 13 (II.334 L.). For further discussion of colour terms – including ‘pale yellow’ – and relevant references cf. Book II, nn. 16 and 17. Clearly, ‘white’ here does not indicate our usual sense of ‘white wine’, but the lightest shade of wine, something close to what we would call a ‘colourless’ liquid. 30

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midway between pale yellow and white, or between pale yellow and yellow. As for their colour, the hottest of the wines mentioned is yellow, and the least hot white. Those between the two partake of the capacity of whichever one they approximate to more closely. Old men derive from wine this very great benefit, first of all, that all their parts are heated; and, secondly, that the liquid of their blood is purged through urine. This is why the wine which is best for old men is whichever is most productive of that effect. And this is that which is finest in its consistency, since such wines provoke urination, and yellow in its colour, since this hue is specific to those wines which are significantly hot. For this reason these wines, even if they are extremely white to begin with, acquire some yellowness with age: they tend to start out slightly pale yellow in their appearance, then become completely pale yellow, and then, after a longer passage of time, midway between pale yellow and yellow. (It is not 337 K. possible for white wines to become completely yellow.) Those pale yellow or yellow wines which are thick generate blood and nourish the body; these too may therefore sometimes be of value for old people, so long as they do not have any whey-like moisture in their veins, and are in need of further nourishment. For the most part, however, people at this age require diuretic wines, because of the presence in them of a moist residue. But none of those wines which remain for a long time in the stomach is ever appropriate for an old man. Wines of this type are the aminaios wines of Bithynia, and amongst Italian wines the Marsian, Signian and Tiburtine, while they are still young. But these are all white wines. There are also black, thick wines, amongst which those which are astringent remain in the stomach for a long time and produce upset in it, for example the Abates in Cilicia and those from Perperene and Aigai in Asia. Those which are black and thick without being astringent, such as the Skybelites and Theraios, remain less long in the stomach, nor do they provoke urine, but are passed out below; for this reason they are drunk 338 K. before food is taken. But these too are not of value for the old, whether drunk before food, or (even more so) if taken at any other time, any more than any other thick-fluid stuff is of value for an old person. For the liver, spleen and kidneys are obstructed by these, and this leads to dropsy in some, and in others – those old people who take them more often – to stones. If an older individual wishes to take sweet wine after his bath, the best choice is the Faustian Falernian, or in the absence of this something similar. This is on the assumption that he has eaten early in the morning, which, as I said, was Antiochus’ practice. Similar wines in this case would

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be those which are both sweet and pale yellow in colour, and next after them the Therenos and the Karuinos. One may also recommend the use of wine mixed with honey, especially for old men in whom there is a risk of the production of kidney stones, or who are suffering from gout or illness of the joints. The best wine with which to prepare this is the Sabine, or one similar to it. Parsley may also be added to the preparation; and this will be sufficient for those suffering from illness of the joints. In 339 K. the case of those suffering from stones, one should add also some scurvygrass or betony of the sort grown amongst the Celts; they call this herb ‘saxiphragos’.34 Some make the drug more elaborate, by adding also spikenard, or in some cases even other things with the capacity to provoke urine. Most, however, prepare a simple drink consisting of wine and honey, with a little rue and pepper. If the person has also eaten before bathing, and his stomach is in no need of assistance, he should drink white wines of the sort which require little water35 after the bath. But all old people should avoid wines which are thick, sweet and black, as these will obstruct the internal organs.

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Foods recommended and contraindicated for the old; avoidance of obstructions 6. Obstructions arising from wine are, nevertheless, moderate. Those caused by foods which produce a viscous or thick fluid, on the other hand, are not easy to cure. For this reason, old people should avoid excess consumption of groats, cheese, eggs, snails, lentils, grape hyacinths and 340 K. pig meat, and even more so that of eels and oysters, and in general any 30 animal whose flesh is hard and difficult to break down. Therefore none of the hard-shelled seafoods is appropriate, nor any of the cartilaginous fish or tunas, nor cetaceous fish in general. Mushrooms that grow from the earth are also inappropriate, as are the meats of deer, goat and beef. These 147 Ko. last are in fact bad at other ages, too; but the meat of sheep is quite a 34

There is some uncertainty about geographical detail, as well as some variation in the precise form of the names appearing in the MSS, of some of the wines mentioned. I read Καρυΐνος (‘Karuinos’), the form given for this wine in a couple of other places in Galen, Bon. Mal. Suc. 11, 420,15.17 H. (VI.801 K.) and HVA III.2, 221,7 H. (XV.632 K.), for the MSS Κυριῆνος (‘Kyrienos’), κυρσηνός in M. From the syntax it is not entirely clear whether it is Celts or people in general who are said to call the plant here mentioned saxiphragos; but Dioscorides (at least in some parts of the MS tradition) claims that it is the ‘Romans’ who call the plant ‘saxifragam’ (IV.16a), which would suggest that it was taken to be the Latin word. 35 Literally ‘little-bearing’ (oligophoroi): the sense of the word, applied by ‘the ancients’ to wines which ‘have no strong astringency, and do not bear the admixture of much water’, is explained at Bon. Mal. Suc. 11, 424,11–12 H. (VI.806–807 K.).

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good food for the young, whereas this too is bad for old men, and even more so that of lamb, which is moist: these are slimy, viscous and productive of phlegm. The meat of kid-goats, on the other hand, is not inappropriate for old men, nor is that of those birds whose habitat is not marshes, rivers or lakes. In all cases, preserved meats are preferable to fresh ones. Above all one must, as already stated, avoid those foods which cause obstruction; and if one finds oneself forced by circumstances to take more of these than one should, one should immediately take the catmint-based drug, the composition of which I described in the fourth book. In the absence of this, one should use the three-pepper drug; and if 341 K. this too is unavailable, one should chop and thoroughly sift some white pepper to a fine powder, and eat this added to one’s prepared food and drink. It is beneficial at this point also to take onion and, if one is used to it, garlic. The antidote involving vipers, known as ‘theriac’, may also be used with benefit in the case of old men, especially when some item which tends to release the obstruction has already been taken along with the obstructing foods. In such cases the assistance from the theriac drug is particularly strong. That involving vipers is especially beneficial in such cases, if given on the day after the emptying of the stomach from below; and equally so that known as ‘ambrosial’ and ‘immortal’, as well as the other drugs composed of the spices mentioned.36 An old man who pays careful attention to his lifestyle, however, has no need of such drugs; he may, however, in some cases require the thinning diet, and in that case what we have written in our separate, specific work discussing The 342 K. Thinning Diet will be sufficient for that person. 7. It is quite evident that, amongst breads, they should not eat those which are lacking in salt, leaven, kneading or baking, and that they 36

Theriac was a drug preparation involving a large number of ingredients, including the viper flesh from which it derives its name (θηριακόν = ‘of a wild animal’). It was developed by Andromachos, physician to Nero, in the first century CE, as an adaptation of the famous mithridatium, the antidote legendarily created and daily consumed by Mithradates VI Eupator of Pontus (on whom see also Book IV, n. 44) to immunize himself against poison. While the ­original purpose of both mithridatium and theriac was as antidotes, they enjoyed considerable popularity in elite circles on the basis of much broader supposed health benefits (one modern explanation offered for this popularity is the inclusion of opium in the mixture). Galen mentions the widespread preparation of theriac and the elite craze for it – especially that of Marcus Aurelius – at Ant. I.4 (XIV.24–35 K.). On the history, and modern scholarly interpretations, of both drug preparations see Totelin (2004), with further literature there cited; see also Totelin (2016a) on the cultural cachet of such preparations, which involved many products sourced from all over the empire. ‘Spices’ translates the plural of the Greek arōma, a term which for Galen indicates a quality of both smell and taste of certain ‘aromatic’ plants, considered to be possessed of a certain level of heat; cf. Alim. Fac. II.15, 286,6 H. (VI.590 K.): ‘all arōma is hot’.

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should not eat the celebrated semolina,37 nor things cooked with it. All these are difficult to digest, have thick fluid and tend to obstruct the internal organs. Indeed, unless a large quantity of honey is added to loaves made with butter and semolina, then there is no food more inimical to all human beings – not just to seniors. Why, though, would one combine beneficial materials with harmful ones, when it is possible to use honey alone, either boiling it up or adding it to the bread without boiling?38 And more care needs to be taken of the beneficial power of the bread than of that of the honey. True, it is preferable for the honey to be similar to the Attic, in both physical form and capacity; but in the absence of this, any honey may be used, unless it is malodorous or has some discernible quality arising from the wax (let alone some other unpleasant quality). The variety of bread just mentioned, so far from producing a good 343 K. effect in the body of the old, is in fact extremely harmful, and increasingly so in proportion with its greater purity. I observe it being prepared for athletes quite regularly; but it is appropriate for them, because of their practices, whereas in an old man – unless it contains a great deal of salt and leaven, and is perfectly baked – it will produce thick, viscous fluid. This would not be good for anyone, if increased to a great extent; and indeed it produces obstructions in the liver, the spleen and the kidneys, especially in those in whom the ends of the vessels in these organs are narrow. There are considerable differences apparent in the width of the veins outside these organs, the veins which we can plainly observe – both differences between individuals and, within a given individual, differences between those in different parts; and it is reasonable that it will be so too with those within. Such differences, however, cannot be known without experience, by which I mean the experience that one may acquire in the case of each stuff taken. For example, I knew a farmer who lived in the country to an age of more than a hundred years, and whose main diet consisted of goat’s 344 K. milk, which he took either fresh, with pieces of bread soaked in it, or sometimes with some honey mixed in, and sometimes also boiled, with some twigs of thyme added along with the bread. Another person then emulated this diet, thinking it responsible for the man’s longevity; but 37

Semidalis refers to an especially fine wheat flour, or the bread made from it; cf. Alim. Fac. I.2, 218,22–219,1 H. (VI.483–484 K.), where such grain is described as the second most nutritious, and the bread made from it the second purest, amongst the Romans and the people they rule over. 38 The phrases τοῦτο μὲν … τοῦτο δὲ … have been translated ‘either … or …’, as seems required by the context, although such a sense seems somewhat unusual.

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for him it had a completely detrimental effect, in whatever manner it was administered. The mouth of his stomach suffered heaviness, and then the right side of the abdominal region was strained. A third person who tried this same use of milk suffered no ill effect in other respects – for he performed good coction upon it, and there was no sharp fume, rancid eructation, production of gas or feeling of heaviness in the abdominal region – but on the seventh day from the inception of the diet he reported a clear sensation of heaviness in the liver; he said that he felt as if something like a stone had been inserted in the right of the abdominal region, and the parts lying above that were being pulled down by it; the tension extended as far as the collarbone. In this last case, then, obviously the liver was suffering obstruction, while in the former it was being aerated. I know, moreover, of a person in whom the long-term use of milk led to the production of a kidney-stone; and 345 K. another who lost all his teeth. This, indeed, has happened to many who use milk as a large part of their diet. Others, however, have taken milk throughout their lives without distress and indeed enjoyed very great benefit from it, some in a way similar to the man who lived in the country for more than a hundred years, as I mentioned. For when the quality of milk possesses nothing which is opposed to the nature of the user, and the paths of exit in the organs are swift as a result of the width of the vessels, the person will derive the benefits of the milk without experiencing any bad effect. The good effects of milk have been mentioned by previous doctors, too, namely: a moderate emptying of the stomach from below, good fluid and nourishment; and these are considerably affected by the pasture of the animals whose milk one is going to use. Some completely ignore this factor, as either totally irrelevant or having a very slight effect on the excellence of the milk. Yet we plainly observe that when the pasture of animals whose milk we are going to use consists of scammony or some of the spurges this gives the milk a purgative power. It is thus obvious, too, 346 K. that the milk will be acrid, sharp and tart in the case of poor pasture; for it is always made similar in nature to the grass. For this reason, our medical predecessors, taught by experience, also mentioned certain ‘good-milk’ pastures (this is the term they use), which we, too, will discuss elsewhere. For present purposes it is sufficient to understand that the nourishment of the animals whose milk we are going to use should be not at all acrid, sharp or tart. (And it is surely obvious, even without my mentioning it, that the animal should be in the prime of life and faultless in its bodily condition.)

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It is, moreover, preferable to use a combination of part goat’s milk and part ass’s milk, because ass’s milk is finer and more whey-like, while goat’s 30 milk is well-balanced in its thickness. The latter thus builds [the body] up more, if that is the requirement; but ass’s milk is in every respect safer: even if taken without bread, it passes through more quickly, has very little flatulence and does not curdle in the stomach, especially if taken 347 K. with salt and honey. 150 Ko. The capacities both of milk and of the materials of all other remedies must be learnt individually, if one is to use them well. I say this to avoid being compelled repeatedly to make the same statements on the same subjects. Even as things are, I believe that I have given a longer exposition on both milk and wine than was appropriate for present purposes. It 5 would have been preferable to state the nature of the benefit that old people derive from them, and then to send the reader off to make the choice of materials on that basis, on the assumption that he had previously learnt both the common capacities, in each case, and the individual differences. So, one would simply state, in the case of wines, that those which are hotter and more diuretic are better for old people, and in the case of milk, that it should not be given to all, but only to those who 10 perform good coction upon it and who experience no symptom in the right abdominal region. However, it has often happened that we have been compelled to extend our discussion because of the cavalier attitude of so many who fail to read those books which give a more detailed account of the individual materials of the remedies. Here, too, then, we 15 may reasonably be forgiven for the manner of our instruction, which 348 K. does not proceed with complete concision, confining itself to general methods. It must be understood that it is impossible to achieve perfection in one’s use of the materials mentioned purely on the basis of a discussion such as that just given of wine and milk. In fact, if one wishes to handle them optimally, one must first specifically learn the account appropriate 20 to each one, that is to say the account whereby we consider the capacity common to that material as well as the individual distinctions within it, right down to the ultimate distinctions. It will be best not to give a lengthy exposition in this treatise of all those things which one should know if one is to take care of an old person. Rather, it will suffice to give an account of some things which are particularly useful for seniors, in the way that we just did for milk and wine, and in other cases to give an even 25 shorter account than this, or in some cases no account at all. It is, however, possible for one who wishes to give an extended account to

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mention all those things which arise frequently in old people, by 349 K. proceeding in this sort of way.39

Common pathologies of old age and their management 8. It will be best also to give an account of those things which affect most old people: hoarseness, mucus, the production of kidney-stones, ailments of the joints, gout, shortness of breath and all such things. Now, we must introduce one particular daily regime, and one set of drugs, for hoarseness; others for the onset of stone; and by approaching all the others in this way, too, you will appear to be meticulous and outstanding in the science of old-age care. One should not give a written account of any of these in a composition on old-age care,40 since those who are trained will be able to transfer the relevant information from the treatments of diseases; on the other hand, equally, one should not here confine oneself to an account of the general features alone, but rather include at the outset some of the individual ones most proper to the investigation at hand, as indeed we have done. It was shown in our work on Mixtures 41 that there is a general consensus that old age is cold, but no such consensus that it is dry, some 350 K. indeed stating it to be wet. But it is surely appropriate to take what was 39

Galen distinguishes between a more comprehensive and a more selective or cursory way of expounding the relevant information; but his precise claim in relation to what he is about to say is not entirely clear, and the text perhaps uncertain. The phrase translated ‘in this sort of way’ (ᾧδέ πως) would more usually and more naturally refer forward, introducing the next part of the discussion; but if we translate accordingly (‘as follows’), without emendation, Galen would appear to be contradicting himself, saying that he is about to give a more extended account of all matters relevant to old-age care, when he has just stated that it is best not to do so. The present – albeit unusual – translation of the phrase seems to solve the problem: Galen’s claim would thus be that he is not going to give a thorough account of all relevant matters, in the same way that he just has of wine and milk. Alternatively, it would be possible to take ᾧδέ πως as referring forward (without self-contradiction), by suggesting that a negative, μὴ, has dropped out before μηκύνειν (arguably an easy omission). The sense would then be: ‘It is, however, possible, even for one who does not wish to give an extended account, to proceed as follows’; and then Galen’s claim would be that he is about to forge a middle way, mentioning all relevant factors but not doing them at exhaustive length as he has in the case of wine and milk. This perhaps makes better sense of what actually does follow, in the preamble to the next chapter, where, however, Galen seems to manifest some ambiguity as to the level of detail claimed as required. 40 The claim here is somewhat confusing, in a way related to the problem outlined in the previous note. The sense might be clearer if some qualifier – e.g. ‘full’ or ‘extended’ – had been added to the simple ‘give a written account’ (graphein). What is clear, at least, is that Galen is still addressing the question of the demarcation of topics, and the level of detail appropriate to a medical discussion within a particular genre of work. 41 See again Introduction, section 5.5.

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shown [there] about its mixture as an assumption for the branch of the art known as old-age care, which is our present subject. We shall thus derive our actual practical aim from that mixture, but address some points individually, partly with the aim of training the student, partly as examples with a view to the discovery of facts not yet stated. This is because not all are so intelligent as to be able to discover the individual facts on the basis of knowledge of a general proposition alone; some require a further guide in order to reach them. One who has a welltrained reasoning-faculty will, on hearing that an old person’s body is cold and dry in its actual parts, but readily filled with whey-like, phlegmatic residues, attempt to get rid of these residues and to heat and moisten the actual solid parts of the body. But some are deceived by the volume of residues into stating, without the relevant distinction, that the mixture of the old is wet; and these have missed the primary aim right at 351 K. the outset, concluding that elderly bodies should be dried. They thus prescribe foods which tend to dry: amongst vegetables, cabbage rather than mallow, blite, monk’s rhubarb, orach and lettuce; amongst pulses, lentils rather than barley; millet rather than beans; Italian millet rather than einkorn; amongst fruits, almonds and terebinth seeds rather than bottle gourd, melons, plums or blackberries; amongst meats, those of wild rather than farmed animals and preserved rather than fresh. They thus in the entire daily regime avoid everything which is wet in its capacity, and prefer to prescribe drying foods. Yet the truth is entirely the contrary, and it is quite evident that wet foods benefit old people. It is the fact that some of these are cold in their mixture, and therefore generate phlegm immediately in the stomach and in the first veins,42 that has led some – those who do not understand the mixture of the old people as a whole, and do not have regard to the 352 K. essential points of the diet – to conclude that wet foods are harmful. After all, oil, baths in drinkable water, and the drinking of wine would not benefit them if they did not require moistening. In fact, their moderate motions and need for sleep are sufficient evidence of the general aims of the diet. Thus, even if we are on occasion compelled to prescribe something which cuts, when phlegm has been generated in the stomach, we must very quickly make the transition to a moistening diet. Indeed, even if we suspect an obstruction, and are thus led to one of those foods or drugs which tend to remove obstruction, it is neither the case that the foods given for nourishment should be entirely lacking in 42

On ‘first veins’ see Book IV, n. 36.

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moisture, nor that one should abstain from them on that day. And on the following day one should hold even more closely to the [primary] aim of the regime, giving groats with honey, or honey mixed with vinegar, when we prepare them as a broth, and instructing it to be served with wine- 15 honey or Falernian wine, or using milk, in the manner mentioned before; or preparing a very thoroughly boiled broth, with the addition of finely powdered pepper. Ripe figs, similarly, are to be preferred to any other summer fruit; and, in winter, dried figs, as well as bread prepared, as 353 K. mentioned, either with honey, with wine-honey, or with some appro- 20 priate wine. Τhe above has been stated for the purpose of clarification by example, so that those who read it will be able to assess the [other] materials on a similar basis, by reference to the overall aim, which, as I have said, consists in heating and moistening. 9. Since phlegmatic and whey-like residues gather in the bodies of older 25 people, urination should be encouraged every day, not through drug-like substances, but by means of celery, honey and diuretic wines; and the emptying of the stomach from below should be provoked above all by oil, which should be swallowed before meals. It is obvious, too, that all vegetable-type foods should be taken before other foods, with olive oil and garum. In some cases, the stomach will be sufficiently emptied, on a 30 daily basis, by these foods, as well as by figs, when these are available, or by plums and whatever other fruit is in season in spring or autumn, and, in winter, by Damascene plums, either boiled or simply soaked in honey- 153 Ko. mixture with a high proportion of honey. It is better still if the honey is 354 K. Attic; and plums from Spain provoke motion much more strongly than those from Damascus. One may, on occasion, take olives which have been preserved in salt water. I would not, however, recommend the 5 taking of aloe, which I observe is the practice of many old people who have a dry stomach. Some form it into little pills, and take it with the juice of cabbage; some on its own, ground down and sprinkled into some fluid, which may be either water or honey-mixture. Those who are richer take aloe in a preparation with cinnamon. Some refer to the aloe-based 10 drug as ‘sacred’, some as ‘bitter’. Some take it dry, so that it may be sprinkled in a drink, some with uncooked honey, taken in moderation. None of these, however, should be used by the old, unless there is a pressing need. If the stomach is amenable to the interventions already 15 mentioned, if not every day, then at least every other day, then one should not give anything drug-like in nature at all. If, on the other hand, after retention over two days, it is not evacuated even on the third, then

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it should be sufficient to give tuberous spurge, and what is known as sea cabbage, and safflower in barley-broth, and the other moderately druglike materials, including indeed resin of the terebinth tree. Sometimes 20 355 K. people take an amount of this equal to a filbert,43 or sometimes two or three. It not only has the capacity naturally to empty without pain, but also to cleanse all the internal organs thoroughly – the liver, spleen, kidneys and lungs. One should use the preparations mentioned in a varied way, rather than choosing one and only administering that; for in the latter case the individual nature of the person taking them will, in the course of time, become habituated and so come to ignore the capacity of 25 the drug. One should thus alternate the above preparations, and also that prepared with dried figs; these should be smooth, and the skin-like covering should be removed; so too with the safflower; and both may be mixed together and chopped. The amount of dried figs should be several 30 times that of safflower. Here, too, one may make trial of the drug in relation to the nature of the person taking it, adding in either more or less of the safflower accordingly. The amount should be roughly two or three dried figs. As I have said, one may find the right amount for oneself on the basis of one’s actual trial of it, in the case of all similar materials. For 356 K. the stomach is in some cases more and in others less amenable to the 154 Ko. same drugs. But none of these drugs should ever be taken in abundance. There are those who take immediate pleasure in a very vehement evacuation; but the greater the evacuation the more their stomachs will suffer retention 5 on the following days. It is for this reason that I do not purge with acrid enemas even in cases where the gastric cavity is suffering retention in chronic illnesses of the sort that many experience especially in the winter, nor in cases where a similar occlusion arises in the recovery phase after a long infirmity, but I pour in only oil: the use of this in the case of healthy old persons is sometimes perfectly permissible, when these are suffering 10 from retention in the stomach. It soaks the hard residues and produces a certain slipperiness in the passage; and the body of the old person itself, which has become hardened in a way similar to hard parchment,44 is softened. This, however, is not a treatment specific to the old; it is 43

The filbert (karuon Pontikon) was often used as a measure of weight in drug recipes; cf. Note on translation, p. xxiv. The term diphthera may also refer to anything made from leather, especially a leather pouch or wallet; but it is standard in the sense of ‘parchment’, and this perhaps gives the better sense here. Cf. the mention of diphtherai at Ind. 33, 12 BJP – in relation to which, similarly, there has been discussion as to whether Galen is talking of bound parchments or leather wallets, although again the former interpretation seems preferable.

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b­ eneficial also to those recovering from long diseases. What, then, is there that is specific to the old person as such? That which is beneficial to his 15 mixture. For it is this through which we actually age, each at different 357 K. times, earlier or later, in accordance either with the state of nature which we had originally or with that which we have acquired by being excessively dried out through habits, daily regime, illnesses, worry, or other such things. The term ‘old age’, which all use, in fact properly refers to the dry, cold mixture of the body arising over a period of many years. 20 Such a state also sometimes arises as a result of a feverish disease, and we then refer to it as ‘old age from sickness’, as has been stated in our work on Withering. For withering is this type of state, arising not just in animals but also in plants. The unavoidable nature of the origin of old 25 age has been described in the first book of the present treatise, too. From those remarks, as well as what has been said in Mixtures and also in the work on Withering, one may equip oneself better for the branch of the art known as old-age care.45 10. For all provision for the state of the body is based upon the knowl- 30 edge of the substance belonging to that state and the capacities of the 358 K. materials of the remedies. So, for example, in the case before us now, that of old age, one who understands the state scientifically – that is, as dryness in conjunction with cooling – will, if he thoroughly learns which such materials of remedies are moistening and heating, be a good doctor for the old. Now, there are four classes of materials [of the remedies], 155 Ko. which are known as: things taken, things done, things evacuated and things making contact externally;46 so one must choose, within each of these, those with the capacity to heat and to moisten. For the purpose of the proper use of each, what is most useful is a training by examples.47

Exercise in old age 321,13 K. That is precisely why a significant amount has been said already about 5 food and drink, by way of example; and now we shall speak about exer45

In the short text Withering (esp. 1–3) Galen defines ‘withering’ (marasmos) in general terms as a drying-out of both animal and plant bodies, of which old age is a specific, naturally occurring and non-pathological case. The same picture of old age as a gradual drying-out is elaborated at Temp. II.2, where the explicit parallel with plants is also made (and attributed to Aristotle) at 46,10–11 H. (I.581 K.). 46 For this fourfold classification see Introduction, section 5.2. 47 Here begins the passage transposed from its earlier position in Kühn’s and the other printed editions, in order to restore the original order; cf. n. 22 above.

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cises. As we learnt earlier, swift ones, as those which involve fast motions are known, have a thinning effect on the body, while the opposite kind 322 K. thicken it; and large amounts of exercise have a drying effect, while moderate exercise fleshens up. We discussed all the other distinctions too, as we did also in the case of massage. The question, which forms of exercise are beneficial and which harmful to old people, will be assessed on the basis of the whole state of the body, the customary practices and the ailments afflicting it. First, as regards the whole state of the body: the best body as regards its constitution – the one with which our discussion has been concerned from the beginning up until now – is in old age most suited to moderate exertions, just as in youth it was most suited to the most vehement ones. That body, on the other hand, which is thicklegged, broad-chested, or more than normally thin-legged, or that in which the chest area is small and generally narrow, as well as that which is bow-legged or knock-kneed,48 or in any other way out of balance, is not suited to many of the exercises. If one’s chest area is of poor constitution, this will be harmed by exercises involving the voice; as will the legs by exercises involving walking. And you should consider the same argument 323 K. to apply to the hands, the neck, the back and the lower back, the hips and the spine as a whole. Any of these which has a poor constitution will be compromised rather than strengthened by exercise, unless one wishes to use the term ‘moderate exercise’ in application to moderate motions for parts of the body which are weak; but then the dispute will be about terminology rather than fact. The exercises especially conducive to the health of the old must be performed by their stronger parts; the remaining parts will then move and be exercised along with these. Furthermore, it is their customary practices which play the greatest part in the discovery of the correct form of exercise. Those motions to which they are accustomed will be free from fatigue, and they will enjoy performing them, just as, conversely, they will experience fatigue and be irked by unaccustomed ones. Activities involving specialist skills, such as the playing of the aulos, trumpet or lyre,49 would not even be possible, any more than would exercise in the wrestling-school, if someone had no training in that. One should, then, make all old men take exercise in the manner to which they have previously been accustomed, but with a relaxation of the 48

The Greek terms are blaisos and raibos. As Galen clarifies at Caus. Morb. 7 (VII.28 K.), the former is applied to a tendency of the legs to bend outwards, the latter to the opposite tendency. On the aulos cf. Book II, n. 84.

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v­ ehemence. The third aim in view in relation to the characteristics of exercises is that derived from the individual’s ailments. 324 K. Such an aim is indeed common to all stages of life, but it does not have the same significance at all stages; nor is there an equal degree of harm done when this is overlooked. People who are readily susceptible to skotōma, epilēpsia,50 vehement inflammations of the eyes or earaches should not engage in exercises which involve leaning forward, bending down or rolling on the ground,51 but rather in long walks, gentle running and passive exercise in carriages, all undertaken to a level that does not produce fatigue. The same applies also to those easily susceptible to paristhmia, antiades or sunanchai,52 or those in whom the uvula readily suffers a flux, or indeed the gums, teeth or any part in the neck or of the head as a whole. For example, many are troubled by hēmikrania,53 while others suffer constant pains in the tendons on very slight provocation. None of these individuals can tolerate exercise which fills the head, but all will benefit from that which involves the legs. Conversely, for those with naturally weak legs exercise of the upper body is preferable: shadow325 K. boxing, wrestling with the hands,54 discus-throwing, use of hand weights and of all exercises performed on the floor of the wrestling-school. For those susceptible to ailments of the middle parts of the body, between arms and legs, all types of exercise are appropriate, provided that they are not contraindicated by one of the other aims. The parts in the chest enjoy exercise of the lower body more, those in the region of bladder and kidneys that of the upper body. The spleen, stomach, liver, intestines and digestive tract, between the upper and lower parts, enjoy both kinds of exercise equally. Massage of the weak parts should be avoided, as long as the sickness continues, but they should have more massage than the other parts while they are healthy; and this should be, in particular, a dry massage, carried out over a long period, both with linen and with the bare hands. Indeed, in cases of periodic pain in a particular part, there is a considerable obstacle to the application of such massage, when undertaken in between, and especially two or three hours before, the onset; for the parts are strengthened by it and 50

Skotōma was an episodic attack involving dizziness and blackouts, epilēpsia involved seizures and loss of consciousness. Cf. Book III, n. 67. 52 The first two terms apparently refer to conditions involving inflammation of the tonsils, the last to one involving sore throat. 53 A complaint involving pain in one half of the head. 54 Cf. Book II, n. 71. 51

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thus absorb less of the flow of liquids55 that usually come down upon 326 K. them.56 Now, all these are common to both old people and those at any 157 Ko. other age; the advice to avoid exercise of the weak parts, however, I address to the old only. In other cases, the further the person is from old age, the more he should exercise the weak parts.

Contrast with exercise regime for bodies still developing Let me venture to give a fuller account here, since the argument may be 5 clarified by an example. Take the case of a body which is still developing, and whose legs are thin. In such a case it is appropriate to apply pitchplasters to the legs, as well as moderate massage, and to resort to running more than to any other exercise. The person in charge should regulate the degree of the motions, in such a way that he neither takes insufficient 10 exercise nor overdoes it to the extent of falling victim to fatigue. This precise degree may appear difficult to recognize, not just in exercises but in all other interventions too; but it is, as we have shown, easily recognized in the case of those who are within a healthy daily regime. In these people, it is not the case that ‘the appropriate time is fleeting’,57 as it is in cases of sickness. Here, it is possible to begin with the safest forms 327 K. according to each measure, and then, on the basis of consideration of the 15 outcome, either to take away or to add something, adjusting any oversight day by day. So, to return to the example of the person with feeble legs: I once took charge of a boy of thirteen years of age, and by undertaking his care in accordance with the aims set out above58 for the rest of 55

The word translated is rheumata; cf. Book III, n. 24. It seems uncertain whether we should accept the text as it stands (with οὐ σμικρὸν in l. 31, literally ‘no small’, i.e. ‘considerable’) or posit that the word σμικρὸν has crept in (this particular litotes, οὐ σμικρὸν, being a very common phrase in Galen), in which case we should rather translate ‘there is no obstacle’. In favour of the latter interpretation, the sentence seems to proceed to recommend such massage, with the phrase ‘strengthened … down upon them’ on the face of it suggesting a positive outcome. In favour of the former interpretation, and of the preservation of the MS reading, Galen is emphasizing the importance of maintaining the habitual state; and it seems possible that the flow of fluids from one part to another, with their absorption in the latter, is in fact taken as a negative consequence: cf. Diff. Feb. II.14 (VII.384 K.) and II.15 (VII.387 K.), where very similar language is used and where such flow from one part to another causes inflammation. (Such flow is particularly relevant to old age; cf. previous note.) 57 Galen here alludes to the well-known first aphorism of Hippocrates: ‘The art is long, life is short, the appropriate time (kairos) is fleeting, trial is perilous, judgement (krisis) difficult’ (Aphorisms 1.1, IV.458 L.); the sense of the phrase quoted is that of a critical moment or brief ‘window of opportunity’ within which the doctor must act. 58 I read προγεγραμμένους (‘set out above’) with VR, against ὑπογεγραμμένους (‘set out below’, M), taking it that Galen proceeds to outline a daily regime which was structured according to the general principles or aims (skopoi) that he has just outlined. If M is correct, then the skopoi would 56

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the period in which he was growing to adulthood, I succeeded in making him a well-proportioned and well-balanced young man. On the first day I applied pitch, twice in succession, according to my usual practice, and instructed him to run, neither swiftly nor far. On the second, after first softening the body with a massage which was well-balanced in terms of hardness and softness, and small in terms of its amount, with oil, I instructed him to run a little further, but no more swiftly than before. After the run, of course, I employed the ‘restorative’ forms of massage. I also instructed him to go for a walk on each day, starting with a moderate one and increasing it gradually, and examining all features of the legs, but especially the large veins, to ensure that they were not being widened beyond the point of good-nutrition of the legs. Such an outcome is problematic, as in the course of time it renders the limbs subject to the flow of 328 K. liquids and distorted, not well-nourished. You must, then, pay attention to this indicator – both to whether the legs are becoming hotter than they should and to whether they present any sensation of fatigue. Provided that none of these signs appears, one should increase the amount of both walks and runs, and one should also apply pitch-plaster every other day. If any of the above signs is observed, one should arrange for the legs to be tilted upwards during sleep, and reduce the amount of all the things mentioned, instructing the person to walk less and run less, and applying the massage from the lower parts upwards. And once the legs have, through this practice on your part, reached a completely normal state, one must return to the employment of remedies which was mentioned at the outset, either using only the very smallest of increments or keeping them the same as before. ‘Round’ massages,59 as they are known, should be used in both hard and soft form; and one should perform these sometimes from above, at other times beginning from the lower parts. Of course, one should perform the massage after application of dust to the legs and the pouring on of oil;60 and the dust should be that known as smooth: this is the 329 K. name given to dust which has nothing rough or acrid in it. Those kinds of dust which have any roughness, like a pumice-stone, or any

be the precise aims of each instruction which he proceeds to specify, which seems a less natural use of the term. 59 Cf. Book II, n. 22. 60 On the use of dust cf. Book II, n. 64 and Book III, n. 67.

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natron-like61 or salt-like acridity, tend to thin rather than to fleshen up. Those who have rather thick legs, but thin arms and forearms, should practise all the hand exercises, but avoid those involving the legs. But the massages and applications of pitch-plaster should be performed in the same manner, as should everything else stated concerning the exercises of the legs.62 358,9 I remember one case, of a boy whose chest deviated considerably from K. the state of good balance enjoyed by the other parts, where I succeeded in building it up to the correct condition on the basis of this kind of remedy. I girded the lower part of his chest area, up to the flanks, with a moderately wide belt, attaching it in such a way that he was supported, without any pain, and so that there was no slack, but also no excessive pressure. I made use of exercises performed with the whole hand, as well as those called by voice-instructors ‘voice projections’, in both cases 359 K. instructing him to carry out a stopping of the breath. This is performed by our exerting a vehement compression on the chest from all sides, while restraining ourselves from exhaling, so that all the breath which has already been drawn in through inhalation is retained. Therefore one should also take in more breath than usual in order to perform this exercise well: the greater the quantity of compressed air, the more the chest is broadened by the tension. Obviously in such cases the voice projections should also be performed both loudly and using the higher tension of the voice, since the aim is to provide a powerful exercise for all the parts of the chest. Now, these exercises will bring about good balance in growing bodies, for those parts which received a poor natural shaping; performed in moderation, they will also benefit adults. One should not, however, attempt such activities with seniors. For these it is better, as already discussed, not to exert the weaker parts; and also better to continue with their accustomed exercises, even if these are [in their nature] moderately harmful. Harmful exercises should, however, be modified in the case of the young, even if they have been completely accustomed to them from 360 K. childhood; for in this case the human capacity is able to withstand the change, provided it is introduced gradually, and there is some hope of I prefer νιτρώδους (VR) to λιτρώδους (M); the difference is trivial, and the latter form at some point came to be used interchangeably with the former, but the former preserves the clear connection with natron (nitron), of which Galen speaks several times in the work; cf. Note on translation, p. xxiii. 62 I read γυμνασίων with VR, against M and Koch γυμνάσια. Here ends the passage transposed from its earlier position in Kühn’s text (321,13–329,8 K.) to restore the original order; we continue here from 358,9 K. (Cf. notes 22 and 47 above.) 61

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benefit from this improvement of exercise in the remaining span of life. An old man, by contrast, even if he were able over a long period of time to wean himself off his bad ones, would not then have the time available in which he might make use of his better habits. He would simply have wasted his labour – just as if an eighty-year-old man were to begin to learn a craft or skill.

Variations between bodily states, natural and age-related; management of the various bad-mixtures Just as there is a considerable variation amongst old people themselves, 10 both in their actual age and in the state of their bodies, so too amongst those who are naturally dry and cold, in relation to the state of good balance, there is a considerable [difference],63 amongst those in the middle of this bad-mixture, both between different people who have it and between them and old men. One should, of course, moisten and 15 heat them; and one should do this with confidence, while refraining from powerful exercises, so long as their capacity is still in vigorous form. The primary aim in view, from which we take our indication of treatments, is a particular bad-mixture of the body, not old age, or any stage of life considered in general terms. Since, however, it is by a process of estima361 K. tion that we arrive at our measure of the states, for that reason we also 20 consider the stage of life.64 And the knowledge of habits has the same function as that of the so-called antecedent causes: we are assisted by all of these in acquiring a more accurate knowledge of the state; but we do not derive indications for treatment from these sources. For an Empiric, of course, such things 25 too form part of the whole ‘concatenation’,65 since for him treatment is 63

The text seems somewhat suspect as it stands (or perhaps Galen is using language loosely): the word ‘difference’ is not repeated here, nor implied by the grammatical gender of the phrase τὸ ἐν μέσῳ, which itself seems somewhat odd: Galen does not usually refer to the midpoint of a badmixture. Perhaps one should emend ὀλίγον to ὀλίγη (so that the feminine noun διαφορὰ, ‘difference’ would be taken as the noun understood with ‘considerable’) and τὸ to τῶν – ‘difference of (or amongst) those in the middle’; this would solve the former problem, though we are still left with the latter oddity. The general sense of the argument, at least, is reasonably clear: there is a parallel between the case of old people, who are cold and dry as a result of their age, and those who have a cold, dry mixture congenitally; there are, however, considerable differences, both within each of those broad categories, and between them. 64 The argument seems to be that there is a general statistical correlation, not a precise one, between stages of life and states of the body in terms of hot, cold, etc.; but that, although not exact, this correlation justifies us in the inference (here described in terms of stochasmos, estimation) that will lead us to treat the bodies of the old in a particular way, namely to heat and moisten them. 65 ‘Concatenation’ translates the Empiricist term of art sundromē; cf. Book III, n. 64.

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based on observation of these, not discovered on the basis of indication. It is for good reason that Hippocrates directed most of his writings on both diagnosis and prognosis towards our training in individual cases, as indeed did the best of his medical successors; for they understood very well that it is not difficult to find the correct remedies for a body which we encounter in health or in sickness, if one has an accurate knowledge of its state.66 We must, as has been very frequently stated, take as our starting-point the therapeutic precept ‘opposites cure opposites’; then, we must acquire expertise in the materials of remedies, thoroughly learning their capacities; and we must approach each body by introducing either 362 K. opposites, in the case of one in a bad state, or things of similar properties, in the case of one with the best constitution. You will also treat those bad-mixtures which are within the broad spectrum of health by opposites, if you wish to rectify them; and this is possible where there is plenty of leisure.67 In a situation where there is a lack of leisure, you will treat them by similars, and especially so when the person is habituated in this way. In general, the latter of these tends to be the case more frequently, since natures without being directed tend to choose those things which are appropriate to them, and do so until they return to their previous disposition.

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11. But the daily regime which rectifies bad-mixture aims in general to 10 proceed beyond this. Thus, we fall victim most frequently to the diseases closest to our natures, hotter natures being more readily affected by hot diseases and colder natures by cold ones, and so on with the others. So, every badly-mixed body returns more readily to its own nature than to the best mixture. The latter is at the midpoint between all the bad- 15 363 K. mixtures; if, then, someone falls victim to an illness which is proper to that person’s nature, then this best mixture is further away from that [state], whereas in the case of an illness not proper to the person’s nature, it is less far. One should not, then, change the habits, either, even if these are poor habits, so long as the body is still suffering discomfort; and in In l. 30 I read οὐ χαλεπῶς (VRN) as opposed to χαλεπῶς (M and Koch); Koch arrives at the same sense, but at the cost of inserting the negative μὴ (so, ‘if one does not have an accurate knowledge …’), for which there is no MS authority, in the previous line. Also in l. 30, I translate the text of VR, ὑγιαῖνον ἢ νοσοῦν, ‘in health or in sickness’ (whereas M reads νοσοῦν ὑγιαῖνον, without the ‘or’, from which Koch suppresses ὑγιαῖνον, so that we would have only ‘in sickness’). (However, I suspect some corruption of the text. The sense intended is clearly that the doctor should know the individual nature of a patient, that is to say his or her natural state, before encountering her or him in a state of disease; and this is not exactly what the text says, on any of the available readings.) 67 On this requirement, see Introduction, sections 3.1 and 5.6.

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fact, even in cases of most perfect health one should not always change them, but only when the person contemplating that change has sufficient freedom from public obligations.68 These, then, are the precepts common to all mixtures; but they admit of modifications in individual cases, depending upon the extent to which each bad-mixture falls short of the peak good-mixture. It is therefore in no way surprising that those badly-mixed natures located at the midpoint between perfect health and observable disease admit of a twofold manner of daily regime; nor, indeed, that the same interventions are observed sometimes to benefit and sometimes to harm people. If everyone had a similar constitution, then it would indeed be surprising if some were benefited by opposites and others harmed by them; but since in fact there are many opposing [kinds of ] human constitution, it is natural enough that what benefits them may be opposite in character. 364 K. One might, therefore, find it surprising that all those doctors who have undertaken to write compositions on matters of health have failed in their account to make this distinction between different natures. It is as impossible for a doctor to use one and the same beneficial pattern of life for all individuals, as it is for a cobbler to use one and the same last. It is for this reason that some state that the healthiest thing is a substantial daily exercise, while others state that there is nothing wrong with complete idleness;69 that some think it most healthy to bathe, and others not to; and so too with the drinking of water and wine and all other such matters, not just in the context of daily regimes for health but also of treatments to administer to the sick: they write completely opposite statements, so much so that it is rare to find a point on which they all agree. Experience itself shows cases of people being benefited and harmed by the same things, and, vice versa, by the opposite things. For example, I know some individuals who fall sick immediately if they go three days without exercise, and others who remain healthy in spite of never taking 365 K. exercise; and, amongst these latter, some who go without bathing and 68

Politika pragmata may imply such civic obligations as are involved in public office or political activity, but also possibly business obligations more broadly. The term politikos has a wide application, to all activities or concerns to do with the polis, city, as opposed to the domestic environment. 69 I read ἔνιοι for ἐνίοις twice (in ll. 34 and 35), thus providing subjects for the verb φασι in a way which gives much better sense than the alternative, which would instead give the sense: ‘they [not specified] state that for some the healthiest thing …’. Galen’s point here is the disagreement between different groups of doctors, not that doctors in general make differential prescriptions for different sorts of patient – which is precisely what he accuses them of not doing. (The change of the nominative to dative forms is readily explained on the basis of the dative construction with δοκεῖ which follows immediately in ll. 36 and 37.)

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some who experience fever immediately if they miss a bath, as was the case with Primigenes the Mitylenaean. Now, the manifest truth of this is known even by those who assemble their art by experience alone. Yet none of them has written down any account of the indicators of these – 10 as they have in the case of diseases – by attention to which we might discover the daily regime which each person needs. It is in rare cases that one finds what the Empirics refer to as ‘concatenations’ perfectly exemplified, as it is with peripneumonia or pleuritis. The discernment of most diseases involves a conjecture, rather than arising from an assemblage of definite symptoms,70 and requires a man with a complete understanding 15 of the state of the body and the capacity to discover all the individual features which accord with this.

Example of Primigenes; care for hot natures; importance of observing differences The matter before us now was discovered by me, guided by reason itself, when still a young man – from which indeed it is evident that long experience is incapable of discovering such things without the aid of reason. So, in the case of Primigenes,71 hearing that he invariably suffered fever if 20 366 K. he missed a bath, I reasoned that smoky residues were being generated in him which were in need of transpiration, but that since his skin was too dense too allow them to be evacuated, they were all gathering beneath his skin and generating heat. Baths are thus extremely useful for such natures as this, not only by virtue of the evacuation of the smoky residue but also 25 by virtue of the contact with fresh moisture. I therefore decided to learn fully what kind of quality this heat had, by placing my hand flat on Primigenes’ chest. When it was found to be acrid and biting, in a way similar to the case of those who have taken a large quantity of onions, I was then even more convinced that I had correctly discovered the cause of what was happening; and I then enquired whether he experienced 30 sweating when he did not bathe: when he said that he did not I was even more firmly convinced of the security of my knowledge of his state. On the other hand, I have known others who had an equally biting hotness 70

‘Assemblage of symptoms’ (athroisma sumptōmatōn) is an explicit use of Empiricist jargon (cf. Book III, n. 64); Galen as it were puns on this jargon in using the verb assemble (athroizein) in relation to the art a few lines earlier. 71 Nothing is known about this person beyond what Galen tells us. The same person and symptoms are mentioned at Hipp. Epid. II VI.44, 956,2 Vagelpohl (where, however, the garbled form of the name in the extant Arabic text was conjecturally emended to ‘Hermogenes’ by the editors, evidently unaware of the present passage).

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but did not suffer fever just by missing one bath, since in their case the residue was evacuated by sweating. In Primigenes’ case it was not just his 367 K. natural constitution but also the form of his daily regime which was responsible for his suffering fever on missing a single bath; for he spent most of the day at home, continually writing or reading, because of his engagement with the theoretical studies in Peripatetic [philosophy]: in his time, he was second to none in this field. We know that even in people who do not naturally generate such a residue, its generation may nonetheless be caused by overwork and mental exertion. That is why another person, who had a biting heat equal to Primigenes’, did not immediately experience fever after one day without a bath. He was not an intellectual, and his daily activities involved a great deal of walking about72 the city, as well as buying and selling, and squabbling, during which activities he necessarily sweated. It is for this reason, too, that I succeeded in keeping another person, who had fallen ill every summer with an acute, bilious disease, completely disease-free for very many years, by forbidding him exercise. This was someone with a hot, dry mixture, like that of Primigenes, who used to engage in intense exercise in the sun and dust. His heat would therefore rise immoderately, and his skin would become densified in a 368 K. way which impeded transpiration; when both these things befall a body simultaneously, there is an immediate liability to fever. I therefore repeat now the remark that I have always been accustomed to make, in relation to the whole of the art of medicine: reason discovers the objects of enquiry73 most quickly, but it is experience that confirms their reliability. It is still more surprising, in view of Hippocrates’ statement that for hot natures it is better to remain idle than to undertake exercise,74 to observe so many doctors not attempting to discern which such persons are, but prescribing exercise to everyone indiscriminately; and equally surprising to observe a considerable number of others, conversely, ­maintaining that exercise is of no value for health,75 as well as a third 72

The verb ‘walk about’ is cognate with the word ‘Peripatetic’ (derived from the Peripatos, literally ‘walk-around’, a colonnade in central Athens, which was particularly associated with the Aristotelian school). The verb is an everyday, neutral one, but it seems not wholly impossible that its occurrence here (and below at 164,1 Ko., VI.371 K.) just after the mention of this ‘foremost Peripatetic’, involves a light double entendre. 73 For Galen’s terminology and grammar of the term zētoumenon, ‘object of enquiry’, see Thras., n. 2. 74 Galen seems to have in mind, here and at a number of further points in the text, a brief aphorism from the Epidemics: ἐνθέρμῳ φύσει, ψύξις, ποτὸν ὕδωρ, ἐλινύειν (‘for a hot nature, cooling, drinking water, cessation’, Epid. VI.4.13, V.310 L.). 75 Cf. Book I, n. 68 and Introduction, section 2.3.

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group who allow those accustomed to exercise to continue with it, but prevent those not so accustomed. All these groups are in error, although the last-mentioned are less so than the others. Most of those who have acquired any particular habit are in fact choosing what is appropriate to their own nature, as a result of having frequently experienced harm from, and therefore rejected, what is inappropriate. There are, however, those 369 K. who, either because their judgement is overruled by pleasure, or because of excessive stupidity, do not realize the causes of the harm they are suffering, and who therefore persist in bad habits. (These, however, are few in number, whereas those who do make a change are in the majority.) It is reasonable to suppose, then, that those doctors who consider it right to preserve all established habits are likely to do less wrong, while those who think that it makes no difference to health whether one consumes food after exercise or without having done exercise, as well as those who encourage everyone to exercise, do more harm than that first group. And of these two latter groups, those who advise exercise consistently before food do less harm than the other. Some, indeed, take it that this was what Hippocrates was recommending with the statement, in the Aphorisms, ‘Exertions should come before food’;76 but they fail to realize that the discussion there is of the relative order of exercise and food. He is not saying that both are beneficial for all people, rather that in those cases where exercise is appropriate, it should precede food. The fact that it is not appropriate for everyone is clearly indicated in the Epidemics, where he recommends ‘cessation’77 for hot natures; and also by implication in the Aphorisms, through his indication of the general application of ‘opposites cure opposites’.78 370 K. The impression of a conflict may also sometimes arise in relation to such precepts, since some use the term ‘exercise’ in reference to all motion which is well-balanced for the body to which it is applied, while others use it only for the more vehement sort. In the former sense of ‘exercise’, then, it is something required by all human beings, as is surely obvious to everyone; in the latter sense, this is not the case. The claim that some make in this context that people remain healthy in prison seems to me to be quite incorrect. In fact, all people in this situation are completely ruined in the course of time, since they are entirely prevented from taking exercise. There is nothing remarkable in the fact that they may continue for some days before succumbing to the 76

In fact from Epid. VI.4.23 (V.314 L.); cf. Book II, n. 5. Again, Epid. VI.4.13 (V.310 L.); cf. n. 74 above. For this standard Hippocratic dictum and Galen’s citation of it, cf. Book I, n. 62.

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unhealthy lifestyle. If, then, we are to include all motion under the heading of ‘exercise’, then walking, having a massage and bathing will also count, so long as in each case the motion is well-balanced in relation to the disposition of the body. But if you prevent a person from engaging even in these, he will certainly fall ill. Indeed, we observe that those who are so prevented do indeed fall sick, and indeed die, in prison, 371 K. if their confinement continues for a long time. If, on the other hand, one uses the term ‘exercise’ only for vehement motions, it will then be true that not all people require it. In fact, this same Primigenes was an example of this: he required no forceful motion, but before bathing used simply to go for a walk in the colonnade in front of the bath house. Even massage with oil and the wiping-off of the water after the bath are sufficient motions for a man with this kind of mixture. He would also walk about before dinner in discussion with his followers, and in his house in the morning.79 There is, then, no one who derives benefit from complete idleness. By recommending ‘cessation’ for those with a hot nature, Hippocrates is instructing them to refrain from vehement motions. I myself have assisted many who used to become quite ill at the onset of autumn as a result of the motions they were accustomed to performing throughout the summer. I restored them to health by forbidding these activities. There have been others, too, whom I have prevented from engaging in vehement exercise, and others again whom I saved from the illnesses to which they were previously often subject, by moving them from idleness 372 K. to exercise. The latter are those who are colder than the well-balanced state of good-mixture, in an opposite state from the hot, dry ones. I have written about the indicators of the mixtures, not only in my treatise on Mixtures, but also in the Art of Medicine, as one of my singlevolume works is entitled. It is extraordinary how many doctors are unable to discern even things which are manifest through sense perception. How is it possible not to notice the sheer extent of the difference that exists between human beings, whereby some are benefited, and others harmed, by the same practices and foods – as is the case also in sicknesses? They should therefore have been aware of the manifest truth, that not all people require the same interventions, and should have made 79

Hetairoi: traditionally translated ‘companions’, the term in Galen seems usually to refer to a philosopher’s or doctor’s (including Galen’s) followers or students. He typically says that most of his works are written for them, often in response to explicit requests. Further on this see Singer (2019b); and cf. Thras., n. 9.

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these distinctions in their compositions, giving instruction as to which individuals are benefited, and which harmed, by each. What is the reason for their omission of these specifications, in spite of their having been discussed by Hippocrates? It is the wretched desire to gain reputation amongst men by acquiring the title of leader of a sect. That is the reason 373 K. that those people set out to follow, not the manifest phenomena, but the 25 beliefs which they have themselves posited as assumptions. Most of the more recent [doctors] who have fallen in with these people80 have done so simply through their lack of any better education, whereby they are completely ignorant and unschooled in demonstration. Anyone who does have the ability to follow a demonstration will very easily distinguish false doctrines from true ones, and those written without appropriate specifications from those written with them, and 30 will convict all those who have written without such specifications of a lack of skill.

Summary of correct care for different bodily mixtures 12. Pay attention, then, to the following brief account of the correct nature of these specifications, which proceeds from the most basic ones. Those who are naturally endowed with a biting hotness, such as generates smoky residues, benefit from baths and from brief, leisurely motions, 165 Ko. whereas long, swift ones will tend to be harmful. Such people should bathe not just once but twice a day, especially in summer, and should eat nourishment which has good fluid, with nothing acrid about it. It is also bad for them to spend time in the sun, or to experience rage or excessive 5 374 K. mental exertion. Those natures which are opposite to these, that is those with cold, wet mixture, require stronger motions, as well as a much thinner daily regime (the nature of which has been described in a singlevolume work).81 Such people do not experience harm even if they take exercise in the sun, nor if they abstain from bathing. Indeed, the difference between these two kinds of nature is the largest of all. While the wet, cold mixture is most opposed in nature to the hot, 10 dry one, the largest [difference] is between the hot, wet one and the VR ἐμπεσόντων seems to me clearly preferable and more idiomatic (the sense being that of ‘coming upon’ or ‘getting involved with’, but also with connotations of getting into trouble) than M ἐκπεσόντων. 81 Galen refers again to The Thinning Diet. 80

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cold, dry one.82 The cold, dry mixture is similar to that of old men; for this reason, such bodies age quickly. We have discussed these sufficiently above. The wet, hot mixture is susceptible to rheumatic ailments. In this case, too, the preferred course of action is that of general application to all badly-mixed natures, namely, to correct it by opposites when there is abundant leisure, but to preserve it through similars when the person is prevented by numerous obligations from devoting time to himself. Exercise for such bodies should be as follows. They must exert them375 K. selves to a considerable extent, because of their bodily wetness, but not do so in an intense manner, because of the hotness. One must also be very careful in managing the transition from a more idle daily regime to one involving exercise: these bodies very quickly fall victim to diseases involving flow of liquids unless they have been evacuated before exercise. Anything in them which is solidified and thick in terms of its fluid, or indeed just moderately cold, will immediately become aerated and made to flow. Thus, in spring, too, such natures are particularly susceptible to those diseases arising as a result of build-up, that is to say: sunanchē, kunanchē, 83 catarrh, haemorrhoids, flow of blood, coughing-up of blood, gout, illnesses of the joints, inflammation of the eyes, peripneumonia, pleuritis, and all those that belong to the class of inflammation. Blood should therefore be removed from them immediately, right at the beginning of spring, either by the cutting of a vein or by scratching the ankle.84 Patients who refuse this form of evacuation should be purged by means of a complex drug, with the capacity to draw out yellow bile, phlegm and some part of the whey-like residues. The above statements regarding exercise should be taken as applying 376 K. also to baths. These too are dangerous if taken before evacuation, but are beneficial once this has been done, especially if the water used is not drinkable, but rather water with a diuretic capacity. The highly beneficial 82

The text is uncertain here, as is the precise distinction Galen wishes to make. The MSS present garbled readings, and the text translated here is based on Hartlich’s emendation, which follows the Latin translation of Niccolò. Galen moves from the conceptual opposition between the hot-dry and the wet-cold combination to that between the hot-wet and the cold-dry combination, the latter being that found in old age; but what, if anything, is at stake in the distinction between ‘largest’ (difference) and ‘most opposed’, is unclear; and it is unclear, too, whether the claim is that one of these oppositions is in principle more significant than the other. While it seems impossible to reconstruct the original text with full accuracy, I suggest that the second μεγίστη (‘greatest’) may be an erroneous repetition of the first, in place of μεγάλη (‘large’), and that the argument should rather run: ‘While the wet, cold mixture is most opposed in nature to the hot, dry one, there is a large difference also between the hot, wet one and the cold, dry one.’ 83 Illnesses involving sore throat. 84 Cf. Book IV, n. 16.

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nature of wine for dry, cold natures has already been stated. We must next investigate whether it is inappropriate for all hot natures, and whether the ‘drinking water’ of the Epidemics85 may here be preferable. It may seem completely absurd to some that a young man undergoing military or athletic training, or a manual worker engaged in digging, reaping, ploughing, or carrying out any such heavy labour, should be confined in his diet to water; and so Hippocrates will seem to have made a blunder on this point, declaring in unqualified terms that water-drinking is indicated for hot mixtures. My view, however, is that this is not in fact an unqualified statement. He is referring to the extreme form of hot nature, which is of course a bad-mixture, rather than to that which simply has a high predominance of internal heat. This internal heat is, as he says, increased by athletic activity. One who is hot to the point of bad-mixture 377 K. will not be either an athlete or a solider, nor could such a person ever be a successful labourer, either in the fields or in the city. Such practices are carried out by strong men; and one cannot become strong without a well-balanced mixture. Yet these people, in their well-balanced state of mixture, will have a high predominance of internal heat. Inasmuch as the nature of these people is itself well-balanced, they should therefore be given a well-balanced amount of wine; and the amount should, indeed, remain well-balanced precisely so long as the nature remains so. For such natures necessarily become colder than that, not just in old age but even in the post-prime period. But that nature which is hottest within the bounds of the healthy bad-mixture should be given no wine at all. It should be understood that there are three distinct types of hot mixture: first, that in which the other opposition, that between dry and wet, is well-mixed; secondly, that with an unbalanced excess of dryness; and thirdly, that in which the wet predominates along with the hot. In the first of these, the hot will never reach the point of 378 K. extreme imbalance, since in such a case dryness supervenes very quickly; and this, by definition, is not present here. In the second, it is possible for a very great abnormal heat to arise (still within the bounds of the healthy bad-mixture) over a prolonged period; and it is also possible for an extreme imbalance of heat involving wetness to become very great in a short time. Now, for the first type we will advocate the administration of watery wine, in accordance with the state’s degree of departure from extreme bad-mixture. In neither of the other cases will we allow this, so long as it 85

Drinking water is recommended for a ‘hot nature’, again at Epid. VI.4.13 (V.310 L.).

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is in the extreme state, as already shown. In the case of bad-mixtures which are not of that sort, we will give small quantities of watery wine; that is wine which is white in its colour and fine in its consistency. By the same token, we shall administer hotter wines in cases of a cold badmixture. An extremely hot wine is appropriate for an extremely cold bad10 mixture – and so analogously for other cases too. 379 K. For one should bear in mind not simply the maxim that ‘opposites cure opposites’, but also the degree of the opposition in each case. In the pharmacological context we have shown that one must investigate not just whether a drug is hot or cold, but also the level of hot or cold in each case;86 and the same procedure must be followed in the case of wine. It is not a question of choosing simply a watery one or a hot one, but, more 15 precisely, one which has the level of hotness or coldness which is appropriate in relation to the particular form of the bad-mixture.

Different stages of old age What has been said here applies to those in the middle period of old age. It should be understood that there is a first stage, sometimes known as ‘fresh old age’, in which people are still capable of public activity, and 20 then a second stage (to which people apply the term ‘wrinkled’),87 and that it is of this stage that it is said:         but when he has bathed and has eaten, Let him then sleep softly.88

This is not, however, the case with the third stage, which was, as we mentioned before, that of the scholar Telephus, when he bathed twice or 25 three times in the month. For the feebleness of people at this stage makes them unable to tolerate frequent bathing. A further characteristic is that 380 K. they no longer accumulate biting residues because of the cooling of their 86

In Simple Drugs Galen elaborates a theory whereby each active property of a drug or herb – its degree of hotness, coldness, dryness or wetness – may be classified according to a four-level schema: these different levels of intensity must be assessed by the doctor, and determine the drug’s therapeutic effects. On this see Harig (1974); further on Galen’s pharmacology Singer (2020b); Martelli, Raggetti and Singer (forthcoming). 87 For ‘public activity’ (politika), cf. n. 68 above. I read σῦφαρ (‘wrinkled’, a rare word for a piece of wrinkled skin, as suggested by Schöne, 1924), for the MSS’ less readily comprehensible σύμφορον (= ‘suitable’ or ‘accompanying’). 88 Cf. n. 19 above.

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condition. A person at this stage is referred to as ‘proceeding’ – which, according to those who take pleasure in etymology, is derived from the notion of the procession being sent forth to the land of the dead.89

89

‘Proceeding’ translates the rare Greek word pempelos; the etymology given connects this to the words pompē (‘procession’) and ekpempein (‘send forth’), which had a particular application to the passage to the underworld.

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Summary of previous argument; aims of present book 381 K. 1. In embarking, in this book, upon a discussion of healthy daily regimes based on the assumption of a different kind of case,1 I must first remind the reader of the essential points of what has been said so far. This will provide a necessary basis for the argument that follows. We first made a statement of the nature of health itself; secondly, we proceeded to a general outline of it; thirdly, to the methods by which it is preserved; and we also considered how the constant process of change to which living bodies are subject means that, even in healthy cases, health is at risk of being destroyed, and that our assistance is therefore needed, to 382 K. avoid such a great change taking place as to constitute the actual presence of disease. Such assistance consists of food and drink which replenish whatever part of the bodily substance has flowed out. Another, irremediable, source of change was indicated, namely that which comes about through age, there being a gradual process of drying-out of the whole living being from the time of its initial generation until its decease. Yet those who have no knowledge of the healthful daily regime are likely to die sooner than they should according to the principles of nature. Since, however, as I have stated, nourishment is necessary for all generated living beings, and since not all the substance of their foodstuffs is nourishing, so that some superfluous bad part of that substance remains – which, indeed, is 1

Literally, ‘in making a start upon a different assumption (hupothesis) of healthy daily regimes’: hupothesis here refers to the ‘assumed case’ he has before him in the discussion, and picks up the intended structure of the work (on which see Introduction, section 8.3), understood as based on a series of such hupotheseis regarding different constitutions and lifestyles; and cf. ll. 21 and 24 below, where the cognate verbal forms hupothemenoi and hupethemetha (‘posit’) are used.

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specifically known as ‘residue’2 – certain parts within the body have been created by nature for the separation and evacuation of this. There are, moreover, very considerable natural differences between different bodies; it is therefore reasonable to suppose that each will require its own specific form of provision of health. We thus began by positing for our discussion the case of a human being with the best possible constitution, and set ourselves the task of considering how best 383 K. to preserve such a person in health. Since, however, there are many factors, arising in all sorts of ways, which may interrupt a person’s scheme of conduct of health, we posited the case of a person who has not only the best constitution but also leisure to devote to himself,3 being free from all public obligation; and we then gave a thorough account, in the first five books, of the methods by which to preserve such a person’s health, from earliest childhood to extreme old age.4 Let us then proceed now to consider both those who are prevented by their personal circumstances from eating, drinking and taking exercise at the right times and those who are from the outset possessed of a morbid bodily constitution. Our discussion of these people will be more concise than the foregoing, although the subject is in itself a larger one. The reason for this is that we have already stated the capacities of most of the relevant materials which we employ in the provision of health. We observe that changes in our bodies arise as a result of massage, bathing, exercise, food, drink, heating, cooling, the use of or abstention from sexual activity, and so on;5 and the 384 K. capacities of these have, as I said, already been stated.

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Classes of faulty constitution 2. The faulty constitutions of the body belong to two classes. Some have an even, and some an uneven, mixture of the elemental and primary 10

2

On the linguistic connection between the term for ‘superfluous’ and for ‘residue’, see Book I, n. 21. 3 Cf. the use of the verb (scholazein, ‘have leisure to devote’) in very similar phrases above at II.1, 38,22 Ko. (VI.82 K.) and II.2, 39,9 Ko. (VI.84 K.), where this requirement is first introduced, and a number of times subsequently, as well as at Bon. Mal. Suc. 12, 426,14–16 H. (VI.810 K.), where those ‘who have leisure to devote to themselves’ are contrasted with those ‘who have taken up a military or public life’ and who therefore have an excess of work as well as a lack of sleep. Further on Galen’s emphasis on this ‘leisure’ requirement, see Introduction, sections 3.1–2 and 5.6. 4 See again Introduction, section 8.3. 5 For Galen’s various similar lists of such factors, and their classification, see Introduction, section 5.2.

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parts of the body (which are called by Aristotle ‘uniform’).6 What I mean by ‘even’ is the case where all parts of the body equally have turned to a particular state of bad-mixture: they have all become colder than they should, or hotter, or wetter or drier, or, indeed, by some coupling of these qualities, colder and wetter, hotter and drier, hotter and wetter, or colder and drier. What I mean by ‘uneven’ is the case where the change is not the same throughout, some parts having become hotter but others colder, or some drier but others wetter; or, again, by coupling, where some parts have become wetter and colder but others drier and hotter, or some wetter and hotter but others colder and drier. The organic parts of the body too may be either even or uneven in their composition. Let me here state first the nature of the most morbid constitutions of the body, just as I indicated the nature of health. Health is itself single; for there is one optimal case within every class of thing;7 but the faulty cases are of course numerous. Amongst these there is, as already stated, a twofold distinction of class, between those which involve an even bad385 K. mixture of all the parts and those which involve different bad-mixtures. Now, of those involving an even bad-mixture, the worst are of course those which have these to a high degree, and especially so if these are simultaneously cold and dry. As regards those with uneven constitutions, on the other hand, it is difficult even to enumerate the variations.8 One may, however, state the variations of these bodies too, according to two classes, or types (or whatever term one prefers to use). The most morbid 6

The distinction between duskrasiai which affect the whole body evenly and those which appear disproportionately in one part or another is a clinically important one for Galen; he turns to direct discussion of it at the beginning of ch. 9 below. It is also discussed at various points in Mixtures (see further n. 9), and has an entire treatise devoted to it (The Uneven Bad-Mixture). On the Aristotelian-based distinction of types of part of which the body is composed, see Introduction, section 4.5.1. 7 Cf. the discussion above in Book I, chs. 4–5. 8 It seems that the plural noun epallaxeis may refer not just to ‘changes’, but to the variations, or varieties of phenomenon, that arise as a result of those changes (unlike the noun hupallaxis, which standardly means just a modification or change). Relatedly, in the next sentence I emend ὑπαλλάξειεν to ἐπαλλάξειεν (a verb form cognate with epallaxis), which I have translated ‘state the variations’. Galen sometimes uses this cognate verb epallattein, similarly, to mean the enumerating or classifying of a set of changes or ‘varieties’, not just, as more usually, the process of producing those changes. Cf. the use of the verb above at II.1, 39,5 Ko. (VI.83 K.) and II.4, 50,16.25 Ko. (VI.111 and 112 K.), where I have translated ‘combine’; and cf. the usage at Caus. Puls. I.10 (IX.39 K.), where it means something like ‘state the varieties’. Some such sense is required here, and this does not seem to be provided by the verb in the MSS, hupallattein, which means simply to change or modify. (I note that VR have ὑπαλλάξεις, not ἐπαλλάξεις, also in the case of the noun. It seems that this cannot be right, for the reasons given, but it does indicate how easily the forms with the ep- prefix could be corrupted into the more familiar ones with the hup- prefix: the explanation would be that that alteration took place in the case of both noun and verb in VR, while in M the original form of the noun was preserved but the verb altered.)

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of these bodies are those involving opposite excesses in the most important parts of the body; less serious are those in which this is the case with other parts. I have even seen some cases of a cold digestive cavity in conjunction with a hot head, as well as some cases of the reverse situa- 5 tion. I have also seen cases where a stomach produced bile, but as an incidental feature, not primarily, nor in virtue of the specific definition of its mixture, since it was not in its nature hot; and, conversely, cases where it underwent cooling although it was not [naturally] cold.9 So too with the head, the liver and the spleen, as well as other parts, which sometimes partake of an opposite bad-mixture although not by nature having any 10 386 K. form of damage which would conduce to that mixture, or indeed being [naturally] in a state opposite to it.

Even bad-mixtures; changes due to age Let us begin our discussion with people who have an even bad-mixture; and within these, let us consider first the hot. As I discussed in Mixtures, it is impossible for any single bad-mixture to remain so over a long period of time, since it necessarily tends to draw to itself another bad- 15 mixture in addition.10 It is for this reason that most doctors have thought that only the four composite bad-mixtures exist, since the hot one through its tendency to remove moisture will always acquire dryness, too, while the cold one, since it does not consume moisture, nurtures wetness. Similarly, it is thought that a dry bad-mixture will render the living being  9

In this and the previous sentence Galen makes two distinctions: that between different mixtures arising in different parts of the body, and that between the innate or normal and the temporary or acquired mixture of a part. (On the terminology of sumbebēkos (‘incidental feature’), cf. Book I, n. 123.) Further remarks relevant to both these distinctions are made in Mixtures, esp. II.6. The specific examples of stomachs producing bile in spite of their natural condition not being hot, as well as of the reverse situation (of which apparently the philosopher Eudemus was an example) are taken up there, with more detail: Temp. II.6, 76,4–23 H. (I.630–631 K.). 10 In Mixtures Galen in fact devotes considerable space to the refutation of the view outlined in the next sentence, that only the composite bad-mixtures exist, which he regards as the erroneous view of ‘the majority of doctors and philosophers’ (see especially Temp. I.8, 30,6–32,4 H., I.556–559 K.), and is rather less explicit on the proposition – which is after all tendentially connected with this erroneous view – that simple bad-mixtures cannot persist long without becoming composite ones. The latter proposition – in particular, that moisture tends to be removed by heat, so that hot and dry naturally go together – is, however, accepted, at least implicitly, at Temp. I.2, 5,25–6,13 H. (I.516–517 K.). Further on Galen’s account of the physiological changes due to age discussed in this and the next paragraph, see Introduction, section 5.5. The specification of the precise period at which activities ‘of soul’ (psuchikai), as opposed to ‘natural’ ones (phusikai), are at their best is, however, an unusual one. While the term psuchikos for Galen in some contexts could refer to the functions of sense perception, and possibly even to voluntary physical motions in general, what is meant here is presumably the domain of intellectual and ethical development.

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gradually hotter during the times of life when it is still growing, and in 20 the times of life after this will dry out the solid parts of the body and accumulate a build-up of residues. In the case of the wet one, too, [the view is that] when it arises in conjunction with a moderate hotness the subject will become well-mixed in terms of both the oppositions. (I refer 387 K. here, obviously, to that between hot and cold and that between dry and 25 wet.) This sort, then, will be well-mixed at the time of the prime, and to a considerable extent also in the post-prime period, in the way appropriate to that latter stage. The best mixture of the body is that which it possesses at the time of youth, while all others are inferior to this, as has been shown. The following point, moreover (which has also been stated previously), should be borne in mind here: that there are two kinds of 30 activities in living beings, and that of these two the natural activities are at their best in children, while those of the soul are at their best after childhood, in the period up to the post-prime. Precise numbers cannot be put on these, in terms of years, although some have attempted to do so. One must rather give a broad characterization. Thus, there are some who begin to reach maturity at the age of 35 fourteen, while others do so a year or more later. Similarly, some begin 171 Ko. their post-prime period immediately after the thirtieth year, while others do so after the thirty-fifth. Now, all human beings suffer a reduction of strength after the period of their prime, but not all lose their health. It is 388 K. true that their state of health will be less perfect than it was previously; 5 health may, however, be possessed not just up to the beginning of old age, but even throughout the whole of that latter stage of life (a stage which in the opinion of some is a ‘natural disease’). In cases where there is no pain, and where the everyday activities of life have not been completely lost, or not become thoroughly weakened, then the person remains healthy, in a particular sense which is the one proper to old age. Here one should, of course, bear in mind again the point demonstrated 10 earlier about health, namely that it involves a very considerable spectrum. There is also a third state of the body, known by the followers of Herophilus as ‘neither’,11 which applies to people who have been saved from dangerous fevers, during their actual recovery, and also to the period of old age. Absence of disease may certainly be a feature of old age; the same degree of strength in one’s activities as enjoyed in one’s 15 prime cannot. If, however, the body remains completely adequate to the fulfilment of the capacities of sight, hearing, walking and all other 11

Cf. Introduction, section 4.2.

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actions, insofar as they are needed in old age, such a state is also reasonably referred to as ‘health for old age’ – provided that one employs that phrase all together, rather than the word ‘health’ understood in absolute 389 K. terms. The latter usage refers to a faultless state, involving excellence of 20 the activities, whereas ‘health for old age’ is not faultless: it involves possession of all the activities, but of none of them in vigorous form.12 Indeed, the part of the medical art known as old-age care has as its aim the maximal preservation of the health that is specific to old age. Those bodies which suffer from a morbid constitution in the very first phase of their generation are not likely to reach old age at all; and, if they do, they 25 will be subject to some chronic disease. In the present book, however, we have set ourselves the task of giving an account of those possessed of a faulty constitution, and of maintenance of such a constitution, to the maximum extent possible, in a state of health.

Hot mixtures; differential treatment for different life circumstances 3. Let us then begin with those individuals who have an even badmixture throughout all parts of their body, and let us now discuss the case of an excessively hot mixture, which is, however, not at fault in terms of the opposition between wetness and dryness. Now, such a nature will appear from the earliest stage healthier than that which is badly-mixed in 390 K. terms of both oppositions (I mean the opposition between hotness and coldness and that between wetness and dryness). The teeth will naturally appear earlier; so, too, will articulate speech and walking; and, in general, growth will be advanced, by comparison with the other states at each year. Once the stage of youth is passed, however, the whole period from that point until the post-prime will show a manifest and excessive degree of heat, making the subject prone to diseases and symptoms of yellow bile. Great hotness tends to consume the moisture and thus make the mixture drier; and, since the prime is a hot time of life, the coupling of the actual mixtures will be both hot and dry. Pale yellow or yellow bile predominates in such mixtures.13 Those who have had this nature up to the age of youth should be kept to the same daily regimes as those with the best nature, whom we discussed in the preceding part of this work. When, however, their bodies reach maturity, one should investigate whether the superfluous bile is passed below along with the faeces, or 12

On the requirement of ‘vigour’ as representing the excellence or optimal version of health, see further Introduction, section 4.1, with n. 49. For the colour of this fluid, and the colour terminology, see Book II, n. 16.

13

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whether it rises to the upper part of the digestive cavity. In the former 391 K. case, as is quite evident, no expenditure of effort is required; in the latter one should evacuate by means of emetics, paying absolutely no heed to those philosophers who forbid the use of warm water as an emetic after exercise and before food.14 Certainly, I would not recommend the use of wine in such a case, unless the subject finds it difficult to vomit through the use of water. There are also certain types of body which should be allowed to take sweet wine, after first drinking water. One should have recourse to emetics even more readily in cases where the original mixture was excessively hot and dry, because such mixtures are more prone to bile at the prime. Moreover, the exercise that one should employ in such cases should preferably be leisurely and soft rather than swift and intense. Such persons tend invariably to be rather thin; and it is universally agreed by all trainers that swift exercises have a thinning effect, while slow ones cause fleshening-up. Some people with excessively hot mixtures do not require exercise at all, a combination of walking and baths being suffi392 K. cient, in conjunction with a soft massage using oil. In these cases, what is transpired is acrid, biting and hot, not vaporous, pleasant and free of any biting quality. These people even enjoy benefit from bathing after their meal; and some have even been known to become extraordinarily much stouter on such a regime. Old wine is contraindicated for these; what is appropriate is a white wine which is fine [in consistency]. In the case of all those who bathe after food, however, one should check that they do not experience any pain, heaviness or tension on the right side of the abdominal region, where the liver is situated. Such bodily constitutions are liable to diseases of the liver when they bathe after having eaten. If any such symptom is experienced, one should immediately give something to release the obstruction of the liver, and forbid all foods with thick fluids, especially those which are viscous. These have been discussed more fully in the three works which I wrote on The Capacities of Foodstuffs, in that on Good and Bad Fluid, and also in 393 K. that on The Thinning Diet.15 For indeed, in cases of pain in the liver, it is necessary to employ the thinning diet until such time as the entire right side of the abdominal region becomes light and free from pain. It is good also to administer an infusion of leaves of wormwood, as well as one composed of anise and bitter almonds; this is best drunk in 14 15

The use of the term ‘philosophers’ here is clearly sarcastic; perhaps there is a connotation of people who produce theoretical expositions which have no basis in experience. Galen refers here (as fairly often) to all his other works of most direct relevance to diet.

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honey-vinegar, at a time halfway between rising from one’s sleep and taking one’s bath. It is better if such things are given after what has been distributed from the stomach to the liver has already been processed, and if some time is allowed for the action arising from these, before the administering of food. The catmint-based drug is good, too, the composition of which has been described in the fourth book of this work.16 In the case of bilious mixtures, however, one should avoid its continuous use. When used for the purpose of the release of obstruction in the liver, it is best drunk in honey-vinegar. If, on the other hand, one’s aim is to modify such persons’ mixtures for the better, the type of food must be opposite to the bad-mixture in ques394 K. tion. This may be achieved gradually and without harm, provided that the doctor supervises the process and the person seeking the improvement has sufficient leisure to carry out all instructions at the appropriate time. In the case of a person engaged in public life, and in servitude to17 a large number of obligations, on the other hand, it is better not even to attempt to modify the mixture, but rather to continue to give the foods appropriate to that mixture – that is to say, wet ones for a wet mixture and dry ones for a dry one. Nutrition comes about through the assimilation of the food providing the nutrition to the body receiving it; and dry foods are more quickly assimilated to dry bodies, wet foods to wet ones. In the case of those with an even mixture, the more pleasant a foodstuff, the more nutritious it is; in the case of uneven bodily mixture, however, where for example the mixture of the liver is one thing and that of the stomach, or of some part after18 the liver, is another, what is pleasant when it is administered is different from what is proper19 to each part. 16

See IV.7, 124,21–125,4 Ko. (VI.282 K.). The verb here used is again douleuein; for Galen’s use of this terminology, both literal and metaphorical, see Introduction, section 5.6, with n. 96. 18 I adopt the reading μεθ᾽ (‘after’) which is that of both M and V, i.e. attested in both branches of the MS tradition, and thus much better supported than Koch’s καθ᾽ (‘in’ or ‘in the region of ’). It is also confirmed by the appearance of the same usage (μεθ᾽ ἧπαρ) in the same sense at both Nat. Fac. II.1, 156,19–23 H. (II.76–77 K.) and PHP VI.8, 410,26–31 DL (V.567–568 K.): by ‘after’ Galen refers to the sequential role that he believes the parts play in the digestive process: foodstuffs undergo a first processing in the stomach, the product of which is taken to the liver, and then, via the veins, to the parts ‘after’ the liver. (Cf. also Book IV, n. 36 on ‘first veins’.) 19 I here use ‘proper’ to translate oikeios (and, in what follows, ‘properness’ for the abstract noun oikeiotēs). The terms bear the sense both of appropriateness or belonging to a particular body or condition and also of physical closeness or similarity of two sorts of stuff to each other, related to the notion that things which are more oikeios in this sense will require less of a process of transformation in the body. The related theory of digestion and absorbability of substances by the body is discussed in detail in Book III of Mixtures. 17

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What is proper to each part, however, has been shown to be dual in 395 K. nature, considered either in terms of the simple qualities or in terms of the substance as a whole.20 The nature of properness in terms of the simple qualities, both for those who intend to change it, at leisure, and for those who are compelled to submit to it because of their lack of leisure, has just been discussed; properness in terms of the whole substance, meanwhile, can be known only by experience. It is properness in terms of the substance as a whole which has the greatest power in relation to the processing of food and drink, not only in the stomach but throughout the body as a whole; it is by virtue of this that the nourishments are modified by animals, and [made] quite different in their physical forms. That21 arising from grain and grass is in no way similar to that which comes from bone and flesh; nor that from bread and grass to that from hemlock and hellebore – for even these constitute nourishment for some animals. There is also properness [considered] in terms of the qualities: here, one will suit wet foods to a wet mixture and dry to a dry, if one wishes to preserve the mixture, but use opposite ones if one wishes to modify it. 396 K. In the case of distortion towards bad-mixture in terms of hot or cold, on the other hand, the administering of opposites is always appropriate. For these types of bad-mixture are more active and one may say more powerful than those in terms of wetness and dryness; and people are readily brought into a morbid state by nourishment of the same quality. By contrast, one will not do any clear harm to any of the parts by making it too dry, nor indeed by keeping it too wet. The most manifest evidence of this is provided by differences due to age. From birth up to the time of youth the flesh is extremely wet, while at older ages it is markedly dry. Here one should remember what was said in my Mixtures, so that one may avoid the error of supposing that the mixture is wet in the case of those individuals who are afflicted by superfluous fluids – an error which deceives people into thinking that old age is wet and cold. It is not the 20

The terminology of action ‘through the whole substance’ of a foodstuff or drug is used by Galen in a number of different intellectual contexts, as explored in detail by Singer (2020b). While in its original context, in Mixtures, the terminology is connected especially with the notion of absorption (see previous note), which is an ‘alteration of the whole substance’, and with a particular kind of drug action, distinct from that ‘in virtue of a quality or pair of qualities’, Galen later (e.g. in the latter books of Simples as well as in some discussions in The Therapeutic Method) comes to associate this kind of action – as suggested in what follows here – with phenomena that can only be known by experience, rather than predicted theoretically. 21 It is a little unclear to which of the feminine nouns just mentioned ‘that’ refers; ‘physical form’ (idea) seems the most natural candidate, though a case could also be made for ‘substance’ (ousia) or indeed ‘nourishment’ (trophē).

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mixture of the parts themselves which is wet in old people; rather, the spaces between the bodies are filled with superfluous wetness in old 397 K. people, who thus also suffer from wet diseases.22 As for the nature of dry diseases, you will acquire a scientific understanding of this if you read my book on Withering – carefully, that is, and not once or twice, nor in a cursory manner, but with concentration, and paying careful attention to everything that is said there. And in order to give it a proper reading, one should train oneself first in the second book of Mixtures, in which it is shown that the mixture of old people is dry. The body now under consideration, however, that which is hotter than it should be, will definitely become dry at the age of the prime if it was in a middle position between wetness and dryness in its original constitution; and it will do so even more if it was at that stage drier. It will, moreover, reach old age more quickly, to the same extent that it reached the prime more quickly. All bodies become drier in the post-prime period; and so it is reasonable to suppose that those which are drier by nature reach the state of dryness associated with the imbalance of old age more quickly. These persons require a wet daily regime especially during their prime; the pattern of this has just been sketched in outline, and involves 398 K. moistening foods and baths, and the abstention from intense or substantial exercise, so that in the spring time they should bathe earlier in the day, and do so again after food. Such individuals are benefited also by the drinking of cold drinks. Sexual activity is completely contraindicated for dry mixtures. They should also avoid the following as much as possible: the heat of the sun, fatigue, mental exertion, lack of sleep, and all swift motions. Rage, too, is a particularly significant factor in giving rise to acute fevers, especially in people with bilious natures. Thus, those items of daily regime which were approved for people who have a hot mixture during their prime, though they initially had a moderate level of wetness, are even more suited to those who are by nature hot and dry. One must obviously also investigate as precisely as possible the quantity by which the dominant element is in excess. The form of the daily regime should be intensified, relaxed or increased to precisely the same extent that the elements of the mixture are above or below the natural level. For this reason, in the case of those who are wetter and also hotter in their nature, one should impose a daily regime which is opposite to those qualities if one wishes to modify the mixture 399 K. in the direction of one which is colder and drier, whereas one should 22

For further argument on this point see especially Temp. II.2, 45,9–47,2 H. (I.580–582 K.).

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conduct one similar in qualities if one wishes to preserve it. Such natures as these are prone in childhood to diseases involving flow of liquids, and those involving fulness, as well as those of putrefaction. They require a lot of exercise, and complete digestion in the stomach; for whatever undergoes decay there forms the basis of diseases of putrefaction for the whole body. Such individuals, then, are benefited by bathing two or three times, even before food, and also by the use of naturally occurring hot water sources. The aim in these cases is to preserve the actual parts of the body in a state of wetness; this, indeed, is the common aim in every kind of mixture, since the opposite state is that which conducts the bodies of living beings more quickly towards old age, and contains within it the very cause of the mortality of generated bodies. In fact, if it were possible to preserve a wet mixture of the body in perpetuity, then the argument of that sophist which I discussed at the outset, who claims that he will render the body of anyone who follows his instructions immortal, would be true.23 Since, however, as has been shown, it is impossible to avoid the 400 K. body’s natural progress towards dryness, the processes of aging and decay are unavoidable; but the person who becomes least dried out should live the longest. Where there is a wet daily regime, giving rise to both residues and a build-up of fluids, it becomes difficult for the good balance to be overcome, and so the person will not be vulnerable to sickness, nor will he age quickly. As regards the actual mixture, those who are wettest are longest-lived of all; and indeed, even when their bodies are overcome, they remain healthier than the others, and are also stronger, in the period up to extreme old age, than their coevals. This mixture has been approved by practically all doctors and philosophers who have an accurate knowledge of the elements of the body; some have even concluded, on these grounds, that this alone is the natural one. For it becomes superior to the others in the course of time, even though it was initially inferior. Therefore, too, the person supervising such a body must provide for the production of out-flowings; this should be done through exercise, as 401 K. already stated, as well as through plentiful bathing before food, and expulsion that takes place through urine and the stomach.24 Perfectly legitimate, too, is the occasional use of phlegm-cleansers and purgings, and above all of foods of good fluid, and wines which provoke urination. 23 24

On this individual see Introduction, section 4.4, with n. 57. Though it makes no difference to translation, there seems no reason to ‘correct’ the plural ἐκκρίσεων (literally ‘expulsions’ or ‘excretions’) of the MSS to the singular form, as Koch does; Galen frequently uses the plural of the noun in such a context.

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Cold mixtures 4. Enough, then, has been said about the hot mixtures. Let us turn next to the cold ones. Here, too, there are three main types: either they are well-mixed in terms of the other opposition, so that they in no way incline more to the wet or more to the dry, or there is a domination of one of these latter qualities. As one would expect, the dry mixture is the 30 worst; for in these cases what obtains normally at the time of old age is already present at the earliest stage. Such people must therefore be both moistened and heated. This is achieved by our providing well-balanced exercises; wet, hot nourishment; the drinking of the hotter kinds of wine, and much sleep, so that the residues from nourishment and drink which 402 K. arise in the body are all evacuated. The question of sexual activity has 177 Ko. already been addressed: this is harmful to all those with the drier sort of mixture, and especially to those who are cold as well as dry. The only people for whom sexual activity is not injurious are those who are wet and hot, and those who are endowed with a great deal of seed by nature; about these we shall speak directly in our discussion of uneven bad- 5 mixtures.25 Mixtures which combine coldness with wetness are bad, and are especially prone to diseases involving flow of liquids. They are benefited by the abstention from bathing, by exercises, by the thinner kind of diet and by ointments which are moderately heating, the types of which were described earlier, in the discussion of fatigue. Those who are colder in their nature, but well-balanced within the mixture of dry and wet, are 10 less badly placed with regard to health and vigour of the body than those who are badly-mixed in that respect too. One must therefore stimulate and invigorate the heat in such individuals, and choose the middle way as regards the type of the daily regime as a whole, in terms of its wetness and dryness. 403 K. All the above statements concern those whose bad-mixture is an even 15 one, that is to say those in whom all parts are equally inclined towards the hot, the cold, the wet or the dry.

Persons with faultless constitution but life of servitude; challenges of time management 5. The subject of those with an uneven bodily constitution does not, however, admit of an equally brief discussion. Here, there are many 25

Galen turns directly to discuss these at the beginning of ch. 9 below; cf. n. 6 above.

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v­ ariations, as the bad-mixture affects different parts of the body in different people. Indeed, even if a person has only two badly-mixed parts, the variations are still numerous. It is for this reason, too, that one should first state everything relevant to one who has a faultless constitution but leads a life of servitude,26 or distraction, or whatever term one prefers; then, everything relevant to those who have an even bad-mixture within that same kind of lifestyle; and only then make the transition to those who have an uneven constitution in respect of the different parts of the body. The notion of the faultless bodily constitution should, as has frequently been stated, be conceived in terms of a spectrum, as, indeed should the notion of health itself. Otherwise, none of us would appear to be in a state of health, since we do not possess a completely faultless state 404 K. of health, nor, indeed, a completely faultless bodily constitution. Rather, we described people as being in a state of health provided that they are not suffering from pain in any part of their body, and are unimpeded in respect of their everyday activities; and similarly we say that they possess a faultless bodily constitution provided that the body is not readily brought into sickness by either external or internal causes. 27 Here we must of course make the distinction that some are in a constant state of disease not as a result of the actual constitution of their own bodies, but as a result of a poor daily regime – one which involves, for example, an idle life, excessive fatigue, errors in the quality, quantity or timing of foods, a harmful manner of performing regular activities, the wrong quantity of sleep, an excessive indulgence in sexual activity, or wearing oneself out with unnecessary distress and worry.28 I am aware of very many individuals who become ill every year through these kinds of cause; 26

Cf. n. 17 above. I read the reflexive pronoun αὑτοῦ (‘itself ’) in place of Koch’s and M’s αὐτοῦ (‘it’) (or VR’s αὐτῶν, ‘them’): the required sense is surely ‘from itself ’, here paraphrased as ‘by internal causes’. For the distinction between diseases arising from external causes and from within the body, cf. V.1, 136,25–26 Ko. (VI.309 K.). 28 The verb (suntēkesthai) literally means to melt or become dissolved. A metaphorical usage, in relation to emotions of grief, is already present in classical Greek poetry (e.g. Euripides, IA 398; Medea 25); but Galen also uses the term to refer to an actual, observable dissolution of the physical substance of the body; cf. Hipp. Epid. VI III.30, 171,14 WP (XVIIB.88 K.). Galen seems to combine both senses at Ind. 7, 4,6–8 BJP, where a literary man who lost all his books in a fire ‘was dissolved/worn out and died’ (διέφθαρη συντακείς); but his view is that such grief or distress indeed has distinct, and potentially fatal, physical consequences. The use of the term ‘unnecessary’ in relation to distress or worry seems logically to entail that there are cases where it is necessary. This may be merely a façon de parler to which no great significance should be attached; but the point is of relevance to Galen’s views as expounded in his ethical writings. Galen distinguishes himself from the Stoic position which suggests that freedom from distress, or unaffectedness, should be an aspiration in all circumstances; it is less clear whether he considers distress actually sometimes necessary or appropriate (as suggested e.g. at Ind. 45, 27

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but in such cases we do not say that they have a poor bodily constitution, as we do in the case of those who are in a constant state of sickness without having made any of the errors mentioned. 405 K. So, then, the first focus of this discussion will be the person with a bodily constitution which is faultless (in terms of that spectrum), but with a life of servitude, involving service to a monarch or person of great power throughout the whole day, but some freedom from this service at either end of it.29 But here too we must clarify what is meant by ‘end’: without some appropriate specification the term may lead to misunderstanding on the part of the reader. If I state that someone has the freedom to attend to the care of his body once the sun sets, without adding which day is in question – whether it is near to the summer or winter solstice, or to one of the equinoxes, or at one of the midpoints between these – then it will be impossible to offer the appropriate instructions.30 In Rome, for example, the longest days and nights are slightly more than fifteen equinoctial hours in length, while the shortest ones are slightly less than nine.31 In Alexandria, on the other hand, the longest are fourteen and the shortest ten. Now, when the days are discussed by Kaufman, 2014), or rather simply making the claim, as a matter of human realism, that it is unlikely to be wholly eradicated in all circumstances. 29 The adjective translated ‘of servitude’ is doulikos, related to douleia, ‘servitude’ or ‘slavery’, on which cf. Introduction, section 5.6 with n. 96 on Galen’s use of such words. Again, it seems clear that what is meant is the life constrained by professional obligations and duties, rather than actual slavery. Moreover, while the use of the verb hupēretein, here translated ‘service’, and the cognate hupēretēs, translated below as ‘someone attending’ (VI.5, 179,3 Ko., VI.406 K.), suggest a person actually employed as a servant, and Galen might not normally regard himself in this category, both the specific context here and the further autobiographical remarks that follow (cf. nn. 33, 40 and 41 below) seem to make clear that the circumstances here envisaged are those affecting the circle of elite individuals who formed an emperor’s entourage, including to some extent Galen himself, rather than servants, let alone slaves, in the proper sense. 30 Galen refers here to the standard system of time-keeping whereby both the entire period of daylight and that of the night were divided into twelve equal hours each (‘seasonal hours’), which would thus vary considerably in length throughout the year. The form of sundial in use in Graeco-Roman antiquity measured these seasonal daylight hours. (Sundials able to measure the time in terms of actual hours – equinoctial hours – were only developed in mediaeval times.) As is clear from the present passage, however, it is clear that while seasonal hours were used for formal and practical purposes, there could be a full consciousness of the discrepancy between these hours and the equinoctial ones. How widespread was such precise temporal consciousness – or such an ability to make the relevant conversions – must remain uncertain. Galen himself had particular interest in the possibility, and the technologies, of accurate time-keeping, and regarded the correct accomplishment of these technologies as emblematic of epistemological rigour, of the highest level of scientific or intellectual achievement. See the extended discussion at Aff. Pecc. Dig. II.5 of the correct method of constructing a sundial, including the use of a water-clock (klepsudra) to confirm its accuracy. 31 Another way of putting this is that the daylight ‘hours’ will be 75 minutes in length at the summer solstice, and 45 minutes at the winter solstice.

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shortest, and the nights longest,32 someone whose duties end at sunset 406 K. will easily be able to undergo massage and bathing, and to take a balanced amount of sleep; but one who is in the same situation when the [days] are longest will not be able to carry out even one of these activities to the right degree. But I have not yet known one whose personal circumstances were as unfortunate as that. Indeed, the emperor who was keenest to attend to the care of his body (amongst those I have known) was Marcus Aurelius.33 He would go to the wrestling-school at sunset on short days, but at the ninth or at the latest the tenth hour on the longest days, so that it was possible for those who accompanied him throughout his daily activities to retire and take care of their bodies during the remaining part of the day, and then to go to bed at sunset.34 (The shortest night, being equal in length to nine equinoctial hours, would provide them with sufficient sleep.) One should therefore consider the previous habits of someone attending the emperor in this way – whether he would exercise or would bathe without having taken exercise. The care that some take of themselves does not even extend to massage; they go straight into the bath after pouring oil on themselves, or sometimes just taking the strygil with them, using this to remove their 407 K. sweat in the bath itself. Yet there are some who tolerate this habit quite well, so that, provided that their transpiration is good, they are not in a constant state of sickness. These are referred to by some doctors and trainers as ‘porously-constituted’;35 and Hippocrates states that they are 32

Koch omits the phrase ‘and the nights longest’, without MS justification. It is true that it is slightly awkward, if it is retained, that the word ‘days’ is not repeated by way of clarification in the phrase ‘the days are longest’, below; but this seems to me insufficient reason for the deletion. 33 While we have come to know the emperor (ruled 161–180 CE) by this name, Galen standardly refers to him simply by the single name Antoninus (which he acquired on acceding to the throne, as adoptive son of the previous emperor Antoninus Pius). Galen was associated with the imperial court from the end of the 160s until Marcus’ death (and probably for many years after that). Although for much of his reign the emperor was absent from Rome on military campaigns, leaving Galen in Rome, Galen recounts close interactions with both Marcus and other members of the imperial family in Prognosis. Further on these biographical details see Introduction, section 2.2, with n. 6, and section 3.4, with n. 44. 34 Sunset on the shortest day of all in Rome would fall at about 16.40; the ninth hour at the summer solstice would fall at roughly 16.55, and the tenth at 18.10. On the MS variant in this sentence, giving a present-tense verb, ‘it is possible’, instead of ‘it was possible’, and its significance for the dating of the treatise, see Introduction, section 8.2, with n. 126. Curiously, a similar issue arises in relation to the present or past time of Galen’s reflections also a little further on in the text: see n. 40 below. 35 The term, araiosunkritos, appears only here in the corpus of Greek literature. Its etymology implies that the sunkrisis, which may refer to the constitution or formation of the body, is porous (araios). However, sunkrisis and its cognates were technical terms in both Atomism (where a sunkrisis is an ‘agglomeration’) and in the Methodist school of medicine. (Cf. Book IV, n. 53, on the related term idiosunkrisia.) Galen elsewhere, e.g. MM IV.4 (X.269–270 K.), with which cf. SMT V.25

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healthier. ‘Those,’ he says, ‘in whom porousness of body leads to greater transpiration are healthier; those in whom this is less so are more prone to disease.’36 In the case of this kind of bodily nature, one should not change the habit; nor should one do so, in general terms, with any nature, except where the person is chronically sick. 6. If someone is in a constant state of sickness, one must investigate the 15 cause; and this will be discovered by our beginning the enquiry with the type of the sickness. When a body’s sickness arises from its own internal badness,37 there are two types of cause: build-up and bad fluid. If the subject appears to be suffering from sicknesses related to fulness, then your aim in his entire daily regime for health will be to produce good 20 408 K. balance in the [quantity of the] fluids. If the disease is due to bad fluid, then the aim will be to produce the best possible fluids.38 Let us first discuss the provision of good balance in terms of quantity, and then proceed to that in terms of quality. For the purposes of the former, let us take the argument back to first principles. When what is transpired by the body is less in quantity than what is taken in, there 25 arise the sicknesses related to fulness. One must therefore preserve a good balance between what is eaten and drunk, on the one hand, and what is evacuated, on the other; and this good balance will be dependent upon our investigation of the quantities of each. We will instruct those who go straight into the bath to undergo massage, and to perform at least some small motions, first; those who are already doing these things we shall 30 encourage to make a gradual increase in both. We should also somewhat diminish the nourishment, in terms either of quantity or of quality, or indeed both. In the case of those who are accumulating a substantial (XI.781–783 K.), criticizes Methodists for their use of the related term metasunkrisis, which he claims to be unclear in its reference, but apparently indicating the (itself confused and incoherent) notion of ‘alteration of the making of channels’ (τὸ τὴν ποροποιΐαν ἐναλλάττεσθαι). So, it seems that the term mentioned here is probably borrowed from Methodists or Methodist-influenced doctors, and that it is meant to refer specifically to the porousness of the channels. (See further Book I, n. 35.) 36 De alimento 28 (IX.108 L.); cf. Book I, n. 87. Galen quotes the sentence with slight verbal differences in these two places. 37 I read the reflexive pronoun αὑτῷ for Koch’s αὐτῷ, as seems grammatically required (that is, the sense is literally ‘from the badness in itself ’, rather than ‘from the badness in it’); cf. n. 27 above. (Both M and R in any case have completely different, and impossible, readings here, αὐτῷ being only supported by V.) 38 Galen makes a fundamental clinical distinction here between an excess of quantity and an error in quality; in the former case (plēthōra, ‘fulness’,) there is a build-up (plēthos) of fluids which are not themselves bad in their balance, in the latter (kakochumia, ‘bad fluid’) there is a bad balance within the fluids that are actually present, though the overall amount is not itself excessive. Cf. Book IV, n. 6.

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fulness very quickly, both should be diminished. For those in whom the accumulation is either not quick, or not substantial, it will be sufficient to reduce one or the other, whichever the person prefers. Reduction in 409 K. quantity is obvious enough; reduction in quality will be brought about by the administering of foods which are low in nourishment. Many who eat pig meat experience a very fast accumulation: such nourishment requires the use of vigorous massage and exercise. Such people should be steered towards vegetables, towards pulses of the less nutritious kind, and similarly towards those fish and birds which are lower in nutrition. The situation is different with those who are accumulating bad fluid rather than fulness. Here, the aim is not a single one, since there is no single type of bad fluid. In some, the accumulation is of excessively cold, phlegmatic bad fluid, in others, of bad fluid which is excessively hot and bilious; in some it is too wet, in others too black-bilious.39 In all these cases, one should reduce those foods and drinks which by their nature tend to generate the fluid which is being accumulated. These have been discussed sufficiently in my three books on The Capacities of Foodstuffs, as well as in another in which the distinction is made between Good and 410 K. Bad Fluid. Separate from these is that on The Thinning Diet, a diet appropriate for those who are accumulating what is known as the ‘raw’ fluid, which is in all cases thick, but sometimes also viscous. The emptying of the stomach from below is the universal remedy in all such cases (and especially so if they are excessively hard by nature); so too is a balanced approach to sexual activity.

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7. Those with faultless bodily constitutions do not have to abstain altogether from sexual activity, as was stated previously to be the case for those with dry constitutions. A particular point to investigate, for the lifestyle under consideration, is whether it is beneficial for them to eat once or twice in the day. The essential points in this investigation are the 25 nature of their bodies and the daily regime to which they have become accustomed; and, thirdly, whether the acquired habit seems to you to be one which is susceptible to transformation, that is, such that the person will tolerate the change. Thus, the indication of what is beneficial depends upon the individual nature, in particular upon whether the stomach is producing bile or not. 30 The manner in which one provides for its emptying from below has already been stated in the fourth book, but we shall repeat it here too. 39

On ‘black-bilious’, also translatable ‘melancholic’, see Book I, n. 116.

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The first foods and drinks taken should always be those which empty the stomach. Amongst wines, these are those which are sweet as well as 411 K. productive of downward emptying (for not all have this property); amongst foods, vegetables taken with oil and garum. Tart wines should be avoided, as should astringent foods, unless these are administered after the entire meal, for the purpose of improving the tension of the mouth of the stomach. This too must be assessed by experience; for some people find this kind of use of astringents not only painless but also beneficial for the downward evacuation of the stomach, through the improvement of tension that takes place in the mouth of the digestive cavity. This becomes more manifest in the case of those in whom this part has less good tension. For those who always used to engage in pre-bathing exercise, before finding themselves caught in a life without leisure, abstention from it is quite harmful, while engagement in it at the same level as before would not only be harmful, but of course also impossible. Such people should employ the type of exercise which, as I previously stated, is referred to as ‘restorative’; and they should also reduce the amount of pig meat eaten. Since, however (as has also been stated), some find it more beneficial to eat before bathing, we should say something both about the time at 412 K. which they should do this, and the quantity and quality of the foods that should be administered. Let me, indeed, venture to state what was my own customary practice on days when I thought it necessary to bathe on the late side either because of examinations of patients or because of some public engagement.40 Say that the day on which this happens is one of thirteen equinoctial hours, and that one may envisage the care of the body beginning 40

The phrase translated ‘public engagement’ is politikē praxis; on the potentially very wide application of the adjective politikos, cf. Book V, n. 68. This passage is of interest in relation to the question of the date of composition, since it seems natural to read it as a retrospective reflection by Galen on his previous professional life and public responsibilities (cf. nn. 29 and 33 above, and 41 below), from a position of retirement. Relatedly, I read εἰώθειν (one letter different from the εἴωθε(ν) of VR) for εἴωθα (M) in l. 16, and ἥγημαι (the reading of most MSS, whereas Koch’s ἡγῶμαι is an emendation) in l. 17. We thus get a past sense: ‘what was my customary practice’ rather than ‘what is my customary practice’; ‘I thought it necessary’ rather than ‘I think it necessary’. (An optative form would usually be expected in an indefinite temporal clause of this type with ἂν, but a past tense indicative is also possible.) This past sense seems clearly required by the context, since Galen proceeds to describe past decisions and actions in what follow: ‘I decided’ (ἔδοξε); ‘that was my own practice’ (ἔπραξα); ‘I never used to drink’ (οὐκ ἔπιόν ποτε). If the suggested emendations are right, Galen is clearly reflecting on his past practice throughout this passage; in any case, he is doing so for most of it. It may thus provide some slight further evidence for the late date of the work, or at least for that of this sixth book; cf. Introduction, section 8.2.

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at the tenth hour.41 On this basis, I decided to take some very simple nourishment – just plain bread – at the fourth hour. Now, that was my own practice; but there are those who cannot bear to take bread on its own, without any prepared food,42 but rather take it with dates, olives, honey or salt. Some take drink at the same time, too; but I never used to drink in conjunction with this form of nourishment, confining myself to the bread alone. As for the amount of each of these nourishments, this should be such that it will be [fully] digested in the stomach before the tenth hour, so that if one wishes also to take exercise, this can be undertaken without harm. Some people experience considerable harm when 413 K. they take exercise after a large amount of food; and some also experience a filling of the head and a sensation of tension or weight, or both, in the liver. You should treat any such [symptom] immediately. In the case of obstructions of the liver, the treatment will involve [interventions to] remove the obstruction; in the case of the filling of the head, it will involve walks, especially before the meal, but quite possibly after the meal too. The latter should, however, be extremely slow; those before the meal should be more intense than these, but still not like the kind of walk we do when we are hurrying for some engagement. The [interventions] which remove obstruction in the liver are those appropriate to slowness of digestion. The best of these are honey-vinegar and the three-pepper preparation, with no admixture of unusual drugs, as well as the thinning diet. These rectify the slowness of digestion and heal obstructions in the liver. When there is decay of the foodstuffs in the stomach, those who pass these stuffs out have a very considerable advantage as regards their health; those who do not should be stimulated to do so by those things which cause emptying from below without pain. These 414 K. are: the drug known as Diospolitikon, provided that it contains the same amount of natron as of the other ingredients; that involving safflower and dried figs; and all others that are composed with safflower and epithymon. 41

The fact that Galen specifically mentions the tenth hour – the same one at which, at the latest, Marcus Aurelius’ entourage were released from their attendance – is surely relevant to the point made above (n. 29) about Galen’s self-inclusion in this group. On the technicalities of seasonal and equinoctial hours, cf. nn. 30, 31 and 34 above. The case Galen takes here is that of a date a couple of weeks after the spring equinox (specifically, around 6 April according to our modern Gregorian calendar, with sunrise in Rome around 06.40, and sunset around 19.40); the discrepancy between the seasonal hour and the equinoctial at this point would be one of only five minutes. The fourth hour would thus fall around 11.00 and the tenth at around 17.30. 42 Opson may also be translated ‘relish’ or ‘sauce’: it refers to either a condiment or a cooked dish which accompanies the bread or other grain-based staple.

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People in such a state are also benefited by vomiting before the meal, which is brought about by the drinking of sweet wine. They should be advised to avoid any food which is rancid, foul-smelling or in general liable to decay, and to select rather those referred to by doctors as possessed of good fluid. (These, as mentioned previously, have been discussed elsewhere in my book on Good and Bad Fluid, as well as in the three in which I discuss The Capacities of Foodstuffs.) What is appropriate for people in this state is the emptying of the stomach from below, performed at intervals by [interventions] which are moderately purgative. Amongst these is the bitter aloe-based [drug]. (Some doctors refer to it thus, some just as ‘the bitter’ aloe.)43 If you encourage the accumulation of the bad fluid over a long period, a painful 415 K. disease will result. People could, in fact, make such provision for themselves, on days when there is some public festival, which frees them from their servitude; but because of their lack of restraint44 they not only do nothing to correct such accumulation of bad fluids in the body, but actually exacerbate the situation by their bad regime on those occasions. Some of them thus fall prey to diseases which are so long-lasting that they in fact endure for the rest of their lives, such as gout, illnesses of the joints, and nephritis, while others are affected by diseases which are acute, but which recur once a year or at least once every two years. Some patients are even affected twice each year.

Moral shortcomings that prevent the following of health advice; treatment of bad-mixtures 8. Now, the art of health makes the claim to preserve in health those who are prepared to follow its instructions; for those who are not, it might as well not exist. The reasons that people do not follow its instructions 43

More literally, Galen says that some doctors refer to it ‘as bitter, in the feminine’ – i.e., they use the feminine form of the adjective, pikra, as the name for this preparation, rather than saying ‘the bitter [neuter form, pikron, whereby the noun pharmakon, drug, is taken as understood] involving aloe’. 44 ‘Lack of restraint’ translates akrasia, a well-known term of art in philosophical discussions, where it is often translated ‘weakness of the will’. Curiously, Galen does not use the noun anywhere in his main surviving work of practical ethics, Affections and Errors, nor (except in a quotation from Plato’s Timaeus) in The Capacities of the Soul Depend on the Mixtures of the Body, although he does use the related adjective akratēs in both works, and both adjective and noun are discussed in The Doctrines of Hippocrates and Plato. For Galen’s conceptions in this area, in particular his understanding of the adjective akratēs and its opposite enkratēs, see Aff. Pecc. Dig. I.6, 23,5 DB (V.33 K.), with Singer’s note ad loc. (Singer 2013: 267, n. 171).

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include the sudden giving-in to pleasure (people who are prone to this are referred to as lacking in restraint, or undisciplined) or to love of 416 K. esteem (which Greeks today call ‘vanity’ [kenodoxia]), as in the case of the person who is prepared to endure any kind of suffering rather than to submit to having pitch-plaster applied to his whole body, when his doctors advise this remedy because of the body’s thinness.45 Such thinness may arise as a result of a bad-mixture, consisting in an excess of dry and cold, throughout the whole body; or also as a result of a natural feebleness in the distributive or nutritive capacity, or in both. ‘Plucking’, as it is commonly called by the Greeks of our times, is of benefit in all these cases, assisting as it does in distribution and nutrition. Many who were previously thin are observed to be made stouter by this remedy, especially those in whom the distributive, but not the nutritive, capacity is weak, the latter being unable to supply sufficient nourishment through a lack of material – which itself arises through a shortage of nourishment being distributed. Still, as I have said, there are those who shun assistance from this quarter through love of esteem, not wishing people to think that they are undergoing pitch-plastering for the same reasons as those who live effeminate lifestyles or are obsessed with their appearance. These people, then, insist on the provision of some other remedy for their thinness. There is 417 K. in fact no other with the same power, although some of the following may also be of benefit: before bathing, to massage the body with motions of the hand which are neither too soft nor too rough, until it becomes red; then to compact the skin with a hard, but not long, massage, rendering it hard; then to engage in moderate exercise, to bathe, but not to remain in the bath for a long time; then to rub off with a dry massage similar to the previous one; and finally, application of a small amount of oil before taking food. The purpose in such cases is to draw good blood into the fleshy parts of the body and to strengthen the nutritive capacity, in such a way that what is drawn in is not dissipated. Now, the nutritive capacity is invigorated by the heating of the fleshy parts, while the ­dissipation of the blood which is drawn into these is prevented by the application of oil, this having the capacity of an adhesive drug.46 If 45

Cf. Book V, n. 21. Further on this procedure and the term translated ‘plucking’ (drōpax) below, see Hipp. Off. Med. III.33 (XVIIIB.894 K.). 46 Though it makes virtually no difference to the translation, I read δύναμιν ἐμπλαστικοῦ … φαρμάκου for δύναμιν ἐμπλαστικὴν … φαρμάκου (literally, ‘the adhesive capacity of a drug’); the former is surely the correct idiom, and the use of the genitive φαρμάκου on its own as a qualifier would be odd.

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considerations of age allow, moreover, such an individual will also benefit from cold bathing in conjunction with all the above. Conversely, in cases where people have been made immoderately stout, 418 K. one should reduce the distribution, while increasing the outflow from the body. Now, distribution is reduced through constant downward evacuation of the stomach, whereby we induce in the organs of nutrition the habit of quickly pushing downwards that which is contained within them. Outflow from the body, meanwhile, will be increased by swift forms of exercise, including running, and very long massage using dissipating oils. The massage should, of course, be soft and tending to provoke porousness. I have indeed in the past turned a quite stout person into a moderately well-fleshed one, in a short time, by compelling him to engage in swift running, then rubbing off the sweat with cloths which were either extremely soft or extremely rough,47 and then giving a very long massage with dissipating oils. (These are customarily referred to by the more recent doctors as ‘anti-fatigue’.) After this massage I made him bathe, then did not immediately allow food, instructing him to take a pause, or even to engage in one of his usual tasks, before then making him bathe a second time. Only after that did I allow him some amount 419 K. of food which was low in nutrition, so that he would be filled, but little of it would be distributed through the whole body. The other bad-mixtures which arise throughout the body should be rectified in the same way, by discovering first the appropriate aim of action, and then the materials which are capable of bringing this about. The present account may thus be a very concise one, provided that one keeps in mind the manner in which to conduct massage, exercise and bathing, as well as food and drugs. Now, massage and exercise have been dealt with earlier on in this treatise, and foodstuffs and drugs in separate works. The form of instruction which addresses itself methodically to the common and general points is both concise and easily remembered in many individual contexts. I, however, am not here confining myself to such a general account, but also adding examples of those individual contexts; this, I believe, will render the present instruction as complete as possible.

47

The mention of two opposites as alternatives here seems odd, especially since the word translated ‘extremely’ usually has the sense of ‘excessively’, and would not usually appear in a positive recommendation. It is tempting to think that some words have fallen out which would give the phrase a negative sense (‘neither too soft nor too rough’).

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Uneven bodily constitutions: their variety and treatment 9. It is time now, therefore, to turn to the uneven bodily constitutions, 420 K. which are in all cases morbid. There is a threefold distinction within such constitutions, because our bodies, too, have a threefold composition.48 One [composition] is that from the primary elements, from which arise the parts called by Aristotle ‘uniform’. The second is that from these very uniform parts (which are themselves in turn the perceptible elements of the non-uniform parts); from these [uniform parts] arises the composition of the organic parts. The third [composition] is that of the whole body, from the organic parts. Now, this third one is easier, in terms of both its discernment and its successful care; the second is more difficult by comparison, and the first hardest of all. It is better, then, to begin with the third, where both discernment and care are easier. Take for example the case where the head (which is not a bad starting-point for this discussion) has a naturally bad mixture, so that it generates a large quantity of residues, causing harm to any of the organs situated below it, to which the superfluous stuff may find its way. Here, what comes about most readily is movement to the mouth and nostrils; but it may also reach the eyes, and in some cases the ears. Such a movement of residues into the 421 K. mouth is received by the mouth of the stomach, and also by the ‘rough artery’, known also as the windpipe. The upper extremity of this, which is attached to the mouth, and is known as the larynx, is an organ of speech, as has been shown in my work on The Voice.49 The larynx, then, is moistened by the stuffs which flow down into it from the head; and the effect of this is first to render the voice hoarse; then, in the course of time, faint. If the trouble becomes worse, it is lost altogether; for in this case the [rough] artery is soaked along with the larynx. If the stuff that flows is acrid, then the harm will not be confined to the parts so far mentioned, but accompanied by an extremely painful burning of the kind which we often observe to arise in the skin even without an external cause. The lungs suffer ulceration too; and the complaint is known as phthoē. If the flow of liquids reaches the mouth of the stomach and the 48

The fundamentally Aristotelian model Galen is here elaborating can be summarized in terms of three different physical levels, or kinds of entity, within the body: in ascending order of complexity, those of the elements, the uniform parts and the organic parts; on this see Introduction, section 4.5.1, with n. 61. Galen’s analysis focusses on the different phases of composition (sunthesis), whereby each such level is brought about on the basis of the one below it: (1) composition of uniform from elements; (2) composition of organic from uniform; (3) composition of whole body from organic. (In terms of levels, then, Galen has actually mentioned four: elements; uniform parts; organic parts; whole body.) 49 Cf. Book II, n. 72.

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stomach itself, then, if it is cold, it will introduce a cold bad-mixture in these parts; if hot, a hot one. This too will cause injury in the course of time; to begin with it harms the appetite and coctive process. 422 K. Now, if the flow of liquid is cold, it produces slowness of digestion, 15 lack of digestion and sharp belching. If the liquid has also undergone decay, then it will introduce decay to the nourishment, with the production of eructations which are rancid or vinegar-like, or which have some other inexpressible or expressible quality. If the harm extends further below, it will injure both bladder and gut. It may affect also the vessels in the mesentery,50 through which distribution takes place to the liver. As a 20 result of this, some suffer lack of appetite, others unnatural appetites of the sort known as ‘dog-like’, or in some cases also the desire for bad foods, in the same way as happens during pregnancy. It is also evident that inflammation of the uvula, paristhmia, paroulides, antiades,51 corrosion of the teeth and ulceration and putrefaction in the mouth follow 25 from the down-flow of juices from the head. The great majority of doctors in such cases will cut the uvula, or will give a drug, to provoke expectoration of the substances that have been brought down into the lung through the rough artery. Others take care of 423 K. the stomach, and still others of the teeth and mouth, or even of the stuffs that have arisen in the nose, not to mention the eyes and ears, which are 30 also harmed in quite a few cases. In my view, however, it would be better to cut off the very source of these ills, if I may so put it, by invigorating the head; or, if this proves impossible because of the vehemence of its natural bad-mixture, at least to take thorough care of it. And one must take one’s indication as to the nature of this care from the actual physical form [observed] in it – not, as is the practice of some doctors, apply 35 treatments involving deadly carrot and mustard to the head in all cases. For if the bad state of the head is the result of a hot bad-mixture, such 186 Ko. drugs will be harmful. Such individuals should rather be soothed with plentiful bathing in drinkable water, in order both to disperse the hot vapours which have arisen in the head and to improve the entire mixture. The use of naturally occurring hot water sources is harmful in such cases. 5 Of these, those which contain sulphur and asphalt are completely contraindicated for naturally hot heads because of their heating effect, while those which are astringent are contraindicated because they stop 424 K. [the body] up. The only naturally occurring waters which they should 50

Cf. Book IV, n. 34. Paristhmia and antiades were inflammations of the tonsils (cf. Book V, n. 52); paroulides refers to a condition of the gums.

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use, if they must, are fresh ones, which at least can be used without harm. That much it is safe to state; to claim that they will actually be benefited by these would not be equally safe. Such waters would not be as hot as 10 they are if they did not possess some drug-like quality. It is preferable to assess such waters by experience; for it is rare in our part of the world that one has to travel more than a hundred stades from the city to find one. At Prusa, indeed, there is one within less than ten. Our own waters at Allianoi (this is the name of the place) belong to one type, all coming 15 from one source; and there is another source of drug-like water also in the suburban area of Prusa, as there is too in our own Lyketoi.52 Those with a very hot and burning head are better advised in summer to have applications of rose-oil, made from roses alone, without thickening agents; and still preferable to this is the oil known as omphakinon [made from unripe olives] and raw-pressed, with roses steeped in it, and best of 20 425 K. all if this is prepared without salts. In some cases the head becomes subject to the symptoms of skotōma and headache as a result of the mixture in the arteries; and then one must resort to arteriotomy – but this is beyond the scope of a treatise on health. 10. There are, on the other hand, cases where there is constant pain in 25 the head resulting from the sensitivity of those nerves which grow out from it, most of which form a concatenation at the mouth of the stomach, but a part of which also descend to the lower part of the stomach;53 and here the cure does belong within the art of health – or rather, what belongs here is to make provisions so that this does not arise in the first place. The best form of prevention is to take care that the 30 bilious fluid either does not flow into the digestive cavity at all or is 52

On Galen’s use of the expression par’ hēmin (‘amongst us’) to refer to Asia, and more specifically the region near Pergamum, cf. Book I, n. 86; Book II, n. 43. The ancient site of Allianoi, about 18 km from Pergamum, was the subject of excavations between 1998 and 2006, before being covered by the construction of a dam in 2011. The excavations revealed both a bath complex and, in adjacent buildings which seem to have had a dedicated medical purpose, an extensive collection of surgical instruments. These buildings, which seem to belong to the second century CE, have been hailed as a uniquely early example of a hospital, or even – much more s­ peculatively – as the site of Galen’s treatment of the gladiators in his care (cf. Introduction, section 3.4, with n. 44). See Baykan (2012) with the helpful review of Nutton (2014). At any rate, the site seems to have been one of considerable medical significance, near to Pergamum and known to Galen. 53 What are meant are the nerves which extend to the ‘mouth of the stomach’, and then to the stomach itself, and through which the sensation of appetite, and the seeking of food, come about; for Galen’s account of this process and the relevant anatomy see further UP IV.7, i.201,25–202,3 H. (III.275 K.); V.9, i.277,4–12 H. (III.378 K.); XVI.5, ii.394–395 H. (IV.289 K.); AA XIV.10, 278 Simon. The nerves in question are in modern terms the pair of vagus nerves extending from the brain. I am indebted to Orly Lewis for the clarification and references.

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completely evacuated. The former provision is carried out through eating earlier. When the mixture of the whole body is on the bilious side, and the region of the digestive cavity is lacking in tension, this needs to be built up by food which is easy on the stomach. When this does not happen, juices flow down into the digestive cavity, and are accumulated 187 Ko. in superfluity in the body. The vapour from these gives rise not just to 426 K. headaches, in some people, but also to the symptoms of cataracts, and sometimes even to epileptic spasms. In all these cases the daily regime should be modified in the direction of the colder and wetter, and what 5 has flowed together should be evacuated by vomiting and by emptying of the stomach from below, and the mouth of the stomach should be invigorated by food every day before it produces bile, and by drugs at longer intervals, namely by the drinking of wormwood and of the drug made with the kind of aloe known as bitter. This cleanses out the bilious material thoroughly from the tunics of the stomach, which the wormwood is 10 by no means able to do. Wormwood possesses cleaning and astringent capacities only, so that it as it were wipes the dirt off the tunics of the stomach, but does not attract outwards and evacuate whatever is deep within it, as does aloe. The ointments applied externally to the stomach in these cases should also be moderately astringent; one may for example 15 use quince oil, mastic oil, nard oil and other such materials. Qunice oil should be preferred in summer, nard in winter, and mastic oil in spring, 427 K. this last being midway between quince oil and the perfumed oil of nard. Nard oil has a heating effect, especially when it has more black cardamom in it, while quince oil has a cooling one. Rich women have available to 20 them ointments which are superior to nard, namely the foliata and those known as spicata, which heat and invigorate the stomach. When, however, the head is not just emitting hot juices to the region of the stomach, but this region itself is possessed of hot bad-mixture, then one should always employ food and drink with a cooling effect, 25 while modifying the level of this effect in accordance with the season of the year, rather than aiming at its opposite as we do in cases of goodmixture (that is, heating in winter and cooling in summer). So, too, if both the parts have a cold bad-mixture, one should always employ hot 30 foodstuffs, drinks and ointments, again modifying them in terms of intensity according to the season. A difficult combination arises when either cold and phlegmatic juices flow down from the head into a hot 428 K. stomach, or hot ones into a cold stomach. Of the two, I have always found the former, wherein phlegmatic, cold fluids are carried down into 35 a digestive cavity which is hot, harder to deal with.

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Worst of all, however, is the case where the person’s constitution and nature are such that his stomach is not easily released, nor is he readily able to vomit. Phlegmatic fluids which remain for a long time in a hot stomach will be subject to decay, so that the stomach experiences biting and sends up bad vapours to the head. If a phlegmatic fluid flows down from the head into a stomach whose nature is cold, such cases are very easily assisted by the taking of the simple three-pepper drug first thing in the morning. Pepper on its own may also be taken in water, if this is completely ground down; and here, white pepper is better and easier on the stomach. The drinking of wormwood is completely contraindicated for people in this state; for this will embed the phlegmatic fluid in their stomach, as it does not have a significant cleaning capacity within it. Nor will aloe, which has a capacity which is attractive of bilious fluid, be of 429 K. benefit to these people. That which is known as ‘the bitter’ has been found to be a good solution, since this cuts through and cleans the thick, viscous fluids, through the sharpness and hotness of the ingredients mixed with it, such as cinnamon. However, one cannot use this drug continually, as one can the three-pepper drug or the catmint-based one. These may be used by someone with a cold stomach every day, without his experiencing any harm. In general terms, six drams of each of the other ingredients, which are also six in number, are combined with a hundred of the aloe. This is the preparation universally produced in Rome as ‘the bitter’. I, however, have two other versions which I prepare, one with a greater admixture of heating agents, the other with less of them. The way in which the admixture of heating agents is increased is simply by reducing the amount of the aloe to eighty drams while keeping each of the others at six; the way in which it is reduced is by increasing the amount of the aloe by twenty, so that again six drams of each of the other ingredients are added to 120 of the aloe. If one cannot get hold of cinnamon, one should of course 430 K. add twice the amount of cassia.54 There are some varieties of cassia which are at such a level in terms of their own proper excellence that they are not greatly inferior to a cinnamon of low intensity; but such a cassia will still fall far short of that with a good level of intensity. Just as we eat bread of the worst sort when good bread is not available, so too we use the best sort of cassia when we have no supply of cinnamon. For bodies where the stomach has a good mixture, but with an inclination towards 54

Galen’s mention of his own large stock of cinnamon, amongst the items destroyed in the great fire of 192 CE, makes clear the value attached to this commodity: see Ind. 6, 4 BJP. Cf. also Nutton (1985); Marganne (1996); De Romanis (1996); Totelin (2016a).

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the cold, the drug known as Diospolitikon is indicated. This, too, I customarily prepare in two different ways. For those whose stomach is constricted, I add the natron of Berenice,55 as it is known, in equal amount to the cumin, rue and pepper; but in those whose stomach is released I use only half the amount. For, as is generally agreed, this drug has the effect of thinning phlegm and evacuating flatulent breaths. Meanwhile, the combination of a stomach suffering from bad-mixture through hotness with a cold head is problematic and difficult to manage. The phlegm flowing down into the stomach requires the three-pepper 431 K. drug and catmint, or indeed the Diospolitikon just mentioned, while the mouth of the stomach is harmed by inflaming drugs. One must therefore attempt to cut through and clean out the phlegm with non-heating materials, such as honey-vinegar. The combination arising in those bodily constitutions in which the mouth of the digestive cavity (also known as the stomachos) is nauseous, while the stomach is suffering retention, is also problematic and hard to treat. Those things which stimulate [its motion] also all immediately upset the entire stomach mouth, so that the foodstuffs come to the surface of it and frequently produce nausea; it then follows unavoidably that the nourishment is not well digested. If, on the other hand, you give them foods which are easy on the stomach, then the stomach will continue to suffer retention, even for a third and a fourth day. For such people, then, I have found one form of regime to be appropriate, consisting of vegetables with oil and garum, and other such things which tend to empty the stomach, with the addition, after sufficient nourishment has been taken, of a certain quantity of materials which will improve the tension of the stomach mouth. These include 432 K. apples, pears and pomegranates, some classes of which are astringent without sharpness. The person should himself try each one in turn, and proceed to use whichever he finds least harmful and most pleasant. Nor should he take a large amount of any of these, but only, as already stated, enough to heal the poor tension of the stomach mouth. In my experience, such use of them makes the digestive cavity easily released. People in this condition are more likely to experience diarrhoea if they take additional astringents after food than if they do not take them at all. Once the tension of the mouth of the digestive cavity has been improved, 55

A natron known as berenikion or (as according to the MSS here) bernikarion is mentioned a few times also in Galen’s pharmacological works. Whatever the exact form of the name one should adopt, it clearly derives from a place, and amid a number of cities named Berenice in the ancient Mediterranean, the reference is surely to Berenice Troglodytarum on the west coast of the Red Sea, an area well known for the harvesting of natron.

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it pushes down those things that rise to the surface, and with them those in the whole upper stomach; and the intestines which receive them continue this motion of the foodstuffs, themselves pushing onward what comes to them from the parts above. For it is evident that, even if something rushes upwards from the region of the anus, the propellant and separative capacity continue the upward motion for a very long time, in 433 K. spite of the fact that such a route is unnatural for an animal.56 The truth of what I say may be realized by recollection of our very frequent experience. It sometimes happens that a biting fluid reaches the region of the anus and stimulates us to its expulsion. If, however, we are compelled to hold it in, because of our public engagements, then when we are released from these we no longer separate it off, but we do frequently experience pain in the head as a result of this, and upset of the stomach. It is therefore reasonable to suppose that even if laxative foods rise to the surface of the mouth of the stomach, the taking of astringents, which produces tension in the upper parts of the stomach,57 will be the cause of the downward motion of the materials contained within it; and that the intestines tend to continue this downward motion right on to the extremity.

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11. Enough has been said on this subject. Let us now move to another uneven constitution – one just as bad as those previously discussed – in which the kidneys produce stones (or whatever term is preferred), and in 15 which the natural state of the whole body happens to be a thin one. 434 K. These [stones] require thinning drugs and diet; and yet these are completely contraindicated for thin bodies. It happened to one such person, who was using these treatments for his kidneys, that he experienced impaired motion and impaired sensation and – as he himself I suggest the insertion of τὰ ἄνω after πρὸς in l. 34, and a repunctuation, omitting the comma after φοράν and adding one after the phrase added. This gives the required sense, whereas the phrase πρὸς τὴν ἄνω φοράν is difficult to understand; and the scribal omission of the phrase with the repeated ἄνω would be easily explicable. 57 The grammar of the first part of this sentence, as transmitted in the MSS, is problematic: the conditional εἰ does not introduce a verb in an appropriate form, being followed only by participles; the verb ἐπιπολάζειν (‘rise to the surface’) appears in a middle, as opposed to active, form, which is nowhere else attested in Galen; and this verb as it stands appears to have στομάχου (‘stomach mouth’) as its subject within a genitive absolute phrase, whereas the verb must refer to the action of the stuffs rising to the top in the stomach mouth, not to the action of that part of the body itself. The overall sense, however, seems reasonably clear; Galen is reiterating and expanding on a point made a little earlier, that astringents, which have the capacity of improving tension of the stomach mouth, will manifest this capacity even if taken after food; and the resulting improvement of tension will have the effect of initiating the downward motion of the foods. 56

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described it – a crackling sound in his fingers. He first consulted the doctors in Campania, where he lived, who concluded that the fingers had undergone cooling as a result of a state which threatened paralysis. They therefore resorted to drugs involving spurge and feverfew, the latter of which is also known as adarkē and adarkion. When the state became much worse, and the symptoms continued constantly to rise to the higher parts, in conjunction with intense pain, the patient called upon my help (I happened to be visiting Campania at the time),58 explaining what he had experienced. I realized that he had arrived at his present state through excessive drying due to the drugs which he mentioned; and I sought what regime could be found for him that would heal this dryness without harming the kidneys. I conceived that this would be one involving the juice of barley-gruel; rock- and sea435 K. fish, along with any others which contain nothing viscous; and similarly those birds which have flesh of a similar kind to these.59 Many of the mountain birds, as they are known, have this sort of mixture, whereas those which are confined in cities, and sold after having been fattened with large quantities of wet nourishment, are completely contraindicated for these people. The best kind of flesh for such a state is that of partridges that live in the mountains; and in addition to this, that of francolins, starlings, blackbirds and thrushes. In the absence of mountain birds, we may take meat from those which have been raised in the fields, and also from pigeons that make their homes in towers, as well as from the sparrows that nest there, which are known as tower-dwellers.60 In cases where people in this state are in farmland at a higher altitude, they may also use the hens and cockerels from the farms themselves; but they should be forbidden the milk of all other animals, and encouraged to use that of asses only: this is the finest in consistency. To put it simply, 436 K. the diet should be midway between a thinning and a thickening one. I have set down the individual items of the diet appropriate in such cases in my work on The Capacities of Foodstuffs, and also in that on Good and Bad Fluid. It would therefore be superfluous to give a lengthy account 58

As made clear in Avoiding Distress (10–11 and 20–23) Galen owned an estate in Campania, at least in later life (very probably in the Bay of Naples, a popular resort for elite Romans). He had also visited the area, whether or not already owning property there, as early as 166, as mentioned at Praen. 9, 118,3–11 N. (XIV.648–649 K.); cf. Hipp. Epid. VI VIII, 461,41 WP. Nutton believes that he was in the process of retiring to this estate, or at least intending to spend more time there, at the time of the disastrous fire of 192; see Nutton in Singer (2013): 50, 52, 80 n. 19 and 92 n. 92. 59 Again, The Thinning Diet also lists the varieties mentioned here. 60 This nomenclature, or nickname, is mentioned also at Vict. Att. 8, 441,35 Kalbfleisch and Alim. Fac. III.18, 356,12 H. (VI.700 K.)

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here. It will be sufficient to say simply that with such persons one should provide for the building up of the whole body by means of the scheme of conduct which I discussed earlier, when I mentioned the person who will endure anything rather than submit to the application of pitch-plasters. When, however, the person suffering from stone is stout, you may employ the thinning diet without concern. You should take it that the same applies61 also in the case of people suffering from illnesses of the joints. Those who are well-fleshed, stout and fatty will be completely unharmed by consumption of the antidotes for joint illness and gout; but those who are thin will undergo drying of their whole body, and will experience a worsening of the state of their feet, and sometimes also of their hands, if these were previously affected. It should be understood, however, that these antidotes for gout differ greatly from those for the 437 K. kidneys, not just by virtue of their thinning of the thick, viscous fluids, but also in their heating and drying effect. In the case of those with kidney complaints, one should not in the first place give anything with a vehement heating effect. A complete account of all such matters has, of course, been given in my treatise on The Therapeutic Method and in those on drugs, of which there are two, first in order that on Simple Drugs and secondly that on Compound Drugs.62 These should neither be completely ignored, here, nor discussed at excessive length, since the bodies in question are in a position between that of perfect health and actual sickness; indeed, it is the branch of the medical art known as the ‘preventive’ which takes care of bodies in such states. We would, indeed, not recommend anyone with a faultless bodily condition either to take drugs or to employ the thinning diet; but we would recommend that those who are prone to harm because of a natural weakness, either of their whole bodies or of certain parts of it, be drawn into the scheme of conduct known as the preventive, and avoid as dangerous that daily regime which on the other hand 438 K. will cause no harm at all to individuals who are naturally endowed with a good bodily constitution and do not shrink from moderate exertion. I tentatively read προσεῖναι: although this reads oddly here, it at least makes better sense than either προσιέναι (M) or προιέναι (VR); προσεῖναι is used in the sense of ‘be present as a feature’ or ‘be present in addition’ although it then standardly governs a noun in the dative, which is not the case here. 62 It is noteworthy that here Galen clearly refers to The Therapeutic Method (and also to Simple Drugs and The Composition of Drugs) as works already completed, something he does not clearly do in the previous books. Further on this point, and on its relevance to the dating, at least of this last book of the work, see Introduction, section 8.2. 61

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Persons prone to diseases affecting the head; interaction of stronger and weaker parts of the body 12. But the case is different for those who readily suffer harm, to such an extent that they constantly fall victim to serious diseases, such as epilēpsia, skotōma, headache and others, in which the head causes symptoms in the lower parts of the body. (I include here the teeth, gums, uvula, and in brief all parts within the mouth and pharynx, as well as the ears, eyes, stomach mouth, digestive cavity, the organs of breathing, windpipe, rough artery, lungs and chest.) Here, the common aim of the elements of daily regime is, first and most importantly, to give the head protection against harm, and then also to take care of the parts harmed. But one must realize that here, too, there is a further specification to be made, by which I mean that it is not all parts which are to be invigorated. The best way of stating this specification is, in fact, by reference to their utility.63 439 K. The utility of the eyes and ears is very great; therefore one must perform what is described by Hippocrates as the ‘channelling away’ of the residues carried down to these from the head.64 This is achieved especially by drawing them off into the nose; or, if this does not work, into the mouth, by the use of drugs which remove phlegm. In the case of the diversion to the nose, it is carried out by drugs which provoke sneezing, and those indicated for cases of its obstruction. You will improve the tension of the eyes, meanwhile, through use of the dry eye-salve [made] of Phrygian stone, placing the probe in contact with the eyelids without touching the tunic on the inside of the eye. (Women perform such a procedure every day in the course of their application of make-up.) For vigour of the ears, that of the red-horned poppy on its own is sufficient, ground by a whetstone into vinegar, and then poured in gently, lukewarm, by means of a probe, or of that familiar instrument which is known by doctors as the ‘ear-pourer’. As soon as you are confident that their tension has been improved, so that nothing is 63

Chreia is elsewhere translated as ‘function’, and used especially to refer to the purpose or functional role that each part performs within the body, also e.g. of the different functions of different forms of exercise, or tools; but it extends also to the sense of ‘usefulness’ or ‘utility’, so that here in talking of the different chreiai of different parts Galen is essentially talking about their relative importance. (The key word of the title of Galen’s magnum opus of anatomically-based physiology, variously translated in English ‘The Usefulness of the Parts of the Human Body’ and ‘The Function of the Parts of the Human Body’, is in Greek chreia.) 64 The reference is to the use of the term παροχέτευσις at Hum. 1, 158,9–10 Overwien (V. 476 L.), where, however, the explicit mention is of the channelling-off of fluids into the head, as well as into the sides. For Galen’s interpretation, and use of the notion elsewhere, see Overwien’s (2014) note ad loc.

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flowing into them, you should continuously drip into them some 193 Ko. perfumed nard oil of the best quality. (The finest used to be produced 440 K. only in Laodicea, in Asia, but is now produced in other cities, too.) The eye-salve known as that of the red-horned poppy will be of even greater benefit to the ears, and will invigorate them, as will also that of roses, that with saffron, that with nard oil, and that of wine and perfumes – these 5 preparations which are made for the richer women at Rome, and which are called foliata and spicata.65 If there is a very constant flow of liquid and pus from the head to the ears, leading to ulcerations, then the latter should be thoroughly healed by means of the ‘Andronios’ drug and similar preparations, in the course of which procedure one should draw 10 the fluids away to the nose and the mouth; and after this one should use those means already mentioned. 13. Just as many of the parts situated below the head are frequently harmed by fluids flowing down from it, so too diseases arise from the liver, kidneys or spleen, in parts which are weaker than them. As was shown in our work on Natural Capacities, every part has a capacity which 15 441 K. is attractive of those fluids which are proper to it – fluids which it exploits for its nourishment by alteration and assimilation – while also, conversely, aiming through some other capacity to separate off that which is superfluous into some neighbouring region. Now, if the part affected has a robust bodily condition, it will not accept the residue thus sent towards it, and so the latter will remain in the part primarily affected and 20 lead to a continuing ailment in that part. If, on the other hand, a part is weaker than that which sends it out, then it will accept it, but will push it onward towards a part which is itself amongst those which are weaker,66 which will in turn push it onward to another, until the superfluous stuff comes down to one of those parts which have none weaker than them. According to this principle, then, of those who are careless in their 25 daily regime, different people suffer continuing disturbances in different parts of the body,67 while the weaker parts always remain unharmed in 65

The Latin names given here by Galen (in Greek transliteration) are attested also by Pliny, HN 13.15; cf. above, VI.10, 187,21 Ko. (VI.427 K.). 66 It might be easier to read αὐτοῦ for αὐτὸ in l. 22, and so translate, instead of ‘which is itself amongst those which are weaker’, ‘which is amongst those weaker even than it’. 67 I translate according to Koch’s text ἄλλος ἄλλῳ μέρει συνεχῶς ἐνοχλεῖται. It would also be possible to follow the reading of R, ἄλλον for ἄλλος, and translate ‘one part is continuously disturbed by another’ (so also the Latin translation of Burgundio: ‘alia pars aliam partem molestat’), but on balance the former option seems to give the better sense.

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those who have no build-up of superfluous products. The clearest demonstration of this is the fact that some people experience such disturbance in their weaker parts for periods of six months or more. If the weakness itself were the cause of the harm, then the feeble part would be permanently affected, since it would have the cause of the affection 442 K. permanently present within it. But since it is in fact not permanently affected, it is quite evident that there is some external factor which completes the process by which the ailment arises, and this indeed is something which is in superfluity, either in amount or in quality. And this stuff which is in superfluity collects either in the body as a whole (the state known as fulness) or in one of those parts which are important, but weak by nature, causing harm either by remaining there or moving on to one of those parts which are weaker by nature. One must first of all therefore make the following investigation and distinction, whether the part is affected through a cause internal to itself, or because of another part affected before it. Now, the harm sometimes befalls the weak parts as a result of these having been subject to cooling, inflammation, physical blows, or fatigue, but more commonly through an accumulation of build-up or bad fluid resultant on the daily regime. One must, therefore, pay attention to the degree of the natural weakness of the part, and must use a specification of the following kind. One must employ a thinner form of daily regime than previously, in 443 K. conjunction, of course, with the appropriate exercises, and must take care to avoid harm arising from external causes. Then, provided that the individual does not become too thin as a result of this, and the feeble part is not disturbed, one should keep to this daily regime; if, on the other hand, the person undergoes thinning in all his parts, or if that [part] which had a bad constitution suffers in some way, one must change daily regime. In the latter case, one should do one of two things: either modify the daily regime for the thinner, or resort to evacuations appropriate to the season. For some a yearly evacuation, at the inception of spring, is sufficient, while in other cases a second is needed, in autumn. When the body has accumulated a build-up, one must perform the evacuation through removal of blood, whereas in the case of bad fluid, one should use a drug which is purgative of the dominant fluid. If, on the other hand, the part is not negatively affected by the appropriate daily regime, but the body becomes thin, one should employ pitch-plastering, as described previously, for the purpose of the building up of a condition which is undergoing thinning.

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Problems arising after emission of seed in certain constitutions; their treatment; the value of self-monitoring 14. The following too is a very bad bodily constitution: some people 444 K. produce a quantity of hot seed, which requires urgent separation; but after its expulsion they suffer relaxation of the mouth of the digestive cavity (that is of the part referred to as stomachos, not just by doctors, but by people quite generally, just as it was referred to by people in ancient times as kardia) and dissolution, becoming weak, dry, thin, pale yellow and hollow-eyed. If, as a result of being affected in this way by intercourse, they abstain from sexual relations, they experience discomfort in the head and the mouth of the stomach, and nausea. Nor do they derive any great benefit from abstinence; for they then have nocturnal emissions, which occasion them the same kind of harm that they suffered after intercourse. One person in such a condition told me that not only did he himself experience a biting, hot sensation on the expulsion of seed, but the women with whom he had intercourse experienced this too. I advised this person to abstain from those drinks which are generative of seed, and to take not just drinks, but also drugs which have the effect of 445 K. extinguishing it (the materials of these have been discussed in my works on Foodstuffs and on Simple Drugs), as well as to engage in exercises involving especially the upper parts of the body, such as the exercise with the small ball, as well as that with the big ball, and that involving handweights; and after bathing to have some cooling ointment applied to his entire lower back. Examples are that known as the raw-pressed and omphakinon [made of unripe olives] oil, as well as the rose oil and quince oil made from such olive oil. For some patients I have myself also put together ointments of a rather thick consistency, so that they would not readily be dispersed. This is done through the use of wax and of other cooling substances. First, make what is known by doctors as a ‘wax-oil’, then soften it very well with your hands in a mortar, and pour on a cooling juice, stirring it in for a long time until you have a homogeneous mixture. You will find a written account of the materials of such cooling juices in my treatise on Simple Drugs. The most readily and easily accessible are those of houseleek, hound’s berry, navelwort, fleawort, knotgrass, water chestnut and purs446 K. lane. This last does not produce juice except by being ground in a mortar, with the addition of some other juice which is moist, fine and watery in its consistency, viscous and thick, like that of unripe olives or of roses. These are available in summer, while many of the others are available in

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other seasons too; the juice of lettuce, for example, is also one of the cooling ones. Linseed, too, when boiled in water, produces a cooling juice. I once observed one of those trainers who supervise athletes fix a lead plate to the athlete’s genital area to prevent him from having nocturnal emissions. I showed this arrangement to a lay person who was affected in this way, and he was grateful to me for its use. Another, however, whose flesh was weaker in its nature, could not endure the hardness of the lead; I therefore advised that he place upon his bed some of the herbs just mentioned, adding to them some tender shoots of chaste and of rue. He immediately felt the benefit of these, and used them constantly thereafter. I also advised him to consume the seed of the 447 K. chaste, and he was grateful to me for this too, as also for the same advice concerning the rue. This kind of material is discussed in the work on Simple Drugs and in that on The Capacities of Foodstuffs. For present purposes, I consider it necessary to add the caution that one should avoid those materials which are excessively cooling, just as one should avoid those ointments made with poppy and mandragora. None of these should be taken, nor, once the plants are fully grown, is it possible to use these in the same way as those previously mentioned, as an underlay to sleep on. I also once suggested the use of roses, and the person in question in that case too derived benefit by using these as an underlay, without harm to his kidneys. (Vehement cooling of the parts contiguous with the lower back will cause such damage.) There is something else that I conceived to be useful to those in this kind of state, as well as validating this through personal experience. This, indeed, must always be taken as the criterion of such conceptions; and one should not write down something as useful which one has not personally tested, unless one adds explicit mention of that fact in one’s text: that one has conceived something to be useful, but not yet tested it. 448 K. Let me then tell you what it is that I just mentioned, which I conceived would be of considerable benefit to those who use them. I said that those suffering disturbance as a result of such a bodily constitution should observe the following precautions. When they appear most clearly to have accumulated a build-up of semen that is in need of separation, they should on the first day adopt a moderate regime, involving good fluid, and then, after their evening meal, engage in sexual intercourse before sleep; on the second, when they have had sufficient sleep, rise and undergo massage with linen until the skin is red; then,

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employ some moderate massage with oil; then, after a fairly short interval, take some unleavened,68 fine, terracotta-oven-baked bread, served with mixed wine, before turning to their customary activities; and, in the interval between the massage with oil and the administering of the bread, if there is a suitable place nearby, go for a walk in that place, unless the weather is the cold of winter, in which case it is better to stay indoors. I once recommended this invigorating of the mouth of the stomach through food to a scholar69 who suffered from continual epileptic spasms; and he derived great benefit from it. My expectation that he would benefit from it was greatly reinforced by the information that he experi449 K. enced this symptom of spasms when he had not eaten for a very long time, and even more so when he happened to have been in a state of distress or rage. Moreover, I saw that the condition of his body was thin; and when questioned he admitted that his stomach mouth was continually producing bile. I proffer this one general piece of advice to all readers of the present work, people who are not medically trained, but nevertheless have some schooling in logical argument: do not conduct your lives in the way that most human beings do, adopting a lifestyle similar to that of beasts without reason, but rather assess through experience which foodstuffs and drinks, as well as which kinds of motion, do you harm, and also, in which quantities. Similarly, monitor the effects upon you of sexual activity, that is to say whether it is harmful to you or not, and further what interval of days renders it either harmful or harmless. I have personally observed that while some undergo significant harm, others remain unharmed by engagement in such activity, even into their old age. People in either of these classes – those who suffer significant harm and those who suffer none at all – are rare; the great majority of human 450 K. beings are positioned at some point on the spectrum between the two. I therefore recommend the educated – and, after all, it is not any random person that will read this work – to pay particular attention to this question: which factors benefit them and which harm them. In this way they will have little need of doctors, as long as they remain in a state of health.

68 69

VR give the alternative εὔζυμον, ‘well-leavened’, for ἄζυμον, ‘unleavened’. On the term grammatikos and the related grammatikē see Book V, n. 28 and Thras., n. 38.

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The quince-juice drug 15. One of my followers,70 after reading this whole book, stated that one of the matters which I promised to discuss at a later point had in fact been completely omitted, namely that of the quince-juice drug,71 which is good for the appetite of people suffering from lack of it, and for coction in those people who are not subjecting their foods to good coction, and which in general renders the stomach more vigorous. So I thank the person who reminded me of this, and I add here the details of its preparation, which are as follows. Take the larger, sweeter, less sour sort of quinces, which are known amongst the Greeks in my homeland of Asia as strouthia, and take two Roman pints of their juice.72 Then add the same amount of the finest honey, and one-and-a-half pints of vinegar. Boil this mixture to a 451 K. moderate extent on thoroughly burnt charcoal, adding three ounces of previously peeled ginger and two of white pepper; then again boil on similarly burnt charcoals until it achieves the honey-like consistency which is normal for the preparation of drugs for the mouth of the stomach. This drug is extremely useful for those whose liver is lacking in tension. It is of course best taken when the person has gone without food; and the amount should be a medium-sized spoonful. Even if taken after food, however, it will do no harm. One may also well take it before the first meal of the day, and then again before the evening meal. The best time is two or three hours before food. If you wish to give it a still more astringent effect, use the flesh of the quinces in the preparation too. For those who have a badly-mixed heat in their stomach, and those who are in any way filled with bile, give the juice without the ginger and pepper, mixed only with vinegar and honey, in the above-mentioned proportion. For stomachs which are roughly at a midpoint in the mixture of their stomachs, so that they do not have an accumulation of either 452 K. bilious or phlegmatic residue, you should add half the above quantity of ginger and pepper, that is to say one ounce of pepper and one-and-a-half of ginger; and for those bad-mixtures involving coldness, four ounces of 70

For the term hetairos cf. Book V, n. 79. The promise was made at IV.7, 126,6–8 Ko. (VI.284–285 K.); the value of this preparation is mentioned also at MM VIII.5 (X.576 K.). The present passage is interesting for the clear evidence it gives of students or followers reading Galen’s work in a version distributed in draft before a further revision and ‘final’ ekdosis. For discussion of Galen’s practices in this area see Singer (2019b). 72 On the weights and measures mentioned here, see Note on translation, p. xxiv. 71

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ginger and three, or two-and-a-half, of pepper. You may also prepare it according to the middle proportion, with the use of pepper. This, then, is how to provide for the different parts of the body, when 20 these have mixtures opposite to each other. There are then also cases where a person has an uneven mixture, either in a uniform part or in an organic one; and a separate discussion will be dedicated to these.73 73

Galen may again mean the dedicated work, The Uneven Bad-Mixture, although Koch suggests that he has in mind books VI onwards of The Therapeutic Method. (The latter option would complicate the manner of cross-references between this work and The Therapeutic Method still further; cf. n. 62 above.)

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Appendix: Galen and others on the parts of medicine

In the Introduction we considered Galen’s theory of health and his conception of the relationship between an art of ‘healthfulness’ and the broader art of medicine, or of ‘the human body’. A little more should be said by way of clarification of his project of definition and subdivision of the art, and of how the conception of the branches of medicine he offers relates to others in the tradition, and indeed elsewhere in his own work.1 In Thrasybulus, Galen insists on the single nature of the ‘art concerned with the human body’, of which there are two main branches, the healing or therapeutic and the preservative or prophylactic. He further insists that the definition and subdivision of arts is correctly carried out on the basis of goals, telē, not of either the materials used or the different ­individual activities or practitioners involved; and warns against the danger that, through faulty reasoning, one may end up positing an improbable plurality of arts. Galen’s central project in this text is to establish the subordinate position of physical exercise, as a discipline, to medicine, and thus the superior status of the medical profession to that of the sports trainer with regard to health. The rivalry, as already explored in the Introduction, was clearly one of real social and practical, as well as intellectual, significance in elite Graeco-Roman society. At the same time, Galen’s approach to the subdivision of medicine into parts or branches stands in opposition to some other subdivisions presented in the ancient medical tradition, and to some extent even in opposition to his own way of presenting it elsewhere. 1

For further analysis see Singer (2014b) and for detailed discussion of all the traditional divisions of medicine mentioned here von Staden (1989): 89–104 (with a particular focus on Herophilus); Boudon (1994) (with a particular focus on Galen).

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It is arguable that in earliest Greek times the medical art was understood as consisting of two main branches, pharmacy and surgery: such a division is implicit, at least, in the summaries of the doctor’s activities found in Homer, as indeed quoted by Galen in Thrasybulus.2 By the Roman imperial period, one prominent subdivision of the art was a tripartite one, adding dietetics (or regimen) to those two. The medical encyclopaedist Celsus presents this tripartite subdivision as established, at least by Hellenistic times;3 a similar scheme offers a four-part division, with ‘prognosis’ added to the above three.4 Galen himself also acknowledges the existence of these alternative approaches to the division of the art.5 Another kind of division is that implied by Herophilus’ definition of medicine as knowledge of the healthy, the morbid and the ‘neither’, for which we have a number of testimonies, from Galen amongst others. This definition is itself a development of an earlier one, attested by Plato, according to which medicine is the knowledge of the healthy and the morbid. 6 As we have seen, Galen sometimes adopts this definition himself. Although subdivision into parts or branches of the art is arguably not central to the purposes of the Herophilean definition, to the extent that it does imply a subdivision this seems to be one based neither on goals of the art nor on materials, but rather on kinds of knowledge. However, while the sense of Herophilus’ division in its original context may remain obscure, the main healthy-versus-unhealthy distinction can, as we have already suggested, in a sense be assimilated to Galen’s fundamental division into the healing art (represented especially by The Therapeutic Method) and the ‘healthful’ (represented by Health), with the ‘neither’ occupying as it were an intermediate ground between the two.7 While the ‘neither’ does not, then, map clearly onto Galen’s fundamental bipartite division of the art, we have seen too that there seems to 2

Thras. 32, 78,9–15 H. (V.869 K.), with n. 80. Celsus, Medicina, prohoemium 9 (18,17–20 Marx): isdem temporibus in tres partes medicina diducta est, et una essent quae victu, altera quae medicamentis, tertia quae manu mederetur. primam ΔΙΑΙΤΗΤΙΚΗΝ secundam ΦΑΡΜΑΚΕΥΤΙΚΗΝ tertiam ΧΕΙΡΟΥΡΓΙΑΝ Graeci nominarunt. But it is not clear precisely which period he intends by isdem temporibus: in the previous sentence he has just mentioned ‘Diocles, then (deinde) Praxagoras and Chrysippus, then (tum) Herophilus and Erasistratus’. Some scholars attribute this tripartition to Diocles himself, but the evidence is inconclusive. 4 Vindician, Fragmentum Bruxellense 40 (23 Wellmann): divisam esse dicimus medicinam in partes quatuor: regularem, quam diaetam vocamus; manuum officium, quod chirurgian vocamus; medicamen, quod farmaciam vocamus; praenoscentiam, quam prognosin dicimus. 5 Part. Med. 1, 119,4–7 Schöne. 6 Charmides 170e. 7 See Introduction, section 4.2, with n. 54. 3

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be some congruence between the notion of the neither and that of the ou phusei: both may refer to states, either between health and disease, or which partake of both, but also apparently to interventions or influences on the body which are not in themselves either healthy or unhealthy, but the value of which depends on circumstances.8 As already suggested, it is difficult to recover the sense that the tripartite division had in Herophilus’ own system; there is a plurality of interpretations, in both ancient authors and modern scholarship.9 Leaving these complexities aside, however, we may say that it seems reasonably clear what Galen intends by the distinction, which is in any case not central to his scheme and – except in the single case of Ars Medica – appears in his work as it were in quotation marks rather than in propria persona. Perhaps more significant, as an alternative to Galen’s fundamental conceptualization of medicine, is that attested by Celsus. Galen would agree on the prominence of dietetics or regimen, which for him corresponds precisely to ‘healthfulness’, and which, as we have seen, he locates in the Hippocratic works Regimen and Airs, Waters, Places, and attempts also (with more difficulty) to locate in Plato.10 But he would disagree on the fundamental principle of the subdivision in terms of activities or ­materials – drugs/pharmacology, surgery, dietetics – as opposed to overall aims. As we shall see, however, Galen does himself seem to acknowledge a similar division – indeed one which adds diagnosis to Celsus’ three, and thus looks very similar to that attested for Vindician – at least as an alternative model. For in another text, Parts of Medicine, Galen offers a further treatment of the question of divisions of the art, even more elaborate than that of 8

See Introduction, section 5.2. The pseudo-Galenic Introductio claims that Herophilus put in the ‘neither’ all remedies for disease: ἅπαντα τὰ προσφερόμενα ἐν ταῖς νόσοις βοηθήματα καὶ ἡ ὕλη αὐτῶν, 6 (XIV.688 K.). Such an interpretation seems impossible to map onto anything Galen says about the ‘neither’; it is perhaps difficult to see what sense it could have had for Herophilus, too. (One might think that the intention was rather to say that the category should include all materials which may be used, differentially according to different circumstances, in both health and disease, and thus in themselves belong in neither category.) An alternative interpretation, that of pseudo-Alexander, On Fevers, associates the ‘neither’ category with prophylaxis (21,19 Tassinari); this in a way provides a link between the Herophilean tripartition and the four-part scheme attested above for Vindician. As a modern interpretation of the Herophilean tripartition, von Staden (1989): 90–92 takes it that the ‘healthy’, understood as a form of knowledge, corresponds to the domain of physiology and anatomy, and that the ‘neither’ includes surgery and (as per the apparent sense of the summary from the Introductio, above) pharmacy; this again is different from Galen’s interpretation or appropriation of the distinction. 10 See Introduction, section 2.2, with n. 11, and section 8.5. 9

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Thrasybulus.11 Here, while insisting on, or at least preferring, the same fundamental bipartite division of Thrasybulus, he offers further subdivisions, as well as alternative nomenclature, and even seems to allow that alternative mode of subdivision, according to main activities, as in some sense legitimate. As he says there (in Niccolò da Reggio’s translation): Non igitur te turbet multitudo incisionum, neque si secundum diversos modos inciserunt medicativam anteriores, se si nihil eorum, que occurrunt, obmissum est, considera. Let not then the plurality of the divisions upset you, nor the fact that previous authors may have made the divisions in different ways; just consider whether nothing of relevance has been omitted. Part. Med. 9, 129,13–15 Schöne12

In this text he also acknowledges an Empiricist approach to the division of the art, conducted in terms of a primary and a secondary set of divisions, the former (finales) understood in terms of the ‘ends’ of the art, the latter (constitutivae) in terms of its actual operations or procedures. He also claims that there is considerable variation between different Empiricists in their versions of these sets, but for example ‘semiotic’ or diagnostic (signativa) and ‘therapeutic’ (curativa) are central in the former category, with some adding ‘healthful’ (sanativa), while observation (inspectio) and case history (hystoria), along with ‘the transition to the similar’ (similis transitio), are central to the latter.13 In spite of – or to an extent because of – its acknowledgement of a wealth of alternative approaches, sometimes interacting with each other in a confusing way, the core aim of the Parts of Medicine is essentially similar to that of Thrasybulus. Both are crucially concerned with (1) a conceptualization of the art and its subdivisions in terms of the fundamental aim of health, and the various subordinate aims arising within that, in the context of different states and different kinds of body; (2) the claim that a firmly grounded scientific medicine, with strong epistemological claims, rather than either sports training or individual surgical or pharmaceutical specialisms, is the overarching model within which these aims must be pursued; (3) the dangers of confusion that may arise from other approaches which lead to a chaotic plurality of individual arts. 11

See the further discussion of von Staden (2002). The text is only extant in an Arabic translation and in the Latin translation of Niccolò da Reggio, both edited in Corpus Medicorum Graecorum, Supplementum Orientale II, respectively by M. Lyons and H. Schöne. 13 Part. Med. 2, 120,7–15 Schöne. 12

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In the interests of clarifying the Galenic picture of the parts of medicine, as well as some of the variations and subtleties that it includes, the following diagrams lay out, first, his understanding of the chief divisions of the art as put forward in Thrasybulus; secondly, a confused scheme, with an overabundance of ‘arts’, which he warns against, also in Thrasybulus; and thirdly the more complex and nuanced schemes of Parts of Medicine, which in fact seems to present three methods of subdivision – the first two more conceptually similar, the last closer to the activity-based division of Celsus and Vindician. (1) The location of healthfulness (according to Thrasybulus) THE ART CONCERNING THE BODY

CREATIVE ART

THERAPEUTICS (MEDICINE PROPER)

CORRECTIVE ART

PRESERVATIVE (= HEALTHFULNESS)

HEALTHFULNESS ART OF GOOD-CONDITION (EUEXIA) (IN SPECIFIC SENSE) (concerned with euexia, also (concerned with stable health) with improvement of the other two)

ARTS OF RECUPERATION AND PREVENTION (concerned with unstable health)

(2) A confused scheme (from Thrasybulus)

STATES 1. Illness 2. Unstable health 3. Stable health 4. Good-condition (euexia) 5. Athletes' good-condition 6. Extreme good-condition

ARTS 1. Healing (converting illness to unstable health) 2. Converting state 2 to state 3 3. Preserving state 3 4. Converting state 3 to state 4 5. Preserving state 4 6. Converting state 4 to state 5 7. Preserving state 5 8. Converting state 5 to state 6 9. Preserving state 6

3  The parts of medicine and the location of healthfulness.

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Appendix: Galen and others on the parts of medicine

(3) The parts of medicine (from Galen, Parts of Medicine)

(a) scheme 1 (special subdivision) PRESERVING GOOD-CONDITION

(for stable health) PRESERVING HEALTH

PROPHYLACTIC DEALIING WITH HEALTH

(for unstable health)

RECUPERATIVE GERIATRIC

MEDICINE

DEALING WITH DISEASE

(for stable disease) chronic diseases

(for superficial disease)

3 The parts of medicine and the location of healthfulness (cont.).

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acute diseases



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409

(b) scheme 2 of simple diseases

MEDICINE (= knowledge and cure of diseases)

of compound diseases

of diseases affecting certain parts

preservative prophylactic

recuperative all can be further divided

geriatric

paediatric

concerned with eutrophia (involving massage)

(c) scheme based on operations of medicine

regimen pharmacy MEDICINE

surgery diagnosis

diagnosis of different disease types prognosis

3 The parts of medicine and the location of healthfulness (cont.).

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List of departures from the editions of Helmreich and Koch

Thrasybulus Helmreich

Singer

6, 38,26 H. (V.814 K.)

ἐλάττονι δὲ τῆς

ἐλάττονι δὲ αὕτη τῆς

7, 40,10 H. (V.816 K.)

στίχον

στοῖχον

7, 40,16–18 H. (V.816 K.)

[καὶ ἡ ἀκρότης … εὐεξία] καὶ ἡ ἀκρότης … εὐεξία

9, 44,15 H. (V.821 K.)

τέχνην

μίαν τέχνην

24, 62,13 H. (V.847 K.)

[ὑγεία παρὰ πᾶσιν ὁ σκοπός]

ὑγεία παρὰ πᾶσιν ὁ σκοπός

28, 70,13 H. (V.858 K.)

τῇ δυνάμει

ἢ τοῦ δυνάμει

36, 82,5 H. (V.874 K.)

ναὶ

καὶ

36, 82,6 H. (V.874 K.)

ἥ γε

εἴ γε

36, 82,18 H. (V.874 K.)

αὐτὰ μὴν

αὐτά γε μὴν

36, 83,1 (V.875 K.)

πόνους

πότους

41, 91,2–4 H. (V.886 K.)

ὑποδυόμενον … ἐργαζόμενον

ὑποδυομένην … ἐργαζομένην

Health Koch

Singer

I.4, 7,22 Ko. (VI.11 K.)

αὐτοῖς

αὐτοὶ

I.5, 9,11 Ko. (VI.15 K.)

ὁμοιομερῶν ἢ ἀνομοιομερῶν

ὁμοιομερειῶν

410

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411

Koch

Singer

I.5, 9,28 Ko. (VI.16 K.)

ἀλλήλων διαφέρουσιν

––

I.7, 17,11 Ko. (VI.34 K.)

ἢ ἡλικίαν

ἡ ἡλικία

I.8, 19,12 Ko. (VI.39 K.)

ἐπὶ τέλους εἰρησομένης

ἐπὶ τέλος ἐλεγχομένης

I.9, 23,1 Ko. (VI.47 K.)

μαῖαν

μητέρα

I.11, 26,24 Ko. (VI.54 K.)

[μοχθηρὰν]

μοχθηρὰν

I.12, 30,35 Ko. (VI.66 K.)

τοῦ τρέφοντος αὐτὰ χυμοῦ

ἐκ τοῦ τρέφοντος αὐτὸ χυμοῦ

I.13, 33,30 Ko. (VI.72 K.)

ἐκροὰς

––

II.2, 39,32 Ko. (VI.85 K.)

μεῖζον ἢ ἔλαττον

μεῖζον

II.2, 40,2 Ko. (VI.85 K.)

διατριψόμενοι

τριψόμενοι

II.2, 40,30 Ko. (VI.87 K.)

εὐροῦς

εὐρεῖς

II.4, 51,30 Ko. (VI.114 K.)

ἧττον

ἥττον᾽

II.4, 52,24 Ko. (VI.116 K.)

εἶπον

εἶπε(ν)

II.9, 61,32 Ko. (VI.138 K.)

ἔνδον

ἔνδοθεν

II.11, 66,12 Ko. (VI.149 K.) ἀνάλωσις

ἀλλοίωσις

II.11, 68,35 Ko. (VI.155 K.)

καὶ διασύρουσι

––

II.12, 71,21 Ko. (VI.161 K.)

ἐξ ὧν συμπληροῦνται

ἐξ ὧν τε συμπληροῦται

III.2, 78,20 Ko. (VI.177 K.) ἀπὸ τῆς θεραπείας III.2, 79,8 Ko. (VI.178 K.)

ἐφιέμενα

III.2, 79,22 Ko. (VI.179 K.) κατά τι

ἐπὶ τῆς ἀποθεραπείας ἐφιεμένου κατά τε

III.8, 91,8 Ko. (VI.206 K.)

οὐ

––

III.13, 101,1 Ko. (VI.228 K.)

βαλανέων

βαλανείων

IV.4, 113,3 Ko. (VI.256 K.)

τὰ κεφάλαια

τὸ κεφάλαιον

IV.6, 122,13 Ko. (VI.277 K.)

κοπώδεις διαθέσεις

κοπώδει διαθέσει

IV.9, 130,2 Ko. (VI.293 K.)

τοῦ

τὸ

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List of departures from Helmreich and Koch Koch

Singer

IV.11, 134,24 Ko. (VI.304 K.)

μακράν

μικρόν

V.4, 143,19 Ko. (VI.332 K.)

αὐτῷ

αὐτὸ

V.5, 144,32–145,1 Ko. (VI.335 K.)

ἕκαστος δυνήσεται σκόπον ἔχων ἐπὶ τῇ τῶν οἴνων δοκιμασίᾳ

ἕκαστος δυνήσεται σκόπους ἔχων ἐπὶ τῶν γερόντων ἐν τῇ τῶν οἴνων δοκιμασίᾳ

V.5, 146,10 Ko. (VI.338 K.) Κυριῆνος

Καρυΐνος

V.10, 157,19 Ko. (VI.327 K.)

ὑπογεγραμμένους

προγεγραμμένους

V.10, 158,12 Ko. (VI.329 K.)

λιτρώδους

νιτρώδους

V.10, 158,17 Ko. (VI.329 K.)

γυμνάσια

γυμνασίων

V.10, 159,29–31 Ko. (VI.361)

γνόντι … νοσοῦν γνόντι … ὑγιαῖνον ἢ [ὑγιαῖνον], χαλεπῶς νοσοῦν, οὐ χαλεπῶς

V.11, 160,34–35 Ko. (VI.364 K.)

ἐνίοις … ἐνίοις

ἔνιοι … ἔνιοι

V.11, 164,25–26 Ko. (VI.373 K.)

ἐκπεσόντων

ἐμπεσόντων

V.12, 167,20 Ko. (VI.379 K.)

σύμφορον

σῦφαρ

VI.2, 169,31 Ko. (VI.385 K.)

ὑπαλλάξειεν

ἐπαλλάξειεν

VI.3, 173,34 Ko. (VI.394 K.)

καθ᾽ ἧπαρ

μεθ᾽ ἧπαρ

VI.5, 177,33 Ko. (VI.404 K.)

αὐτοῦ

αὑτοῦ

VI.5, 178,25 Ko. (VI.405 K.)

ἡμεραῖς

μὲν ἡμεραῖς μεγίσταις δὲ νυξὶν

VI.6, 179,17 Ko. (VI.407 K.)

αὐτῷ

αὑτῷ

VI.7, 181,16–17 Ko. (VI.412 K.)

εἴωθα … ἡγῶμαι

εἰώθειν … ἥγημαι

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List of departures from Helmreich and Koch

413

Koch

Singer

VI.8, 183,25 Ko. (VI.417 K.)

ἐμπλαστικὴν

ἐμπλαστικοῦ

VI.10, 189,34 Ko. (VI.432 K.)

πρὸς τὴν ἄνω φοράν,

πρὸς τὰ ἄνω, τὴν ἄνω φορὰν

VI.11, 191,20 Ko. (VI.436 K.)

προσιέναι

προσεῖναι

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List of titles, abbreviations, editions and online resources of Galenic works

This appendix lists all extant treatises of Galen (including some dubia et spuria) alphabetically by standard Latin abbreviation, as well as giving the Latin title (in its accepted or most usual version), the original Greek title (again, it its most usual version) and the English title in the form adopted in this series, and brief references to modern editions and translations. It gives an idea of the breadth of Galen’s works and their potential interest to a twenty-first-century audience. It also gives an idea of the status of Galenic editing and of what a complete ‘Galen in English’ would involve in terms of size. In the second column appear the volume and page numbers of each treatise in the standard edition of Kühn (1821–1833), which (with the exception of a few works not printed there) is always used for reference purposes; see further below under ‘Online resources’. In the final column appear modern critical editions and translations into modern European languages, where these are available, in chronological order. These are cited only by author surname and date. Full bibliographical references for important collections (e.g. Garofalo and Vegetti 1978, Singer 1997a, Johnston 2006, Vegetti 2013) appear in the main Bibliography; otherwise, full references may be found in the bibliographical survey of Fichtner (2019) (accessible, with regular updates, through the CMG website at http:// cmg.bbaw.de/online-publications/hippokrates-und-galenbibliographie-fichtner); see also Hankinson (2008a): 405–411. Editions prior to Kühn are in general not cited.

Online resources The entire back catalogue of the authoritative series of critical editions produced by Corpus Medicorum Graecorum et Latinorum – many of them also including translations – is freely available to consult online through the website of the Berlin-Brandenburgische Akademie der Wissenschaften. The same website also makes available a number of other editions (‘weitere Ausgaben’) of Galen’s works, in particular those published by Teubner, as well as some works extant

414

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List of Galenic works

415

only in Arabic and/or Latin, under ‘Suppl. Or.’ These appear respectively at the following links: http://cmg.bbaw.de/epubl/online/editionen.html http://cmg.bbaw.de/epubl/online/publiweitereausgaben_galen.html http://cmg.bbaw.de/epubl/online/publisupplor.html While bibliographical details of individual publications are not given below, when a text is available through one of the above links, this has been indicated by the highlighting of the relevant item in bold. The Loeb Classical Library series is also available online, though by subscription, at the following link (editions appearing in this series are signalled simply by the addition of the word ‘Loeb’): www.loebclassics.com/browse?t1=author.galen Finally, the standard edition of Kühn is also available, and downloadable, online, through the Biu Santé website of the Bibliothèques d’Université de Paris: www.biusante.parisdescartes.fr/histoire/medica/ (search for ‘Galien, Kühn’)

Abbreviations Abbreviations of editors’ names are given if used in introductions and footnotes. Abbreviations for editions and translations are used as follows: [Edn] = edition; [D] = Dutch translation; [E] = English translation; [F] = French translation; [G] = German translation; [I] = Italian translation; [S] = Spanish translation. Editions and translations are of and from Greek if not stated otherwise. Abb.

Latin & Greek titles

English title

Editions and translations

AA

De anatomicis administrationibus (II.215–731 K.) Περὶ ἀνατομικῶν ἐγχειρήσεων

Anatomical Procedures

Simon (1906) [Edn Arabic, G, books IX.6–XV]; Singer (1956) [E, books I–IX.6]; Duckworth, Lyons and Towers (1962) [E from Arabic, books IX.5–XV]; Garofalo and Vegetti (1978) [I, books I–IX.5]; Garofalo (1986) [Edn Arabic and Greek, books I–IV]; Garofalo (1991) [Edn, I]; Garofalo (2000) [Edn Arabic and Greek, books V–IX.5]; López Salva (2002) [S, books I–IX.5]

https://doi.org/10.1017/9781009159524.014 Published online by Cambridge University Press

416

List of Galenic works

Abb.

Latin & Greek titles

English title

Editions and translations

Adv. Jul.

Adversus Julianum Against Julian (XVIIIA.246–299 K.) Πρὸς τὰ ἀντειρημένα τοῖς Ἱπποκράτους ἀφορισμοῖς ὑπὸ Ἰουλιανοῦ

W. = Wenkebach (1951) [Edn]

Adv. Lyc.

Adversus Lycum Against Lycus (XVIIIA.196–245 K.) Πρὸς Λύκον

Wenkebach (1951) [Edn]

Adv. Typ. Scr.

Adversus eos qui de typis Scripserunt (VII.475–512 K.) Πρὸς τοὺς περὶ τυπῶν γράψαντας ἢ περὶ περιόδων

Against Those Who Have Written on Disease Patterns

Aff. Pecc. Dig.

De propriorum animi cuiuslibet affectuum dignotione et curatione; De animi cuiuslibet peccatorum dignotione et curatione (V.1–103 K.) Περὶ διαγνώσεως καὶ θεραπείας τῶν ἐν ἑκάστου ψυχῇ παθῶν καὶ ἁμαρτημάτων

The Diagnosis and Treatment of the Affections and Errors Peculiar to Each Person’s Soul (‘Affections and Errors’)

Marquardt (1884) [Edn]; van der Elst (1914) [F]; DB = De Boer (1937) [Edn]; Harkins (1963) [E]; Menghi and Vegetti (1984) [I]; Barras, Birchler and Morand (1995) [F]; Singer (1997a) [E]; Magnaldi (1999) [Edn]; Godderis (2008) [D]; Singer (2013) [E]

Alim. Fac.

De alimentorum facultatibus (VI.453– 748 K.) Περὶ τροφῶν δυνάμεως

The Capacities of Foodstuffs

H. = Helmreich (1923) [Edn]; Beintker and Kahlenberg (1939–1954) [G]; Grant (2000) [E]; Powell (2003) [E]; Wilkins (2013) [Edn, F]; Ferreira (2020) [Portuguese]

[An. Ut.]

An animal sit quod in utero geritur (XIX.158–181 K.) Εἰ ζῷον τὸ κατὰ γαστρός

Whether What Is in the Womb Is an Animal

Wagner (1914) [Edn]; Colucci (1971) [I]

Ant.

De antidotis (XIV.1– 209 K.) Περὶ ἀντιδότων

Antidotes

Winkler (1980) [G]

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List of Galenic works

417

Abb.

Latin & Greek titles

English title

Editions and translations

Ars Med.

Ars medica (I.305– 412 K.) Τέχνη ἰατρική

The Art of Medicine

Lafont and Ruiz Moreno (1947) [S]; Malato (1972) [I]; Garofalo and Vegetti (1978) [I]; Singer (1997a) [E]; Boudon (2000) [Edn, F]; Godderis (2009) [D]; Johnston and Horsley (2016) [Edn, E, Loeb]

Art. Sang.

An in arteriis natura sanguis contineatur (IV.703–736 K.) Εἰ κατὰ φύσιν ἐν ἀρτηρίαις αἷμα περιέχεται

Whether Blood Is Naturally Contained in the Arteries

Albrecht (1911) [Edn]; Furley and Wilkie (1984) [Edn, E]; Goss and Goss Chodkowski (1985) [E]

At. Bil.

De atra bile (V.104– 148 K.) Περὶ μελαίνης χολῆς

Black Bile

DB = De Boer (1937) [Edn]; Barras, Birchler and Morand (1998) [F]; Grant (2000) [E]

Bon. Hab.

De bono habitu (IV.750–756 K.) Περὶ εὐεξίας

Good-Condition

Helmreich (1901) [Edn]; Bertini Malgarini (1992) [I]; Barras and Birchler (1994); Singer (1997a) [E]; Johnston (2020) [Edn, E, Loeb]

Bon. Mal. Suc.

De bonis malisque sucis Good and Bad (VI.749–815 K.) Fluid Περὶ εὐχυμίας καὶ κακοχυμίας

H. = Helmreich (1923) [Edn]; Ieraci Bio (1987) [Edn, I]

CAM

De constitutione artis medicae ad Patrophilum (I.224– 304 K.) Πρὸς Πατρόφιλον περὶ συστάσεως ἰατρικῆς

Dean-Jones (1993) [E]; Fortuna (1997) [Edn, I]; Boulogne and Delattre (2003) [Edn, F]; Johnston and Horsley (2016) [Edn, E, Loeb]

Cath. Med. Quos, quibus Purg. catharticis medicamentis et quando purgare oporteat (XI.343–356 K.: the text is a collection of Galen’s statements, excerpted in Oribasius) Τίνας δεῖ ἐκκαθαίρειν καὶ ποίοις καθαρτηρίοις καὶ πότε

The Constitution of the Art of Medicine, to Patrophilus

Whom to Purge, with Which Cleansing Drugs, and When

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418

List of Galenic works

Abb.

Latin & Greek titles

English title

Editions and translations

Caus. Morb.

De causis morborum (VII.1–41 K.) Περὶ τῶν ἐν τοῖς νοσήμασιν αἰτιῶν

Causes of Diseases Grant (2000) [E]; Johnston (2006) [E]

Caus. Puls. De causis pulsuum (IX.1–204 K.) Περὶ τῶν ἐν τοῖς σφυγμοῖς αἰτιῶν

Causes in the Pulse Pino Campos (2020) [S]

Caus. Resp. De causis respirationis (IV.465–469 K.) Περὶ τῶν τῆς ἀναπνοῆς αἰτιῶν

Causes of Breathing

Furley and Wilkie (1984) [Edn, E]

Caus. Symp.

De symptomatum causis (VII.85–272 K.) Περὶ αἰτιῶν συμπωμάτων

Causes of Symptoms

Garofalo and Vegetti (1978) [I]; Johnston (2006) [E]

CC

De causis contentivis (not surviving in Greek) Περὶ τῶν συνεκτικῶν αἰτιῶν

Containing Causes

Kalbfleisch (1904) [Edn Latin]; Lyons (1969) [Edn Arabic, E]; Kollesch, Nickel and Strohmaier (1969) [Edn Latin]; Hankinson (1988) [Edn Latin]

Comp. Med. Gen.

De compositione medicamentorum per genera (XIII.362– 1058 K.) Περὶ συνθέσεως φαρμάκων τῶν κατὰ γένη

The Composition of Drugs According to Kind

Comp. Med. Loc.

De compositione medicamentorum secundum locos (XII.378–1007; XIII.1–361 K.) Περὶ συνθέσεως φαρμάκων τῶν κατὰ τόπους

The Composition Santana Henríquez (2005) [S, of Drugs books I and II] According to Places

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List of Galenic works

419

Abb.

Latin & Greek titles

English title

Editions and translations

Cons.

De consuetudinibus (not in Kühn) Περὶ ἐθῶν

Customary Practices

Daremberg (1854–1856) [F]; M. = Müller (1891) [Edn]; SP = Schmutte and Pfaff (1941) [Edn Arabic, G]; Klein-Franke (1979) [Edn Arabic]

CP

De causis procatarcticis Antecedent Causes (not surviving in Greek) Περὶ τῶν προκαταρκτικῶν αἰτιῶν

Bardong (1937) [Edn Latin with Greek translation]; Hankinson (1998) [Edn Latin, E]

Cris.

De crisibus (IX.550 –768 K.) Περὶ κρίσεων

Crises

A. = Alexanderson (1967) [Edn]; Rodriguez Alfagame (2003) [S]

Cur. Rat. Ven. Sect.

De curandi ratione per venae sectionem (XI.250–316 K.) Περὶ φλεβοτομἰας θεραπευτικόν

Treatment by Venesection

Brain (1986) [E]; Durán Mañas (2020) [S]

[Def. Med.] Definitiones medicae (XIX.346–462 K.) Ὅροι ἰατρικοί

Medical Definitions

Lafont and Ruiz Moreno (1947) [S]; Kollesch (2023) [Edn, G]

Dem.

De demonstratione (not in Kühn) Περὶ ἀποδείξεως

Demonstration

Müller (1895) [Edn fragments]

Di. Dec.

De diebus decretoriis Critical Days (IX.769–941 K.) Περὶ κρισίμων ἡμερῶν

García Sola (2010) [S]; Cooper (2011) [Edn Arabic, E]

Di. Hipp. Morb. Ac.

De diaeta Hippocratis in morbis acutis (not surviving in Greek: inauthentic text at XIX.182–221 K.) Περὶ τῆς κατὰ τὸν Ἱπποκράτην διαίτης ἐπὶ τῶν ὀξέων νοσημάτων

L. = Lyons (1969) [Edn Arabic, E]

Hippocrates’ Regimen in Acute Diseases

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420

List of Galenic works

Abb.

Latin & Greek titles

English title

Diff. Feb.

De febrium differentiis The Distinct Types Wernhard (2005) [Edn Arabic, (VII.273–405 K.) of Fever G]; De Stefani (2011) [Edn Περὶ διαφορᾶς Arabic] πυρετῶν

Diff. Puls.

De differentiis pulsuum The Distinct Types Tovar and Ruiz Moreno (1948) (VIII.493–765 K.) of Pulse [S]; Pino Campos (2010) [S] Περὶ διαφορᾶς σφυγμῶν

Diff. Resp.

De difficultate respirationis (VII.753–960 K.) Περὶ δυσπνοίας

Dig. Insomn.

De dignotione ex Diagnosis by insomnis (VI.832–835 Dreams K.) Περὶ τῆς ἐξ ἐνυπνίων διαγνώσεως

Dig. Puls.

De dignoscendis pulsibus (VIII.766– 961 K.) Περὶ διαγνώσως σφυγμῶν

[Fasc.]

De fasciis Bandages (XVIIIA.768–827 K.) Περὶ τῶν ἐπιδέσμων

Difficulty in Breathing

Editions and translations

Minor (1911) [Edn, partial]

Demuth (1972) [Edn]; Guidorizzi (1973) [Edn, I]; Oberhelman (1983) [E]

The Discernment of the Pulse

Schubring (1963) [Edn, G]

Foet. Form. De foetuum formatione The Shaping of the Singer (1997a) [E]; Nickel (IV.652–702 K.) Embryo (2001) [Edn, G] Περὶ κυουμένων διαπλάσεως Gal. Fasc.

Ex Galeni From Galen’s Notes commentariis de fasciis on Bandages (XVIIIA.828–838) Ἐκ τῶν Γαληνοῦ ὑπομνημάτων περὶ ἐπιδέσμων

Gloss.

Glossarium (XIX.62– 157) Τῶν Ἱπποκράτους γλωσσῶν ἐξήγησις

Glossary of Perilli (2017) [Edn, I] Hippocratic Terms

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List of Galenic works

Abb.

Latin & Greek titles

Hipp. Aër.

In Hippocratis De aere Commentary on aquis locis commentarii Hippocrates’ Airs, (not surviving in Waters, Places Greek) Περὶ τοῦ Ἱπποκράτους περὶ τόπων, ἀέρων, ὑδάτων

[Hipp. Alim.]

In Hippocratis De alimento (XV.224– 417 K.) Εἰς τὸ Ἱπποκράτους Περὶ τροφῆς

Hipp. Aph. In Hippocratis Aphorismos (XVIIB.345–887; XVIIIA.1–195 K.) Εἰς τοὺς Ἱπποοκράτους Ἀφορισμοὺς ὑπομνήματα Hipp. Art.

English title

421

Editions and translations Wasserstein (1982) [Edn Hebrew, E]; Strohmaier (2023) [Edn Arabic, G]

Commentary on Hippocrates’ Nutrition

Commentary on Hippocrates’ Aphorisms

Savino (2020) [Edn, I book VI]

In Hippocratis Commentary on Aballe (1972) [I] De articulis Hippocrates’ Joints (XVIIIA.300–767 K.) Εἰς τὸ Ἱπποκράτους Περὶ ἀρθρῶν

Hipp. Com. De comate secundum Hippocratem (VII.643–665 K.) Περὶ τοῦ παρ᾽ Ἱπποκράτει κώματος

Coma According to Mewaldt (1915) [Edn] Hippocrates

Hipp. Elem. De elementis ex Hippocrate (I.413–508 K.) Περὶ τῶν καθ᾽ Ἱπποκράτην στοιχείων

The Elements According to Hippocrates

Helmreich (1878) [Edn]; DL = De Lacy (1996) [Edn, E]; Tassinari (1997) [I]

https://doi.org/10.1017/9781009159524.014 Published online by Cambridge University Press

422

List of Galenic works

Abb.

Latin & Greek titles

English title

Editions and translations

Hipp. Epid. I

In Hippocratis Commentary Epidemiarum librum I on Hippocrates’ (XVIIA.1–302 K.) Epidemics I Εἰς τὸ πρῶτον βιβλίον τῶν Ἐπιδημιῶν Ἱπποκράτους

WP = Wenkebach and Pfaff (1934) [Edn]; Vagelpohl (2014) [Edn Arabic, E]

Hipp. Epid. II

In Hippocratis Epidemiarum librum II (XVIIA.303–479 K.) (inauthentic Greek text) Εἰς τὸ δεύτερον βιβλίον τῶν Ἐπιδημιῶν Ἱπποκράτους

Commentary on Hippocrates’ Epidemics II

WP = Wenkebach and Pfaff (1934) [G from Arabic]; Vagelpohl (2016) [Edn Arabic, E]

Hipp. Epid. III

In Hippocratis Epidemiarum librum III (XVIIA.480–792 K.) Εἰς τὸ τρίτον βιβλίον τῶν Ἐπιδημιῶν Ἱπποκράτους

Commentary on Hippocrates’ Epidemics III

Wenkebach (1936) [Edn]

Hipp. Epid. VI

In Hippocratis Commentary Epidemiarum librum on Hippocrates’ VI (XVIIA.793–1009 Epidemics VI K.; XVIIB.1–344 K.) Εἰς τὸ ἕκτον βιβλίον τῶν Ἐπιδημιῶν Ἱπποκράτους

WP = Wenkebach and Pfaff (1956) [Edn books I–VI with G from Arabic of books VI–VIII]; Vagelpohl (2022) [Edn Arabic, E]

Hipp. Fract.

In Hippocratis Commentary De fracturis on Hippocrates’ (XVIIIB.318–628 K.) Fractures Εἰς τὸ Ἱπποκράτους περὶ ἀγμῶν ὑπομνήματα

Andreoni (1972) [I]

[Hipp. Hum.]

In Hippocratis De humoribus (XVI.1– 488 K.) Εἰς τὸ περὶ χυμῶν Ἱπποκράτους ὑπομνήματα

Commentary on Hippocrates’ Humours

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List of Galenic works English title

423

Abb.

Latin & Greek titles

Editions and translations

Hipp. Off. Med.

In Hippocratis De Commentary on Lyons (1963) [Edn Arabic, E] officina medici Hippocrates’ In the (XVIIIB.629–925 K.) Surgery Εἰς τὸ Ἱπποκράτους κατ᾽ ἰητρεῖον ὑπομνήματα

Hipp. Prog.

In Hippocratis Prognosticum (XVIIIB.1–317 K.) Εἰς τὸ Προγνωστικὸν Ἱπποκράτους ὑπομνήματα

Commentary on Hippocrates’ Prognostic

Heeg (1915) [Edn]; Rubio Fernaz (2010) [S]

Hipp. Prorrh.

In Hippocratis De praedictionibus (XVI. 489–840 K.) Εἰς τὸ Προρρητικὸν Ἱπποκράτους ὑπόμνημα

Commentary on Hippocrates’ Prorrhetic

Diels (1915) [Edn]

[Hipp. Sept.]

In Hippocratis De septimanis (not surviving in Greek) Εἰς τὸ Ἱπποκράτους περὶ ἑβδομάδων ὑπομνήματα

Commentary on Bergsträsser (1914) [Edn Hippocrates’ Seven Arabic, G] Months’ Children

Hipp. Vict. In Hippocratis De salubri victu ratione (XV.174–223 K.) Εἰς τὸ περὶ διαίτης ὑγιεινῆς τῶν ἰδιωτῶν Ἱπποκράτους ἢ Πολύβου ὑπόμνημα

Commentary on Hippocrates’ Regimen for Health [= Commentary on Hippocrates’ The Nature of the Human Being, Book III]

Mewaldt (1914) [Edn]

[Hipp. Vict. De victus ratione Morb. Ac.] in morbis acutis ex Hippocratis sententia (XIX.182–221 K.) Περὶ τῆς κατὰ τὸν Ἱπποκράτην διαίτης ἐπὶ τῶν ὀξέων νοσημάτων

Regimen in Acute Westenberger (1914) [Edn]; Diseases According see also Di. Hipp. Morb. Ac. to Hippocrates

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424 Abb.

List of Galenic works Latin & Greek titles

English title

Editions and translations

[Hist. Phil.] De historia philosophica (XIX.222–345 K.) Περὶ φιλοσόφου ἱστορίας

History of Philosophy

Diels (1870) [G]; Diels (1879) [Edn]

HNH

In Hippocratis De natura hominis (XV.1–223 K.) Εἰς τὸ Ἱπποκράτους περὶ ἀνθρώπου φύσιος

Commentary on Hippocrates’ The Nature of the Human Being

M. = Mewaldt (1914) [Edn]

HRCIS

De hirundinibus, revulsione, cucurbitula, incisione et scarificatione (XI.317–322 K.) Περὶ βδελλῶν, ἀντισπάσεως, σικύας καὶ ἐγχαράξεως καὶ κατασχασμοῦ

Leeches, etc.

[Hum.]

De humoribus (XIX.485–496 K.) Περὶ χυμῶν

Humours

Schmidt (1964) [Edn]; Marra (1966) [Edn, I]; Grant (2000) [E]

HVA

In Hippocratis de acutorum morborum victu (XV.418–919 K.) Εἰς τὸ Περὶ διαίτης ὀξέων Ἰπποκράτους ὑπομνήματα

Commentary on Hippocrates’ Regimen in Acute Diseases

H. = Helmreich (1914) [Edn]

Inaeq. Int.

De inaequali intemperie (VII.733– 752 K.) Περὶ ἀνωμάλου δυσκρασίας

The Uneven Bad-Mixture

Grant (2000) [E]; García Novo (2010) [Edn, E]; Johnston (2020) [Edn, E, Loeb]

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List of Galenic works

425

Abb.

Latin & Greek titles

English title

Editions and translations

Ind.

De indolentia (not in Kühn) Περὶ ἀλυπίας

Avoiding Distress

Boudon-Millot (2007) [Edn, F]; BJP = Boudon-Millot, Jouanna and Pietrobelli (2010) [Edn, F]; Kotzia and Sotiroudis (2010) [Edn]; Garofalo and Lami (2012) [Edn, I]; Nutton (2013) [E]; Vegetti (2013) [Edn, I]; Rothschild and Thompson (2014) [E]; Brodersen (2015) [G]

Inst. Log.

Institutio logica (not in Introduction to Kühn) Logic Εἰσαγωγὴ διαλεκτική

Mynas (1844) [Edn]; Kalbfleisch (1896) [Edn]; Mau (1960) [Edn, G]; Kieffer (1964) [E]; Garofalo and Vegetti (1978) [I]; Dalimier (1998) [F]; Ingravalle (2014) [I]

Inst. Od.

De instrumento odoratus (II.857–886 K.) Περὶ ὀσφρήσεως ὀργάνου

Wright (1924) [E]; Kollesch (1964) [Edn, G]

[Int.]

Introductio seu medicus Introduction (XIV.674–797 K.) Εἰσαγωγὴ ἢ ἰατρός

Petit (2009) [Edn, F]

Lib. Prop.

De libris propriis (XIX.8–48 K.) Περὶ τῶν ἰδίων βιβλίων

Müller (1891) [Edn]; Garofalo and Vegetti (1978) [I]; Singer (1997a) [E]; Martínez Manzano (2002) [S]; BM = BoudonMillot (2007) [Edn, F]; Vegetti (2013) [Edn, I]

Loc. Aff.

De locis affectis Affected Places (VIII.1–452 K.) Περὶ τῶν πεπονθότων τόπων

The Organ of Smell

My Own Books

Daremberg (1854–1856) [F]; Siegel (1976) [E]; Durling and Kudlien (1992) [Edn Latin]; Andrés Aparicio (1997) [S]; Gärtner (2015) [Edn, books I–II, G]; Brunschön (2021) [Edn, books V–VI, G]

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426

List of Galenic works

Abb.

Latin & Greek titles

English title

Editions and translations

Marc.

De marcore (VII.666– Withering 704 K.) Περὶ μαρασμοῦ

Theoharides (1971) [E]

Med. Exp.

De experientia medica Medical (not in Kühn, only Experience fragments surviving in Greek) Περὶ τῆς ἰατρικῆς ἐμπειρίας

Walzer (1944) [Edn Arabic, E]; Walzer and Frede (1985) [E from Greek and Arabic]; Dalimier (1998) [F]

Med. Nom. De nominibus medicis (not surviving in Greek) Περὶ τῶν ἰατρικῶν ὀνομάτων

Medical Names

[Mel.]

De melancholia (XIX.699–720 K.) Περὶ μελαγχολίας ἐκ τῶν Γαληνοῦ καὶ Ῥουφοῦ κτλ.

Melancholy According to Galen, Rufus, etc.

MM

Methodus medendi The Therapeutic (X.1–1021 K.) Method Μέθοδος θεραπευτική

Hankinson (1991) [E, books I–II]; Johnston and Horsley (2011) [Edn, E, Loeb]; Cerezo Magán (2013) [S]

MMG

Ad Glauconem de methodo medendi (XI.1–146 K.) Θεραπευτικὰ πρὸς Γλαύκωνα

The Therapeutic Method, to Glaucon

Daremberg (1854–1856) [F]; Dickson (1998) [E]; Cerezo Magán (2013) [S]; Johnston (2016) [Edn, E, Loeb]

Mor.

De moribus (not surviving in Greek) Περὶ ἠθῶν

Character Traits

Kraus (1939) [Edn Arabic]; Mattock (1972) [E from Arabic]; Badawi (1981) [Edn Arabic]; Davies and Singer (2013) [E]

Morb. Diff. De morborum differentiis (VI.836– 880 K.) Περὶ διαφορᾶς νοσημάτων

Meyerhof and Schacht (1931) [Edn Arabic, G]

The Distinct Types Johnston (2006) [E] of Disease

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List of Galenic works

427

Abb.

Latin & Greek titles

English title

Editions and translations

Morb. Temp.

De morborum temporibus (VII.406– 439 K.) Περὶ τῶν ἐν τοῖς νόσοις καιρῶν

The Opportune Moments in Diseases

Wille (1960) [Edn]

Mot. Dub.

De motibus dubiis (not On Problematical Nutton and Bos (2012) [Edn, surviving in Greek) Movements Latin and Arabic]

Mot. Musc. De motu musculorum (IV.367–464 K.) Περὶ μυῶν κινήσεως

The Motion of Muscles

Daremberg (1854–1856) [F]; Goss (1968) [E]; Rosa (2009) [Edn, I]

Musc. Diss. De musculorum dissectione (XVIIIB.926–1026 K.) Περὶ μυῶν ἀνατομῆς

The Anatomy of Muscles [for Beginners]

Goss (1963) [E]; Debru and Garofalo (2005) [Edn, F]

Nat. Fac.

Natural Capacities Daremberg (1854–1856) [F]; H. = Helmreich (1893) [Edn]; Brock (1916) [Edn, E, Loeb]; Beintker and Kahlenberg (1939–1954) [G]; Garofalo and Vegetti (1978) [I]; Mortarino (1996) [I]; Zaragoza Gras (2003) [S]

De naturalibus facultatibus (II.1–214 K.) Περὶ φυσικῶν δυνάμεων

Nerv. Diss. De nervorum The Anatomy of dissectione (II.831– the Nerves 856 K.) Περὶ νεύρων ἀνατομῆς

Goss (1966) [E]; Debru and Garofalo (2008) [Edn, F]

Opt. Corp. De optima corporis Const. nostri constitutione (IV.737–749) Περὶ ἀρίστης κατασκευῆς τοῦ σώματος ἡμῶν

The Best Constitution of Our Bodies

Helmreich (1901) [Edn]; Penella and Hall (1973) [E]; Bertini Malgarini (1992) [I]; Singer (1997a) [E]; Johnston (2020) [Edn, E, Loeb]; Barras and Birchler (2022) [Edn, F]

Opt. Doct.

The Best Method of Teaching

Marquardt (1884) [Edn]; Barigazzi (1991) [Edn, I]

De optima doctrina (I.40–52 K.) Περὶ ἀρίστης διδασκαλίας

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English title

Opt. Med.

Quod optimus medicus The Best Doctor Is sit quoque philosophus also a Philosopher (I.53–63 K.) Ὅτι ὁ ἄριστος ἰατρὸς καὶ φιλόσοφος

Daremberg (1854–1856) [F]; Müller (1891) [Edn]; Wenkebach (1932/1933) [Edn]; Bachmann (1966) [Edn Arabic, G]; Brain (1977) [E]; Garofalo and Vegetti (1978) [I]; Singer (1997a) [E]; Martínez Manzano (2002) [S]; BM = Boudon-Millot (2007) [Edn, F]

Opt. Med. Cogn.

De optimo medico cognoscendo (not surviving in Greek)

Iskandar (1988) [Edn Arabic, E]

Recognizing the Best Physician

Editions and translations

[Opt. Sect.] De optima secta The Best Sect (I.106–223 K.) Περὶ ἀρίστης αἱρέσεως

Daremberg (1854–1856) [F]

Ord. Lib. Prop.

De ordine librorum propriorum (XIX.49– 61 K.) Περὶ τῆς τάξεως τῶν ἰδίων βιβλίων πρὸς Εὐγενιανόν

The Order of My Own Books

Müller (1891) [Edn]; Singer (1997a) [E]; Martínez Manzano (2002) [S]; BM = BoudonMillot (2007) [Edn, F]; Vegetti (2013) [Edn, I]

Oss.

De ossibus ad tirones (II.732–778 K.) Περὶ ὀστῶν τοῖς εἰσαγομένοις

Bones for Beginners

Singer (1952) [E]; Moore (1969) [Edn, E]; Goss and Goss Chodkowski (1984) [E]; Debru and Garofalo (2005) [Edn, F]

Part. Art. Med.

De partibus artis The Parts of the medicativae (not Art of Medicine surviving in Greek) Περὶ τῶν τῆς ἰατρικῆς μερῶν

Schöne (1911, repr. 1969) [Edn Latin]; Lyons (1969) [Edn Arabic, E]

Part. Hom. De partium The Distinct Types Strohmaier (1970) [Edn Diff. homoeomerium of Uniform Part Arabic, G] differentia (not surviving in Greek) Περὶ τῆς τῶν ὁμοιομερῶν σωμάτων διαφορᾶς

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List of Galenic works

429

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Editions and translations

Parv. Pil.

De parvae pilae exercitio (V.899–910 K.) Περὶ τοῦ διὰ μικρᾶς σφαίρας γυμνασίου

The Exercise with the Small Ball

Marquardt (1884) [Edn]; Schaefer (1908) [Edn]; Schütze (1936) [G]; Wenkebach (1938) [Edn, G]; Singer (1997a) [E]; Johnston (2018) [Edn, E, Loeb]

PHP

De placitis Hippocratis The Doctrines of et Platonis (V.181– Hippocrates and 805 K.) Plato Περὶ τῶν Ἱπποκράτους καὶ Πλάτωνος δογμάτων

Müller (1874) [Edn]; DL = De Lacy (1978–1984) [Edn, E]; García Valdés, González Suárez and Vedejo Manchado (2020) [S]

Plat. Tim.

In Platonis Timaeum (not in Kühn, only fragments surviving) Περὶ τῶν ἐν τῷ Πλάτωνος Τιμαίῳ ἰατρικῶς εἰρημένων

Commentary on Plato’s Timaeus

Daremberg (1848) [Edn, F]; Schröder (1934) [Edn Greek and Arabic fragments]; Larrain (1992) [Edn]

Plat. Tim. Comp.

Timaei Platonis Compendium (not in Kühn, surviving in Arabic)

Compendium of Plato’s Timaeus

Kraus and Walzer (1951) [Edn Arabic with Latin translation]

Plen.

De plenitudine (VII.513–583 K.) Περὶ πλήθους

Fulness

Otte (2001) [Edn, G]

[Pond. Mens.]

De ponderibus et mensuris (XIX.748– 781 K.) Περὶ μέτρων καὶ σταθμῶν διδασκαλία

Weights and Measures

Hultsch (1864) [Edn]

Praen.

De praecognitione (XIV.599–673 K.) Περὶ τοῦ προγινώσκειν

Prognosis

N. = Nutton (1979) [Edn, E]

Praes.

De praenotione Prediction (XIX.497–511 K.: the text is an extract from CAM) Περὶ προγνώσεως

Fortuna (1988) [Edn]

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430 Abb.

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Editions and translations

Praes. Puls. De praesagitione ex Prognosis by the pulsibus (IX.205–430 Pulse K.) Περὶ προγνώσεως διὰ σφυγμῶν [Praes. Ver. De praesagitione vera Exp.] et experta (XIX.512– 518 K.) Πρόγνωσις πεπειραμένη καὶ παναληθής

True and Expert Prognosis

[Prog. Dec.] Prognostica de decubitu ex mathematica scientia (XIX.529–573 K.) Περὶ κατακλίσεως προγωστικὰ ἐκ τῆς μαθηματικῆς ἐπιστήμης

Prognosis Based on the Hour When a Patient Goes to Bed Based on the Science of Astrology

Prolaps.

De humero iis Dislocations modis prolapso quos not Seen by Hippocrates non vidit Hippocrates (XVIIIA.346–422 K.: part of Hipp. Art.) Περὶ τῶν οὐχ ἑωραμένων Ἱπποκράτει ἐκπτώσεων

Prop. Plac. De propriis placitis My Own (full text not in Kühn) Doctrines Περὶ τῶν ἑαυτῷ δοκούντων

Nutton (1999) [Edn Latin, E]; BMP = Boudon-Millot and Pietrobelli (2005) [Edn, F]; Garofalo and Lami (2012) [Edn, I]; Vegetti (2013) [Edn, I]

Protr.

Daremberg (1854–1856) [F]; Marquardt (1884) [Edn]; Walsh (1930) [E]; Galli Calderini (1986) [Edn, I]; Barigazzi (1991) [Edn, I]; Singer (1997a) [E]; B. = Boudon (2000) [Edn, F]; Martínez Manzano (2002) [S]

Protrepticus (I.1–39 K.) Προτρεπτικὸς λόγος ἐπὶ τὰς τέχνας

Exhortation to Study the Arts

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List of Galenic works

431

Abb.

Latin & Greek titles

English title

Editions and translations

Ptis.

De ptisana (VI.816– 831 K.) Περὶ πτισάνης

Barley Gruel

Hartlich (1923) [Edn]; Grant (2000) [E]

Puer. Epil.

Puero epileptico consilium (XI.357– 378 K.) Ἐπιλήπτῳ παιδὶ ὑποθήκη

Advice to an Epileptic Boy

Temkin (1934) [E]; Keil (1959) [Edn]

Puls.

De pulsibus ad tirones (VIII.453–492 K.) Περὶ τῶν σφυγμῶν τοῖς εἰσαγομένοις

The Pulse for Beginners

Tovar and Ruiz Moreno (1948) [S]; Trifogli (1958) [I]; Singer (1997a) [E]; Pino Campos (2015) [S]

[Puls. Ant.] De pulsibus ad Antonium (XIX.629– 642 K.) Περὶ σφυγμῶν πρὸς Ἀντώνιον φιλομαθῆ καὶ φιλόσοφον

The Pulse, to Antonius

Lutz (1940) [G]

Purg. Med. De purgantium The Capacity of Fac. medicamentorum Cleansing Drugs facultate (XI.323–342 K.) Περὶ τῆς τῶν καθαιρόντων φαρμάκων δυνάμεως

Ehlert (1960) [Edn]

QAM

Daremberg (1854–1856) [F]; M. = Müller (1891) [Edn]; Hauke (1937) [G]; García Ballester (1972) [S]; Biesterfeldt (1973) [Edn Arabic, G]; Garofalo and Vegetti (1978) [I]; Menghi and Vegetti (1984) [I]; Barras, Birchler and Morand (1995) [F]; Singer (1997a) [E]; Bazou (1999) [Edn]; Zaragoza Gras (2003) [S]; Godderis (2008) [D]; Bazou (2011) [Edn]; Singer (2013) [E]; Johnston (2020) [Edn, E, Loeb]

Quod animi mores corporis temperamenta sequantur (IV.767– 822 K.) Ὅτι ταῖς τοῦ σώματος κράσεσιν αἱ τῆς ψυχῆς δυνάμεις ἕπονται

The Capacities of the Soul Depend on the Mixtures of the Body

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432

List of Galenic works

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Latin & Greek titles

English title

Editions and translations

[Qual. Incorp.]

Quod qualitates incorporeae sint (XIX.463–484 K.) Ὅτι αἱ ποιότητες ἀσώματοι

The Incorporeality Westenberger (1906) [Edn]; of Bodies Giusta (1976) [Edn, I]

[Rem. Parab.]

De remediis Readily Procured parabilibus (XIV.311– Remedies 581 K.) Περὶ εὐπορίστων

[Ren. Aff.]

De renum affectibus (XIX.643–698 K.) Περὶ τῆς τῶν ἐν νεφροῖς παθῶν διαγνώσεως καὶ θεραπείας

Affections of the Kidneys

San. Tu.

De sanitate tuenda (VI.1–452 K.) Τὰ ὑγιεινά

Health

Ko. = Koch (1923) [Edn]; Beintker and Kahlenberg (1939–1954) [G]; Green (1951) [E]; Grimaudo (2012) [Edn, book I, I]; Cerezo Magán (2015) [S]; Johnston (2018) [Edn, E, Loeb]

Sem.

De semine (IV.512– 651 K.) Περὶ σπέρματος

Semen

DL = De Lacy (1992) [Edn, E]

Sept. Part.

De septimestri partu (not surviving in Greek) Περὶ ἑπταμηνῶν βρεφῶν

The Seven-Month Walzer (1935) [Edn Arabic, G] Pregnancy

SI

De sectis ad eos qui introducuntur (I.64–105 K.) Περὶ αἱρέσεων τοῖς εἰσαγομένοις

Sects for Beginners Daremberg (1854–1856) [F]; H. = Helmreich (1893) [Edn]; Garofalo and Vegetti (1978) [I]; Walzer and Frede (1985) [E]; Dalimier (1998) [F]; Martínez Manzano (2002) [S]

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433

English title

Editions and translations

Sim. Morb. Quomodo simulantes morbum deprehendendi (XIX.1–7 K.) Πῶς δεῖ ἐξελέγχειν τοὺς προσποιουμένους νοσεῖν

How to Detect Malingerers

Lafont and Ruiz Moreno (1947) [S]; Deichgräber and Kudlien (1960) [Edn]

SMT

De simplicium medicamentorum [temperamentis ac] facultatibus (XI.379– 892; XII.1–377 K.) Περὶ τῆς τῶν ἁπλῶν φαρμάκων δυνάμεως

The Capacities [and Mixtures] of Simple Drugs (= ‘Simple Drugs’)

Soph.

De sophismatibus penes dictionem (XIV. 582–598 K.) Περὶ τῶν παρὰ τὴν λέξιν σοφισμάτων

Linguistic Sophisms

Sub. Nat. Fac.

De substantia The Substance facultatum naturalium of the Natural (IV.757–766) (the Capacities text in Kühn is a fragment of Prop. Plac.) Περὶ οὐσίας τῶν φυσικῶν δυνάμεων

Subf. Emp. Subfiguratio empirica (not surviving in Greek) Ὑποτύπωσις ἐμπειρική

Outline of Empiricism

[Suc.]

Pharmacological Substitutions

De succedaneis (XIX.721–747 K.) Περὶ ἀντεμβαλλομένων βιβλίον

Gabler (1902) [Edn]; Edlow (1977) [E]; Ebbesen (1981) [E]; Dalimier (1998) [F]; Schiaparelli (2002) [Edn, I] [see Prop. Plac.]

Deichgräber (1965) [E Latin]; Walzer and Frede (1985) [E from Latin]; Atzpodien (1986) [G]; Dalimier (1998) [F]

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Editions and translations

Symp. Diff. De symptomatum Distinct Types of differentiis (VII.42–84 Symptom K.) Περὶ τῆς τῶν συμπτωμάτων διαφορᾶς

Johnston (2006) [E]; Gundert (2009) [Edn, G]

Syn. Puls.

Synopsis de pulsibus (IX.431–549 K.) Σύνοψις περὶ σφυγμῶν

Synopsis on the Pulse

Scarano (1990) [I]; Pino Campos (2005) [S]

Temp.

De temperamentis (I.509–694 K.) Περὶ κράσεων

Mixtures

H. = Helmreich (1904) [Edn]; Durling (1976) [Edn Latin]; Singer (1997a) [E]; Tassinari (1997) [I]; Singer and van der Eijk (2018) [E]; Johnston (2020) [Edn, E, Loeb]; Barras and Birchler (2022) [Edn, F]

[Ther. Pamph.]

De theriaca ad Pamphilianum (XIV.295–310 K.) Περὶ θηριακῆς πρὸς Παμφιλιανόν

Theriac, to Pamphilianus

Boudon-Millot (2021) [Edn, F]

Theriac, to Piso

Coturri (1959) [I from Latin]; Richter-Bernburg (1969) [G from Arabic]; Leigh (2015) [Edn, E]; Boudon-Millot (2016) [Edn, F]

[Ther. Pis.] De theriaca ad Pisonem (XIV.210– 294 K.) Περὶ θηριακῆς πρὸς Πίσωνα Thras.

Thrasybulus, sive Thrasybulus Utrum medicinae sit an gymnasticae hygiene (V.806–898 K.) Θρασύβουλος, πότερον ἰατρικῆς ἢ γυμναστικῆς ἐστι τὸ ὑγιεινόν

Tot. Morb. De totius morbi Temp. temporibus (VII.440– 462 K.) Περὶ τῶν ὅλου τοῦ νοσήματος καιρῶν

H. = Helmreich (1893) [Edn]; Singer (1997a) [E]; Johnston (2018) [Edn, E, Loeb]

The Opportune Moments in Diseases as a Whole

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English title

Trem. Palp. De tremore, Tremor, Spasm, palpitatione, Convulsion and convulsione et rigore Rigor (VII.584–642 K.) Περὶ τρόμου καὶ παλμοῦ καὶ σπασμοῦ καὶ ῥίγους

435

Editions and translations Sider and McVaugh (1979) [E]

Tum. Pr. Nat.

De tumoribus praeter naturam (VII.705– 732 K.) Περὶ τῶν παρὰ φύσιν ὄγκων

Typ.

De typis (VII.463–474 Disease Patterns K.) Περὶ τύπων

García Sola (2010) [S]

UP

De usu partium (III.1–939; IV.1–366 K.) Περὶ χρείας τῶν ἐν ἀνθρώπου σώματι μορίων

The Function of the Parts of the Human Body

Daremberg (1854–1856) [F]; H. = Helmreich (1907–1909) [Edn]; May (1968) [E]; SavageSmith (1969) [Edn Arabic, E of book XVI]; Garofalo and Vegetti (1978) [I]; Daremberg and Pichot (1994) [F]; Cerezo Magán (2009) [S]

[Ur.]

De urinis (XIX.574– 601 K.) Περὶ οὔρων

Urines

Thieme (1937) [G]

[Ur. Comp.]

De urinis compendium Summary on (XIX.602–608 K.) Urines Περὶ οὔρων ἐν συντόμῳ

[Ur. Comp. De urinis ex Gal.] Hippocrate, Galeno (XIX.609–628 K.) Περὶ οὔρων ἐκ τῶν Ἱπποκράτους καὶ Γαληνοῦ καὶ ἄλλων τινῶν

Unnatural Lumps Richter (1913) [G]; Reedy (1968) [Edn, E]; Lytton and Resuhr (1978) [E]

Urines According to Hippocrates, Galen

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436

List of Galenic works

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English title

Editions and translations

Us. Puls.

De usu pulsuum (V.149–180 K.) Περὶ χρείας σφυγμῶν

The Function of the Pulse

Furley and Wilkie (1984) [Edn, E]; Pino Campos (2015) [S]

Ut. Diss.

De uteri dissectione The Anatomy of (II.887–908 K.) the Uterus Περὶ μήτρας ἀνατομῆς

Goss (1962) [E]; Nickel (1971) [Edn, G]

Ut. Resp.

De utilitate The Function of respirationis (IV.470– Breathing 511 K.) Περὶ χρείας ἀναπνοῆς

Noll (1915) [Edn]; FW = Furley and Wilkie (1984) [Edn, E]

Ven.

De venereis (V.911– 914 K.: the text is a collection of Galen’s statements, excerpted in Oribasius) Περὶ ἀφροδισίων

Sexual Activity

Ven. Art. Diss.

De venarum arteriarumque dissectione (II.779– 830 K.) Περὶ φλεβῶν καὶ ἀρτηριῶν ἀνατομῆς

The Anatomy of Goss (1961) [E]; Debru and Veins and Arteries Garofalo (2008) [Edn, F]

[Ven. Sect.] De venae sectione (XIX.519–528 K.) Περὶ φλεβοτομίας

Venesection

Ven. Sect. Er.

De venae sectione adversus Erasistratum (XI.147–186 K.) Περὶ φλεβοτομίας πρὸς Ἐρασίστρατον

Venesection, Brain (1986) [E]; Durán Mañas against Erasistratus (2020) [S]

Ven. Sect. Er. Rom.

De venae sectione adversus Erasistrateos Romae degentes (XI.187–249 K.) Περὶ φλεβοτομίας πρὸς Ἐρασιστρατείους τοὺς ἐν Ῥώμῃ

Venesection, against the Erasistrateans at Rome

Kotrc (1970) [Edn, E]; Brain (1986) [E]; Durán Mañas (2020) [S]

Vict. Att.

De victu attenuante (not in Kühn) Περὶ λεπτυνούσης διάιτης

The Thinning Diet

Kalbfleisch (1923) [Edn]; Marinone (1973) [Edn Greek and Latin, I]; Grasso (1989) [I]; Singer (1997a) [E]

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Bibliography

Adamson, P., Hansberger, R. and Wilberding, J. (2014) (eds.) Philosophical Themes in Galen, Bulletin of the Institute of Classical Studies Supplement 114, London: Institute of Classical Studies. Ahonen, M. (2014) Mental Disorders in Ancient Philosophy, Cham: Springer.   (2018) ‘Making the distinction: the Stoic view of mental illness’, in Thumiger and Singer (eds.), 343–362. Amigues, S. (1984/2002) ‘Phytonymes grecs et morphologie végétale’, Journal des savants July–December 1984, 151–173, reprinted in ead. Études de botanique antique, Mémoires de l’Académie des Inscriptions et BellesLettres 25, Paris: de Boccard.   (1988–2006) (ed. and trans.) Théophraste: Recherches sur les plantes, 5 vols., Paris: Les Belles Lettres.  (2010) Théophraste: Recherches sur les plantes: À l’origine de la botanique, Paris: Belin.   (2012) (ed. and trans.) Théophraste: Les causes des phénomènes végétaux, Tome I, Livres I et II, Paris: Les Belles Lettres. André, J. (1985) Les noms des plantes dans la Rome antique, Paris: Les Belles Lettres. Bardong, K. (1942) ‘Beiträge zur Hippokrates- und Galenforschung’, Nachrichten von der Akademie der Wissenschaften in Göttingen, PhilologischHistorische Klasse 7, 577–640. Barnes, J. (1991) ‘Galen on logic and therapy’, in F. Kudlien and R. Durling (eds.) Galen’s Method of Healing, Studies in Ancient Medicine 1, 50–102, Leiden: Brill.   (1993) ‘Galen and the utility of logic’, in Kollesch and Nickel (eds.), 11–34.   (2003) ‘Proofs and syllogisms’, in Barnes, Jouanna and Barras (eds.), 1–24. Barnes, J., Jouanna, J. and Barras, V. (2003) (eds.) Galien et la philosophie, Entretiens sur l’antiquité classique de la Fondation Hardt 49, Vandoeuvres: Fondation Hardt. Baumgarten, H. (1963) ‘Galen über die Stimme: Testimonien der verlorenen Schrift Peri Phones, Ps.–Galen De voce et anhelitu’, Diss. Göttingen.

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438

Bibliography

Baykan, D. (2012) Allianoi Tıp Aletleri, Studia ad Orientem Antiquum 2, Istanbul: Institutum Turcicum Scientiae Antiquitatis, Türk Eskiçağ Bilimleri Enstitüsü Yayınları. Beck, L. (2005) (trans.) Pedanius Dioscorides of Anarzabus: De materia medica, Altertumswissenschaftliche Texte und Studien 38, Hildesheim: OlmsWeidmann. Beta, S. and Sassi, M. M. (2003) I colori nel mondo antico: esperienze linguistiche e quadri simbolici. Atti della giornata di studio, Siena, 28 marzo 2001, I quaderni del ramo d’oro 5, Florence: Edizioni Cadmo. Borg, A. (1999) (ed.) The Language of Color in the Mediterranean: An Anthology on Linguistic and Ethnographic Aspects of Color Terms, Stockholm: Almqvist & Wiksell International. Borg, B. (2004) (ed.) Paideia: The World of the Second Sophistic, Millennium Studies in the Culture and History of the First Millennium CE 2, Berlin: de Gruyter. Börno, M. and Coughlin, S. (2020) ‘Galen on bad style (κακοζηλία) in some Hippocratic works’, in V. Nutton and L. Totelin (eds.) Ancient Medicine, Behind and Beyond Hippocrates: Essays in Honour of Elizabeth Craik, special issue of Technai: An International Journal for Ancient Science and Technology 11, 145–175, Pisa and Rome: Fabrizio Serra Editore. Boudon, V. (1994) ‘Les définitions tripartites de la médecine chez Galien’, in ANRW II.37.2, 1468–1490.  (2000) Galien: Oeuvres, Tome II: Exhortation à l’étude de la médecine; Art medical. Texte établi, traduit et annoté, Paris: Les Belles Lettres. Boudon-Millot, V. (2007) Galien: Oeuvres, Tome I: Introduction générale; Sur l’ordre de ses propres livres; Sur ses propres livres; Que l’excellent médécin est aussi philosophe. Texte établi, traduit et annoté, Paris: Les Belles Lettres.   (2009) ‘Galen’s bios and methodos: from ways of life to path of knowledge’, in Gill, Whitmarsh and Wilkins (eds.), 175–189.  (2012) Galien de Pergame: un médecin grec à Rome, Paris: Les Belles Lettres.   (2015) ‘Mystère autour d’une petite balle: à quel jeu jouaient Galien et MarcAurèle?’, Galenos 9, 37–56. Bouras-Vallianatos, P. (2019) ‘Galen in Byzantine medical literature’, in P. Bouras-Vallianatos and B. Zipser (eds.) Brill’s Companion to the Reception of Galen, 86–110, Brill’s Companions to Classical Reception 17, Leiden: Brill. Bowersock, G. W. (1969) Greek Sophists in the Roman Empire, Oxford: The Clarendon Press. Bowie, E. (1974) ‘Greeks and their past in the Second Sophistic’, in M. I. Finley (ed.) Studies in Ancient Society, 166–209, London: Routledge and Kegan Paul. Bowie, E. and Elsner, J. (2009) (eds.) Philostratus: Greek Culture in the Roman World, Cambridge: Cambridge University Press. Brunschwig, J. and Nussbaum, M. C. (1993) (eds.) Passions and Perceptions: Studies in Hellenistic Philosophy of Mind, Proceedings of the Fifth Symposium Hellenisticum, Cambridge: Cambridge University Press. Carastro, M. (2009) (ed.) L’antiquité en couleurs: catégories, pratiques, représentations, Grenoble: Éditions Jérome Millon.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

Bibliography 439 Cavallo, G. (1980) ‘La trasmissione scritta della cultura greca antica in Calabria e in Sicilia tra i secoli X–XV: consistenza, tipologia, fruizione’, Scrittura e Civiltà 4, 157–245. Cleland, L. and Stears, K., with Davies, G. (eds.) (2004) Colour in the Ancient Mediterranean World, Oxford: John and Erica Hedges. Coughlin, S. (2018) ‘Athenaeus of Attalia on the psychological causes of bodily health’, in Thumiger and Singer (eds.), 109–142. Coughlin, S. (forthcoming) ‘Galen’s Hippocratism’, in Singer and Rosen (eds.). Coughlin, S., Leith, D. and Lewis, O. (2020) (eds.) The Concept of Pneuma after Aristotle, Berlin: Edition Topoi. Craik, E. M. (1995) ‘Diet, diaita and dietetics’, in A. Powell (ed.) The Greek World, 387–402, London: Routledge.  (2015) The ‘Hippocratic Corpus’: Content and Context, London: Routledge. Dalby, M. (2000) Empires of Pleasure: Luxury and Indulgence in the Ancient World, London: Routledge.  (2003) Food in the Ancient World from A to Z, London: Routledge. De Miro, E., Sfameni Gasparro, G. and Calì, V. (2009) (eds.) Il culto di Asclepio in area mediterranea. Atti del convegno internazionale, Agrigento, 20–22 novembre 2005, Rome: Gangemi. De Romanis, F. (1996) Cassia, cinnamomo, ossidiana: uomini e merci tra oceano indiano e mediterraneo, Rome: L’Erma di Bretschneider. De Romanis, F. and Maiuro, M. (2015) (eds.) Across the Ocean: Nine Essays on Indo-Mediterranean Trade, Leiden: Brill. De Romanis, F. and Tchernia, A. (1997) (eds.) Crossings: Early Mediterranean Contacts with India, Delhi: Manohar. Dean-Jones, L. and Rosen, R. M. (2015) (eds.) Ancient Concepts of the Hippocratic: Papers Presented at the XIIIth International Hippocrates Colloquium, Leiden: Brill. Debru, A. (1995) ‘Les démonstrations médicales à Rome au temps du Galien’, in van der Eijk, Horstmanshoff and Schrijvers (eds.), vol. I, 69–81.  (1996) Le corps respirant: la pensée physiologique chez Galien, Leiden: Brill.   (1997a) (ed.) Galen on Pharmacology: Philosophy, History and Medicine. Proceedings of the Vth International Galen Colloqium, Lille, 16–18 March 1995, Studies in Ancient Medicine 16, Leiden, Brill.   (1997b) ‘Philosophie et pharmacologie: la dynamique des substances leptomères chez Galien’, in Debru (ed.), 85–102.   (2008) ‘Physiology’, in Hankinson (ed.), 263–282. Dench, E. (2017) ‘Ethnicity, culture, and identity’, in Richter and Johnson (eds.), 99–114. Detienne, M. (1994) The Gardens of Adonis: Spices in Greek Mythology, trans. J. Lloyd, 2nd edn, Princeton, NJ: Princeton University Press. Devinant, J. (2018) ‘Mental disorders and psychological suffering in Galen’s cases’, in Thumiger and Singer (eds.), 198–221.  (2020) Les troubles psychiques selon Galien. Étude d’ un système de pensée, Études Anciennes 159, Paris: Les Belles Lettres.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

440

Bibliography

Dieppe, P., Gill, C. and Marsden, D. (2014) ‘Galen and wellbeing: whole person care’, International Journal of Whole Person Care 1(2), 76–78. Donini, P. L. (2008) ‘Psychology’, in Hankinson (ed.), 184–209. Edelstein, E. J. and Edelstein, L. (1945/1998) Asclepius: Collection and Interpretation of the Testimonies, with a new introduction by G. B. Ferngren, Baltimore: The Johns Hopkins University Press. Eshleman, K. (2012) The Social World of Intellectuals in the Roman Empire: Sophists, Philosophers and Christians, Cambridge: Cambridge University Press. Fischer, N. (2010) ‘Gymnasia and the democratic values of leisure’, in König (ed.), 66–86. Flemming, R. (2000) Medicine and the Making of Roman Women: Gender, Nature and Authority from Celsus to Galen, Oxford: Oxford University Press.   (2007) ‘Galen’s imperial order of knowledge’, in König and Whitmarsh (eds.), 241–277. Follet, S. (2004) (ed.) L’hellénisme d’époque romaine: nouveaux documents, nouvelles approches (1e s. a. C – IIIe s. p. C.), Paris: de Boccard. Fortenbaugh, W. W., Sharples, R. W. and Sollenberger, M. G. (2003) Theophrastus of Eresus: On Sweat, On Dizziness and On Fatigue, Philosophia Antiqua 93, Leiden: Brill. Fortuna, S. (2012) ‘The Latin editions of Galen’s Opera Omnia and their prefaces’, Early Science and Medicine 17, 391–412. Frede, M. (1985) ‘Introduction’, in Walzer and Frede. Furley, D. J. and Wilkie, J. S. (1984) Galen on Respiration and the Arteries: An Edition with English Translation and Commentary of De usu respirationis, An in arteriis natura sanguis contineatur, De usu pulsuum, and De causis respirationis, Princeton, NJ: Princeton University Press. Gadaldini, A. (1565) Galeni librorum secunda classis, materiam sanitatis conservatricem tradit, etc., 4th edn, Venice: Giunti. García Ballester, L. (1993) ‘On the origin of the “six non-natural things”’, in Kollesch and Nickel (eds.), 105–115. Garofalo, I. (1988) Erasistrati fragmenta, collegit et digessit, Biblioteca di studi antichi 62, Pisa: Giardini Editori e Stampatori. Garofalo, I. and Vegetti, M. (1978) Opere scelte di Galeno, Turin: UTET. Gauthier, P. (1995/2010) ‘Notes sur le rôle du gymnase’, in M. Wörrle and P. Zanker (eds.) Stadtbild und Bürgerbild im Hellenismus, 1–11, Munich: Beck Verlagsbuchhandlung, trans. M. Lianou as ‘Notes on the role of the gymnasion in the Hellenistic city’, in König (ed.), 87–101. Gill, C. (2010) Naturalistic Psychology in Galen and Stoicism, Oxford: Oxford University Press.   (2018) ‘Philosophical psychological therapy: did it have any impact on medical practice?’, in Thumiger and Singer (eds.), 365–380. Gill, C., Whitmarsh, T. and Wilkins, J. (2009) (eds.) Galen and the World of Knowledge, Cambridge: Cambridge University Press. Gleason, M. (1995) Making Men: Sophists and Self-Presentation in Ancient Rome, Princeton, NJ: Princeton University Press.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

Bibliography 441   (2009) ‘Shock and awe: the performance dimension of Galen’s anatomy demonstrations’, in Gill, Whitmarsh and Wilkins (eds.), 85–114. Golden, M. (1998) Sport and Society in Ancient Greece, Cambridge: Cambridge University Press.  (2008) Greek Sport and Social Status, Austin: University of Texas Press. Goldhill, S. (2001) (ed.) Being Greek under Rome: Cultural Identity, the Second Sophistic and the Development of Empire, Cambridge: Cambridge University Press. Graf, F. (1992) ‘Heiligtum und Ritual: Das Beispiel der griechisch-römischen Asklepieia’, in A. Schachter and J. Bingen (eds.) Le Sanctuaire grec, 159–199, Entretiens sur l’antiquité classique de la Fondation Hardt 37, Vandoeuvres: Fondation Hardt. Graver, M. (2007) Stoicism and Emotion, Chicago: University of Chicago Press. Green, R. M. (1951) A Translation of Galen’s Hygiene, with an introduction by H. E. Sigerist, Springfield, IL: Charles C. Thomas. Grimaudo, S. (2008) Difendere la salute: igiene e disciplina del soggetto nel De sanitate tuenda di Galeno, Naples: Bibliopolis.  (2012) Galeno: La salute (De sanitate tuenda – libro I), Palermo: Duepunti edizioni.   (2021) ‘Ancient Medicine in the Galenic corpus: the story of a concealment’, in Pormann (ed.), 254–265. Grmek, M. and Gourevitch, D. (1994) ‘Aux sources de la doctrine médicale de Galien: l’enseignement de Marinus, Quintus et Numisianus’, ANRW II.37.2, 1491–1528. Haars, M. (2018) Die allgemeinen Wirkungspotenziale der einfachen Arzneimittel bei Galen. Oreibasios, Collectiones medicae XV. Einleitung, Übersetzung und pharmazeutischer Kommentar, Quellen und Studien zur Geschichte der Pharmazie 116, Munich: Beck. Habicht, C. (1969) Altertümer von Pergamon, Band VIII.3: Die Inschriften des Asklepieions, Berlin: de Gruyter. Hadot, I. (1969) Seneca und die griechisch-römische Tradition der Seelenleitung, Berlin: de Gruyter. Hadot, P. (1995) Philosophy as a Way of Life, trans. M. Chase, London: Blackwell. Hall, J. (1997) Ethnic Identity in Greek Antiquity, Cambridge: Cambridge University Press.  (2002) Hellenicity: Between Ethnicity and Culture, Chicago: University of Chicago Press. Hankinson, R. J. (1991) Galen on the Therapeutic Method, Books I and II, translation with introduction and commentary, Oxford: The Clarendon Press.   (1993) ‘Actions and passions: affection, emotion, and moral self-management in Galen’s philosophical psychology’, in Brunschwig and Nussbaum (eds.), 184–222.   (1994a) ‘Galen’s theory of causation’, ANRW II.37.2, 1757–1774.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

442

Bibliography

  (1994b) ‘Galen’s concept of scientific progress’, ANRW II.37.2, 1775– 1789.   (2008a) (ed.) The Cambridge Companion to Galen, Cambridge: Cambridge University Press.   (2008b) ‘The man and his work’, in Hankinson (ed.), 1–33.   (2008c) ‘Epistemology’, in Hankinson (ed.), 157–183.   (2008d) ‘Philosophy of nature’, in Hankinson (ed.), 210–241.   (2017) ‘Substance, element, quality, mixture: Galen’s physics and his Hippocratic inheritance’, Aitia 7.2; https://doi.org/10.4000/aitia.1863.  (forthcoming) Galen, Works on Human Nature, Volume 2: Commentary on Hippocrates’ The Nature of the Human Being, translated with introduction and notes by R. J. Hankinson, Cambridge: Cambridge University Press. Hankinson, R. J. and Havrda, M. (2022) (eds.) Experience, Reason, and Method: Studies in Galen’s Scientific Methodology, Cambridge: Cambridge University Press. Hardy, G. and Totelin, L. M. V. (2016) Ancient Botany, London: Routledge. Harig, G. (1974) Bestimmung der Intensität im medizinischen System Galens: Ein Beitrag zur theoretischen Pharmakologie, Nosologie und Therapie in der Galenischen Medizin, Berlin: Akademie Verlag. Harris, W. V. (ed.) (2016) Popular Medicine in Graeco-Roman Antiquity: Explorations, Columbia Studies in the Classical Tradition 42, Leiden: Brill. Havrda, M. (2017) ‘Body and cosmos in Galen’s account of the soul’, Phronesis 62, 69–89.   (2022) ‘From problems to demonstrations: two case studies of Galen’s method’, in Hankinson and Havrda (eds.), 116–135.   (forthcoming) ‘Logic and scientific method’, in Singer and Rosen (eds.) Helmreich, G. (1893) Galeni Pergameni Scripta Minora, vol. III: Περὶ αἱρέσεων τοῖς εἰσαγομένοις, Θρασύβουλος, Περὶ φυσικῶν δυνάμεων, Leipzig: Teubner. Hirt, M., Leith, D. and Henry, W. B. (2014) The Oxyrhyncus Papyri, volume LXXX, edited with translations and notes, Graeco-Roman Memoirs 101, London: The Egypt Exploration Society. Hoffman, A. (1998) ‘The Roman remodeling of the Asklepieion’, in H. Koester (ed.) Pergamon, Citadel of the Gods: Archaeological Record, Literary Description, and Religious Development, 41–61, Harrisburg, PA: Trinity Press International. Ilberg, J. (1889) ‘Über die Schriftstellerei des Klaudios Galenos, I’, Rheinisches Museum 44, 207–239.   (1892) ‘Über die Schriftstellerei des Klaudios Galenos, II’, Rheinisches Museum 47, 489–514.   (1896) ‘Über die Schriftstellerei des Klaudios Galenos, III’, Rheinisches Museum 51, 165–196.   (1897) ‘Über die Schriftstellerei des Klaudios Galenos, IV’, Rheinisches Museum 52, 591–623.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

Bibliography 443 Isaac, B. (2004) The Invention of Racism in Classical Antiquity, Princeton, NJ and Oxford: Princeton University Press. Janick, J., Paris, H. S. and Parrish, D. C. (2007) ‘The cucurbits of Mediterranean antiquity: identification of taxa from ancient images and descriptions’, Annals of Botany 100 (7), 1441–1457. Johnston, I. (2006) Galen on Diseases and Symptoms, translation with introduction and notes, Cambridge: Cambridge University Press.  (2018a) Galen, Hygiene, Books 1–4, ed. and trans., Loeb Classical Library 535, Cambridge, MA: Harvard University Press.  (2018b) Galen: Hygiene, Books 5–6; Thrasybulus; On Exercise with a Small Ball, ed. and trans., Loeb Classical Library 536, Cambridge, MA: Harvard University Press. Jones, C. P. (1998) ‘Aelius Aristides and the Asclepieion’, in H. Koester (ed.) Pergamon, Citadel of the Gods, 63–76, Harvard Theological Studies 46. Jouanna, J. (1975/2002) (ed. and trans.) Hippocratis De natura hominis, CMG I 1,3, Berlin: Akademie Verlag.  (1992/1999) Hippocrates, English trans. M. B. DeBevoise of Hippocrate (Paris: Fayard), Baltimore and London: The Johns Hopkins University Press.   (2008/2012) ‘Dietetics in Hippocratic medicine: definition, main problems, discussion’, in id. (2012) Greek Medicine from Hippocrates to Galen: Selected Papers, trans. N. Allies, edited with a preface by P. J. van der Eijk, Studies in Ancient Medicine 40, Leiden: Brill, 137–153; first published as ‘La régime dans la médecine hippocratique: définition, grands problèmes, prolongements’, in J. Leclant, A. Vauchez and M. Sartre (eds.) Pratiques et discours alimentaires en Méditerranée de l’Antiquité à la Renaissance, 53– 72, Paris: Publications de l’Académie des Inscriptions et Belles-Lettres. Jüthner, J. (1909) Philostratos über Gymnastik, Leipzig: Teubner. Kah, D. and Scholz, P. (2004) Das hellenistische Gymnasion, Wissenskultur und gesellschaftlicher Wandel 8, Berlin: Akademie Verlag. Kannicht, R. (2004) Tragicorum Graecorum Fragmenta, vol. V: Euripides, Göttingen: Vandenhoeck & Ruprecht. Kaufman, D. H. (2014) ‘Galen on the therapy of distress and the limits of emotional therapy’, Oxford Studies in Ancient Philosophy 47, 275–296. Keil, B. (1958) Aelii Aristidis Smyrnaei quae supersunt omnia, Berlin: Weidmann. Kennell, N. M. (2001) ‘Most necessary for the bodies of men: olive oil and its byproducts in the later Greek gymnasium’, in M. Joyal (ed.) Altum: SeventyFive Years of Classics in Newfoundland, 119–133, St John’s: Memorial University of Newfoundland.   (2009) ‘The Greek ephebate in the Roman period’, The International Journal of the History of Sport 26(2), 323–342. Keyser, P. and Scarborough, J. (2018) (eds.) The Oxford Handbook of Science and Medicine in the Classical World, Oxford: Oxford University Press. Koch, K. (1923) De sanitate tuenda libri VI, in Corpus Medicorum Graecorum V 4,2, Leipzig and Berlin: Teubner.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

444

Bibliography

Kollesch, J. (1988) ‘Anschauungen von den ἀρχαί in der Ars Medica und Galens Seelenlehre’, in Manuli and Vegetti (eds.), 215–242. Kollesch, J. and Nickel, D. (1993) (eds.) Galen und das hellenistische Erbe: Verhandlungen des IV. Internationalen Galen-Symposiums, Sudhoffs Archiv, Beiheft 32, Stuttgart: Franz Steiner Verlag. König, J. (2005) Athletics and Literature in the Roman Empire, Cambridge: Cambridge University Press.   (2009) ‘Training athletes and explaining the past in Philostratus’ Gymnasticus’, in Bowie and Elsner (eds.), 251–283.   (2010) (ed.) Greek Athletics, Edinburgh: Edinburgh University Press.   (2017) ‘Athletes and trainers’, in Richter and Johnson (eds.), 155–167. König, J. and Whitmarsh, T. (2007) (eds.) The Order of Knowledge in the Roman Empire, Cambridge: Cambridge University Press. König, J. and Woolf, G. (2017) (eds.) Authority and Expertise in Ancient Scientific Culture, Cambridge: Cambridge University Press. Korpela, J. (1995) ‘Aromatarii, pharmacopolae, thurarii et ceteri: zur Sozialgeschichte Roms’, in van der Eijk, Horstmanshoff and Schrijvers (eds.), 101–18. Kühn, C. G. (1821–1833) Claudii Galeni Opera omnia, edition with Latin translation, 22 vols, Leipzig: Knobloch, reprinted Hildesheim: Olms, 1964–1965. Kupreeva, I. (2014) ‘Galen’s theory of elements’, in Adamson, Hansberger and Wilberding (eds.), 153–196. Kyle, D. G. (2015) Sport and Spectacle in the Ancient World, second edition, Chichester: John Wiley and Sons. Leith, D. (2007) ‘A medical treatise On Remedies? P. Turner 14 revised’, Bulletin of the American Society of Papyrologists 44, 125–134.   (2008) ‘The diatritus and therapy in Graeco-Roman medicine’, Classical Quarterly n.s. 58(2), 581–600.   (2009) ‘The onkoi in Asclepiades’ theory of matter’, Oxford Studies in Ancient Philosophy 36, 283–320.   (2014) ‘Galen’s refutation of atomism’, in Adamson, Hansberger and Wilberding (eds.), 213–234. Lewis, O. (2017) Praxagoras of Cos on Arteries, Pulse and Pneuma, Studies in Ancient Medicine 48, Leiden: Brill.   (2022) ‘Galen against Archigenes on the pulse and what it teaches us about Galen’s method of diaeresis’, in Hankinson and Havrda (eds.), 190–217.   (forthcoming) ‘The mechanics of Galen’s theory of nutrition’, in G. Kazantzidis and M. Gerolemou (eds.) The Body as Machine in Antiquity, Cambridge: Cambridge University Press. Lewis, O., Thumiger, C. and van der Eijk, P. J. (2017) ‘Mental and physical gradualism in Graeco-Roman medicine’, in G. Keil, L. Keuck and R. Hauswald (eds.) Vagueness in Psychiatry, 27–45, Oxford: Oxford University Press.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

Bibliography 445 Littré, E. (1839–1861) Oeuvres complètes d’ Hippocrate, edition with French translation and notes, 10 vols, Paris: J. B. Baillière. Lloyd, G. E. R. (1988) ‘Scholarship, authority and argument in Galen’s Quod animi mores’, in Manuli and Vegetti (eds.), 11–42.   (1993) ‘Galen on Hellenistics and Hippocrateans: contemporary battles and past authorities’, in Kollesch and Nickel (eds.), 125–143. Manetti, D. and Roselli, A. (1994) ‘Galeno commentatore di Ippocrate’, ANRW II.37.2, 1529–1635. Manuli, P. (1984) ‘Lo stile del commento: Galeno e la tradizione ippocratica’, in G. Giannantoni and M. Vegetti (eds.) La scienza ellenistica: atti delle tre giornate di studio tenutesi a Pavia dal 14 al 16 april 1982, 375–394, Naples: Bibliopolis. Manuli, P. and Vegetti, M. (1988) (eds.) Le opere psicologiche di Galeno. Atti del terzo colloquio galenico internazionale, Pavia, 10–12 settembre 1986, Naples: Bibliopolis. Marganne, M.-H. (1996) ‘Un cinnamone fantomatique’, Topoi 6, 657–664. Marrou, H.-I. (1956/1982) A History of Education in Antiquity, trans. G. Lamb, Madison, WI: University of Wisconsin Press. Martelli, M., Raggetti, L. and Singer, P. N. (forthcoming) ‘Pharmacology: texts, theories, and practices’, in Singer and Rosen (eds.). Mattern, S. M. (2008) Galen and the Rhetoric of Healing, Baltimore: The Johns Hopkins University Press.  (2013) The Prince of Medicine: Galen in the Roman Empire, Oxford: Oxford University Press.   (2017) ‘Galen’, in Richter and Johnson (eds.), 371–388. Miller, J. I. (1969) The Spice Trade of the Roman Empire 29BC to AD 641, Oxford: The Clarendon Press. Mioni, E. (1981) Bibliothecae Divi Marci Venetiarum codices graeci manuscripti, vol. I, Rome: Istituto Poligrafico dello Stato. Mirrione, C. (2017) ‘Theory and terminology of mixture: the concepts of krasis and mixis in Galen’s thought’, Diss. Humboldt-Universität, Berlin. Mitchell, S. (1990) ‘Ethnicity, acculturation and empire in Roman and late Roman Asia Minor’, in Mitchell and Greatrex (eds.), 117–150.  (1995) Anatolia: Land, Men and Gods in Asia Minor, 2 vols., Oxford: The Clarendon Press. Mitchell, S. and Greatrex, G. (1990) (eds.) Ethnicity and Culture in Late Antiquity, London and Swansea: Duckworth and The Classical Press of Wales. Morgan, T. (1998) Literate Education in the Hellenistic and Roman Worlds, Cambridge: Cambridge University Press. Newby, Z. (2005) Greek Athletics in the Roman World: Victory and Virtue, Oxford: Oxford University Press. Nussbaum, M. (1993) ‘Poetry and the passions: two Stoic views’, in Brunschwig and Nussbaum (eds.), 97–149.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

446

Bibliography

 (1994) The Therapy of Desire: Theory and Practice in Hellenistic Ethics. Princeton: Princeton University Press. Nutton, V. (1973) ‘The chronology of Galen’s early career’, Classical Quarterly 23, 158–171, repr. in Nutton (1988), ch. 2.   (1983) ‘The seeds of disease: an explanation of contagion and infection from the Greeks to the Renaissance’, Medical History 27, 1–34.   (1985) ‘The drug trade in antiquity’, Journal of the Royal Society of Medicine 78, 138–145.  (1988) From Democedes to Harvey: Studies in the History of Medicine, London: Variorum Reprints.   (1992) ‘Healers in the medical market place: towards a social history of Graeco-Roman medicine’, in A. Wear (ed.), 15–58.  (2013) Ancient Medicine, second edition, London: Routledge.   (2014) ‘Allianoi: a missing link in the history of hospitals?’, review of Baykan (2012), Medical History 58.1, 122–125.  (2020) Galen: A Thinking Doctor in Imperial Rome, London: Routledge.   (2022) ‘Galen and the Latin De voce: a new edition and English translation’, in T. Raiola and A. Roselli (eds.) Nell’ Officina del filologo: studi sui testi e i loro lettori per Ivan Garofalo, 141–166, Biblioteca di Galenos 7, Pisa and Rome: Fabrizio Serra Editore. Oberhelman, S. M. (2013) (ed.) Dreams, Healing, and Medicine in Greece: From Antiquity to Present, Farnham: Ashgate. Overwien, O. (2014) (ed. and trans.) Hippocratis De humoribus, CMG I 3,1, Berlin: de Gruyter. Perilli, L. (2004) Menodoto di Nikomedia: contributo a una storia galeniana di medicina empirica con una raccolta commentate delle testimonianze, Munich and Leipzig: K. G. Saur.   (2006a) ‘“Il dio ha evidentemente studiato medicina”: libri di medicina nelle biblioteche antiche: il caso dei santuari di Asclepio’, in A. Naso (ed.) Stranieri e non cittadini nei santuari greci. Atti del convegno internazionale, 472–510, Florence: Le Monnier Università/Storia.   (2006b) ‘Asclepio e Ippocrate: una fruttuosa collaborazione’, in A. Marcone (ed.) Medicina e società nel mondo antico. Atti del convegno di Undine (4–5 ottobre 2005), 26–54, Florence: Le Monnier Università/Storia.   (2009) ‘Scrivere la medicina. La trascrizione dei miracoli di Asclepio e il Corpus Hippocraticum’, in C. Brockmann, W. Brunschön and O. Overwien (eds.) Antike Medizin im Schnittpunkt von Geistes- und Naturwissenschaften, Internationale Fachtagung aus Anlass des 100jährigen Bestehens des Akademievorhabens Corpus Medicorum Graecorum/Latinorum, 75–120, Berlin: de Gruyter. Petit, C. (2017) ‘Galen, pharmacology and the boundaries of medicine: a reassessment’, in L. Lehmhaus and M. Martelli (eds.) Collecting Recipes: Byzantine and Jewish Pharmacology in Dialogue, Science, Technology and Medicine in Ancient Cultures 4, 51–79, Berlin: de Gruyter.  (2018) Galien de Pergame ou la rhétorique de la Providence: médecine, littérature et pouvoir à Rome, Mnemosyne Supplements 420, Leiden: Brill.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

Bibliography 447   (2019) (ed.) Galen’s Treatise Περὶ ἀλυπίας (De Indolentia) in Context: A Tale of Resilience, Studies in Ancient Medicine 52, Leiden: Brill. Petridou, G. (2017) (ed.) Embodying Religion: Lived Ancient Religion and Medicine, special issue of Religion in the Roman Empire 3(2), Tübingen: Mohr Siebeck. Petridou, G. and Thumiger, C. (2016) (eds.) Homo Patiens: Approaches to the Patient in the Ancient World, Studies in Ancient Medicine 45, Leiden: Brill. Petsalis-Diomidis, A. (2010) ‘Truly Beyond Wonders’: Aelius Aristides and the Cult of Asklepios, Oxford: Oxford University Press. Pietrobelli, A. (2013) ‘Galien agnostique: un texte caviardé par la tradition’, Revue des Études Grecques 126, 103–135. Pleket, H. W. (1975/2010) ‘Games, prizes, athletes and ideology: some aspects of the history of sport in the Greco-Roman world’, in König (ed.), 145–174. Polito, R. (2016) ‘Competence conflicts between philosophy and medicine: Caelius Aurelianus and the Stoics on mental diseases’, Classical Quarterly n.s. 66, 358–369. Pormann, P. E. (2008) (ed.) Rufus of Ephesus, On Melancholy, SAPERE 12, Tübingen: Mohr Siebeck.   (2021) (ed.) Hippocratic Commentaries in the Greek, Latin, Syriac and Arabic Traditions: Selected Papers from the XVth Colloque Hippocratique, Manchester, Studies in Ancient Medicine 56, Leiden: Brill. Powell, O. (2003) Galen, On the Properties of Foodstuffs, introduction, translation and commentary, with a foreword by J. Wilkins, Cambridge: Cambridge University Press. Raina, G. (2003) ‘Considerazioni sul vocabolario greco del colore’, in Beta and Sassi (eds.), 25–40. Raschke, M. C. (1978) ‘New studies in Roman commerce with the East’, ANRW II.2, 604–1361. Raven, J., Lindsell, A. and Raven, F. (2000) Plants and Plant Lore in Ancient Greece, Oxford: Leopard’s Head. Reinhardt, T. (2011) ‘Galen on unsayable properties’, Oxford Studies in Ancient Philosophy 40, 297–317. Reveal, J. M. (1996) ‘What’s in a name: identifying plants in pre-Linnaean botanical literature’, in B. K. Holland (ed.) Prospecting for Drugs in Ancient and Medieval European Texts: A Scientific Approach, 57–90, Amsterdam: Harwood Academic Publishers. Richter, D. S. and Johnson, W. A. (2017) (eds.) The Oxford Handbook of the Second Sophistic, Oxford: Oxford University Press. Riddle, J. M. (1985) Dioscorides on Pharmacy and Medicine, Austin: University of Texas Press. Robert, L. (1937) Études anatoliennes: Recherches sur les inscriptions grecques de l’Asie Mineure. Paris: L’Institut Français d’Archéologie de Stamboul.   (1984/2010) ‘Discours de l’ouverture’, Actes du VIIIe Congrès international d’épigraphie grecque et latine, Athènes 1984, trans. M. Lianou as ‘Opening address: Eighth International Congress of Greek and Latin Epigraphy’, in König (ed.), 108–119.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

448

Bibliography

Roby, C. (2016) ‘Galen on the patient’s role in pain diagnosis: sensation, consensus, and metaphor’, in Petridou and Thumiger (eds.), 304–322. Rocca, J. (2003) Galen on the Brain: Anatomical Knowledge and Physical Speculation in the Second Century AD, Studies in Ancient Medicine 26, Brill: Leiden.   (2021) ‘Pneuma as a holistic concept in Galen’, in Thumiger (ed.), 268– 291. Rosen, R. M. (2010) ‘Galen, satire and the compulsion to instruct’, in H. J. F. Horstmanshoff and C. R. van Tilburg (eds.) Hippocrates and Medical Education: Selected Papers Read at the XIIth International Hippocrates Colloquium, Universiteit Leiden, 24–26 August 2005, 325–342, Leiden: Brill. Russell, D. A., Trapp, M. and Nesselrath, H.-G. (2016) (eds.) In Praise of Asclepius: Aelius Aristides, Selected Prose Hymns: Introduction, Text, Translation and Interpretative Essays, SAPERE 29, Tübingen: Mohr Siebeck. Rusten, J. and König, J. (2014) Philostratus: Heroicus; Gymnasticus; Discourses 1 and 2, Loeb Classical Library 521, Cambridge, MA: Harvard University Press. Salas, L. A. (2021) Cutting Words: Polemical Dimensions of Galen’s Anatomical Experiments, Studies in Ancient Medicine 55, Leiden: Brill.   (forthcoming) ‘Anatomy and physiology’, in Singer and Rosen (eds.). Sassi, M. M. (2003) ‘Il problema della definizione antica del colore, fra storia e antropologia’, in Beta and Sassi (eds.), 9–23. Scanlon, T. F. (2014) (ed.) Sport in the Greek and Roman Worlds, 2 vols., Oxford Readings in Classical Studies, Oxford: Oxford University Press. Scarborough, J. (2010) Pharmacy and Drug Lore in Antiquity: Greece, Rome, Byzantium, Farnham: Ashgate. Schlange-Schöningen, H. (2003) Die römische Gesellschaft bei Galen: Biographie und Sozialgeschichte, Berlin: de Gruyter. Schmitz, T. (1997) Bildung und Macht: zur sozialen und politischen Funktion der zweiten Sophistik in der griechischen Welt der Kaiserzeit, Munich: Beck. Schöne, H. (1924) ‘Verbesserungen zum Galentext’, Sitzungsberichte der Deutschen Akademie der Wissenschaften zu Berlin, Philosophisch-Historische Klasse, Jahrgang 1924, 15. Sezgin, F. (1967) Geschichte des arabischen Schrifttums, vol. III: Medizin, Pharmazie, Zoologie, Tierheilkunde bis ca. 430 H., Leiden: Brill. Singer, P. N. (1991) ‘Aspects of Galen’s Platonism’, in J. A. López Férez (ed.) Galeno: obra, pensamiento e influencia, 41–55, Madrid: Universidad Nacional de Educación a Distancia.   (1996) ‘Notes on Galen’s Hippocrates’, in M. Vegetti and S. Gastaldi (eds.) Studi di storia di medicina antica e medievale in memoria di Paola Manuli, 66–76, Florence: La Nuova Italia.  (1997a) Galen: Selected Works, translated with an introduction and notes, Oxford: Oxford University Press.   (1997b) ‘Levels of explanation in Galen’, Classical Quarterly n.s. 47(2), 525–542.   (2013) (ed.) Galen: Psychological Writings: Avoiding Distress, Character Traits, The Diagnosis and Treatment of the Affections and Errors Peculiar to Each

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

Bibliography 449

       

   

           

   

 

Person’s Soul, The Capacities of the Soul Depend on the Mixtures of the Body, translation with introductions and notes by V. Nutton, D. Davies and P. N. Singer, with the collaboration of P. Tassinari, Cambridge: Cambridge University Press. (2014a) ‘Galen and the philosophers: philosophical engagement, shadowy contemporaries, Aristotelian transformations’, in Adamson, Hansberger and Wilberding (eds.), 7–38. (2014b) ‘The fight for health: tradition, competition, subdivision and philosophy in Galen’s hygienic writings’, British Journal for the History of Philosophy 22(5), 974–995. (2016/2021) ‘Galen’, in Stanford Encyclopedia of Philosophy, ed. E. N. Zalta, Spring 2016, revised Winter 2021, https://plato.stanford.edu/archives/ win2021/entries/galen/. (2017) ‘The essence of rage: Galen on emotional disturbances and their physical correlates’, in R. Seaford, J. Wilkins and M. Wright (eds.) Selfhood and the Soul: Essays on Ancient Thought and Literature in Honour of Christopher Gill, 161–196, Oxford: Oxford University Press. (2018) ‘Galen’s pathological soul: diagnosis and therapy in ethical and medical texts and contexts’, in Thumiger and Singer (eds.), 381–420. (2019a) ‘Galen and the culture of Pergamum: a view of Greek medical– intellectual life in Roman Asia’, in B. Türkmen, F. Kurunaz, N. Ermiş, and Y. Ekinci Danısan (eds.) II. Uluslararası Bergama Sempozyumu, 9–10 Mayıs 2013, 131–169, Izmir. (2019b) ‘New light and old texts: Galen on his own books’, in Petit (ed.), 91–131. (2020a) ‘Galen on pneuma: between metaphysical speculation and anatomical theory’, in Coughlin, Leith and Lewis (eds.), 237–281. (2020b) ‘A change in the substance: theory and its limits in Galen’s Simples’, Archives Internationales d’ Histoire des Sciences 70 (special issue ed. M. Martelli, C. Petit and L. Raggetti), 16–53. (2021a ) ‘Is Graeco-Roman medicine holistic? Galen and ancient medicalphilosophical debates’, in Thumiger (ed.), 154–183. (2021b) ‘Beyond and behind the commentary: Galen on Hippocrates on elements’, in Pormann (ed.), 114–146. (2021c) ‘Classification, explanation and experience: mental disorder in Graeco-Roman antiquity’, in U. Steinert (ed.) Systems of Classification in Premodern Medical Cultures: Sickness, Health, and Local Epistemologies, 279–306, Abingdon and New York: Routledge. (2022a) ‘The relationship between perceptual experience and logos: Galen’s clinical perspective’, in Hankinson and Havrda (eds.), 156–189. (2022b) ‘What is a pathos? Where medicine meets philosophy’, in G. Kazantzidis and D. Spatharas (eds.) Medical Understandings of the Emotions in Antiquity: Theory, Practice, Suffering, 17–42, Trends in Classics Supplementary Volumes 131, Ancient Emotions 3, Berlin: de Gruyter. (forthcoming) ‘Graeco-Roman therapy of the emotions: medical techniques, biological understandings’, in D. Cairns and C. Virág (eds.) In the Mind,

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

450

Bibliography

in the Body, and in the World: Emotions in Early China and Ancient Greece, New York and Oxford: Oxford University Press. Singer, P. N. and van der Eijk, P. J. (2018) Galen: Works on Human Nature, Volume 1: Mixtures (De temperamentis), translated with introduction and notes, Cambridge: Cambridge University Press. Singer, P. N. and Rosen, R. M. (forthcoming) (eds.) The Oxford Handbook of Galen, Oxford: Oxford University Press. Smith, W. (1979) The Hippocratic Tradition, Ithaca: Cornell University Press.   (1980) ‘The development of classical dietetic theory’, in M. Grmek (ed.) Hippocratica: Actes du Colloque Hippocratique de Paris, 4–9 septembre 1978, 439–448, Paris: Éditions du Centre National de la Recherche Scientifique. Steger, F. (2016) Asklepios: Medizin und Kult, Stuttgart: Franz Steiner Verlag. Stewart, K. A. (2019) Galen’s Theory of Black Bile: Hippocratic Tradition, Manipulation, Innovation, Studies in Ancient Medicine 51, Leiden: Brill. Swain, S. (1996) Hellenism and Empire: Language, Classicism and Power in the Greek World AD 50–250, Oxford: The Clarendon Press. Sweet, W. E. (1987) Sport and Recreation in Ancient Greece: A Sourcebook with Translations, New York and Oxford: Oxford University Press. Tassinari, P. (1994) Ps.-Alessandro d’ Afrodisia: Trattato sulla febbre, edizione critica, traduzione e commento, Alessandria: Edizioni dell’ Orso. Temkin, O. (1991) Hippocrates in a World of Pagans and Christians, Baltimore, MD: The Johns Hopkins University Press. Theoharides, T. C. (1971) ‘Galen on marasmus’, Journal of the History of Medicine and the Allied Sciences 26, 369–390. Thumiger, C. (2021) (ed.) Holism in Ancient Medicine and its Reception, Abingdon and New York: Routledge. Thumiger, C. and Singer, P. N. (2018) (eds.) Mental Illness in Ancient Medicine: from Celsus to Paul of Aegina, Studies in Ancient Medicine 50, Leiden: Brill. Tieleman, T. (1996) Galen and Chrysippus on the Soul: Argument and Refutation in the De Placitis books II–III, Philosophia Antiqua 68, Leiden: Brill. Totelin, L. M. V. (2004) ‘Mithradates’ antidote – a pharmacological ghost’, Early Science and Medicine 9(1), 1–19.   (2015) ‘When foods become remedies in ancient Greece: the curious case of garlic and other substances’, Journal of Ethnopharmacology 167, 30–37.   (2016a) ‘The world in a pill: local specialities and global remedies in the Graeco-Roman world’, in R. Futo Kennedy and M. Jones-Lewis (eds.) The Routledge Handbook of Identity and the Environment in the Classical and Medieval Worlds, 151–170, London: Routledge.   (2016b) ‘Technologies of knowledge: pharmacology, botany, and medical recipes’, in Oxford Handbooks Online. doi 10.1093/ oxfordhb/9780199935390.013.94 Touwaide, A. (1993) ‘Phytonymie et pharmacologie: contribution à la sémantique du lexique phytonymique grec ancien à travers le traité de matière médicale de Dioscoride’, in Actes du colloque international ‘Les phytonymes grecs et latins’ tenu à Nice les 14, 15 et 16 mai 1992 à la Faculté

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

Bibliography 451 des Lettres, Arts et Sciences humaines, Université de Nice-Sophia Antipolis, 291–305, Nice: Centre de recherches comparatives sur les langues de la Méditerrranée ancienne.   (1997) ‘Bibliographie historique de la botanique: les identifications de plantes médicinales citées dans les traités anciens après l’adoption du système de Linné (1707–1778)’, Centre Jean Palerne, Lettre d’informations 30, 2–22. van der Eijk, P. J. (1999a) (ed.) Ancient Histories of Medicine: Essays in Medical Doxography and Historiography in Classical Antiquity, Leiden: Brill.   (1999b) ‘Historical awareness, historiography and doxography in Greek and Roman medicine’, in van der Eijk (ed.), 1–31.  (2000/2001) Diocles of Carystus: A Collection of the Fragments with Translation and Commentary, vol. I: Text and Translation, vol. II: Commentary, Studies in Ancient Medicine 22 and 23, Leiden: Brill.   (2013) ‘Galen and the scientific treatise: a case study of Mixtures’, in M. Asper (ed.) Writing Science: Mathematical and Medical Authorship in Ancient Greece, Science, Medicine, and Technology in Ancient Cultures 1, 145–175, Berlin: de Gruyter.   (2015a) ‘On “Hippocratic” and “Non-Hippocratic” medical writings’, in Dean-Jones and Rosen (eds.), 17–47.   (2015b) ‘Galen on the assessment of bodily mixtures’, in B. Holmes and K.D. Fischer (eds.) The Frontiers of Ancient Science: Essays in Honor of Heinrich von Staden, Beiträge zur Altertumskunde 338, 675–698, Berlin: de Gruyter.   (2017) ‘The place of disease in a teleological world-view: Plato, Aristotle, Galen’, in J. Rocca (ed.) Teleology in the Ancient World: Philosophical and Medical Approaches, 217–241, Cambridge: Cambridge University Press.   (2020) ‘Galen on soul, mixture and pneuma’, in B. Inwood and J. Warren (eds.) Proceedings of the 10th Symposium of Hellenistic Philosophy, 62–88, Cambridge: Cambridge University Press. van der Eijk, P. J., Horstmanshoff, H. F. J. and Schrijvers, P. J. (1995) (eds.) Ancient Medicine in its Socio-Cultural Context: Papers Read at the Congress Held at Leiden University, 13–15 April 1992, 2 vols., Leiden: Rodopi. van Hoof, L. (2010) Plutarch’s Practical Ethics: The Social Dynamics of Philosophy, Oxford: Oxford University Press. van Nijf, O. (2001) ‘Local heroes: athletics, festivals and elite self-fashioning in the Roman East’, in Goldhill (ed.), 306–334.   (2010) ‘Athletics, festivals and Greek identity in the Roman East’, in König (ed.), 175–197.   (2012) ‘Athletes, artists and citizens in the imperial Greek city’, in A. Heller and A.-V. Pont-Boulay (eds.) Patries d’origine et patries électives: les citoyennetés multiples dans le monde grec d’ époque romaine, 175–194, Bordeaux: Ausonius. Vegetti, M. (1981) ‘Modelli di medicina in Galeno’, in V. Nutton (ed.) Galen: Problems and Prospects, 47–63, London: Wellcome Institute.   (1999a) ‘Tradition and truth: forms of philosophical-scientific historiography in Galen’s De placitis’, in van der Eijk (ed.), 333–357.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

452

Bibliography

  (1999b) ‘Historiographical strategies in Galen’s physiology’ (De usu partium, De naturalibus facultatibus), in van der Eijk (ed.), 383–395.  (2013) Galeno: Nuovi scritti autobiografici: introduzione, traduzione e commento, Rome: Carocci Editore. Villard, L. (2002) (ed.) Couleurs et vision dans l’antiquité classique, Rouen: Publications de l’Université de Rouen. von Staden, H. (1989) Herophilus: The Art of Medicine in Early Alexandria, Cambridge: Cambridge University Press.   (1992) ‘The discovery of the body: human dissection and its cultural contexts in ancient Greece’, The Yale Journal of Biology and Medicine 65, 223–241.   (1997a) ‘Galen and the Second Sophistic’, in R. Sorabji (ed.) Aristotle and After, Bulletin of the Institute of Classical Studies Supplement 68, 33–54, London: Institute of Classical Studies.   (1997b) ‘Teleology and mechanism: Aristotelian biology and early Hellenistic medicine’, in W. Kullmann and S. Föllinger (eds.) Aristotelische Biologie: Intentionen, Methoden, Ergebnisse, 183–208, Stuttgart: Franz Steiner Verlag.   (2002) ‘Division, dissection, and specialization: Galen’s On the Parts of the Medical Technē’, in V. Nutton (ed.) The Unknown Galen, 19–45, London: Institute of Classical Studies.   (2009) ‘Staging the past, staging oneself: Galen on Hellenistic exegetical traditions’, in Gill, Whitmarsh and Wilkins (eds.), 132–156.   (2011) ‘The physiology and therapy of anger: Galen on medicine, the soul, and nature’, in F. Opwis and D. Reisman (eds.) Islamic Philosophy, Science, Culture, and Religion: Studies in Honor of Dimitri Gutas, 63–87, Leiden: Brill. Walzer, R. and Frede, M. (1985) Galen: Three Treatises on the Nature of Science: On the Sects for Beginners, An Outline of Empiricism, Medical Experience, translated with an introduction, Indianapolis: Hackett. Webb, R. (2017) ‘Schools and paideia’, in Richter and Johnson (eds.), 139–153. Wellmann, M. (1901) Die Fragmente der sikelischen Ärzte Akron, Philistion und des Diokles von Karystos, Berlin: Weidmann. Whitmarsh, T. (2001) Greek Literature and Roman Identities: The Politics of Imitation, Oxford: Oxford University Press.   (2010) (ed.) Local Knowledge and Microidentities in the Imperial Greek World, Cambridge: Cambridge University Press. Wikander, C. (2008) ‘Technologies of calculation; part I: weights and measures’, in J. P. Oleson (ed.) The Oxford Handbook of Engineering and Technology in the Classical World, 759–769, Oxford: Oxford University Press. Wilkins, J. (2013) (ed. and trans.) Galien: Oeuvres, Tome V: Sur les facultés des aliments, Paris: Les Belles Lettres.   (2016) ‘Treatment of the man: Galen’s preventive medicine in the De sanitate tuenda’, in Petridou and Thumiger (eds.), 411–431.   (2020) ‘Bodily fluids (“humours”) and flavours in Galen’s Simple Medicines’, Archives Internationales d’ Histoire des Sciences 70 (special issue, ed. M. Martelli, C. Petit and L. Raggetti), 54–75.

https://doi.org/10.1017/9781009159524.015 Published online by Cambridge University Press

Bibliography 453 Wilkins, J., Harvey, D. and Dobson, M. (1995) (eds.) Food in Antiquity, Exeter: Exeter University Press. Wilson, N. (1987) ‘Aspects of the transmission of Galen’, in G. Cavallo (ed.) Le strade del testo, 47–64, Bari: Adriatica. Wöhrle, G. (1990) Studien zur Theorie der antiken Gesundheitslehre, Hermes Einzelschriften 56, Stuttgart: Franz Steiner Verlag. Woolf, G. (1994) ‘Becoming Roman, staying Greek: culture, identity and the civilizing process in the Roman East’, Proceedings of the Cambridge Philological Society 40, 116–143. Yegül, F. K. (1992) Baths and Bathing in Classical Antiquity, NY and Cambridge, MA: The Architectural History Foundation and The MIT Press.  (2010) Bathing in the Roman World, Cambridge: Cambridge University Press. Websites https://galenolatino.com

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English–Greek glossary

This glossary shows equivalences between English terms used in the translation and the original Greek words, for both (1) a selection of terms of technical or conceptual significance in Galen’s medical and philosophical thought and (2) items of relevance to the materia medica mentioned in the text, in particular the plants and minerals named and the preparations based on them. Occurrences in the text, and where relevant discussions of the terms in the notes, can be traced back through the Greek word index.

1. Terms of technical or conceptual significance English

Transliterated Greek

Greek

abdomen accumulate [fluids or residues in body] acrid acridity age   old age   old age care ailment   of joints aim [noun]

epigastrion athroizein

ἐπιγάστριον ἀθροίζειν

drimus drimutēs hēlikia  gēras  gērokomikon pathēma, pathos  arthritis epangelma, parangelma, skopos ephiesthai, stochazesthai alloioun alloiōsis onkos, plēthos  metron

δριμύς δριμύτης ἡλικία   γῆρας   γηροκομικόν πάθημα, πάθος   ἀρθρῖτις ἐπάγγελμα, παράγγελμα, σκοπός ἐφίεσθαι, στοχάζεσθαι ἀλλοιοῦν ἀλλοίωσις ὄγκος, πλῆθος   μέτρον

aim at alter alteration amount  right

454

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English art   practitioner of  perverted astringent

English–Greek glossary Transliterated Greek

technē  technitēs  kakotechnia stuptēriōdēs, stuphein [in participle form]  effect  stupsis attract [physically, within epispasthai, helkein body] attraction holkē bad-mixture duskrasia [= unbalanced state of body] balance summetria   bad, imbalance  ametria  good  summetria bile cholē  bilious  cholōdēs   bitter-bilious   pikrocholos   black-bilious   melancholikos bitter pikros blood haima breath pneuma  psychic  psuchikon ‘building-up’ [form of kataskeuē exercise] ‘build-up’ [pathological, plēthos of fluids in body] build up [i.e. reinforce, anathrepsis, anatrephein body or strength] bulk onkos capacity [alterative, dunamis natural, of soul, of drug, etc.] care [for body, health] epimeleia, pronoia   take, undertake  pronoein channel [in body] poros character, character trait ēthos class genos cleanse kathairein   cleanse (out)  ekkathairein  cleansing  katharsis  cleansing-through  diakathairein

455 Greek τέχνη   τεχνίτης   κακοτεχνία στυπτηριώδης, στύφειν   στύψις ἐπισπᾶσθαι, ἕλκειν ὁλκή δυσκρασία συμμετρία   ἀμετρία   συμμετρία χολή   χολώδης   πικρόχολος   μελαγχολικός πικρός αἷμα πνεῦμα   ψυχικόν κατασκευή πλῆθος ἀνάθρεψις, ἀνατρέφειν ὄγκος δύναμις ἐπιμέλεια, πρόνοια   προνοεῖν πόρος ἦθος γένος καθαίρειν   ἐκκαθαίρειν   κάθαρσις   διακαθαίρειν

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456

English–Greek glossary

English

Transliterated Greek

Greek

coction [= digestion]   lack of   bring about, subject to   which has not undergone cold colour [of complexion, urine, wine, etc.]  good   have   poor [of skin] combination composite composition [within body; of recipe] concatenation [of symptoms, Empiricist concept] condition  atmospheric   [= stable state of body]   see also good-condition connate consistency [of a substance] constitution   [of art or body]   [of body, in sense of natural endowments or formation] contraindicated control [by capacities in the body] cook [i.e. digest]  half-cooked  uncooked coupling [esp. of qualities] craftsman [including divine] create, creation

pepsis  apepsia  pettein  apeptos

πέψις   ἀπεψία   πέττειν   ἄπεπτος

psuchros chroia, chrōma

ψυχρός χροιά, χρῶμα

 euchroia   euchroein  achroia mignuein, mixis sunthetos sunthesis

  εὔχροια   εὐχροεῖν   ἄχροια μιγνύειν, μῖξις σύνθετος σύνθεσις

sundromē

συνδρομή

 katastasis  hexis

  κατάστασις   ἕξις

sumphutos sustasis

σύμφυτος σύστασις

  sunistanai, sustasis  kataskeuē

  συνίσταναι, σύστασις   κατασκευή

enantios dioikein

ἐναντίος διοικεῖν

pettein  hēmipeptos  apeptos suzugia

πέττειν   ἡμίπεπτος   ἄπεπτος συζυγία

dēmiourgos, technitēs

δημιουργός, τεχνίτης

dēmiourgos, genesis

δημιουργός, γένεσις

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English–Greek glossary

457

English

Transliterated Greek

Greek

cure  thoroughly damage

iasthai, iasis  exiasthai blabē, blaptein, paschein, pathos diaphtheiresthai, diaphthora, phtheiresthai, phthora horismos, horos, logos apodeiknuein apodeixis diagnōsis diaphora pettein  apepsia diaginōskein, diagnōsis ania, anian nosēma  nosein  apathēs  nosodēs katastasis, schesis dialuein, luein

ἰᾶσθαι, ἴασις   ἐξιᾶσθαι βλαβή, βλάπτειν, πάσχειν, πάθος διαφθείρεσθαι, διαφθορά, φθείρεσθαι, φθορά

diairein, diairesis, diaphora, diorizein lupein, lupē  alupōs anadosis

διαιρεῖν, διαίρεσις, διαφορά, διορίζειν λυπεῖν, λύπη   ἀλύπως ἀνάδοσις

pharmakon  pharmakōdēs xēros hupagein, hupagōgē

  ἐπισπᾶσθαι, ἕλκειν   προσστέλλειν, συστέλλειν φάρμακον   φαρμακώδης ξηρός ὑπάγειν, ὑπαγωγή

zētēma, zētēsis

ζήτημα, ζήτησις

decay definition demonstrate demonstration diagnosis difference digest   failure to / lack of discern(ment) discomfort disease   be affected by   free from  -prone disposition dissolve [residues in body; fatigue] distinction, make

distress ‌‌‌‌‌‌‌  without distribution [of nourishment in body] draw   away, in, into   epispasthai, helkein   in [of muscles]   prosstellein, sustellein drug  drug-like dry empty(ing) [the stomach] from below enquiry

ὁρισμός, ὅρος, λόγος ἀποδεικνύειν ἀπόδειξις διάγνωσις διαφορά πέττειν   ἀπεψία διαγινώσκειν, διάγνωσις ἀνία, ἀνιᾶν νόσημα   νοσεῖν   ἀπαθής   νοσώδης κατάστασις, σχέσις διαλύειν, λύειν

https://doi.org/10.1017/9781009159524.016 Published online by Cambridge University Press

458

English–Greek glossary

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Transliterated Greek

Greek

essence estimate [noun] estimate [verb] evacuate  evacuation excess exercise [noun]  ‘building-up’  complete   expert(ise) in   lack of  passive  preparatory  wrestling-school exercise [verb], also give, make, perform, etc. exercise exert, exertion  mental expel experience expulsion fatigue   anti-, free from, etc. feature, incidental feeble  be feebleness fine   in consistency flesh  -y   abundance of   good flesh  well-fleshed fleshen up  fleshening-up, fleshened-up state fluid [within body]

ousia stochasmos stochazesthai ekkenoun, kenoun  kenōsis huperbolē gumnasion, gumnasma   g. kataskeuastikon   g. teleion   gumnastikos/ē   agumnasia   aiōrēsis   g. paraskeuastikon   palaisma gumnazein

οὐσία στοχασμός στοχάζεσθαι ἐκκενοῦν, κενοῦν   κένωσις ὑπερβολή γυμνάσιον, γύμνασμα   κατασκευαστικόν   τέλειον   γυμναστικός/ή   ἀγυμνασία   αἰώρησις   παρακευαστικόν   πάλαισμα γυμνάζειν

ponein, ponos   phrontizein, phrontis ekkrinein empeiria, peira ekkrisis kopos  akopos sumbebēkos arrōstos  arrōstein arrōstia leptos  leptomerēs sarx  polusarkos  polusarkia  eusarkia  eusarkos sarkoun  sarkōsis

πονεῖν, πόνος   φροντίζειν, φροντίς ἐκκρίνειν ἐμπειρία, πεῖρα ἔκκρισις κόπος   ἄκοπος συμβεβηκός ἄρρωστος   ἀρρωστεῖν ἀρρωστία λεπτός   λεπτομερής σάρξ   πολύσαρκος   πολυσαρκία   εὐσαρκία   εὔσαρκος σαρκοῦν   σάρκωσις

chumos, [plural] hugrotētes, hugra

χυμός, ὑγρότητες, ὑγρά

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English–Greek glossary

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English

Transliterated Greek

Greek

  bad fluid   of bad fluid   of good fluid form fresh fulness [of fluids, a pathological state]   of/related to function generate generation goal good-condition [i.e. excellence of stable state of body] good-mixture [as state of body] harm   harmless, unharmed   free/immune from healing   of healing health healthful, healthy, healthpractitioner heat hot ill, illness imbalance immoderate indicate indication indicator inflammation inflammation-like   be inflamed innate instructor   art of

 kakochumia  kakochumos  euchumos eidos, idea glukus, prosphatos plēthōra

  κακοχυμία   κακόχυμος   εὔχυμος εἶδος, ἰδέα γλυκύς, πρόσφατος πληθώρα

 plēthōrikos chreia gennan genesis telos euexia

  πληθωρικός χρεία γεννᾶν γένεσις τέλος εὐεξία

eukrasia

εὐκρασία

blabē, blaptein   ablabēs   apathēs therapeia  therapeutikos hugeia hugieinos

βλαβή, βλάπτειν   ἀβλαβής   ἀπαθής θεραπεία   θεραπευτικός ὑγεία ὑγιεινός

thermotēs thermos nosein ametria ametros endeiknusthai endeixis gnōrisma phlegmonē phlegmonōdēs  phlegmainein emphutos paidotribēs  paidotribikē

θερμότης θερμός νοσεῖν ἀμετρία ἄμετρος ἐνδείκνυσθαι ἔνδειξις γνώρισμα φλεγμονή φλεγμονώδης   φλεγμαίνειν ἔμφυτος παιδοτρίβης   παιδοτριβική

https://doi.org/10.1017/9781009159524.016 Published online by Cambridge University Press

460

English–Greek glossary

English

Transliterated Greek

Greek

intense [of exercise or motion] intensify intensity invigorate  rejuice   [= fluid, in body]   [of plant, etc.] know  foreknow knowledge   possessed of  scientific massage massaging material [especially of medical remedy] mixture consist of, etc.  well-mixed   see also bad-mixture, good-mixture modify morbid motion nature   of nature, natural necessary, of necessity nourish nourishment  good  poor   experience poor obstruct obstruction organ  internal outflow   (point of )

suntonos

σύντονος

epiteinein suntonia rōnnunai  anarrōnnunai

ἐπιτείνειν συντονία ῥωννύναι   ἀναρρωννύναι

 ichōr  chulos epistasthai, ginōskein  proginōskein gnōsis, epistēmē  epistēmōn  epistēmē tripsis anatripsis hulē

  ἰχώρ   χυλός ἐπίστασθαι, γινώσκειν   προγινώσκειν γνῶσις, ἐπιστήμη   ἐπιστήμων   ἐπιστήμη τρίψις ἀνάτριψις ὕλη

krasis  kerannunai  eukratos

κρᾶσις   κεραννύναι   εὔκρατος

hupallattein nosōdēs kinēsis phusis  phusikos anankaios, ex anankēs anatrephein, trephein threpsis, trophē  eutrophia  atrophia   atrophein emphrattein emphraxis organon, splanchnon  splanchnon aporrein, aporroē   ekroē, ekrous

ὑπαλλάττειν νοσώδης κίνησις φύσις   φυσικός ἀναγκαῖος, ἐξ ἀνάγκης ἀνατρέφειν, τρέφειν θρέψις, τροφή   εὐτροφία   ἀτροφία   ἀτροφεῖν ἐμφράττειν ἔμφραξις ὄργανον, σπλάγχνον   σπλάγχνον ἀπορρεῖν, ἀπορροή   ἐκροή, ἔκρους

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English–Greek glossary

461

English

Transliterated Greek

Greek

pattern [of exercise, life, etc.] peak phlegm porous  make  -ness prime   be in proportion, good  adjust   of good proportion, well-proportioned   in proportion to, etc. purge, purgative  purging question, set [for a formal enquiry] rage rectification, rectify

idea, tupos

ἰδέα, τύπος

akmē, akros phlegma araios  araioun  araiotēs akmē  akmazein euruthmia  ruthmizein  euruthmos

ἀκμή, ἄκρος φλέγμα ἀραιός   ἀραιοῦν   ἀραιότης ἀκμή   ἀκμάζειν εὐρυθμία   ῥυθμίζειν   εὔρυθμος

  ana logon kathairein  katharsis problēma

 ἀνὰ λόγον καθαίρειν   κάθαρσις πρόβλημα

recuperative [part of the art of medicine] regime, daily   conduct, give remedy residue   free of   full of restoration [post-exercise procedure]   bring about restorative   [in above sense]   [part of the medical art] scientific   see also knowledge secretion sediment [in urine]

thumos θυμός epanorthoun, epanorthōsis ἐπανορθοῦν, ἐπανόρθωσις analēptikos ἀναληπτικός diaita, diaitēma  diaitan boēthēma perittōma  aperittos  perittōmatikos apotherapeia

δίαιτα, διαίτημα   διαιτᾶν βοήθημα περίττωμα   ἀπέριττος   περιττωματικός ἀποθεραπεία

 apotherapeuein

  ἀποθεραπεύειν

 apotherapeutikos  epanorthōtikos

  ἀποθεραπευτικός   ἐπανορθωτικός

epistēmonikos

ἐπιστημονικός

ekkrisis ἔκκρισις hupostasis, huphistamenon ὑπόστασις, ὑφιστάμενον

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462

English–Greek glossary

English

Transliterated Greek

Greek

separate (off), separation [of residues, etc. in body]   separative [capacity] sex, sexual activity/ intercourse shape, shaping [of human body] sharp sick, sickness simple skill, specialized soul   of soul   see also character sour specify, specification

apokrinein, apokrisis, diakrinein, diakrisis

ἀποκρίνειν, ἀπόκρισις, διακρίνειν, διάκρισις

 apokritikos aphrodisia

  ἀποκριτικός ἀφροδίσια

diaplasis, plattein

διάπλασις, πλάττειν

oxus nosein, nosos haplous technē psuchē  psuchikos

ὀξύς νοσεῖν, νόσος ἁπλοῦς τέχνη ψυχή   ψυχικός

struphnos aphorizein, diorizein, diorismos, horizein thumos, thumoeides

στρυφνός ἀφορίζειν, διορίζειν, διορισμός, ὁρίζειν θυμός, θυμοειδές

 euthumos  athumos  oxuthumia thumikos diathesis; also diakeisthai + adverb stegein, stegnōsis

  εὔθυμος   ἄθυμος   ὀξυθμία θυμικός διάθεσις; διακεῖσθαι

ischus, rōmē ousia glukus sumptōma austēros tonōdēs suntasis, tasis  eutonos  eutonia  tonoun leptunein kairos

ἴσχυς, ῥώμη οὐσία γλυκύς σύμπτωμα αὐστηρός τονώδης σύντασις, τάσις   εὔτονος   εὐτονία   τονοῦν λεπτύνειν καιρός

spirit, spirited [part of soul]  good-spirited   lacking in  sharp-spiritedness spirited [adjective] state [of body] stop(page) [in part of body] strength substance sweet symptom tart [as taste] tensed tension   with good   good state of  improve thin [verb] time, appropriate

https://doi.org/10.1017/9781009159524.016 Published online by Cambridge University Press

στέγειν, στέγνωσις



English–Greek glossary

463

English

Transliterated Greek

Greek

train(ing)  physical    expert in, focussed   on, etc.   training assistant trainer (physical) transpiration, transpire type   different, distinct unbalanced uniform [type of part of the body] vehemence vehement venesection   employ, undergo vigour viscous volume [in body] wet young man youth

askein, gumnazein  gumnastikē   gumnastikos

ἀσκεῖν, γυμνάζειν   γυμναστική   γυμναστικός

 progumnastēs gumnastēs diapnein, diapnoē eidos, idea  diaphora ametros homoiomerēs

  προγυμναστής γυμναστής διαπνεῖν, διαπνοή εἶδος, ἰδέα   διαφορά ἄμετρος ὁμοιομερής

sphodrotēs sphodros phlebotomia  phlebotomein eurōstia, rōmē glischros onkos hugros neaniskos meirakion

σφοδρότης σφοδρός φλεβοτομία   φλεβοτομεῖν εὐρωστία, ῥώμη γλίσχρος ὄγκος ὑγρός νεανίσκος μειράκιον

2. Items of relevance to materia medica English

Transliterated Greek

Greek

ajowan almond aloe anise asphalt, containing barley, barley broth/gruel bean beet betony blite bryony

ammi amugdalon aloē anison asphaltōdēs ptisanē kuamos teutlon kestron bliton bruōnia

ἄμμι ἀμύγδαλον ἀλόη ἄνισον ἀσφαλτώδης πτισάνη κύαμος τεῦτλον κέστρον βλίτον βρυωνία

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English–Greek glossary

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Transliterated Greek

Greek

cabbage  sea caper cassia catmint celery chamomile chaste cheese cinnamon  black cucumber, squirting cumin date dill Diospolitikon einkorn elecampane fat feverfew fig fleawort fruit, summer garlic garum ginger gourd, bottle grape hyacinth groat hartwort honey honey-mixture honey-preserve honey-vinegar honey-water hound’s berry houseleek hyssop

krambē  thalassokrambē kapparis kasia kalaminthē selinon chamaimēlon agnos turos kinnamōmon  amōmon sikuos agrios kuminon phoinix anēthon Diospolitikon zeia helenion lipos limnēstis sukon psullion opōra skorodon garon zingiberi kolokunthē bolbos chondros seseli meli melikraton apomeli oxumeli hudromeli struchnon aeizōon husōpon

κράμβη   θαλασσοκράμβη κάππαρις κασία καλαμίνθη σέλινον χαμαίμηλον ἄγνος τυρός κιννάμωμον   ἄμωμον σίκυος ἄγριος κύμινον φοῖνιξ ἄνηθον Διοσπολιτικόν ζειά ἑλένιον λίπος λίμνηστις σῦκον ψύλλιον ὀπώρα σκόροδον γάρον ζιγγίβερι κολοκύνθη βολβός χόνδρος σέσελι μέλι μελίκρατον ἀπόμελι ὀξύμελι ὑδρόμελι στρύχνον ἀείζωον ὕσωπον

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English–Greek glossary

465

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Transliterated Greek

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knotgrass leek lentil lettuce linseed lovage mallow mandragora marsh mallow meat melon milk millet millet, Italian monk’s rhubarb mushroom nard natron navelwort oil  lily  marjoram  mastic  nard  perfumed  quince  rose olive  unripe onion orach parsley pennyroyal pepper  black  long  white   three-pepper drug pine

polugonon prason phakē thridakinē linospermon libustikon malachē mandragoras althaia kreas sikuōn pepōn gala kenchros elumos lapathon mukēs nardos nitron kotulēdōn elaion  sousinon  sampsuchinon  mastichinon  nardinon  muron  mēlinon  rodinon elaia   omphax, omphakinos krommuon atraphaxus petroselinon glēchōn peperi  melan  makron  leukon   to dia triōn p. elatē

πολύγονον πράσον φακή θριδακίνη λινόσπερμον λιβυστικόν μαλάχη μανδραγόρας ἀλθαία κρέας σικύων πέπων γάλα κέγχρος ἔλυμος λάπαθον μύκης νάρδος νίτρον κοτυληδών ἔλαιον   σούσινον   σαμψύχινον   μαστίχινον   νάρδινον  μύρον   μήλινον   ῥόδινον ἐλαία   ὄμφαξ, ὀμφάκινος κρόμμυον ἀτράφαξυς πετροσέλινον γλήχων πέπερι   μέλαν   μακρόν   λευκόν   τὸ διὰ τριῶν π. ἐλάτη

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466

English–Greek glossary

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Transliterated Greek

Greek

plum poplar, black poppy   red-horned (eye-salve made with) pulse(s) purslane quince resin rose rosemary rue safflower saffron, of salt scammony scurvy grass semolina spikenard spurge  tuberous sulphur, containing terebinth theriac (antidote, drug) thyme vinegar water chestnut wine-honey wormwood

kokkumēlon aigeiros mēkōn  glaukion

κοκκύμηλον αἴγειρος μήκων   γλαύκιον

osprion, chedropa andrachnē mēlon, kudōnion rētinē rodon libanōtis pēganon knikos krokōdēs hals skammōnia betonikē semidalis nardou stachus euphorbion, tithumallos  linozōstis theiōdēs terminthos thēriakē, thēriakon thumos oxos tribolos oinomeli apsinthion

ὄσπριον, χεδροπά ἀνδράχνη μῆλον, κυδώνιον ῥητίνη ῥόδον λιβανωτίς πήγανον κνίκος κροκώδης ἅλς σκαμμωνία βετονική σεμίδαλις νάρδου στάχυς εὐφόρβιον, τιθύμαλλος   λινόζωστις θειώδης τέρμινθος θηριακή, θηριακόν θύμος ὄξος τρίβολος οἰνόμελι ἀψίνθιον

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Greek word index

Page and line numbers refer to Koch’s CMG edition of Health or to Helmreich’s Teubner edition of Thrasybulus; references to the latter text begin with ‘T’. The listing of occurrences is not always exhaustive, especially in cases of very frequent words. Where a listing is not exhaustive, this is indicated by ‘etc.’ ἀβίαστος unforced (activity) 75,9 ἀβλαβής harmless 149,9; not harmful 189,24; 197,8; not injurious 177,3; unharmed 193,26; 197,10 ἀγαθός (superlative ἄριστος) optimal 14,11; (neuter plural) benefits 40,25 ἀγγεῖον vessel 5,3 etc. ἀγνοεῖν not have an idea 3,12 ἄγνος chaste (tree) 195,33.35 ἀγρυπνητικός insomniac 15,16 ἀγρυπνία inability to sleep 114,21–22; lack of sleep 96,3; 99,20.23; T90,5; poor sleep 19,32; T39,13; sleeplessness 99,27; 140,24; troubled sleep 114,24 ἀγυμνασία lack of exercise 33,26; lack of schooling 48,7 ἀγωγή scheme of conduct (for health) 135,13 (with note); 138,5; 168,24; 191,17; 192,8 ἀγωνιᾶν suffer anxiety 61,23 (with note); 61,34 (with note) ἀδάμας diamond 6,30 ἄδηλος non-evident 33,29–30; not evident 31,13.15; (negative) obviously 158,31; uncertain T37,3 ἀδιόριστος undifferentiated 94,21; (adverb) without the relevant distinction 151,22 ἀδολεσχία babbling 19,11.13 ἀείζωον houseleek 195,19 ἀειπάθεια perpetual pathology 10,19 (with note); 14,26 ἀήρ air 4,10 etc.; T55,13; T56,2 etc. ἀθροίζειν accumulate (fluids, residues, etc.) 26,14; 107,12.23; 108,6; 132,23; 134,24; 167,27 etc.; assemble (the art) 161,9

ἄθροισμα assemblage (of symptoms) 96,10 (with note); 161,14 (with note) ἀθρόως all at once 31,10; 77,33; 79,21.28; 83,4; 132,12.19; T58,3; concertedly 132,19; suddenly 140,18 ἄθυμος lacking in spirit 15,15; 19,34; 58,8.14.20; (comparative) less spirited 19,16 αἴγειρος black poplar 127,23.24.31 αἰδεῖσθαι suffer shame 61,23.28.32 αἰδώς shame 112,7.12 αἷμα blood 4,5 etc.; T83,18 etc. αἵρεσις choice 23,2; sect 9,7.9; view 37,10 αἰσθάνεσθαι be aware 14,26; detect T81,17.18; feel 131,23; have a sensation 84,19.20, 87.30; see T56,18 αἰσθητικός capable of sensation (bodies) 105,33; 106.10 αἰτία cause 78,1 etc.; T45,12 etc. αἴτιον cause 10,21; 25,8; T41,21.27; T49,22; T52,9; reason 46,1; responsible 13,10 αἰώρησις passive exercise 66,32; 67,13; 107,15; 142,8 ἀκμάζειν be fully grown 196,5; be in one’s prime 39,19; 141,18.25; 149,26; 171,15; 172,7; be in season 152,32; enjoy peak 6,25 ἀκμή peak 5,2; 71,17; 175,8.20; prime 28,20; 170,26 ἀκολασία lack of discipline 136,8; 138,2.3 ἀκόλαστος undisciplined 59,15; 182,34 ἀκολουθεῖν (ἐξ ἀναγκῆς) be the (necessary) consequence 6,2; be consequent upon 9,5 etc.; follow (upon) 74,10 etc. ἄκοπος anti-fatigue (a type of drug) 97,13 (with note); 97,21; 126,32; 184,2; free from fatigue

467

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468

Greek word index

74,17 (with note); 75,9; 155,31; which does not bring about fatigue 142,8; (adverb) to a level that does not produce fatigue 156,11 ἀκρασία lack of restraint 182,23 (with note) ἀκρατής lacking in restraint 182,34 ἀκρίβεια completeness (of an activity) 34,2.10; precise form (of health) 8,18; precision 12,29 ἀκριβής accuracy T84,22; accurate 68,4; 110,33; 123,9; 142,24; T44,18; T80,14; complete (health) 8,1.2.19; 75,18; 77,12; 150,16; 160,18; perfect 14,12; T57,1 (good balance); precise 4,34; 7,27; 12.15; 14,8; 14,32.33; 57,31; 113,21; thorough 132,31 ἀκριβοῦν address with precision 28,36; be precise 58,1; correct by greater precision 58,25; (perfect participle passive) discussed in detail T71,22; perfect 12,1; perfectly exemplified 161,12 ἀκριβῶς accurately 53,18; 111,5; 139,5; 159,30; 176,18; actually 109,7; 110,23; carefully 147,22; 165,21; completely 26,29; 27,28; 30,29; 34,9; 38,24.31; 52,2; 57,9; 61,6; 63,11; 70,26; 71,24; 76,15; 106,11; 119,21; 123,29; 139,12; T56,23; correctly T35,18; definitely 97,13; genuinely T50,4.7; particularly 23,22; perfectly 52,25; 192,2; 14,21; 148,11; T80,6.23; precisely 6,3.7; 11,36; 15,7.10.13.17; 21,14; 22,10; 22,23; 42,30; 52,10; 60,13; 70,19; 72,7; T83.2 etc.; with precision 119,5; 137,13; properly 67,9; T71,17; thoroughly 6.10; 119,6; 125,19; 147,12; 152,17 ἄκρος peak (of ) 5,5; T40,17; T43,19; T44,4; T48,26; T53,15 etc.; (plural) extremities T61,8; εἰς ἄκρον ἀφικέσθαι maximal realization T83,25; ἐπ᾿ ἀκρόν extreme 43,6 ἀλγεῖν experience pain 86,28; have pain 137,28; suffer pain 156,15 ἄλγημα pain 89,17; 173,7 ἄλειμμα (application of ) oil 32,28; 88,33; 122,8.23; 183,32.37 ἀλείφω apply (oil) 101,11.15.16; 102,20; 109,2; 114,6; 122,5; oil 24,19; (middle) (have) application (of oil) 36,18; 40,2; 88,8.9.11; 97,9; 129,1; 186,18; 195,9 ἀλεκτορίς hen 191,7 ἀλεκτρυών cockerel 191,7 ἀλθαία marsh mallow 129,4 ἀλλοιοῦν alter 3,6; 17,6.18; 33,22.26; 36,24; 39,31 etc.; cause alteration 35,28 ἀλλόκοτος unpleasant 22,28; 148,6 ἀλλοίωσις alteration 39,31; 40,28 etc. ἀλλοιωτικός (δύναμις) alterative 33,35 ἀλουτεῖν abstain from bathing 25,27; 165,9 ἁλμη saltiness 22,28; salt water 153,4; T89,27

ἀλόη aloe 153,5.10.11; 182,18; 187,8.14; 188,14.19.23.25.26 ἅλς salt(s) 16,15 (with note); 16,24; 36,20 (with note); 125,26; 132,5; 147,28; 148,11; 149,34; 181,24; 186,21 ἁλυκός salty 26,26; 109,31 ἀλύπως without distress 25,4; 28,26; 149,6; without pain 153,21; 158.21; 182,5 ἀμβλύς dull 15,16; 26,7; 73,30; (adverb) T45,24 ἄμεμπτος faultless 13,1; 13,31.34; 14,7.10.32; 16,1.14; 17,29; 19,15; 38,28.30; 56,20; 56,22 (superlative); 73,11; 84,2 (superlative); 101,8.11; 126,30; 149,27; 171,19; 177,25.28.32; 178.10; 180.22; 192.4 ἀμερής partless 9,11 (with note) ἀμετρία imbalance 15,1; 16,36; 20,13; 21,11.15; 26,2; 69,15; 70,20; 113,7; 138,30; 139,3.9; 140,27.28; 141,6; 175,9; T83,16 ἄμετρος immoderate 21,7; 33,7; 34,29; 74,21; 75,1; 89,20.23; 94,12; 100,5; 102,9 etc.; unbalanced 20,4.33; 21,30; 74,2; 81,29; 83,31; 86,25 etc. ἀμέτρως immoderately 7,7; 26,12; 32,26.30; 140,10.15; (κεκραμένοις) with an unbalanced mixture 56,23 ἄμμι ajowan 118,1 ἀμύγδαλον almond 151,30; 173,12 (bitter) ἀμυδρός faint 4,32.33; 69.18; feeble 139,2 ἀμυδρότης faintness 60,31; 66,8 ἄμωμον black cinnamon 187,19 ἀνάγειν base on 106,16; bring (many arts) under (a single heading) T65,9; reduce (in logical sense) 50,1; 53,18; refer (something to something else) T69,15; render 71,12; take (the argument) back (to), turn (someone) to 141,30 ἀναγκαῖος essential 135,9.10; have need 74,32; it follows 6,32; 9,5; 9,20; 23,27; 40,32; 47,25; 48,3.34; have to T38,15; T44,15; imposed 29,14.17; inevitably 133,27; must (neuter) 106,8; T45,4; necessary 4,3; 6,7; 8,11; 18,21; 31,20.23; 46,26; 70,22; 74,22; 75,3; 80,11; 84,11; 103,3; 137,9; 168,4.15; 178,6; 196,3; T55,20; it is necessary 3,21; 4,22; 6,13; 14,2, 16,32; 25,25; 29,32; 30,1; 37,6; 48,25; 50,1; 67,32; 113,1; 119,1; 173,9; necessarily 8,29; 24,33; 98,20; 110,28; 111,6; 134,4; necessity 47,3; unavoidable (forms of bodily harm) 4,2 101,12; 108,18; 133,11; 154,25; 176,9 (with note); 4,3; 5,18; 7,6; 38,16 ἀνάγκη it follows 40,20; have to T38,8; must T46,10; T47,8; T51,14; necessary cause 5,13; necessary T45,8; T51,9; T52,4.9.25; T56,6;

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Greek word index

necessarily T38,20; T41,18; T52,12.15.17; T55,6; T55,12.13; need T38,22; T56,3; necessity T53,4; T47,8; (+ negation + infinitive) cannot T41,14; T55,16; ἐξ ἀνάγκης unavoidably 47,37 ἀνάδοσις distribution (of nourishment) 13,21; 24,6; 31,1; 40,34; 66,26 etc. ἀνάθρεψις building up (of body or strength) 49,4; 91,31; 191,16; 194,25; T39,8 ἀναθυμίασις vapour 27,16; 187,2 ἀνακτᾶσθαι regain 3,11 ἀναληπτικός recuperative (part of the art) 142,22; 189,10; T73,24.28; T74,4.14.24; T76,2; T87,13 ἀναμιμνῄσκειν recollection 190,2; remind 12,2; 139,15.24.30; 168,3; 197,23; T44,19; T67,10; T75,2; (give) reminder 7,26; 13,8; 15,5; 29,31; 70,22; 108,28 ἀναπνοή inhalation 65,19; 67,19; respiration 5,30; 6,1; 39,30.31; 65,19; 67,19; 130,29 ἀνάπτειν (medio-passive) be kindled 61,20; 87,27; provoke (fever) 19,32; 141,27 ἀναρρωννύναι reinvigorate 69,35; 98,10; 99,8 ἀνατρέπειν overturn 10,5; upset 102,17 (stomach mouth); 120,15; 126,16; 189,7; 189,14 (stomach mouth) ἀνατρέφειν bring up 73,16; build up (the body or flesh) 26,12 (with note); 52,34; 89,34; 91,23.24; 132,13; 134,23; 142,17; 143,5; 149,30; T63,26; nourish 26,12 ἀνάτριψις massaging 23,21.31; 24,1; 42,25; 42,32.33; 43,1.9; 49,18; 52,12; 57,29; 67,2; 70,27; 75,19; 83,29; 101,6.24.27.30; 102,4 (with note); 125,22; 141,26; 143,1; 144,8 etc. ἀναυξής lacking in growth 25,29; 71,5 ἀναφώνησις voice projection 78,6; 158,23.30 ἀνδράχνη purslane 195,21 ἀνέχειν (medio-passive) endure 195,31; be held in check 131,4; refrain 159,16; tolerate 18,36; 23,6; 28,26; 156,16 etc.; be unable 99,25 ἀνήθινος (made with/of ) dill 97,18; 128,28.31 ἄνηθον dill 97,19; 128,31; 132,5 ἀνία discomfort 20,35; 21,18 ἀνιᾶν cause discomfort 21,3; 30,30; be source of discomfort 21,18.32; (medio-passive) be in discomfort 18,9; 21,3 ἀνιαρός causing discomfort 30,16; uncomfortable 84,17 ἀνιέναι lower intensity 187,31; relax (intensity or vehemence of motion or exercise) 66,6; 138,33; 156,4; release (muscle) 30,31; (effect of massage) 44,20.35.37; 78,8; slacken 45,5; 54,16 ἄνισον anise 118,13.17.10; 129,34; 173,12

469

ἀνομοιομερής non-uniform 184,25; see also Book I, n. 35 ἀνοχλησία untroubled existence 10,15 ἀντιδιαιρεῖν place in contradistinction (to) 37,2; T86,12.17; T91,18; T92,2; (medio-passive) in contradistinction to T76,14 ἄντικρυς absolute 18,22; directly 70,18; 114,28; from the outset T36,10; quite 46,33; straight 179,4.28 ἀντικεῖσθαι oppose 141,5; be opposite (in nature) 36,31; 93,14 ἀνώμαλος uneven 22,27; 56,25; 61,1; 169,29; 173,33; 177,4.17.25; 184,19; 190,13; 198,22 ἀξίωμα status 3,7; 95,4 ἀπαθής free from (disease) 136,16; immune from harm T57,10; incapable of being affected 3,20 (with note); 6,29; (adverb) in untroubled (health) 137,19 ἀπακριβοῦν (perfect participle passive) completely 8,24; precise 12,8 ἁπαλός soft 81,28; 85,11; 140,1; tender 45,32; 195,33 ἀπαρεμπόδιστος (neuter singular as noun) unimpeded nature 10,35 ἀπεικός implausible T88,1; unlikely 34,7; unreasonable T99,7 ἄπεπτος which has not undergone coction 23,15.19; 40,35; 41,10 etc.; uncooked 41,12; 109,22; 111,9; 113,5; 114,2; 115,10; 123,1; 124,12; 132,14 ἀπέριττος free of residues 6,18; 137,2 ἀπεψία non-coction 96,2; failure to carry out coction 123,23; failure to digest T39,13; indigestion T36,15; lack of coction 86,23.25; 97,28; 99,21.22; 107,16; 108,24.32; lack of digestion 185,15 ἁπλοῦς absolute 14,9 etc.; simple 38,28; 89,1; 118,6.11 etc. ἁπλῶς in general 32,29; T45,26; just T66,7; on its own T42,24; T43,2; T51,21; in short 37,3; 68,30.36; 115,20; (in) simple (form/terms), simply 26,26; 45,21; 122,24; T34,16; T52,4; 61,24; 79,33; 114,31; 153,1; 167,10; straightforward(ly) 7,28; 11,21; T44,3; 10,36; in absolute sense/terms 25,6; 93,7; 38,13.24; 94,16; 171,19; tout court T42,9; T47,5; in unqualified sense/ terms 166,10; T51,4.16.18.23; without qualification 84,25 ἀποδεικνύειν appoint T54,20; demonstrate 4,12; 5,30; 7,30; 18,24; 29,32; 31,22; 52,38; 77,26; 80,19; 134,8; 141,7; 171,10 etc.; T38,12; T69,12; T92,11; (infinitive as noun) demonstration T36,23; lead to (ailment) 193,21; render 16,9; 71,4; T54,24

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470

Greek word index

ἀπόδειξις demonstration 8,27.32; 80,12; 84,11; 99,15; 134,7; 164,27.28; 193,27; T33,13 (with note); T37,21; (ἐπιστημονική) scientific T37,21 ἀποθεραπεία restoration (type of post-exercise procedure) 52,15 (with note); 60,11; 71,20; 74,8.11.16.20.25; 75,14; 76,27; 78,7.20.24 etc.; T99,23 ἀποθεραπεύειν (bring about, etc.) restoration 52,13; 71,19; 75,5; 78,11 etc. ἀποθεραπευτικός restorative (form of massage) 55,7; 87,16; 89,26 etc. ἀποκρίνειν (perform) separation T67,3; separate (off) 31,29; 110,21; 118,21; 190,5; 193,18 ἀπόκρισις question and answer T35,6 (with note); response T84,15; (of fluids, residues, etc.) separation 6,14.21; 194,27; 196,18 ἀποκριτικός (capacity) of separating off, separative 87,29; 106,2; 189,33 ἀποκυεῖν (medio-passive) be born 4,34; 8,28; 16,21 ἀπόμελι honey-preserve 115,12 (with note); 121,9; 132,8 ἀποπατεῖν defaecate 21,4.24; 77,9; 102,13; 143,27; T85,17 etc.; excrete as faeces 77,9 ἀπόπατος lavatory T35,31; stool 137,31 ἀπορρεῖν drip downward 119,20; disperse 195,13; flow away/out 5,20.27.35; 6,5; 70,12; 168,10; T57,17; outflow 29,33 ἀπορροή outflow 36,30; 37,2 ἀποτελεῖν accomplish 49,23.29.33; 67,28; achieve 109,10; (medio-passive) become 22,19; bring about 3,17; 5,15; 8,16; 48,32; 50,5; 68,21; 96,30; make 5,9; 42,17; 57,9; 69,1; 81,7; 82,11; 121,17; perform 5,7; produce 112,35; produce an end result 50,25; render 25,29; 93,15; 99,7; 143,9 ἀποφαίνειν declare T36,12.18; T84,20; T95,15; 91,17; 166,10; show T38,7; make (in transformative sense) 157,20; render 20,6; 75,24; 170,20; restore (to health) 164,7; (middle) assert, make assertion 18,23; 36,23; 44,36; 47,19.29; 53,25; 94,16; T83,6; T97,12 etc.; (middle) give account T97,16; state 151,23 ἀραιοῦν make porous (effect on flesh) 43,3; 68,16, 75,26, 98,24, 101,22 etc. ἀραιός infrequent 58,4; porous 25,10.16; 53,33.36; 54,4 (with note); 54,20.31; 68,22 etc. ἀραιότης porousness 25,13; 42,16, 96,6.11.23.31; 101,28; 140,14; 179,11 etc. ἀραιωτικός tending to provoke porousness 183,34 ἀρετή beneficial power 148,2; excellence T40,9.16; T47,17; T51,1.2; 25,20; 149,16 (of milk); 171,20; 188,29; virtue T82,13

ἀρθρῖτις ailment of joints 150,32; illness of joints 290,20; 137,29; 146,13; 165,28; 182,27 ἁρμόττειν be appropriate 35,12; 93,7; 99,23; 148,10; 174,19; 181,38; 189,18; 191,12; (present participle) fitted to 15,7; be indicated 192,29; suit 29,10; 75,25; 93,36; 97,19; 120,23; 174,15; 175,21; be suitable T87,21; tune 12,16 ἀρρωστεῖν be feeble 6,17; 11,3; 141,28; (present participle as noun) patient T36,13; T39,4 ἀρρωστία feebleness T51,8; 11,21; 20,1; 32,32.34; 33,21.25; 66,13,21.23; 98,21; 167,25; infirmity 154,7; weakness 140,14 ἄρρωστος feeble 20,21; T40,4; T45,24 etc. ἀρτηρία artery 4,20 etc. ἄρτος bread T92,18; T93,12; T97,26; T98,3; 23,7; 24,3; 115,18; 133,29; 143,29; 144,12; 147,28; 148,1.2.6.23.25; 149,32; 152,19; 174,12; 181,22.23.26; 188,31; 196,23,25; food 80,1; loaf T94,10 ἀρχή beginning 7,26; 30,6; 171,5; T45,6; earliest stage 16,8; source (of generation) 4,3 (with note); 4,6.19.26; 61,19 etc.; first principle 179,23; original amount 121,2; outset 164,6; T75,6; start 18,6; starting-point 19,33; 53,20; T33,7; T70,25; (in argument) 19,33; T33,7; T34,20 etc.; (ἐξ ἀρχῆς) initially 175,20; κατ᾿ ἀρχάς to begin with 145,17; τὴν ἀρχὴν in the first place 100,15; 191,27 ἄσαρκος (comparative) less well-fleshed 5,7.9 ἀσελγής unseemly 26,6 ἀσθένεια weakness 10,36; 33,26; 192,6; 193,29; 194,10; T40,13.14; T51,8 etc. ἀσθενής weak 32,17; 65,4; 69,33; 94,5; 98,20; 111,27; 127,20; 142,13.17; 143,16; 156,27; 157,2.4; 193,21.22.24.27.28; 194,3.4.7.31; 195,30; T45,23 etc. ἀσκεῖν cultivate 63,17.24 (tension) T35,26 (logical theory); T82,13 (virtue, Plato); T95,21 (wrestling-school exercise); train, (medio-passive) be trained, undertake training 23,34; 79,31; T84,19.23; T85,2; T95,24; T99,25 ἄσκησις cultivation (of strength) 63,4.24; practice 51,27 ἀσύμμετρος out of balance 155,19; poorly balanced 51,18 ἀσφαλτώδης containing asphalt 17,23; 107,33; 186,6 ἄτακτος disordered 21,2 (motion); irregular 61,2 (motion); (adverb) in an irregular way 7,7; in a disorderly way 20,34; 21,21 ἀτελής imperfect T45,20 (with note); T46,5; T53,13; incomplete 44,17

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Greek word index

ἄτμητος indivisible 10,11; 12,8.15; not admit of any division 8,24 ἀτμός vapour 25,33; 31,10; 71,1; 186,3; 188,5 ἀτμώδης vaporous 96,35; 172,30 ἄτομος atom 9,11 (with note) ἀτράφαξυς orach 132,1; 151,27 ἀτροφεῖν experience poor nourishment 102,6 (with note); 141,28; 142,5 ἀτροφία poor nourishment 20,1 (with note); 102,6 ἀτταγήν francolin 191,2 αὐλεῖν play the aulos; (participle as noun) aulos-player/playing 77,31 (with note); 78,4 156,1 αὔλησις playing of the aulos 67,21 (with note); 78,1 αὔξησις growth 25,24.30; 28,25; 42,18; 82,9; increase 5,2; 13,21; 40,23; 61,14.21.24.25; 62,4; 66,11.17; 70,10; increment 158,5 αὐστηρός tart 32,2 (with note); 34,19.34; 87,2; 149,19.24; 181,2 αὐτοφυής naturally occurring (water source) 36,20 (with note); 81,2; 107,15; 175,33; 186,5.8 αὐχμηρός parched (state of the body) 28,4; 86,11; 99,27 αὐχμώδης parched (state of the body) 86,16; 88,16; parching 17,10 ἄφθαρτος immune from decay 29,23 ἄφλεβος narrow-veined 15,15 ἀφορίζειν specify (a time) 23; 73,24; make specifications 39,14 (with note); 40,13; 44,11; 48,22; 49,11; 61,13; 64,25; 73,7.24 ἀφροδίσια sex 39,13 (Hipp.); 39,13.17.18,19.22; 96,2 97,31; 98,5; 99,6.12.14; sexual activity 22,3,10; 27,10; 36,16; 98,20.27; 99,3.10.11.19; 101,29; 139,20; 140,13; 169,5; 175,15; 176,36; 177,3; 178,5; 180,21.23; 197,7; T90,5; sexual intercourse 194,33 ἀφροδισιαστικός lustful 15,17 ἄφυσος free from flatulence 117,20.26.27 ἄχροια poor colour (of skin or body) 19,34; 96,31 ἀχώριστος inalienable (property) 45,34; 46.7; inseparable 7,4; 22,12 ἀψίνθιον wormwood 173,11; 187,8.10; 188,9 βαλανεῖον bath 12,4; 61,16; 81,33; 82,2; 88,8; 97,3; 114,15; 165,34; 179,5.6.28; 183,19; bath house 24,14.21; 43,25; 143,32; 163,29; bathing 96,28; 108,3; 114,9.15.20 βάρβαρος barbarous T97,7; foreign 24,22 (with note); 24,25; 118,24 (with note); 119,28 βετονική scurvy grass 146,16

471

βίαιος forceful 40,24; 64,14; 68,7.8; 69,17; 163,28; (adverb) forcefully 62,13; 67,14; 112,9; violent 16,9; 31,10; (adverb) violently 28,24; 122,15; (neuter singular as noun) forcefulness 76,12.16; violation (of linguistic usage) 12,1 βλαβή damage 96,20; harm 3,22; 4,1; 5,17.18; 34,15; 162,31; 185,18; 194,13.36; T40,11.12; T93,11 βλάπτειν damage 12,24; 33,11; harm 33,4; 55,18; 99,25; 160,25.27; 164,17.21; 193,12; 187,16; T39,21; T56,4; cause harm 7,8; do harm 198,4; be harmful 177,2; have a negative effect T55,27; (passive) experience harm 143,16; (+ οὐδέν) completely unharmed 191,22 βλίτον blite 151,27 βοήθεια assist 188,6; assistance 111,28; 146,22; 147,18; 183,12 βοήθημα remedy 106,28; 109,13; 140,31; 150,1.13; 154,30.33; 158,5.19; 159,31.33; 180,20; 182,37; 183,7.13; T42,1; T89,16; T92,6 βολβός grape hyacinth 146,29 βουβών swelling of gland 136,18 (with note); 137,1 βούτυρον butter 147,31 βράγχος hoarseness 150,31.33; sore throat 17,19 βραχυλογία abbreviated manner (of expression) 51,33; 80,14; concision 80,14; 150,16 βραχύλογος abbreviated (manner of communication) 48,4 (with note); 48,21; 49,10 βρυωνία bryony 129,4 γάλα milk 9,31; 17,26.27; 18,1.2.3; 22,14,20; 23,15,18; 148,29; 149,5,6,10,12; 150,19,26; (ass’s) 149,28.30.31; (goat’s) 148,22 γάρον garum 132,4 (with note); 152,29; 181,2; 189,19 γαστήρ stomach 15,23.28; 22,13 etc. T56,19; T85,8 etc. γένεσις creation T37,6; T51,25; T59,4; T66,20; T68,15,16; engendering 74,28; generation 4,3 (with note); 4.5.19.22; 10,21; 18,2; 31,8; 162,5; 171,24; inception 91,28; origin 5,18; 31,19.21; 33,28; process by which (ailment) arises 193,32; production (of kidney-stones) 150,31 γενικός general 137,12 (headings); T91,20.24; generic 68,26; of class 169,25; (comparative) at a higher level of generality T68,21 γεννᾶν generate 152,1; 164,33; 184,31; T64,4.6; generation T66,19; 85,8; 34,11;

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472

Greek word index

produce 144,24; 190,15; 194,27; give rise T41,2; (passive) arise 99,22; (aorist participle passive) newly-born 18,7 γεννητός generated 5,13.16; 10,20; 29,24 γένος class T60,27; T52,13; 4,2.8; 13,5; 18,26; 19,24; 34,2; 40,18; 48,31; 73,7; 104,32; 130,14; 169,8; 189,22; 197,12; race 24,24 γῆ earth 4,10 etc. γῆρας old age 5,10.11; 137,23; 154,19.22.25; 157,3; 168,27; 171,5.6.9.14; 197,11 γηροκομεῖν apply old-age care 144,2 γηροκομικός of old-age care 151,2 (science); 151,3 (composition); (neuter singular as noun) old-age care 138,12; 142,23; 151,11; 154,27; 171,21 γίγνεσθαι arise (ἐπὶ = from) 19,32; 84,26; 93,21; 100,6; 112,1; 154,24; be 31,23; 117,19; 142,7; be achieved 23,21; be administered 181,4; be carried out 42,4; 45,3; 61,4; be done 195,14; be made from 186,18; 195,12; be performed 65,30; 158,16; be taken 125,22; be there 71,10; 84,24; become 5,8; 51,27; 71,11.13; 136,34; 166,22; 173,10; 176,12; 181,8; T33,14; T57,22; bring about 184,10; come about 7,29; 18,33; 36,7; 91,29; 96,23; (perfect) is created T47,22; exist 103,29; (+ dative) experience 161,30.31; happen 93,24; lie 78,27; occur 88,26; (+ παρά τι) (occur) in conjunction with; reach 18,35; 166,28; result 107,7; T86,14; render 197,9; (+ αἰτία) cause 192,14 γινώσκειν acknowledge T70,10; be aware T33,4; decide 28,9; find 159,29; have knowledge 53,24; know 126,9; realize 7,15 etc.; recognize 7,18.22.23 etc.; (+ χάριν) be grateful 195,30; (medio-passive) be known T87,23 γλαύκιον (eye-salve made with) red-horned poppy 192,333 γλεύκινος fresh young wine 107,13; made with fresh young wine (of kind of perfume or unguent) 97,12.13 (with note) γλήχων pennyroyal 124,22.28 γλίσχρος viscous 90,12; 96,23;114,35; 115,2.4.20; 124,16; 126,10; 128,24; 173,5; 190,31; 191,26; 195,23; T83,18 γλισχρότης viscosity 33,21.23; 35.11; 112,25 γλυκύς fresh (of water) 25,23; 35,10; 186,8; (of moisture) 161,25; sweet 23,10; 97,11; 108,4; 126,16; 161,31 γνώμη opinion 92,18; view T83,3; 18,24; 48,25; 50,15; 53,8 γνώρισμα indicator 14,1; 15,10; 22,30; 57,15; 58,22; 84,35; 107,9; 157,31; 164,12; T41,27 etc.

γνῶσις knowledge T71,4; 13,12; 67,36; 159,21.23; realization 10.11; understanding 174,33 γράμμα book (of a work) 15,22; 28,11; 34,27; 38,5; 73,18; 103,29; 147,10; 180,31; work 3,2; 5,31; 56,18; 147,25; 154,23.27; letter 11,8; T71,21; T84,13; writing T35,19; 8,5; 24,15 γραμματικός scholarly T77,25 (research); (feminine singular as noun) language and literature T46,18 (with note); T46,25; T46,27; T77,25; scholarship T70,16; (masculine singular as noun) scholar 144,4 (with note); 167,24; 196,28; T65,16 γράφειν prescribe 38,24; write 20,14; T97,8 etc. γυμνάζειν give exercise 115,28; make (someone) exercise 41,9.29; 59,6; 140,23; 163,2; T90,20; instruct in an exercise 80,30; perform an exercise 64,12; 70,30; take exercise 157,10; 181,29; (medio-passive) school oneself T37,22.24; train 93,36; 94,1.5; T33,6; T35,7; T100,1; (passive) undergo exercise 92,6 γυμνάσιον (physical) exercise 19,5; 27,9; exercise 35,35; 39,25.30.32; 40,25; 55,3; 59,4; 60,8; 61,14; 64,18; 71,31; 80,6; 92,20; 98,25; 116,3; 143,33; 162,24; 175,30; 184,10.12; T56,18; T90,10; gymnasium 39,35 γύμνασμα physical exercise 22,7 γυμναστής (physical) trainer 35,36 (with note); 43,5.15; 44,10.28; 50,12; 51,30; 52,15; 53,24; 60,16; 60,21 (with note); 60,22; 63,29 (with note); 65,26; 67,36; 69,6.12.21.31; 73,2; 75,10; 79,11.16; 94,19 etc.; T34,2; T42,6; T79,3.6.7; T85,4; T95,24; T96,12; T97,6.17 γυμναστικός focussed on / involved in physical training 84,6; 89,19; T43,6.7.8; (masculine singular as noun) expert in physical training 68,30; T81,19 (Plato); T92,11; γυμναστική (τέχνη) (art of ) physical training 18,16; 51,27; 69,35; T33,17 (with note); T34,6.13.23.25; T35,2; T36,15.25; T37.1; T38,4.10.12; T42,12.13; T45,4; T70,8 ; T72,1; T75,4.8; T76,6.10.12.15; T78,22; T79,22; T83,14; T79,1.4; T80,10.19.28; T81,6 (Plato); T81,22; T82,6 (Plato); T82,17; T83,3.16; T85,21; T86,4; T87,13.15; T90,11.22.23; T91,6.11.17; T92,13; T94,14; T95,8.17.20; T96,1.14; T99,15 ; T100,3; (neuter plural, as title of Theon’s book) Physical Training 92,20

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Greek word index

δαπανᾶν (passive) be used up 22,14; 128,21 δεικνύναι show 3,13; T37,10 etc. δεόντως appropriately 96,12; reasonably (enough) 17,15; 25,7; (negative) inappropriately 139,21 δέχεσθαι be subject to (change) 14,13; receive 27,24 etc. δῆλος evident(ly) 46,7.33; 130,9; 136,34 ; 161,18; T33,15; T72,20; T83,1; obvious 52,22; T40,7.23; 144,30; 149,18; T46,4; T48,5; T49,7; T51,14; T70,1; T72,17; T91,17; (adverb) T38,14; T39,10; T46,23; T74,8 δηλωτικός indicative (of ) 11,28; 111,31; T47,11 δημιουργός artificer T84,10; T85,11; (divine) craftsman 4,7; 79,5; T54,4; creative (of ) T36,18; T49,9.16; create T38,13; T43,19; T44,24; T49,1; T52,11; T53,20; T83,16 διαβάλλειν malign 50,15; undermine 45,30; (passive) be put off 82,15 διαγινώσκειν decide 84,10; discern 36,6; 68,6; 72,15; 87,3; 96,30; 118,2; 139,5; 162,22; T90,7; discernment 184,27 διάγνωσις diagnosis 140,30 (with note); 159,27; discernment 58,31 (with note); 94,28; 110,1.21.33; 112,15; 161,14; 184,29; T34,27; T61,8; T84,20; (+ λαβεῖν) discern 114,22 διάγραμμα table 50,31 (with note); 51,11; 52,36; 53,15; 95,19 (with note) διάθεσις state 3,10; 5,11 etc.; T39,19.22; T46,20 (with note) διαιρεῖν distinguish 4,5; 28,11; 36,33; 61,12; T48,12; T65,20; T76,19; make distinctions 6,27; 7,16; 12,25; 39,24; 40,7.12; 60,7; 160,31 ; determine T38,13; divide T60,22; solve (προβλήματα) T35,23; T59,13 διαίρεσις distinction 37,5; 65,25; 180,16; T88,15; division 106,32 δίαιτα daily regime (healthful) 6,19; 16,30; 132,12; 154,18; 168,14; 172,32; 179,20; 192,9; diet 35,12; dietetics T62,22 διαιτᾶν conduct/give daily regime 17,20; 24,12; 25,20; dietetics T64,26; keep to a diet 121,26; (middle) eat 180,4; (have) habitat 147,6; adopt a lifestyle 197,5 διαίτημα (item of ) daily regime 15,2; 28,9.10.15; 160,38; 168,2; 175,19; 192,18; 194,9.15; T69,25; T98,22; diet 90,17; 190,16 διακαθαίρειν cleansing-through 179,14 διακεῖσθαι be adapted 18,16; be in a state 51,19; (ἄριστα) be in the best possible state T47,23; (μοχθηρῶς) be in a faulty state

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16,26; καλῶς be in a good state T47,17; οὕτω διακείμενος in such a state 117,29; 170,3; 189,28; 196,10; T39,11 διακόπτειν interrupt 10,14; 168,24 διακρίνειν distinguish 140,6; 164,28; T71,6; select 69,23; separate (of residues) 111,15; T61,20; T67,2.24; T79,13 (in logical sense) T59,22; T70,9.12; separate out 30,7.12; urinate 111,26 διάκρισις separation (of urine) 111,21 (with note); 168,19 διαλογισμός argument 20,5 διαλύειν break down 119,8.10; dissolve 115,10.13; 116,32; unclench 63,1.7 διάνοια intellect 15,16; 19,34; 118,34; T49,12 διάπλασις shaping 3,16 (with note); 7,32; 13,9; 15,7 διαπνεῖν (middle) transpire, transpiration 25,16; 55,20; 161,21; 172,30; 179,24 διαπνοή transpiration 25,13 (Hippocrates); 31,13.15 etc. διαπονεῖν exert 65,8.18; 68,12; exertion 62,13; 69,26 διασπᾶν tear apart 7,9; 85,26 διαστρέφειν (passive) become distorted 19,3 διασῴζειν preserve 5,30; T35,18; save 171,12; (medio-passive infinitive) self-preservation 141,24 διαφθείρειν be destructive 4,4; destroy 7,20; 12,11; 19,23.24; 59,16; T53,8; ruin 163,17; (medio-passive) decay 7,1; 182,4; lose 3,12.19; undergo decay 106,24; 175,31; 185,16; T86,18 διαφθορά decay 4,1; 182,3; 185,16; loss T57,9 διαφορά difference 8,32; 9,4; 13,16; 73,4; 148,19; 168,20; T58,9; different type 18,27; 176,28; T61,16; T62,17; distinct type 9,20; 43,11.14.15; 53,13; 94,25 distinction 13,16; 14,2; 43,18; 44,3; 47,26.33.34; 60,29; 112,37; 155,10; division T73,15.19; (different) variety 27,29; T55,20 διαφορεῖν disperse 44,21 (Theon); 45,14.15.19.28; 46,23.24; 47,14; 55,8; 81,12; 87,24; 114,9; 186,2; T56,18; T57,20; have a dispersive effect 129,4; (passive) undergo dispersal 92,30 διαφυλάττειν continue 189,31.35; keep free (from illness) 135,17; maintain T58,16; preserve 6,1.18; 78,29; 162,33; T37,13 διαχώρημα faeces 110,26; 172,13; T89,25 διαχώρησις excretion 106,25 διδασκαλία exposition 135,4; 140,8; (form of ) instruction 45.30: 46,29.30; 48,22; 53,2; 74,6; 150,15; 184,14.18; teaching 38,28; 103,22; εἰς διδασκαλίαν ἄγειν address 138,12

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διδάσκειν give instruction 39,15; 66,15; 73,17; 164,20; T80,10; T94,16; give one’s views 103,17; teach 5,24; 49,33; T59,10; (passive) learn T77,18 διέξοδος exit 79,29; path(way) of exit 33,22.77; 149,9; T84,8 διέξερχεσθαι give a thorough account of 100,26 διέρχεσθαι (give) account 15,3; 28,9; 29,12; 35,30; 38,4; 59,23; 63,32; 99,11; 134,6; 168,27; deal with (sophistical enquiries) 7,24; discuss 176,6; give exposition T97,14; go through T35,5; run through T75,16 διηγεῖσθαι explain 118,28; give a thorough exposition 37,12; 44,34; 80,24; 119,5 διοικεῖν (passive) be controlled by 22,16; 66,4 (with note); 133,7; T54,4; T56,15 διορίζειν define 6,28; make specifications 22,10; 24,10; 56,21; distinguish T45,4; T69,15; (middle) make determination 109,16; make distinctions 164,20; 177,33; specify 45,2; 54,27; 56,12; 61,10; 80,21; 93,10; 109,19 διορισμός specification 98,12; 113,21; 132,31; 164,21.29.30.32; 178,15; 192,21.22; 194,10; distinction T37,5 Διοσπολιτικόν Diospolitikon (drug preparation) 117,6; 125,7; 182,6; 188,34; 189,8 διφθέρα parchment 154,12 (with note) δοκεῖν appear 12,16; T36,11; (+ infinitive) apparently T64,1; seem 8,27; T75,13; (give) impression 84,15; 85,3.27; 94,34; have the view 39,10; 130,21; (impersonal) decide 73,14; 161,26; 181,21 δοκιμάζειν test 22,23; 53,23; 119,3; trial T82,13 (Plato) δοκιμασία examination 145,1; testing 118,30 δόκιμος reputable 36,8; 61,26 δόξα belief 14,24; 53,23; 84,24; 98,9; 164,25; opinion T34,2; reputation 44,8; 164,23 δουλεία servitude 74,27 (with note); slavery 38,18.19 (with note); 39,4 δουλεύειν be in servitude 136,22 (with note); 173,26; be in slavery 38,22 δραχμή dram 118,12.14.16.17 (with note); 124,23.24.25; 127,17; 188,19.24.26 δριμύς acrid(ity) 26,13; 85,8.12; 91,23; 100,18; 107,6; 114,4; 117,12.17; 119,17; 149,19.24; 154,8; 158,11; 161,27; 165,4; 172,29; 185,7 δριμύτης acridity 86,21; 104,27; 105,5.22; 158,12 δύναμις capacity 5,23.25 etc.; significance 156,6; δυνάμει by implication 56,17; see also ἀλλοιωτικός; ἀποκριτικός; προωστικός; φαρμακώδης; φυσικός; ψυχικός δυναστεύειν master 28,2

δυσκρασία bad-mixture 12,19; 14,34; 15,24.26 etc. δύσλυτος established (of a bodily state) T39,17; T46,20; T47,13 δυσπάθεια protection against harm 16,23 (with note); 35,23; 40,26 δυσπαθής (having) protection against harm 55,19; 192,19 δυσώδης malodorous 26,26; 148,5 ἑβδομάς seven-year (period) 28,13.32; 38,6; 39,8; 71,26; 82,24 ἐγγίγνεσθαι (+ dative) acquire 35,21; (+ dative) arise in 66,29; 67,26; 85,27; 93,30; 98,27; 105,24; origin T82,12; (+ dative) reach 106,10 ἐγκέφαλος brain 34,1.3; 130,29 ἔγχελυς eel 146,30 ἐθισμός habit 19,25; habituation 82,18; practice 28,28 ἔθνος people 121,35; 144,31 ἔθος customary practice 17,7.9.13; 108,2; 155,12.30; habit 59,15; 107,12; 159,7.21; 160,16; 162,28.31.33; 179,3.7.13; 180,27; ἔθος ἐστίν be commonly used 140,20 εἰδικός of type (distinctions) 104,15 εἶδος form 4,35; 9,27; T62,17; T63,18; (of bad-mixture) 167,17; (of human body) 73,9; (of exercise) 59,23.24; 60,14; 65,6; 69,14; 74,13; 156,22; (of life) 38,11; (of motion) 18,28; (of daily regime) 175,24; type (of bodily constitution) 169,31; (of cause) 179,17; (of fluid) 113,1; (of bad fluid) 105,4; 110,8; (of massage) 44,2; (of massage and holding of breath) 75,21; (of water) 186,14; κατ᾽ εἶδος in the particular sense T89,10; specific 73,4 εἰκός likely 17,29; 81,28; 84,5; 168,14; οὐ unlikely 97,26; probably 19,15; reasonable 12,15; 120,18; 148,18; reasonable to suppose 162,33; T85,13 εἰκότα, τά the relevant arguments 19,11 εἰκότως it is reasonable that 22,19; reasonably 93,7; 150,14; 171,18; for good reason 159,26; as one would expect 176,30 ἐκδιηγεῖσθαι give a thorough account 28,14 ἐκκαθαίρειν cleanse (out) 30,5; 33,15; 34,5; 40,31; 41,3; 77,12; 79,6; 107,31; 187,9 etc. ἔκκαυσις over-heating (from the sun) 35,8; 97,28 ἐκκενοῦν empty T58,4 ; evacuate 26,14; 31,24; 35,16 etc.; T57,19; T89,26; cause evacuation 71,4; (passive) lose T58,1 ἐκκρίνειν expel 6,16; 30,8.21.31; 31,4.9.11.15; 32,33.34; 76,23

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Greek word index

ἔκκρισις expulsion 109,26; 176,22; 190,4; 194,28; secretion 31,31; 107,13.29 ἐκλύειν reduce 126,21; 183,28.29; relax 42,7; 71,14; 76,3.15; 175,23; cause relaxation 76,7 ἐκροή, ἔκρους (point of ) outflow 30,28; T57,25; see also Book I, n. 117 ἐκτίθεναι lay out (in table) 50,31; 52,35; set out (assumption or procedure) 56,19; T33,14 ἔκφραξις release of obstruction (in liver) 173,21 ἐκφράττειν release obstruction (of liver) 147,17; 173,3; 181,33.37; remove obstruction 152,10 ἐλαία olive 153,4; 181,25; T48,19.20 ἔλαιον oil 23,9; 41,31; 42,1; 43,31; 55,7; 61,7; 71,9; 75,36 etc.; T90,1 ἐλάτη pine 127,12; 128,2; τὸ διὰ τῆς ἐλάτης φάρμακον pine-based drug 126,32; τὸ διὰ τοῦ σπέρματος τῆς ἐλάτης ἄκοπον the antifatigue (drug) made with pine-nuts 97,21 (with note) ἑλένιον elecampane 118,4 ἕλκειν attract 6,16 (with note); 30,20; 32,32; 33,18; 41,1; 134,19; 142,1; draw away 193,9; draw in / into 158,27; 183,21.23; 189,13; 192,8; T55,14; draw out 165,33; pull 87,25 (with note) ἔλυμος Italian millet 151,29 ἐμπειρία experience 21,33; 57,32; 63,27; 90,26; 92,35; T78,2; research T78,1 ἔμπειρος experienced (in) 19,27; 35,33; 61,10; 69,21 ἐμποδίζειν impede 10,14.17; 116,17; prevent 73,13; (passive) suffer hindrance T39,22 ἔμφραξις obstruction 20,8; 33,5.27; 34,26; 79,18; 96,25; 146,22; 148,14; 188,33; 192,29 ἐμφράττειν obstruct 6,17; 35,11; 41,26.29; 79,16.26; 80,2.6; 115,1.5; 146,3.24; 147,17; 181,33; T84,7; cause obstruction 147,8 ἔμφυτος innate 5,15.36; 18,6; 20,1; 24,33; 31,9; 40,23; 66,13.18; 133,7; T84,7; internal 61,20.24; 62,4 ἐναντίος contraindicated 75,28; 86,32 etc.; opposite(s) 14,2; 17,1.2 (Hippocrates); 17,8.14.16.18; 28,2 etc.; T41,12 (knowledge of ); T63,27; T64,2; T74,9 ἐναργής clear 148,32; evident T71,18; manifest 13,35; 14,11; 49,23.25.26.29; 56,8; 65,23; 107,9; 174,24 ἐνδείκνυσθαι display 26,27; indicate 47,4.37; 51,31; 75,15; 85,20; 98,16; 111,19.23.29; T47,6; T77,5.6; T8,18; give indications 58,37; provide with an indication 139,7; show 96,14 ἐνδεικτικῶς on the basis of indication 159,26

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ἔνδειξις indication 17,8; 132,22; 159,17.24; 180,29; 185,34; verbal account 56,8 ἐνέργεια activity 7,34; 12,20; 34,2; 40,26; 42,15; 45,2; 58,19; T40,11; T48,9.11; T51,19; T59,5; T64,12; T68,9 etc.; see also καθ᾽ ὁρμήν; φυσικός ἐννοεῖν conceive, have conception 19,9; 92,34; 196,13 ἔννοια notion 11,31; 84,13.14 (with note); 84,24; 89,6 (with note); T33,10; T34,5; T40,24; ἡκέτω εἰς ἔννοιάν σοι consider T39,3 ἔντασις tightening 77,30; 78,28.31; 85,19.21; 87,28 ἐντείνειν (passive) be under tension 78,7; tighten 76,28; 77,11.16.24 ἔντερα intestines 30,13.22.23; 31,35; 32,7.18; 33,4; 41,19; 77,1.4; 134,14; 156,25; 189,31; 190,10 ἐνυπάρχειν be present within 4,13; 10,28; 104,12 ἔξαρθρος dislocated 7,9 ἐξελέγχειν compromise (of bodily condition) 155,25; confound 141,22 ἐξερεύγεσθαι discharge 33,2.19; produce (scum) 120,30 ἐξευρίσκειν discover 18,11.20; 21,22; 40,34; 53,7; 59,3; 92,19; T71,7.16; T88,23; T95,3; discovery T83,22; find 22,22; find out 3,18; 51,24; 69,28; 83,32, 95,13; 107,23 ἐξέχειν (be) in excess 28,1 ἐξηγεῖσθαι (give) an explanation 15,6; 72,15; 73,26; explicate T34,26; T35,2; give exegesis of (an ancient text) 51,32; καθ᾽ ἕκαστον give a full account T76,16 ἑξῆς following 71,32; next 28,29; 39,2.3; 81,2; 92,7; subsequent 16,6; 35,1; 108,8; then 139,27; T77,11; ἑξῆς ἂν εἴη it may now be time to proceed to 52,38; κατὰ τὸ ἑξῆς successively 70,25; κατὰ τὸν ἑξῆς λόγον in what follows 126,8 ἐξιᾶσθαι thoroughly cure 3,9; 34,22; 99,29; 100,9 ἕξις condition 14,2; 17,16; 57,16; 98,23; 113,33; 140,24; 167,27; 194,25; T46,23; T83,7; T46,25 (with note); καθ᾽ ἕξιν stable (health) 142,25 (with note); T38,23 (with note); T39,17 etc. ἐπαγγέλλεσθαι announce intention 73,10; (make the) claim 96,11; 137,4; 182,32; (with infinitive) make to do 137,10; tell 111,26 ἐπάγγελμα aim 34,15; what (something) professes 29,9 ἐπαγωγή analogy T37,8.21 ἐπαινεῖν advocate 77,16; approve of 10,22.25; (negative) cannot be countenanced 115,22;

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476

Greek word index

give credit to 47,32; look positively upon 14,3; laudable T44,7; praise T47,16; propose T79,23; (passive participle) celebrated 147,28 ἔπαινος credit (for a discovery) 50,14 ἐπάλλαξις variety 28,10; 169,30 (with note) ἐπαλλάττειν combine 39,5; 50,16.25; 169,31 (with note) ἐπανέρχεσθαι recapitulate 40,15 ἐπανορθοῦν (active and middle) rectify, rectification 5,19; 14,34; 19,22; 138,3; T54,6 etc.; (middle) repair T54,8; T57,13 etc. ἐπανόρθωσις rectification 52,25; 70,3; 83,36; 84,31; 94,29; T57,7 ἐπανορθωτικός able to rectify T57,10; restorative (part of the art) T73,11; T75,23; T89,27; μέρος τῆς τέχνης section of the art involving small restorations T73,29 ἐπεγείρειν provoke 98,29; 122,23; stimulate 20,20; 55,14; 141,28; 177,12; T82,20 ἐπέρχεσθαι (give) account of 164,31; address 151,12; approach 151,1; consider T44,9; deal with 73,6; go through 94,32; ἐπέρχεταί μοι (with infinitive); 118,30 I have now come to; θαυμάζειν ἐπέρχεταί μοι I am amazed 14,23; it strikes me as remarkable 92,4; it amazes me T99,26; πόθεν ἐπέρχεται (with infinitive) what is the reason that 43,14 ἕπεσθαι be a consequence 46,4; T52,4 etc.; (participle) consequent 81,16; follow (from) 5,17; 123,9; 185,25 etc.; κατ᾽ ἀνάγκην follow of necessity 13,1; ἐξ᾽ ἀνάγκης follow necessarily/of necessity 6,22; 13,3 etc. ἐπέχειν/ἐπίσχειν hold (one’s breath) 77,32; restrict 28,25; retain 31,32; 34,25; 77,32; (passive) suffer retention 34,17; 189,18; (middle) be constricted 188,35 ἐπιβολή application (esp. in context of massage) 42,9.25.34; 46,13; 76,16; T61,12 ἐπιγάστριον abdomen 30,17 (with note); 30,33; 67,22; 76,34; 77,5.11.24.29 ἐπιγίγνεσθαι (+ dative) arise after; result from 86,23 ἐπιδεικνύειν present 135,16; show 10,22; 15,2; 19,9; 24,31; 29,19; 46,31; 73,28; T53,23.27; T71,14; T99,15 ἐπίδοσις contribution 25,23 ἐπιθολοῦν cloud 58,35; 102,17; (middle) be polluted 27,16.20 ἐπιθυμία desire 20,5; 38,21; 164,23; 185,22 ἐπικεῖσθαι adjoin, be adjoined to 30,14.20.28 ἐπίκρασις mixing 26,8 ἐπικράτεια dominance 4,15 ἐπικρατεῖν dominance 4,14; 112,1.16.23; dominate 42,23; 94,30; 98,21; (be) dominant

95,9.13; 98,18; 112,22; 113,30; 194,22; domination 176,30 ἐπιληψία epilēpsia 20,9; 156,8 (with note) ἐπιμέλεια care 38,12; 73,17 ἐπινοεῖν conceive 50,8.28; 190,30; 196,10.14; (form) conception 49,18.25; 196,12; T66,8; consideration 126,17; (passive) be known as 188,18 ἐπίπληξις rebuke 23,30 ἐπισκέπτεσθαι/ἐπισκοπεῖσθαι consider 13,6; 71,30; T56,10; T72,4.13; T87,19; examine 22,22; investigate T85,20 ἐπίσκεψις consideration 139,32; examination 181,17; investigation 103,6; T86,7 ἐπισπᾶσθαι attract 123,3.5; demand 95,9; draw in/into/inwards 92,9; 116,11; 122,20.27; 133,17; T67,1; draw to oneself 22,17; 85,30; 92,12; 133,22 ἐπίστασθαι (participle) expert T98,19; know 37,6; 69,11; 82,13 etc.; T78,13; T92,14.17; T93,16; T97,21; have knowledge of 60,14; 69,9; T41,24; T77,14; T78,20; T90,13; (participle) people with knowledge T98,23; understand 31,26; 67,34 (with note); 68,6.23; 69,13; 96,14; 119,3; 136,1 etc.; have understanding of T64,27 ἐπιστατεῖν (be) in charge 157,8; direct 94,20; supervise 6,30; 16,4.12; 72,6; 173,24; 195,27; T79,21; (participle) supervisor 57,30; 97,25; 176,20; T57,26; T79,13; T91,2 etc. ἐπιστάτης supervisor 84,4; T42,6; T57,14; T80,22; T92,12; ὑγιεινός preceptor of health 59,20 ἐπιστήμη knowledge 28,35 (with note); T41,7.10.13 etc.; (scientific) 58,30; 59,10; science T71,6; (of health) 103,23; γηροκομική of old-age care 151,2; φυσική natural T70,6 ἐπιστημονικός scientific 53,22 (θεώρημα, principle); 174,33 (γνῶσις, understanding); T37,22 (ἀπόδειξις, demonstration); (adverb) scientifically 154,32 ἐπιστήμων expert 16,10; 159,33; T85,21; T87,8; T91,5.7; possessed of knowledge 101,4; with knowledge 35,34; with understanding 68,26; 140,31 ἐπίσχειν see ἐπέχειν ἐπίσχεσις retention 31,26; 32,7; 77,36 ἐπιτείνειν extend 74,9; intensify 66,6; 98,7.16; 138,33; 175,23; ἐπιτείνοντας καὶ ἀνιέντας with alterations of intensity 187,31 ἐπιτήδειος appropriate 26,9; 80,3; 97,14; 114,14; 119,11.24; 127,21; 144,32; 146,32 etc.; fit (for) 15,20; good (for) 197,21; indicated 184,33; suitable 70,2; 78,7;

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Greek word index

87,2.12; 94,17; 115,11.16; 117,29; 124,18; 128,33 etc.; suited (for/to) 102,6; 155,16.20; useful 25,6; 26,9; ξύλα wood fittings T94,1; εἰς ὑγίειαν conducive to health T96,5 ἐπιτηδείως appropriately 23,10 ἐπιτήδευμα activity 166,13; (regular) 178,4; custom 24,25; exercise 159,2.5; habit 154,17; practice 82,15; 164,17; 166,16; T79,8; T90,24; T96,20; T100,6; (daily) T80,13; T90,4; (habitual) 29,16; 305,22 ἐπιτίθεσθαι apply 35,14; (participle) contiguous 196,9; impose a condition on 23,33 ἐπιτρέπειν advocate 167,3; allot T49,3; T87,17; allow 161,22; encourage 75,26; 99,1; 182,19; 191,9; instruct 24,3; 26,17.23 etc.; invite 62,37; stimulate 41,10; ἐμβραχῆναι have (something) soak 127,7 ἐπιχειρεῖν attempt 73,7; 88,24; 128,16; T97,8 etc.; γράφειν commit one’s view to writing 135,18; embark on (argument) T33,5 (with note); set out to 164,24; take upon oneself 119,5; try 148,29; undertake 135,20; 160,31; εἰς ἑκάτερον argue on either side 7,10; T37,7 ἐρεθίζω stimulate 190,3; (medio-passive) become irritated 22,12 ἑρμήνεια (manner of ) communication 48,4; 51,34; 56,8.18 ἑταῖρος follower 164,2 (with note); 197,18 ἕτοιμος ἐξ ἑτοίμου λαμβάνειν take as assumed 7,17; T36,14 ἑτοιμότης readiness (to motion) 4,29 εὐαρμοστία good tuning 12,14 εὔδηλος (quite) evident 41,6; 58,34; 185,22; 193,31; (abundantly/quite) obvious(ly) 46,34; 48,11; 149,1; 152,27; 163,15; 175,21; T44,14; T58,3; T72,19 etc.; of course 169,28; 188,27; 198,2 εὐεκτικός endowed with/of good-condition 94,13; T50,11; euectic T70,8 (with note); T73,22.28; T74,2.12.26; T89,11.14 εὐεξία good-condition 8,8 (with note); 28,33; 40,19 etc.; T36,25; T39,18 (with note) εὔθυμος good-spirited 58,18 (with note); 82,27 (with note) εὐκοσμία good order 28,30 εὐκρασία good-mixture 7,28; 12,2.13.19; 13.8.13; 14,10.12.24; 15,21 etc. εὔκρατος well-mixed 12,3.8–12; 13,34 etc. εὔλογος (adverb and neuter singular) natural 86,3; 160,29; reasonable/reasonably 11,9; 49,31; 60,20; 123,15; 190,7; T75,5; reasonable to suppose 168,20; 175,9 εὐμέλεια melodious use (of the voice) 18,13 εὔογκος (comparative) of fuller volume 139,10 εὐπείθεια ready obedience 23,34; 28,31

477

εὐπειθής readily obedient 4,6 εὕρεσις discovery 3,9; 151,15; 155,31; T33,7; T34,20 εὑρίσκειν come across 126,14; T65,5; discover 37,9 (discovery); 44,9; 53,12.15; 59,3; 110,2; 159,26; 161,11.16.18.28 etc.; T35,14; T75,8; find 13,16.25; 23,24; 29,5; 49,22; 85,1; 141,19; 153,34; 159,31; 161,2.11 etc.; T65,23; T86,1.12; T95,14; provision 183,12; οὐ πολλάκις εὑρεῖν ἔστι occur rarely T79,5 εὐρυθμία good proportion 23,14 (with note) εὔρυθμος well-fitted 4,6; well-proportioned 68,19; 70,32; 157,20; (adverb) in a a well-proportioned manner 67,37 (with note); 68,13; (neuter singular as noun) good proportion 71,8 εὐρυχωρία open space 6,11; 77,3; 106,27 εὐρωστία vigour 11,21; 62,16; 66,13.22; T40,14 εὔρωστος robust 193,19 (condition); vigorous 49,6 (capacity); T46 (activities) εὐσαρκία good flesh T45,2.26; T49,23 εὔσαρκος well-fleshed 14,6; 15,10; 183,35; 191,21 εὐτονία good (state of ) tension 40,27; 60,31; 62,22.35; 63,14.23; 64,1; 96,34 εὔτονος contributing to/involving/productive of/with good tension 62,11.12.15.16; 63,27.33; 64,27; 88,13; 68,8.14.17; 73,31; 138,34; 139,24; with a good level of intensity 188,30 εὐτροφία good nourishment 91,35; 92,16; 157,29 εὔτροφος well-nourished 157,31 εὐφόρβιον spurge 190,22 εὐχροεῖν have good colour (of skin or body) 96,33 εὔχροια good colour (of skin or body) 126,24; 139,12; T45,2.26; T49,23 εὔχυμος of (or which enjoys) good fluid 22,7; 86,25; 88,12; 89,19; 108,17 etc. εὐωδής having a good smell 22,13; 119,16 ἐφεδρεύειν be in the offing 41,8; (harm) be potentially attendant (on) 26,19; 35,20; 74,29; 85,24 ἐφεξῆς next after that 31,26 etc.; next in order 74,8; subsequent(ly) 3,8; 35,1.31; in succession 17,7 ἐφεξῆς, τὰ what comes next 13,11; what follows 97,21; what is next in order 5,34 ἔφηβος adolescent 136,28 ἐφίεσθαι aim (at) 79,9; 193,18; (be) desirous of 5,23; be directed towards T48,14 ἐφίσταναι put in charge 29,29; set up (an art) T61,23; T62,16.25; (middle) appear upon

https://doi.org/10.1017/9781009159524.017 Published online by Cambridge University Press

478

Greek word index

the surface 111,11; 120,29; (participle) with concentration 174,35 ἐφόδιον advantage 182,5; preparation 28,30 ἔχειν (with adverb) (be) in a certain state/ constitution; ἀμέμπτως in a faultless constitution 23,13; ἄριστα in the best state 24,12; εὖ in a good state T81,17; κατὰ φύσιν in a normal state 10,25; 17,15; T80,4; μέσως in a middle state 22,25; παρὰ φύσιν in an abnormal state 11,19.20; T78,23; χεῖρον in a worse state 10,4; φαύλως in a bad state 11,6; have 4,3.7; 5,25; 10,8; 12,31; 14,12; 15,20 etc.; T34,5; T44,15; T46,17; restrain 31,31; λαβήν be vulnerable T37,4; λόγον have/stand in a relationship T50,18.23; κατάστασιν be in a disposition T55,19; φύσει be naturally endowed T62,9 ἔχεσθαι hold (on)to 67,9; 152,13; proceed to 5,33.4; 13,11; αἱ ἐχόμεναι ἡμέραι those days that follow 123,11 ἔχιδνα viper (in theriac drug) 147,15.20 ζειά einkorn 151,29 ζεῖν steam (of temperature of water) 81,3 (with note); 93,27.29; 128,12 ζέσις seething (of blood) 61,25 (with note) ζεστολουσία steaming-water bathing 92,7 (with note); 93,8.34; 94,8 ζηλοῦν emulate 24,25 ζητεῖν enquire into T38,8 (with note); ζητούμενον, τό object of enquiry 162,19; T33,8; T34,21; T35,14; T36,11.14.17.19.21; T37,3; investigate T73,3; look for T37,23; seek 14,21; 190,28 ζήτημα enquiry 7,24; 48,26; 103,2; T75,7; topic for enquiry T33,2 (with note); T35,27; T38,1 ζήτησις enquiry 7,10; 8,21; 142,28; 179,16; T36,26; T41,1.5; T42,8; T75,14; question 103,7; T41,1 ζιγγίβερι ginger 115,12; 118,14.15.18.23; 119.27; 129,34; 197,29; 198,10.14.16.17 ζύμη leaven 147,28; 148,11 ζυμίτης leavened bread 115,18 ζωμόν soup 111,12; 144,1; T98,3; λευκόν clear broth 132,3 ζῷον animal 5,14 (with note); 5,20; T66,19.23 etc.; living being 5,8; 28,17 etc. ἡδύς pleasant 21,31; 22,24.29; 26,29; 120,20; 121,20; 125,29; 126,11.19; 172,30; 173,32; 174,1; 189,24; T81,21; sweet 197,25 ἦθος character (of soul) 19,15.25 (with note); 20,12; 28,36; character trait 16,5 (with note); 19,22; 58,34

ἡλικία age 8,28; 13,24.26; 14,14 etc.; stage of life 13,17 (with note); 13,17.18; 16,6 etc. ἡμιμόχθηρος halfway to being bad 26,32; 132,27 ἡμίπεπτος (fluid in body) half-cooked 30,35; 102,16; 109,5.8; 113,5.26; 115,10; 133,21 ἧπαρ liver 20,9; 30,3.18; 33,1.17; 66,3; 77,1; 92,28; 116,10; 146,4 etc. ἡττᾶν reduce 34,32 θαλασσοκράμβη sea cabbage 153,18 θάλπος heat T39,12; T56,7; warmth 16,21; 21,6.7; 112,10; 122,22; 123,21 θειώδης containing sulphur 17,23; 107,33; 186,5 θεραπεία healing T69,4; T81,6 (Plato); T95,6; treatment 95,9; 96,10; 98,16; 122,12; 129,26.27; 151,5; 159,26; T86,15 (Erasistratus) θεραπεύειν treat 72,15; 91,18; 96,12; 100,19; T64,16.17 etc.; give treatment 181,32 θεραπευτικός of/on healing; (art) 12,32; T36,9; T76,14; T81,8; (method) 131,25; 191,25; (sc. μόριον, part of art) 3,4; T67,20; T71,20; T73,13; T74,11.16; T75,25; T87,24; (study) 36,4; 103,9.13; 106,13; 132,32; (treatise) 118,31; therapeutic (motto) 159,32 θερμός hot 3,14; T56,2 etc. θερμότης heat 5,15.36 etc. θεώρημα theoretical principle 80,11; T70,11.14.25; T84,22; (ἐπιστημονικόν) scientific principle 53,23 θεωρητικός theoretical (art) T72,22 θεωρία theoretical study 74,5 (with note); 103,21; 135,6; T59,26; (of health) 136,19; 137,10; (in Peripatetic philosophy) 162,3; T71,19; T85,1; λογική logical theory 43,16; T35,7.25; T59,19 θήγειν sharpen 20,22 θηλάζειν nurse (i.e. give milk) 22,11.21 θήλη teat 18,8 θηριακός theriac 147,15 (antidote); 147,18 (drug) θλᾶν crush 7,9.13.19; 42,11; 84,19; 85,28; 89,10; 94,34; 127,4.28 θλίβειν compress 158,25; (medio-passive participle) under pressure 27,3; 76,30; undergo compression 42,11; be compressed 76,35; 158,28; be subjected to compression 79,3; χωρίς τοῦ θλῖψαι without pressure 42,3 θλῖψις compression 33,6(bis).28; 34,27; 76,13; pressure T61,13 θολερός muddy 26,25; cloudy (of urine) 111,13.21

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Greek word index

θολοῦν (perfect participle passive) clouded 26,7; 107,19 θρέψις nourishment 36,31; 142,4; 145,24; 149,13; nutrition 13,22; 40,28; 66,27; 91,13.15; 173,29; 183,5 θριδακίνη lettuce 115,17; 131,30; 151,27; 195,25 θρίξ hair 4,16; 15,14; 31,18 θυμικός spirited 15,15; 19,16 (with note); 58,7.21 θυμοειδής (neuter, as noun) the spirited (sc. part of soul) 20,15 (with note); 20,21.23; T82,19 (Plato) θυμός rage 14,19; 19,31; 20,5 (with note); 26,6; 61,24.27; 99,34 (with note); 175,17; T90,6 (with note); spirit 106,3 (with note); the spirited part (of soul) 26,6 θύμος thyme 118,13.18; 124,23; 129,34 θυμοῦν experience rage 165,4; rage 20,34; 21,21; 196,32; (aorist participle passive) suffering rage 61,23; having become enraged 112,11 θύνον tuna 146,31 ἰᾶσθαι cure T40,19; T42,19; T44,10; T57,15; T66,23; T69,5; T78,13; T88,24; (passive) be put right T59,1; repair is carried out T57,6 ἴασις cure 60,21; 86,29; 87,31; 88,27; 90,33; 97,1; 106,17.33; 108,10; T39,7; T59,2; T69,4; medicine T78,17 ἰδέα (physical) form (of a stuff or body) 31,10; 45,17; 111,8; 148,3; 174,11; 185,34; pattern (of exercises) 135,26; (of life) 160,33; type 14,7; 20,22; 177,8.13; (of life) 29,8 ἰδίᾳ individually 44,15.28.31; 150,2; separate(ly) T77,19; specific(ally) 5,31; 39,35; 73,10; 124,19; 147,25; 150,19 ἴδιος (one’s) own 22,16; 50,12; 51,24; 86,18; 160,13; (one’s) own specific 168,21; (one’s) own individual 61,21; par excellence T80,20; proper 132,33; separate 22,16; specific 13,11; 14,31; 29,10.11; 30,5; 34,16; 45,18; 47,4; 49,30.33; 125,16 (with note) etc.; T34,18; T35,1; T42,6 etc.; arising directly from 135,5 ἱκανός able T39,14; adequate 42,1; apt 28,29; capable T39,10; 3,17; 18,16; 19,7; 161,16; considerable 8,23; 11,35; 12,13; 56,33; (adverb) considerably 45,5; enough 53,26; 83,25; (comparative) more marked 97,16; sufficient 4,29; 16,24; 28,6; 30,30; 37,11; 56,10; 128,3.26; 137,5; 141,24; 152,7; T35,21; (with negative) require 87,25 ἰσχάς dried fig 152,19.32; 153,27.30.33; 182,8 ἴσχειν acquire 4,32; 122,6; begin 171,1; get 4,34; give 149,18; have T47,20; 193,16;

479

hold up 79,29; possess 170,28; retain 31,31; 70,11; 81,26; 115,8; 154,5; 189,13; T56,20; be subject to 171,26; (negative, participle) without 111,10 ἰσχναίνειν (be) thin 43,8; 46,34.36.38; 47,1.3 etc. ἰσχνός thin 5,8; 14,3; 15,11 etc.; 157,6; 172,25; T39,5 (with note) ἰσχνότης thinness 14,1; 48,37; 49,3; 89,18; 95,21 etc. ἰσχνοῦν (be) thin 35,19 ἰσχυρός (adverb) forcefully 123,3; heavy 166,8; (adverb) markedly 85,14; powerful 102,9; 116,25; 125,30; 158,32; 159,16; (adverb) severe T39,4; strong 4,23; 11,18; 28,34; 31,16; 40,27.31; 42,12; 62,24; 77,17 etc.; T39,8; T50,5; T96,18.23; bringing strength T50,9; (adverb) substantially 97,14; (of exercise or motions) vigorous 18,36; 41,22; 110,23; 114,5; 139,1; 180,6; violent 112,7 (distress); 112,11 (anger) ἴσχυς strength 5,5; 63,3; 171,2; T43,13; T51,20; T82,3.16; T83,19; T96,21 ἰχθύς fish 144,11; πελάγιος of deep water 143,36; πετραῖος of the rocks 115,17; 124,17; 132,2; 143,36 ἰχώρ juice (in sense equivalent to χυμός) 185,25; 187,1.23.33 καθαιρεῖν destroy, destruction T50,14; T51,11; reduce 14,36; 17,1; 47,23; 50,3; 57,20; 138,31; 171,3; (medio-passive) suffer reduction (of strength) 171,3 καθαίρειν cleanse 30,26; 79,16; 80,6; purge 67,30; 109,16; 113,29; 116,7; 145,13; 165,32; T61,4; T91,21; (participle) purgative 182,17; 194,22; take (waste water) away 27,19 κάθαρσις cleansing 35,2; 79,19; emission (menstrual) 22,12; purging 107,14; 109,19.30; 113,18.31; 116,11.15; 176,24 καθιστάναι μετέωρον lift out 119,19 (mediopassive) become 19,33; embark upon 48,27; T36,5; T83,12; find oneself in the position to T86,2; go into a state of 26,2; (be) located 160,23; (be) placed 26,2; settle (of child) 21,24; (of symptom) 109,10; be subject to 164,9; subside 57,18.22; 114,11 καθ᾽ ὅλου general 150,16; 151,16; 163,10; 168,5; 185,15.17; overall (opposed to κατὰ μέρος, individual) T59,7.22; T65,21; T66,9.12.14; T68,17; T69,14; T70,24; T76,24; T91,19.24 καιρός appropriate time 22,8; 23,22.28.30; 35,24.27; 36,1; 37,9; 39,15; 82,17; 138,3;

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480

Greek word index

157,13 (with note); T57,20; T80,16; T90,8; time 81,32; (of year) 82,20 κακοτεχνία perverted art T44,7 (with note); T44,20.24; T81,24; T91,1.4; T96,13; T99,20 κακοχυμία bad fluid 96,5; 104,30; 105,4.5; 106,26; 107,6.8 etc. T86,19 (Erasistratus) κακόχυμος of/with bad fluid 86,22; 94,4; 107,17; 110,5; 122,3; 173,7 καλαμίνθη catmint 124,21.22.28; τὸ διὰ καλαμίνθην φάρμακον catmint-based drug 119,32; 124,21; 126,9; 130,2; 147,9; 188,17; drug involving catmint 189,7 κανών standard 28,8; 38,29 (with note); 53,22; 56,19; Standard (= Canon, of Polyclitus) 56,29; T34,27; T71,7 κάππαρις caper 121,25 καρδία heart 61,25; 66,2.5.23; kardia 194,30 καρυκεία rich sauce 117,31; 132,34 κασία cassia 118,5; 188,28.30.31 κατακλίνειν cradle 21,25; (medio-passive) recline 67,6 κατάλυσις dissolution 98,3 καταπλήττειν shock 83,8 καταρροϊκός involving catarrh 20,10 κατάρροος catarrh 17,20; 165,27 κατασκευάζειν provide (e.g. strength in body) 68,18; (perfect passive) be endowed with a constitution (of a certain sort) 16,27; 19,14 etc.; T45,10 κατασκευαστικός ‘building-up’ (exercises) 78,23; 94,8 (with note) κατασκευή ‘building-up’ (form of physical exercise) 75,2 (with note); constitution (of the body or its parts) 7,35; 8,7.12; 9,7 etc.; T45,9; T46,3 etc. κατάστασις (atmospheric) condition 110,16; 128,34; disposition 3,6; 10,16.24; 77,34; 78,4; 82,26; 89,13; 94,18; 96,3; 142,29; 160,7; 163,22; T39,16; T55,19 καταχρᾶσθαι exploit 193,16; use 116,28; (passive participle) in an applied usage 53,36 κατάχρησις ἐκ καταχρήσεως in an applied usage/sense 54,2; 60,17.23 καταχρηστικῶς by extension 87,8 κατεργάζειν process (of foods in nutrition) 6,9; 41,7; 92,32 κατέχειν affect 131,24; hold 30,15; 64,21; hold in 34,13; 190,4; T56,20; (passive) be in the grip of 89,11; restrain 62,16; 158,26; take hold of 62,24; 134,11 κατοχή retention 76,26 κέγχρος millet 151,28 κελεύειν ask 67,37; 69,22; 110,32; demand T77,8; T97,18; dictate T70,23; get

(someone) to do (something) 62,27; insist 183,12; instruct 21,28; 22,11; 26,33; 34,34; 63,1; 70,27; 71,28; 72,2; 83,14.22.26 etc.; T56,12; T96,6; order 20,20; 135,24; prescribe T93,1; require T88,7; T94,8; suggest 26,20; 126,1; ἡσυχάζειν κελεύειν call a halt T95,12 κενοῦν evacuate 5,28; 6,3.20.23 etc.; 34,13; (participle, of diet) evacuating 34,30; (passive participle) things voided (in fourfold classification of materials relevant to health) 36,9.21 κένωσις evacuation 26,9; 30,2.5; 31,22; T56,11 etc. κεραννύναι mix 13,32 etc.; (perfect passive + ἐκ) consist of mixture of 4,8; (perfect passive) has been put in the mixture 4,27; (perfect passive) have had a mixture 19,18 κέστρον betony 145,16 κεφάλαιον chief (causes) 122,21; chief concern T56,22; chief point 38,2; 66,10; 73,19; 94,20; 105,32; T75,17; essential point 31,21; 35,30; 107,2; 152,4; 168,3; 180,25; T45,5; T49,10; heading 137,12; main heading 113,3 (with note) κεφαλή head 15,22; 23,19; 25,33.35; 63,22; 68,11; 77,20.23; 80,21; 96,6 etc.; T60,11; T82,11 κίνησις motion 4,28; 5,10; 18,13.19.28.29.32.36; 20,5.13.16.33; 21,2; 36,13–15; 39,25–34; T39,6; T55,16 etc. κιννάμωμον cinnamon 153,9; 188,15.27.29.32 (with note) κιρρός tawny (colour of wines) 121,28 (with note); 124,10; 145,2 (with note) κίχλη thrush 191,2 κλαυθμός weeping 19,31 κνίκος safflower 153,18.29.30.32; 182,14 κνισ(σ)ώδης rancid 128,9 (of oil); 148,31 (of eructation); 182,11; 185,16 (of food) κοιλία digestive cavity 23,23; 40,35 etc. κοινός (in) common 3,9; 9,27.29; 29,10.11; 34,14; 39,18; 49,28.30.31 etc.; T63,11.12; T64,10 etc.; of common application 73,19; 111,20; general 57,7; 118,32; 197,2; of general application 73,3; 165,15; in the general sense 112,28; in a more general sense 39,34; 40,5; T73,25; public 29,21; 40,1; universal 142,16; 180,20; κοινῇ equally T64,20 κοκκύμηλον plum 151,31; 152,31; Damascene 152,32 κολάζειν check 15,1;16,36; correct 165,16 κολακεία flattery T44,25 (with note); T96,9 κολοκύνθη bottle gourd 131,30.32; 151,30

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Greek word index

κολυμβήθρα bath 82,3 (with note); 97,7; swimming-bath 12,10 κομμωτική (art) of the beautician T44,8.23 κόπος fatigue 74,22.25.28.29; 75,5.8.12 etc. κοποῦν (passive) suffer/be in a state of/be subject to fatigue 74,31; 88,14; 90,10.18.37; 92,3; 97,14; 194,8 κόρυζα cold 17,19; mucus 150,31.33 κοσμεῖν improve 29,3 (with note); 38,6; perfect T94,5 κόσμιος well-ordered 28,29 κόττυφος blackbird 191,2 κοτύλη cup 127,12.13 (with note) κοτυληδών navelwort 195,20 κοχλίας snail 146,29 κράμβη cabbage 151,26; 153,7 κρᾶσις mixture 4,23; 8,29 etc. κρατεῖν (be) dominant 28,2; 175,22; master 111,17.26; 141,24; overcome 176,12; take hold of 63,7 κρατύνειν be powerful 5,4; overcome 176,14; strengthen 24,29; 29,1; 82,10 κρέας meat 23,8; 133,30; (of pig) 79,34; 146,29; 180,4; 181,13; (of deer, goat, beef, sheep, birds) 147,1–5; (of wild animals) 151,31 κρίνειν assess 7,33; 12,19; 27,1; T36,2; bring (disease) to crisis T67,7 (with note); distinguish T70,15; divide T69,13; T70,23; division T70,2 κρίσις assessment 23,2; κρίσιν ἔχει must be decided T42,8 κριτήριον criterion 196,11; instrument of assessment 12,18; principle of assessment T59,21 (with note); T71,8; standard by which to assess 40,16 κροκώδης of saffron 193,4 κρόμμυον onion 147,14; 161,28 κύαμος bean 151,29 κύημα embryo 4,31 κυίσκεσθαι gestation 16,17 κύμινον cumin 117,10 κύριος important, of importance 34,2.9; 49,15; 138,13; 170,2.3; 194,3; proper, properly (of terminology) 45,37; 53,30.35.36; 54,8; 60,16.23; 154,19; T49,19 κύστις bladder 30,20.26; 31,2; 32,34; 33,16; 41,19; 137,28; 156,24; T60,16 κύτος vessel (of stomach) 15,28 κωλύειν forbid 162,12; 172,16; hinder 90,13; 91,14; impede 33,23; 82,9; order to refrain from 135,21; prevent 4,27; 13,23; 19,6; 24,19; 25,16; 30,15; 70,10; 76,20 etc.; T53,5.7; T63,2; εἰ μηδὲν ἕτερον κωλύει unless there is some contraindication 131,11; μηδὲν

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κωλύειν there is nothing wrong 160,35; οὐδὲν κωλύει it is perfectly permissible 154,10; it is perfectly legitimate 176,23; quite possibly 181,34; οὐ κεκώλυνται there is no obstacle T65,24; οὐ κωλύω one may recommend; 146,10; τί κωλύει why should it not be the case T49,25.26; why might not T50,2 λαβή (wrestling) hold 101,24; T95,4; wrestling grip 58,4; τάχ᾽ ἂν ἔχοι λαβήν T37,5 might be vulnerable λαμπρός clear 26,31 λάπαθον monk’s rhubarb 132,1; 151,27 λαπάττειν empty (the stomach) 143,34; 152,30; 153,22; 180,33; 189,20; T56,19 λάχανον vegetable 27,21; 100,17; 115,17; 144,10; 151,26; 180,6; 181,1; 189,19 λειεντερία passing of food undigested 37,4 λέξις form of expression 48,5.7; 51,34 λεπτομερής fine in consistency 79,20 (with note); 97,6.11; 106,7; 127,27; 191,10 λεπτός fine 85,7; T56,16; T85,9; (in consistency) 179,33; 124,11; thin 99,26; 191,22 λεπτύνειν thin (esp. of residues) 40,30; 41,23; 47,24.25; 75,17; 79,4; 85,9; (participle) thinning (diet) 34,26.29; 35,12.16 etc. (diet); 35,20 (drugs) λιβανωτίς rosemary 129,2 λιβυστικόν lovage 118,2; 124,24 λίκνον cradle 18,19.30; 66,33 λιμναῖος from a marsh 26,25 λίμνη lake 24,20; 27,22; 147,6; marsh 27,16 λίμνηστις feverfew 190,22 λινόζωστις tuberous spurge 153,17 λινόσπερμον linseed 195,26 λιπαρός smooth 32,4; 34,19.34; 35,10; (adverb) smoothly 97,4; 109,2; 153,27; gently T35,15 λίπος fat 41,27 (with note); 42,5; 55,8; 76,14.16; 128,15; 139,31; 143,1; lubrication 102,2; oil 88,9; 157,24 λίτρα pound 127,13.15.16.25 (with note) λίχνος gluttonous 19,17 λογιζόμενον, τό (τῆς ψυχῆς) reasoning part (of soul) 26,6 λογικός logical: (theory) 43,16; T35,7.25; T59,20; (method) T59,7; rational: (animal) 25,5; T88,14.17; (part of soul) 34,4; (principles) T62,9; theoretical 7,10; 8,21; 103,6 λογισμός reasoning-faculty 151,17 λόγος account 80,13; 184,9 etc.; argument 6,19 etc.; book (of a work) 24,11; 37,11; 38,3; 39,2; 71,22.23.32; 73,16; discussion 7,23 etc.; language 20,33 etc.; rational plan

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Greek word index

4,7 (with note); word 39,15 etc.; ἀνὰ λόγον in accordance with 108,10; analogous 5,11; 33,16; proportional/in proportion to 46,13; 90,23; in the same way as 27,25; similar in function/similarly 109,24; 119,26; κατὰ τὸν ἴδιον λόγον in virtue of (its) specific definition 170,6; T55,2 (with note) λουτρόν bath 14,19; 16,30; 17,21; 24,2; 25,22.25; 35,11; 61,16; 66,19; 70,8; 71,24; 74,23; 80,35; 81,17; 88,6; 90,17; 91,12.14.27; 94,17; 96,27; 99,30; 108,3; 114,7; 122,22; 124,15; 138,26; 139,27.31; 141,9; 146,6.23; 152,5; 161,24; 163,30; 164,33; 166,1; 172,25; 173,14; 175,12; bathing 23,20.31; 24,6.10.20; 28,26; 80,9; 81,24; 90,1; 101,29; 108,3; 114,12; 125,23; 135,27; 139,17; 140,15; 161,31; 163,28; 167,26; 169,4; 172,31; 176,23; 181,9.14; 183,14; 184,2.11; 186,2; 195,9; T61,3; T90,6 λύειν dissolve: (residues) 31,10; 35,15; (fatigue) 87,15.16; 90,19.31; relax (as function of a massage) 43,3.7; 43,9.10 (Hippocrates); 44,38; 46,27 λυμαίνεσθαι be injurious 27,27 λυπεῖν distress; (passive) be distressed 8,20; 99,26; 196,32; τὸ λυποῦν source of distress 21,17.22; 106,35; 109,29; be the source of distress 122,13; cause distress 10,31 λύπη distress 14,19; 18,10.12; 21,1.17; 99,21.23.27; 122,29 etc. λυπηρός source of distress 21,11 μάθημα education 118,34; study 28,28; teaching T84,24 μαῖα see Book I, n. 82 μαλακός soft 15,14; 16,17 etc. μαλάχη mallow 132,1; 151,26 μανδραγόρας mandragora 196,4 μαστίχινος (neuter, as noun) mastic oil 187,15.17 μάχεσθαι (participle) in conflict (logical) T84,19; (ἑαυτῷ) contradict oneself 51,12; squabble 162,9 μέθοδος method 31,30; 38,27; 53,20; 95,15; 96,17; 131,16; 137,12; 150,16; (dative) methodically 29,18; κατὰ μέθοδον methodically 184,14; procedure T33,6.14; T35,13; T71,16; T72,12; (logical) T59,7; (of division) T88,11; therapeutic (in title) 191,29 μειράκιον youth 13,18; 29,3; 42,19 (with note); 69,12.21; 71,3.29; 72,1.6; 136,28; 170,28; 172,3.10; 174,25 μελαγχολικός black-bilious 22,5; 33,15 (with note); 109,31; 110,10.11.13; 180,12

μέλι honey 117,21; 25.26; 119,16.20; 120,2.24.29; 121,3.6.8.21; 125,21.23.27 etc. μελίκρατον honey-mixture 115,11.19; 116,27; 123,10.15; 153,1.9; T61,6 μέλος song 20,15 (with note); 21,19; (plural) limbs 84,16.20; 144,3; (plural) parts 23,14; 83,5; παρὰ μέλος inappropriately 7,22 μεμπτός faulty 13,35; 14,33; 171,20.32; T39,19.21.24 μέσος halfway (between) 173,13; T40,2; midway (between) 15,11; middling (ἰδέα, of food) 99,5; ἐν τῷ μέσῳ midway (between) 14,5; (neuter plural) midpoints 50,4.5; 73,32; (superlative neuter) the very middle 57,1; μέσως ἔχον in a middle state (between) 22,25 μεταβάλλειν change 6,8 etc. μεταβολή change 14,14 etc. μετάπτωσις change 8,28 μεταφορά ἐκ μεταφορᾶς in a transferred usage 54,2.8 μέτριος appropriate T56,13; gentle 156,10; (adverb) lightly 127,28; medium 52,6.12; 53,11; 61,6; moderate 18,13.35; 20,26; 22,9; 23,14; 24,3; 41,14.18.30; 42,2; 43,8.11 etc.; in moderation 39,13.15 (Hipp.); 153,12; 158,34; (adverb) partially 117,13; (adverb) quite well 179,7; (adverb) to the right degree 178,28; well-balanced 51,14.16 (with note); (neuter singular as noun) correct condition 158,18; (comparative) less serious 170,2 μέτρον, τό amount 70,2; 72,10; 197,27; in the correct amount T94,16; right amount 153,34; calculation 108,10; degree 46,19; extent 71,21; 72,12; 75,8; level 20,21; measure 22,8; 26,5; 35,24.27; 37,9; 56,2.4.5.16; 58,1.16.22.26.34.37 etc.; ἐν μέτρῳ gradually 159,4 μήκων poppy 196,4 μήλινος (neuter, as noun) quince oil 187,15,16.18.19; 195,11 μῆλον, κυδώνιον quince 126,7; 197,21.25 μιαίνειν contaminate 27,22 μιγνύειν add 118,13; 123,32; 125,23; 126,15; 128,4.20; 129,13; 144,8; 146,16; 147,31.33 etc.; admixture 182,1; 188,20.22; combination 4,25.26; 129,23; combine 39,3; 95,30; 96,16; 117,9; 120,24.28; 121,2.5; 125,20; 129,27; 130,5.8; have intercourse 22,12; make a composite 84,20.22; mix 117,25; 119,16; 120,7; 145,5 (bis); 152,14; 153,29; 188,14; T78,12 μινυθεῖν diminish (flesh, by massage) 43,10 (Hippocrates); 50,6; 53,10 μῖξις combination 4,12; 112,21; 123,31; 187,31; ἀφροδισίων sexual relations 194,33

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Greek word index

μόδιος peck (Italian) 127,12.24 (with note) μόριον part (of art/specialized skill) 3,3; 4,32; 5,4; 6,6 etc. μοχθηρός bad 15,29.30; 19,25; 22,20.26.30; 26,24 (with note); 27,20; 28,7; 114,9 etc.; T83,13.26; faulty 13,2; 16,26; 37,10; 39,2.4.5; 53,19.22; 59,12.16; 70,5 etc.; T47,21; flawed T65,7; poor 108,20; 111,27; 113,24; 130,16; 133,26.32; 138,13; 149,19; 160,17; 178,2 μύκης mushroom 146,33 μύρον perfumed oil 97,12 (with note); 187,18; 193,1 μύσις closing, closure 33,6.8.28; 34,33; 35,4; 96,22 νάρδινον nard oil 187,16.18.19; 193,1.5 νάρδος nard 187,17.20 νάρδου στάχυς spikenard 118,5 νεανίσκος young man 27,12; 81,20; 83,10; 84,6; 90,11; 94,5.15; 98,22; 108,17; 143,15; 157,20; 166,6 νεῦρον nerve 4,20; 62,28; 85,18; 92,14 (with note) etc. νεφρός kidney 30,26; 146,4.12; 148,13; 149,3; 150,31; 153,22; 156,24; 190,14.18.29; 193,13; 196,8 νεώτεροι recent, more recent (of authors, doctors, trainers) 36,8 (with note); 42,34; 43,15; 52,15; 67,3; 103,2; 142,21; 164,26; 184,1; T73,24 νικᾶν overcome 24,33; overrule 162,30; win T79,11; T85,2; T97,5; (passive) give in to 182,34 νίτρον natron 36,20 (with note); 117,7.10; 182,7; of Berenice 189,1 (with note) νιτρώδης containing natron 17,23 (with note); 107,34 (with note) νοεῖν (negative) with no conception 73,3; imagine T57,23; understand 52,32; 53,12 νόησις conception 51,37 νοσεῖν illness 7,25; 11,22; (participle) in sickness 10,25; 17,16; 159,30; 179,17; 192,2; be in sickness 11,19; T40,11; have a sickness 29,22; be subject to illness 164,9; be affected (by disease) 160,11; 182,29; 194,6; fall ill 162,11; 163,23; T39,15; fall sick 161,5; 163,23; become ill 164,5; 178,7; (be) sick 11,23; 17,27; 66,15; 130,10; 135,19; 136,9; 140,33; 161,1; T36,10; T39,8; T41,26; T58,7; T66,23; T69,5; T80,3.4.22; T86,6; T88,24; T97,2; suffer (sickness/disease) 20,11; 38,26; 134,24; 135,16; 136,25.32; 174, 32; 179,19; (perfect participle) who has just recovered from illness T73,23; διὰ

483

χρόνου be chronically sick 179,14; συνεχῶς be in a constant state of disease/sickness 177,33; 178,9; 179,8.15; presence of disease 168,9; ἐν οἷς χρόνοις νοσεῖ as long as the sickness continues 156,27 νόσημα disease 12,24; 17,7.8.11; 19,33; 20,10; 154,14; T42,19; T69,4; T74,7 νόσος sickness 3,7.9 etc. νοσώδης disease-prone 137,20; morbid: (body) 170,1; (constitution) 168,30; (state) 142,26; (symptoms) 97,30; 100,14; 102,8.22; unhealthy 163,19; (comparative) verging on morbidity 97,25 νουθέτησις admonition 23,30 νοῦς intelligence T85,6; mind T85,8; νοῦν ἔχων (person) of intelligence 24,5; 26,17; 46,35; 80,19; προσέχειν τὸν νοῦν pay (careful) attention 59,20; 71,15; 93,13; 102,22; 112,13; 136,35; 164,31; 174,35; T45,13; T92,10; concern T56,23 ξέστης pint 197,27.28 (with note) ξηρός dry 3,14 etc. ξυμφέρειν see συμφέρειν ὄγκος amount 184,5; bulk 9,10 (with note); lump (dropsical) T61,10; volume (of body) 71,3; 83,18; 114,34 (with note); 124,6; 129,21; 130,15; 132,16.23; 139,21; T83,20; (of living being) 126,33; 130,15; 133,13.15.22; (of muscle) 86,17; 88,21; παρὰ φύσιν abnormal 89,7; 93,14; T84,6 εἰς ὄγκον (ἐξ)αἴρεσθαι be raised up in volume (of body, or muscles) 57,14 (with note); 57,16.17.22; 70,31; 93,11; 94,34; 131,3 ὀδαξεῖσθαι experience irritation 21,3 οἰκεῖος adapted 19,7 (with note); appropriate 18,34; 21,14; 160,6; 162,28 etc.; proper 7,26; 22,17; 65,16; 174,2 (with note) etc.; which belongs to 26,11; εἶναι properly belong (to) T34,19.23.26; οἰκείως διακεῖσθαι be in themselves adapted 18,16 οἰκειότης properness 174,4 (with note); 174,10.14 οἰκειοῦν (passive) be adapted to 19,4 (with note) οἰκονομία management 66,25; management of a household T82,7 (Plato) οἰκουμένη inhabited world 43,29; 56,12; 97,11 οἰνόμελι wine-honey 144,1; 152,15.20 οἶνος wine 25,31.33; 26,5.12.15; 30,19; 100,12; 107,18.20; 109,4.5 etc. ὀκνεῖν reluctance T35,6; be reluctant (to move or engage in exercise) 59,6; 86,12; shrink from 48,29; 192,10; (negative) venture to 157,5; 181,17

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Greek word index

ὀκνηρός reluctant (to move) 58,14; 88,13 ὄκνος reluctance (to move or engage in exercise) 89,18 ὁλκή attraction 40,27; weight 127,17 ὁμιλεῖν be in contact with 34,28; come into contact with 7,7; 16,21; 55,23; T55,6; be brought in contact with 122,26; be exposed to 24,15; have intercourse 195,3; (be in) proximity 46,16; τὸν ὁμιλήσοντα (τοῖσδε τοῖς γράμμασι) the prospective student (of this work) 8,5 ὁμοειδής belong(ing) to the same form 10,24; 104,4 ὁμοιομέρεια (plural) homoiomeries 9,11 (with note) ὁμοιομερής uniform (parts of body) 3,14 (with note); 3,15; 7,30.33 etc.; see also Book I, n. 35 ὁμοῖος (adverb) equally 89,28; 129,2; even 169,26; 170,27; exactly like T97,24; same 89,9; (adverb + ἔχειν) have the same effect 27,30; βίος same kind of life-style 177,24; (adverb) in the same manner 158,16; of the same quality 174,21; for the same reasons 183,11; of the same sort 6,9; (adverb) in the same way T86,24; τρόπον the same way 134,18; similar 5,20; 16,36; 17,9.12.17; 30,27; 78,18; 85,26; 89,18; 91,8; 100,2; T99,2 etc.; similarity 127,27; similar in qualities 175,28 ὁμοιοῦν appear similar to 91,3; assimilate, make similar 46,18 133,25; 134,20; 173,29.30 ὀμφάκινος (neuter singular as noun) oil made from unripe olives 87,1 (with note); 186,19; 195,11 ὄμφαξ unripe olive 195,23 ὀνίνασθαι benefit from 183,27; be benefited 175,14; 177,7; derive benefit 12,29; 132,20; 164,3; 196,7.29; gain benefit 16,5.7 ὀνίσκος fish of cod type 132,2 ὄνομα name 6,11; T85,2; term 34,8; 40,5; 53,35 etc.; T47,4; T76,23; (plural) terminology 44,37; T74,35; (plural) words 100,30 ὀνομάζειν apply a term T98,25; call 60,22; 87,8; 104,11; T51,4; T86,23; T95,22; (present participle passive) (what are) known as 3,14; 14,6; 138,10; 189,13; T74,14; refer to as 171,18; term 3,10; 13,23; 155,26; use terminology 4,10; use term 12,2; 46,27; ἀπό τινος ὀνομάζεσθαι take one’s name from something T64,19 ὄντως genuine(ly) 8,17; 91,32; T45,1; T83,24 ὄνυξ nail 4,16 ὄξος vinegar 114,34 (with note); 115,5; 117,12; 119,28.29; 120,4.6.23.26; 121,2.4.5.8;

125,25; 131,32; 144,34; 152,14; 192,34; 197,28; 198,11 ὀξυθυμία sharp-spiritedness 122,23 (with note) ὀξύμελι honey-vinegar 115,12 (with note); 115,19; 116,26; 120,1.17.21.27; 173,13.21; 181,37; 189,10 ὀξύνειν make sharper, sharpen 121,12.17.18 ὀξύς acute (of disease or fever) 162,11; 175,18; 182,28; high-pitched, at a high pitch (of voice) 77,22.32; 78,5; sharp (of taste) 109,31; 120,4.8; 149,19.24; swift (of motion or exercise) 62,10; 64,16.21; 68,9; 68,36 (with note); 69,15; 73,29; 86,26; 88,13; 98,2.30; 110,10; 138,32; 139,16; 155,7; 157,13; 165,1; 172,24.26; 175,17; 183,32.35; (adverb) swiftly 64,15.32; 157,22.25; sharpness (of intelligence, νοῦς) T85,6; ὀξὺ βλέπειν sharp-sightedness 11,17 ὀξύτης (taste) sharpness 189,22; swiftness 60,30; ἡ κατ᾽ ὀξύτητα τάσις the higher tension (of the voice) 158,30 ὀξώδης vinegar-like 110,18; 185,17 ὀπώρα (summer) fruit 100,17; 152,18 ὀργανικός organic (parts or bodies) 3,15 (with note); 7,31 etc. ὄργανον instrument 79,5.22 (with note); 192,35; T59,25; organ 5,6; 6,14; 9,3; 26,10; 30,7; 32,34; 34,12; 40,22.26; 62,20 etc.; organic body 54,20; organic part 35,21; 62,35; 66,25; tool T94,3 ὀρέγεσθαι have appetite 83,15; have as an aspiration T45,25; desire T47,18; wish T71,12 ὁρίζειν clarify 178,13; (perfect passive participle) definite 161,14; demarcate T70,14; designate 68,7; (arrive at) determination 72,13; regulate 157,9; specify 56,3.5 ὁρισμός definition T36,20; T75,6 ὁρμᾶσθαι arise 4,4; 70,16; 136,25; develop from 37,7; ἀπό τινος (+ participle) on the basis of, proceeding from 68,31; 129,19; ἔκ τινος (+ participle) starting from 51,26 ὁρμή impulse (of nature) 59,9; καθ᾽ ὁρμήν voluntary (activities or motions) 13,18 (with note); 66,21 ὄρνις bird (as food) 115,18; 124,17; 144,1.11; 180,7; 190,33; 191,3 ὅρος bound 20,2; 36,19; defining feature 39,30; definition T41,17 ὀρρός liquid (secreted) 110,28; 111,7; 145,13; whey 30,25 ὄσπριον pulse 23,7; 27,21; 115,16 (with note); 133,30; 151,28 ὀστοῦν bone 4,16.20; 5,3; T60,10; T91,22 etc. ὀστρακόδερμος hard-shelled (seafood) 146,32

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Greek word index

ὄστρεον oyster 146,30 ὀσφύς lower back 65,7.10; 68,11; 78,17; 131,20; 155,23; 195,9; 196,9 οὐγκία ounce 197,30 (with note); 198,15.17 οὐρητικός diuretic 107,32; 115,21; 145,25; 150,9; 152,26 οὖρον urine 26,14; 41,11.16; 70,27; 100,53; 107,10; 109,5; 110,30; T89,25 etc. οὐσία being T48,16 (with note); T64,23; T72,6; essence 14,31 (with note); τοῦ πράγματος of the matter 15,6; θυμοῦ of rage 61,26.27; (of types of fatigue) 84,14 (with note); 89,6 (with note); T33,11 (with note); T41,5; T46,14 ; substance 4,10.13.14; 5,14.19.27.29.36; 7,2; 16,2; 45,15; 154,30; 168,11.16; 174,4.9; T64,4 ὀχετός conduit 27,19; 34,5 ὄχημα carriage 18,32.34; 66,32; 67,5.13; 108,21; 143,24; 156,11; vehicle (of distribution) 31,1 ὄψον dish T96,7; prepared food 147,13; 181,23 (with note) πάθημα ailment 85,33; 86,31; 155,13; 156,5; 193,32 πάθος affection (of the soul) 62,1.2; 66,20; 112,6.14; 122,23; ailment 20,8; 66,14.16; 155,13; 165,15; T86,14; damage 58,22; κατὰ πάθος as a pathological state 141,30; see also Book I, n. 10 παιδεία (καλῶν) pursuit of the fruits of learning 136,24 παιδεύειν educate, education 16,12; 18,18; 59,14; 197,14 παιδοτρίβης child-rearer T79,5 (with note); instructor 25,28 (with note); 63,28 (with note); 68,25; 69,5; T95,17.19 παιδοτριβική the art of the instructor T94,1 (with note); T95,6.25 παίζειν play 23,32; 24,3 παλαιός ancient (author) 10,23; 42,33; 48,4.7.25; 51,25.32 πάλαισμα wrestling-school exercise 63,23; T92,12.14; T94,23; T95,21 πάλαιστρα wrestling-school 43,26; 62,31; 63,15.27; 64,14; T90,13.19.23; T97,21 παλαιστρικός (masculine, as noun) expert in wrestling-school exercise 69,37; (feminine, as noun) expertise in wrestling-school exercise T92,14; T96,11 παράγγελμα aim 34,15; precept 125,17; 142,16; 160,20; 163,11; (therapeutic) 159,32; (of health) 135,20; 137,5 παράγειν couch (cataracts) T60,8; draw (into) 183,24; draw onward 30,8; 32,33

485

παρασκευαστικός preparatory (exercise, massage) 52,27; 55,6.10; 57,27; 97,34 etc. παραλείπειν leave aside 96,27; not mentioning 164,21; omit 45,19.26; 46,4.25.28; 48,19.23; 49,31; 50,19; 73,7 etc.; without recourse to 130,30 παραπέμπειν move on 6,16; 30,26 παρασκευάζειν build up 63,26; create 168,18; make 25,16; prepare 17,26; 55,22; 74,33; 133,28; produce 6,15; T96,8 παραφυλάττειν pay particular attention to 197,15; precautions 196,16; take care 23,21 παρηγορεῖν console 21,24; soothe 88,34; 186,2 παροξύνειν spur on 20,28 παροξυσμός onset 156,33 παρορᾶν overlook 51,35; 75,10; 156,7; τὸ παροφθέν oversight 157,16 πάσχειν be affected 3,21 (with note); sustain damage T58,25; T59,1.2; T84,9; undergo affection (of soul) 112,10; (perfect participle active) damaged T67,11 παχύς fat T85,8; large (ἔντερα, intestines) 32,18 (with note); stout (of bodies) 14,4; 15,12 etc.; thick(ness) (of fluids, foods, residues) 23,6; 31,15; 33,21.23; 34,29; 35,11 etc. παχύτης thickness 22,25; 116,33 πεῖρα experience 23,6; 27,1; 56,24; 58,25.27; 83,28; 98,32; 99,24.26; 148,19; 149,21; 153,33; 161,3.9.19; 162,19; 174,7; 181,5; 186,11; 196,11; 197,6; trial (of child’s nature) 24,28; 25,1.2; (of a drug) 153,33 πελιδνός blue-grey (colour) 22,27; 112,21.22 πέπερι pepper 115,12; 117,2.4.8; 118,13.17.24; 119,7.9; 124,25 (bis); 125,26; 126,5 etc.; λευκόν white 117,3.11; 147,13; 197,30; μακρόν long 116,32; 117,11; 118,22; 119,5.11; μέλαν black 117,5 (with note); τὸ διὰ τριῶν π. three-pepper preparation 117,29; 126,4; 129,29; 129,33; 147,11; 182,1; 188,7; three-pepper drug 188,17; 189,7 πέρας end 148,15; 178,13.14; extremity 185,1; 190,11; the outside 30,14; 31,18 πέρδιξ partridge 191,1 περιέχειν contain 76,7; 105,2; 107,8; 129,17; 190,10; T61,10 etc.; (present participle) ambient (air) T55,1; surrounding (air) 7,6.7; 32,26; 36,17; 56,7 etc.; (participle, with ἀήρ understood) surrounding air 12,12 etc. περιστερά pigeon 191,4 περιττός outstanding 151,2; superfluous 6,10 (with note); 30,32; 34,8; 54,23; 75,27; 79,23; 81,13; 88,34; 94,7; 100,13; 113,19; 130,29;

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486

Greek word index

134,13; 138,25; 168,17; 172,12; 174,28.31; 184,33; 193,17.24.26; T66,13; in superfluity 187,1 περίττωμα residue 6,2; 6.12 (with note); 6,24 etc. περιττωματικός full of residues (of body) 86,22; 108,15; of blood 108,15; residuebased (of fatigue) 90,24; 91,6; 94,35; 95,5; (of moisture) 117,18 πετροσέλινον parsley 124,22.27; 129,33; 146,15 πέττειν bring about coction 114,8 etc.; carry out coction on 99,3 etc.; perform coction (upon) 99,3; 148,30 etc.; subject to coction 124,6; 134,2; 197,22 etc.; (passive) undergo coction 23,16; 41,2.7; 70,26; 133,11 etc.; (passive) be subjected to coction 111,10 etc.; digest 189,16 etc. πέψις coction 13,21; 66,26; 106,20; 111,19; 114,2; 121,29; 126,3; 133,33.35; 134,20; 175,31; 197,22; coctive process 41,7.15; 185,14; process of coction 117,1 πήγανον rue 117,8.16; 146,21; 189,2; 195,34.36 πηλικότης magnitude 3,16; 7,32; 13,9 πήρωσις being maimed 11,5 πικρός bitter 22,28; 26,13 etc.; (as name of drug) 182,17.18; 188,21 πικρόχολος bitter-bilious 22,5; 32,32 etc. πιλεῖν compact 16,19; 33,12; 54,3; 183,16 πιμελή fat 81,28; 85,10 πιττοῦν apply pitch-plaster 142,5 (with note); 157,7.35; 182,36; 183,11 πίττωσις pitch-plastering 158,15; 194,24 πλάτος spectrum (within health) 8,2.23; 10,26; 11,35; 12,5.14.16; 13,10.12.34; 160,2; 171,10; 177,26; 178,10; (of types of body) 56,33; κατὰ τὸ πλάτος broad 170,34 πλάττειν shape 19,28; 28,27; 38,6 πλατύς broad (of estimation) 70,23; (adverb, comparative) fuller (of explanation) 107,3; flat (of hand) 161,26 πλῆθος (large) amount 21,7; 33,21.23; 34,20; 47,18.22; 57,29; 71,10; 76,14; 79,34; 80,5; 83,2; 90,14; 93,29 etc.; build-up (of fluids, residues, or foods) 33,7; 40,35; 85,7; 87,22; 105,10.12.15; 106,8; 109,21.23.29; 113,26; 116,20.28; 118,11; 123,8.19; 130,19.22; 132,23; 165,26; 170,22; 176,11; 179,18; 180,4.8; 194,9.21; 196,17; T83,17; T84,6 etc.; (as title of work by Galen) 105,18 (with note); (τὸ πολὺ π.) the great majority 185,23; 197,14; multitude (of terms) 53,28; 54,17; (large) number 93,29; 96,8; 98,5; T61,16; T65,18 etc.; (δόσεως) dosage 119,25

πληθώρα fulness 96,4; 105,1 (with note); 105,3.12; 194,2 πληθωρικός of fulness, related to fulness (diseases or sicknesses) 175,29; 179,18.25; πληθωρικῶς διακείμενοι in a state of fulness 58,13 πλημμελῶς in a disorderly manner 34,20; unharmoniously (of motions) 21,5 πλήρωσις filling 34,29; 54,14; 181,33 πνεῦμα breath 31,5; 40,23.31; 41,26; 61,32; T84,8 etc.; (psychic) 66,12 (with note); 66,21; (stopping of, as exercise) 67,22; 71,18; 75,20.22 etc. πνευματοῦν (passive) become aerated 116,31; 149,2; 165,25 ποιητικός productive 11,24; 44,19; (art) T48,3; T68,6; T72,20.27; (cause) T41,21; T42,1; lead to 83,6; produce T79,24 ποιόν quality 8,30 (bis); 36,26 (bis); 52,34; 137,4; T58,10.13; T90,8 ποιότης quality 4,9; 34,23; 36,1; 48,1; 52,29; 80,5; 120,25; 148,5; 185,18; T80,16.24 etc. πολιτεύεσθαι engage in public life 10,33 πολιτικός political 29,16; τὰ π. πράττειν public activity 167,19; engage in public life 173,26; π. πράγματα public obligations 160,19 (with note); π. ἀσχολία public obligation 168,25; π. πρᾶξις public engagement 181,18; 190,5; π. πράξις/ πράξεις the affairs of the city T83,5; T97,1; (feminine, as noun) the art concerning civic affairs T54,15; the political art T81,3 πολύγονον knotgrass 195,20 πολυσαρκία abundance of flesh 14,1 πολύσαρκος fleshy 15,11; 15,12 πονεῖν engage in exertions 25,26; 100,19; exert oneself 40,6; 58,9; 74,28; 84,16; 88,13; 165,20; T53,3; exertion 67,11; 138,31; undergo exertion 76,3; 93,12; 139,16; T82,20; μάτην waste one’s labour 159,8; wear out T37,16.19 ; T67,15.19; suffer damage T54,6; T73,3 πόνος exertion 15,20; 26,10; 39,11.13 (Hippocrates); T82,19 etc. πόρος channel (in body) 9,10 (with note); 31,3.7; 33,2.19.30; 34,10.28; 35,3.11.15; 40,30.31; 41,3.24.26.29 etc.; Τ56,16 (of water) 27,7 ποσός (neuter, as noun) degree (of opposition) 167,12; quantity T73,16; (of elements in mixture) 4,12; (of food, massage, etc.) 36,26.28; 39,14; 44,29; 45,2; 48,18; 52,34; 73,27; (of fluids or residues) 108,9; 113,11; 137,3; κατὰ τὸ ποσόν quantitative T58,11

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Greek word index

ποσότης quantity 3,16 (with note); 31,36; 32,2; 36,1; 44,13.15; 44,17.19.23 (Theon); 45,33; 47,7.19.20; 48,2; 58,28 etc. T80,16; T90,8; (κατ᾽ οὐδεμίαν ποσότητα) not to any great extent 46,10 πραγματεία study 31,22; 35,33; 37,12; 80,26; 103,9; 106,13.15; T55,5 (with note); T86,13.16 (Erasistratus); treatise 5,33 (with note); 51,31; 73,2; 80,33; 81,17; 103,15.17; see also ὑγιεινός πραγματεύεσθαι attend to T56,22; be actively involved T54,22; concern oneself with 22,1; T55,10; exert oneself upon T53,12 πράσον leek 115,5; 132,5 πραΰνειν relieve 26,13 (acridity); 115,26 (fatigue state) πρεσβύς (comparative) older 146,6; 152,25; 174,26; elder T78,22 πρεσβύτης senior 27,13; 144,28; 147,33; 150,25; 158,34 προαίρεσις choice 38,25; κατὰ προαίρεσιν (activities) deliberate 65,28 (with note); 66,20; κατὰ κοινὴν προαίρεσιν in accordance with a common decision 65,34 (with note) προβάλλειν set (a question for enquiry) T33,2 (with note); T34,12.15.17.21; T35,5 πρόβλημα set question 7,16; T33,16; T35,1.3.11; T36,1; T59,9.11.15.17 προγινώσκειν foreknow 96,12 (with note); predict 27,2 (with note) προγυμναστής training assistant 78,28 (with note); 82,32 πρόδηλον immediately evident 10,7; 24,32; 46,5; quite evident 108,4; 147,27; 172,14; T52,14; T74,11 προηγεῖσθαι precede 107,17; 110,4; 163,7; (of argument or assumption) 53,16; 56,10; (participle) preceding (type of cause) 104,11 (with note); 104,16 προϊστάναι (middle) be in charge 3,21; (perfect active participle) person in charge 58,29.38; 59,10; govern T100,7 προκεῖσθαι be (my) task 7,16.24; 38,7 etc.; be/have task T48,13.23; the subject (of our account) 103,7; (participle) under consideration 52,1; 55,33; 56,36; under discussion 135,5; (neuter participle as noun); the task in hand 7,17; the matter in hand 54,26 προνοεῖν (active and middle) provide/provision (for body, of healthcare intervention) 17,25; 23,26; 176,21.34; 189,30; 198,20; T56,9; take care (of ) 3,20 (with note); 28,35; 30,2; 79,16; 131,26; 148,1; 153,23; 178,33; 179,16; 185,28.33; 186,29; 192,4.20; T62,2;

487

T88,25; T92,21; undertake care (of ) 140,30; 157,19 πρόνοια care 6,33 (with note); 22,2; 23,19; 100,24; 132,16; 179,4; 184,27.30; 185,34; provision (for body, etc.) 154,29; 179,21; 182,21; 186,32; (ὑγιεινή) provision of health 168,21; 169,3 προπέμπειν push on (of residue) 30,12 προπετής rash 26,6; 86,24 προπέττειν subject to preliminary coction 6,8 προσήκειν (be) appropriate 5,32; 13,29; 19,17; 113,3; 136,2; 178,15; T56,19; T71,28 etc.; belong to T87,15 concern 19,28; 29,1; should 4,20; 5,6; 57,22; 83,12; T44,4 etc.; be suited to 155,18 προσστέλλειν draw in (muscles) 76,28; 77,17; 86,11.16; 88,16 πρόσταγμα prescription (of art of health) 73,13; 136,31 πρόσφατος fresh: (water) 26,23; (foods) 147,6; 151,32; recent 58,13; 118,7; 123,23; temporary 32,12; 33,2.24; 34,22; 82,25 προσφέρειν administer 99,8; 100,8; 161,1; 173,12 etc.; allow 184,3 etc.; take 32,5; 36,8; 133,27; 147,9; 153,5; 196,5; 198,5; T62,22; T63,3; T86,18; T89,18; T89,22 etc. προσφορά administer(ing) (of food, etc.) 148,27; 173,17; 174,1.19; 180,4; 181,4; 196,25; introduction (of opposites) 17,14 προσφύειν add on (to the body) 6,4.10; 133,24 προτρέπειν bring out 31,32; encourage 42,14; 152,25; provoke 109,6; 125,12; stimulate (distribution in the body) 101,18; 189,14 προφαίνεσθαι start to appear 71,16 προφυλακή prevention 91,20; 103,25; 186,29 προφυλακτικός preventive (branch of medicine) 192,3; T74,6.14; (scheme of conduct) 192,8; prophylactic T87,14 προωστικός propellent (capacity) 32,17; 33,3; 189,33 πρωτοπαθεῖν be primarily affected 193,20 πρῶτος first 19,1; 30,11; 39,24; 57,3; 91,35; 114,1; 130,14; 180,32; T34,12; T66,23 ; T98,11 etc.; primary 3,3; 49,13; 66,10; 151,24; T51,24 etc. πτισάνη barley-broth 153,18; barley, barleygruel 69,7; 114,31.32; 115,7; 116,27; 117,22; 124,16; 125,25; 131,27; 131,31; 151,28; 190,30; T93,15; T97,26; broth 152,15.16 πυκνός dense 16,16.20; 25,4.10.15; 53,33; 54,1 (with note); 54,5.9.20.33; 68,22; 70,11; 88,14; 161,22 etc.; density T83,17; frequent 39,33 πυκνοῦν densify 35,6; 43,2; 54,31; 68,14; 75,25.32; 81,8; 93,25; 96,32; 99,7; 101,21; 143,7; 162,15

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488

Greek word index

πύλη ‘gate’ (of liver) 33,17 πῦρ fire 4,11 etc. πυρετός fever 10,32; 17,9; 19,32; 20,8; 92,3; 100,20; 106,6.7.12.14; 131,5; 136,12.27.32; 141,28; 171,12; 175,18 πυρρός reddish 41,13 (with note); 41,17 ῥεῖν flow away 5,19; flux 7,1; flow towards 27,3 ῥεῦμα (flow of ) liquids 81,13 (with note); 118,10; 156,34; 185,12.15; 193,8; ῥεύματα ποταμῶν a flowing river 24,27 ῥευματίζεσθαι suffer a flux 156,13 ῥευματικός (diseases) involving flow of liquids 20,10; 165,22; 175,29; 177,6; subject to the flow of liquids 157,30 (limbs) ῥῆσις quotation 39,14; 43,9; 44,12; 46,38; 47,5.33; 50,26; 51,23; 53,9.12; 92,18; T81,1; statement 94,20 ῥητίνη resin (of pine) 127,16 etc. ῥῖγος rigor 85,13; 105,29.30; 106,6.7; 112,6; 122,30 ῥῖνες nose 131,18; 185,29; 192,26; 193,10; nostrils 34,6.11; 184,34; T45,17 ῥόδινος (neuter, as noun) rose oil 186,18; 195,11 ῥόδον rose 186,10.20; 193,4; 195,23; 196,7 ῥοπή shift 14,20 ῥυθμίζειν adjust the proportion (by massage) 23,11 ῥύμη force 31,5.17; 41,21.26; 79,10 ῥυπᾶν be dirty 21,27 ῥυπαρός dirty 21,27 ῥύπος dirt 31,20 ῥῦσις flowing-away 4,15 ῥυτός flowing 4,18 ῥώμη vigour 35,21; 68,18.21; 177,12; 192,33; T39,8; T46,1; T49,26; T50,23; T51,2.21; T82,21 (Plato) etc.; strength 24,31; 63,11.26 etc. ῥωννύναι invigorate 81,14; 177,12; 183,23; 185,32; 187,6.21; 192,22; 193,4; T56,15; strengthen 63,4; 155,25; 156,33; (past participle passive) in vigorous form 159,16; 171,21; (past participle passive, adverbial form) vigorous(ly) 76,13; 111,15 σαμψύχινος (oil) infused with marjoram 128,32 σαρκοῦν fleshen up 43,8 (with note); 43,9.11; 44,21.25; 45,9 (Hippocrates); 45,10; 47,1.9.10.25; 49,5.27; 50,6.7.8; 52,23; 53,11; 54,34; 68,15.21; 172,26; T63,26 σάρκωσις fleshened-up state 47,24.28; 49,1; 52,4; fleshening-up 49,26; 57,21 σάρξ flesh 35,18; 44,26; 45,28; 47,9; 70,11; 85,13; 104,24; 122,15; 130,8; 146,31; 190,35; 198,8; T66,24; T83,17 etc.

σείειν move about 67,7 (with note); 67,12 σελάχιος cartilaginous (fish) 146,31 σέλινον celery 124,23; 152,26 σεμίδαλις semolina 147,29 (with note); 147,31 σέσελι hartwort 118,1; 124,22.26 σημεῖον sign 36,4.5; 41,15; 71,16; 113,25; 114,18.20; 115,31.34.35; 126,24.29; 157,34; T41,20.25 σηπεδονώδης putrefying 27,25; 106,5; of putrefaction 175,30.32 (diseases) σηπεδών putrefaction 27,21.26; 185,24 σίκυος ἄγριος squirting cucumber 129,3; σικύων πέπων melon 151,30 σιτίον (usually plural) food(s) 6,1; 24,6; 35,1; 41,4; 90,14; 102,12; 133,12; 143,13; 162,35; 164,17; 181,30; 190,7; T61,2; T80,26; T83,1; T87,19.20 etc.; meal(s) 60,10 σκαμμωνία scammony 149,17; T61,6; T91,22 σκάφη tub 24,16 σκέμμα investigation 33,8; T33,8; T74,20; T75,3; point of enquiry 16,32; 18,21; 56,4; 63,30 σκέπασμα covering 16,23 σκευάζειν prepare 69,7; 117,32; 120,2; 125,9; 131,32; 152,15; 186,21; 198,1.9; T98,2 etc.; produce T93,16; τὸ ἐσκευασμένον fake product 119,8 σκίμπους camp bed T55,22 ; T68,10 ; couch T45,21; T68,3; hammock 18,20.31; 66,33 σκίρρος induration 33,5.8.13; 34,30; 54,14 σκιρτᾶν skip 19,6 σκληρός hard 15,14; 16,18.20 etc. σκληρότης hardness 5,3; 25,29 etc. σκοπεῖν (usually middle) investigate 3,8; 107,28; 110,19; 113,31; 139,15; 167,13; T48,18; T49,9; T72,10 etc.; conduct an investigation 40,10; 101,6 etc.; investigation T88,3; see T90,20 σκοπός aim (in view) 6,19; 42,22; 70,25; 72,16; 87,30; 94,29; 106,33; 130,6; 138,29; 151,12; 159,17 etc.; T47,26; T48,4.6.7; T59,23; T62,13.16; T63,13.23; T65,19 etc.; limit 83,27 σκόροδον garlic 147,14 σκότωμα skotōma 156,8 (with note) σούσινος (neuter singular) perfumed oil made with lilies 97,12.15 (with note) σόφισμα sophistic argument 19,9; T52,2 σοφιστικός sophistical 7,24; 103,2 σοφός clever 21,19; T76,26; of wisdom T84,22 σπέρμα semen 4,5.7.13.17; 196,17 etc.; seed(s) 10,27; 124,23; 126,36; 127,9; 195,4 etc. σπερμαίνειν produce semen 39,21 σπλάγχνον internal organ 15,25.26; 20,9; 56,27; 67,12.14.19; 77,13; 78,11; 146,24;

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Greek word index

147,30; 153,23; organ 30,20; 33,1; 148,15; 149,9 σπλήν spleen 30,21; 33,16.18; 76,32; 77,1; 146,4; 148,13; 153,22; 156,24; 170,9; 193,13 στέγειν stop (stuffs within) 75,26 στεγνοῦν stop up 93,27; 186,7 στέγνωσις stoppage 35,5; 94,24; 95,37; 96,19 στερρός firm 16,16 στοιχεῖον element 4,8.11.23 etc. στόμα mouth 15,30; 18,11; 23,9; 33,2; 100,8; 111,1; 125,6; 137,31; 148,27; 181,4.7; 184,33.35; 185,1.24.29; 186,27; 189,8.12.29; 192,15.27; 193,10; 194,28 etc.; outlet 33,6; 35,4 στόμαχος mouth of the stomach 114,29; 117,3; 120,15; 184,35; 185,11; 187,6; 190,8; 194,34; 196,28; stomach mouth 100,12; 102,17; 126,16; 189,14.21.26; 192,16; 197,2; stomachos 189,13; 194,29 στόμιον outlet 30,29; 34,33 στοχάζεσθαι aim (at a goal) 49,14; 95,1; 129,25; T66,6; estimate 72,6; guess 20,35; 21,31; make a conjecture 107,10; 108,9; quest 126,21; tailor to 142,8 στοχασμός estimate 57,30; 58,26; 70,23 στοχαστικός estimator 21,13; (adverb) by a process of estimation 159,19 στρουθίον sparrow 191,5; strouthion (name of a type of quince) 197,25 στρυφνός sour 32,1 (with note); 34,19; 197,25 στρύχνον hound’s berry 195,20 στυπτηριώδης astringent 35,9 (with note); 96,27; 186,7 στύφειν be astringent 32,4; 96,24; 127,28; 145,31.33; (neuter plural participle) astringent (stuffs, etc.), astringents 33,9; 35,9; 96,24; 122,27; 181,3.6; 189,8; 190,23.28; (oils) 101,31; 102,3; 127,28; 187,15 στύψις astringent effect 86,32 σύγγραμμα composition 29,26; 36,32; 49,32; 51,25; 136,3; 137,8; 151,3; 160,31; 164,20; T84,11; T86,10; T99,18.21 συγκαταβάλλειν lay down in the foundation 4,21 συγχεῖν (past participle passive) flowing-together (of flesh) 44,22 (Theon); 45,9 συζυγία coupling (of qualities or properties) 32,25.27; 44,3.7; 50,18; 53,14; 73,27; 95,17; 169,14.18; 172,7 etc.; pair 84,27 σῦκον fig 152,18.30 συμβεβηκός feature that arises 36,6 (with note); incidental feature 61,27 (with note); 81,12; feature 112,31 (common); 125,15; κατὰ συμβεβηκός incidentally 65,31; 105,25;

489

T53,12.18; T54,23; T55,1; T56,1; T70,4; as an incidental feature 160,6; in an incidental manner T56,7 συμμετρία balance 7,28; 8.15.17.18; 9,14 etc.; good balance 3,15; 5,30; 9,25; 47,22; 55,17; 138,27; 158,33; 176,12; 179,25; T45,2; T49,24 ; T57,2; T66,15; T83,15 etc.; κατὰ μίαν συμμετρίαν according to a single formula 120,10; κατὰ τὴν μέσην συμμετρίαν according to the middle proportion 198,18 σύμμετρον (neuter as noun) good balance 21,11.12 etc.; state of good balance 28,4 etc. σύμμετρος well-balanced 9,23; 47,19; 50,9; 51,15; 57,15; 81,22; 138,18; 157,23 etc.; moderate 25,26; 170,23 etc. σύμπας as a whole 17,29 etc.; entire 16,2.30 etc.; whole 5,21 etc. συμπίπτειν arise (of disease or symptom) 20,11; 85,6.29; 97,26; 107,25; 110,5; (of perfect good-mixture) 14,22; befall 16,9 (from outside); 88,25; 136,11; happen 67,7; 120,16 σύμπτωμα symptom 62,2 (with note) etc. συμφέρειν (also ξυμφέρειν) be advantageous 17,5; be appropriate 52,6; 157,7; 163,8; 178,19; be beneficial 90,36; 93,20; 115,6; 119,28; 124,11; 126,32; 132,30; 147,14; 154,14; 160,34; 163,7; 180,25.29; benefit 93,35; 182,9; should 165,3; 166,23; οὐδαμῶς inappropriate 52,6; 178,19 συμφυής conjoined 86,3 σύμφυτος connate 4,2 etc. συνάγειν bring together T63,24; draw together 16,19; 33,11; 42,6; 45,1.35; 89,25; 93,25.27; 98,25.30 συνδρομή concatenation 96,10 (with note); 159,25; 161,12 συνέχεια cohesion 119,18 συνεχής continuous (of exercise or motion) 60,34; 61,31; 64,34; retaining its cohesion 119,20 σύνθεσις composition: (of animal body) 3,16; 7,32; (of drugs) 118,29; 119,2; 124,21; 125,16.18; 126,3.7.15.35; 128,2 etc. σύνθετος composite 32,14; 46,36; 64,26; 77,26; 84,30; 85,6; 86,6; 89,2.12; 110,27; 123,26.28.32; 170,16; πραγματεία τῶν συνθέτων treatise on Compound Drugs 191,31 συνιστάναι constitute (an art or specialized skill) 10,8 (with note); T44,25 (with note); T71,10.13; T87,24; T98,11; T99,4; (middle) arise (from) 32,19; 35,3; 38,12; 86,21; 130,13; 131,3; 170,23; 185,29; come about 84,25; 86,21; 94,13; 95,22.28; 105,1; gain

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490

Greek word index

consistency 4,30; consist in (ἐν) 7,33; 12,28; 54,20 etc. σύνοψις summary form 35,32 σύνταξις arrangement 15,9 σύντασις tension 87,30.32 συντελεῖν accomplish 19,10; affect/have effect on 149,13.16; be beneficial 181,6; be of benefit 183,5; be of help 114,15; be a significant factor 81,15; (help to) bring about 91,13; 109,6; conduce to 29,21; contribute 30,17; 76,2; T63,25 συντήκειν melt (of flesh) 35,18; wear oneself out (with note) 178,6 συντίθεναι combine 98,9; (medio-passive) (be) composed of 173,12; 182,8; include 118,5; make 121,15; prepare 117,7; 127,23; 146,20; 188,21.35; put together 117,31; 195,12 συντονία intensity 77,10; tautness (of body) 68,21 σύντονος (of motions or exercises) intense 68,8.33; 97,2; 98,2.30; 162,13; 165,20; 172,24; 175,13; 181,36; (of body) taut 69,1.4; 83,19 σύστασις consistency 32,2; 195,22; (of urine) 111,3; (of drug preparation) 119,18; 195,13; 198,1; (of wine) 121,28; 122,2; 167,7; constitution (of the body) 175,4;194,26; (of an art) T71,9 (with note) συντείνειν tense 75,19.27.30; 87,33; 88,1.2.29 συστέλλειν contract 57,20; draw in 71,2; reduce 135,24 σφαλερός dangerous 165,35; T43,6 (Hippocrates); T83,8.23; unstable 5,10 σφάλμα blunder 64,12; error 138,20.29; mistake 31,28; 140,26 σφίγγειν close up 33,11; 42,7.16 σφοδρός vehement 20,16; 21,2.21; 33,9; 36,13; 64,26; 78,21.22; 81,29 etc.; (of exercise) 39,28.29; 101,25; 139,1.2; 163,25 etc. σφοδρότης vehemence 39,30; 60,32; 66,7; 156,4; 185,32 σφυγμός pulse 5,30; 6,2 etc.; T61,7 σχέσις disposition T46,22; T49,1; κατὰ σχέσιν unstable (health) 142,25 (with note); 142,27; T38,24 (with note) etc. σχολάζειν have leisure to devote to 38,22; 39,9; 73,15; 74,27; 75,12; 168,25; devote time to 165,18 σωτηρία preservation 19,8; T38,3 σωφροσύνη self-control 23,35 σώφρων self-controlled 59,17 τάσις tension 54,14; 76,3; 77,35; 84,21.23; 85,23; 86,13; 89,3; 91,22; 93,18; 99,31; 131,21; 149,1; 158,30; 173,1; 181,31

τεκμήριον evidence 14,11; 174,24 τέλειος/τέλεος adult 26,5; 158,34; complete 39,5; 134,19; 184,18; (of form of exercise) 74,30; 75,2; 92,5.20; 93,1.7; 94,2; T99,23; maturity 172,11; perfect 8,1.2; 14,9; T45,22 (with note); T46,2.5.8; T53,14; τὸ τέλειον completion 74,10 (with note); (comparative) higher-level T94,3 τέλος goal 49,14.15; 57,27; T36,24.25; T37,4.6; T38,4.17.18 etc.; ἐπὶ τέλος finally (with note) τερμίνθινος of the terebinth tree 127,18; 129,11; 153,19 τέρμινθος terebinth 151,30 τεῦτλον beet 69,7; 129,3; 132,1; T93,16 τέχνη art 3,2; 8,22; 18 etc.; T36,9.20 etc.; specialized skill 3,20.22; 29,5 etc. τεχνίτης craftsman T68,5; practitioner (of an art) 60,18; T37,17; T52,23.27; T53,4.5; T57,9.12; T58,15; T65,8; T68,18.23; T79,6; T86,25; T87,3; skilled 59,33; specialist 67,34 (with note); 68,27; 90,16 τήρησις safe-guarding 18,21 τίθεναι add T43,18; apply T77,18; have 14.31; consider 14,11; establish 36,8; give 6,12; place 13,33; 17,7; posit 37,6; 39,7; 103,11; T37,7; T41,10; T44,14; put aside 39,10; set down 138,5; take (a case) 51,38; T36,19; use T36,26 τιθύμαλλος spurge 149,18 τιτθός teat 18,10; 21,23; 22,21 τιτρώσκειν pierce 7,9.13.19; 85,12; T57,24 τονοῦν improve the tension of 89,25; 181,4.7; 189,21.29; 192,29.36 τονώδης tensed (kind of fatigue) 89,9.16; 90,7.36; 95,20.34; 104,18.32; 105,12; 130,18 τρέφειν nourish 6,9; 18,4; 22,14; 23,4.19.24; 25,21; 30,35.36; 41,5 (Hippocrates) etc.; nurse 18,10; 22,1 etc.; rear 21,31; 24,14.21 etc.; (participle) carer 24,3 τρίβολος water chestnunt 195,20 τρίψις massage 35,10; 43,35; 46,40; 49,30; 53,17; 73,22; 87,21; 101,29; 139,21; 172,29; 179,28; 196,25; T61,2; T80,17; T92,15 ; T97,9.12.19 etc. τροφή nourishment 16,29; 17,24; 18,1.4.5; 22,1.7.17; 23,19.24.32.35; 25,11; 30,3.24; 32,6 etc.; 41,7.9; 109,3 etc. τροφός nurse 18,11; 22,22; 23,2.22.25; 66,33 etc. τύπος pattern 4,32.33; 99,32; 175,11 τυρός cheese 146,29 ὕβρις arrogance 26,6 ὑγ(ι)εία health 3,7.10.14.18 etc.; T36,26 etc.

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Greek word index

ὑγιαίνειν (be) healthy 8,22,26 etc.; T36,10; T42,5; T45,8.10 etc.; enjoy health 14,5 ὑγιεινός healthful 15,2; (σύμπτωμα, symptom) 104,5; concerned with/of/for/related to health: (aims) 6,28; (art, part of art) 8,6; 10,8; 12,31; 16,3.10; 19,27; 29,9; 35,35; 37,7; 73,13; 136,31; 186,28 etc.; (bounds) 36,29; (material) 35,33; (πραγματεία, study) 5,33; 8,14; 10,5; 33,14; 34,31; 36,3; 67,31; 73,2; (ὑποθήκη) instruction 73,10; (masculine, as noun) health-practitioner 35,34 (with note); 60,16.20 (with note); 61,11; 67,33; 84,11; T86,21.22 (Erasistratus); T86,25; T87,4; T90,7; T96,8.11; T98,21; (neuter, as noun) healthfulness 3,4 (with note) etc.; T33,17 (with note) etc. ὑγρός wet 3,15; 13,27; 17,24; 34,18; 40,30 (with note); 41,27; T61,4; T71,2; (neuter plural as noun) fluids 85,11; 104,27; 174,28; T61,10; (neuter singular as noun) moisture T57,17 ὑγρότης moisture 13,19; 26,15; 100,12; T57,18 etc.; (plural) fluids 81,12 (with note); 105,27 etc. ὕδερος dropsy 17,20 ὑδρόμελι honey-water 121,14 ὕδωρ water 4,10; 35,9; 83,5; 91,5; 120,7; 128,12; 152,5; 195,26; T80,12; T87,18.22; T89,27 etc.; (in Hippocratic title) T87,10 ὕλη material 4,6; 34,24.26; 35,1; 67,35 (with note); 69,21.29.31; 115,14; 141,24; 150,18; 159,33; 183,8; 195,6; 196,1; T48,1; T62,5; T69,16; T70,2; T71,3; T79,24; T89,9; T92,5; T94,4 etc. ὑμήν membrane 4,21; tunic 192,31 ὑπάγειν empty (the stomach) from below 113,15; 125,9; 147,19; 152,27; 182,6 ὑπαγωγή emptying (of the stomach) from below 123,5; 149,13; 180,20.31; 181,6; 182,17; 183,30; 187,6 ὑπαλλάττειν alternate 153,26; change 21,28 (bedding); modify 14,20; 45,2; 52,29; 56,16; 69,19; 135,26; 159,3; 173,22.27; 174,10.16; 175,26; 187,5.26.30; 194,16; admit of modifications 160,20; see also Book VI, n. 8 ὑπάρχειν be 38,25; 52,38; 61,12; 85,12; 91,27; 111,9; 191,22; T59,20; T64,1; T70,7; T75,12; T78,17; be the case T47,18; be a feature 171,14; be present 133,15; belong to T40,10; T72,8; T75,22; T92,8; consist (in) 3,15; exist T44,22; (+ dative of subject) have 11,36; 119,10; T75,20 ὑπερβολή excess 14,36; 15,13.18; 25,15.19; 48,12; 55,17.24; 86,25; 138,19; 183,2 ὑπηρετεῖν be obliged to perform services 136,23; be subordinate to 54,29.30; 55,3;

491

be a servant T96,2; serve T55,25; service 178,11; submit to 174,6; treat 16,4 ὑπνώδης prone to sleep 15,16; 114,17 ὑπογραφή characterization T36,20 (with note); T36,26; outline 4,32.33; 168,5 ὑπόγυιος imminent 34,22; recent 86,23 ὑπόθερμος lukewarm 106,4 ὑπόθεσις (underlying) assumption 5,33; 7,27.31; 13,6; 29,15.19; 30,11; 31,23; 56,11; 98,13.14; 105,33; 133,5; 151,10; 168,2; basis 10,6; 123,26; 175,32; 181,21; (present) subject 24,11; 56,1; 97,22.27; 108,16 ὑποθήκη instruction (for health, etc.) 29,9; 73,2.10; 135,27; 136,3; 178,20 ὑποκεῖσθαι assume T74,21; be (taken as) basis 7,33; 8,3.14; 38,5; T71,15 etc.; be the subject 23,12; 58,10; 90,10; (be) situated below 76,22.32; 184,32; 193,13; take the case 113,24; 157,6; under discussion 73,20; underlie T38,18; T89,8; T92,5 ὑπολαμβάνειν take it that 11,19; take (to be) 47,14 etc. ὑπόμνημα (plural) discussion(s) (referring to Galen’s own works) 19,20; 28,16; 30,10; 35,1.31.37; notes (mostly referring to Galen’s own works) 48,6.26; 65,21; T33,3 (with note); T36,1; books 54,25; 108,8; 130,31; 168,27; 175,2; 180,14; 182,14; work(s) (referring to Galen’s own works) 151,8; 165,8; 173,6.18; 185,2; 191,13; 193,15; 195,6; 196,2 ὑπόστασις sediment (in urine) 111,10.24.27; 122,6 ὑποτιθέναι proffer (advice) 197,4; (middle) instruct 38,25; posit (as assumption) 10,26; 52,1; 56,36; 164,25; T38,3; posit as case (for discussion) 168,21.24; set out basic princples 44,31; take as basis for discussion 73,14 ὑποχόνδριον abdominal region 26,30 (with note); 26,32; 116,30; 117,1; 148,28.31.33; 150,12; 172,35; 173,10 ὑποχωρεῖν pass off from 26,30; (passive) be passed below 172,12 ὗς hog T85,12; pig 20,23; 117,32; T97,4.7 ὕσωπον hyssop 123,10 ὑφηγεῖσθαι explain 6,20; 7,25; lay out (argument) 6,20 ὑφιστάμενον sediment (in urine) 111,4 (with note); 111,16.23 φαίνεσθαι appear 8,26; 41,16; 86,11; 112,3; 139,15; 171,33; 196,17; T63,24 etc.; be apparent 96,18; T52,24; T69,17; T86,23; T98,9 etc.; become apparent that 71,2; 99,24; T97,15

https://doi.org/10.1017/9781009159524.017 Published online by Cambridge University Press

492

Greek word index

φακή (dish of ) lentils 69,7; 146,29; 151,28; T93,15 φαντασία impression 47,35; 163,11 φάρμακον drug 18,28 (with note); 36,19; 129,12; 154,3; 184,12; T63,3.6; T69,24; T78,12 (Homer); T78,15; T80,2.4; T91,13 etc.; (aloe-based) 153,10; 182,18; (ambrosial/ immortal) 147,21; (‘Andronios’) 193,9; (bitter) 188,16; (catmint-based) 119,32; 124,21; 126,9; 130,2.3; 147,9; 173,17; 188,17; (Diospolitikon) 182,6; 188,34; 189,8; (emetic or laxative) 67,30; 107,31; (for the mouth of the stomach) 198,1; (theriac) 147,18; (three-pepper) 182,1; 188,7.16; (thinning) 190,16; (wet) T61,4; potion T78,10 (Homer) φαρμακώδης drug-like (capacity, fluid, quality, water) 17,22; 32,22 (with note); 117,30; 118,9; 152,26; 153,16.19; 186,10.16 φαῦλος bad 22,19; 159,7; 188,31 (negative) impressive 80,18; (negative) quite good 147,2; (negative with superlative) very large 103,23; poor 133,14.33; poor-quality 120,29; of poor quality 121,20 φθείρεσθαι decay 7,4; 176,9; T57,13; be destroyed 168,8; loss T58,23 φθορά decay 5,13; 6,31 etc.; destruction 10,21 etc. φιλίατρος medicine-lover 118,33 (with note) φιλονεικεῖν competition 20,26 φιλονεικία competitiveness 94,11 φιλόνεικος competitive 58,19.21 φιλοτιμία love of esteem 38,20; 182,35; 183,10 φιλότιμος desirous of esteem 58,21 φλεβοτομεῖν (employ) venesection 109,16; cut 109,18; 116,7; (passive) undergo venesection 131,16; cut veins T65,4 φλεβοτομία venesection 113,9.13.14; 116,8; 130,25.30; 131,25.27; 132,24; 133,1.3; (in title of Galenic work) 130,33; 132,32 φλέγμα phlegm 112,2.24.25.35; 152,1; 165,33; 189,3.6.9 φλεγμαίνειν be inflamed 84,19; inflammation 88,28; suffer inflammation 85,29 φλεγμονή inflammation 33,5.8.12.27; 34,30; 44,24; 47,6.17.29; 54,13; 86,14; 88,22; 136,17; 165,29 φλεγμονώδης inflammation-like 84,21.23; 89,17 etc.; 90,12; 91,1.23; 94,35; 95,5.12.20 etc.; 104,18; 131,2; 132,9.16 etc. φλέψ vein 4,20 etc.; (πρώτη, first) 118,12; 119,31; 122,17; 152,2 (with note) φοῖνιξ βάλανος φ. date 181,24 φρίκη shivering 83,6; 85,13; 89,17; 105,29.31; 106,6.7.14; 122,29.30

φρικώδης prone to shivering 86,27; 88,15 φρίττειν shiver 81,8 φροντίζειν concern T53,17; concern oneself with 142,28; experience mental exertion 139,18 (with note); 165,5 φροντίς mental exertion 162,5; 175,16; T85,5; worry 14,19; 19,32; 154,18; 178,6; T90,6 (with note) φρύγειν burn 128,9.19; roast 4,27; 117,13 φυλακή preservation 14,32; 138,7; T37,5; T38,3; T42,5.15; T89,23; T92,2; safeguarding 7,11; 36,7; 39,16 φύλαξ guardian T54,25; T55,3; preservative T49,9; preserver 3,17 φυλάττειν guard against 7,15; preserve (e.g. health) 3,5.8.11.17.18 etc.; (middle) avoid(ance) 5.17; 103,27 etc.; provide protection 3,23; preserve (something in a state) 4,19 etc. φυσικός natural (activities) 13,21; 57,4; 65,34; 66,4; 100,25; 105,19; 136,1; 137,23; 161,35; 170,31; 171,6; 176,8; 185,33; 192,6; 194,10; T52,26; T70,5.6; T71,5; T72,16; T83,26; (in title of Galenic work Natural Capacities) 30,10; 133,6; 134,8; 193,15 φύσις Nature/nature 6,6.7 etc.; (as craftsman) T54,5; κατὰ φύσιν natural 162,4; 176,19 etc.; according to nature 7,34 etc.; normal 7,14 (with note); 11,22; 12,21; 13,7; 16,24; 86,17; 92,33; 95,8; 101,28; 112,19; 140,17; T38,14; T39,9; T43,1; T45,9.14; T48,9; T50,16.17; T57,17; T79,9.23; T80,23; T82,17; T90,19 etc.; παρὰ φύσιν abnormal 11,19.20.23.25.29; 17,19; 89,7; 93,14; 140,29; 141,4; 166,31; T57,3; T78,23; T84,6; not normal T43,2; T43,4 etc.; unnatural 185,21; 189,35; T84,17 φυσώδης flatulent 116,33; 189,4; (neuter singular as noun) flatulence 149,33 φυτόν plant 5,11.12.22; 154,24; 196,6 φωνή language T76,27; T77,10; speech 172,1; 185,2; vocal production 21,19; vocal utterance 67,20; vocalization 78,1; voice 18,13; 65,20; 67,21; 155,21; 158,30; 185,4.7; T97,8; (in title of Galenic work) 65,21; 77,26; 185,2; word 53,32 χαλᾶν slacken (of muscle) 30,31; (effect of massage) 42,7; 43,3; 46,27; 88,2; 89,21 χαλαρός slack 76,20; 88,2; 158,21 χάλασις slackening 87,31.33 χαλαστικός slackening (oil) 97,4.13; 124,5; 127,10 χαλεπός dangerous 171,12; difficult 29,7; 40,33; 113,20; impede T82,11 (Plato);

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Greek word index

painful 182,20; 185,8; problematic 157,30; 189,4.11; T84,3; (comparative) worsening 191,24; (superlative) hardest 184,28 χαμαίμηλον chamomile 128,25 χεδροπά pulses (as food) 180,6 χεῖν cause to flow (residues) 55,5; 85,9; (passive) be made to flow 165,25; (past participle passive) flowing (of flesh) 45,11; 47,1 (Theon); 54,3 (with note) χολή bile 33,19; 34,25; 41,10.16; 110,22.25; 111,8; 112,3.20; 165,33; 172,4.8.13; 198,10 χολώδης bilious 20,6; 26,8 etc. χόνδρος cartilage 4,21; groat 114,3 (with note) etc.; T93,15 χρεία function 8,21; 10,34; 53,8; 159,21; T47,22; T82,18 etc.; need 79,33; 126,6; 147,23; 171,16; T87,12; reason 108,18; use 13,12; T79,16; utility 192,22 (with note); 192,23; εἰς χρείαν ἰοῦσαν in actual use 12,16; πρὸς τὰς ἐν τῷ βίῳ χρείας for everyday purposes 12,18; τῶν κατὰ τὸν βίον χρειῶν functional purposes in life 59,33; ἕνεκα τῆς χρείας for the purpose of 60,2; χ. τέχνης employment of art 16,6; ὅταν ἡ χρεία καλῇ when called for T94,18 χρήσιμος beneficial 75,22; 128,19; 144,14; 147,19; 163,6; of use T67,10; useful 19,13; 49,11; 50,1; 52,37; 93,1; 103,5; 150,25; 196,12; T90,15 etc.; value T40,8; (negative) not of value 146,1 χρῆσις employment in practice T33,15; use 18,7; 32,5; 40,34; 60,6; 81,19; 100,6; 117,15; 126,11; 149,3; 169,5; 186,5; 198,19; T80,25; usage T77,24 χρηστός beneficial 15,9; 16,5; 17,10; 27,14; 54,28; 71,4; 133,9; 143,7 etc.; good 13,1; 22,5; 59,16; 113,12; 116,9; 123,19; 183,22; T79,24; T91,3; T92,19.20; T95,8; T96,4 etc.; of service T96,11; serviceable T94,5; of use T43,15; useful T77,21 χρίσμα ointment 177,8; 187,14.20.30; 195,10.13; 196,5 χροιά colour: (of urine) 41,12; 111,3; (of living being, i.e. complexion) 71,6; 112,13.15.20; (of milk) 22,27; (of sweat) 110,22; (of wine) 121,28; 122,2; 145,2.9.16; 146,9; 167,7

493

χρῶμα colour 11,29; 112,4 (with note); 112,23; hue 145,16 χυλός juice 114,31; 115,6; 117,22; 126,6; 131,28; 153,7; 190,30; 195,16.17.21; 197,20.27 χυμός fluid 26,13; 30,35 (with note); 34,19; 40,35; 41,13 ψιλός: τριχῶν devoid of hair 15,14 ψύλλιον fleawort 195,20 ψυχή soul 16,4; 18,17; 19,15.22.24.28.29.34; 20,4.12.33; 21,2.16; 23,34; 26,4.7; 28,27.28.35; 34,4; 58,10.21.34; 59,14; 62,1; 66,1; 82,27; 112,10; 122,31; 138,27; T52,7; T81,3.14 ψυχικός of the soul: (activity) 170,31 (with note); (affection) 66,19; 112,7; 122,23; (capacity) 105,15 (with note); psychic (πνεῦμα, breath) 66,12.20 ψυχρολουσία cold bathing 42,20; 71,30; 82,15; 83,16; 99,1; 183,26; cold baths 83,34 ψυχρός cold 3,14 etc. ὠθεῖν push 31,6.17; 63,13; 76,31.37; 79,1.8.9; 106,2; 134,13; 183,31; 189,29; 193,22 ὦμος raw (of fluids, honey, vinegar) 40,35; 111,19; 112,23; 114,33; 116,21; 120,6; 122,16; 123,8.22; 124,6; 133,13; 180,18 etc. ᾠόν egg 146,29 ὠφελεῖν assist 159,23; T70,16.20; benefit 23,27; 91,1; 151,34; 152,5; 158,34; 160,25.27; 161,3; 164,17.20; 176,1; 183,14; 186,9; 194,35; 196,30; 197,16; T51,13; T52,13.14; T55,9; be helped by 135,15; have a positive effect T55,21.27 ὠφέλιμος beneficial 17,12; 120,21; 155,11; 166,1.3; benefit 149,10; 156,17; useful 155,4; 198,2 ὠχρόλευκος midway between pale yellow and white 145,8 ὠχρόξανθος midway between pale yellow and yellow 110,25 (with note); 145,8.20 ὠχρός pale yellow 41,10 (with note); 41,14.18; 110,22.26; 112,3.17; 145,4.7.19.21; 146,9; 172,9; 194,31

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Index of names

This is an index of names mentioned in Galen’s text with page and line numbers of Koch’s (San. Tu.) or Helmreich’s (Thras.) edition. References to the latter are preceded by ‘T’. For names appearing in the Introduction and notes, the General index should be consulted. Abates (wine) 145,32 Achilles 9,33 (with note) Adriatic (wine) 121,31; 144,22.26 Aeolic T78,4 Aigai 145,32 Aigimios 70,27 (with note) Alban (wine) 121,31; 144,23 Alexandria 118,26; 178,23 Allianoi 186,14 Andronios (drug) 193,9 Antiochus 143,17 (with note); 144,2.4; 146,7 Antoninus See Marcus Aurelius Arabs 56,31; T77,3 Arcturus 124,36 (with note) Aristotle 169,11; 184,23 Ariusian (wine) 121,32; 144,15.29 Arsyenian (wine) 121,33; 144,27 Asclepiades 18,22.24; 19,8; 31,25 (with note); 80,20 Asclepius 20,14; 29,30 sons of T78,21 Asia, Asian 121,32.35; 144,17; 145,32; 193,2; 197,26 Assyrian T76,27; T77,1 Astreotic 124,27 Athens 127,2 Attica, Attic 118,19; 143,29; 153,2; T78,1.6 Aulon 87,5 Berenice 189,1 (with note) Bithynia 145,27 Campania 190,20.26 (with note) Celts 11,27 (with note); 56,31; 146,17; T77,8 Cilicia 145,32

Commagene 97,13.16 (with note) Crete, Cretan 118,19; 124,28 Damascus, Damascene 152,32; 153,3 Diocles T85,22; T99,16 Doric T78,3 Egyptian 11,27 (with note); 56,31; 97,10 Empirics 159,24; 161,12 Epeius T79,14 Erasistratus 18,23; 35,36; 130,22.24.33 (with notes); 131,5; T85,23; T86,11; T98,24 Ethiopian 117,11; T77,3 Falernian (wine) 121,30; 144,18.26.29; 146,8; 152,15 Faustian (wine) 146,8 Gaurian (wine) 144,23 German 24,21.22.28 (with note) Greek 24,24.25 (with note); 144,15; 182,35; 183,5; 197,26; T77,23; T78,19.24; T87,1.7 Hellespont 144,16 Herophilus T85,23; T99,17; 171,11 Hierapolis 27,18 Hippocrates 17,2; 19,20 (The Doctrines of Hippocrates and Plato); 25,11; 36,32; 39,10; 43,6; 44,9.11.37; 45,7.20.30; 46,28.31.32; 47,31; 48,20.22.28; 49,21.32.33; 50,13; 51,22.24; 53,16.26; 54,29; 56,34; 57,18; 87,31; 96,13; 104,6.31; 116,17; 137,11; 141,20; 145,2; 159,26; 162,20; 163,3; 164,4.22; 166,9.11; 179,10; 192,25; T43,3; T80,11; T83,2.10.27; T85,22; T87,9; T91,6;

494

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Index of names

T92,26; T97,11.15.20; T98,1.6; T99,11.16; T100,7 Homer T78,8.17; T79,2.14 Hyperberetaios 127,2 Iberia see Spain Indian T77,3 Ionic T78,2 Iphiclus 11,3 (with note) Istros 144,16 Italy, Italian 97,5; 121,30.35; 127,11.12.25; 144,18.19; 145,29 Karuinos (wine) 146,10 Laodicea 193,2 Lesbian 121,32; 144,15.30 Lyketoi 186,16 Lynceus 11,2 (with note) Macedonia, Macedonian 87,4 (with note); 124,27 Marcus Aurelius 178,30 (with note) Marsian (wine) 145,29 Massaleotic 124,26 Melampus 11,2 (with note) Menemachus T71,23 (with note) Menodotus T71,23 (with note) Milo 11,4 (with note); 62,36 Mitylenaean 161,7 Mysia, Mysian 144,15.16.25.30 (Hellespontic Mysia, with note); T77,8 Naples 144,24 Pergamum 127,1; 144,17 (with note) Peripatetic 162,3 (with note) Perperene 145,33 Persian T77,2 Philotimos 122,11 (with note); 123,6.15; T85,22; T99,17 Phrygian 192,30; T77,8 Plato 19,20 (The Doctrines of Hippocrates and Plato); T62,15; T78,20; T79,4.7; T80,18.27; T81,9; T83,2.10; T85,25; T86,2.7; T87,6.12; T100,7

495

Polyclitus 56,29 (with note) Praxagoras 112,26; 122,12 (with note); 123,14; T85,22; T99,16 Primigenes the Mitylenaean 161,8.20.27.35; 162,13; 163,27 Prusa 186,13.15 Quintus 100,28.31.32 (with note); 101,2 Rome, Roman 127,1; 178,20; 188,21; 193,5; 197,27 Sabine 86,32; 97,5; 121,31; 127,11.25.26; 144,22.26; 146,14 Sardis 27,17 Scythians 11,27 (with note); 24,35; 56,31 Septembrius 127,1 Signian (wine) 144,19; 145,29 Skybelites (wine) 145,34 Sorrentine (wine) 121,30; 144,18.25.29 Spain, Spanish 86,33; 87,1.6; 153,3 Spartan T96,16 Strymon 87,5 Telephus 144,3 (with note) Theon 44,10.14; 45,21; 46,22.36; 47,11.26; 48,13; 50,19.25; 51,12.20.22; 52,16.22.36; 80,26; 91,29; 92,4.18.33; 93,33.35; T99,19 Theophrastus 84,8 Theraios (wine) 145,34 Therenos (wine) 146,10 Thersites 9,33 (with note) Thessalian T77,12.14 Thessalus 101,3 Thracian T77,8 Thrasybulus T33,1 (with note); T84,14 (crossreferences to the book called Thras. in San. Tu. not included) Tiburtine (wine) 144,19; 145,29 Titakazene (wine) 121,33; 144,26 Tmolite (wine) 144,26.30 Triphyline (wine) 144,23 Tryphon T99,19 Tuscan 144,24

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Index of texts and passages cited

1. REFERENCES TO OTHER WORKS WITHIN THE TEXTS  OF  GALEN This is an index of Galen’s mentions of other texts, as well as of specific passages in those texts, within the texts of Thrasybulus and Health. Where a passage is quoted verbatim, or the reference is a clear or explicit one to a specific passage, full reference details are given here. In other cases, probable passages intended are mentioned in the notes ad loc. Some uncertain references are included, indicated by a question mark. Internal forwards and backwards references within each of the two texts are not included. Erasistratus Healthfulness: 140–141

Vict. Att.: 198, 338, 359, 370, 380 De voce: 237, 252

Euripides Fragment 1086, p. 1012 Kannicht: 324

Hippocrates Airs, Waters, Places: 135 (?), 141 De alimento (Nutrition) 15 (IX.102 L.): 125 34 (IX.110 L.): 107 Aph. (Aphorisms): 203 and 357 (actually both references to Epid. VI; see below); 357 1.1 (IV.458 L.): 349 (?) 1.3 (IV.458 L.): 107 1.22 (IV.468 L.): 302 2.5 (IV.470 L.): 286 2.10 (V.472 L.): 206 Epid. (Epidemics) VI.4.13 (V.310 L.): 357 VI 4.23 (V.314 L.): 203, 357 VI.6.2 (V.324 L.): 204 Hum. (Humours) 1, 158,9–10 Overwien (V.476 L.): 395 Regimen: 135 (?), 141 Regimen in Acute Diseases: 335 (?)

Galen Alim. Fac.: 370, 380, 383, 393, 398, 399 Ars Med.: 358 Bon. Hab.: 162, 163 Bon. Mal. Suc.: 370, 380, 383, 393 CAM: 129 (?) Caus. Puls.: 238, 288 (?) Caus. Symp.: 288 Comp. Med. Gen. and Comp. Med. Loc.: 394 Cur. Rat. Ven. Sect.: 320 (?) Hipp. Elem.: 157, 163 Inaeq. Int.: 402 (?) Marc.: 346, 373 MM: 289 (?), 304, 319–320 (?), 394, 402 (?) Nat. Fac.: 192, 320, 321, 396 Opt. Corp. Const.: 162, 163 PHP: 179 Plen.: 288 SMT: 265, 398, 394, 399 Temp.: 100, 194, 330, 342, 346, 358, 367, 372, II: 174, 373 Thras.: 155, 162, 230, 235, UP: 192 Ven. Sect. Er.: 318

Homer Iliad XI.514–515: 133 Odyssey IV.230–231: 133 XXIV.254–255: 331

496

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Index of text and passages cited

Plato Gorgias 464a: 136 464b: 136 Republic III, 407b4–c58: 137 III, 410b5–8: 137

497

Theon Physical Exercises III: 271 IV: 270 Theophrastus Fatigue: 261

2. PASSAGES CITED IN THE INTRODUCTION AND  NOTES This is an index of specific passages, rather than of general discussions of authors or texts, for which the General index may be consulted. Forwards and backwards references to passages of the two texts translated in the volume are not included. Aelius Aristides Sacred Tales I (= Orations XLVII) 73, 393,13–18 Keil: 181 n. 78 Aëtius 285.7 Diels: 167 n. 39 Alexander of Tralles I.15, 557–559: 254 n. 15 ps.-Alexander On Fevers 21,19 Tassinari: 405 n. 9 Anon. Lond. (Anonymus Londinensis) 1–3: 104 n. 13 Ps.-Apollodorus Bibl. (Library) I.8.2: 167 n. 41 I.96–97: 167 n. 41 Apollonius Argonautica I.151–155: 167 n. 41 Aretaeus IV.11, 80,7 Hude: 294 n. 18 Aristotle De anima I.1, 403a29–403b2: 232 n. 59 Categories 7: 110 n. 37 Eth. Nic. (Nicomachean Ethics) II.2, 1104a15ff.: 26 n. 47 II.2, 1104a34ff.: 26 n. 47 V.11, 1138a30f.: 26 n. 47 VI.3, 1140a1–23: 126 n. 66 VII.13, 1153b9–12: 167 n.40

X.3, 1173a23ff.: 26 n. 47 Gen. an. (Generation of Animals) I.1, 715a9–11: 32 n. 61 I.18, 724b26: 258 n. 25 PA (Parts of Animals) II.1, 646a13–24: 32 n. 61 Politics IV.1, 1288b10ff.: 19 n. 33 VII.17, 1336a15–18: 186 n. 85 VIII.6, 1341a18–1341b8: 240 n. 84 Resp. (Respiration) 17, 478b27–28: 158 n. 15 Caelius Aurelianus Cel. Pass. (Acute Diseases) I.9.67–68, 60 Bendz: 264 n. 39 I.14.113, 84,26–27 Bendz: 177 n. 67 I.14.114, 86,8–9 Bendz: 194 n. 109 Tard. Pass. (Chronic Diseases) III.8.149, 768,27–29 Bendz: 177 n. 67 Celsus Med. (De medicina) prohoemium 9, 18,17–20 Marx: 404 n. 3 I.1–2, 29–30 Marx: 27 n. 49 I.3: 177 n. 67 II.14.1: 177 n. 67 II.15.1: 177 n. 67 Demosthenes Olynth. (Olynthiacus) 2.19.7: 180 n. 77 Dioscorides De materia medica I.42f.: 278 n. 302 I.69: 314 n. 58 IV.16a: 337 n. 34 V.9: 300 n. 31

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498

Index of text and passages cited

Erasistratus Fragments 153–167 Garofalo: 177 n. 67 Fragments 161–163 Garofalo: 177 n. 67 Euripides IA (Iphigeneia at Aulis) 398: 376 n. 28 Medea 25: 376 n. 28 Galen AA III.2, 137–138 Garofalo (II.347 K.): 236 n. 71 VI.6, 373,28–374,11 Garofalo (II.563 K.): 301 n. 34 VII.16, 475,3–4 Garofalo (II.644 K.): 180 n. 77 XIV.10, 278 Simon: 388 n. 53 Adv. Typ. Scr. 1 (VII.477 K.): 304 n. 44 Aff. Pecc. Dig. I.1, 23,19–23 De Boer (V.34 K.): 53 n. 103 I.3, 7,21–8,4 De Boer (V.9 K.): 55 n. 105 I.4, 11,24 De Boer (V.15 K.): 156 n. 8 I.4, 11,26 De Boer (V.15 K.): 156 n. 8 I.4, 15,6.11 De Boer (V.20 K.): 156 n. 8 I.5, 18,4 De Boer (V.25 K.): 221 n. 37 I.6, 23,5 De Boer (V.33 K.): 383 n. 44 I.9, 34,9–15 De Boer (V.51 K.): 203 n. 3 I.10, 35,15–20 (V.53 K.): 203 n. 3 I.10, 36,3 De Boer, V.54 K.: 259 n. 30 II: 4 n. 8 II.3, 49,14 De Boer (V.72 K.): 305 n. 45 II.5: 377 n. 30 II.5, 60,24 De Boer (V.90 K.) 305 n. 45 II.7, 68,15 De Boer (V.103 K.): 334 n. 28 Alim. Fac. I.6, 225–226 Helmreich (VI.496–498 K.): 299 n. 28 I.2–17, 217–243 Helmreich (VI.481–525 K.): 299 n. 29 I.2, 218,22–219,1 (VI.483–484 K.): 339 n. 37 I.13, 236,18–237,19 Helmreich (VI.514– 516 K.): 264 n. 41 II.15, 286,6 Helmreich (VI.590 K.): 338 n. 36 II.46, 314,10 Helmreich (VI.634 K.): 74 n. 131 III.18, 356,12 Helmreich (VI.700 K.): 393 n. 60 III.39, 382,20 Helmreich (VI.743 K.): 74 n. 131 III.39, 382,23 Helmreich (VI.744 K.): 73 n. 130

Ars Med. 1a, 275,4–15 Boudon (I.306 K.): 100 n. 4 1b, 276,6–11 Boudon (I.307 K.): 29 n. 54 1b, 276,10–14 Boudon, I.307 K.): 38 n. 73 2, 278,10–12 Boudon (I.309–310 K.): 26 n. 47 21, 340,2 Boudon (I.361 K.): 40 n. 77 21, 340,19 Boudon, I.362 K.): 40 n. 77 23, 345,17–347,2 Boudon (I.367–368 K.): 39 n. 76 23, 346,10–347,1 Boudon (I.367 K.): 39 n. 75 24, 350,8–15 Boudon (I.370–371 K.): 52 n. 102 35, 381,7–8 Boudon (I.401 K.): 40 n. 77 Bon. Mal. Suc. 1, 393,21–28 Helmreich (VI.757 K.): 74 n. 132 2, 394,19–20 Helmreich (VI.759 K.): 73 n. 130 7, 413,10 Helmreich (VI.790 K.): 74 n. 131 11, 420,15.17 Helmreich (VI.801 K.): 337 n. 34 11, 420–425 Helmreich (VI.800–809 K.): 308 n. 47; 335 n. 30 11, 423,6 Helmreich (VI.805 K.): 335 n. 31 11, 424,2 Helmreich (VI.806 K.): 335 n. 31 11, 424,11–12 Helmreich (VI.806–807 K.): 337 n. 3 12, 426,14–16 Helmreich (VI.810 K.): 18 n. 31; 365 n. 3 Caus. Morb. 7 (VII.28 K.): 347 n. 48 Comp. Med. Gen. III.2 (XIII.599–600 K.).: 25 n. 44 III.8 (XIII.636 K.): 304 n. 44 VII.9 (XIII.991 K.): 278 n. 69 VII.11 (XIII.1005 K.): 278 n. 69 VII.11 (XIII.1008 K.): 278 n. 69 Comp. Med. Loc. I.3 (XII.448 K.): 278 n. 68 II.1 (XII.543 K.): 278 n. 68 III.1 (XII.601–604 K.): 278 n. 68 III.1 (XII.604 K.): 278 n. 68 VI.4 (XII.922 K.): 335 n. 31 VII.1 (XIII.6 K.): 278 n. 69 IX.1 (XIII.228 K.): 278 n. 68 CP. 108,26 Bardong: 167 n. 39 Caus. Puls. I.4 (IX.7ff. K.): 238 n. 78 I.7 (IX.14 K.): 40 n. 77 I.10 (IX.39 K.): 366 n. 8 I.12 (IX.53 K.): 238 n. 78

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Index of text and passages cited

II.1 (IX.61 K.): 288 n. 7 II.4–5 (IX.71–75 K.): 288 n. 7 III.1 (IX.105 K.): 41 n. 79 Caus. Symp. II.5 (VII.188 K.): 288 n. 9 II.5 (VII.190 K.): 288 n. 9 II.5 (VII.192 K.) 232 n. 60 II.5 (VII.194 K.): 288 n. 9 III.7 (VII.245 K.): xxiii III.11 (VII.263 K.): 94 n. 164 Cris. III.5 (IX.728 K.): 7 n. 13 Cur. Rat. Ven. Sec. 11 (XI.283–284 K.): 293 n. 16 18 (XI.303 K.): 293 n. 16 Di. Dec. I.2 (IX.775 K.): 7 n. 13 I.6 (IX.798 K.): 167 n. 39 Diff. Feb. I.1 (VII.273 K.): 173 n.52 I.6 (VII.289 K.): 173 n. 52 I.6 (VII.291 K.): 167 n. 39 II.14 (VII.384 K.): 349 n. 56 II.15 (VII.387 K.): 349 n. 56 Diff. Puls. I.1 (VIII. 768–769 K.) I.2 (VIII.498 K.): 244 n. 91 II.8 (VIII.620 K.): 169 n. 46 IV.2 (VIII.704–708 K.): 100 n. 4 IV.2 (VIII.716 K.): 244 n. 91 IV.9 (VIII.741–743 K.): 100 n. 4 IV.11 (VIII.751–752 K.): 244 n. 91 Dig. Puls. I.1 (VIII.768–769 K.): 169 n. 46 I.1 (VIII.771 and 776 K.): 217 n. 29 I.1 (VIII.774–775 K.): 264 n. 40 I.9 (VIII.818 K.): 217 n. 29 IV.2 (VIII.934 K.): 217 n. 29 Foet. Form. 6: 177 n. 65 Hipp. Aph. II.10 (XVIIB.466 K.): 206 n. 15 II.16 (XVIIB 425–428 K.): 175 n. 62 Hipp. Elem. 2–3: 156 n. 9 Hipp. Epid. I I.1, 12,21–22 Wenkebach (XVIIA.17 K.): 314 n. 57 I.12, 31,28–30 Wenkebach (XVIIA.54 K.): 48 n. 92 II.49, 75,4 Wenkebach (XVIIA.145 K.): 94 n. 164 II.80, 90–95 Wenkebach (XVIIA.183–187 K.): 48 n. 92 III.7, 119,30–35 Wenkebach (XVIIA.239 K.): 167 n. 39

499

Hipp. Epid. II VI.44, 956,2 Vagelpohl: 355 n. 71 Hipp. Epid. III III.76, 165,14 Wenkebach (XVIIA.744 K.): 322 n. 70 Hipp. Epid. VI I.3, 16,3 Wenkebach/Pfaff (XVIIA.817 K.): 94 n. 164 II.1, 61,7 Wenkebach/Pfaff (XVIIA.898 K.): 94 n. 164 II.32, 95,28–96,1 Wenkebach/Pfaff (XVIIA.961 K.): 94 n. 164 III.28, 165,20–24 Wenkebach/Pfaff (XVIIB.77 K.): 48 n. 92 III.30, 171,14 Wenkebach/Pfaff (XVIIB.88 K.): 376 n. 28 V, 256,29–257,19 Wenkebach/Pfaff (XVIIB.229–230 K.): 20 n. 34 V, 272,3–4 Wenkebach/Pfaff (XVIIB.249 K.): 94 n. 164 VII, 399,10–11 Wenkebach/Pfaff: 12 n. 23 VIII, 461,41 Wenkebach/Pfaff: 393 n. 58 VIII, 484,3–7 Wenkebach/Pfaff: 39 n. 75 VIII, 485–487 Wenkebach/Pfaff: 56 n. 108 Hipp. Off. Med. II.4 (XVIIIB.734ff. K.): 223 n. 40 III.33 (XVIIIB.894 K.): 384 n. 45 III.26 (XVIIIB.871ff. K.): 210 n. 24 III.26 (XVIIIB.872ff. K.): 226 n. 45 III.29 (XVIIIB.880 K.): 94 n. 164 Hipp. Prog. I.1–4: 275 n. 65 I.2, 198,7–23 Heeg (XVIIIB.3–4 K.): 188 n. 95 I.4, 201–202 Heeg (XVIIIB.7–10 K.): 156 n. 8 HNH I, 32–51 Mewaldt (XV.59–97 K.): 34 n. 65 I.44, 55,10–14 Mewaldt (XV.105 K.): 12 n. 23 III, praef., 89,1–14 Mewaldt (XV.174–175 K.): 6 n. 11 III.7, 94,26–95,1 Mewaldt (XV.186 K.): 48 n. 91 III.7, 95,11–13 Mewaldt (XV.187 K.): 48 n. 92 III.7, 96,9 Mewaldt (XV.189 K.): 94 n. 165 III.21, 104,6–7 Mewaldt (XV.205 K.): 101 n. 9 HVA I.17, 135,2 Helmreich (XV.455 K.): 6 n. 11 I.17, 135,2–10 Helmreich (XV.455 K.): 10 n. 19 I.5, 120,19 Helmreich (XV.425 K.): 121 n. 58 III.2, 221,7 Helmreich (XV.632 K.): 337 n. 34

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Index of text and passages cited

Ind. 6, 4 BJP: 390 n. 54 7, 4,6–8 BJP: 376 n. 28 7, 4,7 BJP: 56 n. 108 10–11: 393 n. 58 20–23: 393 n. 58 33, 12 BJP: 345 n. 44 45: 376 n. 28 Lib. Prop. praef., 136,5–6 Boudon-Millot (XIX.10 K.): 110 n. 38 praef., 136,11–13 Boudon-Millot (XIX.11 K.): 110 n. 38 1, 137,24–26 Boudon-Millot (XIX.13 K.): 237 n. 72 1, 138,6–139,9 Boudon-Millot (XIX.13–14 K.): 65 n. 121 1, 139,24 Boudon-Millot (XIX.15 K.): 110 n. 38 1, 139,14–15 Boudon-Millot (XIX.15 K.): 69 n. 125 3, 144,2–145,15 Boudon-Millot (XIX.21–22 K.): 21 n. 37 3, 142,14–20 Boudon-Millot (XIX.18–19 K.): 25 n. 44 3, 145,10–11 Boudon-Millot (XIX.22 K.): 282 n. 75 9, 160,20–21 Boudon-Millot (XIX.35 K.): 110 n. 38 14: 133 n. 78 15: 62 n. 117 20: 133 n. 78 Marc. 3 (VII.676 K.): 75 n. 133 4 (VII.678 K.): 30 n. 57 4 (VII.680–681 K.): 41 MM I.1 (X.4–5 K.): 12 n. 21 I.3 (X.28 K.): 7 n. 13 III.3, (X.181 K.): 94 n. 164 IV.1 (X.236 K.): 40 n. 77 IV.4 (X.267–268 K.): 164 n. 34 IV.4 (X.269—270 K.): 378 n. 35 V.10 (X.353 K.): 12 n. 21 V.12 (X.366 K.): 48 n. 92 VII.2 (X.461 K.): 40 n. 77 VII.6 (X.473 K.): 258 n. 26 VIII.2 (X.536 K.): 258 n. 26 VIII.5 (X.576 K.): 401 n. 71 VIII.9 (X.589 K.): 40 n. 78 XI.12 (X.771 K.): 40 n. 78 XI.26 (X.790 K.): 264 n. 39 XIII.6 (X.892 K.): 94 n. 164 MMG I.9 (XI.28 K.): 48 n. 92 II.1 (XI.77 K.): 325 n. 3

Morb. Diff. 2 (VI.836–837 K.): 31 n. 59 2 (VI.839 K.): 31 n. 59 9 (VI.869 K.): 25 n. 40 Nat. Fac. I.13, 130,22–24 Helmreich (II.41 K.): 258 n. 25 II.1, 156,19–23 Helmreich (II.76–77 K.): 371 n. 18 II.8, 186,10–14 Helmreich (II.117 K.): 8 n. 16 II.8, 186,14–19 Helmreich (II.117 K.): 34 n. 65 II.9, 203,6–22 Helmreich (II.140–141 K.): 8 n. 1.6 III.10, 230,8–13 Helmreich (II.178 K.): 8 n. 1.6 III.12, 233,26 Helmreich (II.183 K.): 321 n. 69 Ord. Lib. Prop. 1, 90,23–91,12 Boudon-Millot (XIX.52–53 K.): 4 n. 8 3, 98,14–16 Boudon-Millot (XIX.57 K.): 282 n. 75 4, 100,2–4 Boudon-Millot (XIX.59 K.): 25 n. 44 Part. Med. 1, 119,4–7 Schöne: 404 n. 5 2, 120,7–15 Schöne: 406 n. 13 9, 129,13–15 Schöne: 406 Parv. Pil. 2, 96,5–6 Marquardt (V.903 K.): 240 n. 83 3, 99,5–6 Marquardt (V.906 K.): 167 n. 39 PHP II.3, 108,26–28 De Lacy (V.219 K.): 173 n. 54 II.3, 110,23–24 De Lacy (V.221 K.): 173 n. 54 V.2, 296 De Lacy (V.434 K.): 53 n. 104 V.6, 330 De Lacy (V.472–474 K.): 177 n. 66 VI.8, 410,26–31 De Lacy (V.567–568 K.): 371 n. 18 VII.3, 438,28–440,8 De Lacy (V.600–601 K.): 238 n. 75 VIII.1, 480,9–11 De Lacy (V.649 K.): 171 n. 49 VIII.3, 498,23–34 De Lacy (V.672 K.): 34 n. 65 VIII.6, 522,30–32 De Lacy (V.701 K.): 258 n. 25 Plen. 5 (VII.537 K.): 287 n. 6 8 (VII.551–552 K.): 288 n. 8 8 (VII.552 K.): 75 n. 133 11 (VII.571 K.): 287 n. 6 11 (VII.574 K.): 287 n. 6

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Index of text and passages cited

Praen. 3, 84,16.26 Nutton (XIV.615–616 K.): 259 n. 30 4, 88,14 Nutton (XIV.619 K.): 22 n. 40 5, 96,5–100,6 Nutton (XIV.627–630 K.): 21 n. 37 5, 98,12 Nutton (XIV.629 K.): 22 n. 40 5, 100,5 Nutton (XIV.630 K.): 22 n. 40 6, 102,17–104,15 Nutton (XIV.632–634 K.): 231 n. 57 7, 106,10–108,14 Nutton (XIV.636–639 K.): 117 n. 51 7, 108,29–110,10 K. (XIV.640–641 K.): 231 n. 57 8, 110,20 Nutton (XIV.641 K.): 183 n. 81 9, 118,3–11 Nutton (XIV.648–649 K.): 393 n. 58 Praes. Puls. I.1 (IX.219 K.): 232 n. 57 I.4 (IX.249–250 K.): 232 n. 57 I.5 (IX.258 K.): 40 n. 77 Prop. Plac. 2, 173,4–6 Boudon-Millot/Pietrobelli: 25 n. 44 9: 293 n. 17 12: 34 n. 65; 293 n. 17 Protr. 3, 87,10 Boudon (I.5 K.): 259 n. 30 5, 88,21–89,2 Boudon (I.7 K.): 156 n. 7 5, 89,2 Boudon (I.7 K.): 334 n. 28 11, 106,3–11 Boudon (I.27 K.): 15; 140 n. 95 13, 112,15–113,17 Boudon (I.34–35 K.): 167 n. 41 Puer. Epil. 3 (XI.364–365 K.): 254 n. 15 Puls. 9 (VIII.462 K.): 41 n. 79 10 (VIII.469–470 K.): 39 n. 75 11 (VIII.470 K.): 41 n. 80 QAM 1, 32,9–11 Müller (IV.768 K.): 174 n. 58 1, 32,7 Müller (IV.767 K.): 191 n. 102 2, 35,13–14 Müller (IV.771 K.): 331 n. 19 3–4: 58 n. 110 5, 48,4 Müller (IV.787 K.): 173 n. 54 8: 50 n. 99 8, 57,14–21 Müller (IV.798 K.): 146 n. 107 8, 63,4–5 Müller (IV.803 K.): 309 n. 51 10, 67,23–69,13 Müller (IV.808–810 K.): 187 n. 89 11, 78,19–79,9 Müller ( IV.820–821 K.): 58 Sem. I.5, 80,21–22 De Lacy (IV.529 K.): 157 n. 12

SI

501

2, 3,13–17 Helmreich (I.66–67 K.): 275 n. 6 4, 7,3–5 Helmreich (I.72 K.): 275 n. 64 SMT I.1–6: xxiii II.7 (XI.483–484 K.): 264 n. 42 II.16 (XI.498 K.): 264 n. 39 II.27 (XI.538 K.): 278 n. 68 III.9 (XI.560 K.): 278 n. 68 IV.7 (XI.640–642 K.): xxv IV.8 (XI.648 K.): 335 n. 31 IV.20 (XI.690): xxiii IV.20 (XI.690–695 K.): xxiii IV.25 (XI.781–784 K.): 13 n. 24 V.9 (XI.739 K.): 278 n. 68 V.11 (XI.741 K.): 278 n. 69 V.14 (XI.750 K.): 278 n. 69 V.25 (XI.781–783 K.): 378 n. 35 VI.5 (XI.868–870 K.): 264 n. 39 VI.5 (XI.872 K.): 278 n. 68 VIII.17 (XII.114 K.): 264 n. 41 IX.2 (XII.171 K.): 264 n. 41 IX.3 (XII.212 K.): xxiii XI.2 (XII.372–375 K.): xxiii Symp. Diff. 1, 198–214 Gundert (VII.42–53 K.): 233 n. 62 Temp. I.2, 5,25–6,13 Helmreich (I.516–517 K.): 367 n. 10 I.4, 10,4–16,23 Helmreich (I.523–534 K.): 226 n. 44 I.4, 15,5–10 Helmreich (I.531–532 K.): 297 n. 25 I.8, 306–32,4 Helmreich (I.556–559 K.): 367 n. 10 I.9, 33–37 Helmreich (I.561–567 K.): 203 n. 4 I.9, 36,23 Helmreich (I.567 K.): 33 n. 62; 156 n. 6 II.1: 174 n. 56 II.1, 42,16–20 Helmreich (I.576 K.): 57 II.2: 47 n. 87; 346 n. 45 II.2–4: 195 n. 111 II.2, 43.10–56,11 Helmreich (576–598 K.) II.2, 45,9–47,2 Helmreich (I.580–582 K.): 373 n. 22 II.2, 46,10–11 Helmreich (I.581 K.): 158 n. 15 II.2, 53,6 Helmreich (I.592 K.): 173 n. 54 II.4, 60,15 Helmreich (I.604 K.): 55 n. 106 II.4, 62,12–25 Helmreich (I.607–608 K.): 172 n. 50 II.5, 66–67 Helmreich (I.614–616 K.): 194 n. 108 II.5, 68,18–69,5 Helmreich (I.618 K.): 50 n. 99

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Index of text and passages cited

Temp. (cont.) II.6, 71,14 Helmreich (I.662 K.): 184 n. 82 II.6, 76,4–23 Helmreich (I.630–631 K.): 367 n. 9 II.6, 79,24–25 Helmreich (I.636 K.): 33 n. 62 III.1, 91,2–5 Helmreich (I.654 K.): 33 n. 64 III.2, 95,4–5 Helmreich (I.660 K.): 201 n. 126 III.4, 100,22–101,1 Helmreich (I.669–670 K.): 195 n. 112 Tum. Pr. Nat. 1 (VII.706 K.): 41 n. 80 UP IV.7, i.201,25–202,3 Helmreich (III.275 K.): 388 n. 53 IV.15, i.235 Helmreich (III.320 K.): 193 n. 107 V.9, i.277,4–12 Helmreich (III.378 K.): 388 n. 53 V.14, i.287,16–288,1 Helmreich (III.393 K.): 208 n. 20 VI.12, i.339,7–18 Helmreich (III.464–465 K.): 127 n. 67 X.13: 157 n. 12 XI.13–14: 157 n. 12 XVI.5, ii.394–395 Helmreich (IV.289 K.): 388 n. 53 Ut. Resp. 2.11, 96 Furley/Wilkie (V.483–484 K.): 35 n. 67 3: 35 n. 67 5.3, 124 Furley/Wilkie (V.505 K.): 35 n. 67 5.8, 132 Furley/Wilkie (V.510 K.): 35 n. 67 Ven. Art. Diss. 3, 88 Garofalo (II.792 K.): 319 n. 63 3, 90 Garofalo (II.793–794 K.): 319 n. 63 Ven. Sect. Adv. Eras. 4 (XI.314–315 K.): 25 n. 44 Vict. Att. 8, 441,35 Kalbfleisch: 393 n. 60 ps.-Galen Introductio 6 (XIV.688 K.): 405 n. 9 ‘Hippocrates’ Airs, Waters, Places 5–6 (II.20–24 L.): 146 n. 107 De alimento (Nutrition) 8, 141,5–6 Joly (IX.101 L.): 201 n. 126 28 (IX.108 L.): 186 n. 86 34 (IX.110 L.): 107 n. 24

Aph. (Aphorisms) 1.1 (IV.458 L.): 349 n. 57 1.3 (IV.458 L.): 107 n. 25 1.16 (IV.466 L.): 175 n. 61 1.22 (IV.468 L.): 302 n. 35 2.5 (IV.470 L.): 286 n. 4 2.10 (IV.472 L.): 206 n. 15 2.22 (IV.476 L.): 175 n. 61 Epid. (Epidemics) II.5.16 (V.130 L.): 309 n. 51 VI.4.13 (V.310 L.): 356 n. 74; 357 n. 77; 361 n. 85 VI.4.23 (V.314 L.): 204 n. 5; 331 n. 18; 357 n. 76 VI.6.2 (V.324 L.): 204 n. 5 VI.8.23 (V.352 L.): 39 n. 75 VII.89 (V.446 L.): 295 n. 21 Flat. (Breaths) 1 (VI.92 L.): 175 n. 61 Hum. (Humours) 1, 158,3 Overwien (V.476 L.): 296 n. 24; 395 n. 64 Joints 62 (IV.268 L.): 146 n. 106 Nat. Hom. (The Nature of the Human Being) 9, 188,3–10 Jouanna (VI. 52 L.): 175 n. 61 22, 218,6–16 Jouanna (VI.84 L.): 331 n. 20 Off. Med. (In the Surgery) 8 (III.294 L.): 223 n. 40 13 (III.318 L.): 226 n. 45 17 (III.322 L.): 210 n. 24 Prognostic I.2 (II.110 L.): 188 n. 95 Regimen in Acute Diseases 13 (II.334 L.): 335 n. 33 Homer Il. (Iliad) II.216–219: 165 n. 36 XXIII.636: 167 n. 41 XXIII.664–669: 135 n. 135 Odyssey XXIV.254–255: 331 n. 19 Libanius 30.1.68.4: 180 n. 77 Lucian Anacharsis 1: 15 n. 28 Dialogues with the Dead 20.5: 15 n. 28

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Index of text and passages cited

Lucretius De rerum natura VI.1090–1102 Oribasius Collectiones Medicae VI.1, 155,3–4 Raeder: 38 n. 74 Libri Incerti 30–38, 121,9–138,17 Raeder: 9 n. 16 39–41, 138,18–148,16 Raeder: 9 n. 16 Philostratus Gymnasticus 1–2: 16 13: 19 n. 33 VS (Lives of the Sophists) I.541: 232 n. 57 Plato Charmides 170e: 404 n. 6 Gorgias 463a–b: 235 n. 67 464a: 136 n. 87 464b: 136 n. 86 Phaedo 99a–b: 210 n. 25 Laws VII, 789d3: 178 n. 68 Rep. (Republic) III: 6 n. 11 III, 403c–d: 87 n. 153; 88 III, 403e–404a: 88 III, 404a–b 88 III, 405a–b: 88 III, 405c–d: 88 III, 406c: 88 III, 406e: 88 III, 407b: 89 III, 409e–410a: 89 Theaetetus 149a: 183 n. 81

503

Timaeus 88e–89b: 178 n. 68 Plotinus Enneads III.1.7: 104 n. 13 Plutarch Alcibiades 1.8: 240 n. 83 Alexander 8: 305 n. 44 De cohibenda ira 458e7: 318 n. 62 Peri euthumias: 228 n. 48 Quaest. conv. (De quaestionibus convivialibus) 731d–e: 167 n. 39 Quomodo adulator 58a: 305 n. 44 De tuenda sanitate praecepta 122d: 305 n. 44 Progymnasmata 3.4.12.2: 180 n. 77 Seneca Epistulae morales 83.4: 254 n. 16 Soranus Gynaecia II.19, 66 Ilberg: 183 n. 81 Stobaeus Anthology 4.37.27, V.895,22–896,6 Hense: 38 n. 74 SVF III.244: 104 n. 13 Vindician Fragmentum Bruxellense 40, 23 Wellmann: 404 n. 4

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General index

This is an index of words, including names, that appear in the Introduction and notes, not of occurrences within Galen’s text. For those, the Greek word index should be consulted, in conjunction with the English–Greek glossary, or, in the case of names, the Index of names. References to precise passages in ancient texts – as opposed to discursive or general references to those texts, which appear here – will be found rather in the Index of passages cited. Achilles 28, 165 Aelius Aristides 24, 181 Aëtius of Amida xxii, 95 affection, see pathos; unaffectedness age (= stage of life) 30, 37, 45–9, 74–75, 80–81 Galen’s at time of writing 74–75, 77–78 old 44–9, 77, 82–83, 158, old-age care (gērokomikon) 45 see also children Aigimios 244 air ambient 37, 39 in Galen’s element theory and physiology 32, 35, 37 Alcmaeon 25 Alexander the Great 12, 305 Alexandria Galen’s study at 325 Hippocratic scholarship at 10 Allianoi 388 Anacharsis 15 anatomy 4, 62, 95, 237, 282, 388, 395, 405 anatomical demonstrations 21 anatomical terminology xix–xx, 188, 192, 197, 252, 270, 301 see also artery; brain; channel; epigastrion; heart; hupochondrion; liver; nerve;vein Anaxagoras 164 Anaximander 25 Andromachos (doctor of time of Nero) 338 anger 55–56, 63, 143, 180, 232, 238 see also rage; spirit

Antyllus (medical author) 8, 13, 38 anxiety (= agōnia) 56, 63, 231 apodeixis, see demonstration Arabs (in Galen’s anthropology) 50 Arabic tradition and translation of Galenic texts 74, 92, 355, 406 Archigenes 12–13 Aretaeus 294 Aristotle, Aristotelian (influence on Galen, school, terminology) 5, 8, 12–13, 26, 32, 34, 40, 61, 63–64, 84–85, 99–100, 110, 112, 116, 122, 126–127, 155, 157–158, 160, 167, 186, 200, 204, 241, 346, 356, 366, 386 De anima 64, 232 Categories 110, 204 Organon 85 see also cause, elements, teleology art(s) subordinate (to or within medicine, in Galen’s view) 16, 18–20, 146, 241 see also healing; healthfulness; specialism; technē arteriotomy 25 artery xx, 36, 238–239, 301, 309 Asclepiades of Bithynia 30–31, 38, 164, 177, 194, 226, Asclepieion, at Pergamum 24–25 Asclepius 23–25, 55, 88, 134, 180–181 Asia 17, 50, 185–186, 225–226, 308, 335, 388 see also Allianoi; Mysia; Pergamum Athenaeus of Attalia 8–9, 12–13, 38, 184, 229

504

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General index

athlete(s), athletic(s) 3, 5–6, 10, 12, 14–18, 20–21, 29, 87–88, 100, 120, 137–138, 140, 150, 167, 177, 204, 249, 260, 407 Atomism, Atomist 30–31, 164, 166–167, 312, 378 audience, of Galen’s works x, xii, 3, 21–23, 30, 51, 65, 305 see also philiatroi aulos 240, 347 bad-mixture (= duskrasia) 83, 169, 195, 366–367 uneven 366 balance and imbalance (in theory of health) xix, 5, 16, 25–26, 30–31, 34–36, 43, 45, 50, 56–58, 82, 160–161, 164, 184, 241, 257, 287, 379 see also ametria, summetria baths, bathing xiv, 17–18, 20, 24, 36–37, 42, 51, 65, 81, 160, 186, 232, 257–258, 270, 276–277, 282, 388 bile black xix, 34–35, 60, 196, see also melancholia yellow 34–35, 206, 294, 367 blood 32–36, 64, 157, 172, 193, 232, 298 bloodletting, see venesection books, distribution or publication of, see ekdosis brain 35–36, 53, 59, 238, 388 bread 299, 301, 339, 382 Burgundio da Pisa (Latin translator of Galen’s Health) 2, 91, 396 Caelius Aurelianus 60 Campania 308, 393 capacities (= dunameis) natural, of body (phusikai) 33, 160, 171, 192, 195, 238, 265, 289 purgative, of drugs 293 of soul (psuchikai) 48–49, 57, 63, 238, 327 Cardano, Giromalo 1 cause(s) Aristotelian/Platonic theory of four (or five) causes 127 of disease antecedent (prokatarktikon), cohesive/ containing (sunektikon) and preceding (proēgoumenon) 286 emotions as 56 external vs. internal to body 37, 167, 376 of health or alteration in body 29, 38–43, 106, 116, 238, 285 see also non-natural Celsus (medical author) distinctions within health 27

505

tripartite division of medicine 404–405, 407 Celts, in Galen’s anthropology 50, 337 cereal 300–1 channels (= poroi, in body) 13, 31, 164, 194, 197, 206, 265, 379 children, care and upbringing of 8–9, 45, 117, 177–178, 184 Chrysippus 12–13, 53, 404 coction, see digestion colour = complexion, as diagnostic sign 43, 56–57, 207, 296 Galen’s terminology of 206–207, 294, 296, 308, 319, 335, 369 commentaries, Galen’s, see Hippocrates complexion, see colour constitution (of body, natural = kataskeuē) 27–28, 37, 40, 42–44, 49–52, 55, 72, 80–83, 162–163, 166, 168, 249, 364, 378, Craftsman (= dēmiourgos) 157 see also teleology cucurbit xxi date, of Galen’s works 23, 66–79, 83, 91, 198, 304, 378, 381, 394 debate, public xiv, 21, 24, 65, 84–85, 99, 333, see also problēma dēmiourgos, see Craftsman demonstration logical or scientific 4, 99–100, 173 public 69 see also anatomy; debate desiderative (= epihumētikon, in Platonic tripartite soul) 59, 63, 179, 238 diaita 6, 36, 135, 160 see also food; regime, daily diaplasis, see shaping diet, see diaita; food; regime, daily Dieuches (writer on health) 7 digestion 33–35, 180, 295, 298, 301, 329, 371 see also nourishment; nutrition Diocles of Carystus 7–9, 94, 404, Diodorus Cronus 164 Dioscorides xxii, 278, 300, 314, 337 disease causes of, see cause entities xix–xx, 291 old age as 41 ‘seeds of sickness’ (and possible relevance to theory of contagion) 166–167 treatment of within division of art 408–409 see also cause; epilēpsia; fever; health; krisis; melancholia; ‘neither’; plēthōra

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506

General index

distress (and its physical implications) 45, 55–57, 376 as criterion of sickness 28 see also pathos douleia 50, 202, 249, 352, 377 drugs (pharmaka) 6–7, 23, 37, 62, 66, 72–73, 79, 83, 96, 144, 176, 195, 198, 241, 274, 278, 305, 338, 362, 372, 383–384, 394 anti-fatigue 278 cleansing/purgative 293 ‘drug-loving’ (kind of patient) 304–305 dunamis, see capacity duskrasia, see bad-mixture dust (used in exercise) 16, 234, 245, 276, 350

Eudemus (philosopher and associate of Galen) 367 euexia (= good-condition, excellence of condition) 26–27, 102, 127, 162–163, 205, 260, 407 eurōstia, see vigour evacuation (of fluids or residues) 37–39, 81–82, 206, 318 see also drug, cleansing/purgative exercise 8–9, 14–16, 18–21, 25–26, 29, 36–38, 41–42, 44–45, 51, 55–57, 63, 65, 68–69, 80–83, 96, 100, 107, 137–138, 142, 144, 150, 160, 177–178, 181, 187, 204, 226, 229–230, 235, 242, 248–250, 254, passive 45, 177, 239

education 11–12, 14, 20, 24, 29, 47, 52, 57–59, 88, 110, 133, 305 Galen’s 3–4, 355 see also children; grammatikos, grammatikē; shaping Egypt, Egyptian xxii, 30, 50 ekdosis 66–67, 401 elements fundamental, theory of 4, 13, 25, 31–32, 36, 155–157, 164, 386 = set of concepts fundamental to an expertise 217 Elyot, Thomas 1 emetic 62 see also drug, cleansing/purgative; evacuation emotion (also emotional disturbance, emotional state) 25, 36, 39, 45, 55–58, 60–61, 63–64, 143, 172, 231–232, 376, see also anger; anxiety; distress; fear; pathos; phrontis; rage; shame; therapy Empiric(ist) (medical sect) 4, 129, 268, 275, 352, 355 environment 2, 36, 45, 50, 57, 96, 160, see also air ephebate (= ephēbeia) 14–15 Epictetus 19 Epicurus, Epicureans 31, 164, 167, 266 epigastrion (area of abdomen) xx, 192 Erasistratus 7–9, 13, 94, 177–178, 199–200, 317–318, 404 essence, see ousia ethics, Galen’s views and works on 4, 26, 54, 58–59, 95, 383 see also education; pathos; soul; unaffectedness ethnic (differences or stereotypes in Galen’s work) 50, 185 see also Arabs; Celts; Germans; Greekness; Scythians

fatigue (= kopos) 16, 43, 81–83, 196, 249, 262, 268, 272, 274 see also drug, anti-fatigue fear 57 fever xix, 29, 43, 56, 125, 173, 175, 304 fish xxi, 319 fluid (= chumos, humour) xviii, 1, 7–8, 32, 34–35, 39, 43–44, 47, 56–58, 62, 81–83, 187, 193, 196–197, 207, 232, 257, 262, 287–288, 295–296, 298, 301, 308, 349, 379, 395 see also bile; blood; phlegm; plēthōra; residue food xiv, 6–7, 13, 19, 23, 26, 33–37, 41–42, 44–45, 51–52, 55, 57, 65, 68, 70, 72–74, 79, 96, 138, 160, 174, 180, 198, 238, 264, 295, 300, 329, 371, 372, 388, 392 see also bread; cereal; fish; honey; milk; pepper; plants; pulses Gadaldini, Agostino (editor of Juntine Galen) 91–92, 209, 266, 312 garum 319 Germans 50, 185, 258 gerontology, see age good-condition, see euexia grammatikos, grammatikē 110, 334, 400 Greekness (as cultural identity) 16, 50, 185 gumnasion (institution of ) 14–15, 17–20, 100, 204, 230, 259 gymnasium, see gumnasion; wrestling-school gumnastika, gumnastikē, gumnastikos, see trainer, physical; training, physical healing, art of (contrasted with that of healthfulness, and subject of The Therapeutic Method) 2, 6, 23, 29, 36, 71–73, 94, 155, 162, 285, 304, 319, 403–404, 406–407

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General index

health fourfold classification of materials of 13, 38, 48, 143, 346 gradualism in theory of 27 Health as title of Galen’s work 93–95 practitioners of, see art(s); hugieinos; trainer, physical; paidotribēs; progumnastēs spectrum (= platos) of 27–29 stable and unstable 13, 27, 36–37, 41, 104, 162, 407–408 tripartite division (into pharmacy, surgery, dietetics) 404–405 tripartite division of Herophilus (healthy, unhealthy and ‘neither’) 28, 405 see also ‘neither’ (tradition of ) writings on 2, 7, 21 see also Dieuches; Diocles of Carystus; Erasistratus; Herophilus; Mnesistheus; Philotimos; Pleistonicus; Praxagoras see also eurōstia; euexia; ‘neither’; non-natural; philosophy of health; summetria healthfulness (= to hugieinon) 84–86, 88, 106, 137, 155, 162, 177, 308, 407 health-practitioner (= hugieinos, Erasistratus’ term) 6, 8, 43, 230 heart 26, 32–33, 35, 59, 63, 155, 232, 238 heat, innate or internal 33–35, 42–44, 46, 56, 63, 158–159, 231–232 Henry VIII 2, 95 Hermes 15 Herodicus 6, 19, 88 Herodotus (medical author) 8, 13, 38 Herophilus 7, 28–30, 285, 403, 404–405 Hippocrates Hippocratic corpus 5, 10 Galen’s attitude to and interpretation and use of 5–13, 30, 32, 138, 157, 200, 215, 226, 275, 282, 309, 349 Galen’s commentaries on 10, 74–76, 215, 275 Airs, Waters, Places 6, 50, 135, 405 Aphorisms 10, 204, 349 Epidemics 10 The Nature of the Human Being 6, 10, 32, 34–35 Regimen 6, 10, 135, 405 Homer 165, 167, 331, 404 homoiomerēs, see uniform honey (and honey-based preparations) 24, 121, 300 hugieinos (as personal noun), see healthpractitioner

507

humour, see fluid hupochondrion (area of abdomen) xx, 188, 302 imbalance, in theory of health, see balance inflammation 43, 196, 262, 348–349, 387 Iphiclus 167 Italy wines of, see wines see also Rome Jason 167 Juntine (edition of Health) 91–92, 209, 266 kairos 229, 327, 349 kata phusin 40–42, 44, 103, 161, 168 krisis 125, 349 leisure (= freedom from obligations) 7, 18, 20, 28, 50, 64–65, 69, 80, 88–89, 203, 365, see also douleia Linacre, Thomas (Latin translator of Galen’s Health) 2, 91–92, 95, 179, 196–197, 209, 212, 269, 274 liver 26, 32–33, 59, 63, 155, 188, 196, 238–239, 301–302, 371 logic 3–4, 7, 21, 68, 85, 95, 99–100, 120, 157, 170, 173, 204, 305 see also demonstration Lucian 15–16, 140 Lynceus 167 Macedonia 264 Maimonides 1 Marcus Aurelius, emperor 20, 25, 65, 69–70, 83, 203, 338, 378, 382 massage 10, 13, 18, 20, 37, 51, 65, 80–81, 83, 177, 209–210, 226, 235, 240, 249, 254, 409 see also Theon materia medica xiv, 38, 241 Melampus 167 melancholia, melancholy xviii–xix, 7, 62, 196 see also bile, black Menemachus (Methodist author) 129 Menodotus (Empiricist author) 129 Methodist (medical sect) 4, 11–13, 31, 129, 164, 264, 282, 312, 378–379 midwife 183 milk 8–9, 44–45, 342 Milo of Croton 167, 234 mind, see emotion; pathos; soul mineral(s) xx, xxii–xxiii see also natron; salt

https://doi.org/10.1017/9781009159524.020 Published online by Cambridge University Press

508

General index

Mithradates (VI Eupator, of Pontus) 305, 338 Mnesitheus (writer on health) 6–8 music (affective and educative value of ) 45, 55, 57, 137, 177 musical expertise as parallel to medical 169 see also aulos; songs Mysia 186, 334–335 natron xxiii, 200, 291, 351, 391 nature according to, see kata phusin contrary to, see para phusin natural constitution, see constitution impulses of, healthy 52–53 see also capacities, natural; non-natural ‘neither’ (category between health and disease) 27–30, 40–42, 81, 131, 285, 405 neōteroi (= doctors or philosophers of more recent times) 5, 9, 12–13, 30, 38, 45, 332 Nero 338 nerve (= neuron) 26, 197, 238, 301, 388 problem of terminology of xx, 270 neuron, see nerve neutral (category between health and disease), see ‘neither’ Niccolò da Reggio (Latin translator of Galen) 2, 90–91, 93, 188, 332, 360, 406 non-natural (ou kata phusin, ou phusei) 39–42 the ‘six non-naturals’ 38–39, 55 normal and abnormal (in definition of individual’s health), see kata phusin; para phusin nourishment 35, 56, 180, 195, 239, 283, 372 see also nutrition nurse (including wet nurse) 8–9, 45, 65, 177, 183 nurture, see children; education; nurses nutrition 33–34, 107, 159, 201, 206, 238, 289, 299, 321, 339 as title of Hippocratic text 186 n. 86 see also nourishment oil (esp. olive) in exercise and massage 16, 81, 205, 264, 276 infused or perfumed 264, 278 taste of xxv ointment 37 oral (presentation or original context of composition) 21, 65–68, 84, 99 organic (parts of body), organs 26, 31–33, 59, 155, 162, 193, 238, 386 Oribasius xxii, 8–9, 188, 254

ousia (= essence, substance) 100, 110, 112, 116, 157, 173, 232, 261, 274, 372 contrasted with ennoia 4, 266 paidotribēs (= instructor) 19, 134, 187, 235 pain 43, 81, 188, 249, 261, 291, 348 palaioi (= ‘ancients’ in medicine or philosophy) 5, 9, 12, 30, 85 palaistra, see wrestling-school para phusin 40–42, 44, 168, 226 pathos (= affection, ailment, or harm) 39, 53–55, 57, 61–63, 156, 180, 232, 238 see also emotion; therapy; unaffectedness Paul of Aegina 95 pepper 302, 312 perfume, see oil, perfumed Pergamum (Galen’s home city) 16, 24–25, 180–181, 185–186, 225, 314, 325, 333–334, 388 perittōma, see residue pharmakon, see drug philiatros (amateur of medicine, doctor-loving) 22, 66, 304 Philistion (medical author) 7 philosopher(s) in Galen’s personal milieu 21 see also Eudemus; Primigenes health education for 29 (ironic use of term) 30, 370 natural (= phusikos) 232 relationship with doctor as regards health 54–55, 59–60, 62, 179 philosophy Galen’s study of and engagement with 4, 11, 12, 16, 20, 21, 26, 32, 44, 59, 61–64, 78, 86, 95, 104, 156–157, 164, 178, 241, 287, 383 of health 27, 96 relationship with medicine 54, 60 see also Aristotle; Atomism; Epicurus; logic; Plato; Platonist; Stoic; teleology; Theophrastus Philostratus 16–17, 19, 232 Philotimos (medical author) 7–9, 308 phrontis (= mental exertion, worry) 55, 140, 143, 328 plants analogy with withering of, for aging process 158, 346 aromatic 338 identity and use of as materia medica xx–xxii, 38 in relation to animals 32 160, 171

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General index

investigation of properties of 264 see also cucurbit; materia medica; oil; pepper Plato agreement with Hippocrates in Galen’s view 138, 309 Galen’s attitude to, engagement with and manipulation of texts of 5–6, 8, 12–14, 16, 30, 54, 56–57, 61–62, 85–89, 108, 136, 235 method of division 122 tripartite model of soul as relevant to Galen’s Health 59, 62–63, 143, 172, 179–180, 227, 238, 259, 309 views on health and physical training and related terminology 6, 19, 52, 88, 134, 137–138, 200 Gorgias 54, 86, 122, 136, 235 Laws 187 Phaedo 169, 210 Phaedrus 122 Republic 6, 87–89, 122, 137–138 Sophist 122 Statesman 122 Timaeus 157, 178, 383 Platonist background 157 theory of causes 127 Pleistonicus (writer on health) 7 plēthōra (= fulness, or build-up of fluids in body) xx, 227, 275, 287, 379 Pliny the Elder 308, 396 Plutarch 1, 54, 60, 324 pneuma 35–36, 238 Pneumatist (medical sect) 12 Polyclitus 203 pore, see channel Praxagaoras 7–9, 308, 404 Primigenes of Mytilene (Peripatetic philosopher) 333, 355 problēma (= set question for public debate) 65, 84–85, 99, 101, 161 progumnastēs (= training assistant) 19, 254 psuchē, see soul pulse (human), Galen’s works and theories on 13, 39–44, 71, 159, 244, 288 pulse(s) (foodstuff) 300–301 purgative, see drug, purgative Pythagorean 6, 25, 166, 169 Quintus (medical and anatomical authority) 282 Red Sea 391 regime, daily (= diaita) 1–2, 6, 10, 17–19, 29, 39, 58, 80, 82, 88–89, 135, 177, 364, 409

509

regimen, see regime, daily residue (= perittōma) 33–34, 36–37, 44, 159–160, 194–195, 206, 258, 288, 296, 309, 318, 321, 365 see also fluid; sweat; urine Rome xiv, 21, 25, 69, 74, 230, 264, 314, 333, 378 Rufus of Ephesus 8 salt xxiii, xxv, 175, 200 scholarship, ancient, see Alexandria; grammatikos, grammatikē; education; Hippocrates; palaioi; Plato Scythians 50, 185 sects, medical 4, 11–12, 30–31, 164, 268 see also Atomist; Empiric; Methodist; Pneumatist self-sufficiency (= not requiring expert monitor) 52, 228 servitude, see douleia sex, sexual activity 16, 37, 39, 204, 238, 280 see also desiderative shame (physiology of ) 57, 63, 232, 296 shaping (= diaplasis, plattein) (in account of formation of body) 26, 31, 156, 162 of soul, ethical, see soul sign (= sēmeion) 29, 38, 43, 106, 285 slavery, see douleia Socrates 87–89, 137 Solon 15 songs (composition and performance of as presecription at Asclepieion) 25, 180 sophist (sophistic, sophistical, sophistry) 16, 30, 87, 106, 114, 161 ‘Second Sophistic’ 21 Soranus 38, 183 soul 1, 12, 15, 21, 25, 36, 39, 48, 52–63, 86–87, 137, 143 shaping of, ethical 55, 57, 59–61, 156, 169, 172–174, 179–180, 191, 227–228, 238, 259, 367, 383 see also desiderative; emotion; ethics; pathos; spirit; therapy specialism, esp. medical, Galen’s attitude to 4, 7–8, 19, 23, 45, 120, 169, 241 see also art(s) spirit, spirited (= thumoeides, in Platonic tripartite soul) 55–59, 63, 138, 143, 172, 179, 238, 259 Stoic 12, 32, 44, 53–54, 60–61, 104, 156, 171, 178, 266, 376 see also Chrysippus

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510

General index

substance, see ousia summetria (= good balance) 16, 25, 31, 35, 161 see also balance and imbalance sweat (as diagnostic sign) 43 taste 93, 264 of aminaios grape 335 of aromatic plants 338 Galen’s classification of xxiv–xxv technē (= art, specialized skill) 2, 18, 93, 100, 156, 166, 241, 334 see also art(s) teleology 32, 156–157, 177–178 see also Craftsman temple medicine, see Asclepieion, Asclepius Temple of Peace, at Rome 21, 333 Theon of Alexandria (trainer and author of Physical Exercises) 8, 11–12, 30, 79, 149, 211, 270, 272 Theophrastus xxii, 12, 261 therapeutikos (art or branch of art), see healing therapy, ethical or emotional 61–62, 180 theriac 338 Thersites 28, 165 Thessalus (Methodist doctor) 7, 11–12, 164, 282 Thrace 264 thumos, see spirit time-keeping, time measurement 65, 377–378 times of life (hēlikiai), see age tradition, see education; Greekness; health; Hippocrates; neōteroi; palaioi; philosophy; Plato trainer, physical (= gumnastēs) 3–5, 8, 11–12, 15, 19–21, 84, 87, 89, 100, 187, 189, 211, 220, 230, 248–250, 268 see also paidotribēs; progumnastēs training intellectual, see education; logic

physical (= gumnastika, gumnastikē) 3, 5–6, 8, 14–16, 18–20, 22, 52, 99–100, 137–138, 142, 144, 187, 204, 308 see also gumnasion translations of Health Arabic 92 Latin 2, 91–92, 95 see also Burgundio; Gadaldini; Linacre; Niccolò unaffectedness (= apatheia) 53, 156, 175, 376 uniform (= homoiomerēs, type of part of body) 26, 32, 34–35, 155, 162, 164, 386 urine as diagnostic sign 43, 206, 295–296, 301 in fulling 282 n. 76 vein xx, 33, 35, 238–239, 293, 301, 309, 317, 319 ‘first veins’ (i.e. those nearest the liver) 302, 343, 371 venesection 24, 62, 71, 76, 81, 293, 318 vigour (= eurōstia, characteristic of optimal health) 26, 27, 30, 33, 48, 138, 369 Vindician 404–405, 407 vinegar 24, 300 weights and measures xxiv, 304, 314, 345, 401 wine 46, 65, 83, 187, 193, 206, 264, 290, 294, 300, 308, 335, 337 women 17, 51, 202, 278 see also nurses wrestling-school (= palaistra), wrestling-school exercise 16, 18–20, 37, 51, 100, 144–145, 187, 200, 235, 277 Xenophon 229 youth, see age; ephebate

https://doi.org/10.1017/9781009159524.020 Published online by Cambridge University Press