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THE LOEB CLASSICAL LIBRARY
FOUNDED BY JAMES LOEB, LL.D.
EDITED BY ΤΠ E. PAGE, c.H., ΕἸ Ὁ. +E. CAPPS, PH.D., LL.D. +W. H. Ὁ. ROUSE, trrt.p.
eA. POST, M.A. E. H. WARMINGTON, .a., F.R.HIST.SOC.
HIPPOCRATES VOL. I
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HIPPOCRATES
WITH AN ENGLISH TRANSLATION BY ἣν. Ἡ- 5: JONES
BURSAR AND STEWARD OF 5. CATHARINE’S COLLEGE, CAMBRIDGE, CORRESPONDING MEMBER OF THE HISTORICAL SECTION OF THE ROYAL SOCIETY OF MEDICINE
LONDON WILLIAM HEINEMANN LTD
CAMBRIDGE, MASSACHUSETTS
HARVARD UNIVERSITY PRESS
MOMLVII
First printed 1923 Reprinted 1939, 1948, 1957
Printed in Great Britain
CONTENTS
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PREFACE
Tue works, some seventy in all, which in any of our manuscripts are assigned to Hippocrates, comprise what is called the “ Hippocratic collec- tion.” During nearly three centuries there appeared many editions, of some or of all of these works, intended to instruct medical students or practi- tioners. The birth of modern medical science in the nineteenth century stopped finally this long series, but a few scholars still worked at the treatises from an historical standpoint. The literary merit, however, of the Hippocratic writings, at least of the majority, is not great, and it is only within the last few years that they have been subjected to the exact scholarship which has thrown such a flood of new light upon most of the classical authors. Even now very little has been done for text, dialect, grammar and style, although the realization of the value of the collection for the history of philosophy is rapidly improving matters. So for the present a translator must also be, in part, an editor. He has no scholarly tradition behind him upon which to build, but must lay his own foundations.
It will be many years before the task is finished, but in the meanwhile there is work for less ambitious students. My own endeavour has been to make as clear and accurate a translation as the condition of
vii
PREFACE
the text permits, introducing as few novelties of my own as possible, and to add such comment as may bring out the permanent value of the various treatises. They are no longer useful as text-books, but all of us, whether medical or lay, may learn a lesson from the devotion to truth which marked the school of Cos, and from the blunders committed by theorizers who sought a short cut to knowledge without the labour of patient observation and careful experiment.
The present volume has been in preparation since 1910, and the actual writing has occupied all my leisure for the past three years. The time would have been longer, had it not been for the great kind- ness of Dr. E. T. Withington, whose name will probably appear on the title-page of one of the succeeding volumes.
My thanks are also due to the Rev. H. J. Chaytor for his helpful criticisms,
W. Η. 5. Jones,
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GENERAL INTRODUCTION
§ 1. Greek Mepicine AND “ Hippocrates.” We have learned to associate, almost by instinct, the science of medicine with bacteria, with chemistry, with clinical thermometers, disinfectants, and all the apparatus of careful nursing. All such associations, if we wish even dimly to appreciate the work of Hippocrates and of his predecessors, we must en- deavour to break ; we must unthink the greater part of those habits of thought which education has made second nature. The Greek knew that there were certain collections of morbid phenomena which he called diseases; that these diseases normally ran a certain course ; that their origin was not unconnected with geographical and atmospheric environment ; that the patient, in order to recover his health, must modify his ordinary mode of living. Beyond this he knew, and could know, nothing, and was compelled to fill up the blanks in his knowledge by having recourse to conjecture and hypothesis. In doing so he was obeying a human instinct which assures us that progress requires the use of stop-gaps where complete and accurate knowledge is unattainable, and that a working hypothesis, although wrong, is better than no hypothesis at all. System, an organ- ized scheme, is of greater value than chaos. Yet however healthy such an instinct may be, it has
1x
GENERAL INTRODUCTION
added considerably to the difficulties of the historian in his attempts so to reconstruct the past as to make it intelligible to modern readers.
Primitive man regards everything he cannot explain as the work of a god. To him the abnormal, the unusual, is divine. The uncharted region of mysterious phenomena is the peculiar realm of supernatural forces.* “It is the work of heaven” is a sufficient answer when the human intelligence can give no satisfactory explanation.
The fifth century B.c. witnessed the supreme effort of the Greeks to cast aside this incubus in all spheres of thought. They came to realize that to attribute an event to the action of a god leaves us just where we were, and that to call normal phenomena natural and abnormal divine is to introduce an unscientific dualism, in that what is divine (because mysterious) in one generation may be natural (because under- stood) in the next, while, on the other hand, how- ever fully we may understand a phenomenon, there must always be a mysterious and unexplained element in it. All phenomena are equally divine and equally natural.
But this realization did not come all at once, and in the science of medicine it was peculiarly slow. There is something arresting in the spread of an epidemic and in the onset of epilepsy or of a pernicious fever. It is hard for most minds, even scientific minds, not to see the working of a god in them. On the other hand, the efficacy of human means to relieve pain is so obvious that even in Homer, our first literary authority for Greek medicine, rational treatment is fully recognized.
As the divine origin of disease was gradually
x
GENERAL INTRODUCTION
discarded, another element, equally disturbing, and equally opposed to the progress of scientific medicine, asserted itself. Philosophy superseded religion. Greek philosophy sought for uniformity in the multiplicity of phenomena, and the desire to find this uniformity led to guesswork and to neglect of fact in the attempt to frame a comprehensive theory. The same impulse which made Thales declare that all things are water led the writer of a treatise? in the Hippocratic Corpus to maintain that all diseases are caused by air. As Daremberg? says, “the philosophers tried to explain nature while shutting their eyes.” The first philosophers to take a serious interest in medicine were the Pythagoreans. Alemaeon® of Croton, although perhaps not strictly a Pythagorean, was closely connected with the sect, and appears to have exercised considerable influence upon the Hippocratic school. The founder of em- pirical psychology and a student of astronomy, he held that health consists of a state of balance between certain “opposites,” and disease an undue _pre- ponderance of one of them.4 Philolaus, who flourished about 440 B.c., held that bile, blood, and phlegm were the causes of disease. In this case we have a Pythagorean philosopher who tried to include medical
1 The περὶ φυσῶν.
2 Histoire des sciences médicales, p. 82.
3 A young man in the old age of Pythagoras. See Aristotle Meta, A 986a 30. Alemaeon was more interested in medicine than in philosophy, but does not seem to have been a ‘* general pr actitioner.’
4 ᾿Αλκμαίων τῆς μὲν ὑγιείας εἶναι συνεκτικὴν τὴν ἰσονομίαν τῶν δυνάμεων, ὑγροῦ, ξηροῦ, ψυχροῦ, θερμοῦ, πικροῦ, γλυκέος, καὶ τῶν λοιπῶν, τὴν δ᾽ ἐν αὐτοῖς μοναρχίαν νόσου ἀμ χυὰ φθορο- ποιὸν γὰρ ἑκατέρου μοναρχίαν. ---Αδὐῖπ5 V. 30.
xX)
GENERAL INTRODUCTION
theory in his philosophical system.! Empedocles, who flourished somewhat earlier than Philolaus, was a “medicine-man” rather than a physician, though he is called by Galen the founder of the Italian school of medicine.?, The medical side of his teach- ing was partly magic and quackery.
This combination of medicine and philosophy is clearly marked in the Hippocratic collection. There are some treatises which seek to explain medical phenomena by a priori assumptions, after the manner of the philosophers with their method of ὑποθέσεις or postulates; there are others which strongly oppose this method. The Roman Celsus in his preface? asserts that Hippocrates separated medicine from philosophy, and it is a fact that the best works of the Hippocratic school are as free from philosophic assumptions as they are from religious dogma. But before attempting to estimate the work of Hippocrates it is necessary to consider, not only the doctrine of the philosophers, but also the possibly pre-Hippocratic books in the Corpus. These are the Prenotions of Cos and the First Prorrhetic,4 and perhaps the treatise—in Latin and Arabic, the Greek original having mostly perished—on the number seven (περὶ ἑβδομάδων).
1 For the medical theories of Philolaus see the extracts from the recently discovered Jatrica of Menon, discussed by Diels in Hermes XXVIIL., p. 417 foll.
2 Galen X. 5.
3 Hippocrates . . . ab studio sapientiae disciplinam hanc separavit, vir et arte et facundia insignis.
4 Grimm, Ermerins and Adams are convinced of the early date of these. Littré seems to have changed his mind. Con- trast I. 351 with VIII. xxxix. The writer in Pauly-Wissowa is also uncertain. I hope to treat the question fully when I come to Prognostic in Vol. 11.
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GENERAL INTRODUCTION
The Prenotions of Cos and the First Prorrhetic (the latter being the earlier, although both are supposed to be earlier than Hippocrates) show that in the medical school of Cos great attention was paid to the natural history of diseases, especially to the prob- ability of a fatal or not fatal issue. The Treatise on Seven, with its marked Pythagorean characteristics, proves, if indeed it is as early as Roscher would have us believe, that even before Hippocrates disease was considered due to a disturbance in the balance of the humours, and health to a “coction” of them, while the supposed preponderance of seven doubtless exer- cised some influence on the later doctrine of critical days. The work may be taken to be typical of the Italian-Sicilian school of medicine, in which a priort assumptions of the “ philosophic” type were freely admitted. Besides these two schools there was also a famous one at Cnidos,! the doctrines of which are criticised in the Hippocratic treatise Regimen in Acute Diseases. The defects of this school seem to have been :-—
(1) the use of too few remedies ; (2) faulty or imperfect prognosis ; (3) over-elaboration in classifying diseases.’
We may now attempt to summarize the com-
1 There are several Cnidian treatises in the Corpus. See p. xxiii. The Cnidian point of view admits of defence, and their desire to classify was a really scientific instinct. I hope to treat of the Cnidians fully when I come to translate Regimen in Acute Diseases.
2 The Coan school, on the other hand, sought for a unity in diseases. Its followers tried to combine, the Cnidians to distinguish and to note differences. See Littré 11. 202-204.
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GENERAL INTRODUCTION
ponents of Greek medicine towards the end of the fifth century B.c.
(1) There was a religious element, which, however, had been generally discarded.
(2) There was a philosophic element, still very strong, which made free use of unverified postulates in discussing the causes and treatment—especially the former—of diseases.
(3) There was a rational element, which relied upon accurate observation and accumulated ex- perience. This rationalism concluded that disease and health depended on environment and on the supposed constituents of the human frame.
Now if we take the Hippocratic collection we find that in no treatise is there any superstition,' in many there is much “ philosophy’ with some sophistic rhetoric, and among the others some are merely technical handbooks, while others show signs of a great mind, dignified and reserved with all the severity of the Periclean period, which, without being distinctively original, transformed the best tendencies in Greek medicine into something which has ever since been the admiration of doctors and scientific men. It is with the last only that I am concerned at present.
I shall make no attempt to fix with definite pre- cision which treatises are to be included in this category, and 1 shall confine myself for the moment to three—Prognostic, Regimen in Acute Diseases, and Epidemics I. and 111. These show certain character- istics, which, although there is no internal clue to
1 A possible exception is Decorwm, which 1 hope to discuss in Vol. II.
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GENERAL INTRODUCTION
either date or authorship, impress upon the reader a conviction that they were written by the same man, and at a time before the great period of Greece had passed away. They remind one, in a subtle yet very real way, of Thucydides.
The style of each work is grave and austere. There is no attempt at “ window-dressing.” Lan- guage is used to express thought, not to adorn it. Not a word is thrown away. ‘The first two treatises have a literary finish, yet there is no trace in them of sophistic rhetoric. Thought, and the expression of thought, are evenly balanced. Both are clear, dignified—even majestic.
The matter is even more striking than the style. The spirit is truly scientific, in the modern and strictest sense of the word. There is no superstition, and, except perhaps in the doctrine of critical days, no philosophy.? Instead, there is close, even minute, observation of symptoms and their sequences, acute remarks on remedies, and recording, without in- ference, of the atmospheric phenomena, which preceded or accompanied certain “epidemics.” Especially noteworthy are the clinical histories, admirable for their inclusion of everything that is relevant and their exclusion of all that is not.
The doctrine of these three treatises may be summarised as follows :—#*
1 The resemblance struck Littré. See Vol. I., pp. 474, 475.
* Of course even in the greatest works of the Hippocratic Corpus there is, and could not help being, some theory. But the writer does not love the theory for its own sake. Rather he is constantly forgetting it in his eagerness to record observed fact.
* There is a clear account of Hippocratic doctrine in Littré, Vol. L., pp. 440-464.
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GENERAL INTRODUCTION
(1) Diseases have a natural course, which the physician must know thoroughly,! so as to decide whether the issue will be favourable or fatal.
(2) Diseases are caused by a disturbance 2 in the composition of the constituents of the body. This disturbance is connected with atmospheric and climatic conditions.
(3) Nature tries to bring these irregularities to a normal state, apparently by the action of innate heat, which “ concocts” the “ crude” humours of the body.
(4) There are “ critical’’ days at fixed dates, when the battle between nature and disease reaches a crisis.
(5) Nature may win, in which case the morbid matters in the body are either evacuated or carried off in an ἀπόστασις, 8 or the “ coction ᾿᾿ of the morbid elements may not take place, in which case the patient dies.
(6) All the physician can do for the patient is to give nature a chance, to remove by regimen all that may hinder nature in her beneficent work.
It may be urged that this doctrine is as hypo- thetical as the thesis that all diseases come from air. In a sense it is. All judgments, however simple, attempting to explain sense-perceptions, are hypo- theses. But hypotheses may be scientific or philo- sophic, the latter term being used to denote the
1 This knowledge is πρόγνωσις.
2 It is not clear whether this disturbance is regarded as quantitative, qualitative, or both.
® This term will be explained later. Roughly speaking, it means the collection and expulsion of morbid elements at a fixed point in the body. I translate it ‘‘ abscession,” a
term which suggests ‘‘abscess,” perhaps the most common form of an ‘‘ abscession.”
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GENERAL INTRODUCTION
character of early Greek philosophy. A scientific hypothesis is a generalization framed to explain the facts of experience ; it is not a foundation, but is in itself a superstructure ; it is constantly being tested by appeals to sense-experience, and is kept, modified or abandoned, according to the support, or want of support, that phenomena give to it. A “philo- sophic”’ hypothesis is a generalization framed with a view to unification rather than to accounting for all the facts; it is a foundation for an unsubstantial superstructure ; no efforts are made to test it by appeals to experience, but its main support is a credulous faith.
Now the doctrine of the Epidemic group is certainly not of the philosophic kind. Some of it was un- doubtedly derived from early philosophic medicine, but in this group of treatises observed phenomena are constantly appealed to; nor must it be forgotten that in the then state of knowledge much that would now be styled inference was then considered fact, e.g. the “coction” of phlegm in a common cold. Throughout, theory is in the background, observation in the foreground. It is indeed most remarkable that Hippocratic theory is hard to disentangle from the three works on which my argument turns... It is ἃ nebulous framework, implied in the technical phraseology—weis, κρίσις, xpaous—and_ often illus- trated by appeal to data, but never obtrusively insisted upon.
In 1836 a French doctor, M. 5. Houdart,! violently attacked this medical doctrine on the ground that it
1 Rtudes historiques et critiques sur la vie et la doctrine
αἰ Hippocrate, et sur l'état de la médecine avant lui, Paris and London.
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GENERAL INTRODUCTION
, neglected the physician’s prime duty,! which is to effect a cure. Diagnosis, he urges, is neglected in the cult of prognosis; no attempt is made to localize the seat of disease; the observations in the Epidemics are directed towards superficial symptoms without any attempt to trace them to their real cause. The writer is an interested but callous spectator who looks on unmoved while his patient dies.
In this rather rabid criticism there is a morsel of truth. The centre of interest in these treatises is certainly the disease rather than the patient. The writer is a cold observer of morbid phenomena, who has for a moment detached himself from pity for suffering. But this restraint is in reality a virtue; concentration on the subject under discussion is perhaps the first duty of a scientist. Moreover, we must not suppose that the fatally-stricken patients of the Epidemics received no treatment or nursing. Here and there the treatment is mentioned or hinted at,? but the writer assumes that the usual methods
1 ἐς Attendre qu'il plaise ἃ la nature de nous délivrer de nos maux, ¢c’est laisser économie en proie a la douleur, c’est donner le temps aux altérations de dévorer nos viscéres, c’est, en un mot, nous conduire siirement ἃ la mort.”—Op. cit. p. 253. M. Houdart was but following the example of Asclepiades, the fashionable physician at Rome in the first century B.C., who called the Hippocratic treatment a ‘‘meditation upon death.”
2 ««Lisez les Epidémies. Si votre cceur résiste ἃ cette lecture, vous l’avez de bronze. Qui peut voir en effet de sang-froid cette foule d’infortunés conduits ἃ pas lents sur les bords de la tombe, οὰ ils finissent la plupart par tomber, apres avoir souffert durant trois ou quatre mois entiers les douleurs les plus variées et les plus aigués?”—Op. cit. p. 246.
3 H.g. Τρία. III. Case virt. (second series): θερμάσματα and ὀγδόῃ ἀγκῶνα ἔταμον. ᾿
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GENERAL INTRODUCTION
were followed, and does not mention them because they are irrelevant.
The charge of callousness may be dismissed. More serious is the attack on the fundamental principle of Hippocratic medicine, that “ nature” alone can effect a cure, and that the only thing the physician can do is to allow nature a chance to work. Modern medical science has accepted this principle as an ultimate truth, but did the writer of the three treatises under discussion do his best to apply it? Did he really try to serve nature, and, by so doing, to conquer her? Houdart says that practically all the author of the Epidemics did was “to examine stools, urine, sweats, etc., to look therein for signs of coction, to announce crises and to pronounce sentences of death,” ! in other words that he looked on and did nothing. I have just pointed out that the silence of the Epzdemics on the subject of treatment must not be taken to mean that no treatment was given, but it remains to be considered whether all was done that could have been done. What remedies were used by the author of Regimen in Acule Diseases ? They were :—
(1) Purgatives and, probably, emetics.
(2) Fomentations and baths.
(3) (a) Barley-water and barley-gruel, in the preparation and administering of which great care was to be taken.
(ὁ) Wine.
(c) Hydromel, a mixture of honey and water ; and oxymel, a mixture of honey and vinegar.
1 Op. cit. p. 247. X1X
GENERAL INTRODUCTION
(4) Venesection. (5) Care was taken not to distress the patient.?
If we take into account the scientific knowledge of the time, it is difficult to see what more the physician could have done for the patient. Even nowadays a sufferer from measles or influenza can have no better advice than to keep warm and com- fortable in bed, to take a purge, and to adopt a diet of slops. Within the last few years, indeed, chemistry has discovered febrifuges and anaesthetics, the micro. scope has put within our reach prophylactic vaccines, and the art of nursing has improved out of all recog- nition, but nearly all these things were as unknown to M. Houdart as they were in the fifth century B.c.
This criticism of Hippocratic medicine has been considered, not because it is in itself worthy of pro- longed attention, but because it shows that underlying the three treatises I have mentioned there is a fun- damental principle, a unity, a positive characteristic implying either a united school of thought or else a great personality. All antiquity agreed that they were written by the greatest physician of ancient times— Hippocrates. Within the last hundred years, however, doubts have been expressed whether Hip- pocrates wrote anything. Early in the nineteenth century a doctor of Lille published a thesis intitled Dubitationes de Hippocratis vita, patria, genealogia, forsan mythologicis, et de quibusdam eius libris multo
1 It should be noticed that in all the Hippocratic collection no attention is paid to the pulse. The doctor judged whether a patient was feverish, and estimated the degree of fever, by the touch. I have not translated πυρετὸς ὀξύς by ‘high temperature,” but by ‘‘acute fever,’ because I wish to introduce as few anachronisms as possible.
XxX
GENERAL INTRODUCTION
antiquiortbus quam vulgo creditur. Wellmann and Wilamowitz hold similar views nowadays. As the Hippocratic writings are all anonymous, such a hypo- thesis is not difficult to maintain. But it is a matter of merely antiquarian interest whether or not the shadowy “ Hippocrates” of ancient tradition is really the writer of the Epidemics. The salient and im- portant truth is that in the latter half of the fifth century works were written, probably by the same author, embodying a consistent doctrine of medical theory and practice, free from both superstition and philosophy, and setting forth rational empiricism of a strictly scientific character. If in future 1 call the spirit from which this doctrine emanated ‘ Hip- pocrates”’ it is for the sake of convenience, and not because I identify the author with the shadowy physician of tradition.
Similar in style and in spirit to the three treatises discussed above are Aphorisms and Airs Waters Places, along with two surgical works, Fractures t and Wounds in the Head. The severely practical character of the last is particularly noteworthy, and makes the reader wonder to what heights Greek surgery would have risen had antiseptics been known. Aphorisms is a compilation, but a great part shows a close relationship to the Hippocratic group. The least scientific of all the seven treatises is Airs Waters Places, which, in spite of its sagacity and rejection of the supernatural, shows a tendency to facile and unwarranted generalization.
1 With this should be joined the work Articulations, which is very closely allied to Fractures, and is supposed by Galen to have been originally combined with it as a single work. Instruments of Reduction appears to be a compendium of Articulations.
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GENERAL INTRODUCTION
§ 2. Tue Hiprpocraric COLLECTION.
We are now in a position to attempt a brief analysis of the Corpus Hippocraticum. For the moment the external evidence of Galen and other ancient commentators, for or against the authenticity of the various treatises, will be passed over, ‘This evidence is of great importance, but may tend to obscure the issue, which is the mutual affinities of the treatises as shown by their style and content.
In the first place the heterogeneous character of the Corpus should be observed. It contains :—
(1) Text-books for physicians ;
(2) Text-books for laymen ;
(3) Pieces of research or collection of material for research.
(4) Lectures or essays for medical students and novices.
(5) Essays by philosophers who were perhaps not practising physicians, but laymen interested in medicine and anxious to apply to it the methods of philosophy.
(6) Note-books or scrap-books.
Even single works often exhibit the most varied characteristics. It is as though loose sheets had been brought together without any attempt at co- ordination or redaction. Epidemics I., for instance, jumps with startling abruptness from a “ constitu- tion” of the diseases prevalent at one period in Thasos to the function of the physician in an illness, passing on to a few disjointed remarks on pains in the head andneck. Then follows another “ constitution,” after which comes an elaborate classification of the
XxX
GENERAL INTRODUCTION
ordinary fevers, with their periods, paroxysms and crises. At the end come fourteen clinical histories,
I have already mentioned a pre-Hippocratic group and a Hippocratic group, and it has been noticed that the main task of Greek medicine was to free science from superstition and from philosophic hypo- theses. The Corpus contains two polemical works, On Epilepsy and Ancient Medicine, which attack re- spectively the “divine” origin of disease and the intrusion into medicine of the hypothetical specula- tion of philosophers.
There is another group of works which, while they do not display to any marked degree the Hippocratic characteristics, are nevertheless practical handbooks of medicine, physiology or anatomy. The list is a long one, and includes works by different authors and of different schools :-—
The Surgery. The Heart. Places in Man. Glands. Anatomy. Nature of the Bones. Sight. Dentition. Diseases I. Diseases II. and IIT) A ffections.+ Internal A ffections. Sores. Fistulae. Hemorrhoids.
1 Shows influence of Cnidian school. So possibly do other
books, XXiil
GENERAL INTRODUCTION
Prorrhetic I. The Physician, Crises.
Critical Days. Purges.
Use of Liquids.
Seventh Month Child. Eighth Month Child. Generation1
Nature of the Child.+ Diseases IV 3 Diseases of Women.+ Barrenness.+ Diseases of Girls. Nature of Women. Excision of the Foetus. Super foetation.
΄------
Regimen in Health2 Regimen IT. and III. with Dreams.
Another most important group of works consists of those in which the philosophic element predomi- nates over the scientific, the writers being anxious, not to advance the practice of medicine, but to bring medicine under the control of philosophic dogma, to achieve in fact the end attacked by the writer of Ancient Medicine. These works are Nutriment, Regi- men I. and Airs. The first two are Heraclitean; the last is probably derived from Diogenes of Apollonia.
1 Shows influence of Cnidian school. So possibly do other books. 2 Really a continuation of Nature of Man.
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GENERAL INTRODUCTION
Regimen I., however, while strongly Heraclitean, is eclectic. Animals are said to be composed of two elements, fire and water, fire being a composite of the hot and the dry, water of the cold and the moist. Certain sentences are strikingly reminiscent of Anaxagoras, so much so that it is impossible to regard the resemblances as accidental. Take for instance the following :—
(1) ἀπόλλυται μὲν οὖν οὐδὲν ἁπάντων χρημάτων, οὐδὲ γίνεται ὅτι μὴ καὶ πρόσθεν ἣν. ξυμμισγόμενα δὲ καὶ διακρινόμενα ἀλλοιοῦται. —Regimen I. τν.
(2) οὐδὲν γὰρ χρῆμα γίνεται οὐδὲ ἀπόλλυται, ἀλλ᾽ ἀπὸ ἐόντων Renee Bera τε καὶ διακρίνεται.--- Anaxagoras, fr. 22 (Schaubach).
To assign exact dates to these works is impossible, but they are probably much later than Heraclitus himself. The interesting fact remains that Hera- clitus had followers who kept his doctrine alive, second-rate thinkers, perhaps, and unknown in the history of science, but hearty supporters of a creed, and ready to extend it to embrace all new know ledge as it was discovered. Particularly interesting is the work Nutriment. This not only adopts the theory of Heraclitus, but also mimics his sententious and mysterious manner of expression. A few examples may not be out of place.
φύσις ἐξαρκέει πάντα tacw.—Nutriment xv.
κρατέει γὰρ 86. ὃ θεῖος νόμος]... καὶ ἐξαρκέει 7ao..—Heraclitus apud Stob. Flor, II. 84.
μία φύσις εἶναι Kat μὴ €tvat.—Nutriment xxiv.
εἶμέν τε καὶ οὐκ εἶμεν.--- ΗΠ ΘΥδο! 5 Alleg. Hom. 24.
ὁδὸς ἄνω κάτω, pia.—Nutriment XLv.
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GENERAL INTRODUCTION
ὁδὸς ἄνω καὶ κάτω pia καὶ ovtTy.—Heraclitus apud Hippolyt. IX. 10
πρός τι πάντα φλαῦρα Kal πάντα aoteta.—Nutriment XLV.
θάλασσα ὕδωρ καθαρώτατον καὶ μιαρώτατον, ἰχθύσι μὲν πότιμον καὶ σωτήριον, ἀνθρώποις δὲ ἄποτον καὶ ὀλέθριον .--- Πδγδοϊ 5. apud Hippolyt. IX. 10.
χωρεῖ δὲ πάντα καὶ θεῖα καὶ ἀνθρώπεια, ἄνω καὶ κάτω apetBopeva.—Regimen I. ν.
Similar to these philosophic treatises are the essays, ἐπιδείξεις or displays, which propound theses which are not the ὑποθέσεις of philosophers. These are The Art, the object of which is to show that there zs an art of medicine, and Nature of Man, which combats the monist philosophers, and sets forth the doctrine of the four humours as the cause of health, by their perfect crasis, and of disease, through a disturbance of that crasis. To this group we may perhaps add the treatise Decorum, which deals (among other things) with bed-side manners, and Precepts, a work similar in style and subject.
The last two works are interesting for their intro- ductory remarks. Decorum practically identifies medicine and philosophy, which term is used to denote the philosophic spirit, with its moral as well as its intellectual attributes, and recognises the working of an agency not human; it is in fact typical of the ethical science, practical if occasion- ally commonplace, which came into vogue towards the end of the fourth century s.c. The introduc- tion to Precepts is Epicurean. The first chapter, in fact, is a summary of Epicurean epistemology, and is full of the technical terms of that school. A single quotation will suffice :—
XXvi
GENERAL INTRODUCTION
«< SS \ ΄ / > Ν an ᾽
ὃ γὰρ λογισμὸς μνήμη τίς ἐστι ξυνθετικὴ τῶν μετ > , / > ’ Ν > , «ε αἰσθήσιος ληφθέντων: ἐφαντασιώθη γὰρ ἐναργέως ἡ αἴσθησις, προπαθὴς καὶ ἀναπομπὸς ἐοῦσα εἰς διάνοιαν τῶν ὑποκειμένων .----Πγεοορί I,
This definition of λογισμός is practically the same as that of the Epicurean πρόληψις given in Diogenes Laertius X. 33.
A few of the contents of the Corpus Hippocraticum remain unclassified. Of these, by far the most Hippocratic are Epidemics I1., 1V. VII, It is indeed remarkable that in antiquity they were not generally assigned to the “ great”’ Hippocrates. The clinical histories are invaluable, although they are not so severely pertinent as those of Epidemics I. and III., betraying sometimes an eye for picturesque but irrelevant detail.
The treatise curiously misnamed Fleshes contains, amid a variety of interesting anatomical and _ physio- logical detail, traces of Pythagoreanism in the virtue attached to the number seven, and of Heracliteanism in the view put forward that warmth is the spirit that pervades the universe.
Humours deals with the relations of humours to the seasons and so on.
The Oath and The Law are small but interesting documents throwing light on medical education and etiquette.
Finally, the Epistles! and Decree, although merely imaginary essays, show what manner of man Hip- pocrates was supposed to have been by the Greeks of a later age.
1 It is interesting to note that the Platonic collection and the New Testament, like the Corpus, end with a series of
letters. XXVli
GENERAL INTRODUCTION
The Hippocratic collection is a medley, with no inner bond of union except that all the works are written in the Ionic dialect and are connected more or less closely with medicine or one of its allied sciences. There are the widest possible divergences of style, and the sharpest possible contradictions in doctrine. The questions present themselves, why were they united, and when did the union occur ?
Littré’s problem, “When was the Hippocratic collection published?”1 cannot be answered, for it is more than doubtful whether, as a whole, the collection was ever published at all. The publica- tion of a modern work must in no way be compared with the circulation of a book in ancient times. Printing and the law of copyright have created a revolution. As soon as an ancient author let go out of his possession a single copy of his book, it was, to all intents and purposes, “published.” Copies might be multiplied without permission, and a popular and useful work was no doubt often cir- culated in this way. Now at least one hundred, perhaps three hundred, years separate the writing of the earliest work in the Corpus from the writing of the latest. Diocles knew the Aphorisms, Ctesias probably knew Articulations, and Menon certainly knew two or three treatises. Aristotle himself quotes from Nature of Man, though he ascribes it to Polybus. [Ὁ is surely impossible to suppose with Littré that there was anything approaching a publi- cation of the Corpus by the Alexandrian librarians. Even if they had published for the first time only a large portion of the collection, such a momentous event would scarcely have passed unnoticed by the
1 Vol. I., chap. xi. XXVili
GENERAL INTRODUCTION
long series of commentators culminating in Galen. The librarians of Alexandria could not have done more than establish a canon, and if our present collection represents their work in this direction it was done very badly, as the most superficial critic would not fail to notice that a great part of its contents is neither by Hippocrates himself nor by his school.
The Hippocratic collection is a library, or rather, the remains of a library. What hypothesis is more probable than that it represents the library of the Hippocratic school at Cos? The ancient biographies of Hippocrates relate a fable that he destroyed the library of the Temple of Health at Cnidos (or, according to another form of the fable, at Cos) in order to enjoy a monopoly of the knowledge it contained. The story shows, at least, that such libraries existed, and indeed a school of medicine, like that which had its home at Cos, could not well have done without one. And what would this library contain? The works of the greatest of the Asclepiads, whether published or not; valuable works, of various dates and of different schools, bearing on medicine and kindred subjects ; medical records and notes by distinguished professors of the school, for the most part unpublished ; various books, of no great interest or value, presented to the library or acquired by chance.
The Hippocratic collection actually corresponds to this description. This is nearly all the historian is justified in saying. Beyond is mere conjecture. We can omy guess when this library ceased to be the property of the Hippocratic school, and how it was transferred to one or other of the great libraries
xxix
GENERAL INTRODUCTION
which were collected in Alexandrine times, to be re-copied and perhaps increased by volumes which did not belong to the original collection.
It may be urged that if the Hippocratic Corpus were originally a library, it is improbable that all the treatises composing it would be writtenin Ionic. But it is by no means certain when Ionic ceased to be the normal medium for medical science; for all we know the dialect may have been in vogue until long after the κοινή established itself throughout the Greek world. Moreover, we do not know what levelling forces were at work among copyists and librarians, inducing them to assimilate the dialects of medical works to a recognized model. We do know, however, that as centuries passed more and more Ionisms, most of them spurious, were thrust upon the Hippocratic texts. The process we can trace in the later history of the text may well have been going on, in a different form, in the fourth and third centuries B.C.
It is because I regard the Hippocratic collection as merely a library that I do not consider it worth while to attempt an elaborate classification, like those of Littré, Greenhill, Ermerins, and Adams. A library is properly catalogued according to subject matter, date, and authorship ; it is of little use to view each separate volume in its relationship to a particular writer. The Hippocrates of tradition and the Hip- pocrates of the commentators may well be left buried in obscurity and uncertainty. What we do know, what must be our foundation stone, is that certain treatises in the Corpus are impressed with the marks of an outstanding genius, who inherited much but bequeathed much more. He stands for
XxX
GENERAL INTRODUCTION
science and against superstition and hypothetical philosophy. The other contents of the Corpus are older or later than this nucleus, either in harmony with its doctrines or opposed to them. More than this we cannot hope to know for certain,
δ 3. Means oF Datine Hippocratic Writinas.
The means of fixing the dates of the treatises composing the Hippocratic collection are twofold— external and internal,
The external evidence consists of the statements of Galen and other ancient authors.
The internal tests are :—
(a) The philosophical tenets stated or implied ; (6) The medical doctrines ;
(c) The style of the treatise ;
(d) ‘The language and grammar.
(a) When a philosophic doctrine is adopted, or referred to as influential, it is presumptive evidence that the treatise was written before that doctrine grew out of date. We cannot, however, always be sure when a doctrine did grow out of date. It is a mistaken idea to suppose that the rise of a fresh school meant the death of its predecessors. It is certain, for instance, that Heraclitus had followers, after the rise of other schools, who developed his doctrines without altering their essential character.
(6) Medical doctrines also are by no means a certain test. If we could be sure that a knowledge
VOL, I. ἘΠ Xxx)
GENERAL INTRODUCTION
of the pulse was unknown to the writers of the chief ’ Hippocratic treatises, we should be more confident in dating, e.g., the work called Nutriment, which recognizes the existence of a pulse. It is a fact that no use is made of this knowledge in any treatise of the collection, but we must not infer from this that the Hippocratic writers were ignor- ant of pulses. We can only infer that they were ignorant of their medical importance.
(c) The style of a treatise is sometimes a sure test and sometimes not. Sophistic rhetoric is of such a marked character in its most pronounced form that a treatise showing it is not likely to be much earlier than 427 B.c., nor much later than 400 z.c., when sophistic extravagances began to be modified under the influence of the Attic orators. But a work moderately sophistic in general style and sentence-structure may be much later.
There is also a subtle quality about writings later than 300 B.c.,an unnatural verbosity and tortuousness of expression, a suspicion of the “baboo,” that is as unmistakable as it is impalpable. A few of the Hippocratic treatises display this characteristic.
(d) In some respects grammar and diction are the surest tests of all. If the negative μή is markedly ousting ov it is a sure sign of post-Alexandrine date. A preference for compound words with abstract meaning, in cases where a simple expres- sion would easily have sufficed, is a mark of later Greek prose. If any reader wishes for concrete evidence to support my rather vague generalisations, he has only to read Epidemics I,, then The Art or Regimen I., and finally Precepts or Decorum, and try to note the differences.
XXxli
GENERAL INTRODUCTION
$4. Piaro’s Rererences To Hippocrates,
In the Protagoras (311 B) Plato assumes the case of a young man who goes to Ἱπποκράτη τὸν Kdov, τὸν
τῶν ᾿Ασκληπιαδῶν, to learn medicine.
This passage
tells us little except that Hippocrates took pupils
for a fee.
But in the Phaedrus (270 C
E) there is
another passage which professes to set forth the
true Hippocratic method.
Socrates. Do you think it possible, then, satis- factorily to comprehend the nature of soul apart from the nature of the universe ?
Phaedrus. Nay, if we are to believe Hippo- crates, of the Asclepiad family, we cannot learn even about the body unless we follow this method of procedure.
Socrates. Yes,my friend, and he is right. . Yet besides the doctrine of Hippocrates, we must examine our argument and see if it harmonizes
with it. Phaedrus. Yes. Socrates. Observe,
then, what it is that both Hippocrates and correct
It is as follows :—
ΣΩ. Ψυχῆς οὖν φύσιν ἀξίως λόγου κατανοῆσαι οἴει δυνατὸν εἶναι ἄνευ τῆς τοῦ ὅλου φύσεως ;
ΦΑΙ. Εἰ μὲν οὖν Ἵππο- κράτει ye τῷ τῶν ᾿Ασκλη- πιαδῶν δεῖ τι πείθεσθαι. οὐδὲ περὶ σώματος ἄνευ τῆς μεθό- δου ταύτης.
ΣΏ. Καλῶς γάρ, ὦ ἑταῖρε, λέγει. χρὴ μέντοι πρὸς τῷ c Ty: Ν ’ 38 fa Ἱπποκράτει τὸν λόγον ἐξετά- ζοντα σκοπεῖν εἰ συμφωνεῖ.
ΦΑΙ. Φημί
‘\ , 2Q. To τοίνυν περὶ φύσεως σκόπει τί ποτε
χε « ΄ὔ Ν ε eyee Ἱπποκράτης TE και ὁ
XXXill
GENERAL INTRODUCTION
argument mean by an examination of nature. Surely it is in the follow- ing way that we must in- quire into the nature of anything. In the first place we must see whether that, in which we shall wish to be craftsmen and to be able to make others so, is simple or complex. In the next place, if it be simple, we must in- quire what power nature has given it of acting, and of acting upon what ; what power of being acted upon, and by what. If on the other hand it be complex, we must enumerate its parts, and note in the case of each what we noted in the case of the simple thing, through what natural power it acts, and upon what, or through what it is acted upon, and by what.
Ν ΄ fee ἀληθὴς λόγος. ap’ οὐχ ὧδε δεῖ διανοεῖσθαι περὶ ὁτουοῦν φύσεως; πρῶτον , ε a aN ς 7 μέν, ἁπλοῦν ἢ πολυειὸές 3 e / ΄ ἐστιν, οὗ πέρι βουλησόμεθα Ss ‘ εἶναι αὐτοὶ τεχνικοὶ καὶ + Q Ν a ΝΜ ἄλλον δυνατοὶ ποιεῖν, ἔπειτα δέ, ἐὰν wn A 4 σκοπεῖν τὴν δύναμιν αὐτοῦ, ΄΄ Ν ,ὔ ,ὔ 5 Ν τίνα πρὸς τί πέφυκεν εἰς τὸ Ν “ yo Ν ’ὔ δρᾶν ἔχον ἢ τίνα εἰς τὸ πα-
XN € a 7 μὲν ἁπλοῦν Ἢ:
“ ¢€ Ν ἴω oN Ν ΄ θεῖν ὑπὸ τοῦ ; ἐὰν δὲ πλείω 5», 3, a > / εἴδη ἔχῃ, ταῦτα ἀριθμησά- Ww S99! MeL, a μένον, ὅπερ ἐφ᾽ ἑνός, TOUT 5 ἡ 3 ) ε , a , ἰδεῖν ἐφ᾽ EKGOTOV, τῷ TL “ > Ν / ΕΝ a ποιεῖν αὐτὸ πέφυκεν ἢ TW / “ ε Ν 5
τί παθεῖν ὑπὸ Tov ;—Phae-
drus 210 C, D.
It is obvious that if we could find passages in the Hippocratic collection which clearly maintain the doctrine propounded in this part of the Phaedrus we should be able to say with confidence that the
XXXIV
GENERAL INTRODUCTION
Hippocrates of history and tradition was the author of such and such a treatise.
Galen maintains that Plato refers to the treatise Nature of Man. 1 believe that few readers of the latter will notice any striking resemblances between this work! and the doctrine outlined by Plato. More plausible is the view of Littré, that Plato refers to Chapter XX of Ancient Medicine, which contains the following passage :—
ἐπεὶ τοῦτό ΑΞ pet δοκεῖ a ἀναγκαῖον ety αι παντὶ ἰητρῷ περὶ φύσιος εἰδέναι, καὶ πάνυ σπουδάσαι ὡς εἴσεται, εἴπ Se τι μέλλει τῶν δεόντων 7 ποιήσειν, ὃ τί τέ ἐστιν ἄν θρωπος πρὸς τὰ ἐσθιόμενά τε καὶ πινόμενα, καὶ ὅ τι πρὸς τὰ ἄλλα ἐπιτηδεύ- ματα, καὶ ὅ τι ἀφ᾽ ἑκάστου ἑκάστῳ συμβήσεται.
Here the resemblance is closer—close enough to show that the author of Ancient Medicine, if he be not the Hippocrates of history, at least held views similar to his. And here the question must be left. Few would maintain with Littré that the resemblance between the two passages is so striking that they must be connected; few again would deny that Plato was thinking of Antien! Medicine. Ignorance and uncertainty seem to be the final result of most of the interesting problems presented by the Hippo- cratic collection.
§ 5. Tue ComMMENTATORS AND OTHER ANCIENT AUTHORITIES,
About the time of Nero a glossary of unusual Hippocratic terms was written by Erotian, which 1 ΤῸ my mind the closest resemblances are in Chapters
VII and VIII, which deal with the relations between the ‘four humours” and the four seasons.
XXXV
GENERAL INTRODUCTION
still survives. Erotian was not the first to compose such a work, nor was he the last, the most famous of his successors being Galen. An examination of this glossary, combined with testimony derived from Galen, throws some light on the history of the Hippocratic collection. It will be well to quote a passage from Erotian’s introduction, which contains a fairly complete list of commentators.
/ cal Παρὰ ταύτην γέ τοι τὴν αἰτίαν πολλοὶ τῶν ἐλλογίμων lol / r οὐκ ἰατρῶν μόνον, ἀλλὰ Kal γραμματικῶν ἐσπούδασαν > / Νὴ A Ν Ν / SES ἊΝ , ἐξηγήσασθαι τὸν ἄνδρα καὶ τὰς λέξεις ἐπὶ τὸ κοινότερον τῆς ὁμιλίας ἀγαγεῖν. Ἐενόκριτος γὰρ ὃ Kéos, γραμ- Ν ΕΙΣ 7 ε ΄σ΄ «ε ΄, lal ματικὸς ὧν, ὡς φησιν ὃ Ταραντῖνος Ἡρακλείδης, πρῶτος > ay Ν ΄ 2¢ a ΄ ε δὲ Ni ΠΕ, ἐπεβάλετο τὰς τοιαύτας ἐξαπλοῦν φωνάς. ὡς δὲ καὶ ὃ Ν > ΄σ na Κιτιεὺς ᾿Απολλώνιος ἱστορεῖ, καὶ Καλλίμαχος ὁ ἀπὸ τῆς ε lol Lol Ηροφίλου οἰκίας. μεθ᾽ ὅν φασι τὸν Tavaypatoy Βακχεῖον ἐπιβαλεῖν τῇ πραγματείᾳ καὶ διὰ τριῶν συντάξεων πληρῶσαι τὴν προθεσμίαν, πολλὰς παραθέμενον εἰς τοῦτο μαρτυρίας ποιητῶν, ᾧ δὴ τὸν ἐμπειρικὸν συγχρονήσαντα Φιλῖνον διὰ ε ΄ ͵ > a ΄ 7 ΄ a ἐξαβίβλου πραγματείας ἀντειπεῖν, καίπερ ᾿Επικλέους τοῦ Κρητὸς ἐπιτεμομένου τὰς Βακχείου λέξεις διὰ... . συντά- ? i? a ® oS ΄ Ν ἕεων, ᾿Απολλωνίου τε TOD Οφεως ταὐτὸ ποιήσαντος, καὶ a “ a ΄ 3 Διοσκορίδου τοῦ Φακᾶ πᾶσι τούτοις ἀντειπόντος δι ἑπτὰ βιβλίων, ᾿Απολλωνίου τε τοῦ Κιτιέως ὀκτωκαίδεκα πρὸς τὰ τοῦ Ταραντίν ov τρία πρὸς Βακχεῖον διαγράψαντος, καὶ Γλαυκίου τοῦ ἐμπειρικοῦ δι᾿ ἑνὸς πολυστίχου πάνυ καὶ κατὰ στοιχεῖον πεποιημένου ταὐτὸ ἐπιτηδεύσαντος πρός τε j Λυσιμάχου τοῦ Κῴου κ' βιβλίων ἐκπονήσαντο τούτοις Λυσιμάχου τοῦ Κῴου κ βιβλίων ἐκπονήσαντος πραγματείαν μετὰ τοῦ τρία μὲν γράψαι πρὸς Κυδίαν τὸν « , Ἂς Ν Ν if ΄σ Ν lal Ηροφίλειον, τριὰ δὲ πρὸς Δημήτριον. τῶν δὲ γραμματικῶν > ” “ > ΄ \ κ \ » οὐκ ἔστιν ὅστις ἐλλόγιμος φανεὶς παρῆλθε τὸν avdpa. ‘ 32 “ , καὶ yap 6 ἀναδεξάμενος αὐτὸν Evdopiwv πᾶσαν ἐσπούδασε ΄ ͵ λέξιν ἐξηγήσασθαι διὰ βιβλίων ς΄, περὶ ὧν γεγράφασιν
XXXV1
GENERAL INTRODUCTION
᾿Αριστοκλῆς Kat ᾿Αριστέας οἱ “Pddior. ἔτι δὲ ᾿Αρίσταρχος καὶ μετὰ πάντας ᾿Αντίγονος καὶ Δίδυμος οἱ ᾿Αλεξανδρεῖς .-- ΡΡ. 4, 5 (Nachmanson).
A good account of the commentators is given by Littré, vol. I., pp. 83 [01]. Herophilus (about 300 B.c.) appears to have been the first; Bacchius his pupil edited Epidemics I1I., wrote notes on three other Hippocratic works, and compiled a glossary. A great number of short fragments of the works of Bacchius still survive. The most celebrated com- mentator, a medical man as well as a scholar, was Heraclides of Tarentum, who lived rather later than Bacchius.
Erotian in his introduction gives the following list of Hippocratic works :—
σημειωτικὰ μὲν οὖν ἐστι ταῦτα: ἸΤρογνωστικόν, ΤΙρορ- Ν ,ὔ \ Uy 6 oh 3, c , 3 4 ρητικὸν & καὶ β' (ws οὐκ ἔστιν Ἱπποκράτους, ἐν ἄλλοις δείξομεν), Περὶ χυμῶν. αἰτιολογικὰ δὲ καὶ φυσικά" Περὶ ” δ ΄ > , Nee a , ‘ φυσῶν, Περὶ φύσεως ἀνθρώπου, epi ἱερᾶς νόσου, ἹΤερὶ φύσεως παιδίου, Περὶ τόπων καὶ ὡρῶν. θεραπευτικὰ δέ τῶν μὲν εἰς χειρουργίαν ἀνηκόντων. Περὶ ἀγμῶν, Περὶ ἄρθρων, [Περὶ ἑλκῶν, Περὶ τραυμάτων καὶ βελῶν, Περὶ τῶν ἐν κεφαλῇ τραυμάτων, Κατὰ ἰητρεῖον, Μοχλικόν, Περὶ ε ., \ ’ x ΄ ΄ αἱμορροΐδων καὶ συρίγγων. εἰς δίαιταν: Περὶ νούσων a / fal Ν 3, β΄, Περὶ πτισάνης, Περὶ τόπων τῶν κατὰ ἄνθρωπον, Γυναικείων & β΄, Περὶ τροφῆς, Περὶ ἀφόρων, Περὶ ὑδάτων. > / LS a Al age εν} if / rn ἐπίμικτα δέ ἐστι ταῦτα" ᾿Αφορισμοί, ᾽᾿Ἐπιδημίαι ζ.. τῶν δ᾽ εἰς τὸν περὶ τέχνης τεινόντων λόγον Ὅρκος, Νόμος, Περὶ τέχνης, Περὶ ἀρχαίας ἰατρικῆς. Πρεσβευτικὸς γὰρ ΄, a δ κ > ,
καὶ ᾿Επιβώμιος φιλόπατριν μᾶλλον ἢ ἰατρὸν ἐμφαίνουσι τὸν ἄνδρα.---. 9 (Νομηηδηβοη).
The actual glossary, however, refers to more works than these, as will appear from the following table.
XXXVli
GENERAL INTRODUCTION LISTS OF THE HIPPOCRATIC COLLECTION
[Works known to the authors, not necessarily attributed by them to Hippocrates. ]
pivere Name. Bacchius.| Celsus. | Erotian.
] περὶ ἀρχαίης ἰητρικῇς Χ Xx περὶ ἀέρων ὑδάτων τόπων Χ x x Be προγνωστικόν.. x < x * περὶ διαίτης ὀξέων xX x x ἊΝ ἐπιδημίαι 1. 5 x x x 3 ἐπιδημίαι 3 3 x< x x 53 περὶ τῶν ἐν κεφαλῇ τραυ-
μάτων Χ Χ Χ 3 κατ᾽ intpetov . x x x 5 περὶ ἀγμῶν : 2 x x 4 περὶ apOp@y . ὦ Χ Χ Χ aA μοχλικόν x< x Se ἀφορισμοί x x x Aa ὕρκος . Η >< 55 νόμος Χ 5 ἐπιδημίαι ὃ. Ξ Χ x x ᾿ ᾿ς 4. x τ amen mite ΤῊ: x x 56 Ap Gee: Β Χ x is (ἢ Thine : x 3 περὶ χυμῶν. Χ x x - προρρητικὸν 1. XK < 5: Κωακαὶ προγνώσεις. Χ 6 περὶ τέχνης - . Χ Χ Χ ap περὶ φύσιος ἀνθρώπου ὃς Ap περὶ διαίτης ὑγιεινῆς : x be περὶ φυσῶν. : 9 x x 29 περὶ χρήσιος ὑγρῶν. : x x » περὶ νούσων 1 ὃ Χ x X 50 περὶ παθῶν Χ Ἢ περὶ τόπων τῶν KAT
ἄνθρωπον . ὦ x x = περὶ ἱερῆς νούσου . x x ne περὶ ἑλκῶν . Ξ Χ an περὶ αἱμορροΐδων . x 33 περὶ συρίγγων 5 : x Xx
XXXVili
32 3) 3) 9 ” 3») ” 3. 3) 99 ΕΣ
39
70
GENERAL INTRODUCTION
Name. περὶ διαίτης 1 : 8 Ω ΕΣ] — e “ 7} Ὁ 5 περὶ ἐνυπνίων. περὶ νούσων 2 .
, ΄ περὶ νούσων 3. 5 περὶ τῶν ἔντος παθῶν i¢ , περὶ γυναικείης φύσιος
περὶ ἑπταμήνου 5 περὶ ὀκταμήνου : περὶ γονῆς . ς : περὶ φύσιος παιδίου . περὶ νούσων 4 ᾿ Ε
περὶ γυναικείων 1 and 2 περὶ apdpwy περὶ παρθενίων . περὶ ἐπικυήσιος ς ‘ περὶ ἐγκατατομῆς ἐμβρύου περὶ ἀνατομῆ"
δὺ 9. ah περὶ ὀδοντοφυΐης .
περὶ ἀδένων. ὃ ᾿ περὶ σάρκων. - : περὶ ἑβδομάδων Ξ προρρητικὸν 2, .
περὶ καρδίης. τ περὶ τροφῆς - . περὶ ὄψιος : A περὶ ὀστέων φύσιος. περὶ ἰητροῦ : περὶ εὐσχημοσύνης.
παραγγελίαι
περὶ κρισίων. . περὶ κρισίμων.. . ἐπιστολαί : . πρεσβευτικός . ἐπιβώμιος 5 :
Bacchius, ᾿
Celsus. | Erotian.
x X
xX xx xX
xX
xX xX
x xX
X X
xX xx
23?
25
49
Erotian knew also περὶ τραυμάτων καὶ βελῶν, now lost. — The double X X means “‘ by quotation, but not in the list.”
XXKLX
GENERAL. INTRODUCTION
N.B.—The list of Bacchius is made by noting where in the Hippocratic collection occur the strange words upon which he commented; that of Celsus by a comparison of similar passages; that of Erotian from his list, by noting where occur the γλῶσσαι explained by him, and from fragments in scholia (see E. Nachmanson’s edition, pp. 99 foll.). Of course the list of Celsus is dubious from its nature, and Bacchius may have known many more treatises than those we are sure he did know.
The recently discovered history of medicine called Menon’s Jatrica! contains several references to Hippocrates. Diels is of opinion that they are very erroneous.”
In § V. the writer says that according to Hippo- crates diseases are caused by “airs” (φῦσαι), a state- ment which seems to be taken from περὶ φυσών, VE 98 foll. Littré, and the doctrine is described in §§ V. and VI. In §VII. Hippocrates is said to hold doctrines which are taken from Nature of Man, VI. 52 foll. Littré. In ὃ VIII. occur references to Places in Man, VI. 276, 294 Littré, and Glands, VIII. 564 Littré. In ὃ XIX. occur references to Nature of Man, VI. 38 Littré, but the physician named is Polybus.
Galen
Galen is the most important of the ancient com- mentators on Hippocrates, and of his work a great part has survived.
1 Edited by H. Diels, Berlin, 1893. The work was probably written by a pupil of Aristotle.
2 See Diels, p. xvi, note 1, and in Hermes XXVIII., pp. 410 foll.
xl
GENERAL INTRODUCTION
His writings are of value for two reasons :—
(1) They often give us a text superior to that of the MSS. of the Corpus. Sometimes this text is actually given in Galen’s quotations; sometimes it is implied in Galen’s commentary.
(2) They sometimes throw light upon the inter- pretation of obscure passages.
Galen’s ideal of a commentator is beyond criticism. He prefers ancient readings, even when they are the more difficult, and corrects only when these give no possible sense. In commenting he is of opinion that he should first determine the sense of the text and then see whether it corresponds with the truth.?
Unfortunately he is not so successful when he attempts to put his ideal into practice. He is in- tolerably verbose, and what is worse, he is eager so to interpret Hippocrates as to gain support there- from for his own theories. A good example of this fault is his misinterpretation of Epidemics 111. xiv. Littré gives as another fault his neglect of observa- tion and observed fact.
Galen wrote commentaries, which still survive, on the following :—
Nature of Man. \ One book in ancient Regimen of People in Health. [ times. Regimen in Acute Diseases.
Prognostic.
Prorrhetic I.
Aphorisms.
1 On the value of Galen for a reconstruction of the text see especially I. Ilberg in the Proleyomena to Kiihlewein’s edition Vol. I., pp. xxxiv—xlix and lviii-Ixii.
2 See Littré I. 120, 121. or 191]:
xli
GENERAL INTRODUCTION Epidemics I., 11. II., VI.
Fractures.
Articulations.
Surgery.
Humours.+
Nutriment.+
Airs, Waters, Places (only fragments survive).
We also have his G/ossary.
Commentaries on the following are altogether lost :—
Sores.
Wounds in the Head.
Diseases.
A ffections.
He also wrote (or promised to write) the following, none of which survive:—Anatomy of Hippocrates, Characters in Epidemics {{1., Dialect of Hippocrates, The Genuine Writings of the Physician of Cos.
Galen also knew: Coan Prenotions, Epilepsy, Fis- tulae, Hemorrhoids, Airs, Places in Man, Regimen, Seven Months’ Child, Eight Months’ Child, Heart, Fleshes, Number Seven, Prorrhetic II., Glands, and probably Precepts.
The most important of the Hippocratic treatises not mentioned by Galen are Ancient Medicine and The Art.
§ 6. Lire or Hippocrates.
We possess three ancient biographies of Hippo- crates: one by Suidas, one by Tzetzes, and one by Soranus, a late writer of uncertain date.
1 These are supposed by the latest criticism not to be genuine.
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GENERAL INTRODUCTION
From these we gather that Hippocrates was born in Cos in 460 8.6. ; 1 that he belonged to the guild of physicians called Asclepiadae; that his father was Heraclides, and his teachers were Herodicus and his own father; that he travelled all over Greece, and was a great friend of Democritus of Abdera; that his help was sought by Perdiccas king of Mace- donia and by Artaxerxes king of Persia; that he stayed the plague at Athens and in other places; that his life was a long one but of uncertain length, the traditions making him live 85, 90, 104 or 109 years.
In these accounts there is a certain amount of fable, but in the broad outline there is nothing improbable except the staying of the Athenian plague, which is directly contrary to the testimony of Thucydides, who expressly states that medical help was generally unsuccessful.
The Epistles in the Hippocratic collection, and the so-called Decree of the Athenians, merely give, with fuller picturesqueness of detail, the same sort of information as is contained in the biographies.
Plato refers to Hippocrates in two dialogues— the Protagoras? and the Phaedrus.2 The former passage tells us that Hippocrates was a Coan, an Asclepiad, and a professional trainer of medical students; the latter states as a fundamental principle of Hippocratic physiology the dogma that an under- standing of the body is impossible without an understanding of nature as a whole, in modern
1 Aulus Gellius Δι 4. XVII. 21 says that he was older than Socrates. This statement, if true, would put his birth prior to 470 B.c.
2 311 B,C. 8 270 C-E.
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GENERAL INTRODUCTION
language, physiology is inseparable from physics and chemistry.
From Aristotle! we learn that Hippocrates was already known as “ the Great Hippocrates.”
Such is the ancient account of Hippocrates, a name without writings, as Wilamowitz says. There is no quotation from any treatise in the Corpus before Aristotle,? and he assigns as the author not Hippo- crates but Polybus. The Phaedrus passage, indeed, has been recognized by Littré as a reference to Ancient Medicine, but Galen is positive that it refers to Nature of Man.
In fact the connexion between the great physician and the collection of writings which bears his name cannot with any confidence be carried further back than Ctesias the Cnidian,* Diocles of Carystus® and Menon,® the writer of the recently discovered Jatrica. Ctesias and Diocles belong to the earlier half of the fourth century, and Menon was a pupil of Aristotle.
§ 7. THe AscLEPIADAE,
Hippocrates was, according to Plato, an Asclepiad. This raises the very difficult question, who the Asclepiadae were. [05 difficulty is typical of several
1 Politics, VII. 4 (1326 a).
2 Who quotes from Nature of Man.
3 See Littré VI. 58 and Aristotle Hist. Animal. 111. 3 (512 b), and compare Galen XV. 11.
4 Ctesias appears to have known the treatise Articulations, Littré 1. 70.
> Diocles criticises Aphorisms 11. 33. See Dietz Scholia in Hippocratem et Galenum 11. 326, and Littré I. 321-323.
6 Menon refers to Airs (περὶ φυσῶν), Nature of Man, Places in Man, and Glands, Hippocrates being expressly connected with the first two.
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ΠΟΘΈΝΕΒΑΙ, INTRODUCTION
Hippocratic problems. Certainty, even approximate certainty, is impossible owing to the scantiness of the evidence.
The old view, discarded now by the most com- petent authorities, is that the Asclepiadae were the priests of the temples of Asclepius, combining the functions of priest and physician. This view implied that Hippocratic medicine had its origin in temple- practice. For a thorough refutation of it see Dr. E. T. Withington’s excursus in my Malaria and Greek History and his own book Medical History from the Earliest Times.”
Another view is that the Asclepiadae were a guild, supposed to have been founded by Asclepius, the members of which were bound by rules and swore the Hippocratic “Oath.” Such is the view of Dr. Withington himself. It is one which is free from all intrinsic objections, but it is supported by the scantiest of positive evidence.
It should be noticed that the term “ Asclepiadae”’ means literally “the family of Asclepius,”’ and it is at least possible that the Asclepiads were a clan of hereditary physicians who claimed to be descended from Asclepius. It would be very easy for such a family to develop into something like a guild by the admission, or rather adoption, of favoured outsiders. In this way the term might readily acquire the general meaning of medical practitioner, which it apparently has in 6. σ. Theognis 492 :—
εἰ δ᾽ ᾿Ασκληπιάδαις τοῦτό γ᾽ ἔδωκε θεός, ἰᾶσθαι κακότητα καὶ ἀτηρὰς φρένας ἀνδρῶν, πολλοὺς ἂν μισθοὺς καὶ μεγάλους ἔφερον.
pp. 137-156. > pp. 45, 46 and 378. xlv
GENERAL INTRODUCTION —
I do not think that it has been noticed what an interesting parallel is afforded by the term “ Homer- idae.”” A family of poets tracing their descent from Homer finally could give their name to any public reciter of the Homeric poems.!
§ 8. THe Docrrine or Humours.
The doctrine of the humours probably had _ its origin? in superficial deductions from obvious facts of physiology, but it was strongly coloured by philo- sophie speculation, in particular by the doctrine of opposites. Indeed it is impossible to keep distinct the various influences which acted and reacted upon one another in the spheres of philosophy and medicine; only the main tendencies can be clearly distinguished.
Even the most superficial observer must notice (a) that the animal body requires air, fluid, and solid food; (6) that too great heat and cold are fatal to life, and that very many diseases are attended by fever; (c) that fluid is a necessary factor in digestion ;% (d) that blood is in a peculiar way connected with life and health.
These simple observations were reinforced by the speculations of philosophers, particularly when philo- sophy took a biological or physiological turn, and
1 See e.g. Pindar, Nemeans II. 1.
2 It is supposed by some that the humoral pathology originated in Egypt. See Sir Clifford Allbutt, Greek Medicine in Rome, p. 133.
3 See Nutriment LV.: ὑγρασίη τροφῆς ὄχημα. See also Diseases IV., Littré VII. 568: τὸ σῶμα .. . ἀπὸ τῶν βρωτῶν καὶ τῶν ποτῶν τῆς ἰκμάδος ἐπαυρίσκεται,
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GENERAL INTRODUCTION
became interested in the organs of man and their functions.!
The second of the Greek philosophers, Anaxi- mander,” taught that creation was made up of “opposites,” though it is not clear how many he conceived these opposites to be. Many later thinkers, working on lines similar to those of Anaximander, made them four in number—the hot, the cold, the moist and the dry. These were the essential qualities of the four elements, fire, air, water, earth.
There was, however, no uniformity among thinkers as to the number of the opposites, and Alemaeon, a younger contemporary of Pythagoras and a native of Croton, postulated an indefinite number. Alemaeon was a physician rather than a philosopher, and asserted that health was an ἰσονομία of these opposites and disease a μοναρχία of one.4 This doctrine had a
1 Empedocles, Philistion and Pausanias were the chief pioneers in this union of philosophy with medicine which the writer of Ancient Medicine so much deplores. See Burnet, Early Greek Philosophy, pp. 234, 235 (also Galen X. 5, of ἐκ τῆς Ἰταλίας ἰατροὶ Φιλιστίων τε καὶ EumedoxAjjs καὶ Παυσανίας καὶ οἱ τούτων ἑταῖροι.)
2 He was also interested in biology. See Burnet, pp. 72, 73.
3 Aristotle Meta. A 986a 31: φησὶ γὰρ εἶναι δύο τὰ πολλὰ τῶν ἀνθρωπίνων, λέγων τὰς ἐναντιότητας οὐχ ὥσπερ οὗτοι 56. of Πυθαγόρειοι] διωρισμένας ἀλλὰ τὰς τυχούσας, οἷον λευκὸν μέλαν, γλυκύ πικρόν, ἀγαθὸν κακόν, μέγα μικρόν.
4 Aétius V. 80. 1, and Galen (Kiihn) XIX. 343: ᾿Αλκμαίων τῆς μὲν ὑγείας εἶναι συνεκτικὴν ἰσονομίαν τῶν δυνάμεων ὑγροῦ, θερμοῦ, ξηροῦ, ψυχροῦ, πικροῦ, γλυκέος καὶ τῶν λοιπῶν, τὴν δὲ ἐν αὐτοῖς μοναρχίαν νόσου ποιητικήν. See also 344: τὴν δὲ ὑγείαν σύμμετρον τῶν ποιῶν τὴν κρᾶσιν. It would be interesting if the technical word κρᾶσις could be traced back to Alemaeon himself.
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strong influence upon the Coan school of medicine, and indeed upon medical theory generally.
But the opposites are not χυμοί: they are only δυνάμεις. The humoral pathology was not fully developed until for δυνάμεις were substituted fluid substances.! In tracing this development the historian is much helped by Ancient Medicine. ΤῈ is here insisted that the hot, the cold, the moist and the dry are not substances; they are only ‘‘ powers,” and, what is more, powers of merely secondary importance.?_ The body, it is maintained, has certain essential χυμοί, which χυμοί have properties or “powers” with greater influence upon health than temperature. The number of the χυμοί is left indefinite. If the body be composed of opposite humours, and if health be the harmonious mixture or blending (κρᾶσις) of them, we shall expect to see one or other “lording it over the others” (μοναρχία) in a state of disease. .
The two commonest complaints in ancient Greece, chest troubles and malaria, suggested as chief of these humours four: phlegm, blood (suggested by hemorrhage in fevers), yellow bile and black bile (suggested by the vomits, etc., in remittent malaria),
That the humours are four is first clearly stated in Nature of Man, which Aristotle assigns to Polybus, though Menon quotes a portion of it as Hippocratic. . The passage in question runs: τὸ δὲ σῶμα τοῦ ἀνθρώπου
1 It is a pity that the treatise Humours tells us so little about the humours themselves. It is merely a series of notes for lectures, heads of discowrse to medical students.
2 See especially Chapters XIV-XVII, in particular XVIL: GAA ἔστι καὶ πικρὺν καὶ θερμὸν τὸ αὐτό, καὶ ὀξὺ καὶ θερμόν, καὶ ἁλμυρὸν καὶ θερμόν . .. τὰ μὲν οὖν λυμαινόμενα ταῦτ᾽ ἐστί.
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GENERAL INTRODUCTION
ἔχει ἐν ἑωυτῷ αἷμα καὶ φλέγμα καὶ χολὴν ξανθήν τε καὶ μέλαιναν, καὶ ταῦτα ἐστὶν αὐτῷ ἡ φύσις ΝΟΣ ὑγιαίνει μὲν οὖν μάλιστα ὁκόταν μετρίως ἔχῃ ταῦτα τῆς πρὸς ἄλληλα κρήσιος καὶ δυνάμιος καὶ τοῦ πλήθεος, καὶ μάλιστα μεμιγς- μένα ἢ κιτιλ. (Littré VI. 38 and 40).
Some thinkers, belonging to the school of Empe- docles, and being more inclined towards philosophy than towards medicine, made the four chief oppo- sites, materialized into fire, air, water and earth, the components of the body, and disease, or at any rate some of the chief diseases, an excess of one or other. We see this doctrine fairly plainly in Menon’s account of Philistion,! and it is copied by Plato in the Timaeus.?
The doctrines I have described admitted many variations, and in Menon’s Jairica, which is chiefly an account of the origins of disease as given by various physicians, the most diverse views are set forth, Petron of Aegina, while holding that the body is composed of the four opposites, stated that disease was due to faulty diet, and that bile was the result and not the cause of disease. Hippon thought that a suitable quantity of moisture was the cause of health; 4 Philolaus that disease was due to bile, blood and phlegm ;° Thrasymachus of Sardis that blood, differentiated by excess of cold or heat into phlegm, bile, or τὸ σεσηπός (matter or pus), was
1 Jatrica XX.: φιλιστίων δ᾽ οἴεται ἐκ 5 ἰδεῶν συνεστάναι ἡμᾶς, τοῦτ᾽ ἔστιν ἐκ 5 στοιχείων: πυρός, ἀέρος, ὕδατος, γῆς. εἶναι δὲ καὶ ἑκάστου δυνάμεις, τοῦ μὲν πυρὺς τὸ θερμόν, τοῦ δὲ ἀέρος τὸ ψυχρόν K.T.A.
2.80 A: τὸ μὲν οὖν ἐκ πυρὸς ὑπερβολῆς μάλιστα νοσῆσαν σῶμα ξυνεχῆ καύματα καὶ πυρετοὺς ἀπεργάζεται, τὸ δ᾽ ἐξ ἀέρος ἀμφημερινούς K.T.A.
δὲ Tatrica, XX. 4 ibid., XI. δ᾽ Toid.; X VAIL.
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GENERAL INTRODUCTION
the cause ; 1 Menecrates that the body is composed of blood, bile, breath and phlegm, and that health is a harmony of these.?
The Hippocratic collection shows similar diver- sity of opinion. Diseases IV. 51, gives as the four humours bile, blood, phlegm and ὕδρωψ (not water, but a watery humour).? Affections I. ascribes all diseases to bile and phlegm.* Ancient Medicine recognizes an indefinite number of humours.
The great Hippocratic group imply the doctrine of humours in its phraseology and outlook on symptoms, but it is in the background, and nowhere are the humours described. It is clear, however, that bile and phlegm are the most prominent, and bilious and phlegmatic temperaments are often mentioned in dirs Waters Places and Epidemics 1. and ///. There are signs of subdivision in πικρό- χοόλοι ὃ and λευκοφλεγματίαι."
Amid all these differences, which by their very variety indicate that they belonged to theory with- out seriously affecting practice, there is one common principle—that health is a harmonious mingling of the constituents of the body. What these constitu- ents are is not agreed, nor is it clear what exactly is meant by “ mingling.”
The word ἄκρητος, which I have translated “un- mixed” or “uncompounded,” is said by Galen to mean “consisting of one humour only.” It is more
1 Tatrica, XI. (end).
2 Tbid., XIX.
3 Littré VII. 584.
4 Tbid., VI. 208.
5 Regimen in Acute Diseases, XXXIII.: of πικρόχολοι τὰ
ἄνω: Epidemics 111. xtv. (end). § Epidemics 111. χιν.
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GENERAL INTRODUCTION
likely that the word means properly “ showing signs that crasis has not taken place.”
Coction
The course of our inquiry has brought us to the doctrine of “coction” (πέψις). Familiar as ἃ modern is with the difference between chemical blending and mechanical mixture, it is difficult for him to appreciate fairly theories put forward when this difference was unknown, and the human mind was struggling with phenomena it had not the power to analyse, and trying to express what was really beyond its reach. We must try to see things as the Greek physician saw them.
We have in Chapters XVIII and XIX of Ancient Medicine the most complete account of coction as the ancient physician conceived of it. It is really the process which leads to κρᾶσις as its result. It is neither purely mechanical nor yet what we should call chemical ; it is the action which so combines the opposing humours that there results a perfect fusion of them all. No one is left in excess so as _ to cause trouble or pain to the human individual. The writer takes three types of illnesses—the common cold, ophthalmia and pneumonia—and shows that as they grow better the discharges become less acrid and thicker as the result of πέψις.
In one respect the writer of Ancient Medicine is not a trustworthy guide to the common conception of πέψις. He attached but little importance to heat, and it can scarcely be doubted that the action of heat upon the digestibility of foods, and the heat which accompanies the process of digestion itself,
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GENERAL INTRODUCTION
must have coloured the notion of πέψις as generally held. It is true that we read little about innate heat in the Hippocratic collection, but that is an accident, and it certainly was thought to have a powerful influence upon the bodily functions.+
A disease was supposed to result when the equili- brium of the humours, from some “ exciting cause” or other (πρόφασις), was disturbed, and then nature, that is the constitution of the individual. (φύσις), made every effort she could through coction to restore the necessary κρᾶσις.
Crisis
The battle between nature and the disease was decided on the day that coction actually took place or failed to take place. The result was recovery, partial or complete, aggravation of the disease, or death. The crisis (κρίσις) is “the determination of the disease as it were by a judicial verdict.” ?
After a crisis there might, or might not, be a relapse (ὑποστροφή), which would be followed in due course by another crisis.
The crisis, if favourable, was accompanied by the expulsion of the residue remaining after coction and κρᾶσις of the humours had occurred. ‘This expul-
1 See Aphvrisms, ὃ 1. 14: τὰ αὐξανόμενα πλεῖστον ἔχει τὸ ἔμφυτον θερμόν: πλείστης οὖν δεῖται τροφῆς" εἰ δὲ μή, τὸ σῶμα ἀναλίσκεται κ.τ.λ.
2. See Dr. E. T. Withington, Classical Review, May-June 1920, p. 65. There is a good definition of κρίσις in A ffec- tions VIII. (Littré VI. 216): κρίνεσθαι δέ ἐστιν ἐν ταῖς νούσοις, ὅταν αὔξωνται αἱ νοῦσοι ἢ μαραίνωνται ἢ μεταπίπτωσιν ἐς ἕτερον νόσημα ἢ τελεντῶσιν.
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GENERAL INTRODUCTION
sion might take place through any of the ordinary means of evacuation—mouth, bowels, urine, pores— and the evacuated matters were said to be concocted (πέπονα), that is to say, they presented signs that coction had taken place.
But nature was not always able to use the ordinary means of evacuation. In this case there would be an abscession (ἀπόστασις). When the morbid residue failed to be normally evacuated, it was gathered together to one part of the body and eliminated, sometimes as an eruption or inflamma- tion, sometimes as a gangrene or tumour, sometimes as a swelling at the joints.
An abscession did not necessarily mean recovery ; it might merely be a change from one disease to another. The Hippocratic writers are not clear about the point, but apparently the abscession might fail to accomplish its purpose, and so the disease continued in an altered form.? In other words there was abscession without real crisis.
To trace the course of a disease through its various stages, and to be able to see what is portended by symptoms in different diseases and at different stages of those diseases, was an art upon which Hippocrates laid great stress. He called it πρόγνωσις, and it included at least half of the physician’s work.
1 The chief signs οὗ soction were greater consistency, darker.colour,.and ‘ripeness ” or ‘‘ mellowness.’
2 The most important era are:
(a) οὐδὲ yap αἱ γιγνόμεναι τούτοις ἀποστάσιες ἔκρινον ὥσπερ ἐπὶ τοῖς ἄλλοις (Epidemics 11: Ἐτε:):
(b) ἀποστάσιες ἐγένοντο, ἢ μέζους ὥστε ὑποφέρειν μὴ δύνασθαι, ἢ μείους ὥστε μηδὲν ὠφελεῖν ἀλλὰ ταχὺ παλινδρομεῖν K.T.A.
(Epidemics I. ντπ..).
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GENERAL INTRODUCTION Critical Days
Crises took place on what were called critical days. It is a commonplace that a disease tends to reach a crisis on a fixed day from the commencement, although the day is not absolutely fixed, nor is it the same for all diseases. The writer of Prognostic and Epidemics I. lays it down as a general law that acute diseases have crises on one or more fixed days in a series.
In Prognostic Chapter XX the series for fevers is given thus :—4th day, 7th, llth, 14th, 17th, 20th, 34th, 40th, 60th.
In Epidemics I. xxvi. two series are given :—
(a) diseases which have exacerbations on even days have crises on these even days: 4th, 6th, 8th, 10th, 14th, 20th, 24th, 30th, 40th, 60th, 80th, 120th.
(6) diseases which have exacerbations on odd days have crises on these odd days: 3rd, 5th, 7th, 9th, Lith, 17th, 21st, 27th, 31st.
A crisis on any other than a normal day was supposed to indicate a probably fatal relapse.
Galen thought that Hippocrates was the first to discuss the critical days, and there is no evidence against this view, though it seems more likely that it gradually grew up in the Coan school.!
What was the origin of this doctrine? Possibly it may in part be a survival of Pythagorean magic, numbers being supposed to have mystical powers, which affected medicine through the Sicilian-Italian
1 On the other hand, critical days are not discussed at all in Coan Prenotions, the supposed repository of pre-Hippocratic Coan medicine.
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GENERAL INTRODUCTION
school. But a man so free from superstition as the author of Epidemics [. was unlikely to be influenced by mysticism, particularly by a mysticism which left his contemporaries apparently untouched. More probably there is an effort to express a medical truth. In malarious countries, all diseases, and not malaria only, tend to grow more severe periodically ; latent malaria, in fact, colours all other complaints. May it not be that severe exacerbations and normal crises were sometimes confused by Hippocrates, or perhaps a series of malarial exacerbations attracted the crisis to one of the days composing it? The sentence in Epidemics I. xxvi. is very definitely to the effect that when exacerbations are on even days, crises are on even days; when exacerbations are on odd days, crises are on odd days. Evidently the critical days are not entirely independent of the periodicity of malaria.
§ 9. Curer Diseases MENTIONED IN THE HippocraTICc COLLECTION.
Diseases were classified by ancient physicians according to their symptoms; they are now classified according to the micro-organisms which cause them. Accordingly it often happens that no exact equivalent in Greek corresponds to an English medical term and vice versa. The name of a Greek disease denotes merely a syndrome of symptoms.
Perhaps the most remarkable point arising in a discussion of Greek diseases is the apparent absence of most infectious fevers. Plagues, vaguely referred to by the term λοιμός, occurred at intervals, but the
1 For the common Greek conception of λοιμός see pseudo-
Aristotle Problems I. 7. lv
GENERAL INTRODUCTION
medical writings in the Hippocratic collection are occupied almost entirely with endemic disease and do not describe plagues, not even the great plague at Athens. There is no mention of smallpox or measles; no certain reference occurs to diphtheria, scarlet fever, bubonic plague or syphilis. It is extremely doubtful whether typhoid was present in Greece, for although it is similar to severe cases of καῦσος and φρενῖτις, the latter were certainly in most cases pernicious malaria, which is often so like typhoid that only the microscope can distinguish them. It is expressly stated by pseudo-Aristotle ! that fevers were not infectious, and it is difficult to reconcile this statement with the prevalence of typhoid. The question must be left open, as the evidence is not clear enough to warrant a confident decision.?
Colds, “ with and without fever,’ * were common enough in ancient times, but whether influenza prevailed cannot be stated for certain. Its all too frequent result, pneumonia, was indeed well known, but it is puzzling that in the description of epidemic cough at Perinthus,? the nearest approach to an influenza wave in the Hippocratic collection, it is expressly stated that relapses into pneumonia were rare,®
Consumption (φθίσις) is one of the diseases most frequently mentioned in the Corpus, and it is re- markable that in the very passage where we are told
1 Problems, VII. 8.
* See Stéphanos, La Gréce, p 502.
2 See Epidemics IV., Littré V., p. 149. * Epidemics VI., Littré, pp. 331-337. > Loc. ctt., p. 8.59.
GENERAL INTRODUCTION
that fevers are not infectious it is also stated that consumption is so, ‘To consumption are added * ophthalmias,” which term will therefore include all contagious inflammations of the eyes.!
The greatest plague of the Greek and of the ancient world generally was malaria, both mild and malignant, both intermittent and remittent.
The intermittents (διαλείποντες πυρετοί) are :—
ἀμφημερινὸς πυρετός (quotidians) τριταῖος πυρετός (tertians) τεταρταῖος πυρετός (quartans) ?
The remittents (often συνεχεῖς πυρετοῖί) included :—
καῦσος, so called because of the intense heat felt by the patient, a remittent tertian often mentioned in the Corpus.
φρενῖτις, characterized by pain in the hypo- chondria and by delirium. It generally had a tertian periodicity.
λήθαργος, characterized by irresistible coma. It bore a strong likeness to what is now known as the comatose form of pernicious malaria.
ἡμιτριταῖος, semitertian, was pernicious remittent malaria with tertian periodicity.®
τῦφος or tidos, of which five different kinds are mentioned in the Cnidian treatise περὶ τῶν ἐντὸς παθῶν
1 Pseudo-Aristotle Problems VII. 8: διὰ τί ἀπὸ φθίσεως καὶ ὀφθαλμίας καὶ Papas of πλησιάζοντες ἁλίσκονται: ἀπὸ δὲ ὕδρωπος καὶ πυρετῶν καὶ ἀποπληξίας οὐχ ἁλίσκονται, οὐδὲ τῶν ἄλλων ;
2 See e.g. Epidemics I. Χχιν., where quintans, septans and nonans also are mentioned. In the fourth century the existence of these fevers was denied.
3 | have discussed these diseases more fully in my Malaria and Greek History, pp. 63-68.
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GENERAL INTRODUCTION
(Littré VII. 260 foll.), was in at least two cases a species of remittent malaria.
In connexion with the question of malaria it should be noticed that malarial cachexia, the symptoms of which are anaemia, weakness, dark complexion and enlarged spleen, is often described in the Hippocratic collection. Especially vivid is the description in Airs Waters Places. This is further evidence of the malarious condition of the ancient Greek world.
μελαγχολία
This word is closely connected both with the doctrine of the humours and with the prevalence of malaria. It is fully discussed in Malaria and Greek History, pp. 98-101. Generally it means our * melancholia,” but sometimes merely “ biliousness.” In popular speech μελαγχολία and its cognates some- times approximate in meaning to “nervous break- down.” Probably the name was given to any condition resembling the prostration, physical and mental, produced by malaria, one form of which (the quartan) was supposed to be caused by “ black bile”’ (μέλαινα χολή).
> 72 ἐρυσίπελας
See Foes’ Oeconomia, p. 148, where quotations are given which enable us to distinguish ἐρυσίπελας from φλεγμονή. Both exhibit swelling (ὄγκος) and heat (θερμασία), but whereas ἐρυσίπελας is superficial and yellowish, φλεγμονή is internal also and red.
διάρροια and δυσεντερία
The former is local, and causes merely the passing of unhealthy excreta. The latter is accompanied by
lviii
GENERAL INTRODUCTION
fever, and is a dangerous disease, in which the bowel is ulcerated, with the passing of blood. See περὶ παθῶν 23 and 25 (Littré VI. 234, 235), and more especially περὶ διαίτης 74 (Littré IV. 616) :—
τοῦτο γὰρ (διάρροια) ὀνομάζεται ἕως ἂν αὐτὴ μόνη σαπεῖσα ἣ τροφὴ ὑποχωρῇ. ὁκόταν δὲ θερμαινομένου τοῦ σώματος κάθαρσις δριμέα γένηται, τό τε ἔντερον ἕύεται καὶ ἑλκοῦται καὶ διαχωρεῖται αἱματώδεα, τοῦτο δὲ δυ- σεντερίη καλεῖται, νόσος χαλεπὴ καὶ ἐπικίνδυνος.
“Dysentery”’ would include what is now called by this name and any severe intestinal trouble, perhaps typhoid and paratyphoid if these were diseases of the Greek world, while “ diarrhoea”’ means merely undue laxity of the bowels.
Delirium
The Hippocratic collection is rich in words meaning delirium of various kinds. It is probable, if not certain, that each of them had its own associations and its own shade of meaning, but these are now to a great extent lost. Only the broad outlines of the differences between them can be discerned by the modern reader. ‘The words fall into two main classes :—
(1) Those in which the mental derangement of delirium is the dominant idea; e.g. παραφέρομαι, παραφρονῶ (the word common in Prognostic), παρανοῶ, mapaxoovw (the most common word in Epidemics J. and 711.), παρακοπή, ἐκμαίνομαι, μανία.
(2) Those in which stress is laid upon delirious talk ; e. g. λῆρος, παράληρος, παραληρῶ, παραλέγω, λόγοι πολλοί.
lix
GENERAL INTRODUCTION
It is more difficult to say exactly which words in each class signify the greater degree of delirium. Of class (1) ἐκμαίνομαι is obviously the most vigorous word, meaning “ wild raving,” μανία comes next to it, and παρακοπή is apparently slightly stronger than the others. Of class (2) λῆρος or παράληρος seems to be the strongest, then zapadéyw, and finally λόγοι πολλοί.
Pain
There are two common words for pain in the Corpus, πόνος and ὀδύνη. They seem practically synonymous. Perhaps πόνος is more commonly used of violent pains, and ὀδύνη of dull, gnawing pains, but I think that no reader would care to pronounce a confident opinion on the matter.
Ague
There are two words commonly used to describe the chilly feeling experienced in fevers, especially in malarial fevers. These are (a) ῥῖγος and its deriv- atives, and (6) φρίκη and its derivatives. The former lays stress upon the chilly feeling, the latter upon the shivering accompanying it. But in this case also it is possible to discriminate too finely; see e.g. in Epidemics 111. Case 11. (second series), φρικώδης is followed by μετὰ τὸ γενόμενον ῥῖγος, referring ap- parently to the same occasion.
The reader should note the extreme care with which symptoms are described in the Hippocratic group of treatises. It has been pointed out, for instance, that in Epidemics I. Case 1., and Epidemics III. Case xv. (second series), there are possibly
Ix
GENERAL INTRODUCTION
instances of Cheyne-Stokes breathing. Noticed by the writer of these works, this important sy mptom was overlooked until the eighteenth century.
§ 10. πολύς AND ὀλίγος IN THE PLURAL.
It is at least curious that one of the translator's greatest difficulties is to decide what are the meanings of πολύς and ὀλίγος (also of σμικρά) when used in the plural. The reader is at first sight inclined to think that ῥεύματα πολλά (Epidemics 111]. tv.) means “many fluxes,” and so possibly it may. But just above we have ῥεῦμα πολύ, ‘a copious flux,” and so the plural may well mean “ copious fluxes.” The ambiguity becomes more serious when the words are applied to the excreta. Is frequency or quantity the more dominant idea? It seems im- possible to say for certain, but the evidence tends towards the latter view. From Prognostic Chapter XI it seems that quantity is the more important thing, and in the same passage πυκνόν is the word used to denote frequency. The usage in Epidemics I, and 111. bears out this view. “ Frequently shivering” is φρικώδεες πυκνά (pid. III. xi.). In the same chapter occurs the sentence, ai δὲ βῆχες ἐνῆσαν μὲν διὰ τέλεος πολλαί, καὶ πολλὰ ἀνάγουσαι πέπονα, where πολλαί means “many’’ and πολλά “copious.” In Epid. ILL. Case 11. (second series) βῆχες συνεχέες typai πολλαί means “continued coughing with watery and copious sputa.”” In Case 1x. of the same series “ frequent, slight epistaxis” is ἡμορράγει . . . . πυκνὰ κατ᾽ ὀλίγον. After long consideration of this difficult question 1 conelude that πολύς and ὀλίγος in the plural, when
]xi
GENERAL INTRODUCTION
used of excreta, etc., should be translated “ copious ”’ or “abundant” unless the context makes the other meaning absolutely necessary.
The case is somewhat similar with the word σμικρά. Used adverbially this word means “slightly,” “a little,’ more often than it does “ in small quantities.” σμικρὰ κατενόει is almost certainly “lucid intervals,” and σμικρὰ ἐκοιμήθη is “snatches of sleep,” but I do not feel sure that σμικρὰ παρέκρουσε Means more than “slight delirium,’ nor σμικρὰ ἐπύρεξε (Epid. III. xm.) more than “ slightly feverish.”
§ 11. THe Ionic Diatecr or THE Hippocratic COLLECTION.
The later MSS. of the Corpus exhibit a mass of pseudo-ionic forms which are not to be found, or are only rarely found, in the earlier MSS. The uncon- tracted forms, too, are more common in the later authorities. If we follow closely the earlier MSS. we have a text which is very like Attic, with a mild sprinkling of Ionic forms. These facts seem to show that, when Ionic became the medium of scientific prose, it lost touch gradually with the spoken speech and assimilated itself to the predominant Attic, and later on possibly to the κοινή. It retained just enough Ionic to keep up the tradition and to conform to convention. The later scribes, under the mistaken impression that the texts before them had been atticized, restored what they considered to be the ancient forms, often with disastrous results. Many of their ionisms are sheer monstrosities.
In 1804 A. W. Smyth discussed the dialect of the Corpus in his work The Sounds and Inflections of the
)xii
GENERAL INTRODUCTION
Greek Dialects: Jonic.1 He pointed out, however, that the labours of Littré 2 had left much to be done in this department of Hippocratic study, and that the material for a sound judgment was not yet available.
The collection of this material is not yet com- plete, but a good start was made by Kiihlewein, who in Chapter III of the Prolegomena to the first volume of the Teubner Hippocrates (de dzalecto Hippocratica)* laid down the principles followed in the present edition.
§ 12. Manuscripts.
None of our MSS. are very old, but the oldest are far superior to the later, both in readings and in dialect. There is no regular canon, and no recognized order ; each independent MS. seems to represent a different “collection” of Hippocratic works. This fact fits in well with the theory that the nucleus of the Corpus was the library (or the remains of it) of the Hippocratic medical school at Cos.
6 Vindobonensis med. IV., tenth century. Our oldest MS. ” containing : περὶ τῶν ἔντος παθῶν. περὶ παθῶν. περὶ ἱερῆς νούσου. περὶ νούσων α. περὶ νούσων Ὗ περὶ νούσων β. περὶ διαίτης ἃ. περὶ διαίτης β. περὶ διαίτης Ὑ (with περὶ ἐνυπνίων). περὶ γυναικείων ἃ. περὶ γυναικείων β. περὶ γυναικείης φύσιος. Of some books parts are missing.
A Parisinus 2253, eleventh century. It contains:
1 See §§ 94-103, pp. 100-110. 2 See Vol. I., 479-502. 3 pp. Ixv-exxviil. VOL. 1. Gj ἼἽΧΠΙ
GENERAL INTRODUCTION
Kwaxat προγνώσεις. περὶ τροφῆς. περὶ πτισάνης. περὶ χυμῶν. περὶ ὑγρῶν χρήσιος. ἐπιβώμιος. περὶ τέχνης. περὶ φύσιος ἀνθρώπου. περὶ φυσῶν. περὶ τόπων τῶν κατὰ ἄνθρωπον. περὶ ἀρχαίης ἰητρικῆς. ἐπιδημιῶν G. An excellent MS., the use of which has transformed our Hippocratic text. There are four or five cor- recting hands.
B Laurentianus 74,7, eleventh or twelfth century. It contains : κατ᾽ intpetov. περὶ ἀγμῶν. περὶ ἄρθρων. περὶ τῶν ἐν κεφαλῇ τρωμάτων. Two correcting hands.
V Vaticanus graecus 276, twelfth century. It contains: ὅρκος. νόμος. ἀφορισμοί. προγνωστικόν. περὶ διαίτης ὀξέων. κατ᾽ ἰητρεῖον. περὶ ἀγμῶν. περὶ ἄρθρων. περὶ τῶν ἐν κεφαλῇ τρωμάτων. περὶ ἀέρων. ὑδάτων, τόπων. ἐπιδημιῶν αβγδεξζ. περὶ φύσεως ἀνθρώ- που. περὶ φύσεως παιδίου. περὶ γονῆς. περὶ ἐπικυή- σεως. περὶ ἑπταμήνου. περὶ ὀκταμήνου. περὶ παρθένων. περὶ γυναικείης φύσιος. περὶ ὀδοντοφυΐας. περὶ τόπων τῶν κατὰ ἄνθρωπον. γυναικείων αβ. περὶ ἀφόρων. περὶ ἐπικυήσιος (again). περὶ ἐγκατατομῆς παιδίου. περὶ ἰητροῦ. περὶ κρίσεων. περὶ Kpadins. περὶ σαρκῶν. περὶ ἀδένων οὐλομελίης. περὶ ἀνατομῆς. ἐπιστολαί. δόγμα ᾿Αθηναίων. ἐπιβώμιος. πρεσβευτικός.
M Marcianus Venetus 269, eleventh century. It contains: ὅρκος. νόμος. περὶ τέχνης. περὶ ἀρχαίης ἰητρικῆς. παραγγελίαι. περὶ εὐσχημοσύνης. περὶ φύσεως ἀνθρώπου. περὶ γονῆς. περὶ φύσεως παιδίου. περὶ ἄρθρων. περὶ χυμῶν. περὶ τροφῆς. περὶ ἑλκῶν. περὶ ἱερῆς νούσου. περὶ νούσων ἃ. περὶ νούσων β. περὶ νούσων γ. περὶ νούσων 6. περὶ παθῶν. περὶ τῶν ἐντὸς παθῶν. περὶ διαίτης ἃ. περὶ διαίτης B. περὶ διαίτης γ. περὶ ἐνυπνίων. περὶ ὄψιος. περὶ κρισίμων. ἀφορισμοί. προγνωστικόν. περὶ διαίτης ὀξέων. περὶ φυσῶν. μοχλικόν. περὶ ὀστέων φύσιος. περὶ ἀγμῶν. lxiv
GENERAL INTRODUCTION
κατ᾽ intpetov. περὶ ἐγκατατομῆς ἐμβρύου. περὶ γυναι- κείων ἃ. περὶ γυναικείων β. περὶ ἀφόρων. περὶ ἐπι- κυήσιος. περὶ ἑπταμήνου. περὶ ὀκταμήνου. περὶ παρθενίων. περὶ γυναικείης φύσεως. Part of ἐπιδημίων εξ. ἐπιδημιῶν 5. ἐπιδημιῶν Fg ἐπιστολαί. ὁ περὶ μανίης λόγος. δόγμα ᾿Αθηναίων. πρεσβευτικός (mutilated).
C’ Paris 446 suppl. Tenth century.
D Paris 2254
E Paris 2255+. Fourteenth century.
F Paris 2144
H Paris 2142. Thirteenth century.
I Paris rel
4 pene Sige Ὁ Fourteenth century.
S’ Paris 2276
R’ Paris 2165, Sixteenth century.
ἹΒ Barberinus I. 5. Fifteenth century.
δ 13. Cuter Epirions anp TraANsLATIONs, ETC., OF THE Hippocratic Corpus.
1525 Hippocratis Coi medicorum longe principis octoginta volumina, quibus maxima ex parte an- norum circiter duo millia latina caruit lingua, Graeci vero, Arabes et prisci nostri medici, plurimis tamen utilibus praetermissis, scripta sua illustrarunt, nunc tandem per M. Fabium Calvum, Rhavennatem, virum undecumque doctissimum, latinitate donata, Clementi VII pont. max. dicata, ac nune primum in lucem edita, quo nihil humano generi salubrius fieri potuit.
Romae ex aedibus Francisci Minitii Calvi Novo- comensis. 1 vol. fol.
1526 Ἅπαντα τὰ τοῦ Ἱπποκράτους. Omnia opera
Ιχν
GENERAL INTRODUCTION
Hippocratis. Venetiis in aedibus Aldi et Andreae Ansulani soceri. Fol.
1538 Ἱπποκράτους Kwov ἰατροῦ παλαιοτάτου πάντων ἄλλων κορυφαίου βιβλία ἅπαντα. Hippocratis Coi medici vetustissimi, et omnium aliorum principis, libri omnes ad vetustos codices summo studio collati et restaurati. Froben, Basileae. Fol.
This edition was edited by Janus Cornarius.
1545 Hippocratis (Οἱ medicorum omnium facile principis opera quae extant omnia. Jano Cornario medico physico interprete. Venet. Oct. Apud I. Gryphium.
1588 Hippocratis Coi opera quae extant, graece et latine veterum codicum collatione restituta, novo ordine in quatuor classes digesta, interpretationis latinae emendatione et scholiis illustrata ab Hieron. Mercuriali Foroliviensi, Venetiis industria ac sump- tibus Juntarum. Fol.
1588 Oeconomia Hippocratis alphabeti serie dis- tincta, Anutio Foesio authore. Francofurti. Fol.
1595 Tod μεγάλου Ἱπποκράτους πάντων τῶν ἰατρῶν κορυφαίου τὰ εὑρισκόμενα.
Magni Hippocratis medicorum omnium facile prin- cipis opera omnia quae extant in VIII sectiones ex Krotiani mente distributa, nune recens latina inter- pretatione et annotationibus illustrata, Anutio Foesio Mediomatrico medico authore. Francofurti apud Andreae Wecheli haeredes. Fol.
Reprinted 1621, 1624, 1645 and at Geneva 1657.
1665 Magni Hippocratis Coi opera omnia graece et latine edita et ad omnes alias editiones accom- modata industria et diligentia Joan. Antonidae van der Linden. Lugduno-Batav. 1665. 2 vol. octavo.
1679 Hippocratis Coi et Claudii Galeni Pergameni
Ixvi
GENERAL INTRODUCTION
ἀρχιατρῶν opera. Renatus Charterius Vindocinensis, plurima interpretatus, universa emendavit, instaur- avit, notavit, auxit . . . Lutetiae Parisiorum, apud Jacobum Villery. 13 vol. fol.
1743 Ta Ἱπποκράτους ἅπαντα. . . studio et opera Stephani Mackii. Viennae. 2 vol. fol.
1825 Tot μεγάλου Ἱπποκράτους ἅπαντα. Magni Hippocratis opera omnia. Editionem curavit D. Carolus Gottlob Kiihn. Lipsiae. 3 vol. octavo.
1834 Scholia in Hippocratem et Galenum, F. R. Dietz. 2 vols.
1839-1861 Qiuvres completes d’Hippocrate, tra- duction nouvelle, avec le texte grec en regard .. . Par. E. Littré. Paris. 10 vol.
1846 Article “ Hippocrates” in Smith’s Dictionary of Greek and Roman Biography and Mythology, by Dr. W.-A. Greenhill.
1849 The genuine works of Hippocrates trans- lated from the Greek with a preliminary Discourse and Annotations by Francis Adams. London. 2 vol.
1859-1864 MHippocratis et aliorum medicorum veterum reliquiae. Edidit Franciscus Zacharias Ermerins. Trajecti ad Rhenum. 3 vol.
1864-1866 Ἱπποκράτης κομιδῇ Car. H. Th. Rein- hold. ᾿Αθήνῃσι. 2 vol.
1877, 1878 Chirurgie d’Hippocrate, par J. E. Pétrequin. 2 vols.
1894 Hippocratis opera quae geruntur omnia. Recensuit Hugo Kihlewein. Prolegomena_ con- scripserunt Ioannes Ilberg et Hugo Kiihlewein.
The second volume appeared in 1902.
1913 Article ‘“ Hippokrates (16)” in Pauly- Wissowa Real-Encyclopidie der classischen Altertum- smissenscha ft.
Ixvii
GENERAL INTRODUCTION
The early editions are learned but uncritical, being stronger on the medical side than in scholar- ship. Special mention should be made of the Oeconomia of Foes, a perfect mine of medical lore, and it is supplemented by the excellent notes in Foes’ edition. Such a work could have appeared only in an age when Hippocrates was a real force in medical practice.!
The first scholarly edition was that of Littré, and only those who have seriously studied the works of Hippocrates can appreciate the debt we owe to his diligence, or understand why the task occupied twenty-two years. Unfortunately Littré is diffuse, and not always accurate. His opinions, too, changed during the long period of preparation, and the additional notes in the later volumes must be con- sulted in order to correct the views expressed in the earlier.
As a textual critic he shows much common sense, but his notes are awkward to read, and his know- ledge was practically confined to the Paris MSS.
He is at his best as a medical commentator, and he was the first to explain Hippocratic pathology by proving that the endemic diseases of the Hippo- cratic writings must be identified, not with the fevers of our climate, but with the remittent forms of malaria common in hot climates. It is not too much to say that without keeping this fact in view we cannot understand a great part of the Corpus. It is curious to note that Hippocrates was a medical text-book almost down to the time (about 1840)
1 This is in a way a defect. Foes, like Galen, is not sufficiently “detached” from Hippocratic teaching to judge Hippocrates impartially. ;
Ἰχν
GENERAL INTRODUCTION
when malaria ceased to be a real danger to northern Europe.
The most useful critical edition of Hippocrates is that of Ermerins. He was a scholar with a lucid and precise mind, and his critical notes are a pleasure to read. The introductions, too, are stimulating, instructive and interesting, written in a style full of life and charm. As a philologist he was very deficient.
The edition in the Teubner series, edited by Kiihlewein, of which two volumes have appeared, marks a distinct advance. Fresh manuscripts have been collated, and the text has been purged of the pseudo-ionisms which have so long disfigured it.
A word should perhaps be said about Reinhold, whose two volumes of text give us more plausible conjectures than the work of any other scholar.
Of the scholars who have worked at parts of the Corpus mention should be made of Gomperz and Wilamowitz, but especial praise is due to the remark- able acuteness of Coray, whose intellect was like a sword. He always instructs and inspires, even when the reader cannot accept his emendations.
Adams’ well-known translation is the work of a man of sense, who loved his author and was not without some of the qualifications of a scholar. The translation is literal and generally good, but is occasionally misleading. ‘The medical annotation is far superior to the scholarship displayed in the work,
Ixix
any Pe nih eee lultihe ἢ ἐπα τῇ yt tel) αἴτέκος, κὰν et oF a
ἀν ig. νὰ ethers Ee Ot ἐπέ ; he Ὁ
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in A Bios ital eae. eects τ ἤν οὐ ΠΝ ἀκα ia γα ἶ πον Ao ἀωρίᾳ το aay
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at WY aHue “02 Mee tien ts Mpegs Sey een buie-otq= Log matt ὁ αλλ onal ΣΝ ἡαρηῶ es inlay δ Ty RA g δεν, κυ u γλϊμγο ναι fe gine wil pigs onk
Libation aa ee ‘Nae εν aft κα ἡ toa φϑν μὲ at δνδήνγὐη! ema ᾿ εν. tie wires εἴ ΓΝ —- ies ii | eo) ae aK oe eo then ie ; a < " προ να. με | 4" δος ᾿ ᾿ τῷ Υ͵ EAR. ' ΞΕ
HIPPOCRATES
ANCIENT MEDICINE
INTRODUCTION
Amone ancient writers Erotian is the only one who expressly ascribes this little treatise to Hippo- erates himself. Modern critics generally regard it as old, but as not by Hippocrates, the chief exception being Littré. Adams is uncertain, but is inclined to think that Hippocrates was not the author.
Thus the external evidence in support of the view that Hippocrates was the author of this treatise is very slight indeed. The internal evidence is considerably stronger.
(1) The writer, like Hippocrates! holds that health is caused by a “ coction ” of the “ humours.”
(2) He recognises the importance of “ critical” days in an illness.
(3) He holds that medical science is founded on observation and reasoning, not on speculation.
(4) He attaches great importance to the use of “slops’’ of various degrees of consistency.
All these doctrines are in conformity with the views expounded in the works assigned to Hippo- crates. On the other hand, no stress is laid upon prognosis, which Hippocrates considered of primary importance. Again, it would be impossible to show
from the works of Hippocrates that the father of
1 By ‘‘ Hippocrates” is meant the writer of Prognostic, of Regimen in Acute Diseases, and of Epidemics, I., Il.
3
INTRODUCTION
medicine thought little of the power of heat and cold in producing health or disease; our author, however, rates them very low. Moreover, like the Pythagorean physician Alemaeon, he holds that there is an indefinite number of “opposites,” the harmony or crasis of which produces health. The historical Hippocrates is said to have reduced the number of the humours to four, although I can find no trace of this limitation to four in any treatise earlier than the one on the Nature of Man, which is not generally considered authentic.
It may be said that, were the external evidence stronger, the treatise would be accepted as an authentic work of Hippocrates.
Littré! argues that the well-known passage in the Phaedrus,? where ‘ Hippocrates the Asclepiad’’ is mentioned as holding a theory that a knowledge of the human body is impossible without a know- ledge of the universe—interpreted to mean an ex- amination of the δύναμις (or δυνάμεις) of a body according to its inter-relations with other things —refers to Chapter XX of the περὶ ἀρχαίης ἰητρικῆς, and not, as Galen maintains, to the treatise On the Nature of Man. Littré also points out that a passage in our treatise * is very similar to one in Regimen in Acute Diseases, the authenticity of which is un-
doubted.
1 ij. pp. 294-310. Gomperz is inclined to support this view.
2 270, C. D. Littré’s discussion of the sentence τὸ τοίνυν περὶ φύσεως σκόπει τί ποτε λέγει Ἱπποκράτης τε καὶ ὃ dpOds λόγος, to show that it does not refer to any actual words of Hippocrates, is, of course, quite beside the mark. The sentence means ‘‘what H. and right reason mean by περὶ φύσεως."
3 pp. 314, 315, ¢ Chapter X. 4
INTRODUCTION
Littré may have shown that there is a resemblance to our author in the Phaedrus passage. Resem- blances, however, show merely that the writer was Hippocratic, not that he was Hippocrates.
The reference, in Chapter XV, to participation (kowvwetr) in εἴδη and to ‘ absolute existences’ (αὐτό τι ἐφ᾽ ἑωυτοῦ) might lead a critic to infer that the writer lived in the age of Plato. But there are two insuperable difficulties to this hypothesis. One is that in Chapter XX the word σοφιστής is used in its early sense of “philosopher,” which implies that the writer lived before Plato attached to the word the dishonourable meaning it has in later Greek. The other is that the writer attacks the intrusion of philosophic speculation into the science of medicine, and the speculation he has constantly in mind, as being, apparently, the most influential in his day, is that of Empedocles,t who is actually mentioned in Chapter XX as a typical writer περὶ φύσεως. There is a sentence in Chapter XIV which closely resembles, in both thought and diction, the fragments of Anaxa- goras.2- It certainly looks as though the writer of Ancient Medicine was not unfamiliar with the works of this philosopher. All this evidence tends to fix the date as approximately 430-420 B.c., and to suggest as the writer either Hippocrates or a very capable supporter of the medical school of which Hippocrates was a contemporary member.
The author of Ancient Medicine in Chapter II asserts
1 Or possibly that of the Milesian school with its doctrine of opposites, of which opposites the Empedoclean ‘‘ roots” are four, definitely corporealised.
2 ὅταν δέ τι τούτων ἀποκριθῇ Kal αὐτὸ ἐφ᾽ ἑωυτοῦ γένηται, τότε καὶ φανερόν ἐστι καὶ λυπεῖ τὸν ἄνθρωπον.
5
INTRODUCTION
that empiric medicine was in his day an old art, and that the attempt to foist the method of philosophy upon it was comparatively modern. He is obviously correct. Hippocratic science must have been the ripe fruit of a long period of active inquiry ; philosophy began early in the sixth century B.c., and it was late in that century that medicine and philosophy were combined in the persons of prominent Pythagoreans.! It was only natural that, as the main interest of philosophy shifted from cosmology to biology, philosophy should occupy itself with medical problems. The union was closest in Empedocles, thinker, seer, and “ medicine-man, but by the end of the fifth century philosophy had discarded medicine, although to its great loss medicine did not discard philosophy.2
Several recent critics, notably Professor A. E. Taylor,? have pointed out the importance of this little work in the history of thought. It has even been urged that it proves that the technical phrases, and perhaps the doctrine also, of the theory of Ideas, usually ascribed to Plato, were well-known to educated men a generation at least before Plato. The language used in Chapter XV_ is, indeed, strikingly like the terminology of Plato, far too much so to be a mere coincidence.
However this may be, it is plain that in the fifth century B.c, there were thinkers, holding principles nearly akin to those of modern science, who were violently opposed to the application of philosophic
1 See Burnet, Early Greek Philosophy, pp. 223-226 for Alemaeon, and pp. 339-341 for the later Pythagoreans,
2 See especially Burnet, op. cit. pp. 234-235.
3 Varia Socratica, pp. 74-78 and 214-218,
6
INTRODUCTION
procedure to science. ‘This procedure the writer calls the method of ὑποθέσεις. The student of Plato is at once reminded of the Phaedo, Republic, and Sophist, in which dialogues a theory of knowledge is expounded which is stated to be the best possible method of inquiry until the Ideas have been appre- hended. It should be noticed that a ὑπόθεσις is something very different from a modern scientific hypothesis. The latter is a summary of observed phenomena, intended to explain. them by pointing out their causal relationship. The former is not a summary of phenomena; it is a postulate, intended to be accepted, not as an explanation, but as a foun- dation (ὑπο-τίθημι) upon which to build a super- structure. An hypothesis must by tested by further appeals to sense-experience ; a ὑπόθεσις must not be so tested, it must be taken for granted as an obvious truth. Plato would have nothing to do with appeals to sense-experience. According to him, if a ὑπόθεσις is not accepted, it must be abandoned, and a more general ὑπόθεσις postulated, until one is reached to which the opponent agrees.1_ The writer of Ancient , Medicine suggests,? as the proper sphere of ὑποθέσεις, the celestial regions and those beneath the earth. Here, among τὰ ἀφανέα τε καὶ ἀπορεόμενα, Where we have no means of applying a satisfactory test, where in fact sense-perception fails us, is the proper place for ὑποθέσει. He would exclude them all from medicine, but he is constantly suggesting what we moderns call “hypotheses.” The best examples of ὑποθέσεις are the axioms and postulates of geometry.
1 Phaedo, 101 D, E. * Chapter I. The language of the author is more than a little sarcastic.
7
INTRODUCTION
These are not tested or proved; they are assumed, and upon the assumptions a whole science is built.
In place of ὑποθέσεις the author of Ancient Medicine relies, asa modern scientific thinker relies, on careful observation and critical examination! of phenomena, hoping thereby to reach, not the complete and _ per- fect knowledge Plato hoped to attain through his Ideas, but an approximation to truth.”
So the two methods, that of Greek philosophy and that of modern science, stand face to face. The struggle between them was, for the time being, short. Medicine, almost the only branch of Greek science scientifically studied, was worsted in the fight, and medical science gradually degenerated from rational treatment to wild speculation and even quackery and superstition.* The transcendant genius of Plato, strong in that very power of persuasion the use of which he so much deprecated, won the day. The philosophic fervour which longed with passionate desire for unchangeable reality, that felt a lofty con- tempt for the material world with its ever-shifting phenomena, that aspired to rise to a heavenly region where changeless Ideas might be apprehended by pure. intelligence purged from every bodily taint, was more than a match for the humble researches of men who wished to relieve human suffering by a patient study of those very phenomena that Plato held of no account.
1 χογισμῷ, Chapter XII.
2 εἰ μὴ ἔχει περὶ πάντα ἀκρίβειαν, ἀλλὰ πολὺ μᾶλλον διὰ τὸ ἐγγὺς οἶμαι τοῦ ἀτρεκεστάτου δύνασθαι ἥκειν. Ibid. The forty- two clinical histories, given in the Ypidemics of Hippocrates, are excellent examples of the observation which the Hip- pocratic school considered the only foundation of science.
3 See Τὸ. Τὶ, Withington, in Mfalaria and Greek History, by W. H. S. Jones and E. T. Withington.
8
INTRODUCTION
So for centuries philosophy flourished and science languished, in spite of Aristotle, Euclid and Archi-
medes, ANALYSIS.
(1) The rejection of ὑποθέσεις and the defence of the old method in medicine (Ch. I-III).
(2) The origin of medicine, and its connection with the art of dieting (111--Χ 11}.
(3) The comparative unimportance of the four “‘ opposites” in health and disease (XIII-XV).
(4) The importance of certain secretions as com- pared with heat and cold (XVI-XIX).
(5) The correct method of studying medicine (XX-XXIV).
TEXT; ETC.
There has never been published any separate edition of this treatise, but of course it is included in all the great editions of Hippocrates. Not much was done to improve the text before Littré, who seems to have bestowed care and thought upon the little book. The edition of Kiihlewein introduced a radical reformation of the pseudo-ionic forms that disfigured earlier texts, and also several improvements in detail, but his changes are not always happy.
The chief manuscript authority is A,! which seems infinitely superior to all the others. The next most important manuscript is M, the others being of very little help.
In this edition I have kept closely to the spelling of Kihlewein, but the text itself is my own. It
1 Called by Littré 2253.
INTRODUCTION
follows the MS. A very closely, but on several occasions I have accepted (with acknowledgements) the emendations of Coray, Reinhold, Ermerins, Littré, Diels and Kiihlewein. One passage I have rejected on my own authority, and in another I have presented a new combination of readings which I think restores sense out of nonsense. I have generally noted readings only when the choice makes a decided difference to the translation.
The translator is often perplexed how to render semi-technical words which belong to a time when the ideas underlying them were in a transition stage, or when ideas were current which the progress of time has destroyed. “ Hot” and “cold” were no longer bodies, but they were not yet qualities. As Professor Taylor! shows, the word εἶδος is most elusive, referring to the form, appearance, structure of a thing, the physique of persons, ete., and yet it is becoming capable of being applied to immaterial reality. There are about half a dozen words to describe the process which we describe by the single word “ digestion.’ 2. These nice distinctions must be lost in an English version. The most difficult word of all is perhaps δύναμις. Scientific thought in the fifth century Β.6. held that certain constituents of the body, and indeed of the material world generally, manifested themselves to our senses and feelings in certain ways. These are their δυνάμεις, “ powers,” or, as we may sometimes translate, “ properties,”
1 Loe. cit.
2 In deference to authority I translate ἀπαλλάσσειν in Chapters X and XX ‘“‘ come off” well or ill, But Iam almost convinced that in both cases the word means ‘‘ to get rid of food,” ‘‘to digest.”” Compare Chapter III, p. 18, 1. 32.
Io
INTRODUCTION
* characteristics,” “ effects.”” Almost equally difficult is the word φύσις. This appears sometimes to have the meaning which Professor Burnet oe it has in early philosophy, “ primordial matter,” primitive element or elements,” the “ stuff” of which the world is made. Often, again, it has its later mean- ing, “ nature,” while sometimes the two senses are combined or confused. In all these cases perfect consistency of rendering can only be achieved by sacrificing the thought. In my work I have been constantly impressed, and depressed, by the truth of the proverb, “Translators are traitors.”
11
10
ITEP! APXAIM> ΤΗΤΡΙΚΗΣ
I. πόσοι μὲν ἐπεχείρησαν. περὶ ἰητρικῆς λέγειν ἢ γράφειν, ὑπόθεσιν αὐτοὶ αὐτοῖς ὑποθέμενοι τῷ λόγῳ, θερμὸν ἢ ψυχρὸν ἢ ὑγρὸν ἢ ξηρὸν ἢ ἄλλο τι ὃ ἂν θέλωσιν, ἐ ἐς ὡραχὺ ἄγοντες τὴν ἀρχὴν τῆς αἰτίης τοῖσι ἀνθρώποισι νούσων τε καὶ θανάτου, καὶ πᾶσι τὴν αὐτήν, ἕν ἢ δύο ὑποθέμενοι, ἐν πολλοῖσι μὲν Kal! οἷσι λέγουσι καταφανέες εἰσὶ ἁμαρτάνοντες, μάλιστα δὲ ἄξιον μέμψασθαι, ὃ ὅτι ἀμφὶ τέχνης ἐούσης, ἢ χρέονταί τε πάντες ἐπὶ τοῖσι μεγίστοισι καὶ τιμῶσι μάλιστα τοὺς ἀγαθοὺς χειροτέχνας καὶ δημιουργούς. εἰσὶν δὲ δημιουργοὶ οἱ μὲν φαῦλοι, οἱ δὲ πολλὸν διαφέροντες" ὅπερ, εἰ μὴ ἣν ἰητρικὴ ὅλως, μηδ᾽ ἐν αὐτῇ ἔσκεπτο μηδ᾽ εὕρητο μηδέν, οὐκ a ἣν, ἀλλὰ πάντες ὁμοίως αὐτῆς ἄπειροί τε καὶ ἀνεπιστήμονες ἦσαν, τύχῃ δ᾽ ἂν “πάντα τὰ τῶν καμνόντων διοικεῖτο. νῦν δ᾽ οὐχ οὕτως ἔχει, ἀλλ᾽ ὥσπερ καὶ τῶν ἄλλων τεχνέων πασέων οἱ δημιουργοὺὴ πολλὸν ἀλλήλων διαφέ- ρουσιν κατὰ χεῖρα καὶ κατὰ γνώμην, οὕτω δὲ καὶ ἐπὶ ἰητρικῆς. διὸ οὐκ ἠξίουν αὐτὴν ἔγωγε κενῆς "
1 καί MSS. : καινοῖσι Kiithlewein after Schone, 2 κενῆς M: καινῆς A.
12
ΑΝΟΙΕΝΊ MEDICINE
I. Att who, on attempting to speak or to write on medicine, have assumed for themselves a postulate as a basis for their discussion—heat, cold, moisture, dryness, or anything else that they may fancy— who narrow down the causal principle of diseases and of death among men, and make it the same in all cases, postulating one thing or two, all these obviously blunder in many points even of their state- ments,! but they are most open to censure because they blunder in what is an art, and one which all men use on the most important occasions, and give the greatest honours to the good craftsmen and practitioners in it. Some practitioners are poor, others very excellent; this would not be the case if an art of medicine did not exist at all, and had not been the subject of any research and discovery, but all would be equally inexperienced and unlearned therein, and the treatment of the sick would be in all respects haphazard. But it is not so ; just as in all other arts the workers vary much in skill and in knowledge,? so also is it in the case of medicine. Wherefore I have deemed that it has
1 Or, reading καινοῖσι x.7.A., “οὗ their novelties.” 2 Or ‘‘manual skill” and ‘‘ intelligence.”
13
27
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ΠΕΡῚ ΑΡΧΑΙΗΣ IHTPIKHS
ὑποθέσιος δεῖσθαι ὥσπερ τὰ ἀφανέα τε καὶ ἀπο- ρεόμενα, περὶ ὧν ἀνάγκη, ἤν τις ἐπιχειρῇ τι λέγειν, ὑποθέσει χρῆσθαι, οἷον περὶ τῶν μετεώρων ἢ τῶν ὑπὸ γῆν: ἃ el! τις λέγοι καὶ γινώσκοι ὡς ἔχει, οὔτ᾽ ἂν αὐτῷ τῷ λέγοντι οὔτε τοῖς ἀκούουσι δῆλα ἂν εἴη, εἴτε ἀληθέα ἐστὶν εἴτε μή. οὐ γὰρ ἔστι πρὸς ὅ τι χρὴ ἀνενέγκαντα εἰδέναι τὸ σαφές.
IL. Ἰητρικῇ δὲ πάλαι πάντα ὑπάρχει, καὶ ἀρχὴ καὶ ὁδὸς εὑρημένη, καθ᾽ ἣν τὰ εὑρημένα πολλά τε καὶ καλῶς ἔχοντα εὕρηται ἐν πολλῷ χρόνῳ, καὶ τὰ λοιπὰ εὑρεθήσεται, ἤν τις ἱκανός τε ἐὼν καὶ τὰ εὑρημένα εἰδὼς ἐκ τούτων ὁρμώμενος ζητῇ. ὅστις δὲ ταῦτα ἀποβαλὼν καὶ ἀποδοκιμάσας πάντα, ἑτέρῃ ὁδῷ καὶ ἑτέρῳ σχήματι ἐπιχειρεῖ ζητεῖν, καί φησί τι ἐξευρηκέναι, ἐξηπάτηται Σ καὶ ἐξαπα- Tata: ἀδύνατον yap: δι᾽ ἃς δὲ ἀνάγκας ἀδύνατον, ἐγὼ πειρήσομαι ἐπιδεῖξαι, λέγων καὶ ἐπιδεικνύων τὴν τέχνην ὅ τι ἐστίν ἐκ δὲ τούτου καταφανὲς ἔσται ἀδύνατα ἐόντα ἄλλως πως τούτων εὑρί- σκεσθαι. μάλιστα δέ μοι δοκεῖ περὶ ταύτης δεῖν λέγοντα τῆς τέχνης γνωστὰ λέγειν τοῖσι δημότῃσι. οὐ γὰρ περὶ ἄλλων τινῶν οὔτε ζητεῖν οὔτε λέγειν προσήκει ἢ περὶ τῶν παθημάτων ὧν αὐτοὶ οὗτοι
1 ἃ εἴ suggested by Littré: ἀεί A.
2 So the MSS. ἐξαπατᾷ τε has been suggested. See Diels in Hermes XLV. 125.
3 ὅ τι ἐστίν M: ὅτι Aand ἔστιν Kiihlewein.
1 Or, reading καινῆς, ““ὦ novel postulate.” But the writer’s objection is not that the postulate is novel, but that it is a postulate. A postulate, he says, is ‘‘ empty ” in a sphere where accurate and verifiable knowledge is possible. Only
14
ANCIENT MEDICINE, 1-n.
no need of an empty postulate,’ as do insoluble mysteries, about which any exponent must use a postulate, for example, things in the sky or below the earth. If a man were to learn and declare the state of these, neither to the speaker himself nor to his audience would it be clear whether his state- ments were true or not. For there is no test the application of which would give certainty.
II. But medicine has long had all its means to hand, and has discovered both a principle and a method, through which the discoveries made during a long period are many and excellent, while full dis- covery will be made, if the inquirer be competent, conduct his researches with knowledge of the dis- coveries already made, and make them his starting- point. But anyone who, casting aside and rejecting all these means, attempts to conduct research in any other way or after another fashion, and asserts that he has found out anything, is and has been the victim of deception.2. His assertion is impossible ; the causes of its impossibility I will endeavour to expound by a statement and exposition of what the art is.3 In this way it will be manifest that by any other means discoveries are impossible. But it is particularly necessary, in my opinion, for one who discusses this art to discuss things familiar to ordin- ary folk. For the subject of inquiry and discussion is simply and solely the sufferings of these same
in regions where science cannot penetrate are ὑποθέσεις legitimate. For this reason I read κενῆς.
2 Or, with the reading suggested, ‘‘ both deceives and is deceived.”’
3 Or, reading ὅτι ἔστιν, ‘that the art really is an art, really exists,”
15
ΠΕΡῚ ΑΡΧΑΙΗΣ IHTPIKHS
νοσεουσί τε καὶ πονέουσι. αὐτοὺς μὲν οὖν τὰ σφέων αὐτῶν παθήματα καταμαθεῖν, ὡς γίνεται καὶ παύεται καὶ δι’ οἵας προφάσιας αὔξεταί τε 20 καὶ φθίνει, δημότας ἐόντας οὐ ῥηίδιον' ὑπ᾽ ἄλλου δὲ εὑρημένα καὶ λεγόμενα, εὐπετές. οὐδὲν γὰρ ἕτερον ἢ ἀναμιμνήσκεται ἕκαστος ἀκούων τῶν αὐτῷ 1 συμβαινόντων. εἰ δέ τίς τῆς τῶν ἰδιωτέων γνώμης ἀποτεύξεται καὶ μὴ διαθήσει τοὺς ἀκού- οντας οὕτως, τοῦ ἐόντος ἀποτεύξεται. L διὰ 26 ταῦτα οὖν ταῦτα οὐδὲν δεῖ ὑποθέσιος.
TIT. Τὴν γὰρ ἀρχὴν οὔτ᾽ ἂν εὑρέθη ἡ τέχνη ἡ ἰητρικὴ οὔτ᾽ ἂν ἐζητηήθη---οὐδὲν γὰρ αὐτῆς ἔδει--- εἰ τοῖσι κάμνουσι τῶν ἀνθρώπων. τὰ αὐτὰ διαιτω- μένοισί τε καὶ προσφερομένοισι, ἅπερ οἱ ὑγιαίν:ν- τες ἐσθίουσί τε καὶ πίνουσι καὶ τἄλλα διαιτέονται, συνέφερεν, καὶ μὴ ἣν ἕτερα τούτων βελτίω. νῦν δὲ αὐτὴ ἡ ἀνάγκη ἰητρικὴν ἐποίησεν ᾿ξητηθῆναί τε καὶ εὑρεθῆναι ἀνθρώποισι, ὅτι τοῖσι κάμνουσι ταὐτὰ προσφερομένοισι, ἅπερ οἱ ὑγιαίνοντες, οὐ
10 συνέφερεν, ὡς οὐδὲ νῦν συμφέρει. ἔτι δὲ ἄνωθεν ἔγωγε ἀξιῶ οὐδ᾽ ἂν τὴν τῶν ὑγιαινόντων δίαιτάν τε καὶ τροφήν, ἣ νῦν χρέονται, εὑρεθῆναι, εἰ ἐξήρκει τῷ ἀνθρώπῳ ταὐτὰ ἐσθίοντι καὶ πίνοντι βοΐ τε καὶ ἵππῳ καὶ πᾶσιν ἐκτὸς ἀνθρώπου, οἷον τὰ ἐκ τῆς γῆς φυόμενα, καρπούς τε καὶ ὕλην καὶ χόρτον. ἀπὸ τούτων γὰρ καὶ τρέφονται καὶ αὔξονται καὶ ἄπονοι διάγουσιν οὐδὲν προσδεόμενοι ἄλλης διαίτης. καί τοι τήν γε ἀρχὴν ἔγωγε δοκέω καὶ τὸν ἄνθρωπον τοιαύτῃ τροφῇ κεχρῆσθαι. τὰ
20 δὲ νῦν διαιτήματα εὑρημένα καὶ τετεχνημένα ἐν
1 ἑωυτῷ most MSS, 16
ANCIENT MEDICINE, τι.--πῖ.
ordinary folk when they are sick or in pain. Now to learn by themselves how their own sufferings come about and cease, and the reasons why they get worse or better, is not an easy task for ordinary folk; but when these things have been discovered and are set forth by another, it is simple. For merely an effort of memory is required of each man when he listens to a statement of his experiences. But if you miss being understood by laymen, and fail to put your hearers in this condition, you will miss reality. Therefore for this reason also medicine has no need of any postulate.
111. For the art of medicine would never have been discovered to begin with, nor would any medical re- search have been conducted—for there would have been no need for medicine—if sick men had profited by the same mode of living and regimen as the food, drink and mode of living of men in health, and if there had been no other things for the sick better than these. But the fact is that sheer necessity has caused men to seek and to find medicine, because sick men did not, and do not, profit by the same regimen as do men in health. To trace the matter yet further back, I hold that not even the mode of living and nourishment enjoyed at the present time by men in health would have been discovered, had a man been satisfied with the same food and drink as satisfy an ox, a horse, and every animal save man, for example the products of the earth—fruits, wood and grass. For on these they are nourished, grow, and live without pain, having no need at all of any other kind of living. Yet I am of opinion that to begin with man also used this sort of nourishment. Our present ways of living have, I think, been
τὴ
80
40
IIEPI ΑΡΧΑΙΗΣ ΤἸΗΤΡΙΚΗΣ
πολλῷ χρόνῳ γεγενῆσθαί μου δοκεῖ. ὡς γὰρ ἔπασχον πολλά τε καὶ δεινὰ ὑ ὑπὸ ἰσχυρῆς τε καὶ θηριώδεος διαίτης ἀ ὠμά τε καὶ ἄκρητα καὶ μεγάλας δυνάμιας “ἔχοντα ἐσφερόμενοι. οἷά περ ἂν καὶ νῦν ὑπ᾽ αὐτῶν πάσχοιεν πόνοισί τε ἰσχυροῖσι καὶ νούσοις περιπίπτοντες καὶ διὰ τάχεος θανάτοισι. ἧσσον μὲν οὗν ταῦτα τότε εἰκὸς ἣν πάσχειν διὰ τὴν συνήθειαν, ἰσχυρῶς δὲ καὶ τότε. καὶ τοὺς μὲν πλείστους Te Kal ἀσθενεστέρην φύσιν ἐ ἔχοντας ἀπόλλυσθαι εἰκός, τοὺς δὲ τούτων ὑπερέχοντας πλείω χρόνον ἀντέχειν" ὥσπερ καὶ νῦν ἀπὸ τῶν ἰσχυρῶν βρωμάτων οἱ μὲν ῥηϊδίως ἀπαλλάσσονται, οἱ δὲ μετὰ πολλῶν πόνων τε καὶ κακῶν. διὰ δὴ ταύτην τὴν αἰτίην καὶ οὗτοί μοι δοκέουσι ζητῆσαι τροφὴν ἁρμόξουσαν τῇ φύσει καὶ εὑρεῖν ταύτην, ἣ νῦν χρεώμεθα. ἐκ μὲν οὖν τῶν πυρῶν βρέξαντές σφας καὶ πτίσαντες καὶ καταλέσαντές τε καὶ διασήσαντες καὶ φορύξαντες καὶ ὀπτήσαντες ἀπε- τέλεσαν ἄρτον, ἐκ δὲ τῶν κριθέων μᾶζαν: ἄλλα τε πολλὰ περὶ ταῦτα πρηγματευσάμενοι ἥψησάν τε καὶ ὦπτησαν καὶ ἔμιξαν, καὶ ἐκέρασαν τὰ ἰσχυρά τε καὶ ἄκρητα τοῖς ἀσθενεστέροις, πλάσσοντες πάντα πρὸς “τὴν τοῦ ἀνθρώπου φύσιν τε αὶ δύναμιν, ἡγεύμενοι, ὅσα μὲν ἂν ἰσχυρότερα 7) Rie δυνήσεται κρατεῖν ἡ φύσις, ἢν ἐμφέρηται, ἀπὸ τούτων δ᾽ αὐτῶν πόνους Te καὶ νούσους καὶ θανά- tous ἔσεσθαι, ὁπόσων δ᾽ ἂν δύνηται ἐπικρατεῖν, ἀπὸ τούτων τροφήν τε καὶ αὔξησιν καὶ ὑγιείην. τῷ δὲ εὑρήματι τούτῳ καὶ ζητήματι τί ἄν τις 1 So Littré, but he does not admit the conjecture into his
text. The MSS. showa great variety of readings, giving the same sense but irregular constructions,
18
ANCIENT MEDICINE, m1.
discovered and elaborated during a long period ot time. For many and terrible were the sufferings of men from strong and brutish living when they partook of crude foods, uncompounded and _possess- ing great powers!—the same in fact as men would suffer at the present day, falling into violent pains and diseases quickly followed by death. Formerly indeed they probably suffered less, because they were used to it, but they suffered severely even then. The majority naturally perished, having too weak a constitution, while the stronger resisted longer, just as at the present time some men easily deal with strong foods, while others do so only with many severe pains. For this reason the ancients too seem to me to have sought for nourishment that harmonised with their constitution, and to have discovered that which we use now. So from wheat, after steeping it, winnowing, grinding and sifting, kneading, baking, they produced bread, and from barley they produced cake. Experimenting with food they boiled or baked, after mixing, many other things, combining the strong and uncompounded with the weaker components so as to adapt all to the constitution and power of man, thinking that from foods which, being too strong, the human constitution cannot assimi- late when eaten, will come pain, disease, and death, while from such as can be assimilated will come nourishment, growth and health. To this discovery and research what juster or more appropriate name
10r ‘strong qualities,”
το
10
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ΠΕΡῚ ΑΡΧΑΤΙΗΣ ΗΤΡΙΚΗΣ
ὄνομα δικαιότερον ἢ προσῆκον “μᾶλλον θείη ἢ ἰητρικήν; ὅτι γε εὕρηται ἐπὶ τῇ τοῦ ἀνθρώπου ὑγιείῃ τε καὶ σωτηρίῃ καὶ τροφῇ, ἄχλαγμα ἐκείνης τῆς διαίτης, ἐξ ἧς οἱ πόνοι καὶ νοῦσοι καὶ θάνατοι ἐγίνοντο.
VE Ke δὲ μὴ πέχνη αὕτη νομίζεται εἶναι, οὐκ ἀπεοικός" ἧς γὰρ μηδείς ἐστιν ἰδιώτης, ἀλλὰ πάντες ἐπιστήμονες διὰ τὴν Χρ holy TE καὶ ἀνάγκην, οὐ προσήκει ταύτης οὐδένα τεχνίτην καλεῖσθαι" ἐπεὶ τό γε εὕρημα μέγα τε καὶ πολλῆς σκέψιος τε καὶ τέχνης. ἔτι γοῦν καὶ νῦν οἱ τῶν γυμνασίων τε καὶ ἀσκησίων ἐπιμελόμενοι αἰεί τι προσεξευ- ρίσκουσιν κατὰ τὴν αὐτὴν ὁδὸν ζητέοντες ὅ τι ἐσθίων τε καὶ πίνων ἐπικρατήσει τε αὐτοῦ μάλιστα καὶ eens αὐτὸς ἑωυτοῦ ἔσται.
Υ. Σκεψώμεθα δὲ καὶ τὴν ὁμολογεομένως ἰητρι- κήν, τὴν ἀμφὶ τοὺς κάμνοντας εὑρημένην, ἣ καὶ ὄνομα καὶ τεχνίτας "ἔχει, ἦρά τι καὶ αὐτὴ τῶν αὐτῶν ἐθέλει, καὶ πόθεν ποτὲ ἦρκται. ἐμοὶ μὲν γάρ, ὅπερ ἐν ἀρχῇ εἶπον, οὐδ᾽ ἂν ζητῆσαι ἐ ἰητρικὴν δοκεῖ οὐδείς, εἰ ταὐτὰ διαιτήματα τοῖσί τε κάμνουσι καὶ τοῖσι ὑγιαίνουσιν ἥρμοζεν. ἔτι γοῦν καὶ νῦν ὅσοι ἰητρικῇ μὴ χρέονται, οἵ τε βάρβαροι καὶ τῶν ᾿Βλλήνων ἔνιοι, τὸν αὐτὸν τρόπον, ὅνπερ οἱ ὑγιαίνοντες, διαιτέονται πρὸς ἡδονήν, καὶ οὔτ᾽ ἂν ἀπόσχοιντο οὐδενὸς ὧν ἐπιθυμέουσιν οὔθ᾽ ὑπο- στείλαιντο ἄν. οἱ δὲ ζητήσαντες καὶ εὑρόντες ἰητρικὴν τὴν αὐτὴν ἐκείνοισι διάνοιαν ἔχοντες, περὶ ὧν μοι ὁ πρότερος λόγος εἴρηται, πρῶτον μέν, οἶμαι, ὑφεῖλον τοῦ πλήθεος τῶν σιτίων αὐτῶν τούτων, καὶ ἀντὶ πλειόνων ὀλίγιστα ἐποίησαν. ἐπεὶ δὲ αὐτοῖσι τοῦτο ἔστι μὲν ὅτε πρός τινας 20
ANCIENT MEDICINE, πι.--ν.
could be given than medicine, seeing that it has been fiecovered with a view to the health, saving and nourishment of man, in the place of that mode of living from which came the pain, disease and death ?
IV. That it is not commonly considered an art is not unnatural, for it is inappropriate to call anyone an artist in a craft in which none are laymen, but all possess knowledge through being compelled to use it. Nevertheless the discovery was a great one, implying much investigation and art. At any rate even at the present day those who study gymnastics and athletic exercises are constantly making some fresh discovery by investigating on the same metiod what food and what annie are best assimilated and make a man grow stronger.
V. Let us donee: ΠΗ whether the acknowledged art of medicine, that was discovered for the treat- ment of the sick and has both a name and artists, has the same object as the other art, and what its origin was. In my opinion, as I said at the begin- ning, nobody would have even sought for Ἧτο χε if the same ways of life had suited youl the sick and those in health. At any rate even at the present day such as do not use medical science, foreigners and some Greeks, live as do those in lealth, just as they please, and would neither forgo nor restrict the satis- faction of any of their desires. But those who sought for and discovered medicine, having the same inten- tion as the men I discussed Aleit in the first place, I think, lessened the bulk of the fancies and, without altering their character, greatly diminished their quantity. But they unde that this treatment was
1 7.4. that of dieting in health. See Chapter VII. 21
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TOV καμνόντων ἤρκεσε καὶ φανερὸν ἐγένετο whe- λῆσαν, οὐ μέντοι πᾶσί γε, GAN ἦσάν τινες οὕτως ἔχοντες, ὡς μὴ ὀλίγων σιτίων δύνασθαι ἐπικρατεῖν, ἀσθενεστέρου δὲ δή τινος οἱ τοιοίδε ἐδόκεον δεῖ- σθαι, εὗρον τὰ ῥυφήματα μίξαντες ὀλίγα τῶν ἰσχυρῶν πολλῷ τῷ ὕδατι καὶ ἀφαιρεύόμενοι τὸ ἰσχυρὸν τῇ κρήσει τε καὶ ἑψήσει. ὅσοι δὲ μηδὲ τῶν ῥυφημάτων ἐδύναντο ἐπικρατεῖν, ἀφεῖλον καὶ ταῦτα, καὶ ἀφίκοντο ἐς πόματα, καὶ ταῦτα τῇσι τε κρήσεσι καὶ τῷ πλήθει διαφυλάσσοντες ὡς μετρίως ἔχοι, μήτε πλείω τῶν δεόντων μήτε ἀκρη- τέστερα προσφερόμενοι “μηδὲ ἐνδεέστερα.
Vil. ἘΠ δὲ χρὴ τοῦτο εἰδέναι, ὅτι τισὶ τὰ βυφήμαπα ἐν τῇσι νούσοισιν οὐ συμφέρει, ἀλλ᾽ ἄντικρυς," ὅταν ταῦτα προσαίρωνται, παροξύ- νονταί σφισι οἵ τε πυρετοὶ καὶ τὰ ἀλγήματα: καὶ δῆλον τὸ προσενεχθὲν τῇ μὲν νούσῳ τροφή τε καὶ αὔξησις γενόμενον, τῷ δὲ σώματι φθίσις τε καὶ ἀρρωστίη. ὅσοι δὲ ἂν τῶν ἀνθρώπων ἐν ταύτῃ τῇ διαθέσει ἐόντες προσενέγκωνται ξηρὸν σιτίον ἢ μᾶζαν ἢ ἄρτον, καὶ ἢν πάνυ σμικρόν, δεκαπλασίως ἂν μᾶλλον καὶ ἐπιφανέστερον κακω- θεῖεν ἢ ῥυφέοντες, δι’ οὐδὲν ἄλλο ἢ διὰ τὴν ἰσχὺν τοῦ βρώματος πρὸς τὴν διάθεσιν" καὶ ὅτῳ ῥυφεῖν μὲν συμφέρει, ἐσθίειν δ᾽ οὔ, εἰ πλείω φάγοι, πολὺ Ἃ a , a > ? , Ν > > / ἂν μᾶλλον κακωθείη, ἢ εἰ OALya? Kal εἰ ὀλίγα δέ, πονήσειεν ἄν. πάντα δὴ τὰ αἴτια τοῦ πόνου ἐς τὸ αὐτὸ ἀνάγεται, τὰ ἰσχυρότατα μάλιστά τε καὶ ἐπιφανέστατα λυμαίνεσθαι τὸν ἄνθρωπον καὶ τὸν ὑγιᾶ ἐόντα καὶ τὸν κάμνοντα.
1 ἄντικρυς M: φανερῶς A: Hesychius gives φανερῶς as an explanation of ἄντικρυς. 22
ANCIENT MEDICINE, v.—v1.
suflicient only occasionally, and although clearly beneficial with some patients, it was not so in all cases, aS some were in such a condition that they could not assimilate even small quantities of food. As such patients were thought to need weaker nutri- ment, slops were invented by mixing with much water small quantities of strong foods, and by taking away from their strength by compounding and boiling. Those that were not able to assimilate them were refused even these slops, and were reduced to taking liquids, these moreover being so regulated in composition and quantity as to be moderate, and nothing was administered that was either more or less, or less compounded, than it ought to be.
VI. lt must be clearly understood that some are not benefited in disease by slops, but when they take them, their fever and pain grow manifestly worse, and it is plain that what is taken proves nourishment and increase to the disease, but wears away and enfeebles the body. Any men who in this condition take dry food, barley-cake or bread, even though it be very little, will be hurt ten times more, and more obviously, than if they take slops, simply and solely because the food is too strong for their condition; and a man to whom slops are beneficial, but not solid food, will suffer much more harm if he eat more than if he eat little, though he will feel pain even if he eat little. Now all the causes of the pain can be reduced to one, namely, it is the strongest foods that hurt a man most and most obviously, whether he be well or ill.
2 ἢ εἰ ὀλίγα Ermerins: ἢ ὀλίγα A: the words are generally omitted in MSS.
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Vile Tesoun φαίνεται ἑτεροῖον διανοηθεὶς ὁ καλεύμενος ὦ ἰητρὸς καὶ ὁμολογεομένως χειροτέχνης, ὃς ἐξεῦρε τὴν ἀμφὶ τοὺς κάμνοντας δίαιτάν τε καὶ τροφήν, ἢ ἐκεῖνος ὁ ἀπ᾽ ἀρχῆς τοῖσι πᾶσιν ἀνθρώ- ποισιν τροφήν, ἡ νῦν χρώμεθα, ἐξ ἐκείνης τῆς ἀγρίης τε καὶ θηριώδεος διαίτης εὑρών Te καὶ παρασκευασάμενος; ἐμοὶ μὲν γὰρ φαίνεται ὁ ὁ αὐτὸς λόγος καὶ ἕν καὶ ὅμοιον τὸ εὕρημα. ὁ μέν, ὅσων μὴ ἐδύνατο ἡ φύσις ἡ ἀνθρωπίνη ὑγιαίνουσα ἐπικρατεῖν ἐμπιπτόντων διὰ τὴν θηριότητά τε καὶ τὴν ἀκρησίην, ὁ δέ, ὅσων ἡ διάθεσις, ἐν οἵῃ ἂν ἑκάστοτε ἕκαστος τύχῃ διακείμενος, μὴ δύνηται ἐπικρατεῖν, ταῦτα ἐζήτησεν ἀφελεῖν. τί δὴ τοῦτο ἐκείνου διαφέρει ἀλλ᾽ ἢ t πλέον Τ' τό γε εἶδος, καὶ ὅτι ποικιλώτερον καὶ πλείονος πρηγματίης, ἀρχὴ δὲ ἐκείνη ἡ πρότερον γενομένη;
VIII. Ee δέ τις σκέπτοιτο τὴν τῶν καμνόντων δίαιταν πρὸς τὴν τῶν ὑγιαινόντων, εὕροι ἂν τὴν τῶν θηρίων τε καὶ τῶν ἄλλων “ζῴων οὐ βλαβε- ρωτέρην πρὸς τὴν τῶν ὑγιαινόντων. ἀνὴρ “γὰρ κάμνων νοσήματι μήτε τῶν χαλεπῶν τε καὶ ἀπό- ρων “μήτε αὖ τῶν παντάπασιν εὐηθέων, ἀλλ᾽ 6 τι αὐτῷ ἐξαμαρτάνοντι μέλλει ἐπίδηλον el ἢ εἰ ἐθέλοι καταφαγεῖν ἄρτον καὶ κρέας ἢ ἄλλο τι ὧν οἱ ὑγιαίνοντες ἐσθίοντες ὠφελέονται, μὴ πολλόν, ἀλλὰ πολλῷ ἔλασσον ἢ ὑγιαίνων ἂν ἐδύνατο, ἄλλος τε τῶν ὑγιαινόντων φύσιν ἔχων μήτε
1 πλέον MSS. : omitted by Reinhold. Was πλέον a misread gloss (πλὴν) on ἀλλ᾽ 7H?
1 Or ‘‘appearance.” The two pursuits are really one, but they appear toa eee observer to differ.
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ANCIENT MEDICINE, νη.-- νι.
VII. What difference then can be seen between the purpose of him we call physician, who is an acknowledged handicraftsman, the discoverer of the mode of life and of the nourishment suitable for the sick, and his who discovered and prepared originally nourishment for all men, which we now use, instead of the old savage and brutish mode of living? My own view is that their reasoning was identical and the discovery one and the same. The one sought to do away with those things which, when taken, the constitution of man in health could not assimilate because of their brutish and uncompounded character, the other those things which the temporary condi- tion of an individual prevented him from assimilating. How do the two pursuits differ, except in their scope ! and in that the latter is more complex and requires the greater application, while the former is the starting point and came first in time ?
VIII. A consideration of the diet of the sick, as compared with that of men in health, would show that the diet of wild beasts and of animals generally is not more harmful, as compared with that of men in health.? Take a man sick of a disease which is neither severe and desperate nor yet altogether mild, but likely to be pronounced under wrong treatment, and suppose that he resolved to eat bread, and meat, or any other food that is beneficial to men in health, not much of it, but far less than he could have taken had he been well; take again a man in health, with a constitution neither altogether weak nor altogether
2 The text here is very uncertain; I have combined that of Littré with that of Kiihlewein so as to give a good sense: ‘“‘The diet of men in health is as injurious to the sick as the diet of wild beasts is to men in health.”
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παντάπασιν ἀσθενέα μήτε αὖ ἰσχυρὴν φάγοι τι ὧν βοῦς ἢ ἵππος φαγὼν ἂν ὠφελοῖτό τε καὶ ἰσχύοι, ὀρόβους ἢ κριθὰς 7) ἄλλο τι τῶν τοιούτων, μὴ πολύ, ἀλλὰ πολλῷ μεῖον ἢ δύναιτο, οὐκ ἂν ἧσσον ὁ ὑγιαίνων τοῦτο ποιήσας πονήσειέ τε καὶ κινδυνεύσειε κείνου τοῦ νοσέοντος, ὃς τὸν ἄρτον ἢ τὴν μᾶζαν ἀκαίρως προσηνέγκατο. ταῦτα δὴ πάντα τεκμήρια, OTL αὕτη ἡ τέχνη πᾶσα ἡ ἰητρικὴ τῇ αὐτῇ ὁδῷ ζητεομένη εὑρίσκοιτο ἄν.
IX. Kai εἰ μὲν ἣν ἁπλοῦν, ὥσπερ ὑφήγητο, ὅσα μὲν ἦν ἰσχυρότερα, ἔβλαπτεν, ὅσα δ᾽ ἣν ἀσθενέστερα, ὠφέλει τε καὶ ἔτρεφεν καὶ τὸν κάμ- νονταὰ καὶ τὸν ὑγιαίνοντα, εὐπετὲς ἂν ἣν τὸ πρῆγμα" πολλὸν γὰρ τοῦ ἀσφαλέος ἂν ἔδει περιλαμβά- νοντας ἄγειν ἐπὶ τὸ ἀσθενέστερον. νῦν δὲ οὐκ ἔλασσον ἁμάρτημα, οὐδὲ ἧσσον λυμαίνεται τὸν ἄνθρωπον, ἢν ἐλάσσονα καὶ ἐνδεέστερα τῶν ἱκα- νῶν προσφέρηται. .τὸ γὰρ τοῦ λιμοῦ μένος δύνα- ται ἰσχυρῶς ἐν τῇ φύσει τοῦ ἀνθρώπου καὶ γυιῶσαι καὶ ἀσθενέα ποιῆσαι καὶ ἀποκτεῖναι. πολλὰ δὲ καὶ ἄλλα κακὰ ἑτεροῖα τῶν ἀπὸ πληρώσιος, οὐχ ἧσσον δὲ δεινά, καὶ ἀπὸ κενώσιος. διότι πολλὸν ποικιλώτερά τε καὶ διὰ πλείονος ἀκριβείης ἐστί. δεῖ γὰρ μέτρου τινὸς στοχάσασθαι. μέτρον δὲ οὔτε ἀριθμὸν οὔτε σταθμὸν ἄλλον, πρὸς ὃ ἀναφέ- ρων εἴσῃ τὸ ἀκριβές, οὐκ ἂν εὕροις ἀλλ᾽ ἢ τοῦ σώματος τὴν αἴσθησιν. διὸ ἔργον οὕτω κατα- μαθεῖν ἀκριβέως, ὥστε σμικρὰ ἁμαρτάνειν ἔνθα ἢ ἔνθα. κἂν ἐγὼ τοῦτον τὸν ἰητρὸν ἰσχυρῶς ἐπαινέοιμι τὸν σμικρὰ ἁμαρτάνοντα. τὸ δὲ ἀτρε- κὲς ὀλιγάκις ἔστι κατιδεῖν. ἐπεὶ οἱ πολλοί γε τῶν ἰητρῶν τὰ αὐτά μοι δοκέουσιν τοῖσι κακοῖσι 26
ANCIENT MEDICINE, vut.-1x.
strong, and suppose he were to eat one of the foods that would be beneficial and strength-giving to an ox or a horse, vetches or barley or something similar, not much of it, but far less than he could take. If the man in health did this he would suffer no less pain and danger than that sick man who took bread or barley-cake at a time when he ought not. ΑἸ] this goes to prove that this art of medicine, if research be continued on the same method, can all be discovered.
IX. If the matter were simple, as in these in- stances, and both sick and well were hurt by too strong foods, benefited and nourished by weaker foods, there would be no difficulty. For recourse to weaker food must have secured a great degree of safety. But as it is, if a man takes insufficient food, the mistake is as great as that of excess, and harms the man just as much. For abstinence has upon the human constitution a most powerful effect, to enervate, to weaken and to kill. Depletion produces many other evils, different from those of repletion, but just as severe. Wherefore the greater complexity of these ills requires a more exact method of treatment. For it is necessary to aim at some measure. But no measure, neither number nor weight, by reference to which knowledge can be made exact, can be found except bodily feeling. Wherefore it is laborious to make knowledge so exact that only small mistakes are made here and there. And that physician who makes only small mistakes would win my hearty praise. Perfectly exact truth is but rarely to be seen. For most physicians seem to me to be in the same
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κυβερνήτῃσι πάσχειν. καὶ γὰρ ἐκεῖνοι ὅταν ἐν γαλήνῃ κυβερνῶντες ἁμαρτάνωσιν, οὐ καταφανέες εἰσίν" ὅταν δὲ αὐτοὺς κατάσχῃ χειμών τε μέγας καὶ ἄνεμος ἐξώστης, φανερῶς πᾶσιν ἤδη ἀνθρώ- ποις Ov ἀγνωσίην καὶ ἁμαρτίην δῆλοί εἰσιν ἀπο- λέσαντες τὴν ναῦν. οὕτω δὴ καὶ οἱ κακοί τε καὶ οἱ πλεῖστοι ἰητροί, ὅταν μὲν θεραπεύωσιν ἀνθρώ- πους μηδὲν δεινὸν ἔχοντας, ἐς ods ἄν τις τὰ μέγιστα ἐξαμαρτάνων. οὐδὲν δεινὸν ἐργάσαιτο-- πολλὰ δὲ τοιαῦτα νοσήματα καὶ πολλόν τι πλείω τῶν δεινῶν ἀνθρώποις συμβαένει---ἐν μὲν τοῖσι τοιούτοις ἁμαρτάνοντες οὐ καταφανέες εἰσὶν τοῖσιν ἰδιώτῃσιν" ὅταν δ᾽ ἐντύχωσιν μεγάλῳ τε καὶ ἰσχυρῷ καὶ ἐπισφαλεῖ νοσήματι, τότε σφέων τά Te ἁμαρτήματα καὶ ἡ ἀτεχνίη πᾶσι καταφανής" οὐ γὰρ ἐς μακρὸν αὐτῶν ἑκατέρου αἱ τιμωρίαι, ἀλλὰ διὰ τάχεος πάρεισιν.
X. "OT 6 οὐδὲν ἐλάσσους ἀπὸ κενώσιος ἀκαίρου eae γίνονται TO ἀνθρώπῳ ἢ ἀπὸ πληρώ- σιος, καταμανθάνειν καλῶς ἔχει ἐπαναφέροντας mls Nabiac teh 7 othe Sif ἐπὶ τοὺς ὑγιαίνοντας. ἔστι yap οἷσιν αὐτῶν συμφέρει μονοσιτεῖν, καὶ τοῦτο διὰ τὸ συμφέρον οὕτως αὐτοὶ ἐτάξαντο, ἄλλοισι δὲ ᾿ἀριστῆν διὰ τὴν αὐτὴν ἀνάγκην" οὕτω γὰρ αὐτοῖσι συμφέρει. καὶ μὴν τοῦτ᾽ εἰσὶ oc) δι᾿ ἡδονὴν ἢ ἢ Ov ἄλλην τινὰ συγκυρίην ἐπετήδευσαν ὁπότερον αὐτῶν. τοῖς μὲν γὰρ πλείστοισι τῶν ἀνθρώπων οὐδὲν διαφέρει, ὁπότερον ἂν ἐπιτηδεύσωσιν, εἴτε μονοσιτεῖν εἴτε ἀριστῆν, τούτῳ τῷ ἔθει χρῆσθαι. εἰσὶ δέ τινες οἱ οὐκ ἂν δύναιντο ἔξω τοῦ συμφέροντος ποιέοντες ῥηϊδίως ἀπαλλάσσειν, ἀλλὰ συμβαίνει αὐτῶν
1 καὶ μὴν τοῦτ᾽ εἰσὶ of Reinhold: μὴ τούτοισιν of MSS. 28
ANCIENT MEDICINE, ιχ.-- ν᾿
case as bad pilots; the mistakes of the latter are unnoticed so long as they are steering in a calm, but, when a great storm overtakes them with a violent gale, all men realise clearly then that it is their ignorance and blundering which have lost the ship. So also when bad physicians, who comprise the great majority, treat men who are suffering from no serious complaint, so that the greatest blunders would not affect them seriously—such illnesses occur very often, being far more common than serious disease—they are not shown up in their true colours to laymen if their errors are confined to such cases; but when they meet with a severe, violent and dangerous illness, then it is that their errors and want of skill are manifest to all. The punishment of the impostor, whether sailor or doctor, is not postponed, but follows speedily.
X. That the discomforts a man feels after un- seasonable abstinence are no less than those of unseasonable repletion, it were well to learn by a reference to men in health. For some of them benefit by taking one meal only each day, and because of this benefit they make a rule of having only one meal; others again, because of the same reason, that they are benefited thereby, take lunch also. Moreover some have adopted one or other of these two practices for the sake of pleasure or for some other chance reason. For the great majority of men can follow indifferently either the one habit or the other, and can take lunch or only one daily meal. Others again, if they were to do anything outside what is beneficial, would not get oft easily, but if they
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VA / “ ἑκατέροισι παρ᾽ ἡμέρην μιαν καὶ ταύτην οὐχ ὅλην / (δ. \ / Ls \ \ μεταβάλλουσιν ὑπερφυὴς κακοπάθεια. οἱ μὲν yap \ / - / ἢν ἀριστήσωσιν μὴ συμφέροντος αὐτοῖσι, εὐθέως \ \ lal \ \ , Bapées καὶ νωθροὶ καὶ TO σῶμα καὶ THY γνώμην a NaN, / x χάσμης Te καὶ νυσταγμοῦ Kal δίψης πλήρεες" ἢν δὲ καὶ ἐπιδειπνήσωσι, καὶ φῦσα καὶ στρόφος καὶ ἡ κοιλίη καταρρήγνυται. καὶ πολλοῖσιν ἀρχὴ ΄ / \ νούσου αὕτη μεγάλης ἐγένετο, Kal ἢν τὰ σιτία, ἃ / le μεμαθήκεσαν ἅπαξ ἀναλίσκειν, ταῦτα δὶς προσ- \ / a SEK ενέγκωνται Kal μηδὲν πλείω. τοῦτο δέ, ἢν ἀρι- Qn ο [οἱ / στῆν μεμαθηκώς τις---καὶ οὕτως αὐτῷ συμφέρον lo / ¢ ἣν---μὴ ἀριστήσῃ, ὅταν τάχιστα παρέλθῃ ἡ ὥρη, 7). ᾽ ΄ὔ 7, , > ΄ SUN ΄ εὐθὺς ἀδυναμίη δεινή, τρόμος, ἀψυχίη" ἐπὶ τού- γ᾽ Ν lal s / \ τοις ὀφθαλμοὶ κοῖλοι, οὖρον χλωρότερον Kal / / θερμότερον, στόμα πικρόν, καὶ Ta σπλάγχνα an ε ΄ , , δοκεῖ of κρέμασθαι, σκοτοδινίη, δυσθυμίη, δυσερ- γείη. ταῦτα δὲ πάντα, καὶ ὅταν δειπνεῖν ἐπιχει- \ € a ΄ ρήσῃ, ἀηδέστερος μὲν ὁ σῖτος, ἀναλίσκειν δὲ οὐ ο , , / δύναται ὅσα ἀριστιζόμενος πρότερον ἐδείπνει. “ \ > \ \ / ἊΝ , ταῦτα δὲ αὐτὰ μετὰ στρόφου καὶ ψόφου κατα- \ 4 / / Baivovta συγκαίει THY κοιλίην, δυσκοιτέουσί τε , / \ , καὶ ἐνυπνιάζουσι τεταραγμένα τε Kal θορυβώδεα. an \ / ε A 4 , πολλοῖσι δὲ Kal τούτων αὕτη ἀρχὴ νούσου ἐγένετο. / lal ΧΙ. Σκέψασθαι δὲ χρή, διὰ τίνα αἰτίην αὐτοῖσιν nr fal 5 , ταῦτα συνέβη. τῷ μέν, οἶμαι, μεμαθηκότι μονο- - ry \ / \ € , σιτεῖν, OTL οὐκ ἀνέμεινεν τὸν χρόνον TOV ἱκανόν, fal nw fol , μέχρι αὐτοῦ ἡ κοιλίη τῶν TH TPOTEpaly προσενη- ΄ / νεγμένων σιτίων ἀπολαύσῃ τελέως καὶ ἐπικρα- ͵ \ A \ ς ΄ b ? SEIN, τήσῃ καὶ λαπαχθῇ TE καὶ ἡσυχάσῃ, ἀλλ᾽ ἐπὶ 30
ANCIENT MEDICINE, x.—x1.
change their respective ways for a single day, nay, for a part of a single day, they suffer excessive dis- comfort. Some, who lunch although lunch does not suit them, forthwith become heavy and sluggish in body and in mind, a prey to yawning, drowsiness and thirst ; while, if they go on to eat dinner as well, flatulence follows with colic and violent diarrhoea. Many have found such action to result in a serious illness, even if the quantity of food they take twice a day be no greater than that which they have grown accustomed to digest once a day. On the other hand, if a man who has grown accustomed, and has found it beneficial, to take lunch, should miss taking it, he suffers, as soon as the lunch-hour is passed, from prostrating weakness, trembling and faintness. Hollowness of the eyes follows; urine becomes paler and hotter, and the mouth bitter; his bowels seem to hang; there come dizziness, depres- sion and listlessness. Besides all this, when he attempts to dine, he has the following troubles: his food is less pleasant, and he cannot digest what formerly he used to dine on when he had lunch. The mere food, descending into the bowels with colic and noise, burns them, and disturbed sleep follows, accompanied by wild and troubled dreams. Many such sufferers also have found these symptoms the beginning of an illness.
XI. It is necessary to inquire into the cause why such symptoms come to these men. The one who had grown accustomed to one meal suffered, I think, because he did not wait sufficient time, until his digestive organs had completely digested and assimi- lated the food taken the day before, and until they had become empty and quiet, but had taken fresh
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, \ ζέουσάν τε καὶ ἐζυμωμένην Kawa ἐπεσηνέγκατο.
δὲ τοιαῦται κοιλίαι πολλῷ τε βραδύτερον πέσσουσι καὶ πλείονος δέονται ἀναπαύσιός τε καὶ ἡσυχίης. ὁ δὲ μεμαθηκὼς ἀριστίξεσθαι, διότι, ἐπειδὴ τάχιστα ἐδεήθη τὸ σῶμα τροφῆς καὶ τὰ πρότερα κατανάλωτο καὶ οὐκ εἶχεν οὐδεμίαν ἀπόλαυσιν, οὐκ εὐθέως αὐτῷ προσεγένετο καινὴ τροφή. φθίνει δὴ καὶ συντήκεται ὑπὸ λιμοῦ. πάντα γάρ, ἃ λέγω πάσχειν τὸν τοιοῦτον ἄνθρωπον, λιμῷ ἀνατίθημι. φημὶ δὲ καὶ τοὺς ἄλλους ἀνθρώ- πους ἅπαντας, οἵτινες ἂν ὑγιαίνοντες ἄσιτοι δύο ἡμέρας ἢ τρεῖς γένωνται, ταῦτα πείσεσθαι, οἱάπερ ἐπὶ τῶν ἀναρίστων γενομένων εἴρηκα.
XII. Τὰς δὲ τοιαύτας φύσιας ἔγωγέ. φημι τὰς ταχέως τε καὶ ἰσχυρῶς τῶν ἁμαρτημάτων ἀπο- λαυούσας ἀσθενεστέρας εἶναι τῶν ἑτέρων. ἐγγύ- Tata δὲ τοῦ ἀσθενέοντός ἐστιν ὁ ἀσθενής, ἔτι δὲ ἀσθενέστερος ὁ ἀσθενέων, καὶ μᾶλλον αὐτῷ προσ- ἥκει ὅ TL ἂν τοῦ καιροῦ ἀποτυγχάνῃ πονεῖν. χαλεπτὸν de? "τοιαύτης ἀκριβείης ἐ ἐούσης περὶ τὴν τέχνην τυγχάνειν αἰεὶ τοῦ ἀτρεκεστάτου. πολλὰ δὲ εἴδεα κατ᾽ ἰητρικὴν ἐς τοσαύτην ἀκρίβειαν ἥ ἥκει, περὶ ὧν εἰρήσεται. οὔ φημι δὲ δεῖν διὰ τοῦτο τὴν τέχνην ὡς οὐκ ἐοῦσαν οὐδὲ καλῶς ξητεομένην τὴν ἀρχαίην ἀποβάλλεσθαι, εἰ μὴ ἔχει περὶ πάντα ἀκρίβειαν, ἀλλὰ πολὺ μᾶλλον διὰ τὸ ἐγγὺς οἶμαι τοῦ ἀτρεκεστάτου δύνασθαι ἥκειν λογισμῷ ἐκ πολλῆς ἀγνωσίης θαυμάζειν τὰ ἐξευρημένα, ὡς Hens καὶ ὀρθῶς ἐξεύρηται καὶ οὐκ ἀπὸ τύχης.
1 ἐπὶ ζέουσαν Zwinger: ἐπιζέουσαν MSS. 2 Littré with some MSS. reads μὴ here. 3 After λογισμῷ in a MS. now lost occurred the words προσίεσθαι καὶ.
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ANCIENT MEDICINE, xr.—xu.
food while the organs were still in a state of hot turmoil and ferment. Such organs digest much more slowly than others, and need longer rest and quiet. The man accustomed to take lunch, since no fresh nourishment was given him as soon as _ his body needed nourishment, when the previous meal was digested and there was nothing to sustain him, naturally wastes and pines away through want. For I put down to want all the symptoms which I have said such a man shows. And I assert furthermore that all other men besides, who when in good health fast for two or three days, will show the same symptoms as I have said those exhibit who do not take their lunch.
XII. Such constitutions, I contend, that rapidly and severely feel the effects of errors, are weaker than the others. A weak man is but one step removed from a sickly man, but a sickly man is weaker still, and is more apt to suffer distress when- ever he misses the due season. And, while the art can admit of such nice exactness, it is difficult always to attain perfect accuracy. But many departments of medicine have reached such a pitch of exactness, and I will speak about them later. I declare, how- ever, that we ought not to reject the ancient art as non-existent, or on the ground that its method of inquiry is faulty, just because it has not attained exactness in every detail, but much rather, because it has been able by reasoning to rise from deep ignorance to approximately perfect accuracy, I think we ought to admire the discoveries as the work, not of chance, but of inquiry rightly and correctly con- ducted.
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XIII. ᾿Επὶ δὲ τῶν τὸν καινὸν τρόπον τὴν τέχνην ζητεύντων ἐξ ὑποθέσιος τὸν λόγον. ἐπανελθεῖν βούλομαι. εἰ γάρ τί ἐστιν θερμὸν ἢ ψυχρὸν ἢ ξηρὸν ἢ ἢ ὑγρὸν τὸ λυμαινόμενον τὸν ἄνθρωπον, καὶ δεῖ τὸν ὀρθῶς ἰ ἰητρεύοντα βοηθεῖν τῷ μὲν θερμῷ ἐπὶ τὸ ψυχρόν, τῷ δὲ ψυχρῷ ἐπὶ τὸ θερμόν, τῷ δὲ ξηρῷ ἐπὶ τὸ ὑγρόν, τῷ δὲ ὑγρῷ ἐπὶ τὸ ξηρόν. ἔστω μοι ἄνθρωπος μὴ τῶν ἰσχυρῶν φύσει, ἀλλὰ τῶν ἀσθενεστέρων" οὗτος δὲ πυροὺς ἐσθιέτω, οὺς ἂν ἀπὸ τῆς ἅλω ἀνέλῃ, ὠμοὺς καὶ ἀργούς, καὶ κρέα ὠμὰ καὶ πινέτω ὕδωρ. ταύτῃ χρεώμενος τῇ διαίτῃ εὖ οἶδ᾽ ὅτι πείσεται πολλὰ καὶ δεινά" καὶ γὰρ πόνους πονήσει καὶ τὸ σῶμα ἀσθενὲς ἔσται καὶ ἡ κοιλίη φθαρήσεται καὶ ζῆν πολὺν χρόνον οὐ δυνήσεται. τί δὴ χρὴ βοήθημα παρεσκευάσθαι ὧδ᾽ ἔχοντι; θερμὸν ἢ ψυχρὸν ἢ ξηρὸν ἢ ὑγρόν; δῆλον γὰρ ὅ ὅτι τούτων Tl. εἰ γὰρ τὸ λυμαινόμενόν ἐστιν τούτων τὸ ἕτερον, τῷ ὑπεναντίῳ προσήκει λῦσαι, ὡς ὁ ἐκείνων λόγος ἔχει. τὸ μὲν γὰρ βεβαιότατόν τε καὶ προφανέστατον φάρμακον ἀφελόντα τὰ διαιτήματα, οἷς ἐχρῆτο, ἀντὶ μὲν τῶν πυρῶν ἄρτον διδόναι, ἀντὶ δὲ τῶν ὠμῶν κρεῶν ἐἑφθά, πιεῖν τε ἐπὶ τούτοισιν οἴνου. ταῦτα μετα- βαλόντα οὐχ οἷόν τε μὴ οὐχ ὑγιᾶ 'γενέσθαι, ἤν γε μὴ παντάπασιν ἢ διεφθαρμένος ὑπὸ χρόνου τε καὶ τῆς διαίτης. τί δὴ φήσομεν; πότερον αὐτῷ ἀπὸ ψυχροῦ κακοπαθέοντι θερμὰ ταῦτα προσε- νέγκαντες ὠφέλησαν ἢ ἢ τἀναντία; οἶμαι γὰρ ἔγωγε
πολλὴν ἀπορίην τῷ ἐρωτηθέντι παρασχεῖν. ὁ γὰρ τὸν ἄρτον παρασκευάξων τῶν πυρῶν τὸ θερμὸν
ἢ τὸ ψυχρὸν ἢ τὸ ξηρὸν ἢ τὸ ὑγρὸν ἀφείλατο ;
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ANCIENT MEDICINE, xin.
XIII. But I want to return to the theory of those who prosecute their researches in the art after the novel fashion, building on a postulate. For if there be such a thing as heat, or cold, or dryness, or moistness, which injures a man, it necessarily follows that the scientific healer will counteract cold with hot, hot with cold, moist with dry and dry with moist. Now suppose we have a man whose constitution is not strong, but weaker than the average. Let this man’s food be wheat straight from the threshing-floor, unworked and uncooked, and raw meat, and let his drink be water. The use of this diet will assuredly cause him much severe suffering ; he will experience pains and_ physical weakness, his digestion will be ruined and he will not be able to live long. Well, what remedy should be prepared for a man in this condition? Heat or cold or dryness or moistness ? One of these, plainly ; for, according to the theory of the new school, if the injury was caused by one of the opposites, the other opposite ought to be a specific. Of course the most obvious as well as the most reliable medicine would be to abandon his old diet, and to give him bread instead of wheat, boiled meat instead of raw meat, and besides these things, a little wine to drink. This change must restore him to his health, unless indeed it has been entirely ruined by long continuance of the diet. What then shall we say? That he was suffering from cold, and that the taking of these hot things benefited him? Or shall we say the opposite? I think that I have nonplussed my opponent. For is it the heat of the wheat, or the cold, or the dryness, or the moistness, that the baker took away from it? .For a thing which has been
ait ore)
.
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ὃ γὰρ καὶ πυρὶ καὶ ὕδατι δέδοται καὶ ἄλλοις πολλοῖσι ἤργασται, ὧν ἕκαστον ἰδίην δύναμιν καὶ φύσιν ἔχει, τὰ μὲν τῶν ὑπαρχόντων ἀποβέβληκε, ἄλλοισι δὲ κέκρηταί τε καὶ μέμικται.
XIV. Οἶδα μὲν γὰρ καὶ τάδε δήπου, ὅ ὅτι δια- φέρει ἐς τὸ σῶμα τοῦ ἀνθρώπου. καθαρὸς ἄρτος ἢ συγκομιστός, ἢ ἀπτίστων πυρῶν ἢ ἐπτισμένων, ἢ πολλῷ ὕδατι πεφυρημένος ἢ ὀλίγῳ, ἢ ἰσχυρῶς πεφυρημένος, ἢ ἀφύρητος, ἢ ἔξοπτος ἢ “ἔνωμος, ἄλλα τε πρὸς τούτοισι μυρία. ὡς δ᾽ αὔτως καὶ περὶ μάζης. καὶ αἱ δυνάμιες μεγάλαι τε ἑκάστου καὶ οὐδὲν ἡ ἑτέρη τῇ ἑτέρῃ ἐοικυῖα. ὅστις δὲ ταῦτα οὐκ ἐπέσκεπται ἢ σκεπτόμενος οὐκ οἶδεν, πῶς ἄν τι οὗτος δύναιτο τῶν κατ᾽ ἄνθρωπον παθημάτων εἰδέναι; ὑπὸ γὰρ ἑνὸς ἑκάστου τούτων πάσχει τε καὶ ἑτεροιοῦται ὁ ἄνθρωπος ἢ τοῖον ἢ τοῖον. καὶ διὰ τούτων πᾶς ὁ βίος καὶ ὑγιαίνοντι καὶ ἐκ νούσου ἀνατρεφομένῳ καὶ κάμνοντι. οὐκ ἂν οὖν ἕτερα τούτων χρησιμώτερα οὐδὲ ἀναγκαι- ότερα εἴη εἰδέναι δήπου, ὡς δὲ καλῶς καὶ λογισμῷ προσήκοντι ζητήσαντες πρὸς τὴν τοῦ ἀνθρώπου φύσιν εὗρον αὐτὰ οἱ πτρῶτοι εὑρόντες καὶ φήθησαν ἀξίην τὴν τέχνην θεῷ προσθεῖναι, ὥσπερ καὶ νομίζεται. οὐ γὰρ τὸ ξηρὸν οὐδὲ τὸ ὑγρὸν οὐδὲ τὸ θερμὸν οὐδὲ τὸ ψυχρὸν οὐδὲ ἄλλο τούτων ἡγησάμενοι οὐδὲν οὔτε λυμαίνεσθαι οὔτε προσδεῖ- σθαι οὐδενὸς τούτων τὸν ἄνθρωπον, ἀλλὰ τὸ ἰσχυρὸν ἑκάστου καὶ τὸ κρέσσον τῆς φύσιος τῆς ἀνθρωπείης, οὗ μὴ ἠδύνατο κρατεῖν, τοῦτο BXa-
1 Or ‘‘ power.” 2 Or “ powers.”
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ANCIENT MEDICINE, xim.-x1Vv.
exposed to fire and to water, and has been made by many other things, each of which has its own indivi- dual property! and nature, has lost some of its qualities and has been mixed and combined with others.
XIV. Of course I know also that it makes a differ- ence to a man’s body whether bread be of bolted or of unbolted flour, whether it be of winnowed or of unwinnowed wheat, whether it be kneaded with much water or with little, whether it be thoroughly kneaded or unkneaded, whether it be thoroughly baked or underbaked, and there are countless other differences. Barley-cake varies in just the same way. The properties? too of each variety are powerful, and no one is like to any other. But how could he who has not considered these truths, or who considers them without learning, know anything about human ailments? For each of these differences produces in a human being an effect and a change of one sort or another, and upon these differences is based all the dieting of a man, whether he be in health, recovering from an illness, or suffering from one. Accordingly there could surely be nothing more useful or more necessary to know than these things, and how the first discoverers, pursuing their inquiries excellently and with suitable application of reason to the nature of man, made their dis- coveries, and thought the art worthy to be ascribed to a god, as in fact is the usual belief. For they did, not consider that the dry or the moist or the hot or the cold or anything else of the kind injures a man, or that he has need of any such thing, but they considered that it is the strength of each thing, that which, being too powerful for the human constitu- tion, it cannot assimilate, which causes harm, and
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ΠΕΡῚ APXAIHS IHTPIKH
πτειν ἡγήσαντο καὶ τοῦτο ἐξήτησαν ἀφαιρεῖν. ἰσχυρότατον δ᾽ ἐστὶ τοῦ μὲν γλυκέος τὸ γλυκύ- τατον, τοῦ δὲ πικροῦ τὸ πικρότατον, τοῦ δὲ ὀξέος τὸ ὀξύτατον, ἑκάστου δὲ πάντων τῶν ἐνεόντων ἡ ἀκμή. ταῦτα γὰρ ἑώρων καὶ ἐν τῷ ἀνθρώπῳ ἐνεόντα καὶ λυμαινόμενα τὸν ἄνθρωπον. ἔνε γὰρ ἐν ἀνθρώπῳ καὶ ἁλμυρὸν καὶ πικρὸν καὶ γλυκὺ καὶ ὀξὺ καὶ στρυφνὸν καὶ πλαδαρὸν καὶ ἄλλα μυρία παντοίας δυνάμιας ἔχοντα πλῆθός τε καὶ ἰσχύν. ταῦτα μὲν μεμιγμένα καὶ κεκρημένα ἀλλήλοισιν οὔτε φανερά ἐστιν οὔτε λυπεῖ τὸν ἄνθρωπον. ὅταν δέ τι τούτων ἀποκριθῇ καὶ αὐτὸ ἐφ᾽ ἑωυτοῦ γένηται, τότε καὶ φανερόν ἐστι καὶ λυπεῖ τὸν ἄνθρωπον: τοῦτο δέ, τῶν βρωμάτων ὅσα ἡμῖν ἀνεπιτήδειά ἐστιν καὶ λυμαίνεται τὸν ἄνθρωπον ἐμπεσόντα, τούτων. ἕν ἕκαστον ἢ πικρόν ἐστιν "ἢ ἁλμυρὸν ἢ ὀξὺ ἢ ἄλλο τι ἄκρητόν τε καὶ ἰσχυρόν, καὶ διὰ τοῦτο “ταρασσόμεθα ὑπ᾽ αὐτῶν, ὥσπερ καὶ ὑπὸ τῶν ἐν τῷ σώματι ἀποκρινομένων. πάντα δὲ ὅσα ἄνθρωπος ἐσθίει ἢ πίνει, τὰ τοιαῦτα βρώματα ἥκιστα τοιούτου χυμοῦ ἀκρήτου τε καὶ διαφέροντος δῆλά ἐστιν μετέχοντα, οἷον ἄρτος τε καὶ μᾶξα καὶ τὰ ἑπόμενα τούτοις, οἷς εἴθισται ὁ ἄνθρωπος πλείστοισί τε καὶ αἰεὶ χρῆσθαι, ἔξω τῶν πρὸς ἡδονήν τε καὶ κόρον ἠρτυμένων τ καὶ ἐσκευασμένων. _ καὶ ἀπὸ τούτων πλείστων ἐσιόντων ἐς τὸν ἄνθρωπον τάραχος καὶ ἀπόκρισις τῶν ἀμφὶ τὸ σῶμα δυναμίων ἥκιστα γίνεται, ἰσχὺς δὲ καὶ αὔξησις καὶ τροφὴ μάλιστα δι’ οὐδὲν ἕτερον γίνεται ἢ ὅτι εὖ τε κέκρηται καὶ οὐδὲν ἔχει οὔτε ἄκρητον οὔτε ἰσχυρόν, ἀλλ᾽ ὅλον ἕν τε γέγονε καὶ ἁπλοῦν.
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ANCIENT MEDICINE, xiv.
this they sought to take away. The strongest part of the sweet is the sweetest, of the bitter the most bitter, of the acid the most acid, and each of all the component parts of man has its extreme. For these they saw are component parts of man, and that they are injurious to him ; for there is in man salt and bitter, sweet and acid, astringent and insipid,! and a vast number of other things, possessing properties of all sorts, both in number and in strength. These, when mixed and compounded with one another are neither apparent nor do they hurt a man; but when one of them is separated off, and stands alone, then it is apparent and hurts a man. Moreover, of the foods that are unsuitable for us and hurt a man when taken, each one of them is either bitter, or salt, or acid, or something else uncompounded and strong, and for this reason we are disordered by them, just as we are by the secretions separated off in the body. But all things that a man eats or drinks are plainly altogether free from such an uncompounded and potent humour, e.g. bread, cake, and suchlike, which men are accustomed constantly to use in great quantity, except the highly seasoned delicacies which gratify his appetite and greed. And from such foods, when plentifully partaken of by a man, there arises no disorder at all or isolation of the powers? resident in the body, but strength, growth and nourishment in great measure arise from them, for no other reason except that they are well compounded, and have nothing undiluted and strong, but form a single, simple whole.
1 Or ‘flat,’ the opposite of “sharp.” 2. Or “ properties.” 29
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᾽ ’ v τε \ , :) lal XV. ᾿Απορέω δ᾽ ἔγωγε, οἱ τὸν λόγον ἐκεῖνον ͵ iol ς fa λέγοντες καὶ ἄγοντες ἐκ ταύτης τῆς ὁδοῦ ἐπὶ e / / / ὑπόθεσιν THY τέχνην τίνα ποτὲ τρόπον θεραπεύ- \ “ A ovat τοὺς ἀνθρώπους, ὥσπερ ὑποτίθενται. οὐ γάρ ἐστιν αὐτοῖς, οἶμαι, ἐξευρημένον αὐτό τι ἐφ᾽ ἑωυτοῦ θερμὸν ἢ ψυχρὸν ἢ ξηρὸν ἢ ὑγρὸν μηδενὶ ἄλλῳ εἴδει κοινωνέον. ἀλλ᾽ οἴομαι ἔγωγε ταὐτὰ βρώματα καὶ πόματα αὐτοῖσι ὑπάρχειν, οἷσι , / A πὴ πάντες χρεώμεθα. προστιθέασι δὲ τῷ μὲν εἶναι θερμῷ, τῷ δὲ ψυχρῷ, τῷ δὲ ξηρῷ, τῷ δὲ ὑγρῷ, ἐπεὶ ἐκεῖνό γε ἄπορον “προστάξαι τῷ κάμνοντι θερμόν τι προσενέγκασθαι. εὐθὺ γὰρ ἐρωτήσει" “ aA 3 ΄ A τί; ὥστε ληρεῖν ἀνάγκη ἢ ἐς τούτων TL τῶν γινω- \ σκομένων καταφεύγειν. εἰ δὲ δὴ τυγχάνει τι \ \ / » \ Χ 3N\ θερμὸν ἐὸν στρυφνόν, ἄλλο δὲ θερμὸν ἐὸν πλα- ἐφ ya \ \ ” ” » \ \ dapov, ἄλλο δὲ θερμὸν ἄραδον ἔχον --ἔστι yap Kal » \ \ \ » 7 ΄ » ἄλλα πολλὰ θερμὰ καὶ ἄλλας δυνάμιας ἔχοντα id lal e / n ἑωυτοῖς ὑπεναντίας --- ἢ διοίσει τὸ" αὐτῶν προσε- νεγκεῖν τὸ θερμὸν καὶ στρυφνὸν ἢ τὸ θερμὸν καὶ πλαδαρὸν ἣ ἢ ἅμα τὸ ψυχρὸν καὶ στρυφνόν- ἔστι γὰρ καὶ τοιοῦτο--ἢ τὸ ψυχρόν τε καὶ πλαδαρόν' ὥσπερ γὰρ ἐγὼ οἶδα, πᾶν τοὐναντίον ἀφ᾽ ἑκατέρου αὐτῶν ἀποβαίνει, οὐ μοῦνον ἐν ἀνθρώπῳ, ἀλλὰ \ ’ / \ 3 , ‘ > ” lal καὶ ἐν OKUTEL καὶ ἐν ξύλῳ καὶ ἐν ἄλλοις πολλοῖς, \ \ ἅ ἐστιν ἀνθρώπου ἀναισθητότερα. οὐ γὰρ τὸ θερμόν ἐστιν τὸ τὴν μεγάλην δύναμιν ἐ ἔχον, ἀλλὰ τὸ στρυφνὸν καὶ τὸ πλαδαρὸν καὶ τἄλλα ὅσα μοι εἴρηται καὶ ἐν τῷ ἀνθρώπῳ καὶ ἔξω τοῦ ἀνθρώπου, καὶ ἐσθιόμενα καὶ πινόμενα καὶ ἔξωθεν ἐπιχριό- μενά τε καὶ προσπλασσόμενα.
1.2 διοίσει τι M: εἰ δεοίσει τί A: εἰ δεήσει τι most MSS.: δεήσει δέ τι Littré: ἢ μὴ διοίσει τι ; Gomperz.
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ANCIENT MEDICINE, xv.
XV. Iam ata loss to understand how those who maintain the other view, and abandon the old method to rest the art on a postulate, treat their patients on the lines of their postulate. For they have not discovered, I think, an absolute hot or cold, dry or moist, that participates in no other form. But 1 think that they have at their disposal the same foods and the same drinks as we all use, and to one they add the attribute of being hot, to another, cold, to another, dry, to another, moist, since it would be futile to order a patient to take something hot, as he would at once ask, “ What hot thing?” So that they must either talk nonsense or have recourse to one of these known substances. And if one hot thing happens to be astringent, and another hot thing insipid, and a third hot thing causes flatulence (for there are many various kinds of hot things, possessing many opposite powers), surely it will make a difference whether he adminis- ters the hot astringent thing, or the hot insipid thing, or that which is cold and astringent at the same time (for there is such a thing), or the cold insipid thing. For [ am sure that each of these pairs produces exactly the opposite of that produced by the other, not only in a man, but in a leathern or wooden vessel, and in many other things less sensitive than man. For it is not the heat which possesses the great power, but the astringent and the insipid, and the other qualities I have mentioned, both in man and out of man, whether eaten or drunk, whether applied externally as ointment or as plaster.
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XK Vie Ψυχρότητα δ᾽ ἐγὼ καὶ θερμότητα πασέων ἥκιστα τῶν δυναμίων νομίξω δυναστεύειν ἐν τῷ σώματι διὰ τάσδε τὰς αἰτίας" ὃν μὲν ἂν δήπου χρόνον μεμιγμένα αὐτὰ ἑωυτοῖς ἅμα τὸ θερμόν τε καὶ ψυχρὸν ἐνῇ, οὐ λυπεῖ. “κρῆσις γὰρ καὶ μετριότης TO μὲν θερμῷ γίνεται ἀπὸ τοῦ ψυχροῦ, τῷ δὲ ψυχρῷ ἀπὸ τοῦ θερμοῦ. ὅταν δ᾽ ἀπο- κριθῇ χωρὶς ἑκάτερον, τότε λυπεῖ. ἐν δὲ δὴ τούτῳ τῷ καιρῷ, ὅταν τὸ ψυχρὸν ἐπιγένηται καί τι λυπήσῃ τὸν ἄνθρωπον, διὰ τάχεος
πρῶτον δ αὐτὸ τοῦτο πάρεστιν τὸ θερμὸν αὐτόθεν ἐκ τοῦ ἀνθρώπου, οὐδεμιῆς βοηθείης οὐδὲ παρασκευῆς δεόμενον. καὶ ταῦτα καὶ ἐν ὑγιαί- νουσι τοῖς ἀνθρώποις ἀπεργάζεται καὶ ἐν κάμνουσι. τοῦτο μέν, εἴ τις θέλει ὑγιαίνων χειμῶνος διαψῦξαι τὸ σῶμα ἢ λουσάμενος ψυχρῷ, ἢ ἄλλῳ τῳ τρόπῳ, ὅσῳ ἂν ἐπὶ πλεῖον αὐτὸ ποιήσῃ, καὶ ἤν γε μὴ παντάπασιν παγῇ τὸ σῶμα, ὅταν εἵματα λάβῃ καὶ ἔλθῃ ἐς τὴν σκέπην, ἔτι μᾶλλον καὶ ἐπὶ πλεῖον θερμαίνεται τὸ σῶμα' τοῦτο δέ, εἰ ἐθέλοι ἐκθερμανθῆναι ἰ ἰσχυρῶς ἢ λουτρῷ θερμῷ ἢ πυρὶ πολλῷ, ἐκ δὲ τούτου τὸ αὐτὸ εἷμα ἔχων ἐν τῷ αὐτῷ χωρίῳ τὴν διατριβὴν ποιεῖσθαι ὥσπερ διε- ψυγμένος, πολὺ φαίνεται καὶ ψυχρότερος καὶ
ἄλλως φρικαλεώτερος" ἢ εἰ ῥιπιξόμενός τις ὑπὸ πνίγεος καὶ παρασκευαζόμενος αὐτὸς ἑωυτῷ ψῦχος ἐκ τοιούτου ἂν τρόπου διαπαύσαιτο τοῦτο ποιέων, δεκαπλάσιον ἔσται τὸ καῦμα καὶ πνῖγος ἢ τῷ μηδὲν τοιοῦτο ποιέοντι.
Τόδε δὴ καὶ πολὺ μέζον." ὅσοι, ἂν διὰ χιόνος ἢ ἄλλου ψύχεος βαδίσαντες ῥιγώσωσι δια- φερόντως πόδας ἢ χεῖρας ἢ κεφαλήν, οἷα 42
ANCIENT MEDICINE, xvi.
XVI. And I believe that of all the powers! none hold less sway in the body than cold and heat. My reasons are these. So long as the hot and cold in the body are mixed up together, they cause no pain. For the hot is tempered and moderated by the cold, and the cold by the hot. But when either is entirely se- parated from the other, then it causes pain. And at that season, when cold comes upon a man and causes him some pain, for that very reason internal heat first is present quickly and spontaneously, without needing any help or preparation. The result is the same, whether men be diseased or in_ health. For instance, if a man in health will cool his body in winter, either by a cold bath or in any other way, the more he cools it (provided that his body is not entirely frozen) the more he becomes hotter than before when he puts his clothes on and enters his shelter. Again, if he will make himself thoroughly hot by means of either a hot bath of a large fire, and afterwards wear the same clothes and stay in the same place as he did when chilled, he feels far colder and besides more shivery than before. Or if a man fan himself because of the stifling heat and make coolness for himself, on ceasing to do this in this way he will feel ten times the stifling heat felt by one who does nothing of the sort.
Now the following is much stronger evidence still. All who go afoot through snow or great cold, and become over-chilled in feet, hands or head, suffer at
1 Or ‘‘ properties.”
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πάσχουσιν ἐς τὴν νύκτα, ὅταν περισταλεωσί τε καὶ ἐν ἀλέῃ γένωνται ὑπὸ καύματος καὶ κνησμοῦ. καὶ ἔστιν οἷσι φλύκταιναι ἀνίστανται ὥσπερ τοῖς ἀπὸ πυρὸς κατακεκαυμένοις. καὶ οὐ πρότερον τοῦτο πάσχουσιν, πρὶν θερμανθέωσιν. οὕτως ἑτοίμως ἑκάτερον αὐτῶν ἐπὶ θάτερον παρα- γίνεται. μυρία δ᾽ ἂν καὶ ἄλλα ἔχοιμι εἰπεῖν. τὰ δὲ κατὰ τοὺς νοσέοντας, οὐχὶ ὅσοις ἂν ῥῖγος γένηται, τούτοις ὀξύτατος ὁ πυρετὸς ἐκλάμπει; καὶ οὐχὶ ὅπως ἰσχυρός, ἀλλὰ καὶ παυόμενος δι᾽ ὀλίγου, καὶ ἄλλως τὰ πολλὰ ἀσινὴς καὶ ὅσον ἂν χρόνον παρῇ διάθερμος; καὶ διεξιὼν διὰ παντὸς τελευτᾷ ἐς τοὺς πόδας μάλιστα, οὗπερ τὸ ῥῖγος καὶ ἡ ψύξις νεηνικωτάτη καὶ ἐπὶ πλεῖον ἐνεχρό- νισεν' πάλιν τε ὅταν ἱδρώσῃ τε καὶ ἀπαλλαγῇ ὁ TUPETOS, πολὺ μᾶλλον διέψυξε ἢ ἢ εἰ μὴ ἔλαβε τὴν ἀρχήν. ὧ οὖν διὰ τάχεος οὕτω παραγίνεται τὸ ἐναντιώτατόν τε καὶ ἀφαιρεόμενον τὴν δύναμιν ἀπὸ τωὐτομάτου, τί ἂν ἀπὸ τούτου μέγα ἢ δεινὸν γένοιτο; ἢ τί δεῖ πολλῆς ἐπὶ τούτῳ βοηθείης; XVII. Εἴποι ἄν τις" ἀλλ᾽ οἱ πυρεταίνοντες τοῖσι καὐσοισίτε καὶ περιπνευμονίῃσι καὶ ἄλλοισι ἰσχυροῖσι νοσήμασι οὐ ταχέως ἐκ τῆς θέρμης ἀπαλλάσσονται, οὐδὲ πάρεστιν ἐνταῦθα ἔτι τὸ θερμὸν ἢ ἢ τὸ “Ψυχρόν. ἐγὼ δέ μοι τοῦτο μέγιστον τεκμήριον ἡγεῦμαι εἶναι, ὅτι οὐ διὰ τὸ θερμὸν ἁπλῶς πυρεταίνουσιν οἱ ἄνθρωποι, οὐδὲ τοῦτο εἴη τὸ αἴτιον THs κακώσιος μοῦνον, ἀλλ᾽ ἔστι καὶ πικρὸν καὶ θερμὸν τὸ αὐτό, καὶ ὀξὺ καὶ θερμόν,
1 οὐχὶ ὅπως Diels: οὐχὶ οὕτως A: οὐχ οὕτως Μ. 2 ἰσχυρὺς Coray: ἰσχυρῶς MSS.
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ANCIENT MEDICINE, xvi.—xvu.
night very severely from burning and tingling when they come into a warm place and wrap up; in some cases blisters arise like those caused by burning in fire. But it is not until they are warmed that they experience these symptoms. So ready is cold to pass into heat and heat into cold. I could give a multi- tude of other proofs. But in the case of sick folk, is it not those who have suffered from shivering in whom breaks out the most acute fever? And not only is it not powerful, but after a while does it not subside, generally without doing harm all the time it remains, hot as it is? And passing through all the body it ends in most cases in the feet, where the shivering and chill were most violent and lasted unusually long. Again, when the fever disappears with the breaking out of the perspiration, it cools the patient so that he is far colder than if he had never been attacked at all. What important or serious consequence, there- fore, could come from that thing on which quickly supervenes in this way its exact opposite, spontane- ously annulling its effect?! Or what need has it of elaborate tr eatment} p
XVII. An opponent may retort, “But patients whose fever comes from ardent fevers,’ pneumonia, or other virulent disease, do not quickly get rid of their feverishness, and in these cases the heat and cold no longer alternate.” Now I consider that herein lies my strongest evidence that men are not feverish merely through heat, and that it could not be the sole cause of the harm; the truth being that one and the same thing is both bitter and hot, or acid and
1 Or ‘‘ power.” 2 καῦσος was almost certainly a form of remittent malaria. See my Malaria and Greek History (index),
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ΠΕΡῚ APXAIH2 IHTPIKHS
Kal ἁλμυρὸν Kal θερμόν, καὶ ἄλλα μυρία, καὶ πάλιν γε ψυχρὸν μετὰ δυναμίων ἑ ἑτέρων. τὰ μὲν οὖν λυμαινόμενα ταῦτ᾽ ἐστί: συμπάρεστι δὲ καὶ τὸ θερμόν, ῥώμης μὲν ἔχον ὅσον τὸ" ἡγεύμενον καὶ παροξυνόμενον καὶ αὐξόμενον ἅμα ἐκείνῳ, δύναμιν δὲ οὐδεμίαν πλείω τῆς προσηκούσης.
XVIII. Δῆλα δὲ ταῦτα ὅτι ὧδε ἔχει ἐπὶ τῶνδε τῶν σημείων: πρῶτον μὲν ἐπὶ τὰ φανερώτερα, ὧν πάντες ἔμπειροι πολλάκις ἐσμέν τε καὶ ἐσό- μεθα. τοῦτο μὲν γάρ, ὅσοισι ἂν ἡμέων Koputa ἐγγένηται καὶ ῥεῦμα κινηθῇ διὰ τῶν ῥινῶν, τοῦτο ὡς τὸ πολὺ δριμύτερον τοῦ πρότερον γινομένου τε καὶ ἰόντος ἐκ τῶν ῥινῶν καθ᾽ ἑκάστην ἡμέρην καὶ οἰδεῖν μὲν ποιεῖ τὴν ῥῖνα καὶ συγκαίει θερμήν τε καὶ διάπυρον ἐσχάτως, ἣν δὴ ὃ τὴν χεῖρα προσ- φέρῃς" ay πλείω χρόνον παρῇ, καὶ ἐξελκοῦται τὸ χωρίον ἄσαρκόν τε καὶ σκληρὸν ἐόν. παύεται δέ πως τὸ καῦμα ἐκ τῆς ῥινός, οὐχ ὅταν τὸ ῥεῦμα γίνηται καὶ ἡ φλεγμονὴ ἦ, ἀλλ᾽ ἐπειδὰν παχύ- τερόν τε καὶ ἧσσον δριμὺ ῥ ῥέῃ, πέπον καὶ μεμιγμέ- νον μᾶλλον τοῦ πρότερον EO τότε δὲ ἤδη καὶ τὸ καῦμα πέπαυται. ἀλλ᾽ οἷσι δὲ ὃ ὑπὸ ψύχεος φανερῶς αὐτοῦ μούνου γίνεται μηδενὸς ἄλλου συμπαραγενομένου, πᾶσι δὲ ἡ αὐτὴ ἀπαλλαγή, ἐκ μὲν τῆς ψύξιος διαθερμαιθῆναι, ἐκ δὲ τοῦ καύματος διαψυχθῆναι, καὶ ταῦτα ταχέως παρα- γίνεται καὶ πέψιος οὐδεμιῆς προσδεῖται. τὰ δ᾽
1 μὲν ἔχον ὅσον τὸ Reinhold: μετέχον, ὡς ἂν τὸ MSS.
ἐπὶ τὰ AM: ἐστι many MSS.: ἔπι τὰ Kiihlewein. ἐσχάτως, ἣν δὴ Coray: ἐσχάτως. ἢν δὲ MSS. τοῦ πρότερον γινομένου Coray and Reinhold: τὸ πρότερον γινομένῳ A: τῷ πρότερον γινομένῳ Μ.
5 ἀλλ᾽ οἷσι δὲ Littré: ἄλλοισι δὲ MSS. 46
"Ὁ (ὦ to
ANCIENT MEDICINE, xvu.-xvut.
hot, or salt and hot, with numerous other combina- tions, and cold again combines with other powers.} It is these things which cause the harm. Heat, too, is present, but merely as a concomitant, having the strength of the directing factor which is aggravated and increases with the other factor, but having no power” greater than that which properly belongs to it.
XVIII. That this is so is plain if we consider the following pieces of evidence. First we have the more obvious symptoms, which all of us often experience and will continue so to do. In the first place, those of us who suffer from cold in the head, with discharge from the nostrils, generally find this discharge more acrid than that which previously formed there and daily passed from the nostrils; it makes the nose swell, and inflames it to an extremely fiery heat, as is shown if you put your hand upon it.3 And if the disease be present for an unusually long time, the part actually becomes ulcered, although it is without flesh and hard. But in some way the heat of the nostril ceases, not when the discharge takes place and the inflammation is present, but when the running becomes thicker and less acrid, being matured and more mixed than it was before, then it is that the heat finally ceases. But in cases where the evil obviously comes from cold alone, unaccompanied by anything else, there is always the same change, heat following chill and chill heat, and these supervene at once, and need no coction. In all other instances,
1 Or “ properties.”
2 Or ‘‘ effect.”
° Or, with the MSS. reading, ‘And if you keep putting your hand to it, and the catarrh last a long time,” ete.
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ἄλλα πάντα, ὅσα διὰ χυμῶν δριμύτητας καὶ ἀκρησίας, φημὶ ἔγωγε γίνεσθαι τὸν αὐτὸν τρόπον καὶ ἀποκαθίστασθαι “πεφθέντα καὶ κρηθέντα. XIX “Ὅσα τε αὖ ἐπὶ τοὺς ὀφθαλμοὺς τρέπεται τῶν ῥευμάτων, ἰσχυρὰς καὶ παντοίας δριμύτητας ἔχοντα, ἑλκοῖ μὲν βλέφαρα, κατεσθίει δ᾽ ἐνίων γνάθους τε καὶ τὰ ὑπὸ τοῖσι ὀφθαλμοῖσι, ἐφ᾽ ὅ τι ἂν ἐπιρρυῇ, ῥήγνυσι δὲ καὶ διεσθίει τὸν ἀμφὶ τὴν ὄψιν χιτῶνα. ὀδύναι δὲ καὶ καῦμα καὶ φλογμὸς ἔσχατος κατέχει μέχρι τινός, μέχρι ἂν τὰ ῥεύματα πεφθῇ καὶ γένηται παχύτερα καὶ λήμη ἀπ᾽ αὐτῶν ἦ. τὸ δὲ πεφθῆναι γίνεται ἐκ τοῦ μιχθῆναι καὶ κρηθῆναι ἀλλήλοισι καὶ συνεψηθῆναι. τοῦτο δέ, ὅσα ἐς τὴν φάρυγγα, ἀφ᾽ ὧν βράγχοι γίνονται καὶ συνάγχαι, ἐρυσιπέλατά τε καὶ περιπνευμονίαι, πάντα ταῦτα τὸ μὲν πρῶτον ἁλμυρά τε καὶ ὑγρὰ καὶ δριμέα ἀφίει, καὶ ἐν τοῖσι τοιούτοις ἔρρωται τὰ νοσήματα. ὅταν δὲ παχύτερα καὶ πεπαίτερα γένηται καὶ πάσης δριμύτητος ἀπηλλαγμένα, τότε ἤδη καὶ οἱ πυρετοὶ παύονται καὶ τἄλλα τὰ λυπέ- οντα τὸν ἄνθρωπον. δεῖ δὲ δήπου ταῦτα αἴτια ἑκάστου ἡγεῖσθαι εἶναι, ὧν παρεόντων μὲν τοιου- τότροπον γίνεσθαι ἀνάγκη, μεταβαλλόντων δὲ ἐς ἄλλην κρῆσιν παύεσθαι. ὁπόσα οὖν ἀπ᾽ αὐτῆς τῆς "θέρμης εἰλικρινέος ἢ ψύξιος γίνεται καὶ μὴ μετέχει ἄλλης δυνάμιος μηδεμιῆς, οὕτω παύοιτο ἄν, ὅταν μεταβάλλῃ ἐ εκ τοῦ θερμοῦ ἐς τὸ ψυχρὸν καὶ ἐκ τοῦ ψυχροῦ ἐς τὸ θερμόν. μεταβάλλει δὲ ὅ OVTrEp προείρηταί μοι τρόπον. ἔτι τοίνυν τἄλλα ὅσα κακοπαθεῖ ὁ ἄνθρωπος πάντα ἀπὸ δυναμίων γίνεται. τοῦτο μὲν γάρ, ὅταν πικρότης τις ἀπο- χυθῇ, ἣν δὴ χολὴν ξανθὴν καλέομεν, οἷαι ἄσαι 48
ANCIENT MEDICINE, χνπι.-- Χιχ.
where acrid and unmixed humours come into play, I am confident that the cause is the same, and that restoration results from coction and mixture.
XIX. Again, such discharges as settle in the eyes, possessing powerful, acrid humours of all sorts, ulcerate the eyelids, and in some cases eat into the parts on to which they run, the cheeks and under the eyes; and they rupture and eat through the covering of the eyeball. But pains, burning and intense inflamma- tion prevail until the discharges are concocted and become thicker, so that rheum is formed from them. This coction is the result of mixture, compounding and digestion. Secondly, the discharges that settle in the throat, giving rise to soreness, angina, erysipelas and pneumonia, all these at first emit salt, watery and acrid humours, whereby the diseases are strengthened. But when they become thicker and more matured, and throw off all trace of their acridness, then the fevers too subside with the other symptoms that distress the patient. We must surely consider the cause of each complaint to be those things the presence of which of necessity produces a complaint of a specific kind, which ceases when they change into another combination. All conditions, then, resulting from heat or cold pure and simple, with no other power! as a factor, must cease when heat changes into cold or cold into heat. This change takes place in the manner I have described above. Moreover, all other complaints to which man is liable arise from powers. Thus, when there is an out- pouring of the bitter principle, which we call yellow
* Or “quality.” 2 Or ‘‘ qualities.”
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καὶ καύματα καὶ , ἀδυναμίαι κατέχουσιν" ἀπαλ- λασσόμενοι, δὲ τούτου, ἐνίοτε, καὶ καθαιρόμενοι, ἣ ἢ
αὐτόματοι ἢ ὑπὸ φαρμάκου, ἢ ἣν ἐν καιρῷ τι αὐτῶν γίνηται, φανερῶς καὶ τῶν πόνων καὶ τῆς θέρμης ἀπαλλάσσονται. ὅσον δ᾽ ἂν χρόνον ταῦτα μετέ- wpa ἢ καὶ ἄπεπτα καὶ ἄκρητα, μηχανὴ οὐδεμία οὔτε τῶν πόνων παύεσθαι οὔτε τῶν πυρετῶν. καὶ ὅσοισι δὲ ὀξύτητες προσίστανται δριμεῖαί τε καὶ ἰώδεες, οἷαι λύσσαι καὶ δήξιες σπλάγχνων καὶ θώρηκος καὶ ἀπορίη: οὐ παύεταί τι! τούτου πρό- τερον, πρὶν ἢ ἀποκαθαρθῇ τε καὶ καταστορεσθῇ καὶ μιχθῇ τοῖσιν ἄλλοισιν" πέσσεσθαι δὲ καὶ μεταβάλλειν καὶ λεπτύνεσθαί τε καὶ παχύνεσθαι ἐς χυμῶν εἶδος δι᾿ ἄλλων εἰδέων καὶ παντοίων--- διὸ καὶ κρίσιες καὶ ἀριθμοὶ τῶν χρόνων ἐν τοῖσι τοιούτοισι μέγα δύνανται--- πάντων δὴ τούτων ἥκιστα προσήκει θερμῷ ἢ ἢ ψυχρῷ πάσχειν' οὔτε γὰρ ἂν τοῦτό γε σαπείη οὔτε παχυνθείη. tri yap αὐτὸ φήσωμεν εἶναι; κρήσιας αὐτῶν ἄλλην πρὸς ἄλληλα ἐχούσας δύναμιν. 13 ἐπεὶ ἄλλῳ ye οὐδενὶ TO θερμὸν μιχθὲν παύσεται τῆς θέρμης ἢ ἢ
1 7. Ermerins from a lost MS: te M: omitted by A.
2 τί γὰρ αὐτὸ φήσωμεν εἶναι; κρήσιας αὐτῶν ἄλλην πρὸς ἄλληλα ἐχούσας δύναμιν. SoA. M has τί δ᾽ ἂν αὐτὸ φαίημεν... κρῆ- als τε αὐτέων ἐστι, πλὴν πρὸς ἄλληλα ἔχουσα δύναμιν. Kiihle- wein reads φήσομεν, deletes the question stop at εἶναι and puts it after δύναμιν. Littré has τί δ᾽ ἂν αὐτὸ φαίημεν εἶναι; κρήσιας αὐτέων, ἄλλην πρὸς ἄλληλα ἐχούσας δύναμιν.
1 Or ‘‘ distress.” 2 Or ‘‘ property.”
3 There are many reasons for supposing that this sentence is either (a) in its wrong place, or (δ) an interpolation. It seems quite irrelevant, and αὐτῶν should grammatically refer to τὸ θερμὸν and τὸ ψυχρόν, but there is not a crasis of these,
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ANCIENT MEDICINE, xix.
bile, great nausea, burning and weakness prevail. When the patient gets rid of it, sometimes by pur- gation, either spontaneous or by medicine, if the purging be seasonable he manifestly gets rid both of the pains and of the heat. But so long as these bitter particles are undissolved, undigested and un- compounded, by no possible means can the pains and fevers be stayed. And those who are attacked by pungent and acrid acids suffer greatly from frenzy, from gnawings of the bowels and chest, and from restlessness.!. No relief from these symptoms is secured until the acidity is purged away, or calmed down and mixed with the other humours. But coction, alteration, thinning or thickening into the form of humours through other forms of all sorts (wherefrom crises also and fixing their periods de- rive great importance in cases of illness)—to all these things surely heat and cold are not in the least liable. For neither could either ferment or thicken. {For what shall we call it? Combinations of humours that exhibit a power? that varies with the various factors.*f Since the hot will give up its heat only when mixed with the cold, and the cold can be
but only of χυμοί. Hot and cold mixed produce only hot or cold, not a crasis. The sentence might be more relevantly placed at the end of Chapter XVIII, as an explanation of the process ἀποκαθίστασθαι πεφθέντα καὶ κρηθέντα. But transposition will not remove the other difficulties of the sentence. What is avté? Health or disease? If health, then there is but one crasis producing it, not ‘‘many, having various proper- ties.” If disease, then it cannot be a crasis at all, but ἀκρασία. Finally, ἄλλην πρὸς ἄλληλα is dubious Greek. The whole sentence looks like an interpolation, though it is hard to say why it was introduced. The scribe of M seems to have felt the difficulties, for he wrote κρῆσις, πλὴν for ἄλλην, and ἔχουσα.
5!
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TIEPI APXAIH> IHTPIKH=
TO ψυχρῷ οὐδέ γε τὸ ψυχρὸν ἢ τῷ θερμῷ. τὰ δὲ ἄλλα πάντα τὰ περὶ τὸν ἄνθρωπον, ὅσῳ ἂν πλείοσι μίσγηται, τοσούτῳ ἠπιώτερα καὶ βελτίω. πάντων δὲ ἄριστα διάκειται ὁ ἄνθρωπος, ὅταν πᾶν réconta καὶ ἐν ἡσυχίῃ ἢ, μηδεμίαν δύναμιν ἰδίην ἀποδεικνύμενον, περὶ οὗ ἡγεῦμαι ἐπιδεδεῖ- χθαι.
XX. Λέγουσι δέ τινες ἰητροὶ καὶ σοφισταί, ὡς οὐκ εἴη δυνατὸν ἰητρικὴν εἰδέναι ὅστις μὴ οἶδεν ὅ τί ἐστιν ἄνθρωπος. ἀλλὰ τοῦτο δεῖ καταμαθεῖν τὸν μέλλοντα ὀρθῶς θεραπεύσειν τοὺς ἀνθρώπους. τείνει δὲ αὐτοῖς ὁ λόγος ἐς φιλοσοφίην, καθάπερ ᾿᾿μπεδοκλῆς ἢ ἄλλοι οἱ περὶ φύσιος “γεγράφασιν ἐξ ἀρχῆς ὅ τί ἐστιν ἄνθρωπος, καὶ ὅπως ἐγένετο πρῶτον. καὶ ὁπόθεν συνεπάγῃ. ᾿ ἐγὼ δὲ τοῦτο μέν, ὅσα τινὶ εἴρηται ἢ σοφιστῇ, ἢ ἰητρῷ ἢ γέγραπται περὶ φύσιος, ἡ ἧσσον νομίζω τῇ ree τέχνῃ προσ- ἥκειν ἢ τῇ γραφικῇ. νομίζω δὲ περὶ φύσιος γνῶναί τι σαφὲς eS ἄλλοθεν εἶναι ἢ ἐξ ἰητρικῆς" τοῦτο δὲ οἷόν τε καταμαθεῖν, ὅταν αὐτήν τις τὴν ἰητρικὴν ὀρθῶς περιλάβη: μέχρι δὲ τούτου πολλοῦ μοι δοκεῖ δεῖν' λέγω δὲ ταύτην τὴν ἷστο- ρίην εἰδέναι, ἄνθρωπος τί ἐστιν καὶ Ov οἵας αἰτίας γίνεται καὶ τἄλλα ἀκριβέως. ἐπεὶ τοῦτό γέ μοι δοκεῖ ἀναγκαῖον εἶναι ἰητρῷ περὶ φύσιος εἰδέναι καὶ πάνυ σπουδάσαι ὡς εἴσεται, εἴπερ τι μέλλει τῶν δεόντων ποιήσειν, ὅ τί τέ ἐστιν ἄνθρωπος πρὸς τὰ ἐσθιόμενά τε καὶ πινόμενα καὶ ὅ τι πρὸς
>
1 πᾶν added by Kiihlewein. ? Reinhold transposes from καὶ ὅπως to συνεπάγη to the end of the first sentence of the chapter.
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ANCIENT MEDICINE, χιχ.-- χχ.
neutralized only by the hot. But all other com- ponents of man become milder and better the greater the number of other components with which they are mixed. A man is in the best possible condition when there is complete coction and rest, with no particular power! displayed. About this I think that I have given a full explanation.
XX. Certain physicians and philosophers assert that nobody can know medicine who is ignorant what a man is; he who would treat patients properly must, they say, learn this. But the question they raise is one for philosophy; it is the province of those who, like Empedocles, have written on natural science,” what man is from the beginning, how he came into being at the first, and from what elements he was originally constructed. But my view is, first, that all that philosophers or physicians have said or written on natural science no more pertains to medicine than to painting. I also hold that clear knowledge about natural science can be acquired from medicine and from no other source, and that one can attain this knowledge when medicine itself has been properly comprehended, but till then it is quite impossible— I mean to possess this information, what man is, by what causes he is made, and similar points accurately. Since this at least I think a physician must know, and be at great pains to know, about natural science, if he is going to perform aught of his duty, what man is in relation to foods and drinks,
1 Or “‘ property.”
2 About ‘‘nature,” how the universe was born and grew out of primal elements. We might almost translate φύσις by “ evolution.”
8. Or, perhaps, “‘ pertains even less to medicine than to literature.”
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Ta ἄλλα ἐπιτηδεύματα, καὶ 6 τι ἀφ᾽ ἑκάστου ἑκάστῳ συμβήσεται, καὶ μὴ ἁπλῶς οὕτως" πονὴη- ρόν ἐστιν βρῶμα τυρός. πόνον γὰρ παρέχει τῷ πληρωθέντι αὐτοῦ, ἀλλὰ τίνα τε πόνον καὶ διὰ τί καὶ τίνι τῶν ἐν τῷ ἀνθρώπῳ ἐνεόντων ἀνεπιτή- δείον. ἔστι γὰρ, καὶ ἄλλα πολλὰ βρώματα καὶ πόματα πονηρά, ἃ διατίθησι τὸν ἄνθρωπον οὐ Tov αὐτὸν τρόπον. οὕτως οὖν μοι ἔστω οἷον" οἶνος ἄκρητος πολλὸς ποθεὶς διατίθησί πως τὸν ἄνθρω- πον" καὶ πάντες ἂν οἱ εἰδότες τοῦτο γνοίησαν, ὅτι αὕτη δύναμις οἴνου καὶ αὐτὸς αἴτιος" καὶ οἷσί γε τῶν ἐν τῷ ἀνθρώπῳ τοῦτο δύναται μάλιστα, οἴδαμεν. τοιαύτην δὴ βούλομαι ἀληθείην καὶ περὶ τῶν ἄλλων φανῆναι. τυρὸς γάρ, ἐπειδὴ τούτῳ σημείῳ ἐχρησάμην, οὐ πάντας ἀνθρώπους ὁμοίως λυμαίνεται, ἀλλ᾽ εἰσὶν οἵτινες αὐτοῦ πλη- ρούμενοι οὐδ᾽ ὁτιοῦν βλάπτονται, ἀλλὰ καὶ ἰσχύν, οἷσιν ἂν συμφέρῃ, θαυμασίως παρέχεται. εἰσὶ δ᾽ οἱ χαλεπῶς ἀπαλλάσσουσι. διαφέρουσιν οὖν τούτων αἱ φύσιες. “διαφέρουσιν δὲ κατὰ τοῦτο, ὅπερ ἐν τῷ “σώματι ἔνεστι πολέμιον τυρῷ καὶ ὑπὸ τούτου ἐγείρεταί τε καὶ κινεῖται" οἷς ὁ τοιοῦτος χυμὸς τυγχάνει πλείων ἐνεὼν καὶ μᾶλλον ἐνδυνα- στεύων ἐν τῷ σώματι, τούτους μᾶλλον καὶ κακο- παθεῖν εἰκός. εἰ δὲ πάσῃ τῇ ἀνθρωπίνῃ φύσει ἣν κακόν, πάντας ἂν ἐλυμήνατο. ταῦτα δὲ εἴ τις εἰδείη, οὐκ ἂν πάσχοι τάδε.
ΧΧΙ. Ἔν τῇσιν ἀνακομιδῆσι τῇσιν ἐκ τῶν νούσων, ἔτι δὲ καὶ ἐν That νούσοισι, τῇσι μακρῇσι γίνονται πολλαὶ συνταράξιες, αἱ μὲν ἀπὸ τωύτο- μάτου, αἱ δὲ καὶ ἀπὸ τῶν προσενεχθέντων τῶν
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ANCIENT MEDICINE, χχ.--χχι.
and to habits generally, and what will be the effects of each on each individual. It is not sufficient to learn simply that cheese is a bad food, as it gives a pain to one who eats a surfeit of it; we must know what the pain is, the reasons for it, and which con- stituent of man is harmfully affected. For there are many other bad foods and bad drinks, which affect a man in different ways. I would therefore have the point put thus:—‘Undiluted wine, drunk in large quantity, produces a certain effect upon a man.” ΑἹ] who know this would realise that this is a power of wine, and that wine itself is to blame,! and we know through what parts of a man it chiefly exerts this power. Such nicety of truth I wish to be manifest in all other instances. ΤῸ take my former example, cheese does not harm all men alike; some can eat their fill of it without the slightest hurt, nay, those it agrees with are wonderfully strengthened thereby. Others come off badly. So the constitutions of these men differ, and the difference lies in the constituent of the body which is hostile to cheese, and is roused and stirred to action under its influence. Those in whom a humour of sucha kind is present in greater quantity, and with greater control over the body, naturally suffer more severely. But if cheese were bad for the human constitution without exception, it would have hurt all. He who knows the above truths will not fall into the following errors.
XXI. In convalescence from illness, and also in protracted illnesses, many disturbances occur, some spontaneously and some from things casually
1 See Appendix on p. 64.
1 The MSS. have πάσχοι. τὰ δ᾽ ἐν κιτιλ. I have adopted the punctuation of Gomperz.
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τυχόντων. οἷδα δὲ τοὺς πολλοὺς ἐ ἰητρούς, ὥσπερ τοὺς ἰδιώτας, ἢν τύχωσι περὶ τὴν ἡμέρην ταύτην τι κεκαινουργηκότες, ἢ "λουσάμενοι. ἢ περιπατή- σαντες ἢ φαγόντες τι ἑτεροῖον, ταῦτα δὲ πάντα βελτίω προσενηνεγμένα ἢ μή, οὐδὲν ἧσσον τὴν αἰτίην τούτων τινὶ ἀνατιθέντας καὶ τὸ μὲν αἴτιον ἀγνοεῦντας, τὸ δὲ συμφορώτατον, ἢν οὕτω τύχῃ, ἀφαιρέοντας. δεῖ δὲ οὔ, ἀλλ᾽ εἰδέναι, τί λουτρὸν ἀκαίρως προσγενόμενον ἐργάσεται ἢ τί κόπος. οὐδέποτε yap ἡ αὐτὴ κακοπάθεια τούτων οὐδε- TEpoU, | οὐδέ γε ἀπὸ πληρώσιος οὐδ᾽ ἀπὸ βρώματος τοίου ἢ τοίου. ὅστις οὖν ταῦτα μὴ εἴσεται ὡς ἕκα- στα ἔχει πρὸς τὸν ἄνθρωπον, οὔτε γινώσκειν τὰ γινόμενα aT αὐτῶν δυνήσεται οὔτε χρῆσθαι ὀρθῶς.
XXII. Δεῖν δέ μοι δοκεῖ καὶ ταῦτα εἰδέναι, ὅ ὅσα τῷ ἀνθρώπῳ παθήματα ἀπὸ δυναμίων γίνεται καὶ ὅσα ἀπὸ σχημάτων. λέγω δέ τι τοιοῦτον, δύνα- μιν μὲν εἶναι τῶν χυμῶν τὰς ἀκρότητάς τε καὶ ἰσχύν, σχήματα δὲ λέγω ὅσα ἔνεστιν ἐν τῷ ἀνθρώπῳ, τὰ μὲν κοῖλά τε καὶ ἐξ εὐρέος ἐς στενὸν συνηγμένα, τὰ δὲ καὶ ἐκπεπταμένα, τὰ δὲ στερεά τε καὶ στρογγύλα, τὰ δὲ πλατέα τε καὶ ἐπικρεμάμενα, τὰ δὲ διατεταμένα, τὰ δὲ μακρά, τὰ δὲ πυκνά, τὰ δὲ μανά τε καὶ τεθηλότα, τὰ δὲ σπογγοειδέα τε καὶ ἀραιά. τοῦτο μὲν οὖν, ἑλκύσαι ἐφ᾽ ἑωυτὸ καὶ ἐπισπάσασθαι ὑγρότητα ἐκ τοῦ ἄλλου σώματος, πότερον τὰ κοῖλά τε καὶ ἐκπεπταμένα ἢ τὰ στερεά τε καὶ στρογγύλα ἢ τὰ κοῖλά τε καὶ ἐς στενὸν ἐξ εὐρέος συνηγμένα. δύ- vatTo ἂν μάλιστα; οἶμαι μὲν τὰ τοιαῦτα, τὰ ἐς στενὸν συνηγμένα ἐκ κοίλου τε καὶ εὐρέος. κατα- μανθάνειν δὲ δεῖ ταῦτα ἔξωθεν ἐκ τῶν φανερῶν. 56
ANCIENT MEDICINE, xx1.-xxu.
administered. I am aware that most physicians, like laymen, if the patient has done anything unusual near the day of the disturbance—taken a bath or a walk, or eaten strange food, these things being all beneficial—nevertheless assign the cause to one of them, and, while ignorant of the real cause, stop what may have been of the greatest value. _In- stead of so doing they ought to know what will be the result of a bath unseasonably taken or of fatigue. For the trouble caused by each of these things is also peculiar to each, and so with surfeit or such and such food. Whoever therefore fails to know how each of these particulars affects a man will be able neither to discover their consequences nor to use them properly.
XXII. I hold that it is also necessary to know which diseased states arise from powers and which from structures. What I mean is roughly that a “ power”’ is an intensity and strength of the humours, while “structures” are the conformations to be found in the human body, some of which are hollow, tapering ὦ from wide to narrow; some are expanded, some hard and round, some broad and suspended, some stretched, some long, some close in texture, some loose in texture and fleshy, some spongy and porous. Now which structure is best adapted to draw and attract to itself fluid from the rest of the body, the hollow and expanded, the hard and round, or the hollow and tapering? I take it that the best adapted is the broad hollow that tapers. One should learn this thoroughly from unenclosed objects? that can be
1 Or “contracting.”
2 i.e. objects that are not concealed, as are the internal organs.
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τοῦτο μὲν γάρ, τῷ στόματι κεχηνὼς ὑγρὸν οὐδὲν ἀνασπάσεις" προμυλλήνας δὲ καὶ συστείλας, πιέσας τε τὰ χείλεα καὶ ἔπειτεν ἢ αὐλὸν προσ- θέμενος ῥηϊδίως ἀνασπάσαις ἂν 6 πὶ ἐθέλοις. τοῦτο δέ, αἱ σικύαι προσβαλλόμεναι. ἐξ εὐρέος ἐς στενώτερον συνηγμέναι πρὸς τοῦτο τετέχ- νηνταῖι, πρὸς τὸ ἕλκειν ἐκ τῆς σαρκὸς καὶ ἐπι- σπᾶσθαι, ἄλλα τε πολλὰ τοιουτότροπα. τῶν δὲ ἔσω φύσει τοῦ ἀνθρώπου σχῆμα τοιοῦτον κύστις τε καὶ κεφαλή, καὶ ὑστέρη γυναιξίν: καὶ φανε- ρῶς ταῦτα μάλιστα ἕλκει καὶ πλήρεά ἐστιν ἐπάκτου ὑγρότητος αἰεί. τὰ δὲ κοῖλα καὶ ἐκ- πεπταμένα ἐπεσρυεῖσαν μὲν ὑγρότητα μάλιστα δέξαιτο πάντων, ἐπισπάσαιτο δ᾽ ἂν οὐχ ὁμοίως. τὰ δέ γε στερεὰ καὶ στρογγύλα οὔτ᾽ ἂν ἐπισπά- σαιτο οὔτ᾽ ἂν ἐπεσρυεῖσαν δέξαιτο" περιολι- σθάνοι τε γὰρ καὶ οὐκ ἔχοι ἕδρην, ἐφ᾽ ἧς μένοι. τὰ δὲ σπογγοειδέα τε καὶ ἀραιά, οἷον σπλήν τε καὶ πνεύμων καὶ μαζοί, προσκαθεζόμενα μάλιστα ἀναπίνοι καὶ σκληρυνθείη ἂν καὶ αὐξηθείη ὑγρό- τητος προσγενομένης ταῦτα μάλιστα. οὐ γὰρ ἂνϑ ὥσπερ ἐν κοιλίῃ, ἐν ἣ τὸ ὑγρόν, ἔξω τε περιέχει αὐτὴ ἡ κοιλίη, ἐξαλίζοιτ᾽ ἂν Kal ἑκάστην ἡμέρην, ἀλλ᾽ ὅταν πίῃ καὶ δέξηται αὐτὸ ἐς ἑωυτὸ τὸ ὑγρόν, τὰ κενὰ καὶ ἀραιὰ ἐπληρώθη καὶ τὰ σμικρὰ πάντῃ καὶ ἀντὶ μαλθακοῦ τε καὶ ἀραιοῦ σκληρὸς τε καὶ πυκνὸς ἐγένετο καὶ οὔτ᾽ ἐκπέσσει οὔτ᾽ ἀφίησι. ταῦτα δὲ πάσχει διὰ τὴν φύσιν τοῦ σχήματος. ὅσα δὲ φῦσάν τε καὶ ἀνειλήματα ἀπεργάζεται ἐν τῷ σώματι, προσήκει
1 ἀνασπάσεις two late Paris MSS. (2144, 2145): ἀνασπά- 58
ANCIENT MEDICINE, χχιι.
seen. For example, if you open the mouth wide you will draw in no fluid; but if you protrude and contract it, compressing the lips, and then insert a tube, you can easily draw up any liquid you wish. Again, cupping instruments, which are broad and tapering, are so constructed on purpose to draw and attract blood from the flesh. There are many other instruments of a similar nature. Of the parts within the human frame, the bladder, the head, and the womb are of this structure. ‘These obviously attract powerfully, and are always full of a fluid from with- out. Hollow and expanded parts are especially adapted for receiving fluid that has flowed into them, but are not so suited for attraction. Round solids will neither attract fluid nor receive it when it has flowed into them, for it would slip round and find no place on which to rest. Spongy, porous parts, like the spleen, lungs and breasts, will drink up readily what is in contact with them, and these parts especially harden and enlarge on the addition of fluid. They will not be evacuated every day, as are bowels, where the fluid is inside, while the bowels themselves contain it externally; but when one of these parts drinks up the fluid and takes it to itself, the porous hollows, even the small ones, are every- where filled, and the soft, porous part becomes hard and close, and neither digests nor discharges. This happens because of the nature of its structure. When wind and flatulence are produced in the body, the
σειεν 5141 : ἀνασπάσειε 2143: ἀνασπάσαις A, The opt. may be right, as in this treatise the potential optative sometimes occurs without ἄν. See p. 44,1. 59, and p. 52, 1. 2.
2 ἔπειτεν Kiithlewein: καὶ ἐπί re A: καὶ ἔτι τε Μ.
3 Littré adds, after ἄν, ἐν σπληνί.
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ἐν μὲν τοῖσι κοίλοισι καὶ εὐρυχώροισι, οἷον κοιλίῃ τε καὶ θώρηκι, ψόφον τε καὶ πάταγον ἐμποιεῖν. ὅτε γὰρ ἂν μὴ ἀποπληρώσῃ οὕτως ὥστε στῆναι, ἀλλ᾽ ἔχῃ μεταβολάς τε καὶ κινήσιας, ἀνάγκη ὑπ᾽ αὐτῶν ψόφον καὶ καταφανέας κινήσιας γί- νεσθαι. ὅσα δὲ σαρκώδεά τε καὶ μαλθακά, ἐν τοῖσι τοιούτοισι νάρκη τε καὶ πληρώματα οἷα ἐν τοῖσι ἀποπληγεῖσιϊ γίνεται. ὅταν δ᾽ ἐγκυρήσῃ πλατεῖ τε καὶ ἀντικειμένῳ, καὶ “πρὸς αὐτὸ ἀν- τιπέσῃ, καὶ φύσει τοῦτο τύχῃ ἐὸν μήτε ἰσχυρόν, ὥστε δύνασθαι ἀνέχεσθαι τὴν βίην καὶ μηδὲν κακὸν παθεῖν, μήτε μαλθακόν τε καὶ ἀραιόν, ὥστ᾽ ἐκδέξασθαί τε καὶ ὑπεῖξαι, ἁπαλὸν δὲ καὶ τε- θηλὸς καὶ ἔναιμον καὶ πυκνόν, οἷον ἧπαρ, διὰ μὲν τὴν πυκνότητα καὶ πλατύτητα ἀνθέστηκε τε καὶ οὐχ ὑπείκει, φῦσα δ᾽ ἐπισχομένη 2 αὔξεταί τε καὶ ἰσχυροτέρη γίνεται καὶ ὁρμᾷ μάλιστα͵ πρὸς τὸ ἀντιπαῖον. διὰ δὲ τὴν ἁπαλότητα καὶ τὴν ἐναιμό- τητα οὐ δύναται ἄνευ πόνων εἶναι, καὶ διὰ ταύτας τὰς προφάσιας ὀδύναι τε ὀξύταται καὶ πυκνό- ταται πρὸς τοῦτο τὸ χωρίον γίνονται ἐμπυήματά τε καὶ φύματα πλεῖστα. γίνεται δὲ καὶ ὑπὸ φρένας ἰσχυρῶς, ἧσσον δὲ πολλόν. διάτασις μὲν γὰρ φρενῶν πλατείη καὶ ἀντικειμένη, φύσις δὲ νευρωδεστέρη τε καὶ ἰσχυροτέρη, διὸ ἧσσον ἐπώδυνά ἐστιν. γίνεται δὲ καὶ περὶ ταῦτα καὶ πόνοι καὶ φύματα.
XXIII. Πολλὰ δὲ καὶ ἄλλα καὶ ἔσω καὶ ἔξω τοῦ σώματος εἴδεα σχημάτων, ἃ μεγάλα ἀλλήλων διαφέρει πρὸς τὰ παθήματα καὶ νοσέοντι καὶ ὑγιαίνοντι, οἷον κεφαλαὶ σμικραὶ ἢ μεγάλαι, τράχηλοι λεπτοὶ ἢ παχέες, μακροὶ ἢ βραχέες, 60
ANCIENT MEDICINE, xxu.—xxut.
rumbling noise naturally occurs in the hollow, broad parts, such as the bowels and the chest. For when the flatulence does not fill a part so as to be at rest, but moves and changes its position, it cannot be but that thereby noise and perceptible movements take place. In soft, fleshy parts occur numbness and obstructions, such as happen in apoplexy. And when flatulence meets a broad, resisting body, and rushes on it, and this happens by nature to be neither strong so as to endure its violence without harm, nor soft and porous so as to give way and admit it, but tender, fleshy, full of blood, and close, like the liver, because it is close and broad it resists without yielding, while the flatulence being checked increases and becomes stronger, dashing violently against the obstacle. But owing to its tenderness and the blood it contains, the part cannot be free from pain, and this is why the sharpest and most frequent pains occur in this region, and abscesses and tumours are very common. Violent pain, but much less severe, is also felt under the diaphragm. For the diaphragm is an extended, broad and resisting substance, of a stronger and more sinewy texture, and so there is less pain. But here too occur pains and tumours.
XXIII. There are many other structural forms, both internal and external, which differ widely from one another with regard to the experiences of a patient and of a healthy subject, such as whether the head be large or small, the neck thin or thick, long or short, the bowels long or round, the chest and
1 ἀποπληγεῖσι Littré: ἀποσφαγίσι A: ἀποσφαγεῖσι M: ἀπο- φραγεῖσι Coray. 2 ἐπισχομένη Reinhold: ἐπιχεομένη A: ἐπιδεχομένη M.
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,ὔ NEN ΄ , \ κοιλίαι μακραὶ ἢ oTpoyyuhat, θώρηκος καὶ πλεὺ- ρέων πλατύτητες ἢ στενότητες, ἄ ἄλλα μυρία, ἃ δεῖ πάντα εἰδέναι 7 διαφέρει, ὃ ὅπως τὰ αἴτια ἑκάστων εἰδὼς ὀρθῶς φυλάσσηται"
tf rn rn XXIV. Περὶ δὲ δυναμίων χυμῶν αὐτῶν τε / a ἕκαστος ὅ TL δύναται ποιεῖν τὸν ἄνθρωπον b “ / ἐσκέφθαι, ὥσπερ καὶ πρότερον εἴρηται, καὶ τὴν Χ ΄ συγγένειαν ὡς ἔχουσι, πρὸς ἀλλήλους. λέγω δὲ τὸ τοιοῦτον" εἰ γλυκὺς χυμὸς ἐὼν μεταβάλλοι ἐς ἄλλο εἶδος, μὴ ἀπὸ συγκρήσιος, ἀλλὰ αὐτὸς al n
ἐξιστάμενος, ποῖός τις ἂν πρῶτος γένοιτο, πικρὸς By id \ Xx Ν A 5) j? 3 ἿΩ , , ἢ ἁλμυρὸς ἢ στρυφνὸς ἢ ὀξύς; οἶμαι μέν, ὀξύς. ὁ ἄρα ὀξὺς χυμὸς ἀνεπιτήδειος προσφέρειν ἂν τῶν λοιπῶν εἴη μάλιστα, εἴπερ ὁ γλυκὺς τῶν γεπάντων ἀνεπιτηδείοτατος.: οὕτως εἴ τις δύναιτο ζητέων ἔξωθεν ἐπιτυγχάνειν, καὶ δύναιτο ἂν
/ > / 3, δ \ / 7 πάντων ἐκλέγεσθαι αἰεὶ τὸ βέλτιστον. βέλτιστον
ἈΝ ᾿ lel
δέ ἐστι αἰεὶ TO πβῤῥοσωτάτω TOD ἀνεπιτηδείου ἀπέχον.
1 1 obtain this reading by combining A, which has ἀνεπιτή- δειος, ἂν before τῶν λοιπῶν, and τῶν before ye, with the avem- τηδειότατος of M. Other MSS. have ἂν ἐπιτήδειος, omit ἂν before τῶν λοιπῶν and τῶν before ye, and read ἐπιτηδειότατος.
Kiihlewein has 6 ἄρα ὀξὺς χυμὸς ἂν ἐπιτήδειος προσφέρειν τῶν λοιπῶν εἴη μάλιστα, εἴπερ ὁ γλυκύς γε ἐπιτηδειότατος.
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ANCIENT MEDICINE, χχπι.--Χχιν.
ribs broad or narrow, and there are very many other things, the differences between which must all be known, so that knowledge of the causes of each thing may ensure that the proper precautions are taken.
XXIV. As I have said before, we must examine the powers of humours, and what the effect of each is upon man, and how they are related to one another. Let me give an example. Ifa humour that is sweet assumes another form, not by admixture, but by a self-caused change, what will it first become, bitter, or salt, or astringent, or acid? I think acid. There- fore where sweet humour is the least suitable of all, acid humour is the next least suitable to be admi- nistered.! If a man can in this way conduct with success inquiries outside the human body, he will always be able to select the very best treatment. And the best is always that which is farthest re- moved from the unsuitable.
1 Because :—
(1) Health is a crasis of all the humours, none being in excess ;
(2) Sweet humour passes readily into acid ;
(3) Therefore, when sweet is the least suitable as a remedy (there being an excess of it already), acid (which is likely to be reinforced from the sweet) is the next least suitable.
Kiihlewein’s text makes sense only if we transpose ὀξύς and γλυκύς. If you want ὀξὺς χυμός for crasis you can get it best by adding ὀξύς, next best by adding γλυκύς, which naturally turns into ὀξύς.
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APPENDIX
APPENDIX ON CHAPTER XX, p. 54.
οἶνος ἄκρητος πολλὸς ποθεὶς διατίθησί πως τὸν ἄνθρωπον" Kal πάντες ἂν οἱ εἰδότες τοῦτο γνοίησαν, ὅτι αὕτη δύναμις οἴνου καὶ αὐτὸς αἴτιος.
So A; other MSS. have ἀσθενέα after ἄνθρωπον, ἰδόντες for of εἰδότες, 7 after αὕτη and ἐστιν after αὐτός.
This passage contradicts the general argument, which is that in medicine statements about foods must not be made ἁπλῶς. Cheese is not bad food; it is only bad in certain conditions, and in certain ways, and at certain times. In these circumstances cheese has a δύναμις which does not belong to cheese in itself, but is latent until certain conditions call it forth. The error, says the writer, is not made in the case of wine. Everybody knows that in itself wine is not bad; it is drinking to excess, or at wrong times, which is mischievous.
Now the reading of A (in fact any MS. reading) makes the writer say that wine itself is to blame (αὐτὸς attios)—an obvious contradiction of the general argument. My colleague the Rev. H. J. Chaytor most ingeniously suggests that αὐτός refers not to wine but to the man. He would therefore translate ‘‘ this δύναμις of wine and the man himself are to blame.” But not only is it more natural for αὐτός to refer to wine, but