In a fragment on diet for women, Athenaeus quotes an aphorism from the sixth book of the Epidemics. He writes:

“One must encourage exercises (gymnasia) that are suitable for women: of the soul by means of the studies proper for women and concerns about the household because ‘a soul's walk is concern for people’, as the venerable Hippocrates said; while, of the body [exercise] by means of spinning wool and the other work around the house.”

γυμνάσια δ’ ἐπιτρεπτέον τὰ γυναιξὶν ἁρμόζοντα, ψυχῆς μὲν τὰ διὰ τῶν οἰκείων αὐταῖς μαθημάτων καὶ τῶν κατὰ τὴν οἰκίαν φροντίδων («ψυχῆς γὰρ περίπατος φροντὶς ἀνθρώποισι», ὡς εἶπεν ὁ παλαιὸς Ἱπποκράτης), σώματος δὲ διὰ τῆς ταλασιουργίας καὶ τῶν ἄλλων τῶν κατὰ τὴν οἰκίαν πόνων.

Athenaeus of Attalia apud Oribasius, Libri Incerti 23, CMG VI 2,2 112,19-24 Raeder

The aphorism Athenaeus quotes from is found at Epidemics 6.5.5. He seems to think it is about exercise, but the aphorism itself is pretty ambiguous. I’ll translate it literally to try to emphasize just how ambiguous it is:

“Exertion for the joints and for flesh, food, sleep for the viscera. A soul's walk is concern for people.”

Πόνος τοῖσιν ἄρθροισι καὶ σαρκὶ σῖτος ὕπνος σπλάγχνοισιν. Ψυχῆς περίπατος φροντὶς ἀνθρώποισιν.

‘Hippocrates’, Epidemics 6.5.5, V 316,9-10 Littré

The term I translate as “concern” (phrontis) usually means something more like “apprehension” or “worry”. Athenaeus, however, takes it to be a word for any kind of serious thinking, i.e., sustained intellectual activity. The term peripatos, “walk”, can just as easily mean “wandering about”. So the aphorism could be describing apprehensiveness as a kind of wandering thought.

But Athenaeus takes Hippocrates to be claiming that concerns, thoughts, studies, etc., are quite literally forms of exercise—activities that will “nourish” a woman’s (or anyone else’s) soul, just as physical exercise, ponos, nourishes the body. 

His interpretation also likely implies a kind of corporeal dualism like what we find in the Stoics and the Pneumatic physicians. It was this kind of interpretation that two later readers took issue with. They are Galen and Palladius.

The commentaries of Galen and Palladius on the Epidemics are pretty great, if for no other reason than that they give us a glimpse into the game of Hippocratic exegesis playing out in Greek-speaking parts of the Roman empire. But they also give us a sense of how doctors tried to navigate disputes between medicine and philosophy—disputes about disciplinary boundaries, and about whose responsibility it was to treat the ailing soul or mind.

Although this is something of a simplification, it is not too much of a distortion to say that around Galen’s time medicine was usually thought of as restricted to the care of the body; philosophy, on the other hand, was a discipline whose aim was the care of the soul or mind. Some doctors, however, considering that our bodies and our health are affected by our psychological states, started to think it was also important that doctors treat the soul as well. But when these considerations were discussed, they were often accompanied by discussion of the legitimacy of medical intervention in the treatment of the soul. Doctors in other words felt they had to justify the encroachment on philosophy.

Interestingly, their justification was not usually aimed at appeasing philosophers, but other doctors who felt it was not their place to treat the soul. The two passages which follow are clearly aimed at doctors, and are examples of the kind of justification one might give, if not for the medicalization of the mind, then at least for its importance in physiology and therapeutics.

1. Galen, In Hipp. Epid. 6, 17B.263.1-264.6 Kühn = CMG V 10,2,2 280,6-281,6 Wenkenbach

“All the book’s interpreters take ‘walk’ [peripatos] to mean ‘exercise’, so that the sentence would be:

‘for humankind, concerns are an exercise.’

They think [Hippocrates] used the familiar term, ‘walk’ [peripatos], because the word means a kind of exercise. Dioscorides, however, reasonably avoided this interpretation because it is affectatious [kakozêlos]*; he did not write peripatos [in his edition], but added the letter ‘n’, [so that it reads] ‘peri pantos’: 

‘concern for the soul above all belongs to humankind’.

So that what is meant by it is:

‘above all, for humankind what is to be practiced is reasoning.’ 

For after all acts of thinking [dianoêseis] are called ‘concerns’ [phrontides], which is why Socrates, too, was called ‘concerned’ and the man’s wise counsels were called ‘concerns’, as one can even find in the Clouds of Aristophanes, where he makes fun of Socrates and mocks him as an idle-talker.

But if it should seem to anyone that the phrase belongs to philosophical speculation, not medicine—first, let them consider that it applies to all the rational arts in which one needs to exercise reasoning, as it has been said by many other physicians, and not a few times by Erasistratus. ** And furthermore, certain affections occur, some, for instance, which numb the soul’s rational faculty and the faculty of memory, others which are stuporific [karôdê] and soporific [kataphorika]. In these cases, one must consider thinking to be beneficial, just as in other places he [sc. Hippocrates] taught that anger is useful for good humour and regaining a state in accordance with nature.”

Τὸν περίπατον ἀντὶ τοῦ γυμνασίου πάντες ἤκουσαν οἱ ἐξηγησάμενοι τὸ βιβλίον, ἵν' ὁ λόγος ᾖ τοιόσδε· “τοῖς ἀνθρώποις αἱ φροντίδες γυμνάσιον”, <νομίσαντες αὐτὸν τῇ> προσηγορίᾳ κεχρῆσθαι τῇ τοῦ περιπάτου, δηλούσης τῆς φωνῆς ταύτης εἶδός τι γυμνασίου. κακοζήλου δὲ τῆς ἑρμηνείας οὔσης, εἰκότως αὐτὴν ὁ Διοσκουρίδης φυλαττόμενος, οὐ περίπατος ἔγραψεν, ἀλλὰ προσθεὶς τὸ ν γράμμα “περὶ παντὸς”, ὥστε γενέσθαι τὴν λέξιν τοιάνδε· ψυχῆς περὶ παντὸς φροντὶς ἀνθρώποις, ἵν' ᾖ δηλούμενον ἐξ αὐτῆς· “περὶ παντὸς τοῖς ἀνθρώποις ἀσκητέον ἐστὶ τὸν λογισμόν.” αἱ γάρ τοι διανοήσεις ὀνομάζονται φροντίδες, ὅθεν καὶ τὸν Σωκράτην φροντιστὴν ἐκάλουν καὶ φροντίδας τὰ σοφὰ βουλεύματα τἀνδρὸς ὠνό- μαζον, ὡς κἀν ταῖς Ἀριστοφάνους Νεφέλαις <ἔστιν> εὑρεῖν, ἔνθα κωμῳδεῖ καὶ σκώπτει τὸν Σωκράτην ὡς ἀδολέσχην. εἰ δέ τῳ δόξει φιλοσόφου θεωρίας, οὐκ ἰατρικῆς ὁ λόγος ἔχεσθαι, πρῶτον μὲν ἐνθυμείτω κοινὸν ἁπασῶν εἶναι τῶν λογικῶν αὐτὸν τεχνῶν, ἐν αἷς τὸν λογισμὸν χρὴ γυμνάζειν, ὡς ἄλλοις τε πολλοῖς εἴρηται τῶν ἰατρῶν Ἐρασιστράτῳ τ' οὐκ ὀλιγάκις. ἔπειτα δὲ καὶ πάθη τινὰ γίνεται τὰ μὲν οἷον ναρκοῦντα τὸ λογιστικὸν καὶ τὸ μνημονευτικὸν τῆς ψυχῆς, τὰ δὲ καρώδη καὶ καταφορικά. τούτοις οὖν ἡγητέον ὠφελίμους εἶναι τὰς φροντίδας, ὡς ἐν ἄλλοις ἐδίδαξε τὰς ὀξυθυμίας εἶναι χρησίμους εἰς εὐχυμίαν τε καὶ τῆς κατὰ φύσιν ἕξεως ἀνάκτησιν.

Galen, In Hipp. Epid. 6, 17B.263.1-264.6 Kühn

2. Palladius, Commentarii in Hippocratis librum sextum de morbis popularibus, Scholia in Hippocratem et Galenum vol. 2 Dietz, 136,11-137,5

“Having put aside medical matters, Hippocrates comes again to the soul. ‘Soul’—not as in the warmth we were speaking about earlier, but the really immaterial and immortal [soul]. There are two ways it is possible to interpret this statement: for either [it says] ‘walk’ [peripatos] or ‘above all’ [peri pantos]. And ‘above all’ in this sense:

‘that for humankind there is a concern to consider the soul above all [peri pantos]’

since a person ought to honour nothing above this. For Hippocrates says just as the body is exercised, so too the soul ought to be exercised. But the soul is exercised through more [activities], since a walk is one form of exercise. Concern is any exercise [of the soul]. ‘Concern’—not in order to seek after a profit or after a woman, but to seek the comprehension of the truth, the differentiation of true things from false things. For these are exercises. And concern, especially, is [an exercise] of the rational soul. This is why we speak about the ‘Thinkery’ (phrontistêrion) of Socrates and Plato, not because they were generally concerned, but because they dwelled on the truth.

And he [sc. Hippocrates] added, ‘for humankind’ for a reason. He knows that by nature humans are distinguished in this: the spirited [part of the soul] is [a part] in a person’s real nature, but to rule belongs to reason.*** That is why, as much as it concerns philosophers, we are also able to refer the statement to what belongs to us. For if having come to a sick person, you found him tired and drowsy at the wrong time, know that it is a great evil. For whenever the material in the head is excessive, brings heavy sleep, [and] threatens apoplexia, then you ought to command spirit with concern, in order that the boiling [caused by rousing the spirit] will make this humour thin and disperse it. And thus this statement is fitting for both physicians and philosophers.”

Ἐάσας τὰ ἰατρικὰ ὁ Ἱπποκράτης ἐπὶ τὴν ψυχὴν πάλιν ἔρχεται. ψυχὴν δὲ, οὐχ ὡς ἄνω ἐλέγομεν τὴν θερμασίαν, ἀλλὰ τὴν ὄντως ἄϋλον καὶ ἀθάνατον. διττῶς δέ ἐστιν ἐξηγήσασθαι τοῦτον τὸν λόγον. ἢ γὰρ <περίπατος>, ἢ <περὶ παντός>. καὶ περὶ παντὸς οὕτως· ὅτι φροντίς ἐστι τοῖς ἀνθρώποις τοῦ περὶ παντὸς ποιήσασθαι τὴν ψυχήν. οὐδὲν γὰρ ταύτης ὀφείλει προτιμῆσαι ὁ ἄνθρωπος. λέγει γὰρ Ἱπποκράτης, ὥσπερ γυμνάζεται τὸ σῶμα, οὕτως ὀφείλει καὶ ἡ ψυχὴ γυμνάζεσθαι. γυμνάζεται δὲ ἡ ψυχὴ διὰ πλειόνων, ἐπειδὴ ἓν εἶδος γυμνασίου ἐστὶν ὁ περίπατος. πᾶν γυμνάσιον ἡ φροντίς. φροντὶς δὲ, οὐχ ἵνα ζητῇ ἢ περὶ κέρδους, ἢ περὶ γυναικὸς, ἀλλὰ ζητεῖν τὴν κατάληψιν τῆς ἀληθείας, τὴν διάκρισιν τοῦ ἀληθοῦς καὶ ψευδοῦς. ταῦτα γὰρ γυμνάσιά εἰσιν. καὶ μάλιστα τῆς λογικῆς ψυχῆς ἡ φροντίς. ἔνθεν λέγομεν Σωκράτους καὶ Πλάτωνος φροντιστήριον, ὅτι οὐχ ἁπλῶς ἐφρόντιζεν, ἀλλ' ὅτι τὴν ἀλήθειαν κατεγένετο. οὐ μάτην δὲ προσέθηκε τὸ τοῖς ἀνθρώποις. ἀλλ' οἶδεν ὅτι κατὰ φύσιν ἄνθρωπος ἐν τούτῳ κρίνεται, ἐν τῷ ὑπόστασιν μὲν τὸ θυμοειδὲς, ἄρχειν δὲ τῷ λόγῳ. ταῦτα οὖν ὅσα κατὰ φιλοσόφους, δυνάμεθα καὶ ἐπὶ τὰ ἡμέτερα ἀγαγεῖν τὸν λόγον. εἰσελθὼν γὰρ πρὸς τὸν κάμνοντα, εὗρες αὐτὸν καταφερόμενον ἀκαίρως καὶ ὑπνώττοντα, γίνωσκε ὅτι μέγα κακόν. ὕλη γὰρ πλεονάζουσα ἐν τῷ ἐγκεφάλῳ, ὠδίνει κάρον, ἀπειλεῖ ἀποπληξίαν, τότε ὀφείλεις φροντίδι θυμὸν ἐπιτάξαι, ἵνα τοῦτον ἡ ζέσις ἐκλεπτύνῃ καὶ διαφορήσῃ τὸν χυμὸν, ὥστε καὶ ἰατροῖς καὶ φιλοσόφοις πρέπει οὗτος ὁ λόγος.

Palladius, Commentarii in Hippocratis librum sextum de morbis popularibus, Scholia in Hippocratem et Galenum vol. 2 Dietz, 136,11-137,5

Notes

*Galen does not tell us why he and Dioscorides thought this interpretation is affectatious—why it is kakozêlos. The great stylist Hermogenes of Tarsus (roughly contemporary with Galen) says that kakozêlos describes a figure of speech that is implausible or unconvincing, either for reasons of impossibility, inconsistency, ugliness, impiety, injustice, or contrariness to nature—something that makes us think, “that does not seem do-able [οὐκ εἰκὸς τόδε πραχθῆναι]” (Herm. Inv. 4.12 Rabe). One example he uses is Od. 9.481 where Odysseus says the Cyclops, Polyphemus, “lobbed the peak of a great mountain after having snapped it off [ἧκε δ᾽ ἀπορρήξας κορυφὴν ὄρεος μεγάλοιο].” When Galen uses kakozêlos, he tends to use it in this sense (he does not use it often). The majority of Galenic examples are in the Hippocratic commentaries, where he uses it in two ways:

• (i) Sometimes he uses it to describe Hippocrates’ bad style. For example, in Aph. 7.66, Hippocrates calls food “strong for the healthy” and “disease for the sick”, a claim Galen thinks is kakozêlos since food is not itself literally either strong or disease. The sense, however, is clear enough: food is either productive of strength or disease (Hipp. Aph. XVIIIA 179 K). The problem is merely a matter of style.
• (ii) More often, he uses it as a reason for rejecting an interpretation of Hippocrates. For example, there is an aphorism in Epid. 6, which states: “weaker foods have shorter life [βιοτὴν]” (Epid. 6.5.14, V 318,20 L.). Galen thinks the natural reading is that weaker foods are used up and expelled rapidly; and he goes on to say it is kakozêlon to think Hippocrates’ meant that weaker food “continues to live” [μονὴν ζωὴν] in our body for a short time (Hipp. Epid. VI 5.21 (CMG V 10,2,2 299,20-21 Wenkebach = XVIIB 282 K).

In either case, Galen and Dioscorides think “walk” [περίπατος] is kakozêlos enough to warrant an emendation to the text. This may be because it implies thinking is literally a kind of exercise that heats you up; but this would be odd, since Galen himself admits that rational activity is important for maintaining the soul’s heat, e.g., San. Tu. 1.8 (VI 40K).

**On Erasistratus, Wenkebach gives a parallel in his edition: PHP VII 5, 602 Kühn. This is almost certainly wrong. In PHP VII 5, Galen mentions Erasistratus’ views on the anatomy of the nerves and brain. The only thing he says remotely related to the Epidemics 6.5.5 passage is that Erasistratus had time to make precise dissections ‘when he was old and had leisure to focus on the study of the art’ (440,24-25 Wenkebach). What Galen must have in mind is Erasistratus’ belief that practice of the rational arts improves their performance, a view which Galen attributes to Erasistratus at De Consuetudinibus 1, Scripta Minora II 17,1-22 Helmreich.

*** ἀλλ' οἶδεν ὅτι κατὰ φύσιν ἄνθρωπος ἐν τούτῳ κρίνεται, ἐν τῷ ὑπόστασιν μὲν τὸ θυμοειδὲς, ἄρχειν δὲ τῷ λόγῳ.  This sentence is difficult. I’ve translated “but he knows that by nature humans are distinguished in this: that the spirited part of the soul is in the hypostasis, but to rule belongs to reason.” Palladius may be reluctant to say that reason is a part of a the hupostasis, the real nature, of a person; but I’m not sure I understand the point he is making and I’ve found no parallels anywhere else.