Pseudo-Galen, what is a soul and what is a body?

“29. According to Plato, soul is a self-moving incorporeal substance. According to the Stoics, however, it is a subtle body moving out of itself according to seminal principles, while according to Aristotle, it is the actuality of a natural instrumental body potentially having life. Alternatively, soul is pneuma distributed through the whole body, through which we live and reason and act by means of the other senses, the body being its servant.*

30. Body is magnitude three times extended, having in itself height, depth and breadth.** Or, it is magnitude composed of three dimensions.”

κθʹ. ψυχή ἐστιν οὐσία ἀσώματος, αὐτοκίνητος κατὰ Πλάτωνα. κατὰ δὲ τοὺς Στωϊκοὺς σῶμα λεπτομερὲς ἐξ ἑαυτοῦ κινούμενον κατὰ σπερματικοὺς λόγους. κατὰ δὲ τὸν Ἀριστοτέλη ἐντελέχεια σώματος φυσικοῦ ὀργανικοῦ δυνάμει ζωὴν ἔχοντος. ἄλλως. ψυχή ἐστι πνεῦμα παρεσπαρμένον ἐν ὅλῳ τῷ σώματι δι' οὗ ζῶμεν καὶ λογιζόμεθα καὶ ταῖς λοιπαῖς αἰσθήσεσιν ἐνεργοῦμεν ὑπηρετοῦντος τοῦ σώματος.

λʹ. σῶμά ἐστι μέγεθος τριχῇ διάστατον ἔχον ἐν ἑαυτῷ μῆκος, βάθος, πλάτος. ἢ μέγεθος ἐκ τριῶν διαστημάτων συνεστηκός.

[Galen], Medical Definitions 29 and 30, 19.355–356 K

*cf. Anonymus Londinensis:

“‘Soul’ is said in three ways: that which pervades the whole body, and the rational part, and further the entrecheia (i.e., ἐντελέχεια, probably).”

ψυχὴ δὲ λέγεται τριχῶς·
[ἥ τε] τῶι ὅλωι σώματι παρεσπαρ-
μ̣ένη καὶ τὸ μόριον τὸ λογιστικὸν
[κ]αὶ ἔτι ἡ ἐντρέχεια. * καὶ τῆς μ(ὲν) ἐντρε-
[χ]είας ἐπὶ τοῦ παρόντος οὐ χρῄζομεν,
[τ]ῶν δὲ ἄλλων δύο σημαινομένων,
[κα]ὶ μᾶλλον το̣ῦ λο̣γιστ̣ικοῦ.

Anonymus Londinensis I,21-24

**Cf. Apollodorus ap. Diogenes Laertius:

“Body is defined by Apollodorus in his Physics as that which is extended in three dimensions, length, breadth, and depth. This is also called solid body.”

σῶμα δ’ ἐστίν, ὥς φησιν Ἀπολλόδωρος ἐν τῇ Φυσικῇ, τὸ τριχῆ διαστατόν, εἰς μῆκος, εἰς πλάτος, εἰς βάθος· τοῦτο δὲ καὶ στερεὸν σῶμα καλεῖται.

Diog. Laert. 7.175

Solids, Liquids, Gases

On the style of Epidemics 6, Wesley Smith (who translated the text for the Loeb Classical Library) writes: 

“[The Epidemics] are technical prose from a time when prose was coming into being and authors were realizing its potential: unique jottings by medical people in the process of creating the science of medicine.”

Hippocrates VII: Epidemics 2 & 4-7, Harvard University Press, 1994, p.2

The Epidemics is a text without a model, an attempt to capture in writing the experience and practice of medicine. The style, Smith thinks, manifests this naivety. He refers to it as the text’s “innocence” — innocent from later conventions and styles that would come to characterize medical and scientific writing. This innocence makes the Epidemics (like other Hippocratic writings) quite unique; it also makes it quite difficult to read.

Later medical texts look almost nothing like the Epidemics. Medical writers pretty quickly developed standards of exposition that made their writing easier to follow, and one of the effects of this standardization was that a medical text came to be recognizable as such, a distinct form of writing with its own questions, rules, vocabulary and order.

This innovation is already evident in the fourth century, in Diocles’ writings. He had structured his writing on regimen according to times of day, with each time divided into parts dealing with appropriate foods and exercises. Writers on disease, too, began to structure their works: some, according to the location of diseases from head to toe; some, by diseases according to whether they were acute or chronic; some into sections on cause and treatment. And a standard form of medical text, called Remedies  (Peri Boêthêmatôn) was developed by the Pneumatist school, which divided remedies according to the way they acted on the body.

Certainly some authors were not as clear as all this. Dioscorides’ Materia Medica (Peri Hulês) follows a notoriously obscure structure, something later authors complained about. It would have been easier, they thought, if he had ordered things alphabetically. But this just shows that doctors were thinking about the form medical writing should take, and began to adopt standards to avoid the type of obscurity we find in the Epidemics. 

Epidemics 6, however, was also canonical, at least to those sympathetic to Hippocratic medicine. The style of the text may have been obscure, but most everyone who practiced Hippocratic-style medicine would have been familiar with it. And interpreting the text became a way of debating new ideas about what medicine is and how it should be practiced.

Evidence of a tradition of interpretation exists, preserved for the most part by Galen, but also in earlier authors like Dioscorides and Athenaeus and later ones like Palladius. For these Hippocratic doctors, the Epidemics could not simply be read. It needed to be deciphered. And part of the game of interpretation seems to have been to show that, whatever new idea they were promoting, the insight was already present in the writings of Hippocrates (or by showing, especially in the case of Epidemics 6, that parts of it were not by Hippocrates at all, and so could be ignored).

Now, one passage from Epidemics 6 was generally agreed to be a kind of keystone for the whole work. It is found at Epidemics 6.8.7:

“Things from the small tablet to be observed. Regimen consists in repletion and evacuation of foods and drinks. Changes of these: what from what, how it is. Odors: pleasant, noxious, filling, tempting. Changes, from what kinds of things, how they are. The pneumata that come in or go out, [solid] bodies also. Better sounds, and those that harm. And of the tongue, what things are evoked by what. Pneuma, what is hotter to the tongue, colder, thicker, thinner, dryer, wetter, filled up, less and greater. From what come changes, what out of what kinds of things, how they are. Things that contain, impart impulse, or are contained. Speech, silence, saying what one wishes. The words, what one says, either loud or many, truthful or fraudulent. (Smith trans., modified)”

τὰ ἐκ τοῦ σμικροῦ πινακιδίου σκεπτέα. δίαιτα γίνεται πλησμονῇ, κενώσει, βρωμάτων, πομάτων· μεταβολαὶ τούτων, οἷα ἐξ οἵων, ὡς ἔχει. ὀδμαὶ τέρπουσαι, λυποῦσαι, πιμπλῶσαι, πειθόμεναι· μεταβολαὶ, ἐξ οἵων οἵως ἔχουσιν. τὰ ἐσπίπτοντα, ἢ ἐξιόντα πνεύματα, ἢ καὶ σώματα. ἀκοαὶ κρείσσονες, αἱ δὲ λυποῦσαι. καὶ γλώσσης, ἐξ οἵων οἷα προκαλεῖται. πνεῦμα, τὸ ταύτη θερμότερον, ψυχρότερον, παχύτερον, λεπτότερον, ξηρότερον, ὑγρότερον, πεπληρωμένον, μεῖόν τε καὶ τὸ πλεῖον· ἀφ' ὧν αἱ μεταβολαὶ, οἷαι ἐξ οἵων, ὡς ἔχουσιν. τὰ ἴσχοντα, ἢ ὁρμῶντα, ἢ ἐνισχόμενα. λόγοι, σιγὴ, εἰπεῖν ἃ βούλεται· λόγοι, οὓς λέγει, ἢ μέγα, ἢ πολλοὶ, ἀτρεκεῖς, ἢ πλαστοί. (V 344-6 Littré)

(I’ve adopted some of the changes suggested by Smith in the Loeb text and ignored others. Notably, I’ve left out “σώματα” after “ἐνισχόμενα”, following Littré, since as Littré pointed out, no one in antiquity mentions it being there.)

This text has puzzled interpreters for a long time. It is elliptical, confident, and somewhat mysterious. But later doctors saw in it the basis of a system: a list of observations that need to be made in order to assess the health of a patient. 

Two aspects of the list were to become especially important in later medical writers. One is the distinction of pneuma into hot, cold, thick, thin, wet or dry. This distinction has an interesting history that I hope to come back to. But here I want to focus on the distinction of things into “containing, imparting impulse, and contained (τὰ ἴσχοντα, ἢ ὁρμῶντα, ἢ ἐνισχόμενα).” 

We have been working on tracing this distinction for a paper we’re writing on the Pneumatist school. It came to be associated with a way of understanding human physiology that would have a long influence: the division of the constituents of the body into solid parts, humours, and pneuma. It is explicitly mentioned in Galen, the pseudo-Galenic Introduction, pseudo-Alexander on Fevers. It might be in Nicolaus of Damascus On Plants. And in De causis contentivis, especially in chapter 4, Galen hints that it played some role in Pneumatist physiology and causal theory. 

This left us with a bit of a puzzle. How did a distinction of the body into containing parts, parts imparting impulse, and contained parts come to be identified with solids, liquids and gases? This is far from obvious and there is nothing in the text of the Epidemics that suggests it. Why would anyone have interpreted the text this way? Why did it become widely accepted? And how is it related to other ways of describing human physiology, for example, in terms of the elements (...interesting that the distinction is absent from the Definitiones...)?

We looked through the literature, but didn’t find anything substantial. So I thought I would gather all the texts here to make them available. Some of them are still untranslated, and there are likely more texts than the ones below. I will continue to translate and add more as we find them. But hopefully it will be something of a start to sorting out how this interpretation of Epidemics 6 came about and why it became so influential.

I
The Pseudo-Galenic author of Introduction or The Physician

“Others say the human is in fact composed out of three compounds, as well, from wet things, dry things and pneumata. Hippocrates calls them things containing, things contained and things which impart impulse. Containing are whatever are solid bodies—bones, nerves, veins and arteries—out of which muscles, flesh, and every mass of the body are compounded, both internal and external structures. Contained are the wet things carried in the channels and scattered through the whole body, what Hippocrates calls the four humours previously mentioned. Things which impart impulse are the pneumata. According to the ancients, there are two pneumata: psychic and natural. The Stoics also add a third: hectic, which they call a state.”

οἱ δὲ ἐκ τῶν τριῶν καὶ συνθέτων τὸν ἤδη γενώμενον ἄνθρωπον ἐκ τῶνδέ φασι συγκεῖσθαι, ἔκ τε τῶν ὑγρῶν καὶ ξηρῶν καὶ πνευμάτων. καλεῖ δὲ αὐτὰ Ἱπποκράτης ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα. ἴσχοντα μὲν οὖν ἐστιν ὅσα στερεὰ, ὀστᾶ καὶ νεῦρα καὶ φλέβες καὶ ἀρτηρίαι, ἐξ ὧν οἵ τε μύες καὶ αἱ σάρκες καὶ πᾶς ὁ τοῦ σώματος ὄγκος πέπλεκται, τῶν τε ἐντὸς καὶ τῶν ἐκτὸς τὰ συγκρίματα. ἰσχόμενα δέ ἐστι τὰ ὑγρὰ τὰ ἐν τοῖς ἀγγείοις ἐμφερόμενα καὶ κατὰ πᾶν τὸ σῶμα διεσπαρμένα, ἅπερ καλεῖ Ἱπποκράτης χυμοὺς τέσσαρας τοὺς προειρημένους. ἐνορμῶντα δέ ἐστι τὰ πνεύματα. πνεύματα δὲ κατὰ τοὺς παλαιοὺς δύο ἐστὶ, τό τε ψυχικὸν καὶ τὸ φυσικόν. οἱ δὲ Στωϊκοὶ καὶ τρίτον εἰσάγουσι τὸ ἑκτικὸν, ὃ καλοῦσιν ἕξιν.

[Galen] Introductio 9, 14.696.14-697.8 K

“Hippocrates, then, put forward three, saying the elements of man are things contained, containing and imparting impulse, through which he included all the elements of those who came after him, as well as elemental physiology and the aetiology of things contrary to nature. But those after him, I don't know why, divide this divine and truly Asclepian medicine into three, although it is really a unity, and they dispersed the parts that make it up. (i) Some referred only to the humours [when explaining] the composition of things according to nature and the cause of things contrary to nature, as Praxagoras and Herophilus [did]. Others posited the solid bodies as the primary and elemental things, and believed that things are composed out of these and the causes of diseases originate from them, as Erasistratus and Asclepiades [did]. And those around Athenaeus and Archigenes claim that all the natural things are created only by means of the pneuma pervading through them and that all the diseases are governed by it, because it [sc. the pneuma] is the thing affected first – for this reason they are called Pneumatists.”

Ἱπποκράτης μὲν οὖν διὰ τριῶν κεχώρηκεν, εἰπὼν στοιχεῖα ἀνθρώπου ἴσχοντα, ἰσχόμενα, ἐνορμῶντα, δι' ὧν τὰ πάντα τῶν μετ' αὐτὸν περιείληφε στοιχεῖα καὶ τὴν κατὰ στοιχείων φυσιολογίαν τε καὶ αἰτιολογίαν τῶν παρὰ φύσιν· οἱ δὲ μετ' αὐτὸν οὐκ οἶδ' ὅπως μίαν οὖσαν τὴν θείαν ταύτην καὶ ἀληθῶς Ἀσκληπιοῦ ἰατρικὴν τριχῇ διανειμάμενοι καὶ διασπάσαντες τὰ ἐν αὐτῇ συμφυῆ μέρη, οἱ μὲν μόνοις τοῖς χυμοῖς τῶν τε κατὰ φύσιν τὴν σύστασιν καὶ τῶν παρὰ φύσιν τὴν αἰτίαν ἀνέθεσαν, ὡς Πραξαγόρας καὶ Ἡρόφιλος. οἱ δὲ τὰ στερεὰ σώματα τὰ ἀρχικὰ καὶ στοιχειώδη ὑποθέμενοι, τά τε φύσει συνεστῶτα ἐκ τούτων καὶ τῶν νόσων τὰς αἰτίας ἐντεῦθεν λαμβάνουσιν, ὡς Ἐρασίστρατος καὶ Ἀσκληπιάδης· οἱ δὲ περὶ Ἀθήναιον καὶ Ἀρχιγένην μόνῳ τῷ διήκοντι δι' αὐτῶν πνεύματι καὶ τὰ φυσικὰ συνεστάναι τε καὶ διοικεῖσθαι καὶ τὰ νοσήματα πάντα, τούτου πρωτοπαθοῦντος γίνεσθαι ἀπεφήναντο, ὅθεν καὶ πνευματικοὶ χρηματίζουσι.

[Galen], Introductio 9, 698.12-699.10 K

II
Nicolaus of Damascus, Plants (distinct tradition?)

“A plant has three powers, the first derived from the element of earth, the second from that of water, the third from that of fire. From the earth the plant derives its growth, from water its cohesion, and from fire the union of the cohesion of the plant. We see much the same thing in vessels of pottery, which contain three elements—clay, which is, as it were, the material of pottery; secondly, water, which binds the pottery together; and, thirdly, fire, which draws its parts together, until it completes the process of manufacture.”

Τὸ δένδρον τρεῖς ἔχει δυνάμεις, πρώτην ἐκ τοῦ γένους τῆς γῆς, δευτέραν ἐκ τοῦ γένους τοῦ ὕδατος, τρίτην ἐκ τοῦ γένους τοῦ πυρός. ἀπὸ τῆς γῆς γάρ ἐστιν ἡ ἔκφυσις τῆς βοτάνης, ἀπὸ τοῦ ὕδατος ἡ σύμπηξις, ἀπὸ τοῦ πυρὸς ἡ ἕνωσις τῆς συμπήξεως τοῦ φυτοῦ. Βλέπομεν δὲ πολλὰ τούτων καὶ ἐν τοῖς ὀστρακώδεσιν. Εἰσὶ γὰρ ἐν τούτοις τρία, πηλός, ἐξ οὗ γίνεται πλίνθος ὀστρακώδης, δεύτερον ὕδωρ, ὅπερ ἐστὶ τὸ στερεοῦν τὰ ὀστρακώδη, τρίτον τὸ πῦρ τὸ συνάγον τὰ μέρη αὐτοῦ, ἔστ’ ἂν δι‘ αὐτοῦ πληρωθείη ἡ τούτου γένεσις.

[Aristotle], De Plantis 2.1

III
The Pseudo-Alexandrian author of Fevers

Φανερὸν μὲν οὖν διὰ τούτων καὶ ὡς τρία μόνα τὰ ἐν ἡμῖν, ἐν οἷς ἡ παρὰ φύσιν θερμότης, μόρια, χυμοί, πνεύματα· τὰ αὐτὰ δὲ καὶ παρ' Ἱπποκράτει ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα καλεῖται, ἴσχοντα μὲν τὰ μόρια, ἃ καὶ στερεὰ προσαγορεύεται, ἰσχόμενα δὲ οἱ χυμοί, ἐνορμῶντα δέ γε τὰ πνεύματα, ἕκαστον ἐκ τῆς ἰδίας δυνάμεως τὴν προσηγορίαν ἁρμόζουσαν εἰληφός. 

Ἴσχει μὲν γὰρ καὶ κατέχει τὰ στερεά, ἐνίσχεται δὲ καὶ ἐμπεριέχεται ὑπὸ τούτων τὰ ὑγρά τε καὶ διαρρέοντα, ταὐτὸν δὲ εἰπεῖν οἱ χυμοί, ὁρμᾷ δὲ τὰ ἐν ἡμῖν πνεύματα, λεπτομερεστάτης οὐσίας ὄντα καὶ θερμοτάτης, καὶ ῥᾷστα διὰ πάντων χωροῦντα τῶν μορίων τοῦ σώματος.

[Alexander], De febribus 17.1-2

IV
Galen, Differences of Fevers

νῦν δὲ ἀρκεῖ τό γε τοσοῦτον γινώσκειν, ὅπερ, οἶμαι, καὶ ὁ Ἱπποκράτης ἐνδεικνύμενος ἔλεγε, τὰ ἴσχοντα καὶ τὰ ἐνισχόμενα καὶ τὰ ἐνορμῶντα· ἴσχοντα μὲν αὐτὰ τὰ στερεὰ μόρια τοῦ σώματος, ἐνισχόμενα δὲ τὰ ὑγρὰ, ἐνορμῶντα δὲ τὰ πνεύματα προσαγορεύων.

Galen, De differentiis febrium, 7.278.11 K

V
Galen, On Tremor, Palpitation, Spasm and Rigor

μέμνηται δέ πως αὐτῶν ὧδε, τὰ ἴσχοντα λέγων, καὶ τὰ ἐνισχόμενα, καὶ τὰ ἐνορμῶντα· ἴσχοντα μὲν τὰ στερεὰ καλῶν, περιέχει γὰρ καὶ ἀποστέγει τὰ ὑγρά· ἐνισχόμενα δὲ, τὰ ὑγρὰ, περιέχεται γὰρ ὑπὸ τῶν στερεῶν· ἐνορμῶντα δὲ τὰ πνεύματα, πάντῃ γὰρ ἐξικνεῖται τοῦ σώματος ἐν ἀκαρεῖ χρόνῳ ῥᾳδίως τε καὶ ἀκωλύτως.

Galen, De tremore, palpitatione, convulsione et rigore, 7.597.3-9 K

VI
Galen, Commentary on Epidemics 6
(only available in Pfaff’s German translation of the Arabic summary, online at the CMG)

(V 346, 5.6 L[ittré]) Hippocrates: Das Enthaltende und das Eindringende und das Enthaltene.

Galen: Auch diese Worte erklärt jeder von den Kommentatoren anders. Die beste Erklärung ist nach meiner Meinung die Erklärung derjenigen, welche sagen, daß er unter ‘das Enthaltende’ die festen Grundkörper [solid parts] und unter ‘das Eindringende’ oder ‘das Durchdringende’—diese Worte werden auf diese beiden Arten geschrieben—die Winde [pneumata] und unter ‘das Enthaltene’ die Feuchtigkeiten [humors], die die Körper enthalten, verstehe. Hippokrates verlange also, daß man von diesen drei Dingen aus, aus denen jeder lebende Körper bestehe, untersuche und erforsche, welches die Natur und die Kraft eines jeden von ihnen sei.

Galen, In Hippocratis Epidemiarum librum VI commentaria I-VI, CMG V 10,2,2 p.446 Wenkebach

VII
Palladius, Overview of on Fevers

Ἰστέον ὅτι τῶν πυρετῶν τρία εἰσὶ τὰ γένη· τὰ μὲν γὰρ αὐτῶν ἐπὶ ὑγροῖς γίνονται καὶ ἐξάπτονται, τὰ δὲ ἐπὶ στερεοῖς, τὰ δὲ ἐπὶ πνεύμασι, περὶ ὧν ὁ Ἱπποκράτης λέγει ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα, ἴσχοντα μὲν καλῶν τὰ στερεά, ἰσχόμενα δὲ τὰ ὑγρά, ἐνορμῶντα δὲ τὰ πνεύματα. Ὁ δὲ Γαληνὸς ἀναφέρει ὅτι ἀναμέμικται ἔν τε ταῖς ἀρτηρίαις ἁπάσαις διὰ πολλῶν ὀπῶν ἅμα πνεούσαις ἡ ἀερώδης οὐσία τῷ αἵματι καὶ κατὰ τὴν καρδίαν οὐδὲν ἧττον, ὡς ἂν σύρρους ὑπάρχουσα πάσαις αὐταῖς.

Palladius, Synopsis de febribus, 4.1-2

Moving Causes

More trouble with the Definitions...

In On Cohesive Causes, Galen mentions that Athenaeus took over some causal theory from Posidonius, particularly the notion of the synectic or cohesive cause, i.e., the cause responsible for something remaining what it is.

According to Galen, Athenaeus distinguished cohesive causes from two other kinds of causes: preceding (or prohegoumena) causes and antecedent (or prokatarctic) causes. A preceding cause is something internal that over time leads to disease. Examples Galen gives are venom and poison. An antecedent cause is something that gets some process going (On Cohesive Causes 2.3, CMG Suppl. Or. II ed. Lyons p.54). Something like what Aristotle calls an efficient cause.

In the pseudo-Galenic Medical Definitions, we find entries for six kinds of causes, including cohesive, preceding and antecedent causes, as well as an entry for cause in general. In Kühn’s text of the Definitions, Athenaeus’ name appears in definition 155 (XIX 392-3K), the definition of the procatarctic or antecedent cause. Here’s the whole bit from the Definitions on causes:

“154. A cause is that which produces something in the body and is itself incorporeal. Or a cause is, as the philosophers say, what is productive of something or through which something comes to be. Cause is three-fold: there is the antecedent [prokatarctic], preceding [prohegoumenon] and cohesive [synectic].

155. So, an antecedent [prokatarctic] [cause] is that which, having produced the effect, is separate, as the bite [is separate] from the dog, the sting from the scorpion, and the inflammation which produces a fever [is separate from] from the sun. Athenaeus of Attaleia speaks in this way. The agent is a cause, i.e.,  the antecedent [cause]. Otherwise. The antecedent causes are whatever [causes] begin before the result is entirely complete and of which there is nothing preceding.

156. A preceding [prohegoumenon] cause is that which is constructed or co-produced by the antecedent cause and precedes the containing cause. Others in this way. A preceding cause is that which, when it is present, the result is present; when it increases, the result increases;  when it decreases, the result decreases; and when it is removed, the result is removed.

157. A cohesive [synectic] cause is that which, being present, preserves the presence of the disease, but when removed, removes [the disease], as the stone in the bladder; as the hydatid [i.e., a sac filled with fluid unconnected to tissues], as the pterugion [i.e., some kind of obstruction on the eye]; as the enkanthis [i.e., another obstruction of the eye]; [and] as other such things called containing causes, things which the very best physicians [thought] not only [should be placed] in an account of causes, but also [thought were distinct] from settled conditions.

158. A self-complete [autoteles] cause is what produces an end itself by itself.

159. A contributing cause [sunaition] is that which has adequate power with another to produce the result, but it is not being able to produce [the result] on its own power alone.

160. A coöperator [sunergon] is a cause which, when something produces a result but with difficulty, contributes to its more easy generation, not able to produce something on its own.”

[392K] ρνδʹ. Αἴτιόν ἐστιν ὃ ποιοῦν τι ἐν τῷ σώματι καὶ αὐτὸ ἀσώματόν ἐστι. ἢ αἴτιόν ἐστιν, ὡς οἱ φιλόσοφοι λέγουσι, τό τινος ποιητικὸν ἢ δι’ ὅ τι γίνεται. τριπλοῦν δὲ αἴτιον· ἔστι δὲ τὸ μὲν προκαταρκτικὸν, τὸ δὲ προηγούμενον, τὸ δὲ συνεκτικόν.

ρνεʹ. Προκαταρκτικὸν μὲν οὖν ἐστιν ὃ ποιῆσαν τὸ ἀποτέλεσμα κεχώρισται ὡς ὁ δακὼν κύων καὶ ὁ πλήξας σκόρπιος καὶ ἡ ἀπὸ τοῦ ἡλίου ἔγκαυσις ἡ τὸν πυρετὸν ἐργαζομένη. Ἀθήναιος δὲ ὁ Ἀτταλεὺς οὕτω φησίν. αἴτιόν ἐστι τὸ ποιοῦν. τοῦτο δέ ἐστι τὸ προκαταρκτικόν. ἄλλως. τὰ προκαταρκτικὰ αἴτιά ἐστιν ὅσα προκατάρχει τῆς ὅλης συντελείας τοῦ ἀποτελέσματος καὶ ὧν οὐδὲν προηγεῖται.

ρνστʹ. Προηγούμενον αἴτιόν ἐστι τὸ ὑπὸ τοῦ προκαταρκτικοῦ ἤτοι κατασκευαζόμενον ἢ συνεργούμενον καὶ προη-|[393K] γούμενον τοῦ συνεκτικοῦ. οἱ δὲ οὕτως. προηγούμενον αἴτιόν ἐστιν οὗ παρόντος πάρεστι τὸ ἀποτέλεσμα καὶ αὐξομένου αὔξεται καὶ μειουμένου μειοῦται καὶ αἱρουμένου αἱρεῖται.

ρνζʹ. Συνεκτικὸν αἴτιόν ἐστιν ὃ παρὸν μὲν παροῦσαν φυλάττει τὴν νόσον, ἀναιρούμενον δὲ ἀναιρεῖ, ὡς ὁ ἐν τῇ κύστει λίθος, ὡς ὑδάτις, ὡς πτερύγιον, ὡς ἐγκανθὶς, ὡς ἄλλα τοιαῦτα συνεκτικὰ καλούμενα αἴτια, ἅπερ οἱ γενναιότατοι τῶν ἰατρῶν οὐκ ἐν αἰτίων μόνον λόγῳ, ἀλλὰ καὶ ἐκ παθημάτων τιθέντων ταῦτα.

 ρνηʹ. Αὐτοτελὲς αἴτιόν ἐστι τὸ αὐτὸ καθ’ αὑτὸ ποιοῦν τέλος.

 ρνθʹ. Συναίτιόν ἐστιν ὃ σὺν ἑτέρῳ δύναμιν ἴσην ἔχον ποιοῦν τὸ ἀποτέλεσμα, αὐτὸ δὲ κατ’ ἰδίαν μόνον οὐ δυνάμενον ποιῆσαι.

 ρξʹ. Συνεργόν ἐστιν αἴτιον ὃ ποιοῦν ἀποτέλεσμα, δυσχερῶς δὲ, συλλαμβάνον πρὸς τὸ ῥᾷον αὐτὸ γενέσθαι, κατ’ἰδίαν τι ποιεῖν οὐ δυνάμενον.

[Galen] Definitiones 154-160, XIX 392-3 K

The phrase attributed to Athenaeus looks like a statement about antecedent causes: they are productive or efficient causes. This claim fits nicely with what Galen says in On Cohesive Causes. He tells us Athenaeus contrasted antecedent causes, causes of change, with cohesive causes, causes of stability.

Oddly, we get a different picture from both the Aldine and and the BL ms. They put Athenaeus’ statement about efficient causes under the definition of the cohesive cause:

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The 1525 Aldine edition of Galen's Definitions (v.4; ὃροι ἰατρικοί., p.13) reports Athenaeus’ definition of the prokatarctic cause under the heading for the “synectic cause.”  From the BIU Santé / Université Paris Déscartes.

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The misplaced definition is found in the 15th c. British Library’s Add ms. 11888 f.9r

What Athenaeus is supposed to have said is the same in the Aldine, BL, and Kühn texts. Still, I can't figure out why someone would have placed it under the definition of the cohesive cause. Is it merely misplaced, as Kühn seems to have thought? Or, did someone think—whoever composed the text followed by Aldus and the BL ms.—Athenaeus identified cohesive and antecedent causes?

An ambiguous reference in [Galen] Medical Definitions 31 (XIX 356K)

This problem was first brought to my attention by David Leith in a paper he gave on Athenaeus of Attalia’s theory of the elements at Humboldt-Universität in January 2015. His talk inspired me to write this post, and to put together a forum for discussing these kinds of problems as my work on Athenaeus continues. 

The pseudo-Galenic text called the Medical Definitions is one of our main sources for the lost writings of Athenaeus of Attalia. Normally, I am happy if a source has one direct quotation or excerpt from Athenaeus’ works. The Definitions has three.

Athenaeus of Attalia was a physician from the 1st c. BCE. For a time, he likely practiced medicine in Anatolia, where he became a student of the Stoic natural philosopher, Posidonius. At some point, he may have moved to Rome, but waters here are murky. All we know for sure is that he was most well known for the ancient medical school he is said to have founded. Known as the Pneumatic School, those reported to be its adherents combined Hippocratic medicine with Stoic ontology and epistemology; they read and engaged with the biological writings of Aristotle and Theophrastus; and they had close ties with Empiricism and / or Methodism. In many ways, the Pneumatic “school” manifests the kind of eclecticism we typically associate with Galen. From what we are told about him by our sources, this eclectic approach to medicine was already present in the writings of Athenaeus.

But Athenaeus’ major work, On Remedies (ΠΕΡΙ ΒΟΗΤΗΜΑΤΩΝ), is lost. Anything we know about it is known only through fragments—some excerpts preserved in later authors like Oribasius and Aëtius—and second-hand reports in Galen, the pseudo-Galenic Introduction or the Physician, and the Medical Definitions. And right now I am trying to figure out how much our sources can tell us about this lost work.

Of all these sources, the Definitions is special. It’s not only the quantity of direct quotations—which is great—but their content that is exciting. Definitions are a special kind of testimony. As the author of the Definitions tells us at the beginning his work, all the definitions collected and written down were chosen because physicians and philosophers used them as starting-points for thinking and teaching about science and medicine. As starting-points, these definitions can help us to figure out the shape of their thought. And so any definitions attributed to Athenaeus give us a good place from which to reconstruct his medical views, as well. 

The Definitions also help us understand the medical and philosophical context Athenaeus was working in. Among the hundreds of unattributed definitions recorded in the text, there are a few I'm pretty sure were written by Athenaeus (or at least by some people sympathetic to his views);  there are many other definitions written by thinkers who are hostile to him. These nameless and hidden fragments still manifest traces of the debates going on between various natural philosophers and physicians concerning the nature of the human body, of health and disease, and of the structure of science.

The Definitions, however, is a difficult text to use. If you can do your research without it, many scholars will tell you it is best to avoid it. The text of the Definitions is in bad shape. Bits and pieces were continually being added, removed, or shuffled around. And the result is a text that varies a lot from edition to edition. Kühn's text, which is a de facto standard, is especially problematic, since you would have no idea from reading it that the problem even exists. And even with an edition, centuries of corruption may have made impossible to tell what the author (or collator or editor) of the Definitions meant to attribute to particular authors. 

One example of this kind of problem was discussed by David Leith in his talk at the Pneumatist workshop at Topoi, which he also organized with Orly Lewis and me. It is Definition 31, the definition of “element,”  attributed to Athenaeus. Kühn’s text reads:

“31. (i) An element is the first and simplest thing out of which everything has come to be and the simplest and final thing into which everything resolves. And Athenaeus of Attaleia in the third book speaks in this way. (ii) The elements of medicine are just what some of the ancients held, the hot, the cold, the moist and the dry, the first apparent simplest and smallest things out of which humans are composed, and the last apparent simplest and smallest things into which they have their resolution.”

λαʹ. Στοιχεῖόν ἐστιν ἐξ οὗ πρώτου καὶ ἁπλουστάτου τὰ πάντα γέγονε καὶ εἰς ὃ ἁπλούστατον τὰ πάντα ἀναλυθήσεται ὂν ἔσχατον. καὶ Ἀθηναῖος ὁ Ἀτταλεὺς ἐν τῷ τρίτῳ βιβλίῳ φησὶν οὕτως. στοιχεῖα τῆς ἰατρικῆς ἐστι καθάπερ τινὲς τῶν ἀρχαίων ὑπέλαβον, τὸ θερμὸν καὶ τὸ ψυχρὸν καὶ τὸ ὑγρὸν καὶ τὸ ξηρὸν, ἐξ ὧν πρώτων φαινομένων καὶ ἁπλουστάτων καὶ ἐλαχίστων ὁ ἄνθρωπος συνέστηκε· καὶ εἰς ἃ ἔσχατα φαινόμενα καὶ ἁπλούστατα καὶ ἐλάχιστα τὴν ἀνάλυσιν λαμβάνει.

[Galen], Definitiones 31, XIX 356 K

As David pointed out, the way the text is written, it’s ambiguous whether Athenaeus is supposed to have given the first definition (i. of “element”), or the second definition (ii. of “the elements of medicine”). If Athenaeus goes with the first (i. of “element”), it would be a bit strange: why would the author have bothered attributing such a general definition to anyone? It’s a pretty standard Hellenistic definition, and Chrysippus or Zeno could equally well have been cited. If “Athenaeus” goes with the second definition (ii. of “elements of medicine”), then we at least have a reason why Athenaeus (and not someone else) is mentioned (he was a physician). And David believes this definition can actually tell us quite a bit about Athenaeus’ views —about how he saw himself in relation to the “ancients”, about his epistemology, and about his theory of elements. The definition also lets us compare him to other philosophers and physicians to see where he fits in the doxography. And that can tell us a bit more about his context. 

“καὶ Ἀθηναῖος ὁ Ἀτταλεὺς ἐν τῷ τρίτῳ βιβλίῳ φησὶν οὕτως.”

It would be great if it turned out Athenaeus gave the second definition. And it would be strange if the author of the Definitions singled Athenaeus out as the author of the first one. When I looked through the literature, I expected to find lots of different views on the question. It turns out, no one has bothered to make a case for attributing either definition to Athenaeus. Even Wellmann leaves it totally vague. He mentions in a note that Athenaeus’ definition follows the Stoics (“Seine Definition von στοιχεῖον (Gal. XIX 356) ist durchaus stoisch. Vgl. Diog. Laert. VII 136”, DPnS,133n5), but both (i) and (ii) could be said to be in line with the Stoics for different reasons. The selection from Diogenes Laertius which Wellmann cites could also be used to support either interpretation. Did Wellmann think both were Athenaean? And would looking at texts other than Kühn be of any help?

Checking the Aldine

Looking at the Aldine edition of Galen from 1525, the same ambiguity appears:

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The 1525 Aldine edition of Galen doesn't make it any clearer what Athenaeus was supposed to have said. From the BIU Santé / Université Paris Déscartes

The Aldine text of this definition is quite similar to Kühn’s. And like in the Kühn text, Athenaeus’ assertion is followed by the adverb, οὕτως, which normally looks forward to what comes next. So, it's pretty reasonable to think that already in the Aldine, the author attributed the second definition, about the elements of medicine, to Athenaeus. 

But, this isn’t conclusive. David suggested that perhaps both definitions are being attributed to Athenaeus: they make up a kind of definition-pair. I learned a great deal from David’s paper, and I’m mostly convinced by it; but, the 15th c. manuscript of the Definitions which David consulted for his talk has made me a bit worried.

A surprise from Nikolaos 

The manuscript is British Library Add. MS 11888. It seems to remove the ambiguity of attribution in a pretty surprising way. The scribe, named “Νικόλαος”, seems to have attributed only the first definition to Athenaeus. 

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David Leith's tricky case -- British Library Add MSS 11888 f.2v

Not only does he seem to have taken Athenaeus’ name with the former definition, but he also split the definitions of “element” and “elements of medicine” into different sections. (At least this is what it looks like to me.)

This doesn’t conclusively show that the second definition isn't from Athenaeus. Maybe our scribe copied something like the Aldine text, where both definitions were together, but assumed these definitions had been incorrectly combined and helpfully split them up again, adding question titles. Then again, it is possible that the question titles and divisions were original, and that later scribes removed them to save space. Once the titles were removed, it’s easy to see how the two definitions might be run together. 

This leaves me with a bit of a puzzle concerning the Definitions on Athenaeus on the elements. It’s got to be more than a coincidence that Athenaeus’ is the only definition recorded, and that both fit with things he is reported to have said elsewhere. But I’m curious if there are any other earlier sources for the Definitions that might help lead to a solution?