This volume of new essays is based on a conference with the same title held at the University of Exeter in 2005. All those speaking on that occasion have written chapters in this volume, along with Riccardo Chiaradonna whose chapter has been specially prepared for the volume. The aim of this volume, like the conference on which it is based, is to contribute to the upsurge of new research on Galen by focusing on a topic that bridges the interests of specialists in ancient medical history and Classicists and philosophers more generally. The conference also represents the convergence of two current focuses of research in the Department of Classics and Ancient History at Exeter, on ancient medicine especially Galen and on Hellenistic and Imperial Greek culture more generally.

We would like to acknowledge the support for the funding of the conference provided by the British Academy, the Classical Association, the Society for the Promotion of Hellenic Studies and the University of Exeter. We wish to thank most warmly all the contributors to the volume for their illuminating essays, and also the other participants at the conference whose comments helped to inform the final version of the papers. We are grateful to Michael Sharp, Classics Editor for Cambridge University Press, and the general editors of the series in which the volume appears, for their support and guidance.

In Galen's mind, Plato is certainly the highest philosophical authority. While this is not a disputed fact, Galen's own philosophical allegiance is an altogether different matter: can he be reckoned among the (Middle) Platonists of his time? The answers provided to this question vary from positive to negative and to anywhere in between. Galen was no doubt well acquainted with the kind of Platonism taught in the schools: when he was fourteen years old, his father Nicon had him attend lectures by Stoic, Platonic, Epicurean and Peripatetic teachers. Galen never mentions their names, but in the case of three of these teachers he does mention the names of their masters (the Stoic Philopator, the Platonist Gaius and the Peripatetic Aspasius). However, Platonists (and, more generally, scholastic philosophers) did not arouse his admiration: Galen comments disparagingly on their lack of rigour and on their futile, irreconcilable disputes. Such divergences would have led Galen to embrace Pyrrhonian scepticism, had he not been ‘saved’ by geometry and its cognate disciplines: Galen presents geometry, not speculative philosophy, as his model for demonstrative science.

These are all well-known facts, but are not enough to solve the problem of Galen's Platonism. Galen's contemptuous remarks about contemporary philosophers should not, perhaps, be given too much weight. Scholars have argued that Galen depends not only on Plato, but also on the Platonism of his time: this is shown (inter alia) by his conception of god and providence, by his ethics and by his epistemology.

GALEN'S ANATOMICAL PERFORMANCES

When Galen invites us to visualise the thorax as a geographical formation, he represents the body as a world of knowledge, and presents himself as its periegete. The body is a metaphor for the world. Marcus Aurelius, for example, Galen's own emperor, saw the whole order of creation as a body: he compares the selfish and wilful man, who has cut himself off from the unity of nature, to a severed hand or foot or head, lying apart from the rest of the body to which it belongs. The intact body is a powerful symbol of organic unity and, at least to the ancients, the smooth functioning of its component parts under central direction was a figure for the smooth functioning of a hierarchical society. Conversely, the body that has been marked or mutilated, whose interior has been exteriorised and laid open to public view, was a symbol of disturbing resonance and enduring fascination.

GALEN AS AN INTELLECTUAL IN HIS CULTURAL CONTEXT

The recent discovery of Galen's treatise On the Avoidance of Grief in a monastery in Thessaloniki provides a vivid picture of his intellectual life in Rome. Writing in the familiar ancient genre of the consolation, in the manner of Cicero, Seneca or Plutarch, Galen responds to the letters from an unnamed friend who admired his fortitude. Galen had managed to refrain from grief in the face of disaster, first an epidemic of plague among his slaves, and then the destruction of his books, drug supplies and medical instruments in the terrible fire that swept through the Temple of Peace and nearby buildings close to the Palatine hill in Rome in AD 192. With much topographical detail, Galen gives a clear description of the Temple of Peace district and the libraries and storehouses built around the Via Sacra, and his attempts to move valuable items he had at home into store for safe-keeping while he went on a trip to Campania. Disastrously, fire struck and he lost more cinnamon than the merchants could replace, a number of medical instruments, in particular wax moulds for special instruments he was about to commission from the metalworkers, and many books. The books included classic works by Theophrastus, Aristotle and Chrysippus, many of them annotated by Galen, with errors in punctuation and other anomalies removed.

The presence of a wise, powerful, skilful and provident creator figure – alternately labelled ‘nature’ (phusis) and ‘demiurge’ (dēmiourgos) – is absolutely key to Galen's thinking, to the medical and philosophical system he constructs and articulates. This figure has, however, not yet been subject to the intensity of scholarly scrutiny that its structural significance demands. This chapter is an attempt to fill in some of these gaps by investigating, in a more focused manner than hitherto, questions about where Galen's notion of nature and the demiurge comes from and about the work it does in his world of knowledge. I examine the intellectual resources that Galen drew on in fashioning his creator, what is traditional and what original in his formulation, and the identity of both its past precedents and the contemporary features it shares, as well as the motivations that he may have had in producing the particular package that he did.

Two specific, and connected, arguments will be put forward, following on from some more general points about Galen's demiurge, his notion of nature, as it appears and functions within his medical system and fits into his wider cultural context.

At the 2002 Entretiens Hardt, on the topic of Galen and philosophy, I delivered a paper in which I highlighted the complexity of Galen's cultural presuppositions in his concrete analysis of the language of Hippocrates. During the discussion session, I was asked what Galen meant by sunētheia, by language usage, a concept I referred to frequently during my presentation. At that particular moment I gave a provisional and summary answer, adding that the point deserved an independent study. On this occasion, I report on at least the first stage of this study.

My investigation will not be limited to the semantics of a single word: rather, I hope to describe in greater detail the approach Galen adopted with regard to the debate that was at the forefront of linguistic culture – and of cultural enquiry in general – during that period, which focused on the question of a model language advocated by so-called Atticism.

INTRODUCTION

Since this volume is concerned with the topic ‘Galen and the world of knowledge’, it may be proper to begin this paper with a thought experiment about the way in which Galen would position himself within his own ‘world of knowledge’ – and how he would construe the spectrum of different strands of this intellectual world emanating from the prism of his own ego. Let us imagine Galen being subjected to an interview of the type one hears so often nowadays on radio or television and being invited to give an assessment of the factors that have contributed most significantly to his own intellectual development and to his formation as a scientifically and philosophically trained healer. For someone with only a superficial knowledge of Galen's writings, this is not difficult to imagine, for Galen is only too eager, at numerous passages in his work, to indulge in self-presentation, self-analysis and self-glorification. Being asked which of the philosophical schools and medical traditions he would rank highest, there is no doubt that, in his reply, Galen would give pride of place to Hippocrates and Plato; he would mention his personal medical teachers Pelops, Satyrus, Marinus and Numisianus; he would include references to some of the Hellenistic physicians, most notably the Alexandrian anatomists; and he would probably mention Posidonius in favourable terms too (though he would be much more critical of the older Stoics). When asked by the interviewer: ‘And what about Aristotle and the Peripatetic school?

INTRODUCTION

Galen was no sceptic. On several occasions he refers derisively to ‘boorish Pyrrhonists’, suggesting that scepticism, at least in its more extreme forms, is a matter of a lack of culture, an intellectual infantile disorder. Time and again, he stresses that, if only the inquirer is blessed with diligence, honesty and intelligence, and armed with the proper logical tools of rational discourse, he can aspire to a genuine understanding of the way in which the physical (or more particularly the physiological) world works. In Elements According to Hippocrates (Hipp.Elem.), he argues that the successful medical practitioner needs to know the fundamental elements that make up physical objects, and how they interrelate to one another (although as we shall see, there are some qualifications to this necessity); he affirms that it is demonstrable that monism is false; and even more strikingly affirms that Hippocrates himself (in Nature of Man) demonstrated its falsity (Hipp.Elem. I.415–16; cf. 416–42). In a similar vein, On Mixtures (Temp.) talks of the importance of understanding the real states of affairs in regard to the internal mixtures of the body and its various properties, phenomenal and causal, and of properly assessing the varying degrees of heat, cold, dryness and moisture of the various parts. Another ‘physical’ treatise, On the Natural Faculties (Nat.Fac.), argues for the reality of certain fundamental natural capacities (attraction, retention, alteration and expulsion) possessed by distinct parts of animals' bodies in virtue of which they can perform their functions, and against what he stigmatises as the excessively crude materialism of the atomists and their various anti-teleological acolytes.

INTRODUCTION

The staging of an authorial self in multiple venues, contexts and media (including visual demonstration, oral performance and written text) was neither a uniquely Galenic nor a uniquely second-century phenomenon. In medicine it reaches back at least to the Classical period in Greece. But, within extant Greek and Latin technical literature, many of the better attested, more diverse and more colourful acts of authorial self-presentation are Galen's. Through public anatomical dissections and vivisections of animals and through multiple self-presentations in his prolific literary production, he actively participated in the ‘display culture’ of his time, even while deploring it. Deftly adapting different literary forms to different audiences, purposes and subjects (and at times liberally contaminating genres), he conspicuously inserted himself into almost every part of his oeuvre, thereby ensuring that he himself became a vivid, forceful authorial presence in his works. Furthermore, for all his insistence on the possibility of arriving at an objective science of the human body, and despite his effort to identify criteria for establishing a univocal ‘scientific’ language that would be suitable to communicate such a trans-subjective, transpersonal science, he often departed from the depersonalised, self-effacing style of some – but far from all – earlier authors of technical literature, resorting instead to a personally charged rhetoric. The result is a multi-dimensional staging of his authorial selves that pervades his massive extant corpus to a degree matched by few, if any, ancient writers of technical texts.

COMPILATORY WRITING IN THE ROMAN EMPIRE

Galen's relationship with the oratory of the ‘Second Sophistic’ has received a great deal of attention within recent scholarship. His interaction with the medical writing of his predecessors and contemporaries has been widely, albeit far from exhaustively, mapped. And yet, beyond those two areas very little attention has been given to his relationship with the compilatory habits of works that structure so much of the Greek and Latin writing of the Roman Empire. Accumulation of knowledge is a recurring aim for Imperial writers in a wide range of genres. Common techniques and tropes of knowledge-ordering are shared between many different authors and genres that seem at first sight to have little in common: historical and geographical composition, miscellanistic writing, mythography and paradoxography, lexicography, philosophy, scientific writing of many different types, technical and didactic writing, and in addition an enormous range of texts that are barely categorisable within any of those modern groupings, for example Pliny's vast and encyclopedic Natural History, or Athenaeus' ostentatiously eclectic Deipnosophistae. This chapter – focused around a reading of the preface to On the Order of My Own Books (Ord.Lib.Prop.) – offers an initial approach to the problem of how we should situate Galen's work within that vast, if diffuse, Imperial habit of compilation. It aims to draw out Galen's typicality – the way in which he draws on the common language of knowledge-ordering and contributes to it influentially.

AIM AND METHOD

This chapter is entitled ‘Galen and the Stoics’ not ‘Galen and Stoicism’. Its chosen title is intended to convey that it is my purpose to approach Galen's relations with the Stoa as it were from the outside. My main concern will not be with his response to the doctrines of great dead Stoics such as Chrysippus, nor with the conceptual relationship between his system of medicine-cum-philosophy (or parts of it) and Stoicism. Instead I shall be focusing on questions of a different kind. What were Galen's relations with the Stoics of his own day? Who were these Stoics? Further, in addition to Stoic persons, books by Stoics are what interest me: which did Galen know and read? Were there other sources of information on Stoic philosophy on which he drew? Answers to these questions will, I believe, contribute to the study of the presence of Stoicism in Galen's work – a vast subject – and on occasion I shall not refrain from indicating how this may be the case. A few words on the state of scholarly debate may serve to justify this approach.

A quick look at the index of sources in von Arnim's Stoicorum Veterum Fragmenta, still the standard collection of early Stoic fragments, suffices to show that Galen's dealings with Stoicism were extensive and long-standing. Von Arnim was not mistaken about this. The documented evidence is not only extensive but also variegated in nature, ranging from verbatim quotation to unacknowledged borrowing and allusion.

This discussion was prompted by a colleague who asked me recently whether there was a branch of medicine for intellectuals in antiquity. My initial response, before I knew the reason for his question, was ‘no’. Some time later, as I continued to ponder the question, I asked him why he had put it to me. He replied that it arose from the De Triplici Vita of Marsilio Ficino. The first of Ficino's three books is entitled, Primus de uita sana, sive de cura ualetudinis eorum, qui incumbent studio litterarum (Book One, On the Healthy Life, or On Preserving the Health of Those Who Study Literature). Since Marsilio Ficino, the son of a famous doctor, was familiar not only with Plato but also with Galen, two philosophers whose authority he appeals to in the preface of his De Triplici Vita, I became interested in discovering how far one can talk of a branch of medicine for the intellectual faculties in Galen, or for those who embody these faculties, namely intellectuals.

This line of enquiry falls on the borderline between the study of education or training and of therapy in its more familiar or conventional forms. There is, of course, a rich body of ancient theory about the training of the intellect, above all, Plato's elaborate educational programme in the Republic centred on a combination of mathematics and dialectic (Book 7, 521c–540c).

It is clear that Galen's medicine is first and foremost a rational type of medicine, based on the supremacy and value of his method. Galen dedicated a major work, in fourteen books, to the fundamental principles of this method: On the Therapeutic Method (MM) (Kühn X. 1–1021). At the same time, the story of his life and autobiographical anecdotes play an exceptional part in Galen's work. This point has been noted, as the combination of scientific and autobiographical writing remains highly original in medical literature. However, as far as I know, the extent of the linkage between the methodological objectives of Galen, the physician, and the autobiographical project of Galen, the writer, has never been fully brought out. I am, however, deeply convinced not only that there is a strong and unbreakable link between bios and methodos (life and method) in Galen's work, but also that he sees this link as having a particularly important part to play in the acquisition of every kind of knowledge. That is to say, the bios–methodos combination undoubtedly lies at the heart of the world of knowledge to which ancient medicine so powerfully contributed. In late antiquity, Galenic medicine was at the forefront of Greek literature: it maintained very close and original ties with other disciplines such as history, rhetoric and philosophy, and made a truly major contribution to the construction of the world of learning.

There are certain well-known minor differences, in style and content, between and even sometimes within the seven books of the Epidemics in the Hippocratic corpus. But individually and as a collection they contain a wealth of detailed information about the courses and outcomes of the complaints of several hundred particular patients. Scattered through the oeuvre of Galen, and especially in his treatise Prognosis, we find Galen too describing individual cases. Given first Galen's unbounded admiration for Hippocrates, and the energy he devoted to his voluminous Commentaries on the Epidemics in particular, we might have expected Galen's case-histories to follow the patterns the Hippocratic material presented. In fact, however, his accounts of his patients diverge in several important, indeed fundamental, respects.

That discrepancy poses the chief issue I want to explore in this chapter. Why does Galen depart from Hippocratic models so radically? What is the function of the case-histories he cites in his Prognosis and of that treatise as a whole? Some parts of the answers to those questions seem to be clear and uncontroversial, but I shall also offer some speculative comments on the underlying methodological issue that I believe to be of some importance in evaluating Greek medical practice. This concerns the relationship between individual case-histories, the understanding of the signs and symptoms they contain and the generalisations offered as guides to the practitioner.