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Galen remains indisputably one of the major figures in the history of medicine, both occidental and oriental. Whilst his name may not evoke the undiluted reverence accorded to Hippocrates, he is a much more identifiable historical figure with a very substantial surviving body of work accepted as being from his own hand. In terms of influence, particularly in Western Europe, his position in medicine is somewhat akin to that of Aristotle in philosophy, characterized as it is by a dominance extending to the mid-point of the second post-Christian millennium. Unlike both Hippocrates and Aristotle, however, he has always had his share of detractors, in part a consequence of his combative and self-aggrandizing style of writing, in part because of his perceived arrogance, in part because during his lifetime he was a weighty participant in a continuing debate between conflicting schools on the theoretical bases of medicine, and in part subsequently because of the supposed stultifying effect of his ideas, seen by some as hindering further developments in medicine.
The merits of these and other criticisms are debatable. What is incontrovertible is that his writings were not only extensive in amount, but also wide-ranging in scope, embracing all aspects of theoretical and practical medicine and many areas of philosophy as well. Changing concepts of physiology and pathology may have vitiated many of his concepts and practices, but in their more theoretical aspects, his medical writings, and arguably his philosophical writings too, remain relevant.
As noted earlier, the translations of these four treatises have been made from Kühn's Greek text with its accompanying Latin version (VI.836–80K, VII.1–272K). The Kühn text as a whole has been much criticized for its supposed inaccuracy, not least by those using it as a basis for translation, but is, in the case of these four treatises, the only post-sixteenth century Greek text available. There are three other possible sources of the text: (i) early manuscripts, as listed by Diels; (ii) Arabic versions; (iii) Latin versions, as catalogued by Durling. In the present case, the Florentine manuscripts Laurent. plut. 74.16 and 74.12 have been examined, but no significant changes to the Kühn text have been made on the basis of this. The Latin versions used, apart from that included in Kühn, are all those listed by Durling other than the anonymous one. Whatever the precise relationship to the original, the text as presented in the Kühn volumes contains very little that is uncertain or unclear to the extent that textual emendation seems mandatory. Certainly, the preparation of a new Greek text in the form of the estimable, but only very gradually accumulating, CMG series would be a most worthwhile endeavour. This, obviously, is not what is attempted here. Points of apparent textual difficulty are indicated in the footnotes as they arise, as are sentences difficult of comprehension – although these are arguably as likely to be due to Galen's style, also a target of criticism by some, as to errors in transmission of the text.
I.1 A statement of the same aim for symptoms (i.e. complete classification) as for diseases in De morborum differentiis. Everything contrary to nature is either a disease, a cause of disease, or a symptom, this last including epiphenomena.
I.2 Consideration of the term ‘condition’ (diathesis), important for definitions.
I.3 Discussion of the term ‘affection’ (pathos or pathema) and its distinction from ‘disease’.
I.4 A digression on the general issue of terminology and its relative importance.
I.5 A summary of the distinctions between ‘health’ (hugieia), ‘disease’ (nosos) and ‘affection’ (pathos/pathema) and a restatement of their definitions.
I.6 A definition of ‘cause’ and an enumeration of types of ‘cause’ resembling the Aristotelian classification, and also distinguishing between ‘primary’ (per se) and ‘secondary’ (per accidens) causes.
I.7 A definition of ‘symptom’ (and epiphenomenon) and the distinction from ‘disease’ and ‘cause of disease’.
I.8 Consideration of the distinction between ‘symptom’ and ‘affection’ and their possible overlap.
II.1 A division of symptoms into: (i) conditions of the body itself; (ii) damage to functions; (iii) things that follow the former (excess of secretion or retention, abnormal noises). A division of loss of function into ‘privation’ and ‘disorder’.
II.2 Further consideration of the differentiation between ‘symptom’, ‘disease’ and ‘cause of disease’.
III.1 A statement of the basic divisions of the classification of symptoms: (i) all symptoms into ‘psychical’ and ‘physical’; (ii) ‘psychical’ symptoms into ‘sensory’, ‘motor’ and ‘authoritative’; (iii) ‘sensory’ symptoms into those of sight, hearing, smell, taste and touch; (iv) symptoms of each of the senses into loss of sensation and abnormal sensation with subdivision of the latter into ‘indistinctly’ and ‘falsely’.[…]
This chapter is divided into four sections. In the first of these, four groups of key terms, foundational for Galen's analysis of the classification and causation of diseases and symptoms, are considered. These are (i) ὑγίεια, νόσος, and νόσημα; (ii) πάθος, πάθημα, σύμπτωμα and ἐπιγέννημα; (iii) διάθ∊σις, ἕξις and κατασκ∊υή; (iv) δύναμις, ἐνέργ∊ια and ἔργον. In the second section, terms specifically related to causation (αἰτία, αἴτιον, πρόϕασις and the various qualifying terms) are discussed, with particular focus on Galen's usage in the four treatises under examination. The third section comprises a miscellany of other terms important in the translated treatises. In the fourth and final section a glossary of medical terms used in the treatises is provided. The aim in all four sections is to clarify Galen's own usage. Although in the four treatises being considered and elsewhere, Galen is disparaging about those who he considers waste their time and energies on fruitless terminological debate, it is nonetheless clear that definitions are critical to Galen's enterprise in these four treatises, as the space he devotes to the discussion of such matters indicates. In De methodo medendi he also explicitly acknowledges their importance thus: ‘And it is shown in those [writings] that the origins of every demonstration are those things appearing to perception and intelligence and that in all things enquired into it is necessary to change the term (ὄνομα) into a definition (λόγος).’
I.1 A statement of aim – to examine causes of symptoms based on previously stated classificatory divisions.
II.1 Starting with sensory functions, the eye is taken as the first example. There is a threefold division: (i) the primary organ of sensation (crystalloid); (ii) the sensory capacity passing from brain to eye via the optic nerve; (iii) other, subsidiary parts of the eye. Diseases of the eye are to be understood by applying previous classifications to these three structural components.
II.2 Predominantly about the pupil, its relationship to the sensory pneuma presumed to flow via the optic nerve, and variations in pupillary size dependent on this flow. The prediction of outcome in couching of cataract is also considered.
II.3 More on the pupil, together with discussion of what is presumed to be the aqueous humour and its role in protecting the eye from the adverse effects of bright light.
II.4 Mainly about diseases of the choroid, including dissolution of continuity.
II.5 Galen returns to disturbances of the aqueous humour and the symptoms produced by these.
II.6 On eye symptoms arising from disturbances elsewhere in the body.
II.7 Brief consideration of ‘sympathetic’ affections of vision, and also of the general correspondence of the severity of symptoms to the magnitude of disturbance.
II.8 A summary of the effects of changes in the psychic pneuma on vision.
II.9 Disturbances of the cornea, including penetrating injuries, and their effects on vision.
II.10 A very brief statement about disorders of the conjunctiva and the eyelids. […]
I.1 A statement of aim – having catalogued and classified all diseases, to identify the causes of each. For simple (homoiomeric) parts, on the ‘first hypothesis’ (that of anarmoi/poroi) all diseases are either (i) a disproportion of pores, or (ii) a dissolution of continuity. On the ‘second hypothesis’ (that of elements and qualities) there are four ‘simple’ dyscrasias and four ‘combined’ dyscrasias.
II.1 Listing of 5 causes of excessive heat: (i) movement; (ii) putrefaction; (iii) proximity to another hot body; (iv) constriction; (v) food with the ‘necessary capability’. Examples are given in each case, using inanimate objects.
II.2 How excess heat comes about from these five causes.
II.3 A consideration of why a putative cause does not invariably produce the same effect. The explanation lies in variations in the magnitude and duration of the cause and in the state of the affected body. Again, inanimate examples are given.
II.4 Further consideration on the variability of the relationship between presumed cause and expected effect.
II.5 A distinction is drawn between proegoumenic and prokatarktic causes. The former are either ‘conditions pertaining to the animal itself or abnormal movements’ (internal antecedent causes) whilst the latter are external factors (external antecedent causes).
III.1 Enumeration of six causes of excess cold: (i) contact with cold things; (ii) certain foods and drinks; (iii) constriction; (iv) rarefaction; (v) idleness; (vi) disproportionate movement.
III.2 As in II.2, an elaboration of how these causes produce abnormal cold, again illustrated with inanimate examples.
III.3 Examples of causes of contact with external cold and their observed effects clinically.[…]
It is a commonplace to label Thucydides's History “tragic.” The goal of this chapter is to give this label substance and importance. For this reason, this chapter will do more than just discuss the famous passages in Thucydides that have a tragic resonance, such as the Melian Dialogue, which actually has a tragic format as well. Our starting point will instead be the phenomenon of tragedy itself since it is important to justify why we are pursuing Thucydides's connection with tragedy beyond his connection with any other contemporary intellectual or cultural phenomenon. We will then explore some tragic elements in a story we have already encountered, that of Harmodius and Aristogeiton. This short reading is offered only as an indicator to the aspect of tragedy in Thucydides that will be focused upon, namely, the notion of the deinon. Within Sophocles this word is at the center of the tragic condition, and it plays a similar role in Thucydides.
The development of the deinon in tragedy will take up the bulk of this chapter and will require considering its use before tragedy. No doubt it may seem at points that we are traveling too far from Thucydides and too little into many of the issues raised by the tragedies. There is no way around this; this is a book about Thucydides that wishes to rely on more than mere generalities as to what aspects of tragedy inform his work and give it such disclosive power.
This chapter focuses primarily on how it is that Thucydides begins a work that discloses a world. The beginning represents the essence of the conjuring trick; it is the lip of the fly-bottle and so it must entice, even as it is comfortably familiar, while all the while it is a step into something very different. Yet before we can lay out the first steps into the fly-bottle, we must have a better grasp of what it is like within or we will not know when we have entered. Our first task then is to identify the features of Thucydides's text that are world-disclosing.
For this task, we first return to Chios and to the passage with which we began:
After this [battle], the Chians [now under siege] no longer came out against [the Athenians], though the Athenians ravaged their land, their land being well stocked and untouched from the time of the Persian wars until now. For, next to the Spartans, I have observed only the Chians being both fortunate [verbal form of eudaimonia] and moderate [verbal form of sophrosune], and to the extent that their polis prospered, to that extent they ordered [their polis] more securely. And even as regards this revolt, [for people] might think they did it contrary to the safer path, but they did not dare to do it until they would be putting themselves in danger with many good allies and observing that, after the disaster in Sicily, not even the Athenians themselves denied any longer that their affairs were entirely and certainly desperate.[…]
The argument to this point has centered on the Archaeology as the lip of the fly-bottle. The Archaeology itself exhibits all of the features we have identified with a world, especially familiarity and consistency in its portrayal of events. Though Thucydides describes his project in disclosive language so clear that it has taken hundreds of years of modern philosophy to obscure it, it is necessarily the case that the means of disclosure recede into the background. By the time the narration of the war starts, if we are not in the fly-bottle yet, it will not take long. In section 1.24, with the introduction of events at Epidamnus, we are rapidly called upon to see connections emphasized in the Archaeology – for instance, that between wealth, power, and stasis (civil war).
There is, of course, no specific moment in which a world is disclosed, and it would not be fruitful to mimic the text and go through it section by section. To illustrate the worldliness of the world that Thucydides discloses, we will thus discuss an exemplary series of passages, characters, and events centered on the figure of Pericles.
There will presumably be no objection to this insofar as the centrality of Pericles is signaled unambiguously by the text itself, from his three unopposed speeches, to Thucydides's praise of Pericles in his own voice, to the echoes of Pericles found in every speech (and decision) that follows his demise, especially those of his Athenian successors.
This book would have been unduly cumbersome if it spent too much time on the underlying philosophical arguments as the main argument about Thucydides's text proceeded. This was actually more than a logistical hurdle, as there seems to be no reason to delve into the finer points of aspect seeing and world creation if it were not first established that these are important to understanding Thucydides's text. And so, I began with some provisional philosophical arguments, sketches really, and postponed more detailed discussion to the appendixes. Of course, the appendixes can hardly do justice to the philosophical positions I am relying upon, but, as in my discussion of the deinon in tragedy, I do hope that the discussions that follow at least move my position out of the domain of mere hand waving and place them in the context of an important tradition. This appendix will address my debt to Wittgenstein, especially as regards aspect seeing and history.
It should be noted at the outset that Ludwig Wittgenstein published only one book, the Tractatus Logico-Philosophicus, with which he was later dissatisfied. Parts of a second work, the Philosophical Investigations, were apparently getting close to being presentable to his mind, but the work was not published in Wittgenstein's lifetime. Thus all of the many works of Wittgenstein other than the Tractatus are collaborative efforts between Wittgenstein and his editors – generally former students.
The pretragic history of the word deinon is the rich, and surprising, inheritance that the tragedians and Thucydides deploy to make subtle arguments about the human. It is surprising because, though it may be generally granted that the deinon is central to tragedy, it is not seen as particularly important in Homer, much less a term that already describes the uncanny as it relates to logos. In order to support these assertions and to provide still more refinement and content to the argument, this appendix discusses additional issues relating to deinon, including the standard history of the term, and further develops some of the passages discussed in the text, as well as other key passages.
Etymology and History of Interpretation
There are some aspects of the history of the word deinon that are uncontroversial. For instance, deinon is derived from the root δ∊ and the suffix νο. It is also well known that the word deinon is central to tragedy, particularly Sophoclean tragedy, and in some way refers to the features of the human that make tragedy possible. Finally, certainly by the third century b.c., the adjective deinotes (having the characteristic of being deinon) had become a description for a particular type of public speech, namely, the vehement, powerful style.
There is also a standard story about the progression of deinon. In Homer deinon always means “terrible or powerful,” and deinon becomes “uncanny” only in tragedy, particularly in Sophocles. Logos becomes deinon only in the context of the Sophists.
In many ways, Heidegger cannot be more different from Wittgenstein. Heidegger published a voluminous number of works in his lifetime. Unlike Wittgenstein's, Heidegger's philosophical writings almost always explicitly engage the philosophical tradition, and Heidegger clearly believes that there are proper philosophical problems about which it is the task of philosophers to think. Furthermore, especially in the work under consideration here, Being and Time, Heidegger's work is extremely systematic.
Despite the differences, it has become increasingly common to see connections between the two thinkers. The Philosophical Investigations and Being and Time are the twentieth century's two great attacks on Cartesianism. In both cases, that of Heidegger as well as that of Wittgenstein, much emphasis is placed on the fact that the Cartesian picture of isolated subjects is phenomenologically false, and thus the key is to remind us of what we already know. In the case of Wittgenstein, as we saw, the method used was that of short aphoristic sayings meant to reveal the blind spots our philosophical ideas and jargon have obscured. For Heidegger in Being and Time, the task is more ambitious. Heidegger's goal is to redescribe our everyday experience in a manner that is not Cartesian.
From Heidegger's more historical perspective, we are not bound to fall into Cartesianism, as Wittgenstein's more modest therapeutic approach would seem to imply. Not only is Cartesianism not phenomenologically true or philosophically coherent, it is a relatively special perspective on the world, even within Western intellectual history.