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Psychotherapy and Moralising Rhetoric in Galen’s Newly Discovered Avoiding Distress (Peri Alypias)

  • Sophia Xenophontos (a1)

In this article, I examine Galen’s credentials as an ethical philosopher on the basis of his recently discovered essay Avoiding Distress (Peri alypias). As compensation for the scholarly neglect from which Galen’s ethics suffers, I argue that his moral agenda is an essential part of his philosophical discourse, one that situates him firmly within the tradition of practical ethics of the Roman period. Galen’s engagement with Stoic psychotherapy and the Platonic-Aristotelian educational model affirms his ethical authority; on the other hand, his distinctive moralising features such as the autobiographical perspective of his narrative and the intimacy between author and addressee render his Avoiding Distress exceptional among other essays, Greek or Latin, treating anxiety. Additionally, I show that Galen’s self-projection as a therapist of the emotions corresponds to his role as a practising physician, especially as regards the construction of authority, the efficacy of his therapy and the importance of personal experience as attested in his medical accounts. Finally, the diligence with which Galen retextures his moral advice in his On the Affections and Errors of the Soul – a work of different nature and intent in relation to Avoiding Distress – is a testimony to the dynamics of his ethics and more widely to his philosophical medicine.

The philosopher’s lecture room is a ‘hospital’: you ought not to walk out of it in a state of pleasure, but in pain; for you are not in good condition when you arrive. Epictetus, Discourses 3.23.30

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1. By Galen’s own admission, the emperor was referring to him as ‘the first among doctors and unique among philosophers’, On Prognosis, 11, Vivian Nutton (ed.), Galeni De Praecognitione(Berlin: in aedibus Academiae litterarum, 1979), CMG, vol. V.8.1, 128, 27–28 $=$ Karl Gottlob Kühn (ed.), Claudii Galeni Opera Omnia (Leipzig: Carl Cnobloch, 1821–33), vol. 14, 660; elsewhere he claims that his teacher, the Peripatetic Eudemus, knew him for his philosophical standing, considering medicine to be a sideline for Galen, On Prognosis 11, Nutton (ed.), Galeni De Praecognitione, CMG, vol. V.8.1, 76, 27–29 $=$ Kühn (ed.), Claudii Galeni Opera Omnia, vol. 14, 608.

2. A few indicative examples will suffice; logic: Jacques Jouanna, ‘Does Galen have a medical programme for intellectuals and the faculties of the intellect?’, in C. Gill, T. Whitmarsh, J. Wilkins (eds), Galen and the World of Knowledge(Cambridge: Cambridge University Press, 2009), 190–205; epistemology: Robert James Hankinson, ‘Galen on the limitations of knowledge’, in Gill et al., Galen and the World of Knowledge, 206–42; natural philosophy and physiology: Rudolph Siegel, Galen’s System of Physiology and Medicine (Basle: Karger, 1968), Robert James Hankinson, ‘Body and soul in Galen’, in R.A.H. King (ed.), Common to the Body and Soul: Philosophical Approaches to explaining Living Behaviour in Greco-Roman Antiquity (Berlin: Walter de Gruyter, 2006), 231–58.

3. The major representative is Christopher Gill: ‘Did Galen understand Platonic and Stoic thought on the emotions?’, in J. Sihvola and T. Engberg-Pederson (eds), The Emotions in Hellenistic Philosophy(London: Kluwer, 1998), 113–48, and Naturalistic Psychology in Galen and Stoicism (Oxford: Oxford University Press, 2010), mainly 243–329; also Robert James Hankinson, ‘Galen’s Anatomy of the Soul’, Phronesis, 36, 3 (1991), 197–233, and ‘Actions and passions: affection, emotion and moral self-management in Galen’s philosophical psychology’, in J. Brunschwig and M.C. Nussbaum (eds), Passions and Perceptions: Studies in Hellenistic Philosophy of Mind (Cambridge: Cambridge University Press, 1993), 184–222; Teun Tieleman, ‘Galen’s Psychology’, in J. Barnes and J. Jouanna (eds), Galien et la philosophie: Huit exposés suivis de discussions (Geneva: Fondation Hardt, 2003), 131–69; Pier Luigi Donini, ‘Psychology’, in R.J. Hankinson (ed.), The Cambridge Companion to Galen (Cambridge: Cambridge University Press, 2008), 184–209. See also the chapters in the volume by P. Manuli and M. Vegetti (eds), Le Opere Psicologiche di Galeno (Naples: Bibliopolis, 1998).

4. Scholars have only discussed Galen’s medical ethics in the essay That the Best Doctor Is also a Philosopherin relation to Hippocrates; Jacques Jouanna, ‘Galen’s reading of Hippocratic ethics’, in J. Jouanna (ed.), Greek Medicine from Hippocrates to Galen: Selected Papers(Leiden: Brill, 2012), 259–85.

5. 15, Veronique Boudon-Millot (ed.), Galien, Œ uvres, Tome I: Introduction générale; sur l’ordre de ses propres livres; Sur ses propres livres; Que l’excellent médecin est aussi philosophe(Paris: Belles Lettres, 2007), 169, 13 $=$ Kühn (ed.), op. cit. (note 1), vol. 19, 45. Most of Galen’s works on moral philosophy bear titles that are traditional in the essay writing on practical ethics: eg. Attendance at Dialogues, Pleasure and Pain, On Modesty, On Slander, Things Said in Public against Flatterers, On Encouragement.

6. The earliest mention to Avoiding Distress is in a ninth-century catalogue of Galen’s works provided by Hunain ibn Ishāq in his Risāla; see G. Bergsträsser (ed.), Hunain ibn Ishāq: Über die syrischen und arabischen Galen-Übersetzungen: Abhandlungen für die Kunde des Morgenlandes 17.2. (Leipzig: Brockhaus, 1925), 40, no. 120. We know that it was translated into both Syriac and Arabic, although none of the translations survive today. In the late 12th and early 13th centuries, Joseph Ibn Aknı̄n, student of Maimonides, quoted many passages from Avoiding Distress in his Arabic Hygiene of the Soul; Abraham S. Halkin, ‘Classical and Arabic Material in Ibn Aḳnı̄n’s “Hygiene of the Soul”’, Proceedings of the American Academy for Jewish Research, 14 (1944), 25–147: 60–147. Afterwards it was cited by other Arabic and Hebrew authors of the 13th century; see Mauro Zonta, Un interprete ebreo della filosofia di Galeno: gli scritti filosofici di Galeno nell’opera di Shem Tob ibn Falaquera(Turin: S. Zamorani, 1995), 113–23 and BJP, LXX–LXXIV for additional information.

7. For a description of the manuscript, see Antoine Pietrobelli, ‘Variation autour du Thessalonicensis Vlatadon 14: un manuscrit copié au xénon du Kral, peu avant la chute de Constantinople’, Revue des études byzantines, 68 (2010), 95–126. The text was first published by Veronique Boudon-Millot in ‘Un traité perdu de Galien miraculeusement retrouvé, le Sur l’inutilité de se chagriner: Texte grec et traduction française’, in V. Boudon-Millot, A. Guardasole and C. Magdelaine (eds), La Science médicale antique: Nouveaux regards: Études réunies en l’honneur de Jacques Jouanna(Paris: Beauchesne, 2007), 73–123 (henceforth BM). A rev. edn followed: V. Boudon-Millot, J. Jouanna and A. Pietrobelli (eds), Galien, Tome IV: Ne pas se chagriner (Paris: Belles Lettres, 2010) with French translation and commentary (henceforth BJP). The references I give to the Greek text are primarily based on the edition of P. Kotzia and P. Soteroudis of the same year, P. Kotzia and P. Sotiroudis (eds), ‘Γαληνοῦ Περὶ ἀλυπίας᾿’, ῾Ελληνικά, 60 (2010), 63–148 (henceforth KS), with cross-references to the BJP edition for the reader’s convenience (note that the two edns present different chapter division and lining). It is striking that the text of Kotzia and Sotiroudis (otherwise easily available in all major libraries) has been neglected by modern scholars, despite the fact that they were the only editors who had autopsy of the manuscript in preparing their edition. This assisted them on palaeographical grounds to reconstruct corrupted words which the other editors have not been able to identify with certainty. For instance, in §4, 68, 49 KS $=$ §11, 5, 8 BJP, Kotzia and Sotiroudes read α– at the beginning of the word, and –τα at the end of it, and hence supplemented three missing letters in the middle –παν–, suggesting ἄ[παν]τα, whereas the French editors only read α– as the initial letter of a word, suggesting α[ὐτὰ]. Similarly, §4, 68, 51 KS suggest ἐπ[ανῆλθον], but §11, 5, 10 BJP cannot possibly supplement the word, since a beginning epsilon (ε–) is the only letter they can read. Additional reasons that led me to prefer the KS edn is their rich apparatus of parallel passages in contrast to the meagre one of BJP, and their detailed commentary, which provides extensive remarks on philological, philosophical and medical matters arising from the text. Further emendations on corrupted passages have been suggested by Ivan Garofalo, ‘Congetture inedite’, Galenos, 2 (2008), 137–8; Ioannis Polemis, ‘Διορθωτικά στο Περί αλυπίας του Γαληνού᾿, Επιστημονική Επετηρίδα της Φιλοσοφικής Σχολής του Πανεπιστημίου Αθηνών, 43 (2011), 1–8; Antonio Stramaglia, ‘Libri perduti per sempre: Galeno, “De indolentia” 13; 16; 17–19’, Rivista di Filologia e di Istruzione Classica, 139 (2011), 118–47; Anargyros Anastassiou, ‘Galen, de indolentia, §71, S. 21, 17–19 Boudon-Millot, Jouanna $=$ §27, S. 79, 321–322 Kotzia, Sotiroudis $=$ §71, S. 44 Garofalo, Lami, S.’, Galenos, 6 (2012), 49–51; Ivan Garofalo and Alessandro Lami, Galeno: l’anima e il dolore: de indolentia, de propriis placitis (Milan: BUR, 2012), 149–55. The translations of Avoiding Distress cited throughout are mine; the translations of Galen’s other ethical works are appropriated versions of the translations contained in Peter Singer (ed.), Galen: Psychological Writings: Avoiding Distress, Character Traits, The Diagnosis and Treatment of the Affections and Errors Peculiar to Each Person’s Soul, The Capacities of the Soul depend on the Mixtures of the Body (Cambridge: Cambridge University Press, 2014). In the same volume there is a new English translation of Avoiding Distress by V. Nutton, 77–99.

8. Pier Tucci, ‘Galen’s Storeroom, Rome’s Libraries, and the Fire of AD 192’, Journal of Roman Archaeology, 21 (2008), 133–49; Christopher Jones, ‘Books and Libraries in a Newly Discovered Treatise of Galen’, Journal of Roman Archaeology, 22 (2009), 390–8; Vivian Nutton, ‘Galen’s library’, in Gill et al.(eds), op. cit. (note 2), 19–34; Amneris Roselli, ‘Libri e Bibliotheche a Roma al Tempo di Galeno: la Testimonianza del De Indolentia’, Galenos, 4 (2010), 127–48; Matthew Nicholls, ‘Galen and Libraries in the Peri Alupias’, Journal of Roman Studies, 101 (2011), 123–42; Clare Rothschild and Trevor Thompson, ‘Galen’s On the Avoidance of Grief: The Question of a Library at Antium’, Classical Philology, 107, 2 (2012), 131–45.

9. Swain, Simon, ‘Beyond the limits of Greek biography: Galen from Alexandria to the Arabs’, in McGing, B. and Mossman, J. (eds), The Limits of Ancient Biography (Swansea: Classical Press of Wales, 2006), 395427.

10. Eratosthenes of Cyrene (third century BC), Diogenes of Babylon (2nd c. BC), and Plutarch (‘The Catalogue of Lamprias’ no. 172) were all said to have written a lost essay Peri alypias. I came across a work by John Klimax of the 7th c. AD, with the title Περὶ ἀπροσπαθείας, ἤγουν ἀλυπίας (On Tranquility of the Soul, or rather on Avoiding Distress, Book 2 from his The Heavenly Ladder), an interesting example of how Stoic moral notions were appropriated into the context of Christian ethics.

11. For the date of the essay’s composition, see Boudon-Millot, ‘Un traité perdu’, op. cit. (note 7) 76, BJP,LVIII–LIX.

12. Kotzia, Paraskevi, ‘Galen, Περὶ ἀλυπίας: title, genre, and two cruces’, in Manetti, D. (ed.), Studi sul De Indolentia di Galeno (Roma: Fabrizio Serra, 2012), 6991: 77–9.

13. Stobaeus, Anthology, 2.7.2; cf. 2.39.20–41.25: Ioannis Stobaei anthologium, ed. Otto Hense and Curt Wachsmuth, (Berlin: Weidmann, 1884–1912). See Charles Brittain, Philo of Larissa: The Last of the Academic Sceptics(Oxford: Oxford University Press, 2001), 277–80. On the other hand, the genre of therapy of emotions in particular pre-dated Philo and goes back at least to Chrysippus’ ‘therapeutic’ Book 4 of his On Passions, see Gill, Naturalistic Psychology, op. cit. (note 3), 280–300 and Teun Tieleman, Chrysippus’ On Affections: Reconstruction and Interpretation (Leiden: Brill, 2003), 140–97.

14. Mainly Boudon-Millot, ‘Un traité perdu’, op. cit. (note 7), 75–6, who later reconsidered the generic identity of the essay, Boudon-Millot, Jouanna, Pietrobelli, op. cit. (note 7), x. Traditional consolations include Cicero’s Consolation on the death of his daughter Tullia, Seneca’s Consolation to Marcia or Consolation to Polybius, Plutarch’s Consolation to his wife, and Pseudo-Plutarch’s Consolation to Apollonius.

15. For the distinction between the categories of works on alypia and paramythia, Epictetus, Discourses 3.24.116, Heinrich Schenkl (ed.), Epicteti dissertationes ab Arriano digestae(Leipzig: Teubner, 1916).

16. The name of the grammarian is dubious. Vlatadon reads Philides; BM corrected to Philippides; Nutton in his English translation (cited notes 7, 79) suggests Philistides, but I follow the emendation of Kotzia in favour of Callistus, which is based on a close parallel to Galen’s commentary on Hippocratic Epidemics VI, Ernst Wenkebach and Franz Pfaff (eds), Galeni in Hippocratis Sextum Librum Epidemiarum commentaria I-VI(CMG V.10.2.2) (Berlin: in aedibus Academiae litterarum, 1956), 486, 19–24.

17. Book 2, Paul Kraus (ed.), ‘Kitâb al-Akhlâq li-Jâlînus’, Bulletin of the Faculty of Arts of the Egyptian University 5, 1 (1939), 1–51: 39; with English translation by John Mattock, ‘A translation of the Arabic epitome of Galen’s book Peri êthôn’, in S.M. Stern, A. Hourani, V. Brown (eds), Islamic Philosophy and the Classical Tradition: Essays Presented by his Friends and Pupils to Richard Walzer on his Seventieth Birthday(Oxford: Cassirer, 1972), 235–60: 248.

18. Michel Foucault, The History of Sexuality, vol. 3, The Care of the Self, trans. Robert Hurley) (London: Harmondsworth, 1990), 53. As Foucault stresses, works of the principate concerned with the interplay between the care of the Self and the help of the Other build on ‘pre-existing relations’ between author and reader and cause the ‘intensification of existing social relations’.

19. Mainly Susan Mattern, Galen and the Rhetoric of Healing(Baltimore, MD: John Hopkins University Press, 2008); Luis García Ballester, ‘Elementos para la construcción de las historias clínicas en Galeno’, Dynamis, 15 (1995), 47–65; cf. Cristina Álvarez-Millán, ‘Greco-Roman Case Histories and Their Influence on Islamic Clinical Accounts’, Social History of Medicine, 12 (1999), 19–43: 30–3; cf. Susan Mattern, ‘Galen’s Ideal Patient,’ Asklepios, 2 (2008), 116–30.

20. For thaumazein in case histories in relation to praise, see Mattern, Galen and the Rhetoric of Healing, op. cit.(note 19), 80–3. On the performative aspect of Galen’s anatomical demonstrations, see Maud Gleason, ‘Shock and awe: the performance dimension of Galen’s anatomy demonstrations’, in Gill, et al. (eds), op. cit. (note 2), 85–114.

21. On Prognosis 2, Kühn (ed.), op. cit.(note 1), vol. 14, 612 $=$ Nutton (ed.), op. cit. (note 1), CMG, vol. V.8.1, 80.22–25.

22. On Prognosis 11, Kühn (ed.), op. cit.(note 1), vol. 14, 657–660 $=$ Nutton (ed.), op. cit. (note 1), CMG, vol. V.8.1, 126.26–128.32.

23. On Prognosis 2, Kühn (ed.), op. cit.(note 1), vol. 14, 605 $=$ Nutton (ed.), op. cit. (note 1), CMG, vol. V.8.1, 74.15.

24. For the notion of ‘communality’ in Galen, see Jason König, ‘Self-promotion and self-effacement in Plutarch’s Table Talk’, in F. Klotz and K. Oikonomopoulou (eds), The Philosopher’s Banquet: Plutarch’s Table Talk in the Intellectual Culture of the Roman Empire(Oxford: Oxford University Press, 2011), 183–6. The term ‘sociative’ was coined by Friedrich Slotty, ‘Die Stellung des Griechischen und anderer idg. Sprachen zu dem soziativen und affektischen Gebrauch des Plurals der ersten Person’, Indogermanische Forschungen, 45 (1928), 348–63.

25. On hypomnemata in Plutarch, see Sophia Xenophontos, ‘Plutarch’s Compositional Technique in the An Seni Respublica Gerenda Sit: Clusters vs. Patterns’, American Journal of Philology, 113, 2 (2012), 61–91 with additional references.

26. Plutarch, ‘De tranquillitate animi’, in Max Pohlenz (ed.), Plutarchi moralia(Leipzig, Teubner, 1929; repr. 1972).

27. Long, A.A., Epictetus: A Stoic and Socratic Guide to Life (Oxford: Oxford University Press, 2002), 4344. though of course this is often lost in the summaries in the Manual (Encheiridion). See also his pp. 52–66 on Epictetus’ styles of discourse.

28. On how suggestions can influence our cognitions and behaviours, see the new study by Robert Michael, Maryanne Garry and Irving Kirsch, ‘Suggestion, Cognition, and Behavior’, Current Directions in Psychological Science, 21, 3 (2012), 151–6 with additional references; also G. Colket Caner, ‘Use of suggestion in psychotherapy’, The New England Journal of Medicine, 251, 18 (1954), 733–5. For the practical application of suggestion in the medical sphere, including constructed statements that promote suggestion, see B.P.L., ‘Suggestions’, The American Journal of Nursing, 11.2 (1910), 126–7. For further reading, see Hippolyte Bernheim, Die Suggestion und ihre Heilwirkung(Tübingen: Edition diskord, 1888; repr. 1985), Boris Sidis, The Psychology of Suggestion (New York: Arno Press, 1973).

29. Ch. 2–4, Veronique Boudon (ed.), Galien, Œuvres, Tome II: Exhortation à l’étude de la médecine: Art médical(Paris: Belles Lettres, 2000), 85–8 $=$ Kühn (ed.), op. cit. (note 1), vol. 1, 3–6.

30. Also in Galen’s Exhortation to the Study of Medicine, 5: see Boudon (ed.), op. cit. (note 29), 90 ${=}$ Kühn (ed.), op. cit. (note 1), vol. 1, 8–9.

31. For example, Wood, A.M., Joseph, S. and Linley, S.P.A., ‘Gratitude: The Parent of all Virtues’, The Psychologist, 20 (2007), 1821.

32. Norman W. DeWitt, ‘The Epicurean Doctrine of Gratitude’, Americal Journal of Philology, 58, 3 (1937), 320–8. Cf. Voula Tsouna, ‘Epicurean therapeutic strategies’, in J. Warren (ed.), The Cambridge Companion to Epicureanism(Cambridge: Cambridge University Press, 2009), 249–65.

33. For Plato and Aristotle, ‘noble’ as a contrast to ‘malicious’ was one of the criteria for approval or disapproval of an ethical action: Republic 363e–364a: Platonis Rempublicam, ed. Simon Slings (Oxford: Clarendon Press, 2003); Nicomachean Ethics 1104b32: Aristotelis ethica Nicomachea, ed. Ingram Bywater (Oxford: Clarendon Press, 1894; repr. 1962).

34. Also in Diogenes Laertius, Lives of Philosophers7.5, Diogenis Laertii vitae philosophorum, ed. Herbert Strainge Long (Oxford: Clarendon Press, 1964; repr. 1966).

35. Brennan, Tad, ‘Stoic Moral Psychology’, in Inwood, Brad (ed.), The Cambridge Companion to the Stoics (Cambridge: Cambridge University Press, 2003), 257294: 269–74.

36. See Cicero’s formulation of ‘rerum externarum despicientia’ attributed to Panaetius in On Duties 1.66: M. Tullius Cicero, De officiis, ed. Walter Miller (Cambridge, MA: Harvard University Press, 1913).

37. Galen’s phrase ‘I knew nothing of these things on my first stay in Rome’ with reference to rivalries and vices [On Prognosis 2, Kühn (ed.), op. cit.(note 1), vol. 14, 605 $=$ Nutton (ed.), op. cit. (note 1), CMG, vol. V.8.1, 74, 12–13] suggests that he considered Pergamum a space of moral superiority. On the corruption of the medical profession, see for instance On Recognising the Best Physician 1: Galeni de optimo medico cognoscendo libelli versio Arabica, ed. Albert Iskandar (CMG Suppl. Or. IV) (Berlin: in aedibus Academiae litterarum, 1988), 41–7.

38. Seminal discussions include, Simon Swain, Hellenism and Empire: Language, Classicism and Power in the Greek world, A.D. 50–250(Oxford: Oxford University Press, 1996); Graham Anderson, The Second Sophistic: A Cultural Phenomenon in the Roman Empire (London: Routledge, 1993); Tim Whitmarsh, Greek Literature and the Roman Empire: The Politics of Imitation (Oxford: Oxford University Press, 2001), and S. Goldhill (ed.), Being Greek under Rome: Cultural Identity, the Second Sophistic, and the Development of the Empire (Cambridge: Cambridge University Press, 2001). On Galen’s complex relation to the ‘Second Sophistic’, see Heinrich von Staden, ‘Galen and the “Second Sophistic”’, Bulletin of the Institute of Classical Studies, 41 (1997), 33–54.

39. See, for instance, Mireille Armisen-Marchetti, ‘Imagination and meditation in Seneca: the example of praemediatio’, in J.G. Fitch (ed.), Seneca: Oxford Readings in Classical Studies (Oxford: Oxford University Press, 2008), 102–13. Studies on the techniques of ancient meditation include Paul Rabbow, Seelenführung: Methodik der Exerzitien in der Antike(Munich: Kösel, 1954), Ilsetraut Hadot, Seneca und die griechisch-römische Tradition der Seelenleitung (Berlin: Walter de Gruyter, 1969), and Pierre Hadot, Exercices spirituels et philosophie antique (Paris: Etudes augustiniennes, 1981). On the history of meditation in Imperial Stoicism, see R.J. Newman, ‘Cotidie meditare: Theory and Practice of the Meditatio in Imperial Stoicism’, ANRW, II.36.3 (1989), 1473–517.

40. Aurelius, Marcus, ‘Meditations, 7.33 and 7.64’, in Dalfen, Joachim (ed.), Marci Aurelii Antonini ad se ipsum libri XII (Leipzig: Teubner, 1979).

41. From an unnamed Euripidean play; Theseus is the speaker: ‘as I once learned from a wise man,$|$ I fell to considering disasters constantly,$|$ imagining for myself exile from my native land,$|$and untimely deaths and many other misfortunes,$|$ so that if I ever suffer anything from what I was imagining $|$ it will not be unexpected and will not tear my soul apart’, fr. 964: Tragicorum Graecorum Fragmenta, ed. Richard Kannicht, vol. 5.2, (2004), (Göttingen: Vandenhoeck & Ruprecht, 1971–2004), 963. Cf. Galen, On the Doctrines of Hippocrates and Plato 4.7: Galeni: De placitis Hippocratis et Platonis, ed. Philip De Lacy, 3 vols (CMG V.4.1.2) (Berlin: in aedibus Academiae litterarum, 1978–84), 282, 17–23 $=$Kühn (ed.), op. cit. (note 1), vol. 5, 418.

42. For example, in his Method of Healing, 8.3, Kühn (ed.), op. cit. (note 1), vol. 10, 560-1.

43. Book 1, Kraus (ed.), op. cit. (note 17), 29; with Mattock, op. cit.(note 17), 239.

44. Affections and Errors of the Soul 7: Galeni De propriorum animi cuiuslibet affectuum dignotione et curatione; De animi cuiuslibet peccatorum dignotione et curatione; De atra bile, ed. Wilko De Boer, (Berlin: Teubner, 1937), 25, 20–1, CMGV.4.1.1 $=$Kühn (ed.), op. cit. (note 1), vol. 5, 37.

45. 2: Claudii Galeni Pergameni Scripta Minora, vol. 3: Περί αἱρέσεων τοῖς εἰσαγομένοις, Θρασύβουλος, Περὶ φυσικῶν δυνάμεων ed. Georg Helmreich et al.(Leipzig: Teubner, 1893), 178–80.

46. 9.2: op. cit., ed. De Lacy, (note 41), (CMG V.4.1.2) 550, 8–31 $=$Kühn (ed.), op. cit.(note 1), vol. 5, 732–4.

47. Note that in his medical work The Best Method of TeachingGalen supports the presence of a teacher supervisor, whose aim is to correct the mistakes that arise from the natural deficiencies of the student.

48. In the Affections and ErrorsGalen discusses an additional cause of distress next to material losses, the one that comes from inflicting one’s sense of shame upon one’s self, a feeling to which young people are especially prone. Again Galen plays with the social expectations of his addressees, as Graeco-Roman society was predominantly a society of aidos.

49. An opinion developed by Cleanthes [Stobaeus, Eclogues 2.65.8-9: Ioannis Stobaei Eclogarum physicarum et ethicarum libri duo, ed. August Meineke (Leipzig: Teubner, 1860–4)], probably in his book On Excellence of Natural Endowment; (Diogenes Laertius, Lives of the Philosophers 7.175: op. cit., ed. Long, (note 34), and by Chrysippus [Plutarch, On Common Notions Against the Stoics1069E: Plutarchi moralia, ed. Rolf Westman, vol. 6.2 (Leipzig: Teubner, 1959)].

50. 8: op. cit., ed. De Boer, (note 44), CMG, vol. V.4.1.1, 27.22–28.7 ${=}$ Kühn (ed.), op. cit. (note 1), vol. 5, 40–1.

51. 8: op. cit., ed. De Boer, (note 44), CMG, vol. V.4.1.1, 30.10–16 ${=}$ Kühn (ed.), op. cit. (note 1), vol. 5, 44–5.

52. Method of Healing, 7.1, Kühn (ed.), op. cit. (note 1), vol. 10, 457.

53. Galen readjusts his emphases to the level of his audience very frequently, eg. ‘I have also called the faculties within this soul ‘nature’ in my book On the Natural Faculties, because in this tract I was dealing with ordinary doctors’; On My Own Opinions, 3, 19–23; Veronique Boudon-Millot and Antoine Pietrobelli (eds), ‘Galien ressuscité: Édition princeps du texte grec du De propriis placitis’, Revue des études grecques 118, (2005), 168–213: 174.

54. Cicero, Tuscalan Disputations II.17-8, V.31: Tusculanea Disputationes, ed. Max Pohlenz (Leipzig: Teubner 1918); Plutarch, That it is Impossible to live a Pleasant Life according to Epicurus 1088B, 1090A: op. cit., ed. Rolf Westman, (note 49). The same was the case with the Stoic sage, who was expected to have risen above the emotions of pain or anger, Stoicorum Veterum Fragmenta 3.586, ed. Hans Freidrich von Arnim (Stuttgart: Teubner, 1903–24; repr. 1978–9).

55. Gill, Naturalistic Psychology, op. cit. (note 3), 259–60; Hankinson, (1993) ‘Actions and Passions’, op. cit. (note 3): 198–204, Donini, op. cit.(note 3): 194; Singer, Psychological Writings, op. cit. (note 7), 22.

56. Cf. for instance, Lieve van Hoof, Plutarch’s Practical Ethics: The Social Dynamics of Philosophy(Oxford: Oxford University Press, 2010), 160–1.

57. Cf. ch. 4–5, Exhortation to the Study of Medicine, Boudon (ed.), op. cit.(note 29), 87–9 $=$ Kühn (ed.), op. cit. (note 1), vol. 1, 5–7, for groups of people with whom Galen discourages identification.

58. 1.1.7: Galeni De alimentorum facultatibus libri III, De bonis malisque sucis(CMG V.4,2), ed. Georg Helmreich (Berlin: Teubner, 1923) 204, 3–5 $=$ Kühn (ed.), op. cit. (note 1), vol. 6, 457.

59. Philip van der Eijk, ‘Galen’s use of the concept of “qualified experience” in his dietetic and pharmacological works’, in A. Debru (ed.), Galen on Pharmacology: Philosophy, History and Medicine(Leiden: Brill, 1997), 35–58: Laurence Totelin, ‘And to end on a poetic note: Galen’s authorial strategies in the pharmacological books’, Studies in History and Philosophy of Science Part A, 43, 2 (2012), 307–15. In Galen’s technical texts, peira (contrasted with mere logos) is usually connected with his self-promotion strategy and the construction of his authority, see Vivian Nutton, ‘Galen’s authorial voice: a preliminary enquiry’, in L. Taub and A. Doody (eds), Authorial Voices in Greco-Roman Technical Writing (Trier: Wissenschaftlicher Verlag, 2009), 53–62. See also, Heinrich von Staden, ‘Author and authority: Celsus and the construction of a scientific self’, in M.E. Vázquez Buján (ed.), Tradición e innovación de la medicina latina de la antigüedad y de la Alta Edad Media (Santiago de Compostela: Universidade de Santiago de Compostela, 1994), 103–17.

60. Cf. the distinction between ‘core’ and ‘extra’ in Singer, Psychological writings, op. cit. (note 7), 11–12; also the label of ‘smaller-scale, more “occasional” type of literary production’ with reference to Galen’s psychological writings on p.2.

61. Singer, Psychological Writings, op. cit. (note 7), 7–8.

62. An allusion to the common Byzantine perception of Galen and other doctors as longing for money.

63. Preferring βίῳ instead of the manuscript reading βίᾳ.

64. 81 KS ${=}$ 26 BJP.

This article was written during a postdoctoral fellowship at the Université Libre de Bruxelles (ULB), kindly sponsored by the Wiener-Anspach Foundation. I would like to thank David Engels and Chris Pelling who commented on the final version of the article. Deep gratitude is owed to the three anonymous referees for Medical History for their insightful remarks and suggestions. My work has benefited from discussions I had with Petros Bouras-Vallianatos and Christopher Gill. I am grateful to the assistant editor, Alexander Medcalf, for his diligence over the various stages of publication. Special thanks go to the Wellcome Library Open Access Fund for covering the open access publishing costs for this paper.

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