As noted in the Introduction, Galen’s commitment to ethical welfare and the pursuit of virtue is illustrated not only in works that have a transparently moral character, but also across a range of passages in non-practical ethical contexts. With mostly those in mind, this study begins with a critical analysis of the moral topics that concern Galen and the various strategies he employs to foster different types of moralising. The aim is to highlight the central features of his moral didacticism about the right and wrong way to live and the right and wrong way to be in oneself, which we will see in both subtler and more elaborated forms in the ensuing Chapters that focus on individual case studies.

Guiding people towards specific moral paths through encouragement is an overarching category in Galen’s practical ethics. The passage below from the Arabic epitome of Character Traits helps elucidate the key components of such moral coaching:

The distinction between pigs and angels (the Arabic substitution for Galen’s non-monotheistic ‘god’) impinges on the reader’s ethical decision-making, in so far as it juxtaposes two groups of moral agents.Footnote ¹ The first opts for a life of sensation and bestiality specific to animals, in stark contrast to the second one that embraces a life of nobility and excellence. This virtuous type of life is described in attractive terms to Galen’s audience. For it is presented as approximating the level of the divine, a notion encapsulated in the Platonic ideal of assimilation to god, which is invested with social esteem further on in the work, in a statement that teases out what might already be implicit in the foregoing extract: ‘[T]here is no honour greater than that of imitating god, so far as is possible for a human being. This is achieved by despising worldly pleasures and preferring the beautiful’ (De Mor. 41 Kr.).Footnote ² The thematic selection and bipolar organisation of the ethical material, together with the exhortative way in which it is communicated, make it action-directing,Footnote ³ i.e. prompting the reader towards the performance of good deeds. At its heart lie the concepts of exemplarity and imitation together with an appeal to the readers’ concern for their reputations, lest they yield to brutish wickedness instead.

Besides being succinct, direct and clear-cut, Galen’s moral message in this passage is also impersonal, since it conveys general truisms on morality without involving a specific addressee or, for that matter, the author’s moral voice. Individualisation is ruled out for the sake of a universal conceptual framework in which ‘all people’ must act in a certain way without exceptions allowed. No other, more complex, rhetorical technique to navigate one’s course of action in specific domains or real-life situations is on offer. That is the reader’s job, namely to customise the collective injunctions to their own moral life. On that premise, Galen’s moralism here synthesises two types of ethical instruction, viz. ‘protreptic’ (or ‘expository’) and ‘descriptive’ (or ‘exploratory’) moralism, the former suggesting what one ought to do and what to eschew (in this instance, to act virtuously, not wickedly), while the latter probes moral rules about human experience, inviting recipients to make up their own minds about how best to employ them in their lives.Footnote ⁴ In a way, Galen’s allowance for the open-ended, exploratory possibilities of virtuous activity is compatible with the conceit of self-governance as an inherent element of ancient ethics, according to Julia Annas: ‘Ancient ethical theories do not assume that morality is essentially demanding …; rather, the moral point of view is seen as one that the agent will naturally come to accept in the course of a normal unrepressed development’.Footnote ⁵ Scrutinisation of broad-brush advice with a view to its pragmatic use in individual circumstances might be one example of such unrepressed development, a Foucauldian ‘technology of the self’ leading to moral cultivation.Footnote ⁶ As we will see in various parts of this book, even though the moral learners’ autonomy is effectively preserved in Galen, in the sense that they are assumed to practise critical reflection and given moral options, there are sometimes limits to that autonomy, dictated mainly by the addressee’s or reader’s level of philosophical attainment, as well as the author’s didactic goals and self-referential claims in each case (e.g. Chapters 5 and 6).

Unparticularised moralism (which is expository and to some extent exploratory as seen above) appears in medical contexts as well, as for example when Galen stresses the negative repercussions of extreme affectivity on the body: ‘Obviously one must refrain from excess of all affections of the soul: anger, grief, joy, <outburst>, fear, envy; for these will change the natural composition of the body’ (Ars Med. 24, 351.2-6 Boudon-Millot = I.371.10-14 K.).Footnote ⁷ How exactly this occurs is not explained here, with Galen’s moral advice propounded as a basic directive for moderation, which it is up to the readers to make sense of in the light of their particular situation.

This moralising technique accords very well with the function of morally-loaded quotations in non-ethical settings. These are used by Galen to substantiate accepted truth regarding human nature and at the same time refine his readers’ abstractive skills, leading them to reflect if there is anything in what Galen says that could resonate with their own ethical state. A case in point is the beginning of the third Book of The Different Kinds of Pulse (Diff. Puls. 3, VIII.636.1-8 K.). Here Galen deals with the role of varied denotation in provoking unnecessary ambiguity and hence disagreement among people, especially in the realm of science. This topic arises from his more general distaste for linguistic pedantry, which Galen tends to put in a moral context, as, for instance, when he compares it with failure in one’s way of life (bios).Footnote ⁸ In this way, Galen seems to situate himself in the contemporary debate about the primacy of ethics over linguistic or logical subtleties, something which had troubled other philosophers such as Seneca or Epictetus.Footnote ⁹ In order to obliterate fastidiousness, then, he inserts a Euripidean quotation which associates this vice with despicable dispute (eris) over different ideas of goodness and wisdom.Footnote ¹⁰ We will see in a subsequent Chapter that eris is a staple in Galen’s moral outlook, which he accuses his rivals of in order to reinforce their negative characterisation and trounce them. On a first level, therefore the tragic quotation incites revulsion against contentiousness. On another level, Galen makes further use of the concept of the different meanings of goodness and wisdom in Euripides by adding truth (his favourite) as a third virtue in need of unanimous comprehension. This he does in order to emphasise the necessity of a shared mentality as to the notional burden of ethical principles affecting science as much as life. With these two moves, Galen makes the moral substance of the quotation an organic element of his prefatory section that warns against strife and in favour of genuineness, precision and clarity.

In other parts of the same work, Galen attacks the doctor Archigenes precisely for not explicating the true meaning of the heavy pulse, and so wrong-foots him on moral grounds, for prattling (λαλεῖν) and not actually talking (λέγειν), using a comic quotation from Eupolis: ‘Excellent in prattling, but in speaking most incapable’ (λαλεῖν ἄριστος, ἀδυνατώτατος λέγειν).Footnote ¹¹ With its oppositional structure between virtue and vice, excellence and incapability put in general terms, this ethically-oriented quotation too takes on wider relevance, becoming applicable not only to a particular individual, in this case Archigenes, but to every single one of Galen’s readers, who are thus counselled against garrulity (ἀδολεσχία), another common evil that Galen disdains throughout his writings. I shall return to this in Chapter 3.

The moralising effect of the above and other similar quotations is made possible thanks to Galen’s – and, we assume, also his audience’s – belief that moral virtue is a defining feature of humanity. That explains his tendency to encourage admirable instantiations of excellence, e.g. love of truth (φιλαλήθεια), love of labour (φιλοπονία), love of honour (φιλοτιμία), and to attempt to dissuade the reader from wicked ones, most notably envy (φθόνος), love of strife (φιλονεικία), love of reputation (φιλοδοξία), shamelessness (ἀναισχυντία), false modesty (δυσωπία) or meddlesomeness (πολυπραγμοσύνη). In all these cases readers are obliquely urged to respond to their human stature, they are being alerted to and incentivised to adopt what is commonly advocated as human morality: e.g. ‘this is something that is a property of all of us: to embrace, accept and love the good, and to reject, hate and avoid the bad’ (ὑπάρχει τοῦτο πᾶσιν ἡμῖν, ἀσπάζεσθαι μὲν τὸ ἀγαθὸν καὶ προσίεσθαι καὶ φιλεῖν, ἀποστρέφεσθαι δὲ καὶ μισεῖν καὶ φεύγειν τὸ κακόν, QAM 11, 78.8-10 Ba. = IV.815.2-4 K.). In other texts, Galen insists that we are called humans for displaying the positive aspects of our nature, rather than moral infraction such as fierceness, savageness, idiocy and mischief (Di. Dec. 1.9, IX. 815.3-6 K.). And as already noted, a sense of shame is usually invoked when agents allow their rational and humane manners to be superseded by vulgarity and viciousness, e.g. Art. Sang. 7.3, 174.6-9 Furley and Wilkie = IV.729.8.-11 K. Even though this passage refers specifically to a group of Erasistratean doctors, the importance of ‘waking up’ to the shamefulness of something about oneself that one had previously not been properly aware of is verbalised in non-specific terms, by means of the comparison with waking up from a deep sleep (αἰδεσθέντες … ὥσπερ ἐξ ὕπνου βαθέος ἐγερθέντες), an experience no doubt familiar to all members of Galen’s audience.Footnote ¹²

Attitudes to sleep as well as to food and drink (of which more anon) are in fact hotbeds for lessons of morality in Galen. The work Thrasybulus dramatises an imputation against athletes that they are given to excessive sleeping, eating and drinking. A relevant passage reads as follows:

This section equates athletes with hogs (cf. the similar comparison in Character Traits, p. 21) and thus renders them examples of moral unsoundness not only for their fellow-athletes, but for humanity in general. This abstractive perspective gains more weight in the light of Galen’s purposeful linguistic selection, since he uses what he calls a ‘universally approved’ proverb, matching his similarly framed locution ‘This is generally acknowledged’ in the Character Traits passage cited above. The proverb ‘a fat stomach does not make a fine mind’ prioritises mental brilliance over disgraceful bodybuilding in a manner that would have been instantly recognisable to his highly literate audience. Expressions such as these that place stress on generalisable morals do not just enable Galen to make or clinch a point. They are also potent moral statements, focalised around the audience’s underlying sensibilities concerning contemporary morality. In essence, Galen repeats what his readers would already have known as a matter of common sense and everyday moral knowledge. But the narrativity in which he embeds this commonsensical ethics gives rise to a strong moralising ‘impulse’ in his worksFootnote ¹⁴ that speaks to contemporary readers. In this passage from Thrasybulus, the intricate association of athletes with a life of inertia, the imagery of lavatories, excretions, mud and dust underpinning the comparison with pigs, and their resounding disavowal by both Galen and all thinking men, would easily have made such life options unpalatable.

Thus far we have discussed cases of hortatory advice communicated through nominally objective rhetoric. This conveys general pronouncements regarding human life and morality to non-specific recipients. Yet, there are also examples like the following one given below, in which Galen’s persona takes centre-stage to articulate his moral beliefs in a dynamic fashion:

This passage introduces the eighth Book of The Composition of Drugs According to Places. It emphasises the need to engage with truth, which in turn ensures the right application of experience and rationality, the principal methodological tools in Galen’s pharmacology. Galen’s preaching, communicated through the use of an emphatic ‘I’ this time, portrays him as a moral authority by describing his guidance as having a long history and (it is implied) been so successful as to deserve reiterating. This rhetorical manoeuvre also has a direct bearing on the author’s relation to his readers: he expects them to be thoughtful (συνετοί) enough to fulfil his hopes of their embracing the truth, despite the difficulties he mentions associated with that task. The grave consequences mentioned at the end of the passage of giving oneself up to falsehoods (portrayed as metaphorical blindness and deafness) are particularly dire and are connected with a risk of psychic corrosion. They therefore act as a warning, encouraging a proper moral stance towards truth. As has become obvious by now, Galen sets great store by seeking after truth (φιλαλήθεια), making it the backbone of his scientific approach on a methodological and epistemological plane. But this same virtue is also fervently espoused in his ethics, since knowledge of the truth is cast as being able to bring about the improvement of character (βελτίονα τὸ ἦθος)Footnote ¹⁶ but also individual flourishing (εὐδαιμονίαν), predicated on freedom from corrosive passions.Footnote ¹⁷ Galen’s fixation with truth may echo the topos of the Imperial-era moralist tradition whereby happiness is grounded on true understanding, extirpating deceptive perceptions liable to rouse passions. This is what Galen himself asserts in the second part of his Affections and Errors of the Soul, where he addresses moral errors qua faulty judgments (more on this in Chapter 6). Consequently, truth upholds virtue, a view also espoused in the Tabula of Cebes, an allegory of moral life dated to the early centuries of the common era that situates truth at the very core of the moral universe.

Having looked at Galen’s exhortation in terms of his escalated participation in the text, from impersonal to authoritative, we now turn more concretely to the role of the reader in textual situations relating to moralism. We have observed that Galen’s readership are the beneficiaries of his moral teaching, furnished with tips on the sort of values they should base their lives on, hinging on what should naturally obtain in science and society at large. Yet there are also cases in which the reader is personally invoked within the text, requested to take an active position on what they read, by musing over it and (alongside Galen) assessing conflicting behaviours before determining which one to adopt.Footnote ¹⁸ Such active interrogation of the narrated material corresponds exactly to the kind of reading skills ancient pedagogy attempted to foster.Footnote ¹⁹ Galen seems well attuned to these educational currents:

In the majority of passages that we have hitherto explored, Galen’s audience were invited to approve, almost intuitively, a nexus of uncontroversial dispositions in the form of Kantian moral rules.Footnote ²¹ Their role was limited to assimilating Galen’s ready-made advice into their personal moral performance. In the extract above things are different. Galen drives readers out of their comfort zone; he presents them with a problematic – especially by posing the sequence of rhetorical questions cited above – and tasks them with making reasoned moral choices; in other words, he instigates a ‘moral breakdown’. The term, coined by Martin Heidegger, is key to a modern theoretical framework for describing the anthropology of moralities and refers to a critical moment when people ‘are forced to step-away from their unreflective everydayness and think through, figure out, work on themselves and respond to certain ethical dilemmas, troubles or problems’.Footnote ²² In the same way, the decision as to which of two contrasting groups to support in the extract above (a frequent trope in Galen’s ethical discourse, as we have seen)Footnote ²³ rests on the readers’ capacity for ‘thought’ in the face of moral ‘problematisation’, as Michel Foucault put it, in setting up a similar conceptualisation of the breakdown.Footnote ²⁴

It should be noted, however, that even though Galen’s readers are, theoretically speaking, free to deliberate and choose, the specificities of Galen’s rhetorical articulation in the printed passage indicate that the moral option is, in fact, predetermined by his climactic denunciation of people belonging to the second group. This includes men with corrupted souls, who are compared to ‘fatted cattle’ (βοσκημάτων),Footnote ²⁵ echoing Aristotle’s use of the same term in Nicomachean Ethics 1095b19–22, in the context of dismissing the life of pleasure that renders its followers slavish, resembling Sardanapalus. Any association with these corrupted men, Galen affirms, attracts condemnation on the part of prudent, self-controlled individuals. Not only that, but not joining Hippocrates and Plato who form the first group and reproaching Nature as per the second group, constitutes a sacrilegious act of the highest impropriety rather than a ‘hymn of praise to the Creator’, whom Galen elsewhere worships for his outstanding wisdom and power (Mot. Dub. 4.6-9, 136.16-25 Nutton). Galen’s accentuated denunciation has brutish behaviour at one end of the spectrum and divine insolence at the other. As so often, Galenic readers are autonomous, thoughtful entities, but the moralist in Galen rarely shies away from attempting to steer their behaviour.

The previous Chapter argued that Galen recasts traditional morality by introducing fresh interpretative lenses through which ethical matters may be viewed. We have seen that our author finds further opportunities for asserting the standard truths, and his own ways of challenging reflection on them, mainly through a process of defamiliarising his audience. Readers are made to take a step back, ruminate, perhaps wonder for a moment before subscribing to any moral attitude, however familiar to them it might be. They are also encouraged to extrapolate the moral gist of the various ethical narratives and thinking about how it can be appropriated to their everyday experience. There is an even greater presumption of this moral discrimination on the part of Galen’s audience in a group of technical discussions, which are to some extent also concerned with popular ethics, providing Galen with the opportunity for occasional bouts of moralising. As we shall see, in this case Galen is keen to interconnect the moral with the medical by attributing a strong ethical dimension to bodily care.

The Capacities of the Soul Depend on the Mixtures of the Body (henceforth The Capacities of the Soul) is an informative example of this sort. This speculative treatise tackles the thesis that alterations in bodily mixture (krasis)Footnote ¹ due to food, drink or daily habits produce corresponding psychological effects, for example an increase in hot mixture makes people quick-tempered (διὰ γοῦν τὴν θερμὴν κρᾶσιν <οἱ> ὀξύθυμοι γινόμενοι, QAM 11, 88.3-4 Ba. = IV.821.6-7 K.). In putting forward such a physiological explanation of moral behaviour, Galen draws on the notion of the interdependence of body and soul which had become prevalent in learned philosophical and medical discourse by his time.Footnote ² And he develops a model of moral psychology that departs from the one found in his ethical works, for instance in Affections and Errors of the Soul or Character Traits. Here his philosophical leanings go back to Plato’s celebrated tripartition of the soul: i.e. the idea that the human psyche is divided into three parts or faculties, the rational or ruling part (logistikon or hēgemonikon), administering thought, memory and imagination, inter alia; the spirited (thymoeides), sharing in courage and anger; and the appetitive or desiderative (epithymētikon), related to nutrition and desires.Footnote ³ Internal harmony comes about when the rational part, assisted by the spirited, prevails over the appetitive, and that is achieved in practical terms by empowering the intellect through rational reflection and habituation. In this model, the body’s underlying correlates seem irrelevant to the development or therapy of the soul,Footnote ⁴ as is medicine’s usefulness as a contributing science.

By contrast, the conception of the soul we find in The Capacities of the Soul, which is also at the heart of On Mixtures and to some extent On Habits,Footnote ⁵ differs in that it gives much more prominence to the corporeal nature of the soul, and therefore to the medical aspect of moral therapy. It thus captures the essence of a lost Galenic work entitled Whether Physiology Is Useful for Moral Philosophy (εἰ ἡ φυσιολογία χρήσιμος εἰς τὴν ἠθικὴν φιλοσοφίαν),Footnote ⁶ with Galen’s answer to that question surely being in the affirmative.

Now, Galen’s endorsement of naturalistic psychology (unlike his philosophical psychology, which is indebted to Platonic tripartition) seems, on the face of it, to exclude the power of reason and persuasion, since a person is teleologically defined by the substances of the body.Footnote ⁷ In that view the self-governed moral agent of the ethical works, who enjoys ample access to education and philosophy as a way of improving his moral condition, is eclipsed by the essentially helpless embodied entity of the physicalist works, whose ‘nature outweighs nurture’, as Jim Hankinson put it.Footnote ⁸ As I will go on to show, this surface reading needs to be questioned, first because, apart from the body’s biological make-up (which is connate and hence external to the agent),Footnote ⁹ there is also its environment, which people can regulate by exercising voluntary action.Footnote ¹⁰ Secondly, and most importantly for current purposes, because in his physicalist accounts Galen presents the agents’ administration of bodily parameters aimed at their intellectual and ethical amelioration as being inextricably entangled with a discriminating application of moral advice.Footnote ¹¹ Galen thus preserves the concept of their free will as psychological and moral subjects. His support of personal accountability is also in tune with his philosophical opinion that reasoned choice (prohairesis) informs people’s actions and the consequences thereof (more on this in Chapters 4 and 5), and that virtue is a deliberative state involving acts of will,Footnote ¹² not a passive condition. Imperial-era intellectual culture uniformly favoured personal liability anyway,Footnote ¹³ confirming the general assumption that character in the ancient world was shaped by independent agents, responsive to the moral climate in which they lived.Footnote ¹⁴

A first striking example of the way Galen can blend moral persuasion with physiological analysis is provided by what he has to say about the effects of wine and drunkenness. Specifically, the theoretical discussion of The Capacities of the Soul progressively advances to the point at which the build-up of each one of the four humours (blood, phlegm, black bile, yellow bile)Footnote ¹⁵ is said to cause a shift in someone’s mental trajectory, and eventually mentions the drinking of mōrion (a type of mandragora), which produces stupefaction, and the drinking of wine, which eliminates distress (QAM 3, 18.9-19.2 Ba. = IV.776.17-777.8 K.). Galen seeks to emphasise specifically the physiological outcomes of moderate wine-drinking, which, as he explains, makes the soul gentler and braver, while also fostering bodily processes such as digestion, distribution, blood-production and nutrition (QAM 3, 21.1-6 Ba. = IV.778.15-779.3 K.).Footnote ¹⁶

Nonetheless, one soon realises that the notion of moderation is developed outside its psychosomatic ambit, being dealt with as a moral virtue against the backdrop of convivial drinking, an important institution for upper-class citizens in the Roman Εmpire. As his choice of vocabulary makes clear, Galen plays on his audience’s daily acquaintance with wine,Footnote ¹⁷ recognising that this is a key cultural shibboleth in the imagination of the elite. He therefore goes on to offer guidance on how to behave with as much propriety at the symposium as elsewhere. By means of four popular quotations, three from the Odyssey and one from the lyric poet Theognis, he enumerates the benefits of temperate consumption of wine, especially relief from bad thoughts and tormenting feelings, as well as its downsides when the drunkenness goes beyond respectable limits, such as incurring ridicule in public for making laughable gestures or uttering obscenities.Footnote ¹⁸ Galen cautions particularly against conduct that could jeopardise someone’s harmonious co-existence with their fellow-men, as seen in a similar passage in Matters of Health, where excessive consumption of wine elicits irascibility, insolence and lewdness, all critical vices leading to desocialisation (San. Tu. 1.11, 26.4-7 Ko. = VI.55.2-4 K.).Footnote ¹⁹ That Galen’s advice here is addressed to a non-specialist readership is also supported by his heavy reliance on quotations, which as Vivian Nutton rightly observes, is a move that anticipates a wider readership among the nobility.Footnote ²⁰

Galen, consequently, promotes the philosophical associations of wine and is aligning himself specifically with aristocratic concepts of restraint. In doing so, he seems surprisingly sensitive to the social interface of drinking rather than its therapeutic potential or pathogenic outcomes.Footnote ²¹ That is a novel approach, in the sense that in this text Galen is by and large writing from the standpoint of a physician, whose standard duties in the area of regimen included the preservation or restoration of the balanced constitution through prescriptions for diet, physical activity and drugs, and not moral guidance on affability or social integration.Footnote ²² For example, the doctor Soranus of Ephesus, though acknowledging the close links between bodily and moral health, was against the idea that physicians should ‘break with custom and philosophise’ in treating the body.Footnote ²³ And along similar lines, the philosopher Seneca was equally adamant that regimen belonged to the doctor’s area of expertise, and that it was within his competence to give advice about the use of wine in particular: ‘He [i.e. the doctor] will prescribe a diet, with wine as a tonic, and he will tell you when you ought to stop drinking wine so that it will not provoke or irritate coughing’ (Seneca, Letter 78.5).

Galen departs from such views. As we will see in more detail in later Chapters (esp. Chapter 6, 7 and 8), Galen has a wider concept of medicine, which he envisaged as closely intertwined with ethical philosophy, and this leads him to infuse his naturalistic accounts with moral layers, showing special concern for many strands of social and cultural life. Within the context of The Capacities of the Soul, our author assigns himself an innovative role by contemporary standards, that of an expert in shaping characters specifically by means of bodily nourishment:

In this section of the work, Galen is addressing a group of contemporary Platonist philosophers who rejected foodstuffs as a moral determinant (and generally downplayed the physical basis of character), establishing a forceful portrayal of himself as teaching them how to adjust character.Footnote ²⁵ His authority is particularly clear from the use of the expression ἡκέτωσαν πρός με μαθησόμενοι (‘let them come to me to learn’), which is a statement of authority used in other parts of Galen’s writings (e.g. PHP 2.4, 122.27-31 DL = V.234.11-15 K.). His teaching material includes not purely advice on nutrition but also, as he says subsequently, on drink, winds, mixtures of the ambient air and topography.Footnote ²⁶ These are all qualifications provided by Galen so as to help philosophers achieve character improvement, in line with Plato’s numerous accounts of this process (QAM 9, 67.8-11 Ba. = IV.808.9-12 K.). The oppositional construction of this passage is reinforced in the next section, in which Galen, in his usual way, sides with Plato and censures the above-mentioned philosophers not only for failing to understand or recall Plato’s views in this respect but for also being reluctant to do so (QAM 10, 67.12-15 Ba. = IV.808.13-15 K.). This characterisation of them accentuates their lack of self-control or unsoundness of mind (sōphronein) in failing to become Galen’s students, as stressed in the passage above.

In the text that follows this passage, Galen taps into the authority of Plato and refers anew to the issue of wine drinking, citing two quotations from the Laws.Footnote ²⁷ These exhort the reader to consume wine only in moderation in young age, while stressing wine’s usefulness in old age, totally repudiating drunkenness and excess. Even though the Galenic text explains the implications of wine for the body,Footnote ²⁸ what the Platonic citations help emphasise is the need to regulate the use of wine on different military, social and political occasions (e.g. on a tour of duty, while being a magistrate, helmsman or active juror) as well as in private life (e.g. sexual intercourse at night). Similarly, when he goes on to briefly explicate the content of Plato’s quotations, it is the moral effects of wine that Galen develops first:

This passage invites a moral understanding of wine. What Galen really wants to examine is the moral behaviour of potential drinkers, from a ship’s captain to a soldier or a juror – all entrusted with public duties in both Plato’s and Galen’s society. In The Capacities of the Soul, wine is not only negotiated as a nurturing element, but is also explored in association with its ethical usefulness, as actually influencing certain qualities in one’s character, in a practical way in different areas of life, and not vaguely as in the previous passage (i.e. QAM 9, 66.11-67.4 Ba. = IV.807.17-808.6 K.). Galen advances this argument based on the writings of Plato. That explains why he concludes this section by quoting a passage from the TimaeusFootnote ³⁰ that sets ‘nurture’ (τροφή, used here in its stricter sense of nourishment) alongside ‘practices’ and ‘studies’ as ‘factors destructive of vice and productive of virtue’ (ὥσπερ γὰρ ἐπιτηδεύματα καὶ μαθήματα κακίας μὲν ἀναιρετικά, γεννητικὰ δὲ ἀρετῆς ἐστιν, οὕτω καὶ ἡ τροφή, QAM 10, 75.5-7 Ba. = IV.813.4-6 K.).Footnote ³¹ This is how the passage from Thrasybulus discussed earlier also works, bearing out its author’s ‘desire to derive a morality of food consumption from its medical consequences’.Footnote ³² Of course, in Galen’s ethical and other moralising works there is hardly any mention of food or drink affecting moral dispositions specifically through changes in the body’s physiology, though there is an emphasis on philosophical control in the consumption of food and drink, which is intended to alert the reader to the consequences and advocate appropriate behaviour. Chapters 6 and 8 will have more to say on that.

All in all, Galen’s engagement with ethics in The Capacities of the Soul might be interpreted in the light of the distinction he makes in Art of Medicine between innate ethical characteristics determined by bodily temperament,Footnote ³³ and acquired ethical characteristics formulated under the influence of philosophy (Ars Med. 11, 309.3-7 Boudon-Millot = I.336.16-337.2 K.). In The Capacities of the Soul Galen offers a combined agenda for paying heed to both categories of moral traits. The latter through the philosophical caveats about wine in social surroundings, which are meant to educate the reader in exercising self-control. The former through the proposal that wine drinking in moderation produces good mixture and hence virtue in the soul. In this case, the moderate approach to drinking that has been engrained in a moral life may eventually overcome the impact of inherent krasis, making nature an acquired state (φύσιν ἐπίκτητον ἐργάζεται, Hipp. Aph. II 40, XVIIB.554.5 Κ.), as Galen asserts in another work with reference to the role of customary practices in maintaining a healthy body.Footnote ³⁴

It has been suggested that in The Capacities of the Soul Galen advertises a form of medicine whose primary role is to promote moral excellence,Footnote ³⁵ and that through its polemical tone the work is meant to raise the standing of Galen’s medical expertise in accounts of the soul.Footnote ³⁶ The analysis given above and elsewhere in this book shows that moral philosophy in Galen is not in competition with or ancillary to his medicine,Footnote ³⁷ but more of a complementary area, a collaborative science, as we shall observe in the example from Matters of Health discussed below. This suggestion is backed up by Galen’s emphatic assertion that his argument in The Capacities of the Soul ‘is not destructive of the fine teachings of philosophy’ (QAM 11, 77.5-6 Ba. = IV.814.8-9 K.), a locution that indicates acceptance and collaboration between distinct disciplines much more than dismissal and antagonism.

By the same token, the ethical narratives we have seen so far do not merely emphasise the patient’s moral responsibility in opting for a healthy lifestyle, as others have suggested.Footnote ³⁸ They mostly advertise Galen’s moralising agenda for his fellow-men, whom he deemed thinking moral entities rather than simply prospective patients qua embodied creatures. Even though several doctors, such as Aretaeus, Rufus of Ephesus, Soranus or Athenaus of Attalia, had accepted that disease-engendering customs and behaviours were related to moral choices, practices and obligations, Galen is different in that: a) he brings the soul much more prominently into his concept of health and disease and b) he links the advice he gives on moral health in his naturalistic discussions to wider societal and ethical concerns to make it resonate with the popular philosophical tradition on corresponding issues. Hence, by vigorously shoring up the role of practical ethics in the traditional domain of medicine, Galen is playing a double game as physician-cum-ethicist. His originality by comparison with other physicians in combining popular philosophy and medicine is apparent in terms of extent (an unparalleled number of references to and insinuations concerning morals), emphasis (the soul and morality/ethics not playing second fiddle to the body and medicine) and being wider in scope (his practical ethics go hand in hand with the medical art, given that Galen can take a moralising turn on just about any piece of medical analysis or advice). These aspects loom large in Matters of Health too.

This work focuses on hygiene, the art of keeping one’s body in good health. Galen’s target audience here comprises a well-off, educated group of readers, who are advised on how to follow a healthy lifestyle not in a vacuum, but within the urban environment they live in, and in the face of the socio-political difficulties and pressures they are likely to experience. In light of this, ethics could not have been left out of the account on hygiene, given the way it is socially embedded in Galen’s thinking, as seen in the previous part of this Chapter. One of the chief obstacles to health that Galen emphasises throughout is a lack of self-control, which prevents patients from monitoring their desires, leading them into bad habits that disturb their natural constitution.Footnote ³⁹

The beginning of Book 5 of Matters of Health is a good test-case for the creative involvement of incontinence as a moral vice within a health-related matrix. In distancing himself from other doctors and gymnasts who had concerned themselves with hygiene, Galen highlights the efficacy of his preventive medicine as opposed to the lack of success of his rivals’ versions, accusing them in particular of being unable even to preserve their own health, despite what they preach orally or in their writings. One reason for this failure is, according to Galen, their lack of self-control (akolasia), which he links to social ridicule aimed at them, evinced in the adage ‘the doctor to others is himself full of ulcers’ (Euripides, fragm. 1086; Kannicht, TrGF vol. 5, p. 1012, in San. Tu. 5.1, 136.7 Ko. = VI.307.16 K.).Footnote ⁴⁰ The other reason for their failure is overwork. True, elite ethics requires leisure time, but Galen dismisses the excuse that they lack this, by pointing to his own demanding and often physically testing lifestyle and claiming that it has not led him into similar intemperance.Footnote ⁴¹ Nor, he says, has it precluded the nurturing of other virtues, among which Galen particularly stresses his love of learning and (albeit obliquely) his love of the beautiful and of labour.

Having established his professional and moral superiority, Galen repeatedly emphasises the disgrace involved in his colleagues’ erroneous attitudes to health, in order to highlight their moral failings:

This passage leans heavily on a perception endemic in ancient thought that regarded physical beauty as an index of moral decorum. The connection between aesthetic and moral distinction formed a value system, corroborating the proverbial belief that a sound soul dwells within a sound body and thus advocating balance between the two.Footnote ⁴³ This idea affected people’s social perception too, as their deformed body would signify debauchery and hence trigger condemnation by others, who would see them as social outcasts, if not positively sub-human. Galen seems perfectly aware of such attitudes in a section of his Commentary on Hippocrates’s ‘Epidemics VI’ (4, 9, 206.23-207.1 WP = XVIIB.150.8-151.5 K.), where he introduces a moralising note into his Hippocratic sourceFootnote ⁴⁴ when he says that it is ‘entirely shameful’ (αἴσχιστον) for a doctor to exhibit scruffy fingernails, halitosis, body odour and other ‘unnatural’ (παρὰ φύσιν) somatic conditions. That Galen is interested in the ethical components of the physician’s demeanour is also seen from the fact that his moralising twist proceeds from his preceding exegesis of the Hippocratic term σχῆμα denoting character,Footnote ⁴⁵ analysed immediately before the passage on the doctor’s corporeal filthiness. In explicating σχῆμα, Galen develops in particular the moral rectitude demanded of a doctor, i.e. he should be modest and approachable with the patient, not frivolous or snobbish (Hipp. Epid. VI, 4, 9, 205.11-20 WP = XVIIB.148.7-18 K.).Footnote ⁴⁶

On another level, as is obvious from the recurrent forms of aischros in the passage quoted from Matters of Health, Galen bombards the reader with the notion of shame expressing popular disapproval. Feeling shame at one’s own failings was another important resource for achieving a happy life in the ancient world, in that it coincided with the need for politesse and respect for oneself as much as for others in the context of the community.Footnote ⁴⁷ In that respect, Graeco-Roman society fits the rubric of a culture that the twentieth-century para-Freudian anthropology of Ruth Benedict has termed ‘shame-culture’, namely a culture in which violation of moral standards engenders shame, unlike a ‘guilt-culture’ in which the same violations give rise to guilt instead.Footnote ⁴⁸ In dealing in more detail with the operation and characteristics of shame, Benedict, along with Bernard Williams, have argued that shame implicates fear of exposure to the stigmatisation and mockery of the world,Footnote ⁴⁹ which constitutes ‘a fantasy of an audience’ or an ‘imagined gaze’ staring at moral transgressions. Both authors have therefore underscored the importance of seeing and being seen and of the revelation of the sight of a moral crime in their conceptualisation of shame.Footnote ⁵⁰ Remarkably, these are all features that in some ways go back to Roman conceptions of pudor, as evinced particularly in Robert Kaster’s sixth ‘pudor-script’: ‘Upon (or at the prospect of) seeing myself being seen in discreditable terms, I have an unpleasant psychological response, when the behavior or state of affairs that prompts the attention is “up to me” and entails discreditable “lowering” of the self.’Footnote ⁵¹ This experience of shame (albeit a virtual one in the Galenic passage quoted above) occurs when one’s feeling of esteem is imperilled, and this is particularly crucial in a society in which sanction lies in public opinion: ‘What will people say?’. The Stoics envisioned shame as an eupatheia, a commendable emotion that denoted watchfulness for the prospect of justified castigation.Footnote ⁵² This was, to their minds, a strategic means of protecting one’s self-respect, not an egocentric sense of pride and self-confidence, but rather a feeling of behaving with honour and dignity in performing one’s assigned universal or cosmic duties as a rational human agent.Footnote ⁵³ Those conceptual parameters, and especially the externalised character of shame, fit comfortably with Galen’s own understanding of shame in several places in his corpus (more on this in Chapters 4 and 5), including in the passage cited above.

Galen, then, for the sake of his readers, exploits the sense of being ashamed by making it an instrument for avoiding imprudent actions. This course of action, with its strong philosophical antecedents (especially in Aristotle),Footnote ⁵⁴ enables Galen to articulate a brief moral commentary in this health-centred context. Thus he uses the ideal of an honourable death as opposed to a disgraceful life (ἑλέσθαι δὴ μυριάκις τεθνάναι, πρὶν τοιοῦτον ὑπομεῖναι βίον in the San. Tu. extract above). This brings to mind the morality generally held to be associated with Homer’s heroes (e.g. Ajax or Achilles), as mediated above all by the Socrates of Apology 28b-29a, that was kept alive in subsequent Greek popular ethics. Galen transposes this ideal to the domain of decision-making on health issues: this time shame due to incontinence that upsets one’s bodily temperament elicits strong social accusation (and not just ridicule as previously seen in The Capacities of the Soul).

The same heroic ideal of the honourable death features in another passage from The Capacities of Simple Drugs, where shame due to bodily deformity is also in play. However, in this case there is no suggestion that the patient is to be condemned for erroneous preferences. For the text does not cast him as culpable for suffering from elephas,Footnote ⁵⁵ despite the fact that this skin disease was generally known to have originated from the patient’s lifestyle, including their diet.Footnote ⁵⁶ On the contrary, the emphasis is on the patient’s rare philosophical consciousness (‘he was more philosophical than the majority of other men’, φιλοσοφώτερος ἢ κατὰ τοὺς πολλούς, SMT 1.1, XII.314.11-14 K.; cf. SMT 1.1, XII.313.8-10 K.; transl. mine) that instinctively leads him to opt for death rather than a life of pain, disfigurement and, ultimately, dehumanisation.Footnote ⁵⁷ The implication is that even if this patient was indeed responsible for his disease, owing to some form of lack of self-discipline, he had the philosophical stamina to bear the consequences of his actions, thus retaining his self-respect. Both sections, then, underscore, from distinct viewpoints, the role of high-mindedness in issues of the body: the former passage, taken from Matters of Health, shows that self-control is needed to prevent the onset of disease, the latter, from The Capacities of Simple Drugs, that nobility of spirit is needed to face up to disease when it occurs. Remarkably, Aretaeus, who provides the longest surviving nosological testimony on the so-called elephant disease, does not discuss issues of moral responsibility or philosophical attitudes to the disease, which further highlights the markedly moralising aspect of Galen’s disease narratives.Footnote ⁵⁸

It is in contexts such as those just examined that Galen introduces moral uprightness to medical treatment of the body. In doing so, he goes beyond the clichéd – often brief – emphasis of other authors on the importance of moral life to psychosomatic wellbeing.Footnote ⁵⁹ Galen probes the philosophical aspects of moral life in a variety of perceptive ways, informed by his programme of practical ethics, as recorded in other parts of his oeuvre, for example, in delving into the particulars of social shame or in sketching individuals as moral entities and not just embodied ones. Similarly, he insists that the philosophical responses to disease seen above do not come about all of a sudden, but demand long-engrained training in philosophical education and sustained efforts at shaping proper moral habits. His focus on the social and cultural aspects of health is also decisive. We have seen that it is the social environment responsible for the disruption of the body’s normal function that attracts Galen’s attention and makes him venture into the ethical sphere, often quite unexpectedly given the technical nature of his works. This aspect underpins his self-projection as a moral authority, another trait not found in other medical authors concerned with similar issues.

The final sentence of the passage from Matters of Health quoted above portrays Galen as a moralist renouncing his ability to correct intemperance, stating that this is not a suitable occasion to do so. This points allusively to Galen’s activity qua ethicist proper in his ethical works, but in the context of Matters of Health it may also be seen as a sophisticated tactic of self-effacement. By mapping out the community’s inimical responses to incontinence (ἀκολασίαν) as well as shamelessness (ἀναισχυντίαν) and moral weakness (μαλακίαν), vices that play a central role in his adversaries’ (un)ethical portrait too, Galen does in a sense correct (ἐπανορθοῦσθαι) incontinence in readers on a metanarrative level, on the assumption that they would have exercised their comparative and abstractive abilities discussed in the previous Chapter, and have had the appropriate reaction – in this case recognising the need to avoid shamelessness. So by bringing out the ethical connotations of incontinence in his technical discussion of hygiene, Galen makes use of the prospect of a metatextual development of character. And that he assigns a naturalistic substrate to character in Matters of Health does not mean that the salience of moral philosophy in individual thriving is readily dismissed from his account.Footnote ⁶⁰

In fact, ethics also forms a close alliance with Galen’s medical science when it comes to the learning and teaching of medicine, as we can see from the relevant remarks in The Different Kinds of Fever. In describing the characteristics of students of medicine who only have a conceit of medical knowledge (οἴησιν δ᾽ἐπιστήμης) but are ignorant of a significant amount of the true art, Galen lists a number of vices associated with their ignorance: boastfulness (ἀλαζονείας), insensitivity (ἀναισθησίας), rashness (τόλμης), vain prattling (ματαίας φλυαρίας). He then clarifies that his writings on medicine are aimed specifically at passing on true knowledge (ἐπιστημονικόν) and offering instruction in a didactic manner (διδασκαλικόν) (Diff. Feb. 1.3, VII.280.8-281.5 K.), which in general he considers philanthropic (φιλάνθρωπον, Diff. Puls. 4.17, VIII.764.1-3 K.), most probably on the grounds that his teaching – albeit indirectly – eradicates the damaging passions triggered by ignorance. In punctuating his medical texts with relevant moral reflections, Galen renders them more intellectual, philosophical and fashionable, thus widening the appeal of his art to a larger group of followers. These are issues explored in more detail in the Chapters that follow.

In the next Chapter we will investigate another important respect in which Galen differs from other medical authors in his treatment of ethics, and that is in his conceptualisation of the role of medicine in society and culture.

Galen’s most penetrating engagement with ethics in works not clearly designated as ethical surfaces in accounts that explore his perception of a contemporary decline in medicine. This recurrent complaint in his oeuvre intersects with that of medical practitioners’ lack of suitable training and the related issue of the difficulty of demonstrating medical methodology to be grounded on robust logical foundations. Interestingly, in Galen’s opinion, at the root of this sad state of affairs were defective passions, either by being destructive of the proper function of the medical art tout court, or, on a more complex level, as symptomatic of an intense antagonism between Galen and others, which would eventually highlight the moral depravity of the science and society of his day. The ‘others’ are Galen’s medical opponents, but most frequently they are sophists, either in the literal, operative sense (as per the title of Philostratus’s Lives of the Sophists) or metaphorically as cunning doctors, following the Platonic interpretation of sophists as practitioners of devious, over-elaborate and dishonest arguments, as we will see in more detail in Chapter 7.

But what issues does this ‘otherness’ entail for Galen? What exactly is his problem with the members of this group that he has placed in the artificial category of people who get everything morally and intellectually wrong? For one thing, he says they are ignorant, lazy and liars. Furthermore, they nitpick and prattle excessively, waste their time in unproductive quarrelling over words and their meanings, make misjudgments, yield to self-contradictions and mislead inexperienced people through invalid arguments.Footnote ¹ In a nutshell, they fail to obey the rules of Galen’s authentic science, characterised by a firm commitment to truth, accuracy, clarity, economy and hard work. It is from this critical dichotomy that Galen’s ethical concerns flow, when he aspires to see scientific research uncontaminated by love of discord, spite and other corresponding vices that instigate the degraded version of science described above. For Galen medicine should be above all a moral art, just as he claims to have professed and practised it himself. This is at odds with the Stoic mindset represented, for example, by Diogenes of Babylon in Cicero’s On Duties 3.51-64 in the context of a celebrated discussion about the morality of the merchant. Here a technē and its practitioners are said to be immune to moral uprightness, provided that their ministrations produce an end that is beneficial to life. Galen’s own view is radically different, contending as he does that the usefulness of a craft or a profession should always be enmeshed with the honourable, and especially so for medicine. This moral viewpoint is captured in Galen’s idealised perception of himself as a cleanser or purifier of other people’s souls, always allowing truth to prevail (καθαρὸν ἤδη τῇ ψυχῇ τὸν ἀκροατὴν ἔχων, SMT 1.40, XI.457.17-458.2 K.), in imitation of his idol Hippocrates (καθαρὰν ἐργασαμένῳ τὴν ψυχήν, Hipp. Art. 1.6, XVIIIB.340.16-19 K.).

Galen’s subjective description of the lamentable failure of medicine is not just a rhetorical technique for publicising his superiority in relation to his colleagues. Rather, it has a strong philosophical basis, which leads me to argue here and in what follows in favour of it being part of his programme that advocates for a moralising kind of medicine. In The Capacities of the Soul Galen (taking his cue from Posidonius) is realistic enough to accept that vice is endemic within us and thus cannot be wholly eliminated.Footnote ² For that reason, rather than trying to avoid associating with wicked people, he suggests going down the more pragmatic route of connecting with individuals who can purge and prevent the spread of vice (QAM 11, 86.11-87.2 Ba. = IV.820.9-13 K.). This advice evokes Galen’s self-identified role as a cleanser of wicked souls in the SMT passage cited above, something that makes more sense if we bear in mind Galen’s heavily didactic persona throughout QAM as a whole (Chapter 2).

Another factor that, according to Galen, can mitigate vice (besides the mediation of a cleanser) is reproach (elenchos), namely criticism that exposes aberrations (often in displeasing ways) with a view to bringing about moral progress.Footnote ³ In developing a kind of history of societal vice in the introduction to The Capacity of Cleansing Drugs, our author opines that in the past the problem of vice was far less acute than in the Imperial period, when it had proliferated,Footnote ⁴ because in earlier times reproach had obliged people to check their wicked thoughts, dishonourable actions and injustice (Purg. Med. Fac. 1, 1.2-2.1 Ehlert = XI.323.1-324.5 K.). We will see with reference to the Affections and Errors of the Soul in Chapter 6 that reproach is one of the main obligations of the critical supervisor, another role that Galen attaches to his set of ethical activities targeted at the healing of vice, whether communal or individual. As has become clear, in order to shield medical science from degradation, Galen fits it with safety valves, unwritten rules, as it were, which he draws from the moral programme expounded in his ethically-oriented tracts.

We will now go on to investigate some examples in which Galen comments on the improper manners of doctors and/or sophists. The crucial element here is that he consistently expresses his moral responses to such manners, ranging from blame and hatred to revulsion and indignation. The first example comes from Good Humour and Bad Humour and explains the circumstances under which one can justly attract moral disapprobation. As far as Galen is concerned, we should generously forgive (πολλὴν συγγνώμην νέμειν) and indeed sympathise with (συναλγοῦντας) people who could not exercise their capacity of discernment because they had not had good teachers. He regards their condition as a misfortune (δυστυχίᾳ), which should not incur blame, since it did not involve reasoned choice on the part of the agent (οὐ τὴν προαίρεσιν μεμφομένους, Bon. Mal. Suc. 1.11, 68 Ieraci Bio = VI.753.17-754.3 K.). Conversely, those who established schools of erroneous thought, driven by love of distinction (διὰ φιλοτιμίαν), did deserve to be hated (ἄξιοι δὲ μίσους εἰσίν, Bon. Mal. Suc. 1.11, 68 Ieraci Bio = VI.754.3-4 K.), and in this instance their errors and subsequent deception of other people are presented as the result of a calculated decision (ἑκόντες ἐξαπατᾶν … οὐκ ἄκοντες σφαλῆναι, Bon. Mal. Suc. 1.11, 68 Ieraci Bio = VI.754.3-6 K.). Likewise, Galen often proposes unrelenting censure, especially when contentiousness and imprudence are displayed by medical practitioners (ἀσύγγνωστος ἡ φιλονεικία, τάχα δ’ ἀληθέστερόν ἐστιν εἰπεῖν, ἀναισχυντία, Loc. Aff. 3.7, VIII.167.1-11 K.). These instructions on when to show forgiveness and when to blame are in line with Galen’s frequent references to praiseworthy or blameworthy attitudes in Character Traits; and they are used throughout his medical texts too to inform his audience’s responses to problematic behaviour. He also achieves this by labelling detestable agents or predilections with derogatory denotations, such as ‘accursed’ sophistsFootnote ⁵ or a ‘scurrilous’ desire for reputation.Footnote ⁶

On other occasions, Galen is keen to raise awareness of the potential risks or serious corollaries arising from certain moral positions in the context of medicine. In criticising the doctors Herodotus and Dioscorides for their contempt for sense-perception and attributing it to their contentiousness (διὰ φιλονεικίαν, SMT 1.35, XI.445.2-3 K.), Galen cautions that it is difficult to avoid their garrulity (ἔργον εἶναι φυλάξασθαι τὴν αδολεσχίαν αὐτῶν) and useless silly talk (ματαίας φλυαρίας). He goes on to stress that, once people have been perverted by these last two passions (τοὺς διεστραμμένους ὑπ᾽αὐτῶν), it takes a lot of effort to teach them anew (μεταδιδάξαι) and reform them (μεταλλάξαι). The gravity of such a quandary is further highlighted when the author lingers on the feeling of fear that this group of afflicted people must have felt, if they had been aware of the fraudulent theories on the capacity of simple drugs (SMT 1.36, XI.449.1-11 K.). Following his typical moralising pattern, Galen presents moral passions as disordering the proper workings of reason and increasing the emotional perplexity of those suffering from them. Indeed, even though his emphasis seems, strictly speaking, to be on the intellectual corruption of the victims, it is the moral vice of the victimisers that comes out most clearly in the passage, so that they will be disdained by Galen’s audience. To draw attention to the extent to which garrulity and nonsense can be irretrievably destructive, Galen aptly underlines the difficulty, if not impossibility, of intellectual and moral reversal.

The above examples promote a structured hostility to moral failing in the reader through the author’s narrative voice. In other cases, Galen’s recommended reaction to vice is communicated through the addressee, who is described as sharing Galen’s disapproval of dissolute conduct. The preface to Antecedent Causes showcases how some contemporary doctors and philosophers, seeking to establish their reputations but despairing of ever succeeding in the venture, resorted to showmanship and devised sophisms, or captious arguments. Galen focuses on the abundance of such sophisms in his world only to dismiss them with the ironical remark that ‘these wonderful sophisms’ ultimately made the medical art even longer than Hippocrates had originally assumed in his famous aphorism ‘The art is long, life is short’ (CP 1.2-6, 70.7-72.3 Hankinson). Nevertheless, the most patently moral response within the text is that of Gorgias, Galen’s addressee, who, according to Galen, laughs contemptuously at those doctors. Laughter (provoked by scorn and derision) at ethical deportment foreign to Galen’s personal morality is a commonplace in Galen, as we will observe in other Chapters. So, the addressee mirrors the author, who functions as his moral paragon, as indeed elsewhere, such as in The Composition of the Art of Medicine, where Patrophilus, following Galen’s example, is a lover of truth and eager to study medicine (CAM 135.1-6 Boulonge-Delattre = I.224.1-8 K.).Footnote ⁷ The same Galenic technique may involve intratextual characters on other occasions, as we will see with Eudemus in Prognosis in Chapter 8.

Another method with a profoundly moralising intent in the medical texts is the personal opposition that Galen sets up, in order not only to show his rejection of ethical weaknesses in others but also to emphasise his moral self by contrast. This technique betokens how significant the autobiographical component is in Galen’s practical ethics, an observation that underlies the thesis argued for in the light of Avoiding Distress in Chapter 4. Galen’s aversion to specific vices is frequently articulated through a stated wish that his peers had acted differently: ‘I wish they would stop their vain love of strife’ (ἂν εὐξαίμην παύσασθαι ματαίου φιλονεικίας, SMT 1.39, XI.455.6-7 K.; transl. mine). In Fullness the device of a stated wish takes on the subtler form of an entreaty that reveals Galen’s own solution to the grievance and anger (ἄχθονται … ὀργίζονται) occasioned by love of strife, which is simply to feel drawn to like-mindedness (homonoia) (ἡμεῖς οὖν ἀμφοτέρους τε εὐξάμενοι παύσασθαι τῆς φιλονεικίας εἰς ὁμόνοιαν παρεκαλέσαμεν …, Plen. 2, 30.17-18 Otte = VII.520.4-8 K.).

In a context stressing the conceptual ambiguity of Galen’s era due to the competition among sophists and the prevalence of fallacies, the ‘wish’ technique is again deployed (Diff. Puls. 1.1, VIII.493.1 K.), this time to dismiss the way the doctors succumb to meddlesomeness (πολυπραγμονοῦντα), rashness (τολμῶντα) and disparaging (καταμεμφόμενον) (Diff. Puls. 1.1, VIII.497.3-5 K.). All the above vices Galen attributes to the sophists’ special area of activity (οἷα δὴ δρῶσιν οἱ σοφισταί) and makes them superfluous to and outside the remit of medicine (περιττὰ γὰρ ταῦτα ἅπαντα καὶ ἔξω τῆς ἡμετέρας τέχνης, Diff. Puls. 1.1, VIII.497.5-6 K.), which Galen conceptualised as being concerned with the correctness of things, not of names (Diff. Puls. 1.1, VIII.487.7-8 K.).Footnote ⁸ At another juncture in the same work, the otiose use of definitions, which Galen tendentiously blunders as a sophistic practice under the Empire, is contrasted to the Greek custom of employing clear language, which Galen so wholeheartedly endorses as to call it the moderate and philanthropic choice (ἡ μὲν ἡμετέρα προαίρεσις τοιαύτη, μέτριος, ὡς νομίζω, καὶ φιλάνθρωπος, Diff. Puls. 2.2, VIII.1-16 K.). Once more, Galen parades his moral self by means of opposition and identifies it with philosophical uprightness and benevolence, so that when he informs us that his choices attracted the insolent reactions from the sophists, readers would have already been inclined to favour his preeminent character while condemning those he presents as his moral inferiors.

It is on this distinction between his philanthropy in displaying sensible use of definitions and other physicians’ over-the-top talkativeness (ἀδολεσχία) that Galen bases himself when he invents the negative passion of fondness of definition (φιλοριστία) – a hapax legomenon in antiquity – as a feature of the world in which he lived. Driven by the express opinion that obscurity is so prevalent in his day that even three lifetimes would not be enough for the acquisition of knowledge (Diff. Puls. 3.1, VIII.637.9-12 K.), Galen attributes φιλοριστία not just to doctors, most notably Archigenes (τὸ τῆς φιλοριστίας ἐπενείματο νόσημα, Diff. Puls. 4.1, VIII.698.3-6 K.), but also philosophers, orators, musicians and grammarians (Diff. Puls. 4.17, VIII.764.1-12 K.).

The inference to be drawn from these passages is that Galen differs radically from those suffering from the vice of φιλοριστία. Even though he seems to abstain from this and other deplorable qualities, however, Galen sometimes adopts the very practices that he censures in others, including the periodic adoption of an insolently polemical tone. This feature of Galen’s personality has been addressed in scholarly publications, but the extent to which it has been deemed an idiosyncratic aspect of his character has been overstated, given that the epideictic culture of the period would have experienced many other examples of similar acerbic polemic. If seen from the point of view of practical ethics, with which I am concerned here, Galen’s harsh criticism of morally despicable actions is consistent with the curative effects attributed to reprimand in other moralists. Plutarch, for example, argues that any gibe targeted at the improvement of character (πρὸς ἐπανόρθωσιν ἤθους) should be accepted mildly and treated as constructive criticism by an educated and liberal man (On Listening to Lectures 46C-47B). Likewise, the rebuke designed to elicit pangs of conscience and repentance is considered both kindly and healing (θεραπευτικός) (Political Precepts 810C; cf. 803C).Footnote ⁹ Dio of Prusa’s Oration 8.5 is in the same spirit. This explanation might therefore offer a new reading of Galen’s adoption of polemics. Rather than understanding it as a self-contradiction (by assailing others Galen is not practising what he is preaching),Footnote ¹⁰ this analysis marks out the moralising potential of Galen’s deployment of censure, which has a philosophical origin and practical orientation. As such it could be deemed part of the ‘co-operative ideals’, an umbrella phrase coined by Jason König to amend the one-sided scholarly focus on the competitive value-system of Greek medicine, of Galen’s character and work.Footnote ¹¹

It is, then, within the tradition of a morally beneficial polemic that Galen’s attack against Thessalus, the founder of the Methodists, may also be construed, despite its agonistic implications. As we will observe in more detail in Chapter 8, Galen’s main issue with Thessalus is his brashness, attested in the disgraceful views he held regarding the attainment of medical qualifications (a science he thought could be taught within a mere six months) and the role of bygone authorities in medical theory and practice (he notoriously despised Hippocrates, considering himself distinctly superior to the father of medicine). By the same token, it is Thessalus’s infuriating shamelessness that motivates Galen to arm himself with weapons familiar to Thessalus himself:

We have already noted that transformative reproach is part and parcel of Galen’s tool kit as a moral supervisor, and that he exonerates it from blame, so as to make it a fundamental medium of his moralism. Yet why Galen denies that it is his custom to reproach the guilty in the passage above remains a mystery. Why does he feel the need to apologise for his reprimand, given that he could have easily vindicated it, as argued above?

Another polemical intertext might illuminate the issue. In Against Julian Galen indicts the Methodist Julian for unabashed over-talking, insolence and recklessness, comparing him with Thessalus. Galen states that it is for the purposes of reproaching (ἐλέγξειν) a stupid, ignorant man who pretends to wisdom and prattles all the time that he will use harsher words than he normally would (Αdv. Jul. 2, 39.4-8 Wenkebach = XVIIIA.254.7-12 K.). So, again, he pleads for the audience’s forgiveness, requesting that they do not blame him for his chastisement (ὅπως μὴ καταγνωσθῶ πρὸς τῶν ἀναγνωσομένων αὐτά, Αdv. Jul. 2, 39.3-4 Wenkebach = XVIIIA.254.6-7 K.). Just before this section of the work, Galen had also likened Julian to Thersites, an epic character commonly known for his garrulity (ἀμετροεπίαν) and interminable argument (ἀπεραντολογίαν), stressing that he needs an Odysseus to chastise him with corporal punishment (Αdv. Jul. 2, 38.8-15 Wenkebach = XVIIIA.253.11-254.11 K.). As the text makes clear, this Odysseus is not Galen, for in the light of the previous passage, Galen opts for moral correctives, elenchus (ἐλέγξειν), rather than physical violence. This source shows that Galen expands the semantic range of elenchus beyond its conventional meaning of argumentative refutation of the Socratic model, to promote its usefulness as moral criticism, as in the other instances we have seen. A possible answer, then, to the question of why Galen was inclined to apologise for deploying elenchus is that in this way he created the impression of a non-vitriolic and therefore moderate (by contemporary mores) man, who was forced to engage in practices he did not normally indulge in, owing to the extreme failings of others. Indeed, Galen very often admits in frustration that he has been pushed over the edge to respond in unwanted ways to the vices of his foes (SMT 3.10, XI.560.15-17 K.; Diff. Puls. 4.1, VIII.696.5-13 K.).Footnote ¹³ I shall return to this later.

In Julian’s case, Galen declares it dreadful (δεινόν) that Julian is allowed to abuse the most well-educated scholars of antiquity, whilst he himself is unable to reproach the Methodist’s enormous lack of culture (ἀπαιδευσίαν) (Αdv. Jul. 2, 39.7-10 Wenkebach = XVIIIA.253.11-254.12-16 K.). ‘Desperate times’ indeed ‘called for desperate measures’,Footnote ¹⁴ to use Hankinson’s phrase, though, unlike Hankinson, the emphasis of my argument is on the fact that Galen’s rhetorical extravagance often serves serious moralising ends.Footnote ¹⁵ For this rhetorical ploy of apologising demonstrates the urgency and social utility of Galen’s moralism. Through his self-deprecating attitude, Galen both gains his audience’s benevolence as an ethical exemplar and directly leads them to assimilate it as they distance themselves from other people’s cardinal sins. At the very core of this technique lies a strong comparative element that fuels Galen’s apology, reminiscent, for example, of the Plutarchan synkriseis appended to the paired biographies of prominent Greek and Roman men. These are prototypical examples of how comparison in works of the Imperial era could have an ethical payoff. Galen’s audience are meant actively to internalise recommended lifestyles after examining conflicting manners. That is what we have seen happening in Chapter 1, in cases where readers would have responded actively to the text by weighing opposing groups of moral agents against each other before judiciously espousing one of them.

Interestingly, the critical abilities expected of Galen’s readers were the result of a proper education, which entailed the additional advantage of emotional stability. This idea is explored by Galen in passages that associate lack of culture with ineffectual management of passions. For example, in the Commentary on Hippocrates’s ‘Nature of Man’, we learn that Galen’s exegetical work remains unappreciated by uneducated readers who are driven by envy and slander (HNH 1. proem. 9.15-18 Mewaldt = XV.13.8-12 K.);Footnote ¹⁶ and, along similar lines, in Affected Places lack of education (ἀπαιδευσία) produces powerful psychic emotions (Loc. Aff. 5.1, 288.26-27 Brunschön = VIII.301.17-18 K.). Galen, then, conforms to the trend in the Imperial period for considering moral and intellectual shortcomings to result from a deficient philosophical learning, and he aligns himself squarely with what is advocated in contemporary moral works, namely that true education (paideia) engenders happiness (eudaimonia).

The tactics of self-humbling for moralising effect becomes more sophisticated in other works. In the passage from Semen below, Galen exposes an alleged personal weakness to engage his audience’s sympathies, and then to raise it to the status of a virtue:

Polypragmosynē, meddlesomeness or indiscreet curiosity, is a common conceit in the ethical literature of the Second Sophistic.Footnote ¹⁸ Far from being a mere foible, it constitutes a reprehensible moral trait, a malady, as Plutarch’s eponymous treatise makes clear:

In Galen’s scientific discussions, the same trait signifies a positive attribute for a doctor, that is to inquire closely (πολυπραγμονήσας) into the patient’s environment (e.g. Hipp. Epid. VI, 4, 8, 200.4-6 Wenkebach = XVIIB.139.3-5 K.).Footnote ²¹ However, as a moral characteristic, Galen considers it to be negative, judging by his admission in the passage quoted above that he did not regret his curiosity, and the generally remorseful tone with which he describes that quality. In particular the shrewd aside ‘Why shouldn’t I tell the truth?’ engages the audience’s goodwill, so that even before Galen stresses the fruitful outcome of his moral curiosity, readers have sided with him, because he has been depicted as a man endowed with self-knowledge and the stamina to disclose his failings. Intriguingly, the way in which he solicits the reader’s endorsement in this passage seems to build on similar sentiments expressed in the opening of Semen, where Galen makes another personal confession:

Just as being a busybody may arouse social blame, so too may being a disbeliever, and so Galen humbly acknowledges his putative moral flaw only to progressively authorise it through self-deprecation.

Galen admits to other, more grave mistakes. In the Elements According to Hippocrates he narrates, in a lively exchange of the Platonic type, how as a youth he succumbed to fallacies. Even if Galen comes across as a sophist in this episode, it does not detract from his overall loathing of sophistic practices, already discussed above. Conversely, his moral lapse is amply revealed only to be ultimately rejected. The passage in question comes from a setting in which an instructor converses with Galen on Athenaeus of Attalia’s (in Galen’s opinion) paradoxical view that the elements of the medical art are hot, cold, dry and wet, while according to Galen they were fire, water, air and earth. Through the use of sophisms, Galen the protagonist of the episode increasingly infuriates the instructor, making him upset and angry at first and eventually wary of continuing the conversation due to his exasperation. At this point, the readers rightly favour the instructor, who has to suffer Galen’s vain sophistry and thus exclaims:

Galen detracts from his moral character by highlighting the repulsion provoked by his behaviour. Central to this repulsion is the teacher’s referring to Galen’s sophistic practice as an ‘itch’, accentuated by means of the Galenic aside ‘that was the word he used’. The term ‘itch’ is deployed by Galen in Affected Places to encourage readers of the work to act prudently and abandon the irritation they have developed in relation to medical sects, referred to as an itch (Loc. Aff. 3.5, VIII.148.7-10 K.). Likewise, in Natural Faculties sectarian partisanship is said to be harder to heal than any itch (Nat. Fac. 1.8, III.125.15-18 Helmreich = II.34.4-6 K.). Itch therefore is a key term in Galen’s moralising apparatus, being a signifier either of a debased habit or a moral passion of which one cannot easily be cured.Footnote ²⁴

To return to Galen’s impugned moral profile, that is soon restored, once Galen the narrator of the story states that from then on he decided to keep quiet to avoid appearing to quibble (ἐσιώπων ὑπὲρ τοῦ μὴ δοκεῖν ἐρίζειν, Hipp. Elem. 1.6, 110.8-9 De Lacy = 465.1-3 K.). We will see in more detail the philosophical implications of Galen’s tendency to maintain silence in the episodes in Prognosis in Chapter 8. Here too his silence points to an informed resolution to exercise self-control, a repudiation of his earlier tendency to yield to sophistic loquacity and argumentative acrobatics, in favour of calibrated articulation of sound philosophical arguments. Galen teaches moral virtue through narrating formidable incidents of personal moral failing.Footnote ²⁵

The passage just discussed also raises a central issue explored in this book, namely the moral implications of constructing deceitful arguments, which is one of the most pervasive and pointed ethical indictments we find in the whole of Galen’s oeuvre. In one of the most illuminating descriptions of it, in Natural Faculties, Galen likens scheming physicians who cobble together shamelessly fallacious arguments (ἀναίσχυντα σοφίσματα) with the Daoi and the Getae, the stock slaves in Menander’s comedies who excel in cheating their masters.Footnote ²⁶ More exactly, by framing sophisms as no better than the devious antics of an illiterate, socially inferior and morally corrupt group, Galen separates it from loftier endeavours such as medicine and makes it an unacceptable form of conduct for his culturally and socially superior readers.

It has been argued above that, in order to uncover the extremity of vice in other people, and by extension invite readers to abstain from it, Galen strategically declares that he is compelled to resort to forms of conduct uncharacteristic of his true self.Footnote ²⁷ An extended instance of this features in the Doctrines of Hippocrates and Plato, in a setting in which Galen takes umbrage at Chrysippus (ca. 280–207 BC) for making use of invalid proofs in his psychological theories:

A number of points emerge from this passage. First, in terms of narrative technique, the section is thoughtfully heralded as a digression, so that it immediately alerts the reader to the shift from scientific discourse to moral report. This shift is also evinced in the topic under discussion, viz. what Galen here stigmatises as ‘babbling’, an issue conventionally treated by moral philosophers, which substantiates the impression that we are now in the sphere of ethics. Of course, what Galen dismisses as an act of babbling could be a meticulous argument for a loyal Stoic for example; or what Galen has earlier on attacked as pedantry might constitute a crucial piece of conceptual clarification for another intellectual in this period. So his diagnosis of failure here and elsewhere does not represent objective historical reality, but is rather a personal filter through which Galen sketches the modern state of affairs in medicine and society. This filter helps us make sense of the kind of virtues he wishes to parade and the type of moral path he wants to recommend to his readers. That said, his reportage of the modern world might not be a wholly factual one, but it must contain some truth about what was going on around him in some circles or on some occasions. It is not reasonable to accept that Galen was referring to individuals, things or situations to which his readers could not relate either as eye-witnesses or through first-hand experience. These issues are considered in Chapter 7.

Secondly, Galen in the passage quoted above stresses the contaminating effect of associating with babblers to justify how he has been affected by this vice, so that he now babbles himself, contrary to his declared wish elsewhere to remain free from this fault (Hipp. Epid. III, 2.5, 81.23-24 Wenkebach = XVIIA.610.14-15 K.).Footnote ²⁹ His babbling consists in discussing testimonies written by non-experts, especially poets, whom he generally considers most unfitting doctrinal authorities.Footnote ³⁰ This is stated elsewhere too, as, for instance, when Galen discourages his audience from reading Pindar (UP 3.1, 124.7-125.5 Helmreich = III.169.15-171.2 K.) or even Herodotus (AA 3.9, 185.13-15 Garofalo = II.393.7-10 K.) for the purposes of gaining knowledge, relegating the two authors to merely providing enjoyment.

Thirdly, Galen considers Chrysippus’s ‘chattering’ owing to his use of poetic sources a proper subject for criticism, and this is shown by his bold statement that not even Hippocrates or Plato could be deemed adequate authorities unless backed up by proper proof. Chrysippus has overstepped the mark. He has been acting like a feeble-minded old woman,Footnote ³¹ not a true philosopher, and so Galen associates his prattling with other defects, notably envy and contentiousness, but also shamelessness and lack of loftiness of spirit,Footnote ³² in order to dismiss him on moral grounds. Other Chapters in this book will look in more detail into the niceties of such character assassination. But in Doctrines of Hippocrates and Plato Galen often incites his audience to adopt only those philosophical tenets that were advocated by an ethically irreproachable exponent. Philosophical ‘orthodoxy’ is accompanied by moral righteousness. This method seems in a way akin to the Empirics’ belief, as addressed by Galen in The Best Sect, that the comportment (tropos) of the author determines the validity of the observational information (historia) he transmits in his writings.Footnote ³³ The less the author subscribes to love of fame and love of strife, the more probable it is that he is telling the truth. Remarkably, in the same context Galen declares that it falls to the philosopher and not the doctor to judge characters (κρίνειν τὰ ἤθη, Opt. Sect. 14, I.146.10-148.4 K.), which is consistent with his self-projection as a moralist in the passage from Doctrines of Hippocrates and Plato cited above.

We have discussed the kaleidoscope of moral themes and the varying levels of moralism that Galen puts at the disposal of his readers for their ethical edification. We have noted that Galen is adroit at promoting a general sort of moralism (Chapter 1) while at other times he discusses the social aspects of his practical ethics in his physicalist accounts (Chapter 2) or the moral burden of the medical art (Chapter 3). And we have also seen that he deploys a wealth of strategies to that end, such as moralising assault or self-effacement. With this background in mind, we now turn to more detailed analysis of what I consider Galen’s most intriguing moral(ising) texts, which will be explored in self-contained discussions in Part II.