R.J. Hankinson, Saying the Phenomena

7/30/2019 R.J. Hankinson, Saying the Phenomena

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CRITICAL NOTICE

Saying the Phenomena

R.J. HANKINSON

This book' has been an unconscionable time arriving. I first heard tell of it adecade ago as an Oxford undergraduate; rumours of its imminence (in that

geological sense of imminence peculiar to academic publishing) reached mewhile a student in Cambridge a couple of years on; and I saw samizdat pagesfrom some of its parts a little later still (when, I was reliably informed, it was

virtually in the press). And, so I discovered, the saga of the Great Work on

Herophilus had been going on for a good deal longer than that. All that was atleast five years ago - for a while it seemed as though the rest was going to be

silence (although by this time, naturally, the book was turning up in variousbibliographies as 'forthcoming'; usually, infuriatingly, with titles different fromthat under which it finally forthcame).

So, when Heinrich von Staden himself assured me a couple of years ago,while sipping a beer on a Madrid pavement at an unofficial and hence particu-larly pleasant session of a conference on Galen, that the book's debut wasindeed only a matter of months away, it is perhaps understandable that I viewedthis assurance with a certain scepticism.

But it has come out at last: and the wait has been worthwhile. Thisis, quitesimply, a magnificent piece ofwork; ground-breaking and painstaking scholar-

ship combined with judicious interpretation and an enviable knowledge of thevast corpus ofancient medicine to create something which is in the best sense ofthe word definitive. We will not need another edition of Herophilus for a longtime to come.

I

But, sceptics may ask, do we need one now? If so, why? After all, thescholarly world seems to have got along without one for long enough. And who


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was Herophilus anyway? Most Classicists will know that he was a physician who

practised in Alexandria in the third century B.C.; some will perhaps recall

(scandal being intrinsically memorable) that he was alleged to have performed

anatomical experiments on live human beings; but they are unlikely to knowmuch more. Do they need to? Von Staden himself deals with that question, inan appropriately robust fashion, in his Preface:

the first comprehensive presentation of the ancient evidence concerning the extra-ordinary accomplishments of one of the leading scientists of the ancient world

hardly requires an apologia. (p.xi)

Clearly, the validity of that remark rests upon the persuasiveness of the viewthat Herophilus really was a leading scientist, and that his accomplishments

really were extraordinary ones; von Staden's book itself provides the bestpossible vindication for that claim. But ifHerophilus was all that great, howcome the 'comparative neglect' (as the title of one of the rare recent con-tributions to Herophilean studies' has it)? Of course, one major reason is the

simple fact that before von Staden there was no way in which scholars could

study the collected corpus ofHerophilean fragments in anything like a systema-tically tractable fashion. There's a lot of extant Herophilus: but like most

fragmentary authors, it's scattered all over the place; and few of us have the

time, energy, skill, or determination to ferret it out. For Herophilus to take his

proper place in our appreciation ofthe development of science in the Alexand-rian period (those 'five murky centuries between Aristotle and Galen', as vonStaden aptly characterizes them [p.xii]), we need to be able to appreciate the

global contours of his work, rather than merely becoming aware, in a necessari-

ly haphazard and piecemeal fashion, of aspects of its local topography.Werner Jaeger offered the judgement (von Staden quotes it with evident

approval: p.xii) that 'when a critical collection of the extant remains ... of thedoctrines of Praxagoras, Erasistratus, and Herophilus becomes available, the

history of Greek medicine in the period of its greatest scientific progress will

have to be rewritten'.3 Steckerl's edition' of Praxagoras and his school did thetrick for the Coan tradition; von Staden has now given us his magisterial Hero-

philus. We wait only upon a complete Erasistratus (I understand Ivan GarofaloofSiena is engaged on the project - but I have no idea of how far advanced it is)for the picture to be (at least in regard to its principal dramatis personae)complete. For those of us impressed by the need to get to grips with the medical


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tradition in order to form an accurate picture of the currents of later Greek

philosophy (as well as for those simply interested in the history ofscience for itsown sake) these are exciting times.

The second reason for the relative eclipse of Herophilus, one might havethought, would have been the unparalleled ascendancy of Galenic medicine inthe Dark and Middle ages.' For more than a millenium medicine was Galen

(and to a lesser extent Galen's great antecedent Hippocrates); the later compi-lations of such people as Oribasius, Aetius ofAmida, and Paul of Aegina are

really nothing more than Galen ruminantly redigested. It would be no surpriseat all if this almost total ideological stranglehold had throttled whatever rem-nants ofcompeting earlier writers on medicine there were that might otherwisehave survived. And no doubt that ascendancy does go a long way towards

explaining why none of Herophilus's texts survive complete and as such. But, asvon Staden himself notes, Galen's pre-eminence was already being challengedin the renaissance, by the re-emergence after a thousand years' dormancy ofmedical science as an investigative, progressive research programme; given the

retrospective temper of the renaissance as a whole, the usurpation of Galen's

position called for the discovery of some new antique pretender whose claims tothe throne of wisdom could be exalted; and in general the champion of choicewas Herophilus. In the sixteenth century, when the very foundations ofGalenic

physiology were undermined by the discovery of the circulation of the blood, it

was the Alexandrians, with their vaunted expertise in human anatomy andphysiology, to whom the new scientists turned for ancestral support. So what

happened? It seems that Herophilus fell through the temporal crack betweenthe renaissance of interest and the beginning of the modern science of textualestablishment. By the time the scholarly world had developed the tools to

produce a decent collection ofHerophilus, the medical world had lost interestin it, while scholars were pre-occupied with other, and as it seemed more

pressing, commitments.

Finally, of course, one must not underestimate the formidable brake upon

scholarly ambition supplied simply by the scale of the task. It is one thing toremark sagely that the scholarly world would be the better for the appearance ofa proper edition ofsomething or other - it is quite another actually to get startedon the job ofwork oneself.

But what was so great about Herophilus in any case? First ofall, he is creditedwith the discovery of the distinction between and the distinct functions of the

sensory and motor nerves, as well as carrying out the first detailed programmeof neural anatomy. Ifthis attribution is correct (and von Staden argues convin-

cingly that it is: pp.250-1), then this alone would guarantee Herophilus a placeon the scientific roll of honour. What von Staden's work enables us to see (bothin the intelligent and exhaustive arrangement of the material as well as in his


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sage and judicious commentary upon it) is just how much more the Alexandrian

contributed, and how his contributions helped determine the shape of subse-

quent developments in Greek science.

II

Von Staden arranges his material systematically and perspicuously. His In-troduction consists in a brief survey ofpreceding movements in medicine, andof the relation between them (particularly traditional medicine) and the deve-

lopment of Greek medicine in Alexandria from the fourth century B.C. on-wards. After all, Alexandria, although a Greek city, was in Egypt - and Egyptwas the home of a tradition of medical lore and practice which seemed to the

admiring Greeks at least to be of almost unimaginable length and venerability.Surely, one might expect, there would have been some interaction between

them, and Alexandrian medicine should have taken on a distinctive Egyptianflavour?

The answer is disappointing, although in the light of what we now know aboutthe nature of the Greek culture in Ptolemaic Egypt, as well as that of recentstudies of such influences (notably by Geoffrey Lloyd),6 perhaps unsurprising.As von Staden says, 'in the first century of Alexandrian history the Greek

community remained remarkably insulated from the Egyptian population ...a social and cultural pattern that is consistent with modern colonial experience(p.25)'; and, he might have added, with the extraordinary cultural chauvinismof the Greeks. Although Pharaonically organized medicine no doubt persistedoutside the capital, inside it the Greeks ofthe privileged literary and scientificclass assembled there around the Museum and the Library pursued theirresearches in an atmosphere of happy isolation from the profanum vulgus.

Von Staden sketches an account of Egyptian medicine as we know it fromsuch documents as the Edwin Smith papyrus in frequently amusing strokes:take for instance the

Egyptiandoctors' anal fixation:

the pathological preoccupation with the anus that seems to characterize Pharaonicmedicine had consequences for regimen and therapy, and these, too, do not seem tohave made a major impression on Alexandrian medicine. The Egyptians tookloving but very anxious care of the anus, soothing it, washing it, refreshing it,manipulating it to keep it from slipping or twisting - practices which ... are boundto elicit an ethno-psychoanalytic study of Pharaonic Egypt sooner or later. (12)


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No doubt they are; but in default of that we will have to make do with vonStaden's learned references to 'the famous Shepherds of the Anus' (pp. 12-13) .

After this largely negative excursus (negative in the sense that little or no

positive lines ofinfluence are discerned: that ofcourse is a fact of considerablepositive importance in the assessment of the extent to which the Alexandrianswere innovators and pioneers in their fields), von Staden turns, traditionallyenough, to the material dealing with Herophilus's life. This is the first chapter ofPart One of the work, which deals with Herophilus himself;' and it inauguratesthe style of arrangement that von Staden follows throughout. A general essayon the topic (Section A) is followed by a presentation of the fragments themsel-ves (Section B), with a full critical apparatus and an English translation (at leastin the case of those whose originals are Greek and Latin: for the Arabic

tradition von Staden contents himself with printing an English translation),while Section C consists of brief Comments on the texts, generally of ahistorical and a philological nature. The paucity ofour biographical knowledgeis indicated by the fact that von Staden assembles only sixteen texts, some of

very doubtful value, some little more than mere OLd6o)(aLof famous deaddoctors of the type popular in later antiquity. Of the more substantial, philoso-phers will remember the splendid story from Sextus (PH 2 245) about Hero-

philus's encounter with Diodorus' dislocated shoulder:

so when Diodorus dislocated his shoulder once and came to Herophilus for medicaltreatment, Herophilus with charming wit said to him: 'Your shoulder was dis-located either being in the place where it was or being where it was not; but [it wasdislocated] neither where it was nor where it was not; therefore it has not beendislocated.' As a result the sophist implored him to drop such arguments and to

apply instead a suitable treatment based on medicine. (T15, pp.56-7).9

But that anecdote, excellent though it is, tells us nothing genuinely about

Herophilus's history (although it may reflect important features of his me-


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thodology, and I shall consider it in this light later); it is simply part of the

voluminous, mendacious, late Greek biographical tradition; and as such ofverylimited worth.

Equally unhelpful (although equally amusing) is the story of Hagnodice (T8),allegedly the first woman to storm the exclusively male bastions of medicine inAthens by adopting the time-honoured expedient ofdisguising herself as a man

(when indicted for professional malpractice as a result of 'his' dangerously closecontact with female patients, Hagnodice is said to have answered the chargesmost effectively by simply raising her tunic). Hagnodice, in the utterly worth-less testimony of Hyginus, a second-century A.D. fabulist, was a pupil of

Herophilus - and the story took place in Athens. Von Staden writes that

about Herophilus' birth in Chalcedon and his practice in Alexandria' one can besure; but the Athenian setting ofT8 should givesus pause; (p.38)

indeed it should - but pause surely to reflect on the unreliability of late fictions.While no doubt von Staden is right in his cautious judgement that

without more evidence about his life, the possibility that Herophilus at some pointdid practise and teach in Athens, and that an incident during his sojourn therebecome somehow fictionalized into this anecdote, cannot be excluded with absolu-te certainty,

none the less it is quite clear that the story as it stands is preposterous. Hyginusalso credits Hagnodice with the introduction of midwifery to Athens - but asvon Staden himself points out, midwifery was sufficiently established in Plato'stime for him to make his famous metaphorical use of the notion - it hardly stoodin need of Hagnodice to re-invent in three generations later. All that theanecdote unequivocally demonstrates is the fact that Herophilus was an impor-tant enough name in the history ofmedicine for such stories to accrete aroundhim - and the prevalence ofcertain types of literary and historical I6101. The

(presumably unintentionally) amusing dispute as to whether the story properlybelongs to the genre of'discovery literature' or 'exposure literature' (or to somehappy combination of the two, exposure being, after all, a form ofdiscovery)can be properly left to the philologists.

The treatment of this story exhibits the tenor of von Staden's approach to theevidence - in general he is cautious and conservative in analysis, eschewing thewilder flights of interpretative fancy in favour of solid presentation of as muchas we can be sure of. He will indicate areas where speculation is order, even tobe encouraged: but he rarely indulges in it himself. In general, this is all to the


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good in a work of this kind: scholars will trawl their own harvests from its richstocks. Occasionally, however, one would welcome a little more adventurous-ness on von Staden's part, at least in the introductory sections.

A similar circumspection is evident in his canons for inclusion of fragmentsand testimonia, which he details on pp.xvi-xvii: in general, only those textswhich mention Herophilus or his followers by name are included (and even thenvon Staden rightly, if I suppose obviously, insists that mere mention of a name isno guarantee of authenticity). Von Staden justifies his caution (in pointedcontrast with von Arnim's exuberant inclusiveness in SVI by the claim that'what is lacking at present is, after all, a conservative presentation of the

primary evidence on which any subsequent analysis of derivative ... passages... will have to be based' (p.xvi); and that is no doubt true. But, I think, any

honest examiner of the evidence would have to admit that there are some caseswhere, name or no name, the 'testimonium' really bears no testimony whatso-ever- and, regrettably perhaps, the Hagnodice story falls into that category. Ofcourse, only the most carping and curmudgeonly of critics would see that as areason for the omission of such a fine fable.

III

By far thelongest chapters (each

runs to over 100pages)

are those devoted to

Anatomy (VI), and to Physiology and Pathology (VII). These contain a wealthof interesting detail, and the Introductions to each are magisterial surveys andassessments of how much we can ascribe to Herophilus and with what confiden-ce. Here again von Staden adopts a circumspect attitude, frequently takingissue with what he sees to be the overly optimistic constructs of other historians.Fridolf Kudlien and Werner Jaeger crop up regularly in these contexts - butwhen von Staden disagrees with them, he inevitably does so courteously andwith grace, taking great care to accord other scholars the respect they deserve -in this

regard,his

stylecould well be emulated

bysome of our more bilious

colleagues. What emerges even from this conservative presentation is Herop-hilus's enormous innovativeness and importance, in particular in human an-

atomy (especially that of the nervous system) and pulse-lore.Of course it will not be forgotten that, ifthe tradition in Celsus and elsewhere

is right, some of these advances were won by means that one might at bestdescribe as ethically dubious: dissection of live human beings. The veracity ofthe image of Herophilus the vivisector has often been questioned, but, as

Geoffrey Lloyd has remarked," not on very good grounds. Von Staden's

presentation of the material enables us to see just how strong the case is forHerophilus at least having dissected human corpses, which itself constitutes a

remarkable, aberrant relaxation of the powerful Greek taboo upon interferingwith the dead (the taboo is of course by no means exclusively Greek; such


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superstitions bedevilled the progress of science at least at late as the last

century, as the story of Burke and Hare reminds us - indeed they survive even

now, albeit in an etiolated form). The claims of sceptics that Herophilus could

not have made some ofthe egregious mistakes he apparently did make were hefamiliar with human anatomy have been exaggerated (although his apparentbelief in the existence of a human rete mirabile at least renders questionable theextent of his experience of detailed human anatomy: Galen, De Usu Pulsuum,V 155 Kiihn, = T121: von Staden discusses this text on p. 179) ; and the eviden-

ce, coming as it does in part at least from non-hostile sources (Celsus, Galen),seems unequivocal).

As regards vivisection, by far the most important source (although not the

only one: here again it is a huge benefit to have all the available testimony at

one's fingertips) is the Proem to Celsus' de Medicina (23-6, = T63a), writtensome time in the first century A.D. Opinion is divided as to whether Celsus wasa practising doctor, or simply an intelligent lay encyclopaedist - but no onedoubts his general seriousness and reliability. One needs to have powerfulreasons, then, for rejecting this testimony, coming as it does in the heart ofCelsus's discussion of general methodology, reasons stronger than a simpledisinclination to believe in the wickedness ofscientific heroes, a temperamentalresistance to the assimilation of Herophilus to Josef Mengele. Particularlynoteworthy is the cool, dispassionate way in which Celsus reports the debate

between Dogmatists and Empiricists as to the scientific value (and ethicalacceptability) ofsuch procedures. This is no piece ofpolemical scandal-monge-ring. It is the sober report of someone deeply concerned about an issue offundamental scientific (and no doubt ethical) importance; that the terms inwhich the issues are reported may seem to us inhumane, wicked even, is ofno

import whatsoever (although Celsus reports an interesting utilitarian justifica-tion for such practices: one guilty man's death may save many innocent lives;and the victims were condemned criminals who could hardly expect a much

pleasanter fate in any case). To employ the standards ofcontemporary moralityto condemn the behaviour of an alien age is at best anachronism; to use thosestandards to argue a priori that no self-respecting and respectable scientistcould have violated them is the worst type of Whiggishness (even were there

any reason to think that Herophilus was in this sense 'respectable'; which thereis not): bad men are not, pace Galen, necessarily bad scientists.

While some of the sources are undoubtedly hostile (they are early Christian,and hence implacably and indiscriminately opposed to all pagan science, goodor bad, ethically acceptable or morally repellent), von Staden rightly notes thatwhat strikes one is the

degreeto which, on all

important pointsoffact,

theyare

in agreement with Celsus and Galen.

However, readers of Phronesis will no doubt be principally (although ofcourse not exclusively) exercised by the question of what importance Herop-hilus has for the history of philosophy. It will, then, be to chapters IV and V,


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'The Parts of the Art ofMedicine' and 'Theory of Method and Cause', that theywill chiefly turn.

IV

Chapter IV presents reports of Herophilus' views on the question ofjust how

many 'parts' there are to medical science, and how they relate to one another.This type of concern is by no means confined to Herophilus - it is part of the

ubiquitous tendency ofantiquity (and in particular of the increasingly scholasticlater antiquity) to classify and categorize, and has its roots in Socratic definitionas well as in Aristotelian taxonomy; as von Staden writes:

Herophilus'division is ... but one ofthe

manytaxonomic endeavours that had

become characteristic of his age. (p.90)

Sometimes (particularly in the hands oflater writers) these disputes take on anair ofnumbing sterility: why should it much matter, one wonders, whether (asthe title of a text of Galen asks) health is a matter for medicine or for gym-nastics ? Such questions would seem to be of interest only to the type ofpersonwho used to write union rule-books. 13Nevertheless, these questions can involvematters of substance, both theoretical and practical - in medicine, perhaps themost important example is the Empiricists' exclusion of alliohoyia from the

canons of medical science.Herophilus defined medicine as

'the knowledge of (1) things relating to health, (2) things relating todisease, and (3) "neutral" things'; (Fr 43; cf T42, which preserves the samedefinition [with 3U


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related to disease' is 'knowledge of whatever disrupts or destroys the healthyharmony of the body and causes dysfunctions' (p.91). T42 (from the pseudo-Galenic Introductio) says that 'all the remedies applied in diseases and their

material are "neutral"'; and von Staden takes this to mean that the neutral class'includes not only pharmacology..., but also surgery, and to the extent that itis used for therapeutic purposes, dietetics' (p.92). That is, von Staden sees

Herophilus's division as subsuming the the more traditional divisions in termsof medical branches (although he admits that there will be some cases of

overlap: p.91) under his own tripartite taxonomy.I am not so sure. The evidence is extremely sketchy: and it is frequently

unclear what is supposed to be Herophilus's own position and what that of hislater followers and interpreters. T45 (from Galen's Subfiguratio Empirica 5,

pp.52-3 Deichgraber) is a case in point:there are others who say (i) that these (i.e. semiotics, prognosis, therapeutics, andhygiene) are the subdivisions of medical science as a whole, but that these comeabout through a division of its 'neutral parts' which they want to be threefold -bodies, causes, and signs - and separate from the 'healthy' and the 'diseased'. (ii)Herophilus too used to make this [kind of] assumption, saying that the whole ofmedical science consists of'health-related', 'neutral', and 'disease-related' things.(iii) But the 'neutrals' are also [to be found] both among signs and causes [thus vonStaden; perhaps better: 'there are neutrals among both signs and causes as well'].

(p.110)What are the relations between the separate sections of this testimonium (Ihave added the numbers for clarity)? Is (i) to be attributed, at least in part, to

Herophilus? Is (iii) a continuation of the Herophilean testimony, or an objec-tion to it? Von Staden discusses this in Section C (p.113), noting that Deich-

graber held that (i) was Herophilean, and that Herophilus had 'introduced thedistinction between body, cause, and sign which I characterized above

[pp. 104-8] as part of a later Herophilean elaboration

However, we will return to the specific question of whether Herophilusoriginated (or adumbrated) the body-cause-sign tripartition a little later on (it


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later becomes, in one guise or another, canonical - Galen employs it himself,although with the additional category of activities [vEgyEiai] in de MethodoMedendi [MM] X 63-5K).

Von Staden writes:

Herophilus' definition of medicine is ... striking for two major innovations...:introduction of a third element into what had been primarily antithetical divisions, 15and the subsumption of all therapeutic measures and tools under the neutrals.(p.100)

The third element is perhaps of the most intrinsic interest. First of all, it has

suggested a connection with the Stoic taxonomy of things as good, bad, andneither (SVF III 117).16 Von Staden examines the Stoic parallel in some detail

(pp.92-8), and concludes that

despite these differences," the analogies and correspondences between the Stoicand Herophilean divisions remain striking, even to the point that both includeternary subdivisions of their 'neutrals'. (p.94)

But the fact that both the Stoics and Herophilus divide things into three, andsubdivide their third category three ways as well is of little interest unless thereis some community ofpurpose or content about the divisions - and that seems tobe utterly lacking. T44 gives us Herophilus' 'ternary subdivision':

some things are neutral (a) through equal participation in both of their extremes,some (b) through participation in neither, and some (c) through participation nowin this, now in that. (p. 109)

Patently this has nothing whatever to do with the Stoic partition of the indiffe-rents into those productive of attraction, those productive of repulsion, andthose productive of neither (SVF III 121), or those 'preferred', those 'dis-

preferred', and those neither (SVF III 124, 128).18The Stoic position is more

complex (and more interesting) than I think von Staden gives it credit for: for

something to be a 'preferred indifferent' is not for it to be on the way to being agood, but not quite making it there - it is something categorially quite distinct


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either from goodness or badness (which are purely internal moral characteris-

tics, and quite independent ofexternal goods), although it can still have 'what

Antipater called "selective value" (Miia (Stobaeus, Ecl. II 83, =

SVF III 124).If that is right, then there is no real reason for thinking that there is anythingother than an adventitious connection between the Stoic and Herophileancategories; it is not, after all, a particularly impressive logical feat to come upwith the idea of neutrality or intermediacy (Aristotle's concept of contrarietydoes all the formal work necessary - but of course it is a perfectly commonplaceinformal notion); and in any case, as von Staden himself notes, there are plentyof earlier examples of such divisions in Plato and Aristotle (p.97).19 And if allthat is correct, then the debate as to whether the Stoics derived their classifica-

tion from Herophilus or vice versa is sterile; von Staden is right to question thegeneral orthodoxy which has Herophilus getting the idea of tripartition fromthe Stoics - but that's about all we can usefully say. Here is a disappointing (andrelatively rare) case in which, surface consonances apart, there is no reason atall to postulate an intellectually significant rapport between the development of

philosophy and medicine in the Greek world.Let us return to the content of the Herophilean division. First ofall, is it right

to assume, with von Staden, that 'knowledge of things related to health'amounts to anatomy and physiology? There is, as we have seen, frustratingly

little to go on; yet it seems to me that the most natural way of reading theHerophilean distinction is such that it would cut across such categories; 'know-

ledge of things related to health and to disease' would involve knowing, for

example, how the liver ought to function, and hence when it wasn't doing it

properly; how the knee ligaments should be arranged, and hence when they are

disordered; which sorts ofmushrooms are nutritious and which poisonous - andso on. Hence the division into bodies, causes, and signs (ifit is Herophilean: andI shall argue later that it may well be) should also cut across the basic tri-

chotomy. Admittedly this is difficult at first sight to square with T45; but it does

not seem to me that that text has to be read in such a way as to make bodies,causes, and signs exclusively a subset of the neutral category (although it is

clearly more natural to take it thus): the text is compatible with there being athreefold division not merely among the neutrals into body, cause, and sign, butalso among the healthy and the diseased.

The reason for including materia medica among the neutrals is presumablythat (as the Platonic commonplace of the Phaedrus has it) cpaQ?xa are both

drugs and poisons: poisons to the healthy, drugs to the diseased (at least in some

circumstances, and certain quantities: modern examples are strychnine and


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warfarin); and the strength (sometimes even the type) ofmedicament requiredwill vary from case to case according to the constitutional peculiarities of thesufferer. Whether they are to be considered neutral (a), neutral (b) or neutral

(c) will no doubt depend on the type of medicament in question, as well as onthe circumstances of the classification. Take the rose-oil (6bwov) of T44 for

example: elsewhere in the work from which T44 is excerpted,2 Galen describes

6bwov (strictly a mixture of rose-extract and olive oil) as being of a

xgiaig (SMT XI 561), neither Hot nor Cold;21and whether its virtue is to warmor chill will depend on the condition of the patient (in general it is a mild

refrigerant): thus, in regard to its effects, it is neutral (c) - as far as itsconstitution goes, it is neutral (b); and it is easy to see what might count as

constitutionally neutral (a) (any number of complex drugs will fall into this

category).It might be objected that this extends the range of the healthy-unhealthy-neutral classification over too wide an area for it to be of any taxonomic use -but we know (from T48: p . I I I )that Herophilus applied the term 'neutral' to the

physical condition of the elderly in good health. Von Staden comments:

here neutral is not applied to the third main subdivision ofmedicine, comprising allremedial measures..., but to a condition of the body. Neutrals qua remedies ...are clearly different in kind from neutrals qua physical conditons of the body.(p.114)

So they are - but this need not seem surprising or aberrant if we adopt the viewthat the term 'neutral' for Herophilus never has the sense of 'remedial measure',

although it will on occasion refer to it.So what about the bodies-causes-signs distinction? Von Staden notes that

the elaborate amplification ofHerophilus' basic tripartite division in Ars Medica I(I, has been attributed to Herophilus by several scholars - includingHermann Schone, Karl Deichgraber, and Manfred Fuhrmann - but following theprinciple ofseverity developed above (pp. xvi-xvii [see above, p.200], it has not

been included among the testimonia in this edition, because Galen fails to mentionHerophilus by name. (p. 103)


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However, von Staden prints a translation of the entire section of text on

pp.103-4 'to allow readers to judge for themselves'; and the crucial sentenceoccurs almost immediately after the unattributed but indubitably Herophilean

definition of medical science which opens the passage (it is identical with thoseof T42-6) :

'healthy', 'diseased', and 'neutral' each is predicated in three ways: as body, ascause, and symptom. For that which is capable ofreceivinghealth is the body, whilethat which produces and preserves health is itscause, and that which is indicative ofit, its symptom; all these things the Greeks call 'health -related'. (p. 103)

The last clause has a typically Galenic ring to it, and may be Galen's own gloss;but the rest of the quotation has an unmistakeably Aristotelian sound. An

antecedent with striking verbal echoes is to be found at Met. r 2, 1003a34ff:Aristotle, using the same language Galen does, discovers four senses of theword 'healthy': receptive, productive, preservative, and indicative of health.

My suggestion is that Herophilus took over from Aristotle the four-fold divisionof senses of 'healthy', and mapped them onto the three subdivisions, which arenot themselves Aristotelian. What evidence is there for ascribing this division to

Herophilus? I propose to approach that question obliquely, by way of issues inthe fifth chapter: 'Theory of Method and Cause'.

V

Fridolf Kudlien once remarked that Herophilus 'can lay claim to a place ofhonour in the history of medical scepticism'. 13 That judgement appears to beborne out by a puzzling text of Galen's De Causis Procatarcticis (CP)24 XVI197-204 (pp.53-5 Bardong: = T59a);25 von Staden takes issue with that assess-ment. Herophilus is standardly enrolled among the Rationalist or Dogmatistdoctors by the taxonomists of later antiquity,26 and they are paradigmaticallydistinguished from the Empiricists (and later the Methodists) by their pro-


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foundly anti-sceptical insistence that the hidden, underlying conditions of the

body that are causally responsible for the surface manifestations of health anddisease are discoverable on the basis of rational investigation. Serapion, a pupil

of Herophilus, was an Empiricist (indeed, he founded the school): but that initself tells us nothing about Herophilus's own position. Although it is temptingto hypothesize about the possible course of Serapion's intellectual develop-ment, and the possible influence of Herophilus's views on method upon it, sucha hypothesis must necessarily, given the exiguousness of the sources, be specu-lative, and almost completely without foundation.

Herophilus insisted, in good Rationalist style, that there are four faculties

(buv6[iEtg) that regulate living creatures (T131; cf. T57), and apparentlytalked also of a 'vital faculty' (T164); this is not language of a sceptic of any

colouring. Nevertheless, he was no mere arm-chair Rationalist, of the sort laterto suffer Galen's splendid scorn, 27on the contrary, he exalted the importance of

experience and observation (T52-4). This may be taken to suggest some sense inwhich Herophilus may legitimately be regarded as a fore-runner of medical

Empiricism; but it seems likely to be evidence rather of his following Aristotle'sexhortations (particularly in the first book of De Partibus Animalium) to getyour hands dirty in the pursuit ofscientific truth.

So where is the scepticism? At CP XIII 162-4 (pp.41-2 Bardong), Galenwrites:

some people say that nothing exists as a cause ofanything, while others, like theEmpiricists, dispute whether or not there is a cause, and still others, like Hero-

philus, accept it on a suppositional basis [ex suppositione: i.e. ei; andothers again - whoseleader he [sc.Erasistratus]> was - rej ected ,among the causes,the antecedent ... causes as not very plausible. (T58)

Once the proper referent ofthe 'he' in 'whose leader he was' is determined (seen.28), there is not the slightest reason to ascribe to Herophilus or his followers

any doubts about antecedent because on the basis of this passage.29 To accept a


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cause i; vno6Q?wS is not to subscribe to a generalized doubt about theexistence of causes as such (call that GD); rather it is an expression ofepistemicuncertainty as to whether for any particular candidate for causal status we can

be sure in this precise case that it is in fact the cause (label that EU). Causes areby their nature indemonstrable; but that doesn't make Herophilus anything likea Pyrrhonian. On these latter points von Staden (pp. 119-20) is both good, andclear (although his suggestion that Herophilus's notion of causes bio0aEwgmay be connected with Aristotle's notion ofhypothetical necessity seems to meto be misleading and unhelpful). 30

But what should we make of the extraordinary T59a? Here Galen firstaccuses Herophilus of not having the courage of his convictions: having 'ex-

pressed doubt about every cause with many strong arguments, he is himself

subsequently detected using them, by saying "it appears this way to all peop-le"'. Galen's criticisms are, I think, misdirected (even if you have no goodreason for accepting p, and no good reason for accepting q, you may well have a

good reason for accepting the disjunction p or q); but what he reports of

Herophilus's position is as important as it is puzzling.

What then does Herophilus say? 'Whether or not cause exists, is by nature undisco-verable, but it is through a supposition that I think I am being chilled, heated, andbeing repleted with food and drink.' (T59a; p.131)

I give von Staden's translation; but it may be misleading.31 It gives the im-

pression that Herophilus subscribed to GD; however the Latin (see n.31) is


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compatible with the weaker claim ofEU, and it seems at first blush preferableto take it as such. We should perhaps supply instrumental ablatives (e.g. 'by the

wind', 'by the sun') for 'chilled' and 'heated' to put them on all fours with the

repletion example; thus Herophilus is not claiming that there is any doubt thathe is being chilled, heated, etc., for a purely phenomenal construal of those

predicates; rather, what is at issue is whether or not the sun (or whatever) is

responsible for it. That, I think, is a perfectly coherent (moderately soph-isticated, even) attitude to take to the business of causal ascription, and re-

presents an advance on the theories ofscience of Aristotle. It is perhaps not toofanciful to see it as the first adumbration of the Duhem-Quine thesis of theunder-determination oftheory by data - and it certainly anticipates the modesof Aenesidemus against the aetiologists (Sextus, PH 1 180-5) , in particular the

second mode.However, if the first section of T59a can be read as an assertion ofEU rather

than GD, later parts are less easily tractable. Here, it seems, Herophilus (ifGalen's testimony is to be trusted; and there is no obvious reason why it shouldnot be) really is arguing for the genuinely sceptical position. Galen retails three

arguments, all similar in style; the first is typical, and it runs as follows:

(1) if there are causes, then either (a) bodies cause bodies, or (b) incorporealscause incorporeals, or (c) bodies cause incorporeals, or (d) incorporeals cause

bodies;but

(2) neither (a), nor (b), nor (c), nor (d);

so

(3) there are no causes.32

Two things stand out: first the paradigmatically Pyrrhonian form of the argu-

ment ;and

secondlyits

Pyrrhoniancast. Of course the

disjunctiveform of modus

tollens is not proprietory to Pyrrhonism; but the conclusion seems unexception-ably sceptical, an impression which is confirmed a little later on: 'he drew theinference that nothing is the cause of anything.'33

The arguments against causes sketched here on Herophilus' behalf are to befound in fuller, but precisely parallel, form in Sextus (M 9 210-36), and althoughthey are not attributed to anybody (much less Herophilus), it is usually assumedthat their presentation in this form is owed to Aenesidemus's systematization of


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Pyrrhonism in the first century B.C., upon whom Sextus certainly drew heavily.But we know very little about Aenesidemus apart from what Sextus tellsand hence any such attribution is inherently fragile.

In fact, a useful parallel is provided by Diodorus Cronus. Consider again T15(p. 198 above); Herophilus is portrayed as mocking Diodorus's own style of

argument against motion (that it was indeed Diodoran is confirmed by M 10As I remarked above, T15 is worthless history - but the story would be

more pointed if the style ofargument were appropriate not merely to Diodorus,but to Herophilus as well; and that is precisely what the three arguments of T59a

suggest. Hence we may tentatively conclude that Herophilus did indeed advan-ce arguments of this form - and that he was known for it. The unknown sourceof the story of T15 considered Diodorus and Herophilus to be two of a kind.

But the question still remains: what are we to do about the Pyrrhonian cast ofT59a? Von Staden simply notes that this

fragment ... must again be understood in the context of Herophilus' causalhypotheticalism. Proof of the existence of any particular cause, i.e. that a isdemonstrably and indubitably the cause of x, is indeed impossible in Herophilus'view; but Galen suppresses Herophilus' further conclusion: that cause can there-fore only be stated ex hypothesi. (p.l37)

But T59a appears to assert far more than that. Of course it does entail the

impossibility of the 'proof ofany particular cause' - but only because it entails agreat deal more. An attack on the very coherence of our causal concepts cannot

readily be squared with an undogmatic acceptance ofcauses on a hypotheticalbasis. The ghost of a sceptical Herophilus is not to be laid so easily.

Indeed, matters are further complicated by the fact that it isn't clear what the

Pyrrhonians themselves really thought they were doubting - and much scholar-

ly ingenuity has been devoted in recent years to delimiting the scope and targetsof Pyrrhonian scepticism. Is Sextus, in Jonathan Barnes' felicitous image, a'sober sceptic', concerned only to cast doubt on the the overblown theoretical

pretensions of the Dogmatist scientist ('the non-evident objects of scientificinquiry': PH 1 1 3 ? )Or is he rather 'drunken', doubting even the deliverances ofcommon-sense? The first picture has been endorsed by Michael Frede,36 the


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second by Myles Burnyeat;37 Jonathan Barnes himself points out that both

types ofscepticism are to be discerned in Sextus's texts.38 Ifit turns out that the

Pyrrhonists themselves are surprisingly sober, then the gap between methodo-

logical caution of the type clearly and uncontroversially exemplified by Herop-hilus, and Pyrrhonian scepticism will be closed from the other direction.

One possible solution to the apparent mismatch between T59a and the otherevidence is to adopt the genetic approach: Herophilus at one time leanedtowards a generalized scepticism concerning causes; at another (later?) date heelaborated a more sophisticated 'causal hypotheticalism'. But there is no evi-dence for this (apart from dissonance of the texts) - and such explanations are in

any case philosophically boring. We owe it to ourselves at least to search for amore interesting interpretation.

One way one might go about this is suggested by a consideration ofPyrrho-nian methodology. It has long been noted that, in many cases, the argumentsadvanced by Pyrrhonian sceptics in support ofsome relatively mild conclusion

actually, if they are successful, destroy far more than their ostensible targets.The Pyrrhonians themselves seem quite unperturbed by this apparent mis-match ofadversary and weaponry - and it needs to be borne constantly in mindthat a stretch of Pyrrhonian argument against some proposition p ('there are

causes', let us say) is invariably but a part of a two-pronged assault, which willinclude an attack on not.p as well: the desired conclusion is

suspensionofjudgement with respect both top and to its negation.Hence from a Pyrrhonian standpoint, it might well not matter whether or not

Herophilus's arguments actually purported to establish more than they wereintended to - their intention being simply to offer reasons why an uncritical

acceptance of causal claims is to be avoided. From a philosophical point ofview,such a position is in many respects perhaps unsatisfactory - but its sheerunsatisfactoriness is not in itself a reason for not ascribing it (or some analogueofit) to Herophilus. There is perhaps an analogy to be found in the criteria for

proof employed in certian legal systems, in which the degreeof

probability ofthe proposition attested is taken to be directly proportional to the quantity of

testimony brought in its favour.If that is right (and it's admittedly pretty tentative), then it turns out that the

connections between Herophilus and the sceptical tradition are tighter than vonStaden allows, although not tight enough tojustify Kudlien's enrollment ofhiminto the sceptical Hall of Fame; and the connections are methodological, andnot doctrinal (iftalk ofdoctrine in sceptical contexts is not merely oxymoronic).


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VI

Finally, I want to consider what is perhaps the best-known of Herophilus's

methodological pronouncements, and to see how it is to be squared with whatwe have already discovered.In the so-called Iatrica Menonia 21.18-32, preserved in P.Londinensis 137

(Anonymus Londinensis), the author contrasts the attitudes of Herophilus andErasistratus to the business ofdiscerning which parts of the body are simple andwhich compound: according to the author, the latter held that the real, or

primary, bodies are intelligible to the reason, and not perceptible to the

senses ;39Herophilus, by contrast, is alleged to have held that the primary bodiesare those which the senses perceive. This may be a misleading account - but

what matters is the dictum ofHerophilus which the author quotes in support ofit:

Eyo8w8? ia ?paw6pEva npwza, xal l ur) Eon jto&ia(Fr.50a; Suppl.Arist. III.I, pp.37-8 Diels)

Galen clearly alludes to the same slogan at MM X 107K, when he writes:

Someone praised Herophilus in this context, when he said the following in thesevery words: 'let these things' be first, even if they are not first'." (T50b: mytranslation)

These are differences in the Greek, even though both purport to give ipsissimaverba (such differences are not ofcourse uncommon); and 50a presents particu-lar problems of interpretation. Von Staden translates: 'let the appearances bedescribed first even ifthey are not primary', explicitly taking in diffe-rent senses in each occurrence, although he allows in his Commentary (p. 134)that 'let appearances be described as [or: called) primary things even ifthey arenot primary' is a possible translation; AEya8wmight be translated 'stated', or

perhaps even 'enumerated'; and finally there is the question of whether the

difference between T50a and 'r50b is significant.Von Staden rightly draws attention to the similarity between T50 and aspectsof Aristotle's methodology:

'

In his biological treatises, Aristotle frequently sounds the refrain 'first the phaino-mena, then the causes or principles'. Thus ... at the beginningof his On the Parts of


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Animals [1 1, 639b3ff.; cf. 640al4-151,Aristotle asks whether the natural scientistshould first consider the phainomena, and only subsequently treat causes andreasons. His answer is an unqualified 'yes'. (p.118)

Von Staden takes Herophilus to agree with Aristotle on the first point ('(FaLv6-pEva first'), but to replace the second with a simple note of caution:

Herophilus does not deny the importance of causal explanation for theory forma-tion, but he is not as sanguine as Aristotle about attaining knowledge ofcauses.(p.119)

This might be right; certainly however we are to read Fr.50, it leaves open the

possibility that there's more to the world than simply the ?paw6pEva. VonStaden sees in the fragment a deliberate reminiscence of the Aristotelian viewthat in science we begin from the things more familiar to us;4z that is to say,'saying them first' is to be taken literally - they are the first stage on the route to

knowledge. But this reading demands that the two JtQrta's be taken in differentsenses - of course they can have such different senses, but for them to do sowithin the compass of a single sentence without explicit explanation seems tome to be improbably harsh. The alternative, which von Staden mentions in the

Commentary, seems then to me to be more likely. But that gives the passage amore sceptical slant: we should treat (paLVOLLEvaas being primary, even though

they mayturn out not to be. That rider is of course

quite compatiblewith a

Pyrrhonist view; how weak a concession it is depends partly on whether we readIxai EL;with Anon.Lond. (strong), or 'EL xai' with Galen (weak); and it isstill unclear whether 'primary' is to have a metaphysical sense (which would

give the dictum a more sceptical slant), or an epistemic one (which would makeit less so).

Von Staden, then, adduces Aristotelian parallels and antecedents for the

puzzling maxim; but oddly he does not draw attention to the famous remark of

Anaxagoras (echoed approvingly by Democritus: Sextus, M 7 139) that

the


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that is the sense in which, according to T52, 'he makes experienceall-important'.

If this is right, then at the very least one may say that the 'body-cause-sign'

tripartition (see above, p.203) is extremely well suited to Herophilus' epistemo-logical and methodological position: if he did not invent it, then someone elsewould have had to do so for him, and I see little reason not to ascribe it to him

provisionally on this basis; and if that is right much of the long passage fromGalen's Ars Medica I 307-9K (see above, pp.206-7) should, after all, be ad-mitted to the Herophilian testimonia. The place of 'body' needs no justifica-tion ; the 'signs' are the (paLv6ueva from whch medical theory takes its start; andthe 'causes' are the hidden entities, the deep internal conditions, to which thetheorist infers on their basis. Such inferences, and this is Herophilus's great

innovation, are inherently and irremediably fragile - they are always, of theirvery nature, open to refutation and revision in the light of further experience.Herophilus, then, turns out to be a sort ofproto-Popperian. That does not, of

course, make him in any sense (apart perhaps from a methodological one) a

sceptic. It does, however, make him a great scientist and theorist of science.Thus the anatomists of the renaissance were just in their assessment and

justified in their approbation of the great Alexandrian. And that, of course,gloriously justifies von Staden's work. I have dealt with only a small amount ofthe material now made readily available, and I have treated even of that in a

modest and superficial manner. Given these newly accessible riches, one maylook forward to a new and fecund period in Alexandrian studies. For havingmade this possible, Heinrich von Staden deserves the cheers of the whole ofthe

scholarly world. 45

University of Texas at Austin

Documents

R.J. Hankinson, Saying the Phenomena