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    Alexander of Aphrodisias On Medicine As A Stochastic Art

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    © All Rights Reserved
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    Buatiocrarne Black, M. (1962), Model: and Aetaphors,Ihaca = Landes Dvschmann, AG (1948), Kieubi, Phil and Heron A Say ex Ancient Preumatics Copenhaget erat A. (1984). Meccanicaalagat dans tena ellensica, Nesples, 224-296 Fra PAL (1992), Paloma Aexondna, 3 vas. Oxford Farley: B Ju Willis )'S (1984), Galen on Reparation andthe deers Princeton Garofalo, 1 988), Brera fragmenta, Pisa Hann CIS. (1973). The Hunt and the Vacar Sytem on Ancient Greck Medizin, Oxford Hesse, MB. (1970), Madelr and Analogs en Scene, Note Dame Lone, 1M, (1973), The paradowseal txt On che Heart’, Medial Hutoy 17, 115: 6153 Marlen. EW. (1968) Geb and Roman Arter, Oxford Repel L(1988), Le mater Canima, Sage Sieane di Lamprace. Torino Schurmana.A. (1991), Grechiche Mechamik und Antke Wisenchaf, Store Sraden-H von (197S)"Expesiment and Experience in eleniic Medicine, Bullen fhe Inu of Cannel Srudies22, 78-199 2989), Hevophla The eof Medicine Early Alenandi, Camibsidge Vallance, 1 (1990), The lest Theory of Arlepider of Biya, Oxford eget M, (19933), Lnere del! aia’, dans} ollesch,D. Nickel (€d) Galen und “ds hello Erbe. Vhanlungen des iV Tnrernationalen Calen-Syrmposiams (Suh Arch, Bele 32), Seatgaet, 63-77 (19930). Ta spec la pratic: a wolutoneepistemologicsincompiuta della Tedicina lenses dans: NLD. Guaek 6), Sora dl pensero medic ocidenta Te Val. Rome ~ Bar, 73-120 Viano, CA, (1988), Teche non cera sangue nelle atria cei epistemologica ‘del anatomiatiantchi, dans: G. Giannantoni, M. Veger (dl), a cena ele mutica, Nesples, 297-352 anton .M. Veet La 5 Secio Cottornt so Aweieet Medicine Content (ads, Pho vender Eye A ot), J Vel, Anasterdaue IAS an Alexander of Aphrodisias on medicine as a stochastic art KATERINA IERODIA Summary Medical pracce in aniguty war conspicuous for it flues, which seriouly challenged medicines status a6 an art. Anciene philosophers and doctors ted to explain how a whale group af arts including medicine, the Sorelle sockasie arts, was characterised by the fc that even the most co Detent exercise ofthe art could aot putrantee 3 succesfl outcome, Thin paper Focuses on Alerander of Aphrodisia’ (send ceneury AD) explanavon and compares i to some other ancient views, in patiulr 10 Galen, The central Feature of Alexanders suggestion sa distinction between che end of ana and ite functon, Inthe ete of mediine end and function do nat concie: fos the ‘nd iro heal the pins, wheres the function consists Solely in doing aellly what posnble re atan the nd TThe recognition of the fcr that medical practice does not always acain the expected results gives tse co vigorous debates among philosophers.nd doctors theoughout antiquity. For medicine may be considered generally a an art of reat usefulness, but it nevertheless isthe care that medical knowledge, how: ever perfect it may be, fils co yield an ordered ser of infallible and precise statements, This approximate and unreliable character of medical knowledge becomes so alarming that ic even challenges medicine's satus as an art; in face it is enactly such doubts chat gradually lead to the conception of medicine as fan art which is confined to only aim at its ulimate, but often unachieved goals, Especially, in the second century AD, both Alexander of Apheodisias and Galen repeatedly castify medicine asa ‘Stochastic at’ (stachaké rechnd) land the relevant comments dispersed in their writings reveal the intiguing complexities and ramifications of the subject. ‘The task of my paper isco present only part of this later history of the discussion about medicine asa stochastic art! In particular, [shal try r0 re construct Alexanders attempt co explain medicine’ failures without calling into question its status as an arc at che same time, J shall comment on the {am most grateful 19, Allen, J Banes, A. Debru, GER. Lloyd. and R.W Sharples forhis for heir well comments on my fist draft. Alo, woul ikea thane M. Fre sopport inthe cours of weting this paper duting 3 gloomy ad turbulent win For the eal history ofthe challenge tothe satu of medicine 38 7 3 Allen Huschinson (1988) ans signiticane similarities or differences becween Alexander’ views and those ex: pounded by his predecessors and by Galen In his commentary on Aristtle’ Tepes Alexander defines medicine as a stochastic art and distinguishes i¢ ftom the ‘productive arts’ (peisikai techna’).) According to Alexander, medicine, ogether with dialectic, rhetoric, land navigation, belongs to the group of stochastic arts, because it shares with them the following characteristics: | They proceed in a systematic, but not fully determined manner, 2 Their function simply is 0 aim at doing everything possible to achieve their end 2 (a) ‘Their success i not to be judged by the Final outcome. 2b) ‘The failure is du tothe nacure ofthe ar itself. which is such that igs objects ate also influenced by exceral factors, “These chacacteristies are conrasted with the common features of the produc tive arts, such asthe art of building, or thar of weaving, namely: 1 They proceed in a fixed manner. 2 Their function isto aim at reaching their end, 2a) Their success is evaluated by che end product. 2 (b) ‘Ther failure is due solely ro the practitioners faulty performance, Hence, medicine is perceived asa stochastic art, because doctors simply aim at skilfully using their systematic knowledge co cure paienss. But in case the patient dies, the doctor is not to be blamed, if he has used his knowledge hilflly for there always are unpredictable factors which can prevent the cure ofa disease. In other words, the practitioner's performance should be assessed nly by the successful exercise of che function of medicine, namely o do eve- ryehing possible to attain the patients health, and not by the accomplishment tf the end of medicine, which ws the restitution of che patient’ health. It be- comes clear then, that on Alexander’ view what mainly characterises medi tine asa stochastic art, i the fact thac is Function is not to de identified with ins end. Mote generally, the distinction berween stochastic and productive arts seems to rest on the distinction between the function’ (ergon) and the ‘end’ 2 Alevsnder of Aphrodisas Jn rior Topcorum libros, 32.12.34.5 Wallies. 3. The contest berseen stochastic and productive at is doviously not in ine with Aristoiles division ef knowledge into theorevcal, practical and productive {Meraphyiee 1025 b 25). or with hs vcw that very at 6a productive disposition (Eiht Meomachea 1140 4 101. On the other hand, is iceesting co note that the distinction Beeween tochatic and non-stochasic ars can alo be found in Philodemus {Rhetorea 126-68, 1.59.17-19, cf Sextus Empincas, Advenas Mathemancs 2.13). Se ihte ea amas constant sho wth the difference shat the sonestochstc ats dre ere called pagi: 474 (telon of am art that is 0 say in the ease ofthe productive arts the fulfilment of the function guarantees the achievement of their end, whereas inthe case of the stochastic arts there is no such guarantee, Soin order co better understand [Alexanders classification af the arts and his conception of medicine as a stochastic art, one needs to examine more closely che distinction beeween the fend and the function of an art. In particular, ewo interesting issues arise in connection with this distinction: fst, chee is the question of is origins, and second, we need to apprise its significance. To stare with the origin of the distinction berween the end and the function of an ace, we should carefully study another text, usually atsibuted to Alexandes, in which ic is again this particular distinction that constitutes the central crite rion in che classification of ures as stochastic and non-stochastic, That isto sy. in the Quaeitiones Alexander presents owe opposing views on the difference bberween stochastie and non-stochastic ars {i) According to the fis view, both stochastic and non-stochastc art aim tthe achievement ofthis end: however, although inthe case of she hos-stochastc arts a good peeformance guarantees their succes, his is tot guaranteed inthe ease ofthe stochastic ats (i) According ro the secand view, the end stochastic and non-stachastic fre aim at differs: namely, the stochastic ats aim simply at doing feverything possible to achieve eheir end, whereas 1 non-stochastie tim at actualy achieving the end set before them Inaddivion, Alexander himself in the final part ofthis passage suggests a tied possibility as co how one might distinguish between stochastic and non ochastie arcs: According to Alexander’ own view, che end and the function Of the stochastic ats differ in that itis one thing to achieve the end and an: ‘ther thing to do everything possible co achieve che end, whereas in che case of the non-seochastic ars the Function coincides with the end. In other words, [Alexander accepts that the stochastic ars are characterised by the difference siressed inthe second view, between achieving the end and doing everything possible o achieve the end: but he also follows che Fist view to the extent that the insists chacthe stochastic arts aim at she achievement of che end set before them, To identify the advocates of the two views presented by Alexander, as swell as t recognise his own contribution co the subject, we need to bring into the discussion his predecessors doctrines on che end of an art “The Arieotclian text from the Topic, on which Alexander is commenting when he tefrs to the distinetion between stochastic and productive aes, ex 4 lex. Queene 2.16 (p, 61:1-28 Beane 475 hibics certain similavcis with the second view: For Aristotle here is claiming that we should not expect the doctor co cure, oF the cherorician to persuade, by any and every kind of means: i is only within the limits of the possibilities available co the art that i achieves its end, especially if all the possible means ace artfully used, The same ides is expressed in che Rbecortc, where Aristotle declacesthac che end of rhetoric is not acually to convince, but to know the available means of persuasion in each ease Similanly, he points out that medi- cine does not aim at restoring patients to health, but at peoviding them with the proper treatment; so even in the incucable cases in which health is cer- ‘ainly not the final outcome of the application of medicine, the patients are treated as fae as this is possible, Elipical though they may be, these remarks suggest that Aristotle is inclined to postulate both for thetoric and for medi cine an always Feasible and attainable objective, namely doing everything pos sible to achieve che end However, Anstotle never cally elaborates this views on the contrary, there ace some passages in which he clearly commits himself co a diffeene account of the end of rhetoric and of medicine, or more general, of the end of stochastic arts. For example, im Aristotle’s Nicomachean Ethics, ic is explicitly stated that the end of medicine is nothing but to heal, while that of heroic is nothing but ¢o convince.” The general claim made hete is that we do noc deliberate abous the end of an art, but only about what contributes ro its end; for an art always aims ae achieving its ultimate end, Again, in the Magna ‘moralia, Aristotle provides us witha general statement as 0 nis account of the tnd of an art That isto say he claims that an art always aims ac the end, rather than at what contributes co ts end, and any erzors should be ateributed to the choice of che available mans, rather than to the adoption of the final cdi for the end of an are should be seen as kind of principle, towards which everything is directed. Thus, to judge from these passages in che ethical works, Aristotle seems to subscribe w achieving its Final cfirs view, according to which an art aims at snd a8 to the success oF failure ofthe ar, this depends on the performance of its agents To summarise, Aristotle at cimes is aware of the Fact that with a group of| arts among which rhetoric and medicine are included, there isa difference besween the end of the art and its competent exercise. So he is willing ro cake Into consideration the various difficulties inthe specific application of such arts, but tis unelear whether he, because ofthis, would be willing co compro: mise in his specification of their ultimate end Aristotle, Tpit 1018 5-10, & Anite Rcaic 1355 610415. Art. Ethics Ncomaohea 1112.6 11. ‘Art: Mapa movalia 1190 31-28 476 On the other hand, the second view presented by Alexander, which differ ‘entiates the stochastic from the non-stochastc arts on the ground of their different ends, suggests that medicine asa stochastic art does not aim at the attainment of its end, but simply t doing everything posible to achieve it. A Cleat example of an art which does not aim at eeaching its end, but confines itself ro doing everything possible in this tection, is presented in Stoic ethical theory for there is ample evidence to show that, according co the Stois, what ‘matters in the case of virtue at wisdom actually isthe appropriate attempt r0 acain what is natural by means of appropriate actions, buenos the successful sttainment of ie “Thus, in Alexanders On rhe Sou, the Scoies are reported to view the selec- tion of eight things as conttibuting to the end of vireue and to consider the actual attainment of these things as indifferent. Also, in his Lerten, Seneca ‘stcesses the Stoie view thac i isthe selection of the appropriate actions which matters and not whether chese actions succeed." Correspondingly, in Stobacus’ Selection! and in Plucarchs On Conemon Conceptions? is is ce- ported that Diogenes of Babylon defines che end of virtues the rational sele- tion of what is natural, while Antipaterof Tarsus defines i as doing everything, in one’s power to obtain the primaty natural things. Furthermore, in Galen's (On Hippocrateand Plato: Doctrine Posidonius is said ro ctitcise the Stoies for claiming that the end of virtue, namely 0 live in agreement with nature, actually amounts to doing everything possible to obtain the primary things in accordance with nature Finally, che Stoic doctrine of the end of virtue i discussed in rwo passages, which both illustrate it with the example of man aiming with an arrow at a target: the man is pictured as aiming ata target, buc his attempt is said ro be ‘mainly concenteaced on doing everything in his power to aim right; the fact that he may miss his target because, say of a sudden gust of wind, does not call ineo question his mastery of the art of archery. In particular, in Ciceras De fimbus!* and in Plutarch On Common Conception! the end of viscue is pic- tuted as che corzect aiming at che target, whereas striking che cages i as indifferent. Infact according to Plutarch, the Stoies distinguish so clearly beeween doing everything possible to aim straight ar che target and actually iting the target, that they give suficiene ground forthe accusation of intro- ducing ewo ends for che same art; Cicero, on the other hand, seems co be well 9 Alex. De anima 2 (Mantis p. 1643-9 Brant 10. Senecs, Epa 92.1113. 1 Stabaeu,Erlogae 2769-15 Potarchus, Decommanibu nis ronte Soo 27 (1072. 13 Galen, De plain Hipsera et Paton 5 610-14 (5470-471 Geto De fibe3.2 Puts Desommunibur nec contra See 26 (1070-1071 6 477 aware ofthis objection and attempts co defend the Stoic view by stressing that sebae really counts ay the inal end is che aril aiming at, and nor che striking of, she eanget. Leaving aside the analysis of the subsle developments and interesting criti- isms of the Stoic formulae delining the end of virtue, whats important for us here is thar there is a very cleat distinction in Stoic ethical cheory berween reaching the end and skilfully aiming it.‘Thetefore, although the Stoic doc- teine is concerned with viete and does not claim ta in this way incroduce a distinction arsong different kinds of virtues, the second view presented by Alexander, according to which a stochastic tet aims simply at doing everything posible to achieve is nel snd no a its actual attainment, sil can he said to reflect a Stoic doctrine, only used with a different focus and co a different purpose.!6 Besides, i is extremely interesting to note char she illustration by the arrow, and especialy, che use ofthe Greek verb ‘to aim a’ (tachazoma’) make it very tempting co think thae this is supposed to be an etymology af the term ‘stochastic ats Ti conclude, both the Stoxe change ofthe scope ofan art, a well as Aristo- tes insistence an the accomplishment of che final end obviously play an io istinetion beeween the end and the function of arts. Wat now remains 10 be studied in yore details the significance of this portant role in Alexander distinction in connection with the diflerene suggestions as to how the stochastic arts might be distinguished from the non-stochastic. In fact, the issue which immediately arises is whether Alexander’ view actually constieuces an improvement on the other twos that is to sy, one should eaefully examine ‘whether there are good reasons far introducing, as Alexander does, the distin: tion berween the end and the Function of sn att as the basis for differeniasing the stochastic from the non-stochastic arts Let us stact by comparing Alexanders view with that implied in Stoie ethi= fthe ole of medicine from the actual healing ofa patient 9 cal theory 0 sh sumply a competent atcempe status as an art: for if she aim of medicine sco cure diseases and even compe tent doctors repeatedly il to do s0, one can plausibly question che acstic status of medicine. Hence, the second view opts ro limit the demands on the cend of medicine, rather than ¢o put its standing as an area risk. The disadvan tage of this view, already indicated in the ancient sources, like for example in Plutarch’ Ow Connon Conceprionis thatthe goal af medicine cally becomes

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