CRITICAL NOTICE

Saying

the

Phenomena

R.J. HANKINSON

This book' has been an unconscionable time arriving. I first heard tell of it a decade ago as an Oxford undergraduate; rumours of its imminence (in that geological sense of imminence peculiar to academic publishing) reached me while a student in Cambridge a couple of years on; and I saw samizdat pages from 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 at least 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 various bibliographies as 'forthcoming'; usually, infuriatingly, with titles different from that 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 particularly pleasant session of a conference on Galen, that the book's debut was indeed only a matter of months away, it is perhaps understandable that I viewed this assurance with a certain scepticism. But it has come out at last: and the wait has been worthwhile. This is, quite simply, a magnificent piece of work; ground-breaking and painstaking scholarship combined with judicious interpretation and an enviable knowledge of the vast corpus of ancient medicine to create something which is in the best sense of the word definitive. We will not need another edition of Herophilus for a long time to come.

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

194

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 know much more. Do they need to? Von Staden himself deals with that question, in an appropriately robust fashion, in his Preface: the first comprehensive presentation of the ancient evidence concerning the extraordinary 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 view that Herophilus really was a leading scientist, and that his accomplishments really were extraordinary ones; von Staden's book itself provides the best possible vindication for that claim. But if Herophilus was all that great, how come the 'comparative neglect' (as the title of one of the rare recent contributions 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 of Herophilean fragments in anything like a systematically 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 of the development of science in the Alexandrian period (those 'five murky centuries between Aristotle and Galen', as von Staden 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 necessarily haphazard and piecemeal fashion, of aspects of its local topography. Werner Jaeger offered the judgement (von Staden quotes it with evident of the approval: p.xii) that 'when a critical collection of the extant remains ... doctrines 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 the trick for the Coan tradition; von Staden has now given us his magisterial Herophilus. We wait only upon a complete Erasistratus (I understand Ivan Garofalo of Siena 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

195

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 of science for its own sake) these are exciting times. The second reason for the relative eclipse of Herophilus, one might have thought, would have been the unparalleled ascendancy of Galenic medicine in the Dark and Middle ages.' For more than a millenium medicine was Galen (and to a lesser extent Galen's great antecedent Hippocrates); the later compilations of such people as Oribasius, Aetius of Amida, and Paul of Aegina are really nothing more than Galen ruminantly redigested. It would be no surprise at all if this almost total ideological stranglehold had throttled whatever remnants of competing earlier writers on medicine there were that might otherwise have 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, as von Staden himself notes, Galen's pre-eminence was already being challenged in the renaissance, by the re-emergence after a thousand years' dormancy of medical 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 to the throne of wisdom could be exalted; and in general the champion of choice was Herophilus. In the sixteenth century, when the very foundations of Galenic physiology were undermined by the discovery of the circulation of the blood, it was the Alexandrians, with their vaunted expertise in human anatomy and physiology, to whom the new scientists turned for ancestral support. So what happened? It seems that Herophilus fell through the temporal crack between the renaissance of interest and the beginning of the modern science of textual establishment. By the time the scholarly world had developed the tools to produce a decent collection of Herophilus, the medical world had lost interest in 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 to remark sagely that the scholarly world would be the better for the appearance of a proper edition of something or other - it is quite another actually to get started on the job of work oneself. But what was so great about Herophilus in any case? First of all, he is credited with the discovery of the distinction between and the distinct functions of the sensory and motor nerves, as well as carrying out the first detailed programme of neural anatomy. If this attribution is correct (and von Staden argues convincingly that it is: pp.250-1), then this alone would guarantee Herophilus a place on the scientific roll of honour. What von Staden's work enables us to see (both in the intelligent and exhaustive arrangement of the material as well as in his

196

sage and judicious commentary upon it) is just how much more the Alexandrian contributed, and how his contributions helped determine the shape of subsequent developments in Greek science. II Von Staden arranges his material systematically and perspicuously. His Introduction consists in a brief survey of preceding movements in medicine, and of the relation between them (particularly traditional medicine) and the development of Greek medicine in Alexandria from the fourth century B.C. onwards. After all, Alexandria, although a Greek city, was in Egypt - and Egypt was 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 Egyptian flavour? The answer is disappointing, although in the light of what we now know about the nature of the Greek culture in Ptolemaic Egypt, as well as that of recent studies 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 chauvinism of the Greeks. Although Pharaonically organized medicine no doubt persisted outside the capital, inside it the Greeks of the privileged literary and scientific class assembled there around the Museum and the Library pursued their researches in an atmosphere of happy isolation from the profanum vulgus. Von Staden sketches an account of Egyptian medicine as we know it from such documents as the Edwin Smith papyrus in frequently amusing strokes: take for instance the Egyptian doctors' anal fixation: the pathological preoccupation with the anus that seems to characterize Pharaonic medicine had consequences for regimen and therapy, and these, too, do not seem to have made a major impression on Alexandrian medicine. The Egyptians took loving 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 bound to elicit an ethno-psychoanalytic study of Pharaonic Egypt sooner or later. (12)

197

No doubt they are; but in default of that we will have to make do with von Staden'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 of influence are discerned: that of course is a fact of considerable positive importance in the assessment of the extent to which the Alexandrians were innovators and pioneers in their fields), von Staden turns, traditionally enough, to the material dealing with Herophilus's life. This is the first chapter of Part One of the work, which deals with Herophilus himself;' and it inaugurates the style of arrangement that von Staden follows throughout. A general essay on the topic (Section A) is followed by a presentation of the fragments themselves (Section B), with a full critical apparatus and an English translation (at least in 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 a historical and a philological nature. The paucity of our biographical knowledge is indicated by the fact that von Staden assembles only sixteen texts, some of very doubtful value, some little more than mere OLd6o)(aL of famous dead doctors of the type popular in later antiquity. Of the more substantial, philosophers will remember the splendid story from Sextus (PH 2 245) about Herophilus's encounter with Diodorus' dislocated shoulder: so when Diodorus dislocated his shoulder once and came to Herophilus for medical treatment, Herophilus with charming wit said to him: 'Your shoulder was dislocated either being in the place where it was or being where it was not; but [it was dislocated] neither where it was nor where it was not; therefore it has not been dislocated.' 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-

198

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 of very limited worth. Equally unhelpful (although equally amusing) is the story of Hagnodice (T8), allegedly the first woman to storm the exclusively male bastions of medicine in Athens by adopting the time-honoured expedient of disguising herself as a man (when indicted for professional malpractice as a result of 'his' dangerously close contact with female patients, Hagnodice is said to have answered the charges most effectively by simply raising her tunic). Hagnodice, in the utterly worthless 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 be sure; but the Athenian setting of T8 should gives us 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 point did practise and teach in Athens, and that an incident during his sojourn there become somehow fictionalized into this anecdote, cannot be excluded with absolute certainty, none the less it is quite clear that the story as it stands is preposterous. Hyginus also credits Hagnodice with the introduction of midwifery to Athens - but as von Staden himself points out, midwifery was sufficiently established in Plato's time for him to make his famous metaphorical use of the notion - it hardly stood in need of Hagnodice to re-invent in three generations later. All that the anecdote unequivocally demonstrates is the fact that Herophilus was an important enough name in the history of medicine for such stories to accrete around him - and the prevalence of certain types of literary and historical I6101. The (presumably unintentionally) amusing dispute as to whether the story properly belongs to the genre of 'discovery literature' or 'exposure literature' (or to some happy combination of the two, exposure being, after all, a form of discovery) can be properly left to the philologists. The treatment of this story exhibits the tenor of von Staden's approach to the evidence - in general he is cautious and conservative in analysis, eschewing the wilder flights of interpretative fancy in favour of solid presentation of as much as we can be sure of. He will indicate areas where speculation is order, even to be encouraged: but he rarely indulges in it himself. In general, this is all to the

199

good in a work of this kind: scholars will trawl their own harvests from its rich stocks. Occasionally, however, one would welcome a little more adventurousness on von Staden's part, at least in the introductory sections. A similar circumspection is evident in his canons for inclusion of fragments and testimonia, which he details on pp.xvi-xvii: in general, only those texts which mention Herophilus or his followers by name are included (and even then von Staden rightly, if I suppose obviously, insists that mere mention of a name is no guarantee of authenticity). Von Staden justifies his caution (in pointed contrast 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 cases where, name or no name, the 'testimonium' really bears no testimony whatsoever- and, regrettably perhaps, the Hagnodice story falls into that category. Of course, only the most carping and curmudgeonly of critics would see that as a reason for the omission of such a fine fable.

III By far the longest chapters (each runs to over 100 pages) are those devoted to Anatomy (VI), and to Physiology and Pathology (VII). These contain a wealth of interesting detail, and the Introductions to each are magisterial surveys and assessments of how much we can ascribe to Herophilus and with what confidence. Here again von Staden adopts a circumspect attitude, frequently taking issue with what he sees to be the overly optimistic constructs of other historians. Fridolf Kudlien and Werner Jaeger crop up regularly in these contexts - but when von Staden disagrees with them, he inevitably does so courteously and with grace, taking great care to accord other scholars the respect they deserve in this regard, his style could well be emulated by some of our more bilious colleagues. What emerges even from this conservative presentation is Herophilus's enormous innovativeness and importance, in particular in human anatomy (especially that of the nervous system) and pulse-lore. Of course it will not be forgotten that, if the tradition in Celsus and elsewhere is right, some of these advances were won by means that one might at best describe as ethically dubious: dissection of live human beings. The veracity of the 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 for Herophilus at least having dissected human corpses, which itself constitutes a remarkable, aberrant relaxation of the powerful Greek taboo upon interfering with the dead (the taboo is of course by no means exclusively Greek; such

200

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 of the egregious mistakes he apparently did make were he familiar with human anatomy have been exaggerated (although his apparent belief in the existence of a human rete mirabile at least renders questionable the extent 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 evidence, 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), written some time in the first century A.D. Opinion is divided as to whether Celsus was a practising doctor, or simply an intelligent lay encyclopaedist - but no one doubts his general seriousness and reliability. One needs to have powerful reasons, then, for rejecting this testimony, coming as it does in the heart of Celsus's discussion of general methodology, reasons stronger than a simple disinclination to believe in the wickedness of scientific heroes, a temperamental resistance to the assimilation of Herophilus to Josef Mengele. Particularly noteworthy is the cool, dispassionate way in which Celsus reports the debate between Dogmatists and Empiricists as to the scientific value (and ethical acceptability) of such procedures. This is no piece of polemical scandal-mongering. It is the sober report of someone deeply concerned about an issue of fundamental scientific (and no doubt ethical) importance; that the terms in which the issues are reported may seem to us inhumane, wicked even, is of no import whatsoever (although Celsus reports an interesting utilitarian justification 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 of contemporary morality to condemn the behaviour of an alien age is at best anachronism; to use those standards to argue a priori that no self-respecting and respectable scientist could have violated them is the worst type of Whiggishness (even were there any reason to think that Herophilus was in this sense 'respectable'; which there is 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, good or bad, ethically acceptable or morally repellent), von Staden rightly notes that what strikes one is the degree to which, on all important points of fact, they are in agreement with Celsus and Galen. However, readers of Phronesis will no doubt be principally (although of course not exclusively) exercised by the question of what importance Herophilus has for the history of philosophy. It will, then, be to chapters IV and V, 201

'The Parts of the Art of Medicine' and 'Theory of Method and Cause', that they will chiefly turn. IV Chapter IV presents reports of Herophilus' views on the question of just 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 of antiquity (and in particular of the increasingly scholastic later antiquity) to classify and categorize, and has its roots in Socratic definition as well as in Aristotelian taxonomy; as von Staden writes: Herophilus' division is ... but one of the many taxonomic endeavours that had become characteristic of his age. (p.90) Sometimes (particularly in the hands of later writers) these disputes take on an air of numbing sterility: why should it much matter, one wonders, whether (as the title of a text of Galen asks) health is a matter for medicine or for gymnastics ? Such questions would seem to be of interest only to the type of person who used to write union rule-books. 13 Nevertheless, these questions can involve matters of substance, both theoretical and practical - in medicine, perhaps the most 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 to disease, and (3) "neutral" things'; (Fr 43; cf T42, which preserves the same definition [with 3U<TtJlltl' harmlessly substituted for 'txv'YJ'] and T45-6). Health, for him, is within the province of medicine and not (or at least not exclusively) that of gymnastics. What is immediately obvious about Herophilus's division is that it is not, like the others, one between different areas of medical practice (such as dietetics, pharmaceutics, surgery, and prognosis: see Wellman, op.cit. n.3 above, Diocles Fr.4; and Celsus, Med. Pr. 8-9, = T49), or at least not explicitly so. So what is it about? As von Staden emphasizes, our sources are exiguous and difficult to evaluate; but he takes 'knowledge of things related to health' to be 'of everything concerning the construction and proper, harmonious functioning of a healthy body and its parts, i.e. anatomy and physiology' (p.90), while that of 'things

202

related to disease' is 'knowledge of whatever disrupts or destroys the healthy harmony of the body and causes dysfunctions' (p.91). T42 (from the pseudoGalenic 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 it is used for therapeutic purposes, dietetics' (p.92). That is, von Staden sees Herophilus's division as subsuming the the more traditional divisions in terms of 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 his later 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, and hygiene) are the subdivisions of medical science as a whole, but that these come about 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 of medical 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 von Staden; 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 (I have 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 objection to it? Von Staden discusses this in Section C (p.113), noting that Deichgraber held that (i) was Herophilean, and that Herophilus had 'introduced the distinction 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 Herophilus originated (or adumbrated) the body-cause-sign tripartition a little later on (it

203

later becomes, in one guise or another, canonical - Galen employs it himself, although with the additional category of activities [vEgyEiai] in de Methodo Medendi [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, 15 and 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, and neither (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 Stoic and Herophilean divisions remain striking, even to the point that both include ternary subdivisions of their 'neutrals'. (p.94) But the fact that both the Stoics and Herophilus divide things into three, and subdivide their third category three ways as well is of little interest unless there is some community of purpose or content about the divisions - and that seems to be 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 now in this, now in that. (p. 109) Patently this has nothing whatever to do with the Stoic partition of the indifferents into those productive of attraction, those productive of repulsion, and those productive of neither (SVF III 121), or those 'preferred', those 'dispreferred', and those neither (SVF III 124, 128).18 The 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 a good, but not quite making it there - it is something categorially quite distinct

204

either from goodness or badness (which are purely internal moral characteristics, and quite independent of external goods), although it can still have 'what (Stobaeus, Ecl. II 83, = Antipater called "selective value" (Miia SVF III 124). If that is right, then there is no real reason for thinking that there is anything other than an adventitious connection between the Stoic and Herophilean categories; it is not, after all, a particularly impressive logical feat to come up with the idea of neutrality or intermediacy (Aristotle's concept of contrariety does all the formal work necessary - but of course it is a perfectly commonplace informal notion); and in any case, as von Staden himself notes, there are plenty of earlier examples of such divisions in Plato and Aristotle (p.97).19 And if all that is correct, then the debate as to whether the Stoics derived their classification from Herophilus or vice versa is sterile; von Staden is right to question the general orthodoxy which has Herophilus getting the idea of tripartition from the Stoics - but that's about all we can usefully say. Here is a disappointing (and relatively rare) case in which, surface consonances apart, there is no reason at all 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 of all, 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 the Herophilean distinction is such that it would cut across such categories; 'knowledge 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 of mushrooms are nutritious and which poisonous - and so on. Hence the division into bodies, causes, and signs (if it is Herophilean: and I shall argue later that it may well be) should also cut across the basic trichotomy. 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 a threefold division not merely among the neutrals into body, cause, and sign, but also among the healthy and the diseased. The reason for including materia medica among the neutrals is presumably that (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

205

warfarin); and the strength (sometimes even the type) of medicament required will vary from case to case according to the constitutional peculiarities of the sufferer. 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 on the 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;21 and whether its virtue is to warm or 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 its constitution 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-unhealthyneutral 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 of medicine, comprising all remedial 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 view that 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 of Herophilus' basic tripartite division in Ars Medica I has been attributed to Herophilus by several scholars - including (I, Hermann Schone, Karl Deichgraber, and Manfred Fuhrmann - but following the principle of severity developed above (pp. xvi-xvii [see above, p.200], it has not been included among the testimonia in this edition, because Galen fails to mention Herophilus by name. (p. 103)

206

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 sentence occurs almost immediately after the unattributed but indubitably Herophilean definition of medical science which opens the passage (it is identical with those of T42-6) : 'healthy', 'diseased', and 'neutral' each is predicated in three ways: as body, as cause, and symptom. For that which is capable of receiving health is the body, while that which produces and preserves health is its cause, and that which is indicative of it, 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 the word 'healthy': receptive, productive, preservative, and indicative of health. My suggestion is that Herophilus took over from Aristotle the four-fold division of senses of 'healthy', and mapped them onto the three subdivisions, which are not themselves Aristotelian. What evidence is there for ascribing this division to Herophilus? I propose to approach that question obliquely, by way of issues in the fifth chapter: 'Theory of Method and Cause'. V Fridolf Kudlien once remarked that Herophilus 'can lay claim to a place of honour in the history of medical scepticism'. 13 That judgement appears to be borne out by a puzzling text of Galen's De Causis Procatarcticis (CP)24 XVI 197-204 (pp.53-5 Bardong: = T59a);25 von Staden takes issue with that assessment. Herophilus is standardly enrolled among the Rationalist or Dogmatist doctors by the taxonomists of later antiquity,26 and they are paradigmatically distinguished from the Empiricists (and later the Methodists) by their pro-

207

foundly anti-sceptical insistence that the hidden, underlying conditions of the body that are causally responsible for the surface manifestations of health and disease are discoverable on the basis of rational investigation. Serapion, a pupil of Herophilus, was an Empiricist (indeed, he founded the school): but that in itself tells us nothing about Herophilus's own position. Although it is tempting to hypothesize about the possible course of Serapion's intellectual development, and the possible influence of Herophilus's views on method upon it, such a hypothesis must necessarily, given the exiguousness of the sources, be speculative, 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 apparently talked 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 later to 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 in which Herophilus may legitimately be regarded as a fore-runner of medical Empiricism; but it seems likely to be evidence rather of his following Aristotle's exhortations (particularly in the first book of De Partibus Animalium) to get your hands dirty in the pursuit of scientific truth. So where is the scepticism? At CP XIII 162-4 (pp.41-2 Bardong), Galen writes: some people say that nothing exists as a cause of anything, while others, like the Empiricists, dispute whether or not there is a cause, and still others, like Heroand philus, accept it on a suppositional basis [ex suppositione: i.e. ei; others again - whose leader he [sc. Erasistratus]> was - rej ected ,among the causes, the antecedent ... causes as not very plausible. (T58) Once the proper referent of the 'he' in 'whose leader he was' is determined (see n.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

208

cause i; vno6Q?wS is not to subscribe to a generalized doubt about the existence of causes as such (call that GD); rather it is an expression of epistemic uncertainty 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 are by their nature indemonstrable; but that doesn't make Herophilus anything like a Pyrrhonian. On these latter points von Staden (pp. 119-20) is both good, and clear (although his suggestion that Herophilus's notion of causes bio0aEwg may be connected with Aristotle's notion of hypothetical necessity seems to me to be misleading and unhelpful). 30 But what should we make of the extraordinary T59a? Here Galen first accuses Herophilus of not having the courage of his convictions: having 'expressed doubt about every cause with many strong arguments, he is himself subsequently detected using them, by saying "it appears this way to all people"'. Galen's criticisms are, I think, misdirected (even if you have no good reason 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 undiscoverable, but it is through a supposition that I think I am being chilled, heated, and being repleted with food and drink.' (T59a; p.131) I give von Staden's translation; but it may be misleading.31 It gives the impression that Herophilus subscribed to GD; however the Latin (see n.31) is

209

compatible with the weaker claim of EU, and it seems at first blush preferable to 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 that he 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 sophisticated, even) attitude to take to the business of causal ascription, and represents an advance on the theories of science of Aristotle. It is perhaps not too fanciful to see it as the first adumbration of the Duhem-Quine thesis of the under-determination of theory by data - and it certainly anticipates the modes of 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 of EU rather than GD, later parts are less easily tractable. Here, it seems, Herophilus (if Galen's testimony is to be trusted; and there is no obvious reason why it should not 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) incorporeals cause 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 argument ; and secondly its Pyrrhonian cast. Of course the disjunctive form of modus tollens is not proprietory to Pyrrhonism; but the conclusion seems unexceptionably sceptical, an impression which is confirmed a little later on: 'he drew the inference that nothing is the cause of anything.'33 The arguments against causes sketched here on Herophilus' behalf are to be found in fuller, but precisely parallel, form in Sextus (M 9 210-36), and although they are not attributed to anybody (much less Herophilus), it is usually assumed that their presentation in this form is owed to Aenesidemus's systematization of

210

Pyrrhonism in the first century B.C., upon whom Sextus certainly drew heavily. But we know very little about Aenesidemus apart from what Sextus tells and 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 10 As I remarked above, T15 is worthless history - but the story would be more pointed if the style of argument 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 advance arguments of this form - and that he was known for it. The unknown source of 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 of T59a? Von Staden simply notes that this fragment ... must again be understood in the context of Herophilus' causal hypotheticalism. Proof of the existence of any particular cause, i.e. that a is demonstrably and indubitably the cause of x, is indeed impossible in Herophilus' view; but Galen suppresses Herophilus' further conclusion: that cause can therefore 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 of any particular cause' - but only because it entails a great deal more. An attack on the very coherence of our causal concepts cannot readily be squared with an undogmatic acceptance of causes on a hypothetical basis. 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 scholarly ingenuity has been devoted in recent years to delimiting the scope and targets of 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 scientific inquiry': PH 1 1 3 ? )Or is he rather 'drunken', doubting even the deliverances of common-sense? The first picture has been endorsed by Michael Frede,36 the

211

second by Myles Burnyeat;37 Jonathan Barnes himself points out that both types of scepticism are to be discerned in Sextus's texts.38 If it turns out that the Pyrrhonists themselves are surprisingly sober, then the gap between methodological caution of the type clearly and uncontroversially exemplified by Herophilus, and Pyrrhonian scepticism will be closed from the other direction. One possible solution to the apparent mismatch between T59a and the other evidence is to adopt the genetic approach: Herophilus at one time leaned towards a generalized scepticism concerning causes; at another (later?) date he elaborated a more sophisticated 'causal hypotheticalism'. But there is no evidence 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 a more interesting interpretation. One way one might go about this is suggested by a consideration of Pyrrhonian methodology. It has long been noted that, in many cases, the arguments advanced by Pyrrhonian sceptics in support of some relatively mild conclusion actually, if they are successful, destroy far more than their ostensible targets. The Pyrrhonians themselves seem quite unperturbed by this apparent mismatch of adversary and weaponry - and it needs to be borne constantly in mind that 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 will include an attack on not.p as well: the desired conclusion is suspension of judgement 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 were intended to - their intention being simply to offer reasons why an uncritical acceptance of causal claims is to be avoided. From a philosophical point of view, such a position is in many respects perhaps unsatisfactory but its sheer unsatisfactoriness is not in itself a reason for not ascribing it (or some analogue of it) to Herophilus. There is perhaps an analogy to be found in the criteria for proof employed in certian legal systems, in which the degree of probability of the 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 von Staden allows, although not tight enough to justify Kudlien's enrollment of him into the sceptical Hall of Fame; and the connections are methodological, and not doctrinal (if talk of doctrine in sceptical contexts is not merely oxymoronic).

212

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 what we 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 and Erasistratus to the business of discerning which parts of the body are simple and which 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 bodies are those which the senses perceive. This may be a misleading account - but what matters is the dictum of Herophilus which the author quotes in support of it: 8? ia ?paw6pEva npwza, xal l ur) Eon jto&ia Eyo8w (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 these very words: 'let these things' be first, even if they are not first'." (T50b: my translation) These are differences in the Greek, even though both purport to give ipsissima verba (such differences are not of course uncommon); and 50a presents particular problems of interpretation. Von Staden translates: 'let the appearances be described first even if they are not primary', explicitly taking in different senses in each occurrence, although he allows in his Commentary (p. 134) that 'let appearances be described as [or: called) primary things even if they are not 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 aspects of Aristotle's methodology: In his biological treatises, Aristotle frequently sounds the refrain 'first the phainomena, then the causes or principles'. Thus ... at the beginning of his On the Parts of

213

Animals [1 1, 639b3ff.; cf. 640al4-151, Aristotle asks whether the natural scientist should first consider the phainomena, and only subsequently treat causes and reasons. His answer is an unqualified 'yes'. (p.118) Von Staden takes Herophilus to agree with Aristotle on the first point ('(FaLv6pEva first'), but to replace the second with a simple note of caution: Herophilus does not deny the importance of causal explanation for theory formation, but he is not as sanguine as Aristotle about attaining knowledge of causes. (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. Von Staden sees in the fragment a deliberate reminiscence of the Aristotelian view that 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 different senses - of course they can have such different senses, but for them to do so within the compass of a single sentence without explicit explanation seems to me 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 a more sceptical slant: we should treat (paLVOLLEva as being primary, even though they may turn out not to be. That rider is of course quite compatible with a Pyrrhonist view; how weak a concession it is depends partly on whether we read Ixai EL;with Anon.Lond. (strong), or 'EL xai' with Galen (weak); and it is still unclear whether 'primary' is to have a metaphysical sense (which would give the dictum a more sceptical slant), or an epistemic one (which would make it 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 <pmVfAEva are a glimpse of the hidden things (twv (Fr. 59 B 21a DK)

Neither Anaxagoras nor Democritus were in any genuine philosophical sense sceptica143 - but both thought that science should not proceed on the basis of an uncritical reliance on the senses (Democritus went further even than that).44 Herophilus perhaps agrees with them; but wishes to emphasize, against any rampant rationalism, that everything has to start with the ?paw6pEva . They are the things that need to be saved - and they are what science attempts to explain;

214

is the sense in which, according to T52, 'he makes experience all-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' epistemological and methodological position: if he did not invent it, then someone else would 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 from Galen's Ars Medica I 307-9K (see above, pp.206-7) should, after all, be admitted to the Herophilian testimonia. The place of 'body' needs no justification ; the 'signs' are the (paLv6ueva from whch medical theory takes its start; and the 'causes' are the hidden entities, the deep internal conditions, to which the theorist infers on their basis. Such inferences, and this is Herophilus's great innovation, are inherently and irremediably fragile - they are always, of their very nature, open to refutation and revision in the light of further experience. Herophilus, then, turns out to be a sort of proto-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 of the material now made readily available, and I have treated even of that in a modest and superficial manner. Given these newly accessible riches, one may look forward to a new and fecund period in Alexandrian studies. For having made this possible, Heinrich von Staden deserves the cheers of the whole of the scholarly world. 45 University of Texas at Austin

that

215