On the style of Epidemics 6, Wesley Smith (who translated the text for the Loeb Classical Library) writes:

“[The Epidemics] are technical prose from a time when prose was coming into being and authors were realizing its potential: unique jottings by medical people in the process of creating the science of medicine.”

Hippocrates VII: Epidemics 2 & 4-7, Harvard University Press, 1994, p.2

The Epidemics is a text without a model, an attempt to capture in writing the experience and practice of medicine. The style, Smith thinks, manifests this naivety. He refers to it as the text’s “innocence” — innocent from later conventions and styles that would come to characterize medical and scientific writing. This innocence makes the Epidemics (like other Hippocratic writings) quite unique; it also makes it quite difficult to read.

Later medical texts look almost nothing like the Epidemics. Medical writers pretty quickly developed standards of exposition that made their writing easier to follow, and one of the effects of this standardization was that a medical text came to be recognizable as such, a distinct form of writing with its own questions, rules, vocabulary and order.

This innovation is already evident in the fourth century, in Diocles’ writings. He had structured his writing on regimen according to times of day, with each time divided into parts dealing with appropriate foods and exercises. Writers on disease, too, began to structure their works: some, according to the location of diseases from head to toe; some, by diseases according to whether they were acute or chronic; some into sections on cause and treatment. And a standard form of medical text, called Remedies (Peri Boêthêmatôn) was developed by the Pneumatist school, which divided remedies according to the way they acted on the body.

Certainly some authors were not as clear as all this. Dioscorides’ Materia Medica (Peri Hulês) follows a notoriously obscure structure, something later authors complained about. It would have been easier, they thought, if he had ordered things alphabetically. But this just shows that doctors were thinking about the form medical writing should take, and began to adopt standards to avoid the type of obscurity we find in the Epidemics.

Epidemics 6, however, was also canonical, at least to those sympathetic to Hippocratic medicine. The style of the text may have been obscure, but most everyone who practiced Hippocratic-style medicine would have been familiar with it. And interpreting the text became a way of debating new ideas about what medicine is and how it should be practiced.

Evidence of a tradition of interpretation exists, preserved for the most part by Galen, but also in earlier authors like Dioscorides and Athenaeus and later ones like Palladius. For these Hippocratic doctors, the Epidemics could not simply be read. It needed to be deciphered. And part of the game of interpretation seems to have been to show that, whatever new idea they were promoting, the insight was already present in the writings of Hippocrates (or by showing, especially in the case of Epidemics 6, that parts of it were not by Hippocrates at all, and so could be ignored).

Now, one passage from Epidemics 6 was generally agreed to be a kind of keystone for the whole work. It is found at Epidemics 6.8.7:

“Things from the small tablet to be observed. Regimen consists in repletion and evacuation of foods and drinks. Changes of these: what from what, how it is. Odors: pleasant, noxious, filling, tempting. Changes, from what kinds of things, how they are. The pneumata that come in or go out, [solid] bodies also. Better sounds, and those that harm. And of the tongue, what things are evoked by what. Pneuma, what is hotter to the tongue, colder, thicker, thinner, dryer, wetter, filled up, less and greater. From what come changes, what out of what kinds of things, how they are. Things that contain, impart impulse, or are contained. Speech, silence, saying what one wishes. The words, what one says, either loud or many, truthful or fraudulent. (Smith trans., modified)”

τὰ ἐκ τοῦ σμικροῦ πινακιδίου σκεπτέα. δίαιτα γίνεται πλησμονῇ, κενώσει, βρωμάτων, πομάτων· μεταβολαὶ τούτων, οἷα ἐξ οἵων, ὡς ἔχει. ὀδμαὶ τέρπουσαι, λυποῦσαι, πιμπλῶσαι, πειθόμεναι· μεταβολαὶ, ἐξ οἵων οἵως ἔχουσιν. τὰ ἐσπίπτοντα, ἢ ἐξιόντα πνεύματα, ἢ καὶ σώματα. ἀκοαὶ κρείσσονες, αἱ δὲ λυποῦσαι. καὶ γλώσσης, ἐξ οἵων οἷα προκαλεῖται. πνεῦμα, τὸ ταύτη θερμότερον, ψυχρότερον, παχύτερον, λεπτότερον, ξηρότερον, ὑγρότερον, πεπληρωμένον, μεῖόν τε καὶ τὸ πλεῖον· ἀφ' ὧν αἱ μεταβολαὶ, οἷαι ἐξ οἵων, ὡς ἔχουσιν. τὰ ἴσχοντα, ἢ ὁρμῶντα, ἢ ἐνισχόμενα. λόγοι, σιγὴ, εἰπεῖν ἃ βούλεται· λόγοι, οὓς λέγει, ἢ μέγα, ἢ πολλοὶ, ἀτρεκεῖς, ἢ πλαστοί. (V 344-6 Littré)

(I’ve adopted some of the changes suggested by Smith in the Loeb text and ignored others. Notably, I’ve left out “σώματα” after “ἐνισχόμενα”, following Littré, since as Littré pointed out, no one in antiquity mentions it being there.)

This text has puzzled interpreters for a long time. It is elliptical, confident, and somewhat mysterious. But later doctors saw in it the basis of a system: a list of observations that need to be made in order to assess the health of a patient.

Two aspects of the list were to become especially important in later medical writers. One is the distinction of pneuma into hot, cold, thick, thin, wet or dry. This distinction has an interesting history that I hope to come back to. But here I want to focus on the distinction of things into “containing, imparting impulse, and contained (τὰ ἴσχοντα, ἢ ὁρμῶντα, ἢ ἐνισχόμενα).”

We have been working on tracing this distinction for a paper we’re writing on the Pneumatist school. It came to be associated with a way of understanding human physiology that would have a long influence: the division of the constituents of the body into solid parts, humours, and pneuma. It is explicitly mentioned in Galen, the pseudo-Galenic Introduction, pseudo-Alexander on Fevers. It might be in Nicolaus of Damascus On Plants. And in De causis contentivis, especially in chapter 4, Galen hints that it played some role in Pneumatist physiology and causal theory.

This left us with a bit of a puzzle. How did a distinction of the body into containing parts, parts imparting impulse, and contained parts come to be identified with solids, liquids and gases? This is far from obvious and there is nothing in the text of the Epidemics that suggests it. Why would anyone have interpreted the text this way? Why did it become widely accepted? And how is it related to other ways of describing human physiology, for example, in terms of the elements (...interesting that the distinction is absent from the Definitiones...)?

We looked through the literature, but didn’t find anything substantial. So I thought I would gather all the texts here to make them available. Some of them are still untranslated, and there are likely more texts than the ones below. I will continue to translate and add more as we find them. But hopefully it will be something of a start to sorting out how this interpretation of Epidemics 6 came about and why it became so influential.

I
The Pseudo-Galenic author of Introduction or The Physician

“Others say the human is in fact composed out of three compounds, as well, from wet things, dry things and pneumata. Hippocrates calls them things containing, things contained and things which impart impulse. Containing are whatever are solid bodies—bones, nerves, veins and arteries—out of which muscles, flesh, and every mass of the body are compounded, both internal and external structures. Contained are the wet things carried in the channels and scattered through the whole body, what Hippocrates calls the four humours previously mentioned. Things which impart impulse are the pneumata. According to the ancients, there are two pneumata: psychic and natural. The Stoics also add a third: hectic, which they call a state.”

οἱ δὲ ἐκ τῶν τριῶν καὶ συνθέτων τὸν ἤδη γενώμενον ἄνθρωπον ἐκ τῶνδέ φασι συγκεῖσθαι, ἔκ τε τῶν ὑγρῶν καὶ ξηρῶν καὶ πνευμάτων. καλεῖ δὲ αὐτὰ Ἱπποκράτης ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα. ἴσχοντα μὲν οὖν ἐστιν ὅσα στερεὰ, ὀστᾶ καὶ νεῦρα καὶ φλέβες καὶ ἀρτηρίαι, ἐξ ὧν οἵ τε μύες καὶ αἱ σάρκες καὶ πᾶς ὁ τοῦ σώματος ὄγκος πέπλεκται, τῶν τε ἐντὸς καὶ τῶν ἐκτὸς τὰ συγκρίματα. ἰσχόμενα δέ ἐστι τὰ ὑγρὰ τὰ ἐν τοῖς ἀγγείοις ἐμφερόμενα καὶ κατὰ πᾶν τὸ σῶμα διεσπαρμένα, ἅπερ καλεῖ Ἱπποκράτης χυμοὺς τέσσαρας τοὺς προειρημένους. ἐνορμῶντα δέ ἐστι τὰ πνεύματα. πνεύματα δὲ κατὰ τοὺς παλαιοὺς δύο ἐστὶ, τό τε ψυχικὸν καὶ τὸ φυσικόν. οἱ δὲ Στωϊκοὶ καὶ τρίτον εἰσάγουσι τὸ ἑκτικὸν, ὃ καλοῦσιν ἕξιν.

[Galen] Introductio 9, 14.696.14-697.8 K

“Hippocrates, then, put forward three, saying the elements of man are things contained, containing and imparting impulse, through which he included all the elements of those who came after him, as well as elemental physiology and the aetiology of things contrary to nature. But those after him, I don't know why, divide this divine and truly Asclepian medicine into three, although it is really a unity, and they dispersed the parts that make it up. (i) Some referred only to the humours [when explaining] the composition of things according to nature and the cause of things contrary to nature, as Praxagoras and Herophilus [did]. Others posited the solid bodies as the primary and elemental things, and believed that things are composed out of these and the causes of diseases originate from them, as Erasistratus and Asclepiades [did]. And those around Athenaeus and Archigenes claim that all the natural things are created only by means of the pneuma pervading through them and that all the diseases are governed by it, because it [sc. the pneuma] is the thing affected first – for this reason they are called Pneumatists.”

Ἱπποκράτης μὲν οὖν διὰ τριῶν κεχώρηκεν, εἰπὼν στοιχεῖα ἀνθρώπου ἴσχοντα, ἰσχόμενα, ἐνορμῶντα, δι' ὧν τὰ πάντα τῶν μετ' αὐτὸν περιείληφε στοιχεῖα καὶ τὴν κατὰ στοιχείων φυσιολογίαν τε καὶ αἰτιολογίαν τῶν παρὰ φύσιν· οἱ δὲ μετ' αὐτὸν οὐκ οἶδ' ὅπως μίαν οὖσαν τὴν θείαν ταύτην καὶ ἀληθῶς Ἀσκληπιοῦ ἰατρικὴν τριχῇ διανειμάμενοι καὶ διασπάσαντες τὰ ἐν αὐτῇ συμφυῆ μέρη, οἱ μὲν μόνοις τοῖς χυμοῖς τῶν τε κατὰ φύσιν τὴν σύστασιν καὶ τῶν παρὰ φύσιν τὴν αἰτίαν ἀνέθεσαν, ὡς Πραξαγόρας καὶ Ἡρόφιλος. οἱ δὲ τὰ στερεὰ σώματα τὰ ἀρχικὰ καὶ στοιχειώδη ὑποθέμενοι, τά τε φύσει συνεστῶτα ἐκ τούτων καὶ τῶν νόσων τὰς αἰτίας ἐντεῦθεν λαμβάνουσιν, ὡς Ἐρασίστρατος καὶ Ἀσκληπιάδης· οἱ δὲ περὶ Ἀθήναιον καὶ Ἀρχιγένην μόνῳ τῷ διήκοντι δι' αὐτῶν πνεύματι καὶ τὰ φυσικὰ συνεστάναι τε καὶ διοικεῖσθαι καὶ τὰ νοσήματα πάντα, τούτου πρωτοπαθοῦντος γίνεσθαι ἀπεφήναντο, ὅθεν καὶ πνευματικοὶ χρηματίζουσι.

[Galen], Introductio 9, 698.12-699.10 K

II
Nicolaus of Damascus, Plants (distinct tradition?)

“A plant has three powers, the first derived from the element of earth, the second from that of water, the third from that of fire. From the earth the plant derives its growth, from water its cohesion, and from fire the union of the cohesion of the plant. We see much the same thing in vessels of pottery, which contain three elements—clay, which is, as it were, the material of pottery; secondly, water, which binds the pottery together; and, thirdly, fire, which draws its parts together, until it completes the process of manufacture.”

Τὸ δένδρον τρεῖς ἔχει δυνάμεις, πρώτην ἐκ τοῦ γένους τῆς γῆς, δευτέραν ἐκ τοῦ γένους τοῦ ὕδατος, τρίτην ἐκ τοῦ γένους τοῦ πυρός. ἀπὸ τῆς γῆς γάρ ἐστιν ἡ ἔκφυσις τῆς βοτάνης, ἀπὸ τοῦ ὕδατος ἡ σύμπηξις, ἀπὸ τοῦ πυρὸς ἡ ἕνωσις τῆς συμπήξεως τοῦ φυτοῦ. Βλέπομεν δὲ πολλὰ τούτων καὶ ἐν τοῖς ὀστρακώδεσιν. Εἰσὶ γὰρ ἐν τούτοις τρία, πηλός, ἐξ οὗ γίνεται πλίνθος ὀστρακώδης, δεύτερον ὕδωρ, ὅπερ ἐστὶ τὸ στερεοῦν τὰ ὀστρακώδη, τρίτον τὸ πῦρ τὸ συνάγον τὰ μέρη αὐτοῦ, ἔστ’ ἂν δι‘ αὐτοῦ πληρωθείη ἡ τούτου γένεσις.

[Aristotle], De Plantis 2.1

III
The Pseudo-Alexandrian author of Fevers

Φανερὸν μὲν οὖν διὰ τούτων καὶ ὡς τρία μόνα τὰ ἐν ἡμῖν, ἐν οἷς ἡ παρὰ φύσιν θερμότης, μόρια, χυμοί, πνεύματα· τὰ αὐτὰ δὲ καὶ παρ' Ἱπποκράτει ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα καλεῖται, ἴσχοντα μὲν τὰ μόρια, ἃ καὶ στερεὰ προσαγορεύεται, ἰσχόμενα δὲ οἱ χυμοί, ἐνορμῶντα δέ γε τὰ πνεύματα, ἕκαστον ἐκ τῆς ἰδίας δυνάμεως τὴν προσηγορίαν ἁρμόζουσαν εἰληφός.

Ἴσχει μὲν γὰρ καὶ κατέχει τὰ στερεά, ἐνίσχεται δὲ καὶ ἐμπεριέχεται ὑπὸ τούτων τὰ ὑγρά τε καὶ διαρρέοντα, ταὐτὸν δὲ εἰπεῖν οἱ χυμοί, ὁρμᾷ δὲ τὰ ἐν ἡμῖν πνεύματα, λεπτομερεστάτης οὐσίας ὄντα καὶ θερμοτάτης, καὶ ῥᾷστα διὰ πάντων χωροῦντα τῶν μορίων τοῦ σώματος.

[Alexander], De febribus 17.1-2

IV
Galen, Differences of Fevers

νῦν δὲ ἀρκεῖ τό γε τοσοῦτον γινώσκειν, ὅπερ, οἶμαι, καὶ ὁ Ἱπποκράτης ἐνδεικνύμενος ἔλεγε, τὰ ἴσχοντα καὶ τὰ ἐνισχόμενα καὶ τὰ ἐνορμῶντα· ἴσχοντα μὲν αὐτὰ τὰ στερεὰ μόρια τοῦ σώματος, ἐνισχόμενα δὲ τὰ ὑγρὰ, ἐνορμῶντα δὲ τὰ πνεύματα προσαγορεύων.

Galen, De differentiis febrium, 7.278.11 K

V
Galen, On Tremor, Palpitation, Spasm and Rigor

μέμνηται δέ πως αὐτῶν ὧδε, τὰ ἴσχοντα λέγων, καὶ τὰ ἐνισχόμενα, καὶ τὰ ἐνορμῶντα· ἴσχοντα μὲν τὰ στερεὰ καλῶν, περιέχει γὰρ καὶ ἀποστέγει τὰ ὑγρά· ἐνισχόμενα δὲ, τὰ ὑγρὰ, περιέχεται γὰρ ὑπὸ τῶν στερεῶν· ἐνορμῶντα δὲ τὰ πνεύματα, πάντῃ γὰρ ἐξικνεῖται τοῦ σώματος ἐν ἀκαρεῖ χρόνῳ ῥᾳδίως τε καὶ ἀκωλύτως.

Galen, De tremore, palpitatione, convulsione et rigore, 7.597.3-9 K

VI
Galen, Commentary on Epidemics 6
(only available in Pfaff’s German translation of the Arabic summary, online at the CMG)

(V 346, 5.6 L[ittré]) Hippocrates: Das Enthaltende und das Eindringende und das Enthaltene.

Galen: Auch diese Worte erklärt jeder von den Kommentatoren anders. Die beste Erklärung ist nach meiner Meinung die Erklärung derjenigen, welche sagen, daß er unter ‘das Enthaltende’ die festen Grundkörper [solid parts] und unter ‘das Eindringende’ oder ‘das Durchdringende’—diese Worte werden auf diese beiden Arten geschrieben—die Winde [pneumata] und unter ‘das Enthaltene’ die Feuchtigkeiten [humors], die die Körper enthalten, verstehe. Hippokrates verlange also, daß man von diesen drei Dingen aus, aus denen jeder lebende Körper bestehe, untersuche und erforsche, welches die Natur und die Kraft eines jeden von ihnen sei.

Galen, In Hippocratis Epidemiarum librum VI commentaria I-VI, CMG V 10,2,2 p.446 Wenkebach

VII
Palladius, Overview of on Fevers

Ἰστέον ὅτι τῶν πυρετῶν τρία εἰσὶ τὰ γένη· τὰ μὲν γὰρ αὐτῶν ἐπὶ ὑγροῖς γίνονται καὶ ἐξάπτονται, τὰ δὲ ἐπὶ στερεοῖς, τὰ δὲ ἐπὶ πνεύμασι, περὶ ὧν ὁ Ἱπποκράτης λέγει ἴσχοντα, ἰσχόμενα καὶ ἐνορμῶντα, ἴσχοντα μὲν καλῶν τὰ στερεά, ἰσχόμενα δὲ τὰ ὑγρά, ἐνορμῶντα δὲ τὰ πνεύματα. Ὁ δὲ Γαληνὸς ἀναφέρει ὅτι ἀναμέμικται ἔν τε ταῖς ἀρτηρίαις ἁπάσαις διὰ πολλῶν ὀπῶν ἅμα πνεούσαις ἡ ἀερώδης οὐσία τῷ αἵματι καὶ κατὰ τὴν καρδίαν οὐδὲν ἧττον, ὡς ἂν σύρρους ὑπάρχουσα πάσαις αὐταῖς.

Palladius, Synopsis de febribus, 4.1-2

In a fragment on diet for women, Athenaeus quotes an aphorism from the sixth book of the Epidemics. He writes:

“One must encourage exercises (gymnasia) that are suitable for women: of the soul by means of the studies proper for women and concerns about the household because ‘a soul's walk is concern for people’, as the venerable Hippocrates said; while, of the body [exercise] by means of spinning wool and the other work around the house.”

γυμνάσια δ’ ἐπιτρεπτέον τὰ γυναιξὶν ἁρμόζοντα, ψυχῆς μὲν τὰ διὰ τῶν οἰκείων αὐταῖς μαθημάτων καὶ τῶν κατὰ τὴν οἰκίαν φροντίδων («ψυχῆς γὰρ περίπατος φροντὶς ἀνθρώποισι», ὡς εἶπεν ὁ παλαιὸς Ἱπποκράτης), σώματος δὲ διὰ τῆς ταλασιουργίας καὶ τῶν ἄλλων τῶν κατὰ τὴν οἰκίαν πόνων.

Athenaeus of Attalia apud Oribasius, Libri Incerti 23, CMG VI 2,2 112,19-24 Raeder

The aphorism Athenaeus quotes from is found at Epidemics 6.5.5. He seems to think it is about exercise, but the aphorism itself is pretty ambiguous. I’ll translate it literally to try to emphasize just how ambiguous it is:

“Exertion for the joints and for flesh, food, sleep for the viscera. A soul's walk is concern for people.”

Πόνος τοῖσιν ἄρθροισι καὶ σαρκὶ σῖτος ὕπνος σπλάγχνοισιν. Ψυχῆς περίπατος φροντὶς ἀνθρώποισιν.

‘Hippocrates’, Epidemics 6.5.5, V 316,9-10 Littré

The term I translate as “concern” (phrontis) usually means something more like “apprehension” or “worry”. Athenaeus, however, takes it to be a word for any kind of serious thinking, i.e., sustained intellectual activity. The term peripatos, “walk”, can just as easily mean “wandering about”. So the aphorism could be describing apprehensiveness as a kind of wandering thought.

But Athenaeus takes Hippocrates to be claiming that concerns, thoughts, studies, etc., are quite literally forms of exercise—activities that will “nourish” a woman’s (or anyone else’s) soul, just as physical exercise, ponos, nourishes the body.

His interpretation also likely implies a kind of corporeal dualism like what we find in the Stoics and the Pneumatic physicians. It was this kind of interpretation that two later readers took issue with. They are Galen and Palladius.

The commentaries of Galen and Palladius on the Epidemics are pretty great, if for no other reason than that they give us a glimpse into the game of Hippocratic exegesis playing out in Greek-speaking parts of the Roman empire. But they also give us a sense of how doctors tried to navigate disputes between medicine and philosophy—disputes about disciplinary boundaries, and about whose responsibility it was to treat the ailing soul or mind.

Although this is something of a simplification, it is not too much of a distortion to say that around Galen’s time medicine was usually thought of as restricted to the care of the body; philosophy, on the other hand, was a discipline whose aim was the care of the soul or mind. Some doctors, however, considering that our bodies and our health are affected by our psychological states, started to think it was also important that doctors treat the soul as well. But when these considerations were discussed, they were often accompanied by discussion of the legitimacy of medical intervention in the treatment of the soul. Doctors in other words felt they had to justify the encroachment on philosophy.

Interestingly, their justification was not usually aimed at appeasing philosophers, but other doctors who felt it was not their place to treat the soul. The two passages which follow are clearly aimed at doctors, and are examples of the kind of justification one might give, if not for the medicalization of the mind, then at least for its importance in physiology and therapeutics.

1. Galen, In Hipp. Epid. 6, 17B.263.1-264.6 Kühn = CMG V 10,2,2 280,6-281,6 Wenkenbach

“All the book’s interpreters take ‘walk’ [peripatos] to mean ‘exercise’, so that the sentence would be:

‘for humankind, concerns are an exercise.’

They think [Hippocrates] used the familiar term, ‘walk’ [peripatos], because the word means a kind of exercise. Dioscorides, however, reasonably avoided this interpretation because it is affectatious [kakozêlos]*; he did not write peripatos [in his edition], but added the letter ‘n’, [so that it reads] ‘peri pantos’:

‘concern for the soul above all belongs to humankind’.

So that what is meant by it is:

‘above all, for humankind what is to be practiced is reasoning.’

For after all acts of thinking [dianoêseis] are called ‘concerns’ [phrontides], which is why Socrates, too, was called ‘concerned’ and the man’s wise counsels were called ‘concerns’, as one can even find in the Clouds of Aristophanes, where he makes fun of Socrates and mocks him as an idle-talker.

But if it should seem to anyone that the phrase belongs to philosophical speculation, not medicine—first, let them consider that it applies to all the rational arts in which one needs to exercise reasoning, as it has been said by many other physicians, and not a few times by Erasistratus.** And furthermore, certain affections occur, some, for instance, which numb the soul’s rational faculty and the faculty of memory, others which are stuporific [karôdê] and soporific [kataphorika]. In these cases, one must consider thinking to be beneficial, just as in other places he [sc. Hippocrates] taught that anger is useful for good humour and regaining a state in accordance with nature.”

Τὸν περίπατον ἀντὶ τοῦ γυμνασίου πάντες ἤκουσαν οἱ ἐξηγησάμενοι τὸ βιβλίον, ἵν' ὁ λόγος ᾖ τοιόσδε· “τοῖς ἀνθρώποις αἱ φροντίδες γυμνάσιον”, <νομίσαντες αὐτὸν τῇ> προσηγορίᾳ κεχρῆσθαι τῇ τοῦ περιπάτου, δηλούσης τῆς φωνῆς ταύτης εἶδός τι γυμνασίου. κακοζήλου δὲ τῆς ἑρμηνείας οὔσης, εἰκότως αὐτὴν ὁ Διοσκουρίδης φυλαττόμενος, οὐ περίπατος ἔγραψεν, ἀλλὰ προσθεὶς τὸ ν γράμμα “περὶ παντὸς”, ὥστε γενέσθαι τὴν λέξιν τοιάνδε· ψυχῆς περὶ παντὸς φροντὶς ἀνθρώποις, ἵν' ᾖ δηλούμενον ἐξ αὐτῆς· “περὶ παντὸς τοῖς ἀνθρώποις ἀσκητέον ἐστὶ τὸν λογισμόν.” αἱ γάρ τοι διανοήσεις ὀνομάζονται φροντίδες, ὅθεν καὶ τὸν Σωκράτην φροντιστὴν ἐκάλουν καὶ φροντίδας τὰ σοφὰ βουλεύματα τἀνδρὸς ὠνό- μαζον, ὡς κἀν ταῖς Ἀριστοφάνους Νεφέλαις <ἔστιν> εὑρεῖν, ἔνθα κωμῳδεῖ καὶ σκώπτει τὸν Σωκράτην ὡς ἀδολέσχην. εἰ δέ τῳ δόξει φιλοσόφου θεωρίας, οὐκ ἰατρικῆς ὁ λόγος ἔχεσθαι, πρῶτον μὲν ἐνθυμείτω κοινὸν ἁπασῶν εἶναι τῶν λογικῶν αὐτὸν τεχνῶν, ἐν αἷς τὸν λογισμὸν χρὴ γυμνάζειν, ὡς ἄλλοις τε πολλοῖς εἴρηται τῶν ἰατρῶν Ἐρασιστράτῳ τ' οὐκ ὀλιγάκις. ἔπειτα δὲ καὶ πάθη τινὰ γίνεται τὰ μὲν οἷον ναρκοῦντα τὸ λογιστικὸν καὶ τὸ μνημονευτικὸν τῆς ψυχῆς, τὰ δὲ καρώδη καὶ καταφορικά. τούτοις οὖν ἡγητέον ὠφελίμους εἶναι τὰς φροντίδας, ὡς ἐν ἄλλοις ἐδίδαξε τὰς ὀξυθυμίας εἶναι χρησίμους εἰς εὐχυμίαν τε καὶ τῆς κατὰ φύσιν ἕξεως ἀνάκτησιν.

Galen, In Hipp. Epid. 6, 17B.263.1-264.6 Kühn

2. Palladius, Commentarii in Hippocratis librum sextum de morbis popularibus, Scholia in Hippocratem et Galenum vol. 2 Dietz, 136,11-137,5

“Having put aside medical matters, Hippocrates comes again to the soul. ‘Soul’—not as in the warmth we were speaking about earlier, but the really immaterial and immortal [soul]. There are two ways it is possible to interpret this statement: for either [it says] ‘walk’ [peripatos] or ‘above all’ [peri pantos]. And ‘above all’ in this sense:

‘that for humankind there is a concern to consider the soul above all [peri pantos]’

since a person ought to honour nothing above this. For Hippocrates says just as the body is exercised, so too the soul ought to be exercised. But the soul is exercised through more [activities], since a walk is one form of exercise. Concern is any exercise [of the soul]. ‘Concern’—not in order to seek after a profit or after a woman, but to seek the comprehension of the truth, the differentiation of true things from false things. For these are exercises. And concern, especially, is [an exercise] of the rational soul. This is why we speak about the ‘Thinkery’ (phrontistêrion) of Socrates and Plato, not because they were generally concerned, but because they dwelled on the truth.

And he [sc. Hippocrates] added, ‘for humankind’ for a reason. He knows that by nature humans are distinguished in this: the spirited [part of the soul] is [a part] in a person’s real nature, but to rule belongs to reason.*** That is why, as much as it concerns philosophers, we are also able to refer the statement to what belongs to us. For if having come to a sick person, you found him tired and drowsy at the wrong time, know that it is a great evil. For whenever the material in the head is excessive, brings heavy sleep, [and] threatens apoplexia, then you ought to command spirit with concern, in order that the boiling [caused by rousing the spirit] will make this humour thin and disperse it. And thus this statement is fitting for both physicians and philosophers.”

Ἐάσας τὰ ἰατρικὰ ὁ Ἱπποκράτης ἐπὶ τὴν ψυχὴν πάλιν ἔρχεται. ψυχὴν δὲ, οὐχ ὡς ἄνω ἐλέγομεν τὴν θερμασίαν, ἀλλὰ τὴν ὄντως ἄϋλον καὶ ἀθάνατον. διττῶς δέ ἐστιν ἐξηγήσασθαι τοῦτον τὸν λόγον. ἢ γὰρ <περίπατος>, ἢ <περὶ παντός>. καὶ περὶ παντὸς οὕτως· ὅτι φροντίς ἐστι τοῖς ἀνθρώποις τοῦ περὶ παντὸς ποιήσασθαι τὴν ψυχήν. οὐδὲν γὰρ ταύτης ὀφείλει προτιμῆσαι ὁ ἄνθρωπος. λέγει γὰρ Ἱπποκράτης, ὥσπερ γυμνάζεται τὸ σῶμα, οὕτως ὀφείλει καὶ ἡ ψυχὴ γυμνάζεσθαι. γυμνάζεται δὲ ἡ ψυχὴ διὰ πλειόνων, ἐπειδὴ ἓν εἶδος γυμνασίου ἐστὶν ὁ περίπατος. πᾶν γυμνάσιον ἡ φροντίς. φροντὶς δὲ, οὐχ ἵνα ζητῇ ἢ περὶ κέρδους, ἢ περὶ γυναικὸς, ἀλλὰ ζητεῖν τὴν κατάληψιν τῆς ἀληθείας, τὴν διάκρισιν τοῦ ἀληθοῦς καὶ ψευδοῦς. ταῦτα γὰρ γυμνάσιά εἰσιν. καὶ μάλιστα τῆς λογικῆς ψυχῆς ἡ φροντίς. ἔνθεν λέγομεν Σωκράτους καὶ Πλάτωνος φροντιστήριον, ὅτι οὐχ ἁπλῶς ἐφρόντιζεν, ἀλλ' ὅτι τὴν ἀλήθειαν κατεγένετο. οὐ μάτην δὲ προσέθηκε τὸ τοῖς ἀνθρώποις. ἀλλ' οἶδεν ὅτι κατὰ φύσιν ἄνθρωπος ἐν τούτῳ κρίνεται, ἐν τῷ ὑπόστασιν μὲν τὸ θυμοειδὲς, ἄρχειν δὲ τῷ λόγῳ. ταῦτα οὖν ὅσα κατὰ φιλοσόφους, δυνάμεθα καὶ ἐπὶ τὰ ἡμέτερα ἀγαγεῖν τὸν λόγον. εἰσελθὼν γὰρ πρὸς τὸν κάμνοντα, εὗρες αὐτὸν καταφερόμενον ἀκαίρως καὶ ὑπνώττοντα, γίνωσκε ὅτι μέγα κακόν. ὕλη γὰρ πλεονάζουσα ἐν τῷ ἐγκεφάλῳ, ὠδίνει κάρον, ἀπειλεῖ ἀποπληξίαν, τότε ὀφείλεις φροντίδι θυμὸν ἐπιτάξαι, ἵνα τοῦτον ἡ ζέσις ἐκλεπτύνῃ καὶ διαφορήσῃ τὸν χυμὸν, ὥστε καὶ ἰατροῖς καὶ φιλοσόφοις πρέπει οὗτος ὁ λόγος.

Palladius, Commentarii in Hippocratis librum sextum de morbis popularibus, Scholia in Hippocratem et Galenum vol. 2 Dietz, 136,11-137,5

Notes

*Galen does not tell us why he and Dioscorides thought this interpretation is affectatious—why it is kakozêlos. The great stylist Hermogenes of Tarsus (roughly contemporary with Galen) says that kakozêlos describes a figure of speech that is implausible or unconvincing, either for reasons of impossibility, inconsistency, ugliness, impiety, injustice, or contrariness to nature—something that makes us think, “that does not seem do-able [οὐκ εἰκὸς τόδε πραχθῆναι]” (Herm. Inv. 4.12 Rabe). One example he uses is Od. 9.481 where Odysseus says the Cyclops, Polyphemus, “lobbed the peak of a great mountain after having snapped it off [ἧκε δ᾽ ἀπορρήξας κορυφὴν ὄρεος μεγάλοιο].” When Galen uses kakozêlos, he tends to use it in this sense (he does not use it often). The majority of Galenic examples are in the Hippocratic commentaries, where he uses it in two ways:

(i) Sometimes he uses it to describe Hippocrates’ bad style. For example, in Aph. 7.66, Hippocrates calls food “strong for the healthy” and “disease for the sick”, a claim Galen thinks is kakozêlos since food is not itself literally either strong or disease. The sense, however, is clear enough: food is either productive of strength or disease (Hipp. Aph. XVIIIA 179 K). The problem is merely a matter of style.
(ii) More often, he uses it as a reason for rejecting an interpretation of Hippocrates. For example, there is an aphorism in Epid. 6, which states: “weaker foods have shorter life [βιοτὴν]” (Epid. 6.5.14, V 318,20 L.). Galen thinks the natural reading is that weaker foods are used up and expelled rapidly; and he goes on to say it is kakozêlon to think Hippocrates’ meant that weaker food “continues to live” [μονὴν ζωὴν] in our body for a short time (Hipp. Epid. VI 5.21 (CMG V 10,2,2 299,20-21 Wenkebach = XVIIB 282 K).

In either case, Galen and Dioscorides think “walk” [περίπατος] is kakozêlos enough to warrant an emendation to the text. This may be because it implies thinking is literally a kind of exercise that heats you up; but this would be odd, since Galen himself admits that rational activity is important for maintaining the soul’s heat, e.g., San. Tu. 1.8 (VI 40K).

**On Erasistratus, Wenkebach gives a parallel in his edition: PHP VII 5, 602 Kühn. This is almost certainly wrong. In PHP VII 5, Galen mentions Erasistratus’ views on the anatomy of the nerves and brain. The only thing he says remotely related to the Epidemics 6.5.5 passage is that Erasistratus had time to make precise dissections ‘when he was old and had leisure to focus on the study of the art’ (440,24-25 Wenkebach). What Galen must have in mind is Erasistratus’ belief that practice of the rational arts improves their performance, a view which Galen attributes to Erasistratus at De Consuetudinibus 1, Scripta Minora II 17,1-22 Helmreich.

*** ἀλλ' οἶδεν ὅτι κατὰ φύσιν ἄνθρωπος ἐν τούτῳ κρίνεται, ἐν τῷ ὑπόστασιν μὲν τὸ θυμοειδὲς, ἄρχειν δὲ τῷ λόγῳ. This sentence is difficult. I’ve translated “but he knows that by nature humans are distinguished in this: that the spirited part of the soul is in the hypostasis, but to rule belongs to reason.” Palladius may be reluctant to say that reason is a part of a the hupostasis, the real nature, of a person; but I’m not sure I understand the point he is making and I’ve found no parallels anywhere else.

Solids, Liquids, Gases

Galen and Palladius on Mental Exercise and the Boundaries between Medicine and Philosophy