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Epidemics in Context

Scientia Graeco-Arabica
herausgegeben von
Marwan Rashed

Band 8

De Gruyter

Epidemics in Context
Greek Commentaries on Hippocrates
in the Arabic Tradition

edited by

Peter E. Pormann

De Gruyter

ISBN 978-3-11-025979-7
e-ISBN 978-3-11-025980-3
ISSN 1868-7172

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A CIP catalog record for this book has been applied for at the Library of Congress.

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Printed in Germany
Table of Contents V

Table of Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1

Bink Hallum, N. Peter Joosse, Peter E. Pormann,

Simon Swain, Uwe Vagelpohl
A New Manuscript: Istanbul, Süleymaniye Kütüphanesi,
MS Ayasofya 3592 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Greek Epidemics

Philip J. van der Eijk

Exegesis, Explanation and Epistemology in Galen’s Commentaries on
Epidemics, Books One and Two . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Brooke Holmes
Sympathy between Hippocrates and Galen: The Case of Galen’s
Commentary on Hippocratesʼ ‘Epidemicsʼ, Book Two . . . . . . . . . . . . . . . . . . . . 49

Robert Alessi
The Arabic Version of Galen’s Commentary on Hippocrates’ ‘Epidemics’,
Book Two as a source for the Hippocratic Text: First Remarks . . . . . . . . . . . 71

Syriac and Arabic Epidemics

Grigory Kessel
The Syriac Epidemics and the Problem of Its Identification . . . . . . . . . . . . . . 93

Uwe Vagelpohl
Galen, Epidemics, Book One: Text, Transmission, Translation . . . . . . . . . . .  125

Oliver Overwien
The Art of the Translator, or: How did Ḥunayn ibn ʾIsḥāq and his
School Translate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  151
VI Table of Contents

Gotthard Strohmaier
Galen the Pagan and Ḥunayn the Christian: Specific Transformations
in the Commentaries on Airs, Waters, Places and the Epidemics . . . . . . . . . .  171

The later Arabic medical tradition and the Epidemics

Bink Hallum
The Arabic Reception of Galen’s Commentary on Hippocrates’ ‘Epidemics’  185

Peter E. Pormann, N. Peter Joosse

Commentaries on the Hippocratic Aphorisms in the Arabic Tradition:
The Example of Melancholy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  211

N. Peter Joosse, Peter E. Pormann

ʿAbd al-Laṭīf al-Baġdādī’s Commentary on Hippocrates’ ‘Prognostic’:
A Preliminary Exploration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  251

Leigh Chipman
Recipes by Hippocrates, Galen and Ḥunayn in the Epidemics and in
Medieval Arabic Pharmacopoeias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  285

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  303

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  323

List of Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  333

Introduction 1

The Hippocratic Epidemics and Galen’s commentary explicating them are
milestones in the development of both theoretical and clinical medicine.1 The
former contain case notes, detailing the development of various diseases in
actual patients. They display an acute sense of perception and attention to
detail in their clinical observations, paying heed to individual circumstances
and environmental conditions. It is thus not surprising that Galen, the greatest
physician of antiquity, chose to comment upon them with great care. He did,
however, already notice that not all the seven books of the Epidemics went back
to the historic Hippocrates, and that they rather constitute a mixture of notes
varying greatly in style and content. Consequently, Galen decided to comment
only on those books which he viewed as containing at least some genuinely
Hippocratic material, namely Books One, Two, Three, and Six.
The importance of both the Hippocratic Epidemics and Galen’s Commentary
was fully realised at different times throughout history, especially, it would ap-
pear, in those circles particularly concerned with clinical medicine rather than
medical scholasticism. In ninth- and tenth-century Baghdad, in an environment
which saw the rise of sophisticated hospitals, Ḥunayn ibn ʾIsḥāq translated
Galen’s work into Arabic, and even supplemented it occasionally. Moreover,
Ḥunayn himself wrote a treatise in question-and-answer format called Ques-
tions on the Epidemics (Masāʾil al-ʾIbīḏīmiyā), in which he engages with these
case notes and makes them digestible for students. Many other medical luminar-
ies in later times such as ʾAbū Bakr Muḥammad ibn Zakariyā al-Rāzī (Rhazes,
d. c. 925) and Ibn al-Nafīs (d. 1288) held the Epidemics in high esteem. The former
used them and Galen’s Commentary as a model for his own clinical work.2 Not
surprisingly, then, some of al-Rāzī’s most innovative medical research is based
on information contained in Galen’s Commentary on Hippocratesʼ ‘Epidemicsʼ.3
Ibn al-Nafīs, who famously discovered the pulmonary transit in defiance of Ga-
lenic orthodoxy, also composed a commentary on the Epidemics.4 Later, as can
be seen from one extant manuscript, a Jewish physician read Galen’s Commen-

1 See Fichtner 2011a, nos. 6–7, 16–20; Fichtner 2011b, nos. 96–100 for bibliographical
information about editions, translations, and studies. In this introduction, I will keep
documentation to a minimum; many of the points made here will be discussed in much more
detail in the contributions to the present volume.
2 Álvarez-Millán 1999, 2000, 2010.
3 Pormann 2008b, 105–7.
4 Bachmann 1971, Abou Aly 2000, see below, pp. 207–9.
2 Introduction

tary carefully, writing short titles or summaries in the margins of his copy in
Judaeo-Arabic (that is, Arabic written in Hebrew letters).5
Although Arab authors from Ḥunayn onwards took a great interest in Ga-
len’s Commentary on Hippocratesʼ ‘Epidemicsʼ, they also had to surmount some
significant obstacles. Ḥunayn already complained that the Greek manuscripts at
his disposal were in quite a woeful state: he could not find any complete copies.
The situation was even more difficult in the Renaissance Europe. Fully aware
of this deplorable state of the Greek tradition, in the 1620s the Scottish scholar
David Colville copied out carefully those parts of Ḥunayn’s Arabic translation
not extant in Greek.6 Roughly a century and a half later, the celebrated Arabist
Michael Casiri quoted extensively from the Arabic translation, and noted the
crucial importance of this version7, as did the famous German philologist Johan-
nes Mewaldt, saying: ‘Therefore, given that the Greek manuscrips [of Galen’s
Commentary on Hippocrates’ ‘Epidemics’] are so deplorable, we have to rejoice
in the fact that this [Arabic] translation has come down to us […] (Gaudere
igitur debemus in tanta codicum Graecorum penuria, quod illa versio ad aetatem
nostram pervenit, […])’.8 The doyen of Graeco-Arabic studies, the German physi-
cian Max Simon, undertook to edit and translate this Arabic version, but passed
away before he could complete this task. Another German philologist, Franz
Pfaff, continued Simon’s work. When Wenkebach edited Galen’s Commentary
on Hippocrates’ ‘Epidemics’ for the Corpus Medicorum Graecorum, he called on
Pfaff to provide him with a German translation of the Arabic version, both to
improve the Greek text, where it is extant, and to supplement it, where it is
not.9 In order to do so, Pfaff drew on Simon’s previous efforts, and his origi-
nal aim was to publish the Arabic text alongside a revised German translation,
but the economic circumstances in Germany in the 1930s did not allow for the
then costly printing of the Arabic. Pfaff ended his preface by saying: ‘For the
sake of scholarly rigour, the Academy wants to print the Arabic text at a later
date, when the economic situation will again make it possible to allocate such
a great amount of resource (Der Wissenschaftlichkeit wegen will die Akademie
doch den arabischen Text auch drucken lassen, wenn die Wirtschaftslage den
Aufwand größerer Mittel wieder gestattet).’10
In 2006, more than seventy years later, this wish of the Academy had not yet
been realised. Moreover, scholars had become increasingly wary of Pfaff’s Ger-

5 These marginal notes appear in Madrid, Escorial, MS 804 árabe (henceforth MS E1).
6 His manuscript survives in Milan, Bibliotheca Ambrosiana, MS B 135 sup. (henceforth
MS M); see Löfgren/Traini 1975–95, vol. i., pp. 66–67, no. 105. On Colville, see Pormann 2009b.
7 Casiri 1760–70, vol. i., p. 249–57, nos. 800–1.
8 Quoted in Wenkeback/Pfaff 1934, xxii.
9 Wenkeback/Pfaff 1934.
10 Wenkeback/Pfaff 1934, xxxiii.
Introduction 3

man translation.11 Simon Swain and I discussed this situation in the autumn of
2006, and we decided that it was an opportune moment to rectify it by organis-
ing a project to edit the Arabic translation of this highly influential text, and
to make it available through a more reliable and accessible English translation.
The Wellcome Trust kindly agreed to fund this project, and thus the ‘Warwick
Epidemics’ were born. Uwe Vagelpohl and Bink Hallum joined the project as
post-doctoral research assistants, and carried out the bulk of the work: they
prepared a preliminary edition and translation of Galen’s commentary on Books
One and Two. As work progressed, it became clear that the team would benefit
from the input of colleagues working in adjacent areas. Therefore, we decided
to make our draft edition and translation available to interested scholars and
to invite them to engage with our material. We planned a conference at the
Warburg Institute in London to meet and discuss the preliminary results of this
Hallum and Vagelpohl worked on a very tight schedule and managed to pro-
duce the draft editions and translations by early August 2010. More than a dozen
colleagues accepted our invitation to come to London in the second week on No-
vember 2010. In addition to the contributors to this volume, Rebecca Flemming,
Ivan Garofalo12, and Caroline Petit gave papers on ‘Women and Commentary in
Epidemics 2’, ‘Some Problems in the Arabic Translation of Galen’s Commentary
on Epidemics 1–3’, and ‘Proof and Demonstration in Galen’s Commentaries on
the Hippocratic Epidemics’, respectively. Furthermore, Peter Adamson, Charles
Burnett, James Montgomery, and Emilie Savage-Smith kindly agreed to chair
sessions. The ensuing discussions and exchanges helped us tremendously; and
they also showed us clearly that our project elicited a great amount of interest
from various scholarly disciplines.
Two of the speakers and contributors to this volume worked at the Cor-
pus Medicorum Graecorum, a long-running project of the Berlin-Brandenburg
Academy that had recently celebrated its centenary.13 Not only did these two
colleagues from the CMG attend our conference, but the CMG also agreed in
principle to publish the forthcoming editions and translations.14 The Warwick
Epidemics team therefore wishes to thank the CMG, and especially Christian
Brockmann, its project director, and Andreas Wittwer, its head of research.

11 See Strohmaier 1981, 189; and, more recently, Garofalo 2009, 2010a, 2010b.
12 Ivan Garofalo in particular deserves our gratitude, as he painstakingly worked through
the draft editions and translations, offering many corrections and suggestions. He had
already been in the process of publishing the results of his work on Galen’s Commentary on
Hippocrates’ ‘Epidemics’ in his own journal Galenos and elsewhere; see Garofalo 2009, 2010a,
2010b, 2011.
13 See Brockmann / Brunschön / Overwien 2009.
14 Vagelpohl 2012, Hallum / Vagelpohl 2012.
4 Introduction

The first short article which opens this volume discusses a newly discovered
manuscript containing parts of Ḥunayn’s Arabic translation of Galen’s Com-
mentary on Hippocrates’ ‘Epidemics’, Book Two. To my mind, it illustrates the
synergies that result from the presence of a team working on different aspects
of Graeco-Arabic medical history. N. Peter Joosse, who is currently working on a
project to edit, translate, and study the Commentary on Hippocrates’ ‘Prognostic’
by the Arab physician ʿAbd al-Laṭīf al-Baġdādī (d. 1231), found this new manu-
script during a research trip to Istanbul, where he was hunting for Prognostic
manuscripts. This short article argues that the manuscript which he found is of
crucial importance for the textual history, as it represents an independent wit-
ness to the Arabic version. The manuscript will therefore be fully considered in
Hallum’s and Vagelpohl’s forthcoming editions.
The remaining articles published here are all largely expanded and revised
versions of the papers originally presented at the Warburg Institute. They cluster
around three thematic areas: the Epidemics and Galen’s commentary on them in
the Greek tradition; their transmission into Syriac and Arabic; and their impact
in the context of the medieval Arabic medical tradition. The first two articles by
Philip J. van der Eijk and Brooke Holmes both explore the relationship between
the Hippocratic Epidemics and Galen’s commentary on them. Both show in their
way that Galen often read his own doctrine into the Hippocratic text. In other
words, his intention was not to elucidate the meaning that a fifth-century BC
physician could have given to the text. Rather, Galen’s commentary pursued
different aims and objectives; the two most prominent are undoubtedly the fol-
lowing. First, by reading his own doctrines into the Hippocratic text, Galen lent
them a veneer of respectability and authority that they would otherwise lack.
For if the great Hippocrates already adhered to these doctrines, then they were
much more likely to be correct; after all, they had stood the test of time. Second,
Galen operated in a highly competitive medical marketplace where physicians
of different persuasions vied for the attention of patrons and patients alike. And
Galen is positively combative in his Commentary on Hippocrates’ ‘Epidemics’,
ridiculing and refuting the explanations of earlier and contemporaneous ex-
Both van der Eijk and Holmes analyse aspects of these two characteristics.
The former shows in particular that Galen used his own theoretical framework
to confute the commentaries of the Roman doctor Quintus (fl. AD 120–45) as
well as Empiricist physicians. For Galen, the method of qualified experience was
extremely important: it was not sufficient merely to resort to experience (em-
peiría), but it had to be coupled with reason (lógos). Although the Hippocratic
text, especially in the first book, contains more theoretical reflections, it cer-
tainly lacks the highly sophisticated medical doctrines that Galen attributed to
it, especially in the area of epistemology. Van der Eijk also highlights Galen’s
theoretical bias in relation to the case histories contained in the Epidemics. The
Introduction 5

medical historiography of the last two centuries largely regarded them as ‘land-
marks of empirical science’, as van der Eijk puts it: they represent careful clini-
cal observations that do not shy away from recording failure, and are not overly
concerned with theoretical models. Yet, Galen endeavoured to find the underly-
ing theory in these case notes. In other words, for him they illustrate the medi-
cal doctrines to which Hippocrates adhered. The task of the commentator is to
reconstruct or to elicit this theoretical framework from them. Van der Eijk also
calls our attention to the fact that the Epidemics and Galen’s commentary on
them inspired generations of physicians. The genre of the case history first ap-
peared in the Epidemics (at least in the extant Greek medical literature). And al-
though Galen concentrated on the medical theory that the Epidemics contained,
it was largely through his commentary that the genre of the case histories be-
came so popular in the later Arabic tradition.
Holmes focuses on a different aspect in the relationship between Hippoc-
rates and Galen: anatomy. Since the great anatomical breakthroughs in third-
and second-century BC Alexandria, anatomy occupied a prominent position in
medicine. In fact, it would appear that a major debate about the usefulness and
morality of dissection and vivisection took place in Hellenistic times: the Em-
piricists rejected the use of anatomy, whereas the Rationalists defended it.15 Yet,
in the Hippocratic Corpus, anatomy plays only a very minor role, an exception
being Epidemics, Book Two. For Galen, who trained in Alexandria and held anat-
omy in high esteem, Epidemics, Book Two, therefore, offered a unique opportu-
nity to rehabilitate Hippocrates as a keen anatomist (at least in the theoretical
sense). Holmes demonstrates this with the example of co-affection (sympátheia
in Greek; mušāraka in Arabic).
Galen used the concept of co-affection to explain various illnesses. If one part
of the body suffers damage or is affected by an illness, this is called primary af-
fection. For instance, if you eat something bad and suffer from indigestion, your
stomach is primarily affected. But if you suffer from indigestion, and this leads
to melancholy, a disease situated in the brain, then this is a case of co-affection.
The brain and the stomach are linked through the oesophagus, and therefore, a
disease in one part of the body (the stomach) can lead to an affection in another
part of the body (the brain). This theory of co-affection did not exist in the
Hippocratic Corpus, nor was the Greek word for it, sympátheia, used there. Ga-
len, however, was able to introduce co-affection into his commentary through
a clever ploy.
The author of Epidemics talks occasionally about ‘koinōníē’, meaning ‘asso-
ciation’ or ‘partnership’ between different parts of the body. Moreover, the idea
that an affection in one part also transcends to another is not totally alien to the

15 Celsus gives an eloquent account of this controversy in the proem to his On Medicine; see
also Frede 1988 with references.
6 Introduction

Hippocratic Corpus. Using such passages as springboards, Galen introduces his

own theory of co-affection into the Hippocratic text through his commentary.
Moreover, in the Arabic translation, the distinction between ‘co-affection (sym-
pátheia)’ and ‘association (koinōníē)’ is conveniently blurred as both are some-
times rendered by the same word mušāraka. This would then constitute a case
of contextual translation, discussed by Overwien in his contribution: Galen’s
interpretation of the text leads the translator to render a term in a certain way.
Be that as it may, Holmes clearly shows that Galen interprets Hippocrates in
light of his own medical doctrine, thereby lending it greater authority.
The third article in this section deals with a different problem: how can the
Hippocratic text of the Epidemics, Book Two, be reconstructed and analysed with
the help of Galen’s commentary, which is extant only in Arabic. Robert Alessi
had been working on an edition of the Hippocratic Epidemics, Book Two, for the
prestigious Budé collection (CUF) for many years; it was the topic of his Paris
Ph.D. thesis.16 When working on the edition, he previously relied on Pfaff’s Ger-
man translation of the Arabic version, which had not yet been edited. Then, in
May 2007 during the American Association for the History of Medicine meeting
in Montreal, he and I met for lunch on a beautiful spring day.17 I had started
working on the Arabic version and been persuaded that Pfaff’s rendering, al-
though a great achievement for its time, suffered from many problems and was
often misleading about the text of the Hippocratic lemmas as well as Galen’s in-
terpretations of them. Therefore, I urged Alessi to take up the study of Arabic in
order to gain direct access to the source, namely Ḥunayn’s Arabic version. For, I
ventured to promise somewhat optimistically that he would soon have access to
our edition of it. The reader will perhaps understand my joy when I heard from
Alessi three years later that he had heeded my advice and had just completed a
licence (roughly B.A.) in Arabic at the Institut National des Langues et Civilisa-
tions Orientales in Paris. His article results directly from the availability of a
new source and his newly gained competence in this area.
Alessi argues that Galen’s Commentary on Hippocrates’ ‘Epidemics’, Book Two,
is of paramount importance for three reasons. First, it contains the Hippocratic
lemmas; in other words the Hippocratic text on which Galen is to comment is
quoted in full. The text of these lemmas, however, represents an independent
strand of the textual transmission that is much older than that contained in the
Byzantine manuscripts of Hippocrates. Therefore, the Arabic version testifies to
this earlier strand, although only indirectly, that is, through the Arabic transla-
tion, and not in the original Greek. Second, Galen adduces and discusses many
early variant readings that testify again to an earlier stage of the textual trans-
mission. These first two points concern the state of the Hippocratic text that

16 Alessi 1999.
17 Alessi presented a paper on a related subject at this conference; see Alessi 2007.
Introduction 7

the modern editor needs to reconstruct as faithfully as possible. The third point
regards the interpretation. Often, the Hippocratic text is quite obscure and of-
fers significant difficulties. Here, Galen’s commentary can help, as it frequently
provides additional evidence about how the Hippocratic text was understood in
antiquity. Therefore, both for the constitution of the Hippocratic text, and for its
interpretation and translation, Galen’s commentary in its Arabic guise provides
crucial evidence.
Therefore, the Arabic translation of Galen’s Commentary on Hippocrates’ ‘Ep-
idemics’, Books One and Two, that Bink Hallum and Uwe Vagelpohl edited and
translated, offers important evidence for the reconstruction of Hippocrates’ and
Galen’s texts and ideas. This begs the question of how this Arabic translation
was produced. As so many medical texts, Galen’s commentary was rendered
first into Syriac and then into Arabic. Unfortunately, until now, nobody had
studied these Syriac versions in detail, largely because they have not come down
to us. In the late 1970s, two prominent Syriac scholars drew attention to a manu-
script of the Syriac Epidemics, a text that allegedly contained part of Galen’s
commentary on Book Six.18 Yet, until today, the Syriac Epidemics have barely
been studied, nor have they been edited. In his contribution, Grigory Kessel is
the first to rectify this neglect: he was able to investigate this text by looking
at an electronic copy of Vööbus’ microfilm of the manuscript; and he comes to
some startling conclusions.
The Syriac Epidemics are not a Syriac translation of Galen’s commentary, al-
though they testify to it. Rather, as Kessel argues, they are the Syriac version of
a commentary on the Hippocratic Epidemics by the late antique iatrosophist (or
professor of medicine) called Gesius. Gesius taught medicine in fifth-century
Alexandria, but to date, his work has largely been lost to us, whether in the
original Greek or in translation. Therefore, Kessel is the first to unearth a large
text by this mysterious, yet highly influential figure, and that in itself is a major
discovery. By comparing the Syriac Epidemics to the commentaries by Galen and
John of Alexandria, another late-antique iatrosophist, Kessel shows that Gesius
often drew on Galen’s commentary, but that his work also shows clear evidence
for the influence of lecture hall teaching. This comparison reveals that certain
concepts and ideas in John’s commentary already appeared in that by Gesius.
We can thus gain access to the amphitheatres of Alexandria in the fifth century,
a time for which we have very little evidence in the area of medicine. Moreover,
Kessel argues that Sergius of Rēšʿaynā (d. 536) was the translator of this text.
In other words, we have here a document of the earlier phase of Graeco-Syriac
translation activity relating to medical texts. Finally, as the Hippocratic Apho-
risms are frequently quoted in Galen’s Commentary on Hippocrates’ ‘Epidemics’,
it is possible to compare the translation by Sergius of Rēšʿaynā with that by

18 Vööbus 1978, Degen 1981, 151.

8 Introduction

Ḥunayn ibn ʾIsḥāq (d. 873): for we find quotations from the Aphorisms in the
Syriac Epidemics, and Ḥunayn’s translation of the Aphorisms has come down to
us and has been edited. Therefore, the Syriac Epidemics also yield crucial mate-
rial for the study of how Syriac translation technique developed.
Aspects of translation technique also occupy the authors of the remaining
three contributions in this section. Uwe Vagelpohl explores the possibilities of
using quantitative data in order to identify individual translators, or groups of
translators. He opens his article, however, with an important reflection on the
state of the Greek text of Galen’s commentary (where it is extant) and its rela-
tionship to the Arabic translation produced by Ḥunayn ibn ʾIsḥāq. Any study
of Graeco-Arabic translation technique requires a source and a target text. In
the case of Book One, however, the source text is the result of centuries, if not
millennia, of editorial efforts to restore the faulty Greek manuscripts. After all,
Ḥunayn already complained about the problematic state of the textual transmis-
sion, and I have sketched some of the efforts to use the Arabic version to restore
Galen’s commentary at the beginning of this introduction. Yet, in the case of
Book One (and this is equally true for Books Three and Six), the Greek text is a
construct that relies on a good deal of retroversion and conjecture on the basis
of the Arabic translation. In other word, when we compare the Greek source
text as edited by Wenkebach with the Arabic target text edited by Vagelpohl, we
may well be comparing a source text based on the target text rather than vice
Despite this caveat, Vagelpohl argues, the first book of Galen’s commentary
actually affords an excellent opportunity to study Ḥunayn’s translation tech-
nique, as we can be virtually certain that he translated it. Previous translation
studies have largely ignored quantitative data. But Vagelpohl shows that sta-
tistical patterns may well provide the metrics which would allow us to identify
individual translators on the basis of their translation style with much greater
accuracy. He provides two examples of how one could gather such data: by look-
ing, first, at how Greek particles are rendered; and, second, at how Greek com-
pounds, especially those formed with alpha privative, are translated. For Galen’s
commentary and the Arabic translation of Aristotle’s Rhetoric, Vagelpohl is able
to produce accurate statistical data of how often certain translational pairs ap-
pear in each text. Certain patterns appear to be statistically relevant, but he also
notes significant variation within the style of individual translators. Moreover,
Vagelpohl tentatively compares the usage in these texts with three groups of
texts: translations of medical and non-medical texts produced in the Ḥunayn’s
workshop, and translations of non-medical texts produced in the circle of al-
Kindī, the Arabic philosopher who died after 870.
One of the major obstacles to this kind of analysis is the absence of a database
or bank containing a bilingual Greek-Arabic Corpus. If such a database were
available, Graeco-Arabists could select a number of texts that can be securely
Introduction 9

attributed to a given translator (such as Galen’s Commentary on Hippocrates’

‘Epidemics’, translated by Ḥunayn). Then, they could formulate a set of crite-
ria which would establish a translation thumbprint, with how Greek particles
are rendered being one of them. On the basis of these thumbprints, other texts
whose translator is unknown could then be identified as belonging to certain
schools, or perhaps even individuals. Vagelpohl also highlights, however, pos-
sible methodological problems: the presence of a Syriac intermediary that is
almost always lost to us; and the possibility that the translator changed the text
by way of omission, addition, and glossing.
Oliver Overwien focusses on what he calls ‘contextual translation’: in vari-
ous ways, the wider context of a Greek text determines how it is rendered into
Arabic. He investigates more specifically how the Arabic medical terminology
of the day was used to render certain Greek words; how Galen’s works provide
a context for Hippocratic texts; and how textual parallels, that is, phrases that
occur more than once in the Hippocratic Corpus, are taken into consideration
by the translators. For instance, the translator would render the Greek for ‘inner
vein at the elbow’ in Galen as ‘the basilic vein’, a technical term that only gained
currency in Greek after Galen, but also entered Arabic as a loan word. Moreo-
ver, when Ḥunayn and his team translated Hippocrates, they often resorted to
what one might call explicitation: they provided additional information from
other works by Galen in order to render certain terms.
The phenomenon of parallel texts as context is particularly interesting and
complex. Sometimes the same phrasing occurs in two Hippocratic works such
as Humours and Aphorisms. Overwien shows that even when different trans-
lators rendered these works into Arabic, the translation of these passages is
sometimes identical. This can only be explained in terms of one translator draw-
ing on the earlier work of his colleague. But the translators did not always use
the available Arabic translation of the parallel text; rather, they appear to have
done so when Galen’s commentary on the work in question (for instance, the
Aphorisms) pointed out that there was a parallel. This conclusion further dem-
onstrates that the Galenic commentaries were of crucial importance when it
came to translating Hippocratic texts into Arabic.
Gotthard Strohmaier considers another aspect of Greek-Arabic translation
technique: the influence of monotheism on the translators. For most of the
translators in Ḥunayn’s workshop professed Christianity, and the patrons who
commissioned the Arabic translations often adhered to Islam. Both Christians
and Muslims, however, rejected the idea of a polytheistic pantheon, a concept
that frequently occurs even in the medical texts. How, then, did Ḥunayn and
his colleagues deal with this problem? As one would expect, the translators
followed a number of strategies. Sometimes they retained the names of certain
gods such as Asclepius, perhaps because they could expect their readers to be
familiar with them; or when they merely related to buildings or place names
10 Introduction

(e.g., ‘the temple of Hera’). But quite often, ‘the gods’ become ‘God (Allāh)’.
Furthermore, either the translators or later scribes frequently added doxologies
such as ‘the Almighty’, ‘great and exalted’ and so on. In these cases, it is some-
times difficult for the modern editor to decide who made these additions, and
how they should appear in a critical text.
Strohmaier ends his article with an ingenious, if controversial, suggestion. It
concerns a passage from Commentary on Hippocrates’ ‘Epidemics’ in which Ga-
len reports that the famous orator and satirist Lucian (2nd cent. AD) produced
fakes of divinely inspired incomprehensible texts. Lucian then gave them to
‘some grammarians (qawm min al-naḥwīyīn)’, if we follow the reading of one
manuscript. I personally understood this to mean that Lucian composed unin-
telligible oracular poetry, perhaps in the style of the Sibylline oracles, and then
watched how the grammarians would pour over his fakes, trying to understand
their elusive meaning.19 Strohmaier, however, proposes to read the Galenic text
differently as ‘qawm min al-naḥwayn (people of the two ways)’, and explains
this as a reference to Christians and Jews. In other words, Lucian ridiculed
Christians and Jews rather than grammarians.
The Syriac, and especially the Arabic translation of Galen’s Commentary on
Hippocrates’ ‘Epidemics’ had a profound impact on the subsequent medical tra-
dition. This impact can partly be gauged from the many quotations from this
commentary that we find in Arabic medical works from the ninth century on-
wards. Bink Hallum investigates these quotations in his contribution. One story
about a patient believing that he swallowed a snake, and Galen then curing
him of his delusion through a trick appears already in two early Arabic medical
works, composed in the mid-ninth century. Moreover, the man who produced
the Arabic version that we now have, Ḥunayn ibn ʾIsḥāq, did not content him-
self with just rendering this text into Arabic, but he also produced at least four
abridgments of the Hippocratic text and Galen’s commentary. In doing so, he
seemed to be particularly motivated by didactic concerns: he wanted to make
the material more easily acceptable for students. These abridgments range from
collections of the most important passages to aphorisms and a sort of catechism
in question-and-answer format.
Ḥunayn’s Arabic version travelled quickly to the outer reaches of the Islamic
world. For the physician ʾIsḥāq ibn ʿImrān, originally hailing from Baghdad, but
later installed in Kairouan, included quotations from it in his Treatise on Mel-
ancholy in the early tenth century, as did agricultural author al-Ṭinġarī in elev-
enth-century Muslim Spain. The two medical authors who quoted most from
Galen’s Commentary on Hippocrates’ ‘Epidemics’ are Muḥammad ibn Zakarīyāʾ
19 On the Sibylline oracles, see now Lightfoot 2007 with further literature; she discusses
Lycian’s parodies of the Sibylline oracles and their metric characteristics on pp. 159–61.
One example of such parody is contained in Lucian’s Death of Peregrinus, §§ 29–30; see also
Pilhofer et al. 2005.
Introduction 11

al-Rāzī (d. ca. 925) and Mūsā ibn ʿUbayd Allāh, better known as Ibn Maymūn or
Maimonides (d. 1204), the celebrated Jewish thinker, theologian, and physician.
The former strongly advocated the use of case notes in clinical practice and
research, and in this context, he specifically cited the example of the Epidemics.
The latter has many quotations in his own Book of Aphorisms (Kitāb al-Fuṣūl),
probably because certain passages in the Epidemics lent themselves particularly
well to being excerpted as adages and axioms (see the example of Ḥunayn, just
mentioned). Other physicians from the Eastern and Western parts of the Islamic
world such as al-Maǧūsī (d. after 987) and Ibn al-Ǧazzār, quoted from, and com-
mented on, the Epidemics. The last author in this long line is Ibn al-Nafīs (d.
1288), who penned a fully-fledged lemmatic commentary on this text, drawing
on the earlier example of Galen.
In the next two articles, my colleague N. Peter Joosse and I investigate two
other Hippocratic texts and how Arab physicians engaged with them, namely
the Aphorisms and the Prognostic. Whereas Galen’s Commentary on Hippocrates’
‘Epidemics’ is the longest commentary that Galen wrote, his Commentary on
Hippocrates’ ‘Aphorims’ is by far the most influential one in the medieval Islamic
world. This is obviously linked to the popularity of the Hippocratic Aphorisms,
a text which even school-children would at least partly learn by heart. Like the
Epidemics, the Aphorisms were rendered into Arabic by Ḥunayn ibn ʾIsḥāq in
the wake of his translation of Galen’s commentary. But another, earlier trans-
lation also existed that was extracted from the lemmas in the commentary by
Palladius, a physician from sixth-century Alexandria. This older translation still
partly survives in a unique manuscript and quotations in later authors. Moreo-
ver, for the Aphorisms, we have the Syriac version produced by Ḥunayn ibn
ʾIsḥāq. Therefore, we are in the unique position to be able to compare the Greek
original with the Syriac version by Ḥunayn, the earlier Syriac version by Ser-
gius of Rēšʿaynā, perserved in the Syriac Epidemics (see above), the older Arabic
translation, possibly by al-Biṭrīq (fl. late 8th cent.), and that by Ḥunayn.
Building on an earlier article by Franz Rosenthal, we survey more than a
dozen Arabic commentaries on the Hippocratic Aphorisms, written from the
eleventh to the sixteenth centuries. In each case, we list the extant manuscripts,
describe the author’s approach, and investigate the commentary on one particu-
lar aphorism, namely vi. 23: ‘If fear and despondency last for a long time, then
this is something melancholic.’ This pilot study, so to speak, allows us not only
to trace the diachronic interdependence of the various commentators, but also
to study how this manifesto of melancholy elicited explanation. Both Galen’s
commentary and that by the ‘second Hippocrates’, Ibn ʾAbī Ṣādiq (d. after 1068),
proved tremendously influential for the subsequent tradition. Some authors
mostly drew on Galen or Ibn ʾAbī Ṣādiq, but others deliberately distanced them-
selves from the latter. Although the commentaries vary greatly in length—the
longest by Ibn al-Quff (d. 1286) is roughly ten times as long as the shortest by
12 Introduction

Mūsā ibn Maymūn—, they all offer at least one interesting new thought or idea
(with the exception of that by Ibn al-Nafīs, who merely states that this aphorism
is ‘clear’). This extremely rich exegetical tradition undoubtedly deserves further
study. Therefore, it is with great joy that I can announce here that the European
Research Council has granted me €1.5m to explore this topic in depth over a
five-year period, starting in early 2012.
In the late antique medical curriculum, the Hippocratic Prognostic were sec-
ond in importance only to the Aphorisms. This prominent place is also partly
reflected in the Arabic medical tradition. For in addition to the Arabic version
of Galen’s Commentary, an Arabic version of that by Palladius was also avail-
able. Moreover, famous physicians such as Ibn al-Muṭrān (d. 1191), his pupil
al-Daḫwār (d. 1230), ʿAbd al-Laṭīf al-Baġdādī, and Ibn al-Nafīs (d. 1288) all com-
mented on the Prognostic. They often did so because they were convinced that
predicting the course of disease is an essential skill for future physicians. In
other words, the didactic usefulness of the Hippocratic Prognostic continued to
be fully realised in the medieval Islamic world. Although we offer a brief survey
of other commentaries on the Prognostic (two of which have already been ed-
ited), our main focus is that by ʿAbd al-Laṭīf al-Baġdādī.
ʿAbd al-Laṭīf was a highly original and innovative thinker who took an in-
terest in philosophy and linguistics, in addition to medicine. He also took a
great interest in teaching the next generation of physicians and philosophers,
and it is out of this interest that both his commentaries on the Aphorisms and
the Prognostic were born. He took inspiration from the late antique medical
tradition, although his love and zeal for the ancients, especially Hippocrates
and Galen, clearly surpassed that of his predecessors. In his Commentary on
Hippocrates’ ‘Prognostic’, ʿAbd al-Laṭīf draws on his multi-disciplinary exper-
tise. He makes some rather innovative remarks about medicine as being the
‘knowledge of probabilities (al-maʿrifa al-ʾakṯarīya)’, and discusses some finer
points of medical epistemology. But he also displays great philological prowess.
First, he analyses words and phrases in terms of Arabic grammar. But, much
more surprisingly, he also compares the two translations of the Prognostic, the
older, perhaps authored by al-Biṭrīq, and the younger from Ḥunayn’s workshop.
Through this comparison, he is able to come to a better understanding and ap-
preciation of the Hippocratic text.
In this way, Joosse and I explored commentaries on two seminal Hippocratic
works that were written by various Arabic-speaking physicians. These com-
mentaries provide a context to the exegetical activity related to the Epidemics
that took place in Arabic. In the last contribution to this volume, Leigh Chipman
first looks at the influence of the Epidemics in the area of Arabic pharmacology.
In the second book of the Epidemics, there are a number of drug recipes. As the
Epidemics enjoyed such a great popularity, one might expect that Arab pharma-
cologists incorporated these recipes into their pharmacopoeias. But the results
Introduction 13

of Chipman’s investigation are largely negative: the Epidemics are hardly ever
mentioned in later Arabic formularies. Only the tenth-century hospital physi-
cian al-Kaskarī quoted pharmaceutical advice from the Epidemics on occasion in
his Medical Compendium.
In the second part of her article, Chipman turns her attention to the more
general question of how often Hippocrates, Galen and Ḥunayn ibn ʾIsḥāq (who
translated them into Arabic) are mentioned by name in these formularies. Here
again, one is surprised to find that Hippocrates is nearly totally absent from the
pharmacopoeias. Galen’s name is mostly linked to a number of compound drugs
such as pills, electuaries, and so-called ‘holy remedies’ (called hierá in Greek
and ʾiyāraǧ in Arabic). Chipman traces the different versions of these drugs at-
tributed to Galen, and comes to some interesting conclusions. On the one hand,
there are the formularies by practising pharmacists such as Sābūr ibn Sahl (d.
869) and Ibn al-Tilmīḏ (d. 1165). The recipes attributed to Galen that they con-
tain are often hard to trace in the extant œuvre of the latter; and as they are
transmitted from generation to generation, these recipes change. Like cooks, the
pharmacists probably found it difficult to resist the temptation of adding new
ingredients, or altering the quantities of old ones. On the other hand, there is
the fifth book of the Canon of Medicine by Ibn Sīnā (Avicenna, d. 1037), which
is devoted to compound drugs. By tracing the transmission of ‘holy remedies’,
Chipman shows that Ibn Sīnā relied much more on a literal rather than a practi-
cal tradition. Many of his recipes for these holy remedies go back to the Small
Compendium by Ibn Sarābiyūn (fl. 870s), a Syriac medical handbook translated
into Arabic; and Ibn Sarābiyūn in his turn drew on Paul of Aegina (fl. mid-7th
cent.), who excerpted Galen and other authors. Therefore, Chipman confirms
Cristina Álvarez-Millán’s recent analysis that Ibn Sīnā’s medical knowledge is
largely the result of book-learning and not clinical practice.20
The articles collected here all testify to the importance of Arabic version of
Galen’s Commentary on Hippocrates’ ‘Epidemics’. It offers rich pickings not only
for scholars interested in Hippocrates and Galen, but also in the late antique
medical tradition. It formed the basis for the development of the genre of case
notes in Arabic. Moreover, from Ḥunayn’s day onwards, physicians used it to
teach medical students. And it is an interesting object of investigation in the
context of the exegetical culture that emerged in the medieval Islamic world.
And yet, the present collection can only mark a beginning: Hallum’s and Vagel-
pohl’s editions and translations, once published, will undoubtedly provide the
material basis for many more scholarly investigations. This volume can only
hint at the interesting and exciting discoveries that are yet to come.

20 See Álvarez-Millán 2010.

14 Introduction

As said above, the contributors were invited to engage with Hallum’s and Vagel-
pohl’s draft editions and translations, made available in early August 2010. For
the final versions of the articles, Hallum and Vagelpohl provided revised texts
and translations which are cited throughout this volume.21 I would therefore
like to add my expression of gratitude to that of the individual authors who
were able to draw on their work. Then I would like to thanks the authors of
the articles collected here for their willingness to contribute to this volume and
their readiness to consider my suggestions which, at times, led to substantial re-
visions of the submissions. My doctoral student Aileen Das assisted me greatly
in editing the contributions, as did Vagelpohl, Hallum, and Joosse.
The Epidemics project would not have seen the light without the generous
support of the Wellcome Trust which is currently funding four Graeco-Arabic
projects at Warwick, and also provided the finances for the Epidemics in Con-
text conference in November last year. I therefore wish to record my profound
gratitude to the Trustees. Likewise, the Warburg Institute has been a most con-
genial host for the conference; Charles Burnett, François Quiviger, and Elizabeth
Witchell helped bring this event about. I am deeply indebted to them. I would
like to acknowledge the fact that the various libraries at the University of Ham-
burg, my home town, provided an excellent environment in which to edit the
present proceedings. Finally, I would like to thank Marwan Rashed, the editor
of the series Scientia Graeco-Arabica, and Sabine Vogt, my commissioning edi-
tor at De Gruyter, for agreeing so readily and enthusiastically to my proposal to
publish the proceedings with them.
On a more personal level, I would also like to express my gratefulness to my
wife Zakia. As I am about to deliver this book to the press, she is about to de-
liver our first child. I know that she would have preferred for me not to spend
so much time in the library, as I edited the book over the last two months. I ap-
preciate her patience, and the support that she has given me.

Peter E. Pormann Hamburg, July 2011

21 See the list of abbreviations at the beginning of the bibliography on p. 303, below.
A New Manuscript 15

A New Manuscript:
Istanbul, Süleymaniye Kütüphanesi,
MS Ayasofya 3592
Bink Hallum, N. Peter Joosse, Peter E. Pormann,
Simon Swain, Uwe Vagelpohl

When Wenkebach and Pfaff worked on their CMG edition of Galen’s Commen-
tary on Hippocrates’ ‘Epidemics’, Books One and Two, they had copies of two
Arabic manuscripts at their disposal: Madrid, Escorial, MS árabe 805 (hence-
forth E1), and Paris, Bibliothèque nationale de France, MS 2846 fonds arabe
(henceforth P1).1 Whilst preparing an application to the Wellcome Trust for
the Warwick Epidemics project during the academic year of 2006–7, Peter E.
Pormann discovered another manuscript: Milan, Ambrosiana, MS B 135 sup.
(henceforth M).2 P1 is a nineteenth-century copy of M, a humanist manuscript
written by the Scottish monk and scholar David Colville (c. 1581–1629).3 Re-
cently, Ivan Garofalo confirmed Pormann’s analysis that M is a witness to at
least one additional manuscript that is now lost; in other words, it does not
merely represent the readings of E1 and Colville’s conjectures, but also addi-
tional readings of an Escorial codex that perished in the 1671 fire that destroyed
or damaged a substantial part of the monastery’s manuscript holdings.4
As P1 is merely a partial copy of M, we based our preliminary edition on
E1 for Book One (where M is absent); and E1 and M for Book Two. During a
research trip to Turkey, Peter Joosse discovered a new manuscript, containing
roughly the second half of the Arabic version of Book Two. This manuscript, Is-
tanbul, Süleymaniye Kütüphanesi, MS Ayasofya 3592 (henceforth A1), is the ob-
ject of this short note. This note aims at drawing attention to its existence, and
argues that A1 is of paramount importance for the text of Galen’s commentary.
The catalogue entry for A1 provides the following information5:

1 Wenkebach / Pfaff 1934, xxxii; for a more extensive discussion of how Wenkebach and
Pfaff worked, see Vagelpohl, pp. 125–30 below.
2 Pormann 2008a.
3 See Pormann 2009b.
4 Garofalo 2010a, revising his earlier opinion expressed in Garofalo 2009.
5 İhsanoğlu et al. 1984, 2.
16 Bink Hallum, N. Peter Joosse, Peter E. Pormann, Simon Swain, Uwe Vagelpohl

Ɏʥ̵Βā ɬ̑ ɬʉ˶̤ ɡ˙͵ ζ(ǚ͎āǍͫā ŰǨ˳ͫā ŁLJʓ͛) LJʉ˳̈Ǜʉ̑Αā ŁLJʓ˜ͫ ťǍ˶ʉͫLJ̣ Ǩʉʶˏ̒ -
ζɨ̵ (ϔϙζϔ × ϔϓζϘ) ϕϕζϜ × ϔϗζϛ ťLJʉ˙˳̑ć țʶ͵ Ⱥʦ̑ ζɼ͘Ģć ϔϙϗ ǽ͎ ζϖϘϜϕ ɨ͘Ģ ζLJʉ͎Ǎ̿ LJ̈ΐā
.ɼ̵ĔLJʶͫāć ɼˈ̑āǨͫāć ɼʔͫLJʔͫā ɼͫLJ˙˳ͫā

Galen’s Commentary on the Epidemics (Book on Epidemic Disease) (Tafsīr

Ǧālīnūs li-Kitāb ʾIbīḏīmiyā [Kitāb al-maraḍ al-wāfid]), translated by
Ḥunayn b. ʾIsḥāq.

Ayasofya 3592, 164 folios, nasḫ script, 22.9cm × 14.8cm (16.1cm × 10.5cm),
Parts Three, Four and Six.

To this somewhat limited description, we can add that there are nineteen lines
of text per page, written in black ink; the generously spaced nasḫ employed in
this manuscript is very legible but sparsely pointed. The scribe employs muhmal
signs: he often writes a small ḥāʾ under this letter, and sometimes also a small
ʿayn under this letter, in order to indicate the absence of critical dots. Lemmas
and commentary are clearly distinguished by ‘Hippocrates said (qāla Buqrāṭ)’
and ‘Galen said (qāla Ǧālīnūs)’, written on separate lines and centred. In addi-
tion, the Hippocratic lemmas are numbered with marginal ʾabǧad numerals. Ex-
cept for the occasional catch word at the bottom, there are very few marginalia.

The text of A1 begins and ends as follows:

Incipit (fol. 1b, lines 1–7):

ŴāǨ˙̑ ŁLJʓ͛ ɬͲ ɼʉ͵LJʔͫā ɼͫLJ˙˳ˬͫ ťǍ˶ʉͫLJ̣ Ǩʉʶˏ̒ ɬͲ ɼʔͫLJʔͫā ɼͫLJ˙˳ͫā ɬ͇Αā ŁĢ ɨʉ̤Ǩͫā ɬ˳̤Ǩͫā ɷˬͫā ɨʶ̑
ȫʓ͵ĢLJ̑ ɼ˶̈ǚ˳̑ ɼ̓ĔLJʥͫā ƹāǍ́ͫā ƛLJ̤ ɼˏ̿ ǚˈ̑ ΈLJ̑Ǎʓ˜Ͳ ụ̈̌ć LJͲ LJʉ˳̈Ǜʉ̑Βā ȅ˳ʶ˳ͫā.
In the name of God, the merciful, the compassionate. The third part of
Galen’s commentary on the second book of Hippocrates’ book called
‘Epidemics’; what is written after the description of the weather conditions
prevailing in the city of Perinthus.

Explicit (fol. 153b, line 16– fol. 154a, line 4):

LJʉ˳̈Ǜʉ̑Βā ȅ˳ʶ˳ͫā ŴāǨ˙̑ ŁLJʓ͛ ɬͲ ɼʉ͵LJʔͫā ɼͫLJ˙˳ˬͫ ťǍ˶ʉͫLJ̣ Ǩʉʶˏ̒ ɬͲ ƴǨʉ̥Αҙҏā ǽ΀ć ɼ̵ĔLJʶͫā ɼͫLJ˙˳ͫā Ȉ˳̒
Ɏʥ̵Βā ɬ̑ ɬʉ˶̤ ɼ˳̣Ǩ̒.
A New Manuscript 17

The end of the sixth part, which is the last, of Galen’s commentary on
the second book of Hippocrates, book called ‘Epidemics’. Translation of
Ḥunayn ibn ʾIsḥāq.

In its present condition, A1 contains 156 and not 164 folios, as indicated in the
catalogue entry. Discrepancies between the present foliation (in modern Arabic
numerals) and a previous modern foliation (in Eastern Arabic numerals) sug-
gest that several folios have dropped out between folios 90 (marked 90 in both
the present and Eastern Arabic foliations) and 102 (marked 102 in the present
foliation and 110 in the Eastern Arabic). This discrepancy coincides with a gap
in the manuscript between fol. 94b and 95a. The text breaks off at the bottom
of fol. 94b with the end of Book ii.4.79 and recommences on fol. 95a with the
second sentence of Book ii.6.4. The resulting gap corresponds to the last eighth
of Book ii.4 and a small amount of material from Book ii.6, probably amount-
ing to seven or perhaps eight folios, taking into account any colophon that may
have concluded Book ii.4, a note about the loss of Book ii.5 and a title marking
the beginning of Book ii.6. We do not encounter any further text loss between
fol. 95a and the end of the manuscript.
Neither of the extant colophons (for Books ii.3 and ii.6) gives us the name of
the scribe or the place or date at which the manuscript was copied. At the end
of Book ii.3 (fol. 55a), we read that the present copy originated ‘with the copy of
Ḥunayn ibn Isḥāq (Ɏʥ̵Βā ɬ̑ ɬʉ˶̤ ɼʦʶ͵ ɬͲ)’. This does not mean that the copyistʼs
exemplar was Ḥunayn’s own autograph; rather, this concluding note was prob-
ably copied with the rest of the text of ii.3 at every stage of the transmission.
A1 contains only Parts Three, Four and Six of Galen’s Commentary on
Hippocratesʼ ‘Epidemicsʼ, Book Two. On the title page (fol. 1a), the scribe wrote
‘Parts Three, Four and Six of Galen’s Commentary on the end of the Book Two
of the Epidemics of Hippocrates. Translation by Ḥunayn bin ʾIsḥāq (ɼʔͫLJʔͫā ɼͫLJ˙˳ͫā
Ɏʥ̵Βā ɬ̑ ɬʉ˶̤ ɼ˳̣Ǩ̒ ŴāǨ˙ʒͫ LJʉ˳̈Ǜʉ̑Βā ŁLJʓ͛ ɬͲ ɼʉ͵LJʔͫā ɼͫLJ˙˳ͫā ƢLJ˳ʓͫ ťǍ˶ʉͫLJ̣ Ǩʉʶˏ̒ ɬͲ ɼ̵ĔLJʶͫāć ɼˈ̑āǨͫāć)’.
Above these words, another hand added ‘a volume from Galen’s Commentary
on Hippocrates’ Book Entitled ‘Epidemics’. Translation by Ḥunayn, concerning
medicine (ȇ˅ͫā ǽ͎ ɬʉ˶̤ ɼ˳̣Ǩ̒ LJʉ˳̈Ǜʉ̑Βā ȅ˳ʶ˳ͫā ŴāǨ˙̑ ŁLJʓ˜ͫ ťǍ˶ʉͫLJ̣ Ǩʉʶˏ̒ ɬͲ ǚˬʤͲ)’. This
indicates that rather than being defective at the beginning, the manuscript com-
prises the complete volume, presumably preceded by a (now lost) volume con-
taining Book Two, Parts One and Two.
Discounting such merely orthographic differences as ŴāǨ˙̑ (A1) for ŴāǨ˙̑Αā
(E1, M) and LJʉ˳̈Ǜʉ̑Βā (A1) for LJʉ˳̈Ǜʉ͎Βā (E1, M), a number of significant variants dem-
onstrate that while the text preserved by A1 is similar to that of E1 and M and
does not represent a separate recension, A1 is an independent and reliable wit-
ness to Ḥunayn’s text. The text was prepared with some care and copied by a
scribe who was clearly conversant with the subject matter. With the exception
of a marked tendency to produce haplographies and omissions of entire phrases
18 Bink Hallum, N. Peter Joosse, Peter E. Pormann, Simon Swain, Uwe Vagelpohl

by saut du même au même (moving from one instance of a term to the next while
dropping the intervening words), the scribe of A1 correctly reproduced techni-
cal terms and even proper names.
The exact relationship between the manuscripts, especially between E1 and
A1, still needs to be determined. A sample collation of just over four folios of A1,
however, covering around 800 words and corresponding to paragraphs ii.3.1–5
and ii.6.149–150, shall serve to illustrate a number of tendencies.6 It revealed
74 instances in which readings preserved by A1 were at variance with E1, M
or both. By far the largest set of these variants (34 or 46%) consists of instances
in which A1 supported the reading which we had selected for our forthcoming
edition before inspecting A1, possibly a testament to the reliability of the text of
A1. This set of 34 variants can be further divided into two subsets: 17 variants
(50%) in which A1 supports selected readings found in E1 against M, and 17 var-
iants (50%) in which A1 supports selected readings found in M against E1. The
fact that these 34 instances in which A1 preserves our preferred reading, evenly
split between agreement with E1 and M, shows that A1 should be considered
not only a reliable, but also an independent witness to the text.
Further evidence for the independence of A1 is provided by five instances
in which A1 offers preferred readings found in neither E1 nor M, and a further
eight instances in which A1 offers discounted variants found in neither E1 nor
M. Of the latter, however, five may be nothing more than the result of slips of
the pen, palaeographical errors or silent modifications based on stylistic or ter-
minological preferences of the scribe (for example, LJ˳͛ć A1 for LJ˳͛ E1, M in ii.3.3;
two instances of Ǩʉˉʓͫā A1 for Ǩʉʉˉʓͫā E1, M in ii.3.5; ƛǍ˙ͫā A1 for ƛǍ˙ͫ E1, M in ii.6.150;
and Ʀćǚˬ˙˳ͫā A1 for Ʀćǚˬ˙ʓ˳ͫā E1, M in ii.6.150). The text of A1 and the variants it
offers demand to be taken seriously in future studies of the Arabic Epidemics
and have been fully incorporated into our forthcoming edition, as well as in the
quotations from it contained in this volume.

6 The full text of the collated passages can be seen in the appendix below.
A New Manuscript 19


Sample 1: ii.3.1–5 HV7

ɬʉ˶̤ ɼ˳̣Ǩ̒ 10LJʉ˳̈Ǜʉ͎Βā ȅ˳ʶ˳ͫā 9ŴāǨ˙̑Αā ŁLJʓ͛ ɬͲ ɼʉ͵LJʔͫā ɼͫLJ˙˳ˬͫ ťǍ˶ʉͫLJ̣ Ǩʉʶˏ̒ ɬͲ ɼʔͫLJʔͫā 8ɼͫLJ˙˳ͫā (1)
14.13ȫʓ͵ĢLJ͎ ɼ˶̈ǚ˳̑ ɼ̓ĔLJʥͫā 12ƛLJʥͫā ɼˏ̿ ǚˈ̑ ΈLJ̑Ǎʓ˜Ͳ ụ̈̌ć LJͲ 11Ɏʥ̵Βā ɬ̑

ĢLJ̓ǚͫLJ̑ ɷ͵ǚ̑ ɬʦʶ̈ć ΈāĔĢLJ̑ ƹāǍ΀ Ɏʷ˶ʓʶ̈ ȅʓ̤ Ǩ̓ǚʓͲ ƦLJʶ͵ Βҙҏāć ĔĢLJ̑ Ƚ̀ǍͲ ǽ͎ 15ƹLJ˙ˬʓ̵ҙҏā :ŴāǨ˙̑Αā ƛLJ͘ (2)
.ș̈Ģǚʓͫā ƱẠ̌ć ɡˁ͎Αā ɬͲ ɷ̣ć

ɬͲ ɼˈ͎Ĕ Ǩʉˀ̈ ƦΑā ǽˉʒ˶̈ ҙҏ ɷ͵Βā ɡ˳ʤͲ ƛǍ˙̑ ɷˬ͛ 16Ǩʉʉˉʓͫā ǨͲΑā ɬͲ ŴāǨ˙̑Αā Ʉ̿ć ǚ͘ :ťǍ˶ʉͫLJ̣ ƛLJ͘ (3)
ƛLJ˳ˈʓ̵ā» ƛLJ͘ ɬʉ̤ ƛǍˀˏͫā ŁLJʓ͛ ǽ͎ ƱĔḲ̌ć ɷ̤Ǩ̶ć ƴǨʉʔ͛ Ƚ̀āǍͲ ǽ͎ ɑͫĕ ɬʉ̑ć 17.ǚˁͫā ȅͫΒā ǚˁͫā
ŷǍ͵ ķΑā ɼ͛Ǩʥͫā ɬͲ Ǩ̥ΐā ŷǍ˶̑ ɷ͛Ǩʥ̈ ćΑā ƱĔǨʒ̈ ćΑā ɷ˶ʦʶ̈ ćΑā ɷ͈Ǩˏʓʶ̈ ćΑā Ʀǚʒͫā Α ҨҞ˳̈ LJ˳Ͳ 18ɼʓˉ̑ Ǩʉʔ˜ͫā
΋ Αā ȅʓͲ ƦǍͲΑLJ˳͎ Έ ҨҞʉˬ͘ Έ ҨҞʉˬ͘ ƦǍ˜̈ LJͲ LJͲΑLJ͎ .ɼˈʉʒ˅ˬͫ 19ƢćLJ˙Ͳ Ǎ͎́ ΈāǨʉʔ͛ ƦLJ͛ LJ˳ˬ͛ć ƹLJ˅̥ ƦLJ͛
ƛLJ˙ʓ͵ҙҏā łĔĢ
ṳ̈̌āć Ʉ˶̿ ǽ͎ ɷͲҨҞ͛ ɡˈʤ͎ Ƚ̀Ǎ˳ͫā āǛ΀ ǽ͎ LJͲΑāć 22«.ɑͫĕ Ǩʉ͈ łĔĢ ΋ Αā 21ȅʓͲć ƱǨʉ͈ 20ȅͫΒā ƹǽ̶ ɬͲ
āǛ΀ ǽ͎ ƛǍ˙ͫā ɼˬ˳̣ ɷ̑ ɨ́ˏ̈ ƛLJʔͲ ɷ͵ΑLJ͛ āǛ΀ ɡˈ̣ć ĔǨʒͫā ȅͫΒā Ǩʥͫā ɬͲ ƦǍ˜̈ ķǛͫā Ǩʉʉˉʓͫā Ǎ΀ć Ǩʉʉˉʓͫā ɬͲ
ɡˈ͎ 24LJ˳͛ ƱǨʉ͈ 23ɨʉˬˈʓͫ ɷ̑ ǚˀ˙̈ ɨͫć ɷʶˏ˶ͫ ƴǨ͛Ǜ̒ ɷˬˈ̣ LJ˳͵Βā ɷ͵Αҙҏ Έāǩʉ̣ć Έ ҙҏǍ͘ ɷʉ͎ ɷͫǍ͘ ɡˈ̣ć ŁLJʒͫā
ƦΑā ǽˉʒ˶̈ ҙҏ 25ɷ͵Αā Ƚ̵āć ƢҨҞ˜̑ ɬʉ̑ć ŔǨ̶ ŁLJʓ˜ͫā ɑͫĕ ǽ͎ ɷ͵ΒLJ͎ ƴĔLJʥͫā ŰāǨͲΑҙҏā Ǩʉ̑ǚ̒ ǽ͎ ɷ̑LJʓ͛ ǽ͎
.ɼ˳ʉˆ͇ ƴǍ͘ ɷʉ͎ LJ˳͇ Έ ҨҞˁ͎ ƴǨʉʶ̈ ƴǍ͘ ɷˈͲ LJ˳ʉ͎ ҙҏć Ʊǚ̀ ȅͫΒā ƹǽʷͫā ɬͲ ɼˈ͎Ĕ ƹǽ̶ 26Ǩʉʉˉʓͫā ɬͲ ɡ˳ˈʓʶ̈

7 MS E1, fol. 73b, line 22–fol. 74a, line 18; MS A1, fol. 1b, line 2–fol. 3a, line 3; MS M fol. 35b,
line 1–fol. 36a, line 3.
8 Ante ɼͫLJ˙˳ͫā add. ɬ͇Αā ŁĢ ɨʉ̤Ǩͫā ɬ˳̤Ǩͫā ɷˬͫā ɨʶ̑A1.
9 ŴāǨ˙̑Αā] E12, M: om. E1: ŴāǨ˙̑ A1.
10 LJʉ˳̈Ǜʉ͎Βā] E12, M: om. E1: LJʉ˳̈Ǜʉ̑Βā A1.
11 Ɏʥ̵Βā ɬ̑ ɬʉ˶̤ ɼ˳̣Ǩ̒] E12, M: om. E1, A1.
12 ƛLJʥͫā] E12, M: om. E1: ƹāǍ́ͫā ƛLJ̤ A1.
13 ȫʓ͵ĢLJ͎] E12, M: om. E1: ȫʓ͵ĢLJ̑ A1.
14 ɼʔͫLJʔͫā ɼͫLJ˙˳ͫā ... ȫʓ͵ĢLJ͎ ɼ˶̈ǚ˳̑] om. E1, in marg. add. E12.
15 ƹLJ˙ˬʓ̵ҙҏā] M, A1, A2: ƹLJ˙ʶʓ̵ҙҏā E1.
16 Ǩʉʉˉʓͫā] E1: Ǩʉˉʓͫā M, A1.
17 ǚˁͫā ȅͫΒā] E1, A1: om. M.
18 ɼʓˉ̑] A1: Ƚ͎Ĕ M: ɷ˶ʉˈ̑ E1.
19 ƢćLJ˙Ͳ] M, A1: ƢLJ˙Ͳ E1.
20 Post ȅͫΒā add. ƹǽ̶ M.
21 ȅʓͲ] E1, A1: ǽ΀ M.
22 Aph. ii. 51
23 ɨʉˬˈʓͫ] E1, A1: ɨˬˈʓͫ M.
24 LJ˳͛] E1, M: LJ˳͛ć A1.
25 ɷ͵Αā] M, A1: ɷ͵Αāć E1.
26 Ǩʉʉˉʓͫā] E1, A1: Ǩʉˉʓͫā M.
20 Bink Hallum, N. Peter Joosse, Peter E. Pormann, Simon Swain, Uwe Vagelpohl

ǽ͎ ȫʉͫć ĔǨʒͫā ȅͫΒā Ǩʥͫā ɬͲ ƦǍ˜̈ ķǛͫā Ǩʉʉˉʓͫā ǽ͎ Ȉˬ͘ LJ˳͛ ɷͲҨҞ͛ ɡˈʤ͎ Ƚ̀Ǎ˳ͫā āǛ΀ ǽ͎ LJͲΑāć (4)
ƦǍ˜̈ Ǩ̥ΐā Ʉ˶̿ Ǩʉʉˉʓͫā ɬͲ ƦǍ˜̈ 28ǚ͘ ɷ͵ΒLJ͎ .Ⱥ˙͎ ƹāǍ́ͫā ɬͲ ɷ˶Ͳ ƦǍ˜̈ LJ˳ʉ͎ 27ɬ˜ͫć ɷˬ͛ Ǩʉʉˉʓͫā āǛ΀
Ƚ̀Ǎ˳ͫā āǛ΀ ǽ͎ 30Ǩʉʉˉʓͫā ɑͫĕ Ǩ͛Ǜ̈ ɨͫć Ǩʉ̑ǚʓͫā Ɏ̈Ǩ̈́ Ģŕΐҙҏāć ƴķćĔΑҙҏā 29ƛLJ˳ˈʓ̵ā Ɏ̈Ǩ̈́ LJ˳΀ṳ̈̌Αā ɬʉ˙̈Ǩ˅̑
35LJ˳΀āṳ̈̌Βā ɬʉʓ̣́ ȅˬ͇ ƦǍ˜̈ Ǩʉʉˉʓͫā 34āǛ΀ć .ƦǚʒͫLJ̑ Ⱥʉʥ˳ͫā ƹāǍ́ͫā ɬͲ ƦǍ˜̈ ķǛͫā 33Ǩʉʉˉʓͫā 32Ǩ͛ĕ LJ˳͵Βā 31ɷ˶˜ͫć

ƦΑā ȅͫΒā Ȉʤʓ̤ā 38ȅʓͲ ǽˉʒ˶̈ ҙҏ ɷ͵Βā ƛćɎ̈ ŴāǨ˙̑Αāć .œĢLJʦͫā Ʀǚʒͫā 37Ț˅ʶ̑ 36ɷ̒LJ͘ҨҞ˳̑ Ǩ̥ΐҙҏāć ƹāǍ́ͫā ƈLJʷ˶ʓ̵LJ̑
ƈLJʷ˶ʓ̵ҙҏā Ɏ̈Ǩ˅̑ LJͲΒā ɬʉ̣́Ǎͫā ṳ̈̌ΑLJ̑ Έ ҙҏćΑā ƱǨʉˉ̒ ɬ˜ͫć ΈLJˈͲ ΈLJˈʉ˳̣ ɬʉ̣́ǍͫLJ̑ ƱǨʉˉ̒ ƦΑā 40Ʀǚʒͫā ƛLJ̤ 39Ǩʉˉ̒
ĢLJ̤ ƹāǍ΀ ɷʉ͎ Ȉʉ̑ ɬͲ ɷˬ˙˶̒ ƦΑā 41Ȉʤʓ̤ā ȅʓͲ ɡʔ˳ͫā ǽ͎ ȶ̈Ǩ˳ˬͫ ƦǍ˜̈ ķǛͫā ǚˬʤͫā ƴLJ͘ҨҞͲ Ɏ̈Ǩ˅̑ LJͲΒāć
ƴLJ͘ҨҞ˳̑ œĢLJ̥ ɬͲ ƱĔǨʒ̒ 44ȅʓ̤ ɼΈ ˈ͎Ĕ ΈLJˈʉ˳̣ ɬʉ̣́ǍͫLJ̑ ɷ͵ǚ̑ ǚ̈Ǩʒʓͫ ǚˀ˙̒ ҙҏ 43ĔĢLJ̑ 42ƹāǍ΀ ɷʉ͎ Ȉʉ̑ ȅͫΒā
ɷ̑ ǚͲ āĕΒLJ͎ .ɬʉ̣́Ǎͫā ṳ̈̌ΑLJ̑ 46Έ ҙҏćΑā ƱĔǨʒ̒ 45ɬ˜ͫ ĔĢLJʒͫā ƹāǍ́ͫā ƈLJʷ˶ʓ̵LJ̑ ɡ̥āĔ ɬͲć ǚˬʤˬͫ ĔĢLJʒͫā ƹāǍ́ͫā
50ƹāǍ΀ ƦLJ͛ ȅʓͲ ƹāǍ́ͫā ƈLJʷ˶ʓ̵ā ǨͲΑā ɑˬ˳͵ LJ˶ʶͫć ΈLJˈʉ˳̣ 49ɬʉ̣́Ǎͫā 48LJ˶ˬ˳ˈʓ̵ā ɼʥͫLJ̿ ƴǚͲ ɑͫĕ 47ȅˬ͇

.ɷ˜ˬ˳͵ ɬʥ˶͎ 52ĢLJ̓ǚͫā 51ǨͲΑā LJͲΑLJ͎ .LJ́ʉˬ͇ Ǎ΀ ǽʓͫā ƛLJʥͫLJ̑ Ɏʷ˶ʓʶ̈ ƦΑā ɬͲ ǚ̑ ҙҏ ɷ͵Αā ɑͫĕć ΈāĔĢLJ̑ Ȉʉʒͫā
ΈLJˈʉ˳̣ ɬʉ̣́Ǎͫā ɬͲ ǚ̈Ǩʒʓͫā ɷͫLJ˶̈ ȅʓ̤ ΈāǨʉʶ̈ ǨͲΑҙҏā ƛćΑā Ǜ˶Ͳ Ʀǚʒͫā ɷ̑ ȅ˅ˉ̈ LJͲ ƦǍ˜̈ ƦΑā ǽˉʒ˶̈ 53ҨҞ͎ (5)
ķǛͫā Ǩʉˉʓͫā ɨ́ˏ̒ ƦΑā āǛ΀ ɬͲ ĢĔLJ͘ Ȉ͵Αāć .ɷʉˬ͇ ƦLJ͛ ķǛͫā ƛćΑҙҏā œāǩ˳ͫā ǚ̀ œāǩͲ ȅͫΒā 54ɼʓˉ̑ Ǩʉˀʉ͎

27 ɬ˜ͫć] E1: ɬ˜ͫ M, A1.

28 ǚ͘] E1, M: om. A1, in textu add. A11.
29 ƛLJ˳ˈʓ̵ā] M, A1: om. E1.
30 Ǩʉʉˉʓͫā] E1, A1: Ǩʉˉʓͫā M.
31 ɷ˶˜ͫć] E1: ɷ˶˜ͫ M, A1.
32 Post Ǩ͛ĕ scr. et del. Ƚ̀Ǎ˳ͫā E1.
33 Ǩʉʉˉʓͫā] E1, A1: Ǩʉˉʓͫā M.
34 āǛ΀ć] M, A1: Ǎ΀ć E1.
35 LJ˳΀āṳ̈̌Βā ɬʉʓ̣́] E1, A1: LJ˳΀ṳ̈̌Αā ɬʉ̣́ć M.
36 ɷ̒LJ͘ҨҞ˳̑] E1, A1: ƴLJ͘ҨҞ˳̑ M.
37 Ț˅ʶ̑] E1, A1: Ț˅ʶͫ M.
38 ȅʓͲ] M, A1: LJͲ E1.
39 Ǩʉˉ̒ ƦΑā] M, A1: om. E1, in marg. add. Ǩʉʉˉ̒ E13.
40 Ʀǚʒͫā] M, A1: om. E1.
41 ȶ̈Ǩ˳ˬͫ ƦǍ˜̈ ķǛͫā ... Ȉʤʓ̤ā] M: œLJʓ̤ā ... ȶ̈Ǩ˳ͫā ƦǍ˜̈ ȅʓ̤ E1, A1.
42 ƹāǍ΀] E1, A1: om. M.
43 ĔĢLJ̑] M, A1: ĔāǨ̑ E1.
44 ȅʓ̤] M, A1: om. E1.
45 ɬ˜ͫ] M, A1: ɷ˶˜ͫ E1.
46 Έ ҙҏćΑā] M, A1: ȅͫćΑā E1.
47 ȅˬ͇ ɷ̑ ǚͲ] M: ǽ͎ łǚͲ E1: ȅˬ͇ ɷʓ͵ǨͲ A11.
48 LJ˶ˬ˳ˈʓ̵ā] E1, A11: Ȉˬ˳ˈʓ̵ā M.
49 ɬʉ̣́Ǎͫā ... ɷ̑ ǚͲ āĕΒLJ͎] E1, M: om. A1, in marg. add. A11.
50 ƹāǍ΀] E1, A1: ƹāǍ́ͫā M.
51 ǨͲΑā] E1, M: om. A1.
52 Post ĢLJ̓ǚͫā add. ɷ̑ E1.
53 ҨҞ͎] E1, M: ҙҏć A1.
54 ɼʓˉ̑] A1: ɷ˶ʉˈ̑ E1, M.
A New Manuscript 21

ɑˬ̒ ȇ̤LJ̿ 57Ȉˬ˙͵ ƦΒā 56ɑ͵āΑ ɑͫĕć 55Έ ҨҞʉˬ͘ Έ ҨҞʉˬ͘ ɷͫǩ˶̒ ƦΑā ǽˉʒ˶̈ Ʉʉ͛ Ǩʥͫā ȅͫΒā ĔǨʒͫā ɬͲ ƦǍ˜̈
ǽ˶͇Αā ΈLJˈʉ˳̣ ɬʉ̣́Ǎͫā ɬͲ ɼˈ͎Ĕ ɬʦʶ̈ ƦΑā ɬͲ ΈāĢṲ̈̀ ɷ΋͵ǚ̑ Ȉˏʷ͛
΋ ĢLJ̤ Ȉʉ̑ ȅͫΒā ĔĢLJ̑ Ȉʉ̑ 58ɬͲ ƛLJʥͫā
ķǛͫā 62Ǩʉʉˉʓͫā ɼˈ͎Ĕ ƦǍ˜̈ ķǛͫā 61Ǩʉʉˉʓͫā ǚ̀ć œĢLJ̥ ɬͲ Ǩʉʔ˜ͫā 60ĢLJ̓ǚͫLJ̑ć ɡ̥āĔ ɬͲ ƹāǍ́ͫā 59ƈLJʷ˶ʓ̵LJ̑
ɬ͎ ɬͲ ɷͲҨҞ͛ ƦǍ˜̈ ƦΑā ẹ̑ć Ǩʉʉˉʓͫā āǛ΀ ǽ͎ ŴāǨ˙̑Αā ƢҨҞ͛ ƦLJ͛ LJ˳ͫć .ș̈Ģǚʓͫā Ɏ̈Ǩ˅̑ Έ ҨҞʉˬ͘ Έ ҨҞʉˬ͘ ƦǍ˜̈

Sample 2: ii.6.149–150 HV63:

ȅͫǍ̈́Ǎ͘ Ģāǚ˙Ͳ 64ΈLJ͎Ǩ̿ ΈLJ̑āǨ̶ ɷʒ̤LJ̿ ŁǨʷ̈ ƦΑā ǽˉʒ˶ʉ͎ ŷāǚ̿ ĢLJ˳ Όʦͫā ɬͲ ŰǨ͇ āĕΒā :ŴāǨ˙̑Αā ƛLJ͘ (149)
ɨ́͵Αā ɑͫĕć «ťΑāǨͫā Ƚ̣ć» ɬͲ 66ɷ͘LJ˙ʓ̶ā LJ˳͵Βā ɨ̵LJ̑ «ĢLJ˳ʦͫā» ƦǍ˳ʶ̈ ɬʉʉ͵LJ͵Ǎʉͫā ƦΒā :ťǍ˶ʉͫLJ̣ ƛLJ͘ (150)
«ťΑāǨͫā ƦLJ˙ˏ̥» ɨ΀ǚ˶͇ ɷ˳̵ā ƦLJ˜͎ ƦLJ˙ˏʦͫā 70«ǽͫLJ͎»ć ťΑāǨͫā ɨ̵ā ɨ΀ǚ˶͇ «āǨ͘»ć 69«ǽͫLJ͎āǨ͘» 6768ɷ͵Ǎ˳ʶ̈
ΈLJͲĔ 72ƱΑ ҨҞ˳̈ ɷ͵Αā ɡʒ͘ ɬͲć ťΑāǨͫā ɬʦʶ̈ ɷ͵Αā ɡʒ͘ ɬͲ 71Ǩ˳ʦͫā ŁǨ̶ ɬͲ ŰǨˈ̈ ŰĢLJˈͫā āǛ΀ ĿǨ͵ LJͲ ΈāǨʉʔ͛ć
75ɬ˜ͫ ȅ˶ˈͲ «ŷāǚ̿ ĢLJ˳ʦͫā ɬͲ ŰǨ͇ āĕΒā» ƛLJ͘ ɬͲ 74ƛǍ˙ͫ ȫʉˬ͎ ɑͫǛ͛ ǨͲΑҙҏā ƦLJ͛ 73ĕΒāć .ΈāĢLJ̤ ΈLJ̈ĢLJʦ̑
ĢLJ˳ʦͫā ƦΑā ɑͫĕć «ŷāǚ̿ ɨͫnj˳ͫā ťΑāǨͫā 76ƦLJ˙ˏ̥ ɬͲ ŰǨ͇ āĕΒā» ƛLJ͘ ɬͲ ƛǍ˙̑ ɷʉʒ̶ āǛ΀ ƛLJ͘ ɬͲ ƛǍ͘
79āǛ΀ 78Ǜʦ͎ 77.ŁāǨʷͫā ŁǨ̶ ƴǨʔ͛ ɬͲ ťΑāǨˬͫ ŰǨˈ̈ ķǛͫā ŰĢLJˈͫā ɷ˶˜ͫ Ǩʉʔ˜ͫā ŁāǨʷͫā ŁǨ̶ Ǎ΀ ȫʉͫ

55 Έ ҨҞʉˬ͘ Έ ҨҞʉˬ͘] M, A1: Έ ҨҞʉˬ͘ E1.

56 ɑ͵Αā] M, A1: om. E1.
57 Ȉˬ˙͵] E1, A1: ȇˬ˙̒ M.
58 ɬͲ] M, A1: om. E1, in marg. add. E12.
59 ƈLJʷ˶ʓ̵LJ̑] M, A1: ƈLJʷ˶ʓ̵ā E1.
60 ĢLJ̓ǚͫLJ̑ć] A1: ĢLJ̓ǚͫLJ̑ E1, M.
61 Ǩʉʉˉʓͫā] E1, M: Ǩʉˉʓͫā A1: post Ǩʉʉˉʓͫā scr. et del. Ǩʉʔ˜ͫā E1.
62 Ǩʉʉˉʓͫā] E1, M: Ǩʉˉʓͫā A1.
63 MS E1, fol. 122b, lines 12–29; MS A1 fol. 148b, line 17–fol. 149b, line 13; MS M 82b, lines
64 ΈLJ͎Ǩ̿] M, A1, A2: om. et vacat E1.
65 ṳ̈̌āć] M, A1, A2: ƴṳ̈̌āć E1.
66 ɷ͘LJ˙ʓ̶ā] M, A1: ɷ͗LJ˙̵ā E1.
67 ɷ͵Ǎ˳ʶ̈] A1: om. E1: ƦǍ˳ʶ̈ M.
68 ɷ͵Ǎ˳ʶ̈ ɨ́͵Αā ɑͫĕć] om. et vacat E1.
69 ǽͫLJ͎āǨ͘] M, A1: ƛLJ͘ E1.
70 ǽͫLJ͎ć] M, A1: ƛLJ͘ć E1.
71 Ǩ˳ʦͫā ŁǨ̶ ɬͲ ŰǨˈ̈ ŰĢLJˈͫā āǛ΀] M, A1: om. et vacat E1.
72 ƱΑ ҨҞ˳̈] E1, M: ƱΑ ҨҞͲ A1.
73 ĕΒāć] A1: āĕΒāć E1, M.
74 ƛǍ˙ͫ] E1, M: ƛǍ˙ͫā A1.
75 Post ɬ˜ͫ add. ƦǍ˜̈ M.
76 ƦLJ˙ˏ̥] E1, A1: ĢLJʦ̑ M.
77 Post ŁāǨʷͫā add. Ǩʉʔ˜ͫā M.
78 Ǜʦ͎] E1, A1: Ʊǚʥ͎ M.
79 āǛ΀] E1: ƱǛ΀ M, A1.
22 Bink Hallum, N. Peter Joosse, Peter E. Pormann, Simon Swain, Uwe Vagelpohl

ƱǛ́ͫ 84Ʀćǚˬ˙ʓ˳ͫā ɷʉ͇ǚ̈ 83LJ˳͇ ȉʥʒ͵ LJ˶̑ ɨˬ΀ć 82ƹLJ˅ʦͫLJ̑ 81ƛǍ˙ͫā āǛ΀ ǽ͎ ɡʉ͘ LJ˳Ͳ 80ƱǨ̥ΐāć ɑʉͫΒā
ɬͲ Ǽˬʓ˳̈ ĢLJ˳ʦͫā ƛLJ̤ ǽ͎ 86ťΑāǨͫā ƦΑā ƦǍ˳͇ǩ̈ ɨ́͵ΒLJ͎ 85.ɼͲǍʓ˜˳ͫā ĢāǨ̵Αҙҏā ɬͲ ɨ΀ǚ˶͇ ǽ΀ ǽʓͫā ɡ̈ćLJ͘Αҙҏā
ǽ˶ˈ̈ 89ɡ΀ LJ˶ͫ āǍʓʒʔ̈ ɨͫć LJ́ˬˬʥ̈ć łāĢLJʦʒͫā ɑˬ̒ șˁ˶̈ ɷʶʒ̈ć 88ɷ̒ĢāǨʥͫ žǨˀͫā 87ŁāǨʷͫāć ĢLJʦʒͫā
ɡ˳ˈʓʶ˳ͫā ȅ˶ˈ˳ͫā ȅˬ͇ Έ ҨҞ̿Αā ƹLJ˳ͫā ɬͲ ƹǽ̶ ɷ˅ͫLJʦ̈ ɨͫ ķǛͫā ŁāǨʷͫā ƛǍ˙ͫā āǛ΀ ǽ͎ «žǨˀͫā ŁāǨʷͫLJ̑»
ȅˬ͇ ΈLJ͎Ǩ̿ ȅ˳ʶʉ͎ ɡʉˬ͘ ɷʉ͎ ƹLJ˳ͫā ƦΑā ҙҏΒā ƹLJ˳ͫLJ̑ œǩͲ ǚ͘ ķǛͫā ŁāǨʷͫā ɷ̑ ǽ˶ˈ̈ 90LJ˳͵Βā ćΑā Ɏ̇LJ˙ʥͫā ȅˬ͇
ȅͫΒā ɼ̣LJ̤ ΈLJˁ̈Αā 92ɑ̑ ȫʉͫć .ɷ̑ 91œǩͲ ķǛͫā ƹLJ˳ͫā ťLJʉ˙̑ ɷʉˬ͇ ȇˬ͈Αā ŁāǨʷͫā ƦΑҙҏ ƴĢLJˈʓ̵ҙҏā Ɏ̈Ǩ̈́
ɨ̓ Έ ҙҏćΑā ƢLJ˳ʥͫā 93ȅͫΒā ɷˬ̥ǚ̒ ƦΑā ĢLJ˳ʦͫā Ǜʉʒ˶ͫā ŁĢLJʷͫ ŰǨ͇ ȅʓͲ ĔẠ̌Αҙҏā ƦΑā ɡʒ͘ ɬͲ ɷ˶ʉʉʒ̒ć āǛ΀ ȵʉʦˬ̒
LJͲć Ǩʉˈʷͫā ɑʷ͛ ƹāǛˉͫā ĔǍ˳ʥ˳ͫā ƢLJˈ˅ͫā ɬͲć ȇ͵Ǩ˜ͫā ĢLJ˳ʦͫLJ̑ ȇ΀Ǜ̈ ķǛͫā ƢLJˈ˅ͫā ɬͲ ǚˈ̑ ɬͲ ɷ˳ˈ˅̒
ɷ̣āǩͲ ȅˬ͇ ȇͫLJˉͫā ΈLJ˙ʉ͘Ģ ΈLJ̑āǨ̶ ɷͲLJˈ̈́ ǚˈ̑ ɷʉ˙ʶ̒ ɨ̓ 95.ťĢǚ˶̥ ȅ˳ʶ˳ͫā ǽͲćǨͫā Ǩʉˈʷͫā ɬͲ 94ɷ˶Ͳ Ǜʦʓ̈
ƢLJ˳ʥͫā ȅͫΒā ĔǍˈ̈ ɨ̓ ΈāǨʉʔ͛ ΈLJʉʷͲ ǽʷ˳̈ ƦΑā ǽ͎ ɷʉͫΒā Ƣǚ˙ʓ͎ ɷͲǍ͵ ȅ͎Ǎʓ̵ā āĕΒLJ͎ ƢǍ˶ͫā ȇˬ˅̑ ƱǨͲΑLJ̒ ɨ̓ .ƹLJ˳ͫā
.Ŀǚˉ̒ LJͲ ɡʔ˳̑ ȅʷˈʓ̈ ɨ̓ ɨʥʓʶʉ͎

80 ƱǨ̥ΐāć] E1, A1: ƴǨ̥Αā M.

81 ƛǍ˙ͫā] E1, M: om. A1.
82 ƹLJ˅ʦͫLJ̑] E1, A1: ƹLJ˅ʦͫā M.
83 LJ˳͇ ȉʥʒ͵ LJ˶̑] M: LJͲ ǚˈ̑ ȉʥ̑ LJ˳̑ E1: LJͲ ǚˈ̑ ȉʥʒ͵ LJ˶̑ A1.
84 Ʀćǚˬ˙ʓ˳ͫā] E1, M: Ʀćǚˬ˙˳ͫā A1.
85 ɼͲǍʓ˜˳ͫā] E1: ɼ̑Ǎʓ˜˳ͫā M, A1.
86 ťΑāǨͫā] M, A1: ťLJ˶ͫā E1.
87 ŁāǨʷͫāć] M, A1: ŁāǨʷͫLJ͎ E1.
88 ɷ̒ĢāǨʥͫ] E1, A1: ɼ̈ĢāǨʥͫā M.
89 ɡ΀ LJ˶ͫ āǍʓʒʔ̈] M, A1: ɡ΀LJ˘ͫā āǍ˳̵ E1.
90 LJ˳͵Βā ćΑā] M: LJ˳͵ΒLJ͎ E1, A1.
91 œǩͲ] E1, A1: œāǩͲ ǽ͎ M.
92 ɑ̑ E1, A1: ɑͫ M.
93 ȅͫΒā] A1: om. E1, M.
94 ɷ˶Ͳ] E1, A1: om. M.
95 ťĢǚ˶̥] E1: ŦćǨ˶̤ M: ťćĢǚʐ̤ A1.

Greek Epidemics
Exegesis, Explanation and Epistemology 25

Exegesis, Explanation and Epistemology in Galen’s

Commentaries on Epidemics, Books One and Two1
Philip van der Eijk

Introduction: modern and Galenic ways of

reading the Epidemics

In the history of medicine and science, the Hippocratic Epidemics have

consistently been admired for their strong empirical, observational powers.2
The Epidemics in general, it has been said, and books One and Three in
particular, show us Greek medical science in the making.3 In the case histories,
individual patients are being observed day by day during the course of their
illness, and their symptoms and, occasionally, their reactions to treatment are
meticulously recorded, sometimes so accurately that later medical readers have
felt encouraged to undertake attempts at retrospective diagnosis. In the sections
devoted to the so-called ‘constitutions’ (καταϲτάϲειϲ), diseases and symptoms

1 I am deeply grateful to Peter E. Pormann, Simon Swain and the other members of
the Warwick Epidemics team for their invitation and for their help (especially with the
interpretation of the passages preserved in Arabic only) and patience during the revision of this
paper for publication. The research on which this paper is based was funded by the Alexander
von Humboldt Foundation as part of the project ‘Medicine of the Mind, Philosophy of the
Body. Discourses of Health and Well-Being in the Ancient World’, based at the Humboldt-
Universität zu Berlin.
2 Throughout this paper, I use the word ‘Hippocratic’ in the pragmatic, descriptive sense
of ‘having been attributed, at some stage of its transmission, to Hippocrates’, regardless of the
question of the justification of this attribution. Galen had no doubts about the authorship of
Epidemics, book One, but suspended judgement on the authorship of book Two.
3 For appraisals of the Epidemics in eighteenth-century medicine (Boerhaave, van Swieten)
see Leitner 1989. For an example of early twentieth-century assessments of the observational
strengths displayed in the Epidemics, see W. H. S. Jones’ characterisation: ‘But the most
striking feature of this work is its devotion to truth. The constitutions are strictly limited to
descriptions of the weather which preceded or accompanied certain epidemics; the clinical
histories are confined to the march of diseases to a favourable or a fatal issue. Nothing
irrelevant is mentioned; everything relevant is included’ (Jones 1923, 144). For more recent,
and epistemologically more nuanced, but nevertheless very positive evaluations of the powers
of observation in the Epidemics, see Grmek 1989, 284–355; Lichtenthaeler 1993; Jouanna 1999,
291–2, 303–7; Graumann 2000.
26 Philip van der Eijk

are related to more general patterns of weather, climate and environment of

particular regions, thus presenting early attempts at what would be called today
demographic and environmental history of disease. And in the methodological
sections, especially in Book One, we find the author giving account of his own
procedures and stating the general principles of the medical profession.4 Here,
we read the famous definition of the physician’s duties as ‘to help, or to do no
harm (ὠφελέειν, ἢ μὴ βλάπτειν)’,5 followed by the description of the Hippocratic
triangle of doctor, patient and disease, with the former two being involved
in a joint battle against the latter;6 and further down in Epidemics, Book One,
there is the well known checklist of items the physician has to pay attention
to in the examination of a patient and in the casting of a diagnosis and prog-
Throughout the Epidemics, all this takes place against the background of a
mildly theoretical framework that reflects the authors’ presuppositions but
which remains largely implicit. As pointed out by Volker Langholf and Wesley
Smith, we can detect elements of a doctrine of crisis and critical days, a theory
of environmental and meteorological medicine, assumptions about particular
bodily fluids and pathological agents and processes, and presuppositions about
what to look for when examining a patient or visiting an area struck by disease.8
Yet there is no standardisation of disease terminology, no systematic classifica-
tion of disease, nor is there any preoccupation with treatment or cure, for treat-
ment, if referred to at all, is mentioned almost exclusively in the context of the

4 I am using the term ‘author’ here in the singular, although it is of course quite probable that
the Epidemics are the result of multiple authorship or constitute compilations of information
derived from various archival sources. For Galen’s reception of the work, however, this point
is irrelevant.
5 Hippocratesʼ Epidemics, Book i. 11 (i. p. 190, line 3 Kw; ii. pp. 634–6 L) commented
upon by Galen in Commentary on Hippocratesʼ ‘Epidemicsʼ, Book One, p. 76, lines 1–24 W
(xvii/a. pp. 148–9 K; cf. i.2.136–9 V). References to the Greek text (where this survives) of
Galen’s Commentary on Hippocratesʼ ‘Epidemicsʼ are to the edition by Ernst Wenkebach 1934,
followed by the corresponding volume and page number in Kühn 1821–33 (where applicable).
Translations from the Greek are my own, although I have benefited greatly from comparison
with the forthcoming translation of the corresponding Arabic sections by Uwe Vagelpohl and
Bink Hallum, and where relevant, I have added a reference to the corresponding passage (book,
section and paragraph number) in their translation of the Arabic version. Likewise, references
to Book Two (which survives in Arabic only) are to book, section and paragraph number of the
forthcoming translation by Hallum and Vagelpohl, followed by the corresponding page and
line numbers in the CMG translation by Pfaff (where applicable).
6 Hippocratesʼ Epidemics, Book i. 11 (i. p. 190, lines 3–6 Kw; ii. 636 L); commented upon by
Galen in his Commentary on Hippocratesʼ ‘Epidemicsʼ, Book One, p. 76, line 25–p. 77, line 15 W
(xvii/a. pp. 149–51 K; cf. i.2.140–1 V).
7 Epidemics, Book i. 23 (i. p. 199, line 9–p. 200, line 2 Kw; ii. pp. 668–70 L), commented upon
extensively by Galen in his Commentary on Hippocratesʼ ‘Epidemicsʼ, Book One, p. 102, line 23–
p. 110, line 26 W (xvii/a. pp. 203–19 K; cf. i.3.1–27 V).
8 Langholf 1990; Smith 1991.
Exegesis, Explanation and Epistemology 27

patient’s reaction to it. All in all, it has often been argued, we seem to be wit-
nessing the birth of clinical, observational medicine, aspiring at high standards
of accuracy and precision, honesty and integrity. Whoever the authors or re-
dactors of the Epidemics were, they seem to have been primarily occupied with
gathering empirical data, as unbiasedly as possible, without attempting to edit,
fabricate or suppress information in order to promote their own achievements
or elevate their own status. Indeed, one further feature for which the authors
of the Epidemics have long been admired is the fact that they admit failure in
their diagnosis or treatment of patients, thus contributing to the lofty picture of
the self-critical Hippocratic physician that was long cherished by classicists and
members of the medical profession alike.
This is, roughly, the traditional picture that has dominated appraisals of the
Epidemics from the early modern period onwards. Of course, some cracks have
come into this. For one thing, most students of the Epidemics nowadays are
acutely aware that no observation is value-free, and no record of a patient’s
symptoms is beyond selection, interpretation or bias in representation, quite
apart from the fact that access to these observations is complicated by the vo-
cabulary and terminology in which they are cast. These considerations should
make medical as well as non-medical readers beware of taking the descriptions
of the Epidemics too much at face value. In addition, there has been increasing
criticism of the practice of retrospective diagnosis on the basis of the case histo-
ries, though it is worth pointing out that scholars such as the late Mirko Grmek
and, more recently, Lutz Alexander Graumann, still accepted it as a valid pro-
cedure, provided that certain conditions are met.9 Thirdly, comparative literary
and cultural studies into the genre of the medical case history have highlighted
the remarkable variety in forms and functions that case histories may display
in different contexts, civilisations and time frames, again suggesting that one
should not take the specific form and function of the case histories preserved in
the Epidemics for granted.10 And fourthly, linguistic and stylistic analysis of the
Hippocratic case histories, such as that by Rainer Hellweg or Volker Langholf,
has led to the hypothesis that, especially in the later books of the Epidemics,
there is evidence of polishing or at least editing, possibly with a view to pur-

9 See Grmek 1989, especially chapters 11, 12 and 13; Jouanna and Grmek 2000, lxxvi–xc,
e.g. p. lxxxii: ‘In an astonishingly high number of cases described in Epidemics, Books Five and
Seven, one can … formulate a retrospective diagnosis that is fairly certain. (Dans un nombre
étonnamment élevé de cas décrits dans les Épidémies V et VII on peut … énoncer un diagnostif
rétrospectif assez sûr.)’ See also Graumann 2000.
10 Even in Graeco-Roman medicine, case histories display considerable variation, as emerges
from a comparison of Hippocratic case histories with those found in Galen and Rufus; see
Lloyd 2009, Ullmann 1978, Swain 2008 and ed. Pormann 2008c, 64–73; for later developments
in medieval Islamic medicine, see Álvarez Millán 2010; for cross-cultural perspectives, see
Lloyd 2007.
28 Philip van der Eijk

poses of teaching and instruction for medical students, or for illustration of

general theoretical points.11
Yet for all these qualifying considerations, much of the idealised picture of the
Hippocratic Epidemics still stands. They continue to be regarded as landmarks
of empirical science, based on careful and systematic observation and providing
the foundation for comparative analysis of data in order to arrive at universal
truths about disease, the human body and the environment.

However, Galen’s approach to the Epidemics, as reflected in his surviving com-

mentaries on books One, Two, Three, and Six, is rather different.12 Galen has
no desire whatsoever to show that the case histories are unbiased records of
neutral, empirical observation, meant to support an inductive process of data
collection and processing. He unashamedly reads them in the light of theoretical
concepts and ideas reflected in other Hippocratic works and, more importantly,
his own medical writings. Accordingly, Galen claims that there are certain pre-
requisites for a correct understanding of the Epidemics. Thus at an early stage
of his commentary on book One, he says that readers of Epidemics should first
study other Hippocratic works such as Nature of Man, Airs Waters Places and
the Aphorisms in order to understand the work properly.13 Galen often supple-
ments the account provided in the Epidemics with details derived from other
Hippocratic texts or, more often, from his own medical writings, to which he
refers frequently, both his commentaries on other Hippocratic writings, such as
those on Aphorisms and Prognostic,14 and works by himself not in the form of a
There are several reasons for this. One is a general one, to do with the fact that
ancient ways of commenting on a medical or philosophical text are so different
from ours. Galen was part of the interpretative and exegetical culture of the
early Imperial period. This exegetical culture, and Galen’s place in it, has been
11 Hellweg 1985; Langholf 1977b.
12 For practical reasons, I concentrate in this paper on Galen’s commentaries on Books i and
ii, as these – and their Arabic transmission – were the basis for the Warburg conference where
this paper was presented. On special features of Galen’s commentaries on Books iii and vi, see
Manetti and Roselli 1994, 1552–4.
13 P. 6, line 26–p. 7, line 4 W (xvii/a. p. 7 K; cf. i.1.15 V).
14 Book ii.1.70 HV (cf. 172, lines 1–23 Pf).
15 Thus Method of Healing is referred to in Commentary on Hippocratesʼ ‘Epidemicsʼ, Book
One, p. 75, lines 1–2 W (xvii/a. p. 145 K; cf. i.2.129 V); Mixtures is referred to in Book One,
p. 93, line 29 W (xvii/a. p. 186 K; cf. i.2.204 V); in Book Two, ii.1.115 HV (cf. p. 184, line 2 Pf),
ii.3.123 HV (cf. p. 293, lines 18–19 Pf; Pfaff erroneously translates ‘Über die Krisis’), ii.6.6 HV
(cf. p. 355, line 32 Pf); Critical Days is referred to in Book One, p. 63, line 34 W (xvii/a. p. 123
K; cf. i.2.74 V), p. 97, line 14 W (xvii/a. p. 192 K; cf. i.2.216 V), p. 100, line 22 W (xvii/a. p. 199
K; cf. i.2.225 V), p. 124, line 5 W (xvii/a. p. 247 K; cf. i.3.69–71 V); Natural Faculties is referred
to in Book Two, ii.1.142 HV (cf. p. 191, lines 18–19 Pf); Difficulty of Breathing is referred to in
Book Two, ii.3.58–9 HV (cf. p. 274, line 32 Pf), ii.3.69 HV (cf. p. 277, line 13 Pf).
Exegesis, Explanation and Epistemology 29

discussed in considerable depth by Daniela Manetti and Amneris Roselli, Simon

Swain, Heinrich von Staden and Rebecca Flemming, and there is no reason to
repeat their findings.16 Suffice it to say that ancient commentators on philo-
sophical, scientific and medical texts were primarily motivated by pragmatic
reasons, often to do with the teaching practice: the writings of Plato, Aristotle or
Hippocrates had to be studied and explained to students not for historical rea-
sons but because the views they contained were still valid, relevant and true to
philosophical and medical students of many centuries later. Thus early Imperial
commentators’ ways of reading are synthetic rather than analytical, systematic
rather than historical, and often deliberately ahistorical and anachronistic, at-
tributing views to earlier authorities that they could not possibly have held.
Moreover, exegesis served an important function in the exposition of a philoso-
pher’s or medical writer’s own ideas: the authority of the ancients (παλαιοί,
ἀρχαῖοι) provided important backing to a thinker’s own arguments and shaped,
to a very large extent, the structure of one’s own positive argument.
All this is not to deny Galen’s originality or peculiarity in this culture of ex-
egesis; nor is it to play down the variety of forms, modes and genres of exegesis
he and others employed, ranging from the lemmatic running commentary to
much freer ways of engagement with the text of an earlier author. Yet when
confronting our ways of reading the Hippocratic Epidemics with Galen’s, or in-
deed with that of other ancient exegetes, we need to be aware of the differences
between ancient and modern commentaries and of the place of exegesis in the
culture in which they were written.

The title Epidemics and the theoretical dimensions of the work

There is, however, also a more specific reason why Galen’s approach to the
Hippocratic Epidemics is so different from that of modern readers, and this has
to do with his interpretation of the title of the work. As is well known, the
meaning of the title Epidemics (Ἐπιδημίαι) is unclear and ambiguous, and the
word has often been taken to refer to the doctor’s ‘visits’ to his patients.17 Yet
as the Preface to the commentary on Book One shows, Galen takes the word
ἐπίδημοϲ in the sense of ‘epidemic disease’ as opposed to local or endemic
(ἔνδημοϲ) diseases18:

16 Manetti and Roselli 1994; Swain 1996; von Staden 2002, 2006, 2009; Flemming 2008.
17 For a discussion see Langholf 1990, 78–9, referring, among other things, to the use of
ἐπιδημία in the title of the historian Ion of Chios (d. c. 420 BC).
18 Book i.1.2–3 V (the Greek of this section does not survive). All translations from the
Arabic are taken from the forthcoming edition and translation by Vagelpohl and Hallum.
30 Philip van der Eijk

ɬͲ ǚˬ̑ ǽ͎ ŰǨˈ̒ LJ˳͵Βā Ȉ͵LJ͛ ƦΒāć ŰāǨͲΑҙҏā ƱǛ΀ ƦΑā ɼ̈ǚˬʒͫā ŰāǨͲҙҏā ɬʉ̑ć ŰāǨͲΑҙҏā ƱǛ΀ ɬʉ̑ ƈǨˏͫāć
ȇʉˀ̒ ŰāǨͲΑā ǽ͎́ ɼ̈ǚˬʒͫā ŰāǨͲΑҙҏā LJͲΑāć .ŰĢLJ͇ ȇʒ̵ ɬͲ ɨ́ͫ Ńǚʥ̒ ŰāǨͲΑā ǽ΀ LJ˳͵Βā LJ́͵Αā ҙҏΒā Ʀāǚˬʒͫā
ŁLJʓ͛ ǽ͎ ŴāǨ˙̑Αā Ʉ̿ć ǚ͘ć .ɷʉ͎ ŰǨˈ̒ ķǛͫā ǚˬʒͫā ɡ΀Αҙҏ ɼˏͫLJʥ˳ͫLJ͛ ƦǍ˜̒ ȅʓ̤ ΈLJ˳̇āĔ ṳ̈̌āć ǚˬ̑ ɡ΀Αā
ɑˬʓ͎ ɨ΀ǚˬ̑ łҙҏLJ̤ ȇʶʥ̑ Ʀāǚˬʒͫā ɬͲ ǚˬ̑ ǚˬ̑ ɡ΀Αā ȇʉˀ̒ ŰāǨͲΑҙҏā ķΑā Ƚ̀āǍ˳ͫāć ƹāǍ́ͫāć ƹLJ˳ͫā
.ɼ̈ǚˬʒͫā ȅ˳ʶ̒ ǽʓͫā ǽ΀ ŰāǨͲΑҙҏā

Galen said: Hippocrates entitled this book Epidemics because most of his
discussion and detailed description in it deals with the diseases called ‘epi-
demic’. It means ‘the visiting’ and refers to a single disease affecting a large
group at the same time. The difference between these and local [i.e. en-
demic] diseases is that, even though they [sc. epidemics] occur in a certain
location, they are only diseases which affect them due to an accidental
cause. Local diseases are diseases people of one location suffer from all the
time: they are like a [constant] companion of the inhabitants of the place
where they occur. In Airs, Waters, Places, Hippocrates described which dis-
eases affect the inhabitants of each country in accordance with its condi-
tions. These diseases are called ‘local’.

Accordingly, Galen takes the Hippocratic Epidemics – or at any rate book One –
as a treatise on a specific type of diseases affecting large numbers of people due
to causes that go beyond individual people’s eating patterns and lifestyles, and
whose main cause is the air that people breathe. This is because the Epidemics,
in Galen’s interpretation, presuppose a specific classification of diseases, not
only distinguishing ‘epidemic disease’ from local, or endemic, diseases but also
distinguishing ‘common’, or ‘general’ from ‘individual’ or ‘diverse’ diseases19:

ɼ˶̈ǚͲ ɡ΀Αā ȅˬ͇ ṳ̈̌āć Ȉ͘ć ǽ͎ Ńǚʥ̒ ǽʓͫā ŰāǨͲΑҙҏā Ȉˬ͘ LJ˳͛ Ʉˀ̈ ŴāǨ˙̑Αā ƦΒLJ͎ ŁLJʓ˜ͫā āǛ΀ ǽ͎ LJͲΑLJ͎
ζƴǨʉʔ͛ ɼ͇LJ˳ʤͫ ƦҨҞͲLJ̶ ƦLJʉͲLJ͇ LJ˳́͵Αā ŰǨ˳ͫā ɬͲ ɬʉʶ˶ʤͫā ɬ̈ĕLJ΀ ɨˈ̈ć .ɨ΀Ǩ̵ΑLJ̑ ǚˬ̑ ɡ΀Αā ćΑā ɨ΀Ǩ̵ΑLJ̑
Ȉ̀Ǩ͇ ƦΒāć ǽʓͫā LJ́ˬ͛ ŰāǨͲΑҙҏā Ǩ̇LJ̵ LJͲΑāć .ťLJ˶ͫā ɬͲ ƴǨʉʔ͛ ɼ͇LJ˳̣ ȇʉˀ̈ LJ́˶Ͳ ṳ̈̌āǍͫā ŰǨ˳ͫā ƦΑā ǽ˶͇Αā
ɼ͇LJ˳ʤͫā ɑˬ̒ ɬͲ Έāṳ̈̌āć Έāṳ̈̌āć LJ́˶Ͳ ṳ̈̌āć ɡ͛ ȵʦ̈ ɬ˜ͫ Ǩʉʔ˜ͫā LJ́˶Ͳ ṳ̈̌āǍͫā ɨˈ̈ ɨͫ ƴǨʉʔ͛ ɼ͇LJ˳ʤͫ
ɑͫǛ͛ ůLJ̥ ťLJ˶ͫā ɬͲ ṳ̈̌āć ṳ̈̌āǍͫ LJ́̓ćṳ̈̌ ƦΑā LJ˳͛ ŰāǨͲΑҙҏā ƱǛ΀ć .ɼˏˬʓʦ˳ͫā ŰāǨͲΑҙҏLJ̑ žǨˈ̒ LJ˳͵ΒLJ͎
LJ́̓ćṳ̈̌ ƦΑā LJ˳͛ć ɑͫĕ žҨҞ̥ ȅˬ͇ LJ́ʉ͎ ƛLJʥͫLJ͎ ɼʉͲLJˈͫā ŰāǨͲΑҙҏā LJͲΑLJ͎ .ɨ́˶Ͳ ṳ̈̌āć ɡ͛ ǽ͎ ůLJ̥ LJ́ʒʒ̵
.ǽͲLJ͇ ȇʒ̵ LJ́ʒʒ̵ ɑͫǛ͛ ƢLJ͇

As I said, Hippocrates describes in this book diseases which simultane-

ously affect inhabitants of an entire city or country. These two kinds of

19 Book i.1.4–5 V (the Greek of this section does not survive); see also p. 9, lines 4–5 W
(xvii/a. p. 10 K; cf. i.1.22 V), with reference to Airs, Waters, Places.
Exegesis, Explanation and Epistemology 31

diseases [sc. epidemic and local] have in common that they involve a large
community, i.e. that the same disease affects a large group of people. Even
though they [also] affect large groups, there is not a single of the other
diseases which a large number share [in this way]. Rather, each of them
affects each member of the community individually. They are known as
‘variable’ diseases. Just as they affect people individually, each of them
arises from an individual cause. The opposite applies to ‘general’ diseases:
their occurrence is general, as is their cause.

Furthermore, Galen argues, the Epidemics presuppose a specific theory of dis-

ease causation, distinguishing between diet, exercise and air or external influ-

ƢLJˈ̈́ ɬͲ ƛćLJ˶ʓ̈ LJͲ LJ́˶Ͳ ṳ̈̌āć ɼʔˬ̓ ŰāǨͲΑҙҏā LJ́ʉ͎ Ńǚʥʓ͎ Ʀāǚ̑Αҙҏā ȅˬ͇ ĔǨ̒ ǽʓͫā LJ́ˬ͛ ŁLJʒ̵Αҙҏā ťLJ˶̣Αāć
ƹāǍ΀ ɬͲ œĢLJ̥ ɬͲ Ʀǚʒͫā ȅ˙ˬ̈ LJͲ ȉͫLJʔͫāć LJ΀Ǩʉ͈ć łLJ͛Ǩʥͫā ɬͲ ɡˈˏ̈ LJͲ ǽ͵LJʔͫāć LJ˳΀Ǩʉ͈ ɬͲć ŁāǨ̶ ćΑā
ɬͲ ƦǍ˜̈ LJ˳͵Βā LJ́̓ćṳ̈̌ Ǩʔ͛Αā ƦΑā ҙҏΒā ŁLJʒ̵Αҙҏā ƱǛ΀ Ƚʉ˳̣ ɬͲ Ńǚʥ̒ ǚ͘ ɼʉͲLJˈͫā ŰāǨͲΑҙҏāć .ƱǨʉ͈ ɬͲ ćΑā
ǚˬ̑ ɡ΀Αā ȅˬ͇ ćΑā ΈLJˈͲ ɼ˶̈ǚͲ ɡ΀Αā ȅˬ͇ ƢLJˈͫā ŰǨ˳ͫā Ńćṳ̈̌ ƦΑā ɑͫĕć ζƦāǚ̑ΑҙҏLJ̑ Ⱥʉʥ˳ͫā ƹāǍ́ͫā ƛLJ̤
ɬͲ ćΑā ƢLJ͇ ŁāǨ̶ ɬͲ ƢLJˈͫā ŰǨ˳ͫā ƦǍ˜̈ ƦΑā ĔLJ˜̈ ҙҏ ΈLJˁ̈Αā ɑͫǛ͛ć ΈāǨʉʔ͛ Ɏˏʓ̈ LJ˳Ͳ ȫʉͫ ƢLJ͇ ƢLJˈ̈́ ɬͲ
.ƢLJ͇ ŴǨˏͲ ȇˈ̒

There are three types of causes which affect bodies and generate diseases:
the first is food, drink or other things one ingests; the second, physical
exercise and other things one engages in; and the third, the air or other
external [influences] on the body. General diseases are caused by all of
these causes, but they mostly arise because of the condition of the air sur-
rounding the bodies. That is to say, it is rare that a general disease affecting
the inhabitants of an entire city or country arises because of shared food.
Likewise, it also rarely happens that a general disease arises because of
shared drink or excessive [physical] exertion.

20 Book i.1.5–6 V. See the following summary (ii.1.3 HV; cf. p. 155, lines 13–20 Pf): ‘Galen
said: In the first book, Hippocrates described the issue of three states of air which cause
diseases. In the third part of this same book, he described the issue of one pestilential state. He
began by describing all these states in terms of change in the air which surrounds the bodies,
and its deviation from its nature. Then he proceeded by describing the nature of the diseases
which befall many people because of these states. (ŃҨҞ̓ ǨͲΑā ȅͫćΑҙҏā ɼͫLJ˙˳ͫā ǽ͎ Ʉ̿ć ŴāǨ˙̑Αā ƦΒā :ťǍ˶ʉͫLJ̣ ƛLJ͘
Έ ҙҏćΑā Ƣǚ˙͎ .ɼʉ̇LJ̑ć ƴṳ̈̌āć ƛLJ̤ ǨͲΑā ɷ˶ʉˈ̑ ŁLJʓ˜ͫā āǛ΀ ɬͲ ɼʔͫLJʔͫā ɼͫLJ˙˳ͫā ǽ͎ Ʉ̿ćć ŰāǨͲΑā LJ́˶͇ Ȉ̓ṳ̈̌ ƹāǍ́ͫā łҙҏLJ̤ ɬͲ łҙҏLJ̤
ǽʓͫā ŰāǨͲΑҙҏā Ƚ̇LJʒ̈́ ɼˏˀ̑ ɑͫĕ Ƚʒ̒Αā ɨ̓ .ɷʓˈʉʒ̈́ ɬ͇ ɷ̣ćǨ̥ć Ʀāǚ̑ΑҙҏLJ̑ Ⱥʉʥ˳ͫā ƹāǍ́ͫā Ǩʉˉ̒ ɼˏ̿ LJ́ˬ͛ łҙҏLJʥͫā ɑˬ̒ Ʉ̿ć ǽ͎
łҙҏLJʥͫā ɑˬ̒ ɬ͇ ťLJ˶ͫā ɬͲ Ǩʉʔ˜ͫ Ȉ̓ṳ̈̌.)’
32 Philip van der Eijk

Galen demonstrates that this theory of disease causation has a genuine

Hippocratic pedigree by means of a long quotation from Nature of Man, in
which the author (Hippocrates, according to Galen) distinguishes between dis-
eases caused by lifestyle and diseases caused by the air people inhale. When
one particular disease afflicts a large number of people at the same time, we are
dealing with a disease of the latter kind, Hippocrates argues, for this has one
cause common to all, as opposed to people’s lifestyle that is different from one
individual to another.21

Thus according to Galen, causal explanation plays a major part in the Epidemics,
and even where this is not sufficiently clear from the text, his exegesis will point
this out. The following passage makes a connection between exegesis and causal
explanation (aitiología) and thus provides justification for Galen’s procedure22:

… μεμνημένων ἡμῶν, ὅτι τὸ μὲν κυρίωϲ ὀνομαζόμενον ἐξηγεῖϲθαι κατὰ

τὰϲ ἀϲαφεῖϲ γίνεται λέξειϲ, ἤδη δὲ διὰ τὸ τῶν ἐξηγητῶν ἔθοϲ καταχρώ-
μενοι καὶ τὰϲ αἰτιολογίαϲ τῶν ϲαφῶϲ εἰρημένων ἐξηγήϲειϲ ὀνομάζομεν,
ὅπερ καὶ νῦν ἡμεῖϲ ποιοῦμεν ἑπόμενοι τῇ κρατούϲῃ ϲυνηθείᾳ. τὴν γὰρ λέ-
ξιν αὐτὴν οὖϲαν ϲαφῆ καὶ μηδεμιᾶϲ ἐξηγήϲεωϲ δεομένην προφερόμενοι,
τῶν ὑπ’ αὐτῆϲ δηλουμένων ϲαφῶϲ τὰϲ αἰτίαϲ ἐπιχειροῦμεν λέγειν.

… we need to bear in mind that although the term ‘exegesis’ in the proper
sense applies to textual passages that are obscure, we also use it on ac-

21 P. 7, line 23–p. 8, line 13 W (xvii/a. pp. 8–9 K; cf. i.1.18 V): ‘I will show that it was
Hippocrates who distinguished the two kinds of diseases that I discussed in this way, when he
stated that air is the cause of epidemic diseases (καὶ πιϲτώϲομαι τὰ γένη τῶν νοϲημάτων, ὧν
διῆλθον, Ἱπποκράτει διῃρημένα εἶναι οὕτωϲ, αἴτιόν γε τὸν ἀέρα 〈τῶν〉 ἐπιδημίων νοϲημάτων
ἀποφαινομένῳ). For in his Nature of Man he writes the following: “Some diseases develop
because of lifestyle and some because of the air which we live on by inhaling it (αἱ δὲ νοῦϲοι
γίνονται αἱ μὲν ἀπὸ διαιτημάτων, αἱ δὲ ἀπὸ τοῦ πνεύματοϲ, ὃ ἐϲαγόμενοι ζῶμεν). We need to
distinguish between these two kinds of diseases in the following manner. When one particular
disease afflicts a large number of people at the same time, we must attribute the blame for this
to what is most general and used most frequently by all of us: and this is the air we breathe.
It is obvious that the lifestyle of each of us individually cannot be the cause of a disease that
includes everyone without exception, young and old, females and males, drinkers of wine and
drinkers of water, those fed with barley porridge and those fed with bread, those who rarely
toil and those who wear themselves out. Lifestyle, then, cannot be the cause of the disease
since people’s lifestyles are varied in all sorts of ways, whereas the disease that occurred was
one and the same. On the other hand, when diseases that occur at a specific time are varied, it
is clear that their cause is the lifestyle of each of the people who fall ill.’
22 P. 80, lines 3–9 W (xvii/a. pp. 156–7 K; cf. i.2.151 V). Note, however, that at ii.4.15 HV
(cf. p. 317, lines 11–17 Pf), Galen says that his only purpose is to ‘explain the meaning of what
is said (ƛLJ͘ LJ˳ʉ͎ ƱLJ˶ˈͲ ŔǨ̶Αā ƦΑā)’ and ‘not … to clarify Hippocrates’ teachings and provide proofs for
them (ɬʉ΀āǨʒͫLJ̑ LJ́ʉˬ͇ ǽ̒ΐāć ŴāǨ˙̑Αā ƹāĢΐā ɬʉ̑Αā ƦΑā ǽ̀Ǩ͈ ȫʉˬ͎)’.
Exegesis, Explanation and Epistemology 33

count of the normal practice of the exegetes in an improper sense to re-

fer to the statement of the causes of things that have been stated clearly.
This is exactly what we are doing here, following the prevailing habit, for
when presenting a passage that is clear and does not require any exegesis,
we attempt to state the causes of what has been clearly described in this

Thus exegesis in Galen’s view involves not just elucidation of obscure passages
but also causal explanation of phenomena whose description itself is perfectly
clear. This is appropriate, he believes, for the Epidemics are anything but free
from theoretical assumptions about underlying causes. For example, Galen
credits Hippocrates with the distinction between ‘procatarctic causes’ and ‘pre-
disposing’ causes, a distinction not found in any of the Hippocratic writings
and which modern scholarship tends to date to the Hellenistic period.23 Further-
more, Galen argues that the Epidemics unashamedly presuppose an elaborate
theory of environmental and meteorological medicine, in which the dominance
of humours and specific types of diseases and the mixtures of the surrounding
air are all said to be interconnected according to climatic and seasonal patterns
and changes.24 This may be less questionable from a modern standpoint, con-
sidering that environmental factors play such a big part in the Epidemics. Yet
the explanation Galen offers for this is cast entirely in terms of his own theory

23 Book ii.1.14 HV (cf. p. 158, lines 1–32 Pf): ‘I am going to summarise what I have said from
the beginning and then divide it. I say that when Hippocrates said ‘abundant rain came with
the heat of the summer during its entirety. This happened mostly together with a south wind’,
he indicated the cause called ‘procatarctic’, which brings about the generation of carbuncles.
This cause is external to the bodies affected by the disease. By saying ‘pus develops under
the skin’, he indicated the cause called ‘pre-disposing’, which brings about the generation
of the carbuncles. This cause first occurs within the body. By saying ‘when it is congested,
it becomes hot’, he indicated the way in which this cause brings about carbuncles, namely
the excessive heat of the humour predominant in the body, this predominance being due to
putrefaction. He called it ‘pus’, because it is unnatural, bad and malicious. When he said ‘and
generates itching’, this is a symptom which precedes the occurrence of carbuncles. (ɡ˳ʤͲ LJ͵Αāć
«ŁǍ˶ʤͫā ȽͲ ƦǍ˜̈ LJͲ Ǩʔ͛Αā ƦLJ͛ć ɷˬ͛ Ʉʉˀͫā Ǩ̤ ȽͲ ĔẠ̌ ĢLJ˅ͲΑā łƹLJ̣» ɷͫǍ˙̑ ƛĔ ŴāǨ˙̑Αā ƦΒā ƛǍ͘ΑLJ͎ ɷˈ˅͘Αā ɨ̓ ɷͫćΑā Ǜ˶Ͳ ǽͫǍ͘
ƛĔć .ɼ͎ΐҙҏā LJ́ʓͫLJ͵ ǽʓͫā Ʀāǚ̑Αҙҏā ɬͲ œĢLJ̥ ȇʒ̵ Ǎ΀ ȇʒʶͫā āǛ΀ć .Ǩ˳ʤͫā ǚͫǍ̒ ƦǍ˜̈ ɷ˶Ͳ ķǛͫā ĶĔLJʒͫā ȅ˳ʶ̈ ķǛͫā ȇʒʶͫā ȅˬ͇
ǽ͎ Ńǚʥ̈ ķǛͫā ȇʒʶͫā Ǎ΀ć Ǩ˳ʤͫā ǚͫǍ̒ ƦǍ˜̈ ɷ˶Ͳ ķǛͫā ƢĔLJ˙ʓ˳ͫā ȅ˳ʶ̈ ķǛͫā ȇʒʶͫā ȅˬ͇ «ǚ̈ǚ̿ ǚˬʤͫā Ȉʥ̒ Ǩʉˀ̈ć» ɷͫǍ˙̑
ȇͫLJˉͫā Ⱥˬʦͫā ƴĢāǨ̤ ŴāǨ͎Βā Ǎ΀ ɑͫĕć Ǩ˳ʤͫā ȇʒʶͫā ɑͫĕ Ńǚʥ̈ LJ́̑ ǽʓͫā ɼ́ʤͫā ȅˬ͇ «ɬʦ̵ ɬ˙ʓ̤ā āĕΒLJ͎» ɷͫǍ˙̑ ƛĔć Έ ҙҏćΑā Ʀǚʒͫā
«ɼ˜̤ ǚͫćć» ɷͫǍ͘ LJͲΑLJ͎ .ΈLJʔʉʒ̥ ΈLJʈ̈ĔĢ ΈLJ̣ćǨ̥ ɼʉˈʉʒ˅ͫā ɬ͇ ΈLJ̣ĢLJ̥ ƦLJ͛ ɷ͵Αā ɡʒ͘ ɬͲ Έāǚ̈ǚ̿ ƱLJ˳̵ć ɼ͵Ǎˏˈͫā ȇʒʶ̑ ɷ͵LJʒˬ͈ć Ʀǚʒͫā ǽ͎
Ǩ˳ʤͫā Ńćṳ̈̌ Ƣǚ˙ʓ̈ ŰǨ͇ Ǎ͎́.) ’
24 P. 13, lines 11–15 W (xvii/a. p. 18 K; cf. i.1.34 V): ‘What is further useful is this division of
the year into four seasons, as this, too, was shown before by Hippocrates himself in the work
in which he sets out the dominance of humours and the types of diseases and the mixtures
of the surrounding air that govern both of these, and which present four different kinds.
(χρηϲίμη δὲ καὶ 〈ἡ〉 εἰϲ τέϲϲαραϲ ὥραϲ, ὡϲ καὶ τοῦτο δέδεικται πρότερον 〈ὑπ’〉 αὐτοῦ τοῦ
Ἱπποκράτουϲ ἐν οἷϲ τάϲ τε τῶν χυμῶν ἐπικρατείαϲ διδάϲκει καὶ τὰϲ τῶν νοϲημάτων ἰδέαϲ καὶ
τὰϲ ἀμφοτέρων τούτων ἡγουμέναϲ κράϲειϲ τοῦ περιέχοντοϲ, τέτταραϲ ἐχούϲαϲ διαφοράϲ.)’
34 Philip van der Eijk

of ‘mixtures’ or ‘temperaments’ (kráseis), the specific proportions between the

elementary qualities hot, cold, dry and wet that determine an individual pa-
tient’s bodily make-up, susceptibility to disease and interaction with envi-
ronmental factors, and which can be inferred or interpreted on the basis of a
patient’s outward appearances. Galen expounds this theory in his important
treatise Mixtures, to which he often refers in the commentary on the Epidem-
ics. Although in reality this theory owes more to Aristotle than to Hippocrates
(as is clear from the many references to Aristotle in Galen’s Mixtures),25 Galen
nevertheless claims that in developing this theory, he is essentially just spelling
out ideas already present in Hippocrates, as he shows in two others works more
closely associated with the interpretation of Hippocratic texts, namely Elements
according to Hippocrates and the Commentary on Hippocrates’ ‘On the Nature of
Man’. This theory of mixtures is important in order to explain, as Galen puts it,
why different patients react differently to the same causal agents, for this is due
to the interaction between the ‘mixture’ of the environment and the mixture of
the body;26 and this knowledge is in turn an essential condition for the physi-
cian’s ability to predict and to prevent diseases27:

Ȉʒʔ̈ LJ́ˁˈ̑ć Ǩ̀LJʥͫā Ȉ͘Ǎͫā œāǩͲ ɬͲ ɼͫLJʥʓ̵ҙҏā ɷʉͫΒā ŷǨʶ̒ Ʀāǚ̑Αҙҏā ȶˈ̑ ĢLJ̿ LJ́ˬ͛ ŁLJʒ̵Αҙҏā ƱǛ́ˬ͎
ǽ͎ ΑLJ˅ʦͫā ɬͲ ŰǨ˳ͫā ɷͫ ŰǨˈ̈ LJ́ˁˈ̑ć ɼΈ ʓ̑ ĢǨ̀ ɷ˶Ͳ ɷͫLJ˶̈ ҙҏ LJ́ˁˈ̑ć ɼˬ̈Ǎ̈́ ƴΈ ǚͲ œāǩ˳ͫā ɑͫĕ ƢćLJ˙̈ć
LJ˳͵Βā ƹāǍ́ͫā ɬͲ ĢǨˁͫā LJ́ͫLJ͵ āĕΒā Ʀāǚ̑Αҙҏā Ȉ͵LJ͛ LJ˳˜͎ .Ȉ͘Ǎͫā ɑͫĕ œāǩͲ ɬͲ ĢǨˁͫā ɷͫLJ˶̈ ƦΑā ɡʒ͘ Ǩʉ̑ǚʓͫā
ķǛͫā ŰǨ˳ͫā ƦǍ˜̈ Ǩʉ̑ǚʓͫā ɬͲ ŰǨ˳ͫā LJ́ͫ ŰǨ͇ āĕΒā ɑͫǛ͛ ζɷ̣āǩͲ ɡ͛LJʷ̈ LJͲ ŰāǨͲΑҙҏā ɬͲ LJ́ʒʉˀ̈
.ɷʉ͎ ΑLJ˅ʦˬͫ Έ ҨҞ͛LJʷͲ LJ́ͫ ŰǨˈ̈

For all of these reasons, some bodies change quickly owing to the mixture
of the present season and some remain stable and resist this mixture for a
long time. Some do not suffer any harm at all from it and some fall ill due to
an unhealthy lifestyle before they suffer harm from the mixture of that sea-
son. When bodies suffer harm from the air, they only suffer it from diseases
which resemble its mixture; likewise, when they develop a disease caused
by their lifestyle, it resembles the unhealthy aspect of their lifestyle. People
who are aware of this are able not only to predict which diseases occur in

25 See van der Eijk 2012a and 2012b.

26 Book i.1.10–11 V (the Greek of this section does not survive).
27 Book i.1.11 V; the fragmentary Greek text runs as follows (p. 5, lines 30–36 W; xvii/a.
p. 5 K): ‘μόνον προγνώϲεται τὰϲ γινομέναϲ νόϲουϲ ἐν ἑκάϲτῃ τῶν καταϲτάϲεων, 〈ἀλλὰ〉 καὶ
κωλύϲει γίνεϲθαι, ταῖϲ τοῦ περιέχοντοϲ ἡμᾶϲ ἀμέτροιϲ κράϲεϲι τὴν ἐναντίαν ἐπιτεχνώμενοϲ
δίαιταν. εὔδηλον γὰρ ὡϲ, εἴπερ εὐκραϲία τῶν πρώτων 〈ϲωμάτων〉 ἐϲτὶν ἡ ὑγεία, διαφθαρήϲεται
μὲν ὑπὸ τῆϲ τοῦ περιέχοντοϲ δυϲκραϲίαϲ, φυλαχθήϲεται δ ὑπὸ τῆϲ κατὰ τὴν δίαιταν
Exegesis, Explanation and Epistemology 35

each of the constitutions in accordance with their mixture, but also to pre-
vent them from happening by carefully arranging their lifestyle to counter-
act the mixture that excessively dominates the air surrounding us. For it is
obvious that if health consists in the good balance of the primary bodies, it
will be damaged by the bad mixture of the surrounding air, whereas it will
be preserved when the lifestyle counteracts this (bad mixture).

This combination of exegesis and (causal) explanation is very clearly illustrated

by the following passage, which provides exactly such an ‘account of the causes
of what has been clearly described’. This account consists of a detailed discus-
sion of various types or groups of people mentioned in a specific Hippocratic
lemma (‘adolescents, young men, adults with thin-haired bodies, thin and coarse
voices, lisping and quick-tempered, and women’).28 This amount of detail is nec-
essary, according to Galen, for three reasons: (1) because as long as all of these
details are not outlined, the preceding lemma is not useful for the prognosis and
treatment of the diseases; (2) because it becomes difficult for us to discover the
causes of which many of the people mentioned died; and (3) because the text as
it stands is unclear as regards the extent to which people actually died or were
likely to die29:

… εἰ μὴ πάντα ταῦτα διοριϲθείη, πλέον οὐδὲν ἡμῖν οὔτ’ εἰϲ πρόγνωϲιν οὔτ’
εἰϲ θεραπείαν ἐκ τῶν εἰρημένων ὑπάρξει. εἰ δὲ μὴ περὶ πάντων τῶν νοϲη-
μάτων, ἀλλὰ περὶ ὧν τὸν λόγον ἐποιεῖτο μόνων τῶν φρενιτικῶν ἀκούοι-
μεν εἰρῆϲθαι ταῦτα, χαλεπώτατόν ἐϲτι καὶ οὕτωϲ εὑρεῖν τὰϲ αἰτίαϲ, δι’
ἃϲ ἀπώλλυντο οἱ πλεῖϲτοι τῶν εἰρημένων. 〈καὶ〉 μέντοι καὶ αὐτὸ τὸ τοὺϲ
πλείϲτουϲ ἀπόλλυϲθαι διττὸν εἶναι 〈δοκεῖ,〉 … ὥϲτε καὶ τὴν αἰτιολογίαν
γίνεϲθαι διττήν … ἡ μὲν οὖν ἀϲάφεια τοῦ λόγου τοϲαύτη ἐϲτὶ καὶ τοιαύτη,
προηγεῖϲθαι δ’ αὐτῆϲ 〈τῆϲ ἐξηγήϲεωϲ δεῖ τὸ〉 εὑρεῖν τὴν κρᾶϲιν ἑκάϲτου
τῶν εἰρημένων. οὐ γὰρ οἷόν τε ϲυνῆφθαι τῇ καταϲτάϲει τὸν λόγον ἄνευ

… as long as all of these distinctions [sc. about age, physical appearance,

sex etc.] have not been made, the discussion will not provide anything fur-
ther that is useful for prognosis or treatment. Yet when we understand this
passage as not referring to all diseases but only to those diseases he men-
tioned, that is to say, cases of phrenitis, this, too, makes it extremely difficult
for us to discover the causes of which most of the people mentioned died.
Yet even his expression ‘most people died’ allows two interpretations. …
Consequently, our search for the cause [aitiología] takes two forms as well,

28 Book i. 19 (i. p. 195, lines 16–17 Kw; ii. p. 656 L).

29 P. 92, line 30–p. 94, line 4 W (xvii/a. pp. 184–6 K; cf. i.2.202–3 V).
36 Philip van der Eijk

… This is the extent30 and severity of the obscurity in this lemma. Before
providing elucidation [ἐξήγηϲιϲ], we need to identify the mixture of each
of the bodies he described, for without this we cannot connect what is said
[in this lemma] with [what is said about] the constitution.

This discussion draws heavily on Galen’s theory of mixtures as set out in Mix-
tures, where he points out that the categories or types of people mentioned by
Hippocrates correspond with different physiological ‘mixtures’, which can be
identified by inferential reasoning on the basis of external appearances,31 includ-
ing physiognomonical signs. This is echoed at several places in the commentary
on book Two, for example in ii.2.20 HV (cf. p. 183, line 16–p. 184, line 15 Pf),
where indications of the body’s internal physiological state are drawn on the
basis of an individual’s character traits, and in ii.4.79 HV (cf. p. 347, line 17 Pf)
and ii.4.85 HV (cf. p. 351, line 11 Pf), where Galen refers to Mixtures for showing
how parts of the body indicate their mixture (but not that of the whole body);
cf. also ii.6.11 HV (cf. p. 355, line 32 Pf).
Further theoretical concepts, well known from Galen’s other writings, are
introduced and developed as the commentary unfolds. Thus we encounter the
notions of crisis and critical days, for which, again, Galen often refers to his own
writings with these titles.32

Galen’s reading of the Epidemics versus that of the Empiricists

The importance, in Galen’s eyes, of this theoretical background for the

understanding of the Hippocratic text makes it easier to explain Galen’s
frequent impatience, in the commentary on the Epidemics, with empirical, or
Empiricist readings of the text. For reasons that are obvious, and not so different
from those of modern readers I referred to in the beginning, the Empiricists had
taken a strong interest in the Hippocratic Epidemics. Thus in our text, Galen
frequently mentions Heraclides of Tarentum as the first commentator on the
Epidemics; and we find a number of references to Zeuxis and other Empiricists.33

30 Reading τοϲαύτη in p. 93, line 21 W.

31 This idea is developed in book two of Galen’s Mixtures; see especially ed. Helmreich 1904,
p. 40, line 11; p. 42, lines 21–2; p. 50, lines 13–5; p. 72, lines 9–p. 74, line 3.
32 See for example p. 124, line 5 W (xvii/a. p. 247 K; cf. i.3.69 V), where he refers to his
account, in the work On Critical Days, of ‘the cause that induces the occurrence of the crisis
on those days that fall between the days following the cycles.’
33 For example, ii.1.13 HV (cf. p. 158, line 4 Pf), ii.3.6 HV (cf. p. 258, line 34 Pf), ii.3.90 HV
(cf. p. 284, line 19 Pf).
Exegesis, Explanation and Epistemology 37

By contrast, we find only one reference to the Methodists, and a critical one at
that (ii.2.193 HV; cf. p. 255, line 38 Pf).
Yet Galen’s assessment of the Empiricists’ work is not altogether favourable.
His main objection is that they entertain a naive concept of experience and
that, in failing to take account of causes, they miss the point both in their ex-
egesis of the Hippocratic text and in actual medical practice. The main target
of Galen’s criticism is one of his own masters, the medical writer Quintus who,
although perhaps not a full-blown Empiricist in the strict sense of the word,
clearly adopted an empirical approach to the text.34 At an early stage of the
commentary, Quintus is taken to task for saying that ‘we know these phenom-
ena through experience only, without there being any relation to the cause that
necessitates it’35:

κακῶϲ οὖν ὁ Κόιντοϲ ἐξηγεῖται καὶ ταῦτα τὰ βιβλία καὶ τὰ τῶν Ἀφοριϲμῶν,
〈ἐν〉 οἷϲ ὧδέ πωϲ ἔγραψε· ‘περὶ δὲ τῶν ὡρέων, ἢν μὲν ὁ χειμὼν αὐχμηρὸϲ
καὶ βόρειοϲ γένηται, τὸ δὲ ἔαρ ἔπομβρον καὶ νότιον, ἀνάγκη τοῦ θέρουϲ
πυρετοὺϲ ὀξεῖϲ καὶ ὀφθαλμίαϲ καὶ δυϲεντερίαϲ γίνεϲθαι.’ τῇ πείρᾳ γὰρ
μόνῃ τοῦτο ἐγνῶϲθαί φηϲιν ὁ Κόιντοϲ ἄνευ τοῦ κατὰ τὴν αἰτίαν λογιϲμοῦ,
πρῶτον μὲν αὐτὸ τοῦθ’ ἁμαρτάνων, **36 ὅτι τὰϲ αἰτίαϲ, ὧν εἶπε κατὰ τοὺϲ
Ἀφοριϲμοὺϲ τούτουϲ ὁ Ἱπποκράτηϲ, αὐτὸϲ αὖθιϲ ἐν τῷ Περὶ ὑδάτων καὶ
ἀέρων καὶ τόπων ἔγραψεν, εἶθ’ ὅτι τὸ χρήϲιμον μέροϲ τῆϲ διδαϲκαλίαϲ

Thus Quintus erred not only in his exegesis of these books but also in those
on the Aphorisms, in which Hippocrates says the following: ‘Regarding the
seasons, when the winter is dry with northerly wind, and the spring rainy
with southerly wind, it necessarily follows that in summer, acute fevers and
ophthalmia and dysentery occur’. Quintus maintained that we only know
these phenomena through experience without any theoretical reasoning
about their cause. His first error is … that he was not aware that already in
his Airs, Waters, Places Hippocrates described the causes of the things that
he mentioned in his Aphorisms. The second is that he ignored that part of
this chapter’s teaching that is concerned with practical application.

Further down, the same Quintus is criticised for saying that knowledge of the
location in which diseases occur does not contribute in any way to prognosis
and prediction, and for failing to ask himself the question why, in the Epidemics,

34 On Quintus, see Manetti and Roselli 1994, 1580–93; Grmek and Gourevitch 1994.
35 P. 6, lines 6–16 W (xvii/a. p. 6 K; cf. i.1.13 V).
36 There is a lacuna in the Greek text here.
38 Philip van der Eijk

Hippocrates only describes four varieties of changes of seasonal mixtures, even

though in reality there are many.37
In reaction to this, Galen in his own commentary on the Epidemics states
the more nuanced position on the relationship between reason and experience
that we also encounter elsewhere in his works. Of course, Galen does not deny
the importance of experience, far from it: experience is ultimately the decisive
test (βάϲανοϲ). Yet experience needs to be used in close conjunction with rea-
soning (λόγοϲ): it needs to be informed, ‘determined’, ‘qualified’ or ‘specified’
(διορίζεϲθαι) by theoretical considerations. Moreover, to say that there is no
need to pay attention to causes, as the Empiricists do, is plainly wrong.
Galen articulates this carefully nuanced position in a number of passages in
his commentary on the Epidemics. Thus at a crucial point, at the end of the in-
troduction to his commentary on book I, and right before starting with the line
by line commentary of the Hippocratic text, he adds38:

μετὰ ταῦτα δὲ εἰϲ ἐκείνην ἤδη τρέψομαι, τοϲοῦτον ἔτι προειπών, ὅπερ καὶ
ἐν 〈ἄλλοιϲ〉 πολλοῖϲ τῶν ὑπ’ ἐμοῦ γεγραμμένων βιβλίων εἰρῆϲθαι φθάνει,
προτρέποντόϲ μου γυμνάζεϲθαι τοὺϲ ἐκμαθεῖν θέλονταϲ τὴν ἰατρικὴν τέ-
χνην ἐν τοῖϲ κατὰ μέροϲ αἰϲθητοῖϲ, ὡϲ διαγινώϲκειν αὐτούϲ, ἃ καθόλου
προμεμαθήκαϲιν. ταῦτα δὲ αὐτὰ τὰ κατὰ μέροϲ ἀρχὴν τῆϲ 〈τῶν〉 καθόλου
ϲυϲτάϲεωϲ οἱ ἐμπειρικοί φαϲιν εἶναι, λέγοντεϲ ἀληθῆ ἐκεῖνα τῶν θεωρημά-
των ὅϲα τὴν ϲύϲταϲιν ἐξ ἐμπειρίαϲ ἔϲχηκεν. ἡμῖν δὲ οὐχ οὕτωϲ, ἀλλὰ καὶ
διὰ λόγου δοκεῖ πολλὰ τῶν θεωρημάτων εὑρῆϲθαι, κρίνεϲθαι μέντοι καὶ
τούτων τὴν ἀλήθειαν ὑπὸ τῆϲ πείραϲ βεβαιουμένην τε καὶ μαρτυρουμένην.

I will turn to the commentary on Hippocrates’ text after offering a remark

I made in many others of my books, when I urge those who intend to
study medicine to acquire training in individual observable things, so that
they can discern [in practice] what they have learned before [in theory].
The Empiricists claimed that these individual items are the starting point
of the general structure, and they said that the only reliable concepts are
those that have their basis in experience. We do not take this view, for we
think that, in addition, many concepts are derived by reasoning, yet the
truth of these, too, is assessed by experience, which confirms and testifies
to them.

37 P. 17, lines 3 and 18 W (xvii/a. pp. 24–5 K; cf. i.1.44 and 1.46 V). In the same context,
Galen refers to the Empiricists: ‘The Empiricist doctors said that the gatherings of states
of bad mixture, which they call syndromes, and which turn out to be the causes of these
diseases, have been discovered by experience, and in support of this claim they interpreted the
Aphorisms, for example…’ (p. 17, lines 8–11 W).
38 P. 10, line 22–p. 11, line 1 W (xvii/a. pp. 13–14 K; cf. i.1.26 V).
Exegesis, Explanation and Epistemology 39

Likewise in the commentary on Book Two, Galen registers agreement between

Hippocrates and Erasistratus in making a distinction between establishing
something theoretically on the basis of the nature of the thing and by means
of experience.39 Furthermore, Galen expresses agreement with Aristotle’s state-
ment that one should first establish whether something exists or not (τὸ ὅτι)
and only then examine what its causes are (τὸ διότι).40 And in his commentary
on the Hippocratic discussion of the anatomy of the vascular systems (also in
book II), Galen affirms that observation on the basis of dissection is the source
of Hippocrates’ (and Herophilus’) account of the blood vessels41:

39 Book ii.2.31 HV (cf. p. 215, lines 20–43 Pf): ‘Galen said: There are things that are deduced
and learned from the nature of the thing, which is called inference by analogy, and there are
things that you need to test to know them. In my opinion, Hippocrates spoke likewise in this
lemma, which is similar to the statement that Erasistratus made later in the first chapter of
his book known as the General Observations where he wrote “a [kind of] food may loosen
the bowels in some people and block the bowels in others. I know some people who digest
beef more quickly than they digest other foods”. For this is also his opinion on this subject in
another passage in which he said “I know a man who was struck by summer cholera when
he drank a little bit too much Lesbian wine”. It is not possible to determine what is the matter
with one who is in this condition except by testing, and of necessity, you must examine [him]
to judge how he is with a certain thing and test that thing on him if you want to know whether
his nature concerning it is like other people’s nature or if he differs from them concerning
it, and you do this with each thing in this way. (ɼˈʉʒ̈́ ɬͲ ɨˬ΋ ˈΌ̒ć œǨʦʓʶΌ Ή ā ƹLJʉ̶Αҙҏā ɬͲ ƦΒā :ťǍ˶ʉͫLJ̣ ƛLJ͘
΋ ̒ ƹLJʉ̶Α
Ή ā ƹLJʉ̶Αҙҏā ɬͲć ΈLJ̵LJʉ͘ Έ ҙҏҙҏǚʓ̵ā ȅ˳ʶ̈ ɑͫĕć ƹǽʷͫā
ŴāǨ˙̑Αā ƛLJ͘ ȇʶ̤Αā LJ˳ʉ͎ ɑͫǛ͛ć .LJ́˳ˬˈ̒ ȅʓ̤ LJ́̑Ǩʤ̒ ƦΑā ȅͫΒā LJ́ʉ͎ œLJʓʥ̈ ƹLJʉ̶Α
ƦΒā ƛLJ͘ ȉʉ̤ ɼʉˬ˜ͫā ɡ̈ćLJ͘ΑҙҏLJ̑ žćǨˈ˳ͫā ɷ̑LJʓ͛ ɬͲ ȅͫćΑҙҏā ɼͫLJ˙˳ͫā ǽ͎ ȫ̈́āǨ˅ʶ̵āĢΑā ǚˈ̑ ɬͲ ɷͫLJ͘ ķǛͫā ƛǍ˙ͫLJ̑ ɷʉʒ̶ Ǎ΀ć ƛǍ˙ͫā āǛ΀
Ƚ̈ć ťLJ˶ͫā ȶˈ̑ ǽ͎ ɬ˅ʒͫā Ɏˬ΍ ˅̈Ό ǚ͘ ṳ̈̌āǍͫā ƢLJˈ˅ͫā» ɨ́̇āǨ˳ʓ̵ā ɬͲ ŷǨ̵ΑLJ̑ Ǩ˙ʒͫā ƢǍʥͫ ƦǍ̇Ǩ˳ʓʶ̈ ΈLJͲǍ͘ žǨ͇Αҙҏ ǽ͵Βāć ɨ́ˁˈ̑ ǽ͎ ɷˬ͘
ɬͲ ƛćLJ˶̒ ȅʓͲ ƦLJ͛ Έ ҨҞ̣Ģ žǨ͇Αҙҏ ǽ͵Βā» ƛLJ͘ ƦΑā Ǎ΀ć ɷͫLJ͘ Ǩ̥ΐā ƛǍ͘ ǽ͎ ŁLJʒͫā āǛ΀ ǽ͎ ɷ̈ΑāĢ āǛ΀ ƦΑā ΈLJˁ̈Αā ɑͫĕć .«ɼ˳ˈ̈́Αҙҏā Ǩ̇LJʶͫ
ƴΈ ĢćǨ̀ ȇʤ̈ ǚ͘ć ɼ̑ǨʤʓͫLJ̑ ҙҏΒā ƱǨͲΑā žǨˈʓ̈ ƦΑā ɬ˜˳̈ ȫʉˬ͎ ƛLJʥͫā ƱǛ΀ ɷͫLJ̤ Ȉ͵LJ͛ ɬͲ΋ ć .«ɼΉ ˁʉ΀ ɷ̒Ǩʓ͇ā Έ ҨҞʉˬ͘ Έ ҨҞˁ͎ ťǍʒʶͫ Ǩ˳̥
ɼˈʉʒ̈́ ɡʔͲ ɷʉ͎ ɷʓˈʉʒ̈́ ɡ΀ ɨˬˈ̒ ƦΑā łĔĢΑā āĕΒā ɷʉ͎ ƹǽʷͫā ɑͫĕ ŁǨʤ̒ ƦΑāć ƹLJʉ̶Αҙҏā ɬͲ ƹǽ̶ ȽͲ ɷͫLJ̤ Ʉʉ͛ ɷʉˬ͇ ɨ˜ʥͫLJ̑ Ǩˆ˶̒ ƦΑā
ƛLJʔ˳ͫā āǛ΀ ȅˬ͇ ƹLJʉ̶Αҙҏā ɬͲ ṳ̈̌āć ɡ͛ ǽ͎ ɑͫĕ ɡ˳ˈʓʶ̒ć ɷʉ͎ ɨ́ˏͫLJʦ̈ ćΑā ťLJ˶ͫā Ǩ̇LJ̵.)’
40 Book ii.6.28 HV (cf. p. 364, lines 1–13 Pf): ‘Aristotle said (and he was right saying it) that
in all such statements, it should first be determined whether the thing itself exists and then
what its cause are. So, we ourselves also need to do this. First, we should test empirically
whether what was said exists as was said, then, afterwards, we should start studying the
cause through which it exists. That which rarely exists is difficult to test empirically. For
empirical knowledge is only the remembrance of something that is seen many times in the
same condition. I have not seen these features come together in the same single even a few
times, let alone many times so that I could test this lemma empirically. (ŁLJ̿Αāć ƛLJ͘ ȫʉˬ̈́Ǎ˅̵ĢΑā ƦΒāć
LJ˶ͫ ǽˉʒ˶̈ ǚ˙͎ .ɷʒʒ̵ LJͲ ȇˬ˅̈ ɨ̓ ĔẠ̌ǍͲ ɷ͵Αā ȫˏ˶ͫā ǽ͎ ƹǽʷͫā ĢΎǚ˙̈ ƦΑā Έ ҙҏćΑā ǽˉʒ˶̈ ɡ̈ćLJ͘Αҙҏā ɬͲ ƱǛ΀ ƱLJʒ̶Αā Ƚʉ˳̣ ǽ͎ ƦΒā ɷͫǍ͘ ǽ͎
ɬ͇ ȉʥʒͫā ǽ͎ ǚˈ̑ Ǜ̥ΑLJ͵ ɨ̓ ɡʉ͘ LJͲ ƛLJʔͲ ȅˬ͇ ụ̈̌Ǎ̈ ɡʉ͘ ķǛͫā āǛ΀ ɡ΀ ɼ̑ǨʤʓͫLJ̑ ɬʥʓ˳͵ ƦΑā Έ ҙҏćΑā ǽˉʒ˶ʉ͎ ɑͫĕ ɡˈˏ͵ ƦΑā ΈLJˁ̈Αā ɬʥ͵
ƹǽʷͫā Ȼˏ̤ ǽ΀ LJ˳͵Βā ɼ̑Ǩʤʓͫā ƦΑā ɑͫĕć ɼ̑ǨʤʓͫLJ̑ ɷ͵LJʥʓͲā Ǩʶˈ̈ ŴǨˏͫā ǽ͎ ҙҏΒā ụ̈̌Ǎ̈ ҙҏ ķǛͫā ƹǽʷͫāć ƦLJ͛ ɷˬ̣Αā ɬͲ ķǛͫā ȇʒʶͫā
ɬʥʓͲΑā ƦΑā Ģǚ͘ΑLJ͎ ƴǨʉʔ͛ ĢāǨͲ ɬ͇ Έ ҨҞˁ͎ ɼˬʉˬ͘ ΈāĢāǨͲ ƦLJʶ͵Βā ǽ͎ Ȉˈ˳ʓ̣ā ƛLJʥͫā ƱǛ΀ ĢΑā ɨͫ LJ͵Αāć .ƴṳ̈̌āć ƛLJ̤ ȅˬ͇ ƴǨʉʔ͛ ΈāĢāǨͲ ĿǨ̈ ķǛͫā
ɼ̑ǨʤʓͫLJ̑ ƛǍ˙ͫā āǛ΀.)’ A comparable case is in ii.6.130 HV (cf. p. 396, lines 32–8 Pf), where Galen says
that empirical validation of a particular combination of phenomena is difficult because that
particular combination itself is very rare.
41 Book ii.4.5 HV (cf. p. 312, lines 10–19 Pf).
40 Philip van der Eijk

œLJʓʥʉ͎ .ƦāǍʉʥͫā Ʀǚʒ̑ ǚˬʤͫā Ⱥʉʥ̈ ɑͫǛ͛ łǍʉʒͫLJ̑ ƦLJ˅ʉʥͫāć ɼ˶̈ǚ˳ͫLJ̑ ĢǍʶͫā Ⱥʉʥ̈ LJ˳͛ ɷ͵Αā ɑͫĕć
ɷͫ Ǩ́ͅ LJͲ ǽˉʒ˶ʉ͎ ɷ͵ćĔ LJͲ ɬ̈LJ͇ć ǚˬʤͫā Ɏ̶ āĕΒLJ͎ .ǚˬʤͫā Ɏʷ̈ ƦΑā ǚˬʤͫā Ȉʥ̒ LJͲ ɬ̈LJˈ̈ ƦΑā ĔāĢΑā ɬͲ
ɨͫ ŴāǨ˙̑Αā ƦΒLJ͎ .ɷʉ͎ ȇʓ˜̈ ƦΑā ĔāĢΑā ƦΒā ɷʒʓ˜̈ć ƱĢLJʒ̥Βā ĔāĢΑā ɬͲ ɷ̑ Ǩʒʦ̈ć ɷˆˏʥʓ̈ ƦΑā ΈLJ˶ʉ̑ ΈāĢǍ́ͅ ȫʥͫLJ̑
ťǍʉʒʉˬ˙̵Αā ɷʉͫΒā ȅ̤ćΑā ǽ̤Ǎ̑ ɷ˶Ͳ Ɏ̈ǚˀʓ̑ ҙҏć ƦLJ΀Ǩ̑ ćΑā ťLJʉ͘ Ή ɷʉˬ͇ ɷͫĔ ƹǽʷͫā āǛ΀ ɬͲ ȇʓ͛ LJͲ ȇʓ˜̈
.ɼˆ˙ʉͫā ǽ͎ ćΑā ƢLJ˶˳ͫā ǽ͎

Just as Hippocrates only knew these things because he cut open the skin
and observed what he saw under it, so too did Herophilus know them later.
He was not content to learn this from Hippocrates, but aspired to know
from the nature of the things itself from which Hippocrates had learned
what he knew without exception. He wrote books about the anatomy of
the blood vessels like those written by Hippocrates. A number of ancient
physicians have also exposed [sc. by dissection] and seen these blood ves-
sels in people’s bodies, and they wrote books about them similar to those
of Hippocrates and Herophilus.

Yet in Galen’s view, medical knowledge is arrived at not through a process of

unbiased empirical observation or induction; on the contrary, empirical obser-
vation is pointless unless it is accompanied and informed by theoretical consid-
erations. Experience may ‘confirm’ or ‘testify to universal reason (μαρτυρεῖ τῷ
καθόλου λόγῳ)’,42 or it may ‘speak against it’; but empirical observations do not
speak for themselves, and always need to be contextualised and theoretically
underpinned, not only in processes of scientific discovery but also in the assess-
ment, scrutiny and refutation of scientific claims made by others. This reminds
us of Galen’s concept of ‘qualified experience’ (διωριϲμένη πεῖρα), well known
from other contexts, especially dietetics and pharmacology.43 This need for
‘qualification’, ‘determination’ or ‘specification’ (διοριϲμόϲ) of empirical testing
is expressed in a number of passages in the commentary on the Epidemics as
well.44 Furthermore, there are cases, Galen argues, where experience is simply
incapable of testing a claim and where logical or theoretical considerations are
needed. This is expressed in a difficult but influential passage in which Galen
seems to criticise Hippocrates through the mouth of Diocles, whom he cites for
raising a ‘theoretical’ (λογικόϲ) objection against Hippocrates’ assumption of
the existence of quintan, septan and nonan fevers45:

42 P. 142, line 10 (xvii/a. p. 284 K; cf. i.3.116 V).

43 On Galen’s concept of qualified experience see van der Eijk 2005, ch. 10.
44 Thus we may suspect that when Galen says that a statement by Hippocrates ‘is correct
and true, although it is not correct and true when said in this unqualified way’ (ii.6.75 HV),
the Greek term used was ἀδιορίϲτωϲ. See also ii.6.78 HV (p. 381, lines 3–4 Pf): ‘This lemma is
not correct when taken separately and in isolation (Țˀ̈ ɨͫ ĔḲ̌ć ĔǨ͎Αā ƦΒā ƛǍ˙ͫā āǛ΀)’.
45 P. 112, line 15–p. 113, line 5 W (xvii/a. pp. 222–3 K; cf. i.3.32 V).
Exegesis, Explanation and Epistemology 41

… οὐ περὶ ὀνόματόϲ ἐϲτι 〈καὶ〉 ϲημαινομένου ζήτηϲιϲ, ἀλλὰ περὶ πράγμα-

τοϲ … πεμπταίαϲ δὲ περιόδουϲ ἐθεαϲάμεθα ἀμφιβόλουϲ, οὐ μὴν ἀκριβεῖϲ
γε καὶ ϲαφεῖϲ, ὡϲ ἀμφημερινὰϲ καὶ τριταίαϲ καὶ τεταρταίαϲ. οὐ μὴν οὐδὲ
λογικῆϲ ἀποδείξεωϲ ἡγοῦμαι δεῖϲθαι τὸ πρᾶγμα τὴν κρίϲιν ἐκ πείραϲ λαμ-
βάνον … πρὸϲ δ’ οὖν τὸν Ἱπποκράτην τάχα καὶ λογικὴν ἄν τιϲ ἀπόδειξιν
εἴποι, καθάπερ ὁ Διοκλῆϲ. ‘ἐπὶ τίϲι γὰρ ἐρεῖϲ [τίϲι] ϲτοιχείοιϲ ἢ χυμοῖϲ τὴν
πεμπταίαν ἢ ἑβδομαίαν ἢ ἐναταίαν γίνεϲθαι περίοδον οὐχ ἕξειϲ.’ οὐ μὴν
οὐδ’ ἔγραψέ τινα ἡμῖν ἄρρωϲτον οὕτω νοϲήϲαντα, καίτοι γ’ ἐχρῆν, ὥϲπερ
ἄλλων πολλῶν καθολικῶν θεωρημάτων παραδείγματα διὰ τῶν κατὰ μέ-
ροϲ ἐδίδαξεν, οὕτω κἀπὶ τούτων ποιῆϲαι.

… the enquiry is not about the name and what is signified by it but about the
real thing. … As for periods of five days, I have seen ambiguous cases, but not
exact and clear ones comparable to periods of two, three or four days. Indeed
I think this matter does not require theoretical demonstration but is decided
on the basis of experience. … Now against Hippocrates one may perhaps also
raise a theoretical proof, as Diocles does: ‘On the occasion of what elements
or humours a fever recurring every five, or seven, or nine days occurs, you
will not be able to say.’ Nor indeed has he [i.e. Hippocrates] given us any de-
scription of someone who was ill in this manner. Yet just as he taught [in the
form of] examples of many other general postulates by means of individual
[cases], likewise he ought to have produced them in these cases too.

The point of Diocles’ objection seems to be that one cannot tell whether a fever
occurring after an interval as long as four, six or eight days is the same fever
unless there are clear symptoms shared, such as particular states of the elements
(i.e. elementary qualities) or the humours. The problem he is raising is that his
opponent is unable to say what level, number, or nature of shared symptoms
would suffice to make that identification valid. This would make good sense of
Galen’s characterisation of Diocles’ objection as ‘theoretical’, as opposed to the
‘empirical’ scrutiny that Galen refers to in the preceding section.46

46 For a discussion of this passage (Diocles, fr. 57 vdE), see van der Eijk 2001, 125–7. Contrary
to what Wenkebach suggests, the Arabic version is based on a manuscript not reading ϲηπεδόϲιν
but ϲτοιχείοιϲ : ‘Especially against Hippocrates someone who argues against him would need to
argue with a rational demonstration, as did Diocles: “you are not able to say which elements or
humours caused fevers with a cycle of five, seven or nine days” (ɷʉˬ͇ șʓʥ̈ ƦΑā șʓʥʉˬ͎ ɼ̿LJ̥ ŴāǨ˙̑Αā LJͲΑāć
ǽ͎ ćΑā ȫͲLJʦͫā ǽ͎ Ģćǚ̒ ǽʓͫā ȅ˳ʥͫā ƦǍ˜̒ ŴҨҞ̥Αҙҏā ćΑā Ǩ̿LJ˶ˈͫā ķΑā ɬͲ ƛǍ˙̒ ƦΑā Ģǚ˙̒ ҙҏ ɷ͵Αā ɑͫĕć ζȫʉˬ˙̈Ĕ șʓ̤ā LJ˳͛ ɼʉ̵LJʉ͘ ɼʤʥ̑
Ƚ̵LJʓͫā ǽ͎ ćΑā Ƚ̑LJʶͫā)’ (i.3.32 V). Τhis modifies the interpretation of the fragment (Diocles, fr. 57 vdE)
compared to that offered in van der Eijk 2001, 125–7, with στοιχείοιϲ to be understood as the
elementary qualities hot, cold, dry and wet, rather than the elements themselves, in accordance
with Diocles frs. 51 and 54. For later interpretations of this passage in the context of discussions
about the question of the existence of fevers recurring every five or seven or nine days in tenth-
century Arabic medical literature, for example al-Kaskarī, see Pormann 2008a, 100–103.
42 Philip van der Eijk

Galen’s approach to the case histories

In the light of these considerations on the relationship between reason and

experience, the general and the particular, and the theoretical and the practical,
it may now come as less of a surprise that, in his commentary on Epidemics,
books One and Two, Galen has little interest in the peculiarities of the case
histories. At another crucial juncture in the commentary on book One, when he
has arrived at the point in the Hippocratic text where the case histories begin,
he says47:

Before starting with the exegesis of individual patients it seems better, for
the purposes of clarity and brevity, to present a general account about all of
them. In my book The Therapeutic Method, and in other works, I explained
that there are two ways in which one finds out about something one examines:
the first is through reasoning, by which one arrives at knowledge of the gen-
eral, universal genus of each individual phenomenon, the second is through
experience of the individual phenomena until one arrives through it at the
general, universal concept. Our claim is that while all concepts that make an
art complete are general, the actions that the practitioners of the arts carry out
all deal with particular, individual phenomena. Anyone who first determines
and describes a general concept also needs to devote himself to practice in the
particular phenomena, and the particular phenomena are also very useful for
the confirmation of general concepts. They also serve the students who want
to understand as examples of the general concepts that are based on them.
This is why, in the books I have written, I do not limit myself to discussing
general matters but also deal with particulars, transcribing from the books
of Hippocrates, and particularly the Epidemics, those passages in which he

47 P. 126, line 13–p.127, line 15 W (xvii/a. pp. 251–3 K; cf. i.3.79–80 V). I quote the italicised
passages in Greek: διττὴ ἡ τῶν ζητουμένων εὕρεϲιϲ οὖϲα, μία μὲν ἡ διὰ τοῦ λόγου πρὸϲ τὴν
γνῶϲιν ἀφικνουμένη τοῦ καθόλου τε καὶ κοινοῦ παντὸϲ τῶν κατὰ μέροϲ εἴδουϲ, ἄλλη δ’ ἡ
διὰ 〈τῆϲ πείραϲ ἀπὸ〉 τῶν κατὰ μέροϲ ἐπὶ τὸ κοινόν τε καὶ καθόλου παραγιγνομένη. καὶ τὰ
μὲν ϲυμπληροῦντα 〈πᾶϲαν τέχνην θεωρήματα λέγομεν πάντα〉 εἶναι καθόλου, τὰϲ δὲ πράξειϲ
τῶν τεχνιτῶν ἐπὶ τῶν ἀτόμων εἰδῶν γίγνεϲθαι, δεῖϲθαι δὲ τῆϲ ἐπ’ αὐτῶν γυμναϲίαϲ καὶ
〈τὸν τὰ〉 καθόλου πρότερον εὑρόντα καὶ μέντοι καὶ πρὸϲ βεβαίωϲιν αὐτῶν τῶν ηὑρημένων
καθόλου χρήϲιμα γίγνεϲθαι τὰ κατὰ μέροϲ. ἔϲτι δὲ καὶ πρὸϲ τὴν τῶν μανθανόντων γνῶϲιν
οἷον παραδείγματα ταῦτα τῶν ἐπιτετραμμένων αὐτοῖϲ καθόλου θεωρημάτων. διὰ τοῦτο
κἀγὼ κατὰ τὰϲ πραγματείαϲ ἁπάϲαϲ, ἃϲ ἐποιηϲάμην, οὐ τὰ καθόλου μόνον, ἀλλὰ καὶ τὰ
κατὰ μέροϲ διῆλθον, ἐκ τῶν Ἱπποκράτουϲ βιβλίων καὶ μάλιϲτα τῶν Ἐπιδημιῶν παραγράψαϲ
〈ἐκείναϲ τὰϲ〉 ῥήϲειϲ, ἐν αἷϲ διηγήϲατο ἅπαντα ἀπ’ ἀρχῆϲ μέχρι τέλουϲ τὰ ϲυμβάντα τοῖϲ
ἀρρώϲτοιϲ … ἀλλ’ ἐπειδὴ παρέγκεινταί τινεϲ ἀϲαφεῖϲ λέξειϲ, δι’ ἐκείναϲ ἔδοξεν ἄμεινον εἶναι
καὶ τὰ τοιαῦτα ὑπομνήματα ποιήϲαϲθαι … εἰ δὲ τῶν ἐν τῷ Προγνωϲτικῷ γεγραμμένων ἐν τῷ
καθόλου τὰ παραδείγματα μόνα νῦν ἐπιϲημαινοίμην, ἀναπέμπων 〈τὸν μανθάνοντα κατὰ〉 τὸ
ϲύμπαν τῆϲ διδαϲκαλίαϲ εἰϲ τὰϲ γεγραμμέναϲ μοι πραγματείαϲ, ἐλπίζω ϲύντομον ἔϲεϲθαι τὸν
Exegesis, Explanation and Epistemology 43

described all that happened to the patients from the beginning to the end. In
my work Breathing Difficulties, I have discussed all cases of people with
breathing problems mentioned in the Epidemics, and in my work Critical
Days all cases of crisis [mentioned in the Epidemics], and I have followed
the same procedure in my other books. Therefore, for those eager to learn
the art of medicine, there is no need for further exegesis [here]. However,
since there are some unclear passages in the text, I decided on account of these
that it was better to write this commentary as well. If I were to describe the
whole nature of each of the symptoms that Hippocrates mentioned as oc-
curring in each of the diseases, or if I were to describe the causes through
which these symptoms occur, I would be forced to transfer to the present
work everything I said about it in all of my books and I would risk having
to write one whole book about each of these patients. If, however, I merely
mark the accounts of these patients as examples for the general points he
made in the Prognostic and refer the student for full instruction to the books
in which I explained them, I expect that my comments will be short.

This is an important passage for Galen’s views on the relationship between

the empirical and the theoretical, experience (empeiría or peîra) and reason
(lógos). For it provides an epistemological motivation for Galen’s way of han-
dling, in the present commentary, the case histories of Epidemics i. He says that
he has used them in his other works as empirical illustration of the general
points made there, and that, for this reason, he has refrained, in the present
commentary on Epidemics i, from providing comprehensive discussion and
explanation of all the symptoms listed in all the case histories presented by
Hippocrates. In doing so, Galen may well think that he is in good company,
for as he says in an earlier passage, Hippocrates himself, in one of the sections
devoted to the ‘constitutions’ (katastáseis), has done something similar, by con-
firming the general observations he made in his Prognostic with examples from
particular cases; and since Galen previously commented on his Prognostic, there
is no need to explain things in detail here.48 This is in accordance with Galen’s
opinion that the Epidemics follow the Prognostic in sequence in order of compo-
sition by Hippocrates.49

48 Commentary on Hippocratesʼ ‘Epidemicsʼ, Book One, p. 66, lines 3–6 W (xvii/a. pp. 127–8
K; cf. i.2.88 V): ‘At this point, Hippocrates confirms the general observations he made in
his Prognostic with examples from particular cases. Since I previously commented on his
Prognostic, I do not need to repeat anything about the clearly manifest correspondence
between what he described in this book and in the former. (Ἃ καθόλου διὰ τοῦ Προγνωϲτικοῦ
γράμματοϲ ἐδίδαξε, ταῦτα μὲν νῦν ὡϲ ἐπὶ παραδειγμάτων διὰ τῶν κατὰ μέροϲ πιϲτοῦται·
προεξηγηϲάμενοι δὲ 〈τὰ〉 κατὰ τὸ Προγνωϲτικὸν οὐδὲν ἔτι δεόμεθα περὶ τῆϲ ϲυμφωνίαϲ
τούτων πρὸϲ ἐκεῖνα λέγειν ἐναργῶϲ φαινομένηϲ.)’
49 P. 75, lines 9–19 W (xvii/a. pp. 146–7 K; cf. i.2.131 V).
44 Philip van der Eijk

Thus what, at first sight, seems just a matter of literary organisation and ar-
rangement on Galen’s part has a more profound epistemological justification.
After all, Galen could have decided to use his commentary on the Epidemics as
the central text where he would provide the explanations for the phenomena
described in the case histories, and he could have decided to provide cross-ref-
erences to these in his other works. Yet he has organised the material the other
way round, providing full explanation in the commentaries on Prognostic, Airs
Waters Places and Aphorisms, while limiting himself to an outline in the com-
mentary on the Epidemics. This reflects his view on the relationship between
the theoretical and the universal on the one hand and the empirical and the in-
dividual on the other, and on the reversed priority of the former over the latter.
This is of wider relevance for a correct understanding of the nature of Ga-
len’s commentary on Epidemics, Book One. For this commentary belongs to
that group of Galenic commentaries that, at least according to Galen’s own in-
dications in his autobibliographical writings, were primarily written for Ga-
len’s own consumption and not for wider circulation.50 By contrast, according
to these Galenic characterisations of his own writings, the commentary on book
Two was written for a wider readership.51 In this regard, the relationship be-
tween the Galenic commentaries on books One and Two would be the reverse
of that between the two Hippocratic books themselves, at least in Galen’s own
assessment. For according to Galen, book Two of the Epidemics was written by
Hippocrates just as notes for himself, or perhaps for his sons,52 whereas book
One seems to envisage a wider readership. As Galen points out in this connec-
tion, it would be more appropriate to regard book Three of the Epidemics as
book Two in the sequence, and one may add here that in this regard he has mod-
ern scholarship on his side, for books One and Three are generally regarded as
being roughly of the same date – if not by the same author – while books Two,
Four, Six, and again Five and Seven seem to form later collections. In Galen’s
opinion, book Two differs from book One in that, in the first book,53

Ʉ̿ćć ŰāǨͲΑā LJ́˶͇ Ȉ̓ṳ̈̌ ƹāǍ́ͫā łҙҏLJ̤ ɬͲ łҙҏLJ̤ ŃҨҞ̓ ǨͲΑā ȅͫćΑҙҏā ɼͫLJ˙˳ͫā ǽ͎ Ʉ̿ć ŴāǨ˙̑Αā ƦΒā
łҙҏLJʥͫā ɑˬ̒ Ʉ̿ć ǽ͎ Έ ҙҏćΑā Ƣǚ˙͎ .ɼʉ̇LJ̑ć ƴṳ̈̌āć ƛLJ̤ ǨͲΑā ɷ˶ʉˈ̑ ŁLJʓ˜ͫā āǛ΀ ɬͲ ɼʔͫLJʔͫā ɼͫLJ˙˳ͫā ǽ͎
ǽʓͫā ŰāǨͲΑҙҏā Ƚ̇LJʒ̈́ ɼˏˀ̑ ɑͫĕ Ƚʒ̒Αā ɨ̓ .ɷʓˈʉʒ̈́ ɬ͇ ɷ̣ćǨ̥ć Ʀāǚ̑ΑҙҏLJ̑ Ⱥʉʥ˳ͫā ƹāǍ́ͫā Ǩʉˉ̒ ɼˏ̿ LJ́ˬ͛
Ǩ͛ĕ ɷ˶˜ͫ ƛLJʔ˳ͫā āǛ΀ ȅˬ͇ ɼͫLJ˙˳ͫā ƱǛ΀ ǽ͎ ɑͫĕ ɡˈˏ̈ ɨͫć .łҙҏLJʥͫā ɑˬ̒ ɬ͇ ťLJ˶ͫā ɬͲ Ǩʉʔ˜ͫ Ȉ̓ṳ̈̌
ɷʉ͎ Ńṳ̈̌ ķǛͫā ǚˬʒͫā Ǩ͛ĕ ɨ̓ ɼ˶ʶͫā łLJ͘ćΑā ɬͲ ɷʉ͎ Ńṳ̈̌ ķǛͫā Ȉ͘Ǎͫā Ǩ͛ĕ ɨ̓ Ńṳ̈̌ ķǛͫā ŰǨ˳ͫā Έ ҙҏćΑā

50 See On My Own Books ix (ed. Boudon-Millot 2007, p. 160, line 17), with the discussion by
von Staden 2009, 135–44.
51 On My Own Books ix (ed. Boudon-Millot 2007, 160, line 22).
52 Book ii.4.3 HV (cf. p. 311, line 3 Pf), ii.4.28 HV (cf. p. 314, lines 34–5 Pf).
53 Book ii.1.3–4 HV (cf. p. 154, lines 13–28 Pf).
Exegesis, Explanation and Epistemology 45

ɡˈ͎ Ɏ̈Ǩ̈́ Ʉ̿ć ɨ̓ .œāǩ˳ͫā ɑͫĕ ɬ͇ ťLJ˶ͫā Ʀāǚ̑Αā ǽ͎ ǚͫǍ̒ ķǛͫā Ⱥˬʦͫāć Ȉ͘Ǎͫā ɑͫĕ œāǩͲ Ǩ͛ĕ ɨ̓
ƦLJ͛ ķǛͫā ŰǨˈͫāć ɑͫĕ Ƣǚ˙̒ ķǛͫā ŰǨˈͫā Ǩ͛ĕ ɨ̓ Ǩ˳ʤˬͫ ǚͫǍ˳ͫā ȇʒʶͫā Ńṳ̈̌ ɷ̑ ķǛͫā Ⱥˬʦͫā ɑͫĕ
.ƱLJ́ʓ˶Ͳ ɷ͈Ǎˬ̑ ǚ˶͇ ɷʉ͎ Ńṳ̈̌ ķǛͫā ŰǨˈͫāć Ʊǚ̈ǩ̒ ǚˈ̑ ɷʉ͎ Ńṳ̈̌ ķǛͫā ŰǨˈͫāć ƛLJʥͫā ɑˬ̒ ǽ͎ ɷˈͲ
.ģLJʤ̈ ΒҨҞͫ Ʊǚˀ͘ ƹāǍ́ͫā ƛLJ̤ Ǩ͛Ǜ͎ ɷ̑ ȅ˶̓ ɨ̓ ɷ̒ĔLJ͇ žҨҞ̥ ȅˬ͇ ŰǨ˳ͫā Ǩ͛ĕ ɷ˳̈ǚ˙̒ ǽ͎ ȇʒʶͫāć

Galen said: In the first book, Hippocrates described the issue of three states
of air which cause diseases. In the third part of this same book, he de-
scribed the issue of one pestilential state. He began by describing all these
states in terms of change in the air which surrounds the bodies, and its
deviation from its nature. Then he proceeded by describing the nature of
the diseases which befall many people because of these states. In this book,
he did not do this in this way, but rather discussed first the disease which
occurred; then he discussed the season when it occurred; then he discussed
the country in which it occurred; then he discussed the mixture of this time
and the humour generated in the bodies of the people by this mixture; then
he described the way in which the humour works which was the cause
for the carbuncles being generated; and then he discussed the symptom
which preceded this, the symptom which accompanied it in this state, the
symptom which occurred in it after its increase and the symptom which
occurred in it when it reached its climax. The reason for his mentioning the
disease first contrary to his usual practice—he then turns and mentions the
state of the air—is his intent to be brief.

However, this difference is not a matter of principle or doctrine but entirely due
to a desire for brevity, as Galen goes on to say: ‘We find that the author of this
book, whether it be Hippocrates himself, or his son Thessalus, desires to be brief
(ģLJʤ̈ Βҙҏā ȅˬ͇ ΈLJˀ̈Ǩ̤ ɷ˶̑ā ťǍͫLJ̵LJ̓ ćΑā ƦLJ͛ ɷʶˏ͵ ŴāǨ˙̑Αā ɼͫLJ˙˳ͫā ƱǛ́ͫ Ƚ̀āǍͫā ǚʤ͵ ǚ˙͎).’54
Judging by these Galenic self-characterisations, one might be tempted to ex-
plain the brevity of the commentary on book One, especially concerning the
case histories, as a result of Galen’s intention not to publish the work. Yet in
practice, the difference between the commentary on book One and that on book
Two is not so clear-cut. Indeed, when reading the commentary on book One, it
is hard to imagine that it was intended solely for private consumption. It dis-
plays many features found in other Galenic commentaries, though perhaps to
a lesser extent55: there is discussion of variant readings preserved in different
copies of the text;56 there are, as we have seen, the polemical sneers at other

54 Book ii.1.5 HV (cf. p. 154, lines 31–3 Pf).

55 For formal differences between Galenic commentaries not primarily intended for wider
circulation and those envisaging a broader readership see von Staden 2009, especially 150.
56 See, for example, p. 36, lines 9–13 W (xvii/a. p. 64 K; cf. i.1.92 V), p. 43, lines 3–29 W
(xvii/a. pp. 78–80 K; cf. i.1.129 V), p. 76, lines 3–24 W (xvii/a. pp. 148–9 K; cf. i.2.142 V), p. 82,
46 Philip van der Eijk

commentators, especially Quintus and the Empiricists; there is occasional criti-

cism of Hippocrates,57 though more often we find Galen pointing out that the
text as it stands is unclear and can only be properly understood when put, as we
have seen, in the context of other Hippocratic texts or against the background
of Galen’s own works. Yet the main reason for thinking that the audience of the
commentary may well have been larger than Galen’s autobibliography would
let us believe is the fact that the commentary on book One itself tells us that the
text is meant both for people without medical knowledge and those with some
medical knowledge58:

Ἐν τῷ πρὸ τούτου βιβλίῳ λέλεκται περὶ τῆϲ τῶν ὡρῶν εἰϲ ἀλλήλαϲ μετα-
βολῆϲ, εἴρηται δὲ καὶ ἡ κατὰ φύϲιν ἑκάϲτηϲ κρᾶϲιϲ αἵ τε προθεϲμίαι τῆϲ
ἀρχῆϲ αὐτῶν καὶ τῆϲ τελευτῆϲ. ὡϲ ἂν οὖν ἐκείνων μεμνημένων ἡμῶν, ὅϲα
τῶν νῦν λεγομένων ἐξηγήϲεωϲ δεῖται προϲθήϲω, ϲτοχαζόμενοϲ οὔτε μόνων
τῶν ἐϲχάτωϲ ἀμαθῶν οὔτε μόνων τῶν ἱκανὴν ἐχόντων τὴν παραϲκευήν·
πρὸϲ ἅπανταϲ γὰρ ὁ τοιοῦτοϲ λόγοϲ ἕξει μετρίωϲ. τῶν δ’ ἄλλων ὁ μὲν
τοῖϲ ἐϲχάτωϲ ἀμαθέϲιν οἰκεῖοϲ ἀνιάϲει τοὺϲ ἐν ἕξει διὰ τὸ μῆκοϲ, ὁ δὲ τού-
τοιϲ ἐπιτήδειοϲ ἀϲαφὴϲ ἔϲται τοῖϲ ἀμαθέϲιν. ἀλλ’ οὐδὲ χρὴ τοῖϲ τοιούτοιϲ
ὑπομνήμαϲιν ἐντυγχάνειν ἀγαπῶνταϲ, ἀλλ’ ἄλλο παρ’ ἄλλου καὶ ἄλλωϲ
ἀκούϲαντεϲ πλατύτερον πολλάκιϲ ταὐτὰ δυνηθεῖεν 〈ἂν〉 ἄνευ παρακοῆϲ
ἐκμανθάνειν τι χρηϲτόν.

In the preceding book, I described the process of change from one season
to the next and specified the natural mixture of each and the dates deter-
mining the beginning and end of each of them. As we mentioned, I discuss
those passages that are in need of exegesis, but I am aiming neither exclu-
sively at those without any medical knowledge nor exclusively at those
who already have considerable medical knowledge. This mode of explana-
tion will be appropriate for everyone. There are two other modes: the first
one, appropriate for people without any medical knowledge, offends those
who have such knowledge due to its tediousness. The second one, address-
ing those with medical knowledge, is unclear for those without medical
knowledge. Yet people who love medical knowledge do not need to read
such books, but they hear one thing from one person and another from
another, and hearing the same thing many times in different ways they can
learn something useful without misunderstanding.

lines 19–28 W (xvii/a. p. 162 K; cf. i.2.165 V), p. 92, lines 25–6, p. 94, lines 6–10 (in app.) W
(xvii/a. pp. 183–4, 187 K; cf. i.2.202, 2.219 V), p. 99, lines 4–12 W (xvii/a. p. 197 K; cf. i.2.223 V),
p. 123, lines 12–23 W (xvii/a. p. 246 K; cf. i.3.68 V).
57 For example, p. 145, line 26–p. 146, line 7 W (xvii/a. pp. 288–9 K; cf. i.3.126 V), p. 150,
line 1–p. 151, line 8 (xvii/a. pp. 299–301 K; cf. i.3.140 V).
58 P. 45, line 18–p. 46, line 6 (xvii/a. pp. 84–5 K; cf. i.2.3 V).
Exegesis, Explanation and Epistemology 47


We have considered various reasons why Galen’s reading of the Epidemics

is the way it is, and why it is so different from the way the Epidemics have
been read, and continue to be read today, by historians of science and medical
doctors. To Galen, the Epidemics are, essentially, a treatise on a special kind of
disease. They fit in with an existing medical theory and are based on a number
of assumptions and presuppositions, which they are meant to illustrate and
confirm rather than reveal or demonstrate. Furthermore, Galen uses the writing
of the commentary on the Epidemics as an opportunity to criticise the Empiricist
appropriation of the Hippocratic text as a statement of their methodological
principles; and in reaction to the Empiricists’ view on experience, he uses the
commentary as a vehicle for expressing his own belief that experience, however
vital and ultimately decisive as a criterion, needs to be qualified by theoretical
and universal considerations.
48 Philip van der Eijk
Sympathy between Hippocrates and Galen 49

Sympathy between Hippocrates and Galen:

The Case of Galen’s Commentary on Hippocratesʼ
‘Epidemicsʼ, Book Two
Brooke Holmes1

It is well known that Galen’s commentaries on texts from the Hippocratic

Corpus are organised by the methodological principle ‘to make clear what is
unclear’.2 Galen is often content to blame obscurity on the limitations of the
reader, a strategy that allows him to cast himself as an exemplary teacher. The
Commentary on Hippocratesʼ ‘Epidemics’, Book Two, however, confronts a rather
different species of obscurity, one due to the difficult nature of the treatise itself,
which, as Galen regularly observes, is rife with enigmatic words and frustrating
gaps. The difficulty can sometimes be attributed to problems with the state of
the text (variant readings, possible omissions). In other cases, Galen blames the
text’s impenetrability on the interpolations of forgers who aim to create obscu-
rity and ambiguity because, he alleges, they want to create puzzles that only
they can solve, thereby inflating their own reputations.
But perhaps the most important reason for the difficulties posed by Epidem-
ics, Book Two, in Galen’s view, lies in the circumstances of its composition.
Despite the fact that, at the outset of his commentary, he professes not to care
whether the treatise was written by Hippocrates or by his son Thessalus,3 he
later agrees with those who believe that Hippocrates did not write the text for
publication but prepared it, rather, as a notebook: ‘for the mode of the expres-
sion used in the text is inadequate to convey the meaning he intends in a way

1 This essay was written with the generous support of the American Council of Learned
Societies, the Fondation Hardt pour l’étude de l'Antiquité classique, and the Elias Boudinot
Bicentennial Preceptorship at Princeton University. I would like to express my thanks as well
to Peter E. Pormann for the invitation to be involved in the Epidemics in Context project and
the original conference audience for their comments and questions.
2 See, for example, Galen’s Commentary on Hippocratesʼ ‘Aphorismsʼ 1, proe. (xvii/b. p. 561 K);
Commentary on Hippocratesʼ ‘Fracturesʼ 3, proe. (xviii/b. p. 318 K). Galen’s commentaries on
Hippocrates have been the subject of considerable research over the past thirty years. See
especially Smith 1979, 61–176; Manetti and Roselli 1994. See also Manuli 1983b; Lloyd 1991;
Debru 1994; Jouanna 2000b; Flemming 2002; von Staden 2002; Yeo 2005; Flemming 2008;
Manetti 2009.
3 Book ii.1.5 HV (cf. p. 155, lines 31–5 Pf).
50 Brooke Holmes

that is entirely comprehensibleʼ.4 If such stylistic infelicities are inexcusable in

those trying to communicate with a larger public, they are forgivable in those
writing for their own private purposes. The style of Epidemics, Book Two, thus
seems to prove that it was written as an aide-mémoire.5 Given the origin of the
text, we must be content, Galen concedes, ‘with approximation and conjecture
and not secure knowledgeʼ.6
Yet the enigmatic nature of Epidemics, Book Two, also affords the commen-
tator an opportunity. For it allows Galen to present himself as a riddle-solver
and a code-cracker and, hence, the true heir of Hippocrates, the son who does
not just transmit the father’s private writings, as Thessalus does, but unpacks
their latent truths. The terseness of Epidemics, Book Two, which exaggerates
the brachylogy so characteristic of the Epidemics as a whole, also invites expli-
cation and appropriation.7 Galen’s commentary is, accordingly, addressed not
just to enigmas but also to silences. These silences, significantly, tend to crop up
in places where Galen expects a cause. Much as modern readers, at least until
fairly recently, have tended to see in the Epidemics a paradigm of pure clinical
observation, devoid of theoretical commitments, the ancient Empiricists read
these texts as validating their rejection of speculation about hidden things.8 It is,
in fact, partly to wrest control of the Epidemics from the Empiricists that Galen
writes his commentaries in the first place, declaring in his study of Epidemics,

4 Book ii.1.90 HV (cf. p. 177, lines 12–20 Pf). See also ii.1.195 HV (cf. p. 205, lines 18–27 Pf),
ii.2.115 HV (cf. p. 239, lines 42–3 Pf), ii.3.87 HV (cf. p. 283, lines 7–14 Pf). On Thessalus’s
role, see also ii.2.22 HV (cf. p. 213, lines 23–6 Pf), ii.3.64 (cf. p. 276, lines 1–3 Pf). Explaining
the enigmatic style of Epidemics, Book Two, is all the more important in view of the fact
that Galen frequently praises the clarity of Hippocrates’ writing and the master’s interest in
communication: see Sluiter 1995.
5 On private memory, see also Commentary on Hippocratesʼ ‘Epidemicsʼ, Book Six 2.29 (xvii/a.
p. 955 K; p. 93, lines 3–8 W). The distinction between public and private as a generic marker
was already in place in earlier Hippocratic commentaries (Manetti and Roselli 1994, 1568).
6 Book ii.2.49 HV (cf. p. 221, lines 9–11 Pf).
7 On stylistic differences between the various Epidemics, see Smith 1989. Galen’s
commentaries reflect these differences: those on Epidemics, Books One and Three, are less
polemical vis-à-vis other commentators and hew more closely to the text, while those on
Epidemics, Books Two and Six, are more upfront about the interpretive problems involved.
(Galen thought Epidemics, Books Four, Five, and Seven, were not Hippocratic at all.) Some of
the differences in Galen’s treatment can also be explained by whether the commentary was
produced in the first or second ‘phaseʼ of his commentary writing. On the chronology of the
commentaries, see Smith 1979, 123–5, 147–55 on the composition of Epidemics, Book Two.
8 For the modern history of reading the Epidemics and a more nuanced approach to the
texts’ theoretical commitments, see Langholf 1990; King 1998, 54–74. For the Empiricists’
refusal to see causes in the Epidemics, see, for example, i.1.13 V (xvii/a. p. 6 K; p. 6, lines
6–16 W). On Galen’s battles against the Empiricists in his Hippocratic commentaries more
generally, see Manetti and Roselli 1994, 1535–8, 1593–1600, and von Staden 2002, 119–21,
who argues that Galen’s rescue of Hippocrates from the Empiricists is a crucial feature of his
exegetical ‘plotʼ.
Sympathy between Hippocrates and Galen 51

Book One, that ‘Hippocrates already went to the trouble of explaining what he
described. What remains to be done is to give the causes of [the phenomena]
that he describedʼ.9 In the Commentary on Hippocrates’ ‘Epidemics’, Book Two,
Galen does not lose sight of this aim, claiming that Hippocrates advises us to
search for the causes and to study them.10 The commentary on causes that he
supplies is thus presented as an expansion of something inherent in the original
text and a locus for his claim to Hippocrates’ legacy.
The causes that Galen supplies, however, both here and in other Hippocratic
commentaries, are more often than not products of his own medical-philosoph-
ical system, a system heavily indebted to its more immediate predecessors and
especially the Hellenistic anatomists. Indeed, the uneven and inscrutable na-
ture of Epidemics, Book Two, makes it especially susceptible to what Heinrich
von Staden has called Galen’s mode of ‘inflationaryʼ reading.11 That is, the text
readily supplies gaps to be filled by Galen’s own aetiological-theoretical ap-
paratus in the guise of Hippocrates’ (unexpressed) beliefs about hidden causes
and structures.12 But what makes Galen’s exegetical practise in his reading of
Epidemics, Book Two, particularly interesting is the way in which he articulates
the causal apparatus along anatomical lines. The prevalence of anatomy in Ga-
len’s commentary is a response, in part, to the fact that the account in Epidemics,
Book Two, of the blood vessels and ‘nervesʼ was considered by Galen and others
to be the only genuine Hippocratic account of these structures.13 It reflects, too,
Galen’s interest in Hippocrates as not just the father of medicine but the father

9 Book i.2.202 V (xvii/a. p. 183 K; p. 92, lines 21–2 W).

10 Book ii.1.154 HV (cf. p. 195, lines 23–5 Pf).
11 Von Staden 2002, 112. By means of such a reading, von Staden argues, ‘the two ancient
canons—the earlier brachyological and allusive, the later expansive and explicit—often are
made to resemble each other, indeed to be identical in their scientific theories and in their
medical practices. Text and commentary, as an ensemble, thus project a reassuring image
of scientific systematicity and of a scientific truth that is not vulnerable to the vagaries of
temporal context or cultural exigencyʼ (ibid., 114). Rebecca Flemming offers a slightly different
perspective: ‘The most important thing [sc. in Galen’s Hippocratic commentaries] was the
multiplicity and thickness of the connections made, the ways in which points could be joined
up and made sense of, not absolute purity or consistencyʼ (2002, 112).
12 On Galen’s attribution of his own ideas to Hippocrates, see De Lacy 1979, 363; Lloyd 1988;
Debru 1994, 53–4; von Staden 2002, 114–16; Yeo 2005; Flemming 2008, 343–6.
13 Galen dismisses the accounts in On Places in a Human Being, Mochlion, and On the Nature
of a Human Being as spurious (ii.4.4 HV [cf. p. 311, lines 14–22 Pf]). See also Commentary on
Hippocratesʼ ‘Nature of Manʼ 1, proe. (xv. pp. 10–11 K; ed. Mewaldt 1914, 7, lines 21–8, line 18),
where, having pronounced the first and third sections of On the Nature of a Human Being
authentic, he dismisses chapters 9–15 as largely an interpolation, singling out the account of
the blood vessels precisely because it does not accord with the account at Epidemics ii. 1.6; see
also On the Opinions of Hippocrates and Plato 6.3.27–31 (v. pp. 527–9 K; ed. De Lacy 1978–84,
378, line 36–380, line 24). On Galen’s difficulties in recuperating Hippocratic anatomy, see
Lloyd 1991, 403–4.
52 Brooke Holmes

of anatomy, an interest that he inherited from some of his teachers.14 The signif-
icance of anatomy in the tradition of anti-Empiricist Hippocratic interpretation
and the elliptical, sketchy nature of the original treatise create the conditions
under which Galen folds his own, post-Hellenistic vision of the networked body
into his interpretation of Epidemics, Book Two. The Galenic body, richly webbed
with nerves, veins, and arteries, not only insinuates itself into the Hippocratic
account of the blood vessels and nerves but becomes the subtext that Galen un-
covers at other points in the treatise.
In this paper, I analyse the conflation of anatomy and causality in Galen’s
Commentary on Hippocrates’ ‘Epidemics’, Book Two, by focusing on the phe-
nomenon that seems to trigger it most often, that of sympathy (sympátheia),
which Galen uses to describe cases where one part of the body suffers as a result
of its relationship to another part.15 The language of sympathy (sympátheia,
sympáskhein, sympathês) does not appear in Epidemics, Book Two, nor, in fact,
in any other classical-era Hippocratic text.16 Yet Galen shows himself in other
commentaries to be more than willing to put that language into the mouth of
Hippocrates.17 Indeed, he sees a commitment to sympathy within the body in a
broad sense as one of the defining pillars of the master’s system, adopting a line
from the treatise On Nutriment—almost certainly dating from the Hellenistic
or imperial period—as something of a Hippocratic slogan.18 In the case of the

14 Garofalo 1992, 610. Galen wrote a whole treatise entitled On the Anatomy of Hippocrates
in five or six books that is no longer extant (it is mentioned at The Function of the Parts of
the Body 14.4 [iv. p. 154 K; ed. Helmreich 1907–9, ii. 293, lines 15–16]). The great anatomist
Marinus is also said to have endorsed the account in Epidemics, Book Two, at Commentary on
Hippocratesʼ ‘Epidemicsʼ, ii.4.43 HV (cf. p. 331, lines 5–8 Pf).
15 Siegel 1968, 360–82 remains the standard discussion of sympathetic affections in Galen.
See also De Lacy 1979, 361–3; Holmes, Forthcoming. Keyser 1997 discusses sympathy in
Galen’s pharmacology.
16 The word does appear several times in treatises widely believed to be post-classical: see
Letters 13 (ix. p. 334 L; ed. Smith 1994, 64, line 4), 23 (ix. p. 394 L; ed. Smith 1994, 102, line 9);
Precepts 14 (ix. p. 272 L; ed. Heiberg 1927, 35, lines 6–7).
17 See, for example, Commentary on Hippocratesʼ ‘Epidemicsʼ, Book Six 1.2 (xvii/a. pp. 800–1
K; p. 7, lines 17–20 W), where Galen explains a lemma from Epidemics, Book Six, by supplying
katà sympátheian. See also, for example, Commentary on Hippocratesʼ ‘Aphorismsʼ 5.1 (xvii/b.
p. 783 K); Commentary on Hippocratesʼ ‘Jointsʼ 3.96 (xviii/a. p. 623 K); Commentary on
Hippocratesʼ ‘Epidemicsʼ, Book Six 1.2 (xvii/a. p. 803 K; p. 8, line 26 W).
18 Nutriment 23 (ix. p. 106 L; ed. Deichgräber 1973, 36): ‘ϲύρροια μία, ϲύμπνοια μία, πάντα
ϲυμπαθέα, κατὰ μὲν οὐλομελίην πάντα, κατὰ μέροϲ δὲ τὰ ἐν ἑκάϲτῳ μέρει μέρεα πρὸϲ τὸ
ἔργον’ (There is one flowing together; there is one common breathing; all things are in
sympathy, everything according to the whole and according to the part, all the parts in each
part, with reference to its function). On the dating of Nutriment, see Diller 1936; Deichgräber
1973, 69–75; Joly 1975; Jouanna 1999, 401 (all dating it to the post-classical period in view of
Stoic influence, despite differences of opinion regarding how late the treatise is). For Galen’s
citation of the Nutriment passage, see Causes of Pulses 1.12 (ix. p. 88 K); Natural Capacities
1.12 (ii. p. 29 K; ed. Helmreich 1893, 122, lines 6–10), 1.13 (ii. p. 38 K; ed. Helmreich 1893, 129,
Sympathy between Hippocrates and Galen 53

Commentary on Hippocratesʼ ‘Epidemicsʼ, Book Two, we lack the original Greek

text. Nevertheless, it is possible to detect here, too, in Ḥunayn’s use of the terms
šāraka and mušāraka, traces of Galen’s extension of the concept of sympathy
(and related concepts) to Hippocrates.19 On such occasions, Galen does not sim-
ply attribute a concept of sympathy to his classical predecessor. He also takes
advantage of the opportunity to elucidate causal connections by introducing his
own sophisticated model of an intricately and precisely networked body.

Chest, Breasts, Genitals, Voice: The Vascular Network

The language of sympathy does not occur, as I have just observed, in the
Hippocratic treatises dating to the fifth and fourth centuries BC. Yet we do
find, on several occasions, a term that will become closely associated with the
concept of sympathy in Galen—namely, koinōnía (or, rather, the Ionic koinōníē):
‘associationʼ, ‘communityʼ, ‘partnershipʼ. The plural (koinōníai) appears twice,
both times in contexts that suggest sympathetic affections triggered elsewhere
in the body by a primary ill.20 The singular is found, conveniently enough, in

lines 7–9), 3.13 (ii. p. 196 K; ed. Helmreich 1893, 243, lines 10–13); The Method of Healing 1.2
(x. p. 16 K); Tremor, Palpitation, Spasm, and Shivering 6 (vii. p. 616 K); The Function of the
Parts of the Body 1.8 (iii. p. 17 K; ed. Helmreich 1907–9, i. 12, lines 16–18), 1.9 (iii. p. 24 K; ed.
Helmreich 1907–9, i. 17, lines 13–15).
19 The Greek text in Kühn 1821–33 (xvii/a. pp. 303–479) is a forgery probably dating from the
Renaissance. I have therefore relied largely on the Warwick translation, with attention to the
Arabic original where relevant, through the generous help of Bink Hallum, Peter E. Pormann,
and Uwe Vagelpohl. The use of šāraka to translate sympáskhein is seen at Commentary on
Hippocratesʼ ‘Epidemicsʼ, i.2.155 V (xvii/a. p. 158 K; p. 80, line 20 W), suggesting that mušāraka
was used to translate sympátheia. See also below, n. 31. It is worth noting, however, that the
verb and the noun, respectively, can also be used to translate koinéō/koinōnéō and koinōnía/
koinōníē, as at Commentary on Hippocratesʼ ‘Epidemicsʼ, i.2.110 V (xvii/a. p. 136 K; p. 70,
line 11 W), 3.15 (xvii/a. p. 212 K; p. 106, line 31 W), 3.26 (xvii/a. p. 218 K; p. 110, lines 19–20 W).
(I owe these references to Uwe Vagelpohl.) See also Commentary on Hippocratesʼ ‘Epidemicsʼ,
ii.1.73 HV (cf. p. 173, lines 8–11 Pf), where, as Bink Hallum has pointed out to me, the koinōníē
of the Hippocratic text is translated by means of mušāraka. The context is usually sufficient
to determine whether Galen is referring to sympátheia or koinōníē, concepts that are often—
although not always—related (sympathetic affections occur when there is an ‘associationʼ
between two parts). My method here has been to identify passages in the translation
where Galen appears to be discussing sympathetic affections and relationships and then to
check these passages against the instances of šāraka and mušāraka in the Commentary on
Hippocrates’ ‘Epidemics’, Book Two, provided to me by Bink Hallum. On Ḥunayn’s translation
more generally, see Pormann 2008a and the other papers in this volume.
20 Epidemics vi. 3.24 (v. p. 304 L; ed. Manetti/Roselli 1982, 76, lines 4–5); Humours 20 (v. p. 500 L).
For other instances of sympathetic affection in the Hippocratic Corpus, see Holmes, Forth-
54 Brooke Holmes

Epidemics, Book Two, in a discussion of critical signs that closes with a brief
summary of a particular type of sign:

πολλὰ δὲ καὶ τῶν τοιούτων, οἷον ἀποφθειρουϲέων οἱ τιτθοὶ ποϲιϲχναίνο-

νται· οὐδὲ γὰρ ἐναντίον οὐδὲ βῆχεϲ χρονίαι, ὅτι ὄρχιοϲ οἰδήϲαντοϲ παύο-
νται· ὄρχιϲ οἰδήϲαϲ ὑπὸ βηχωδέων ὑπόμνημα κοινωνίηϲ ϲτηθέων, μαζῶν,
γονῆϲ, φωνῆϲ. (Epidemics ii. 1.6, v. p. 76 L)21

There are many phenomena of this kind, as when, in women who are about
to abort, the breasts completely wither up. For there is no contradiction
even in that chronic coughs subside following the swelling of a testicle.
The testicle that has swollen because of the coughs is a reminder of the
relationship between the chest, the breasts, the genitals, and the voice.

The symptom—the withering breast, the swollen testicle—here acquires, beyond

its diagnostic function, a mnemonic one: it recalls to the reader a schema of
relationships within the sexed body with which he is apparently already fa-
miliar. The idea of such a ‘community’ of parts or places within the body is, in
fact, suggested by other Hippocratic writers. For example, a number of treatises
seem to assume—and, on at least one occasion, explicitly refer to—a vessel that,
in the female body, joins the uterus to the breasts, allowing for the transmission
of milk and, under pathological conditions, menstrual blood.22 Many writers
also imply the presence of a kind of tube or vessel connecting the vagina to the
mouth or nostrils, perhaps building on popular concepts of the female body;
there is further evidence, beyond the passage from Epidemics, Book Two, of
a belief in a similar tube in the male body.23 These may be the routes that the
author has in mind here.

21 I print Robert Alessi’s unpublished text for the Budé series here and throughout; I am very
grateful to him for making it available to me. I have also consulted Smith 1994, in addition to
Littré 1839–61. Translations from Epidemics, Book Two, are my own.
22 For milk, see On Seed/On the Nature of the Child 21 (vii. pp. 510–14 L; ed. Joly 1970, 67,
line 9–68, line 18); On the Glands 16 (viii. pp. 570–72 L; ed. Joly 1978, 121, lines 11–20). For
menstrual blood, see On the Diseases of Women ii. 133 (viii. p. 282 L). On the sympathy of the
breasts and the uterus in the Corpus (and Aristotle), see also Dean-Jones 1994, 215–22 and
below, n. 27.
23 Epidemics ii. 5.1 (v. p. 128 L) also suggests a relationship between the testicle and the voice
(Galen’s commentary on this passage, unfortunately, is lost). See further, with an emphasis
on the female body, Manuli 1983a, 157; King 1998, 49–51, 68–9; Dean-Jones 1994, 72–3. For
popular ideas about the relationship of a woman’s ‘two mouthsʼ, see Armstrong and Hanson
1986. The mouth, of course, is not the same as the voice. Nevertheless, it seems likely that the
‘tubeʼ assumed by these authors would be sufficient to relate changes in the sexual organs to
those of the voice. See Duminil 1983, 121, who posits Aristotle’s On the Generation of Animals
4.8, where Aristotle locates the principle of the voice close to the source of the spermatic
Sympathy between Hippocrates and Galen 55

Nevertheless, the underlying web of connections is not described by the

Hippocratic author, creating an opportunity for the commentator to step in and
flesh out what the source text leaves unsaid. Galen intervenes in the text even
before mentioning the koinōníē between chest, breast, genitals, and voice. For if
the symptoms of the withering breasts or the swollen testicle are imagined by
the Hippocratic author to call up a correspondence between the breasts and the
uterus or the chest and the genitals that is familiar to his reader, Galen fears that
his reader will be baffled by such symptoms. He thus hastens to signal ‘the con-
nection and association that exists between the genital organs and the chestʼ as
the underlying explanation of what is happening on the surface.24 ‘Hippocratesʼ
himself, of course, goes on to identify this connection but, as we have just seen,
he does so matter-of-factly and without explanation.
Following a brief interlude about the precise meaning of genitals in the passage,
Galen returns to the connection between the genital region and the chest, which,
he indicates, requires further elaboration: ‘I need to describe the reason for that
connectionʼ.25 What follows is an extended description of the anatomical struc-
tures that Galen sees as the ground of the relationships drawn by the Hippocratic
author. He traces the paths of two sets of veins—one deep, the other superficial—
that create a bond between the upper body (chest, breasts) and the reproductive
organs, on the one hand, and the upper body and the testicles or the vulva, on
the other, concluding: ‘this shows how the connection and association between
the chest and the breasts, the generative organs, and the voice takes place: it is an
association due to these veinsʼ.26 Whereas the author of Epidemics, Book Two, is
vessels in the heart, as the missing link between the voice and the genitals in Epidemics, Book
Two. I think it unlikely that the Aristotelian model underlies the passage here.
24 Book ii.1.72 HV (cf. p. 173, lines 4–7 Pf). The phrase ‘connection and association’ is Bink
Hallum’s translation of ittiṣāl and mušāraka, the latter probably translating Galen’s koinōnía.
(Pfaff offers ‘Verbindungʼ and ‘Gemeinschaftʼ.) For the phenomenon of shrunken breasts
signaling an imminent miscarriage, see also Aphorisms 5.37–8 (iv. p. 544 L), with Commentary
on Hippocratesʼ ‘Aphorismsʼ 5.37–8 (xvii/b. pp. 828–9 K); Aphorisms 5.53 (iv. pp. 550–52 L),
with Commentary on Hippocratesʼ ‘Aphorismsʼ 5.53 (xvii/b. pp. 845–50 K). Galen himself cites
his discussions in the Aphorisms commentary at Commentary on Hippocratesʼ ‘Epidemicsʼ,
ii.1.70 HV (cf. p. 172, lines 28–9 Pf). See further The Affected Parts 6.5 (viii. pp. 436–7 K); The
Function of the Parts of the Body 14.4 (iv. p. 153 K; ed. Helmreich 1907–9, ii. 292, line 19–293,
line 4), 14.8 (iv. p. 179 K; ed. Helmreich 1907–9, ii. 312, line 16–313, line 21). On the vascular
relationship between the uterus and the breasts, see especially the discussion at The Function
of the Parts of the Body 14.4–5 (iv. pp. 150–58 K; ed. Helmreich 1907–9, ii. 290, line 21–296,
line 7), 14.8 (v. pp. 176–9 K; ed. Helmreich 1907–9, ii. 310, line 8–313, line 7). See also, for
example, Commentary on Hippocratesʼ ‘Aphorismsʼ 5.50 (xvii/b. p. 843 K), 5.52 (xvii/b. p. 844 K),
5.53 (xvii/b. pp. 846–7 K); Commentary on Hippocratesʼ ‘Epidemicsʼ, ii.1.96 HV (cf. p. 179, lines
12–16 Pf), ii.3.166 HV (cf. p. 304, lines 17–24 Pf); The Method of Healing 13.19 (x. pp. 925–6 K);
The Anatomy of Veins and Arteries 8 (ii. p. 813 K).
25 Book ii.1.75 HV (cf. p. 173, lines 27–8 Pf).
26 Book ii.1.76 HV (cf. p. 174, lines 16–19 Pf). Note that by Galen’s time, phléps had come
to mean ‘veinʼ as opposed to artery. The difference is not recognised in the classical-era
56 Brooke Holmes

content to speak of the koinōníē of parts of the body, much as another Hippocratic
author simply refers to the ‘relatednessʼ (homoethníē) of the uterus and the breasts,
Galen is compelled to map out in some detail the network that underwrites these
affinities, which he presents as the subtext of Hippocrates’ remarks.27
In articulating the paths of these veins, Galen is not, in principle, violating
the spirit of the original text. The vessels that transport fluids and air were a
fundamental part of Hippocratic medicine, and several authors, including the
author of Epidemics, Book Two, attempted to chart systematically their routes
through the body—an ambitious undertaking, given the apparent absence of for-
mal dissection, at least of humans, in the classical period.28 Moreover, the drive
to identify the underlying causes of symptoms is a marked feature of a number
of Hippocratic texts; the texts of the Epidemics, too, clearly draw on a developed
etiological system.29 Nevertheless, in supplementing the source text, Galen goes
a step further, supplying the details that he believes are required to adequately
account for the vague ‘associationʼ signaled at Epidemics ii. 1.6. The fact that
these details are drawn from his own understanding of the vascular network,
developed through his extensive experience with animal dissection and clinical
practise and also undoubtedly coloured by his own theoretical expectations, is
consistent with his practise elsewhere of grounding associations between parts
of the body and the resulting sympathetic affections in an anatomical landscape
drawn with the pretense of precision.30 In the commentary on Epidemics, Book

Hippocratic texts: see Duminil 1983, 23–61. Galen shows that he is aware of the earlier,
broader usage of phléps in Epidemics, Book Two, at The Opinions of Hippocrates and Plato 6.8.45
(v. p. 574 K; ed. De Lacy 1978–84, 416, lines 24–6), but he is not consistent in his historical
sensitivity. I use the term ‘vascularʼ in part as a way of acknowledging the lack of distinction
in the Hippocratic text.
27 Homoethníē: On the Diseases of Women ii. 174 (viii. p. 354 L). The term also occurs at On
Places in a Human Being 1 (vi. p. 278 L; ed. Craik 1998, 36, line 4), in a slightly different context,
still involving sympathetic affection.
28 Epidemics, Book Two, not only offers an important early account of vascular anatomy but
also, as Wesley Smith has observed, ‘give[s] evidence of a systematic interest in getting control
of the body’s means of communication, defining them, mapping the channels, and learning
to manipulate themʼ (1989, 151). See also Harris 1973, 62 on the interconnecting veins in the
anatomical account at 4.1, which he believes is based on animal dissection (he is followed here
by Langholf 1990, 145, 147). On vascular connectivity elsewhere in the Corpus, see On Joints
45 (iii. p. 556 L; ii. p. 107, line 10–p. 108, line 5 Kw); On Places in a Human Being 3 (vi. p. 282
L; ed. Craik 1998, 40, lines 30–31). In the surgical treatises, the verbs koinéō and koinōnéō are
often used to describe the interconnection of parts of the body (primarily skeletal): see On
Joints 13 (iv. p. 118 L; ii. p. 134, line 8 Kw), 45 (iv. p. 190 L; ii. p. 172, line 3 Kw), 86 (iv. p. 324 L;
ii. p. 243, line 8 Kw); On Fractures 9 (iii. p. 450 L; ii. p. 62, line 4 Kw), 10 (iii. p. 450 L; ii. p. 62,
line 15 Kw), 11 (iii. p. 452 L; ii. p. 63, line 15 Kw).
29 On the interpretation of symptoms in early medical writing, see Holmes 2010, 121–91. On
the etiological basis of the various Epidemics texts, see especially Langholf 1990.
30 Especially in the late work The Affected Parts, Galen emphasises the need for a strong
grounding in anatomy to understand sympathetic affections, especially those involving the
Sympathy between Hippocrates and Galen 57

Two, Galen’s own vision of the inside of the body emerges in the gap that the
Hippocratic text leaves between two apparently isolated events: the disappear-
ance of a cough and the swelling of the testicles; the withering of the breasts
and the abortion shortly after. In his commentary, then, Galen does not simply
respond to the need for a cause or explanation of the phenomenon noted in the
source text but threads his explanation along the pathways of the body that he
(but not necessarily ‘Hippocratesʼ) understands to lie beneath the skin.
Galen’s anatomical knowledge is, in fact, one of the criteria against which
he judges others’ attempts to make sense of the roughly juxtaposed details so
characteristic of the Epidemics. In his Commentary on Hippocratesʼ ‘Epidemicsʼ,
Book Three, for example, he cites the interpretation of one of the case histories
by the followers of Sabinus: Pythion was suffering in his stomach and from this,
these exegetes say, his hands were trembling through sympathy (κἀξ ἐκείνου
κατὰ ϲυμπάθειαν αἱ χεῖρεϲ ἔτρεμον).31 Galen has no problem with his rivals’
recourse to sympathy as a way of explicating a Hippocratic lemma. What he
contests is their allegation that sympathy exists at all between the stomach and
the hands. For, he says, they cannot demonstrate an ‘associationʼ (koinōnía) be-
tween the body parts in question and, as a result, they cannot account for how
an affection is trafficked from one part to the other. It is not just their diagnosis
that falls short without such proof. Their interpretation of the Hippocratic text
fails as well.32
The work of the commentator is hemmed in not only by anatomical fact,
however, but also by the constraints of the text. Galen’s detour into vascular
anatomy at Epidemics ii. 1.6 is facilitated by the silence of the Hippocratic origi-
nal. For the absence of any elaboration of the alleged koinōníē in the lemma

nerves: see The Affected Parts 1.6 (viii. pp. 57, 60–63 K), 3.14 (viii. p. 208 K), 4.7 (viii. p. 257 K).
For his understanding of vascular anatomy, see Harris 1973, 267–306. At the same time, Galen’s
strong commitment to a venous relationship between the breasts and the uterus seems to be
due as much to his expectations as to empirical research. Goss makes a rare intervention in
his translation of The Anatomy of Veins and Arteries when Galen mentions the ‘associationʼ
(koinōnía) between the breasts and the uterus (ii. p. 813 K; ed. Goss 1961, 363), stating: ‘this is
a rather wishful observationʼ. Galen’s interest in this association is probably due not just to
existing ideas about the sympathy of the breasts and the uterus in the medical tradition but
also to his teleological understanding of the female body: see The Function of the Parts of the
Body 4.8 (v. pp. 176–9 K; ed. Helmreich 1907–9, ii. 310, line 8–313, line 7).
31 Commentary on Hippocratesʼ ‘Epidemicsʼ, Book Three 1.4 (xvii/a. p. 520 K; p. 24, lines 6–7 W).
Interestingly, in the Arabic version, we find the word šāraka to render Greek sympátheia. The
phrase is translated as (MS E1, fol. 139a, lines 17–18):

«.LJʓʷˈ̒ĢLJ͎ ζƦāǚʉͫā ɼˬˈͫā ɑˬ̒ ǽ͎ ƴ΋ ǚˈ˳ͫā Ȉ͛ĢLJ̶ ɨ̓ .ɼΉ ˬ͇ ɷ̒ǚˈͲ ǽ͎ ɡ̣Ǩͫā ɑͫǛͫ Ȉ̀Ǩ͇» ɷ͵Βā ƦǍͫǍ˙̈ ɨ΀ǚʤ͵ ǚ͘ć
We have found them saying: ‘A stomach disease occurred to that man. Then the hands shared
that disease [šārakat ... fī tilka l-ʿillati] with the stomach, so that they trembled’.
32 See also ii.4.41–2 HV (cf. p. 329, line 11–p. 330, line 32 Pf), where commentators go astray
because they lack the anatomical knowledge gained through autopsy.
58 Brooke Holmes

means that he is free to draw his own connections between, say, the breasts
and the uterus without having to recuperate anything from the parent text. The
situation is more delicate in Galen’s extended commentary on the account of the
vessels and ‘nervesʼ at the beginning of the fourth section of Epidemics, Book
Two, where he is forced to accommodate a more detailed original text, a text
whose omissions and errors are more glaring.33 The stakes, moreover, are high.
Galen believes the passage represents the only genuine Hippocratic account of
vascular anatomy available. The anatomical description ostensibly proves that
Hippocrates engaged in systematic dissection, allowing Galen to put him first
in an anatomical tradition that continues through Herophilus and Marinus to
Galen himself.
Despite the stress Galen places on the genuine provenance of the vascular
anatomy in the text, the authenticity of the passage is complicated by the fact
that the very style of the description proves in his mind that Epidemics, Book
Two, was not written by Hippocrates as a book for public circulation but, rather,
compiled by his son, Thessalus, ‘from things he found recorded by Hippocrates
on pages, sheets, and scattered fragmentsʼ.34 The lacunose, scattershot nature
of the text is temporarily kept hidden, as Galen offers a generous and polished
‘paraphraseʼ of the Hippocratic account that strategically shifts attention from
exegesis to an impromptu, stand-alone anatomy lesson for the sake of the reader.
But once he has concluded the educational digression, Galen is compelled to
return to the text and the nature of its origins. In revisiting the question of
origins, he implicitly acknowledges the difficulties that his own presentation
of the material has worked to fill: you cannot help but think here, he says, that
Hippocrates was writing only for himself, ‘to remind him[self] of what he had
seenʼ. For, if he had meant for the passage under consideration to be read by
others, ‘he would certainly have explained and clarified it as he had done in the
books he wrote for people to readʼ.35 However authentic the text, then, it was
not intended for our eyes, nor, for that matter, for anyone else’s.

33 Epidemics ii. 4.1 (v. pp. 120–26 L); ii. 4.2–57 HV (cf. p. 310, line 22–p. 338, line 31 Pf).
Alessi’s version of the Hippocratic text, which I have followed, was first presented as Alessi
2007. The passage from Epidemics, Book Two, also appears at On the Nature of Bones 10 (ix.
pp. 178–80 L; ed. Duminil 1998, 147, line 1–149, line 10). The anatomical account is rather
opaque: for discussion, see Harris 1973, 60–62; Duminil 1983, 34–47, 101–8; Langholf 1990,
145–9. The situation is complicated by discrepancies between the passage as it has been
transmitted by the direct manuscript tradition (where it has almost certainly been subject to
corruption) and the lemma in Galen’s commentary. On these discrepancies and the difficulties
they raise, see Duminil 1983, 109–13; Garofalo 1992. The textual problems do not, however,
bear on my discussion here. Alessi 1996 discusses more generally the usefulness of Galen for
establishing the text of Epidemics, Book Two.
34 Book ii.4.3 HV (cf. p. 310, lines 23–6 Pf).
35 Book ii.4.11 HV (cf. p. 314, lines 34–40 Pf).
Sympathy between Hippocrates and Galen 59

From one perspective, the inward-turning nature of the text under these cir-
cumstances makes the task of the interpreter more complex. Yet it also creates
opportunities; more specifically, it opens up a means for Galen to salvage a more
unwieldy source text, a text in which ‘Hippocratesʼ confronts anatomy head-on.
Insofar as, from Galen’s perspective, that confrontation can occur only through
dissection—‘whoever wants to see for himself what is beneath the skin must cut
through the skinʼ36—the text presumably represents Hippocrates’ notes result-
ing from his observation of the vascular system.37 We might imagine, then, that
there is little room for Galen’s own vision.
But while the original text does have a tendency to get in the way, the larger
problem turns out to be not what Hippocrates puts in but what he leaves out.
The reason for these omissions, Galen claims, is the very origin of the text as
a private document, designed only to trigger the memory of its author—hence,
its many gaps and points of obscurity. These gaps are what Galen exploits in
order to slip in his own model of vascular anatomy, this time under the guise of
shared memories of dissection: indeed, he goes so far as to imaginatively retrace
the path of Hippocrates’ scalpel.38 The two great physicians thus together form
a closed community of experts gathered around the open body. Galen’s com-
mentary purportedly translates this ‘sharedʼ but esoteric memory into exoteric
instruction by mediating between Hippocrates’ notes, meant only for his own
eyes and those of his sons, and the readers who, lacking the requisite knowledge,
would otherwise be shut out of the text (the commentary on Epidemics, Book
Two, being one of the commentaries that Galen intended for a wider audience).
Yet it is not simply that the text leaves things out. The very significance of
what it leaves out confirms, for Galen, its personal mnemonic function. Early in
his exegesis of the lemma, he remarks that it is strange that Hippocrates would
neglect to offer a full account of the major veins in the body, that is, those that
are ‘clearly visibleʼ and known to all who practise dissection—the first mention
of a lacuna in the original text—and that he would instead focus on the veins
that had eluded other physicians because of their fineness.39 The absence of
such an account, he concludes, can only prove that Hippocrates wrote the text
to remind himself of the most elusive phenomena that he had seen while dis-

36 Book ii.4.4 HV (cf. p. 311, lines 30–31 Pf).

37 This, in fact, is the conclusion of Langholf 1990, 148–9, arguing that the imperfect and
pluperfect tenses of the passage indicate these are minutes written down after observation (of
a dissected animal).
38 ‘If, first of all, he cut the lower belly along the membrane that is stretched over the belly
known as the peritoneum, then he observed what was beneath it. He saw the intestines and
bowels. On the right side of the abdomen he saw the liver, and on the left he saw the spleen.
After them he saw the kidneys, and after that the stomach and intestines. He saw the stomach
touching the diaphragm, bound by the liver on the right side and the spleen on the left…’
(Commentary on Hippocratesʼ ‘Epidemicsʼ, ii.4.5 HV [cf. p. 311, line 40–p. 312, line 5 Pf]).
39 Book ii.4.11 HV (cf. p. 314, lines 40–43 Pf).
60 Brooke Holmes

secting and for the benefit of his sons—not for a general public. By describing
the anatomical account as a sketch oriented toward what escapes the untrained
or inattentive eye, Galen grants himself considerable leeway to locate what the
text does give him within his own more precise understanding of the vascular
system while also accounting for its more obvious omissions. The reading he
offers is presented as addressing a shortcoming that is due not to the limits of
Hippocrates’ knowledge but to the circumstances and aims of the text’s com-
Galen does at times suggest that Hippocrates’ knowledge has its limits. These
are mentioned casually and in passing, as when Galen disputes Hippocrates’
description of a vein lying below an artery by pointing out that it only appears
to lie below the artery, in reality being stretched to its side, or when he remarks
that Hippocrates is ‘not speaking correctlyʼ.40 He also acknowledges the mo-
ment when the Hippocratic author recognises his own limits and admits that he
does not yet know what happens to the vessels after they descend to the lower
belly (ὅπῃ δ’ ἐντεῦθεν, οὔπω οἶδα).41
Galen’s response in this last case is also interesting, however, for the com-
peting scenarios it suggests for understanding Hippocrates’ confession of ig-
norance. He lends some weight to the ‘not yetʼ (οὔπω) of the text by observing
that Hippocrates did not know about these veins ‘at the time he wrote what he
did about thisʼ.42 He leaves open the possibility, then, that the anomalous gap
in Hippocrates’ understanding was eventually closed through further research.
But he also takes the statement as confirmation of the fact that Hippocrates
intended his notes to be read by his sons. The statement of ignorance, from
this perspective, is perhaps addressed to the sons who will extend the father’s
research program. The self-conscious lacuna within the source text is thus over-
determined. It either marks the space which Hippocrates’ vast learning eventu-
ally came to fill, so that exegesis remains the process of restoring to the reader
the aspects of this learning that remained private (cryptic or unsaid); or it carves
out the space for the master’s sons to supplement their paternal inheritance
with their own learning, so that exegesis shades into the communication of new
knowledge, the son having surpassed the father. For us, of course, the tension
between what Hippocrates leaves unsaid and what Hippocrates does not (yet)

40 Book ii.4.22 HV (cf. p. 320, lines 26–7 Pf), ii.4.34 HV (cf. p. 326, lines 32–4 Pf). Galen has
the greatest difficulty in accounting for the brachylogy of the account of the nerves (ii.4.40–
57 HV [cf. p. 328, line 43–p. 338, line 31 Pf]), but he vents most of his frustration on other
commentators for failing to recognise the difficulty of the original account (while continuing
to exonerate Hippocrates, for the most part, by restating his hypothesis that the master was
simply writing notes to himself: see, for example, ii.4.49 HV [cf. p. 333, line 44–p. 334, line 4
41 Epidemics ii. 4.1 (v. p. 124 L).
42 Book ii.4.28 HV (cf. p. 324, lines 5–6 Pf).
Sympathy between Hippocrates and Galen 61

know is more frequent in Galen’s exegesis than Galen himself would like to
One of the most intriguing cases where Hippocrates fails to note the obvi-
ous in the anatomy at 4.1 is his silence regarding the veins that come from
the breasts; more intriguing still, he observes instead the veins that run to the
shoulders, which are harder to see on account of the fact that they lie deep in-
side the body.43 Galen’s explanation of the silence is that, by making note of the
veins running to the shoulders, Hippocrates was, in a sense, also making note of
those running to the breasts, which share the same origin: in keeping with the
inverted logic of ‘private writingʼ, it was simply more important to mention the
less visible branch rather than the veins that ‘everyone can seeʼ. Yet the omis-
sion becomes particularly interesting in light of our earlier discussion of the
‘communityʼ or ‘associationʼ (koinōníē) between the chest and the reproductive
organs, including the breast and the uterus. For it was precisely by means of the
vein joining these parts that Galen had explained in that passage the transfer of
affections between them, without, of course, saying anything about the absence
of such a vein in the one genuinely Hippocratic account of the vascular system.44
Hippocrates’ refusal to spell out the underlying relationship between the
breast and the uterus becomes increasingly stubborn as we move into the sixth
section of Epidemics, Book Two, where we find a series of remarks implying
the association of the two parts of the (female) body: in each case, the text falls
tantalizingly short of spelling out the venous connection that Galen believes
must lie beneath the affections. Hippocrates says, ‘to hold back the menses in
women, apply a very large cupping instrument to her breast’; Galen steps in
with the reason for the prescription—namely, ‘the shared blood vessels between
the breasts and the wombʼ.45 Hippocrates says that if the milk flows in abun-
dance, the fetus will be weak; conversely, if the breasts are hard, the fetus will be
strong. Galen again supplies the cause: ‘this happens because of the connection
between the blood vessels from which the foetus and the breasts are nourishedʼ.46

43 Book ii.4.16 HV (cf. p. 317, lines 22–9 Pf).

44 When the anatomy at Epidemics ii. 4.1 can be used to underwrite what Galen identifies
as sympathetic affections, he does not hesitate to use it: see Commentary on Hippocratesʼ
‘Aphorismsʼ 7.17 (xviii/a. p. 117 K), where he explains a lemma declaring that hiccups are bad
in the case of inflammation of the liver by referencing a sympathetic affection of the stomach,
noting that the sympathy relies on common nerves (neûra) that are very short, ‘as Hippocrates
himself taught in the second book of the Epidemicsʼ.
45 Epidemics ii. 6.16 (v. p. 136 L); Commentary on Hippocratesʼ ‘Epidemicsʼ, ii.6.94–5 HV
(cf. p. 386, lines 23–33 Pf). See also Aphorisms 5.50 (iv. p. 550 L), with Commentary on
Hippocratesʼ ‘Aphorismsʼ 5.50 (xvii/b. pp. 842–3 K).
46 Epidemics ii. 6.18 (v. p. 136 L); Commentary on Hippocratesʼ ‘Epidemicsʼ, ii.6.98–9 HV
(cf. p. 387, lines 6–20 Pf). See also Aphorisms 5.52 (iv. p. 550 L), with Commentary on
Hippocratesʼ ‘Aphorismsʼ 5.52 (xvii/b. p. 844 K); The Function of the Parts of the Body 14.8 (v.
p. 178 K; ed. Helmreich 1907–9, ii. 312, lines 7–13).
62 Brooke Holmes

In the next line, Hippocrates finally seems to acknowledge the anatomical sub-
structure underlying his remarks, stating bluntly that ‘a thick vessel goes to
each of the breastsʼ (the text transmitted by the direct manuscript tradition and
printed by Littré, Smith, and Alessi reads ‘φλὲψ ἔχει παχέα ἐν ἑκατέρῳ τιτθῷʼ
[there is a thick vessel in each breast]).47 Galen, in any case, thinks Hippocrates
has finally got around to doing etiology for himself, offering ‘a statement by
which he indicated the cause of these two things that he described and also
added to this the connection and joining of the veinsʼ.48 Galen’s own remarks
about the connection between the breast and the uterus would thus seem only
to have anticipated what Hippocrates himself eventually observes.
The difficulty that Galen has to face is that Hippocrates’ vessels do not go
anywhere besides the breasts: indeed, in the version transmitted by the manu-
scripts for Epidemics, Book Two, they do not go anywhere at all, at least techni-
cally (the expression ἐν ἑκατέρῳ τιτθῷ is locative). In short, these vessels do not
join up with the vascular system described at 4.1, nor do they find a pathway
to the uterus. If connectivity implies causality, the Hippocratic ‘explanationʼ is
In fact, it is worth noting that despite the apparent assumption of a connect-
ing vessel relating the breasts to the uterus in a number of Hippocratic texts,
no systematic Hippocratic account of the vascular system supplies anatomical
support for this assumption, as Marie-Paule Duminil has observed;49 the sole ex-
ception is a passage from the probably post-classical compilation On the Nature
of Bones that is also quoted in Aristotle’s History of Animals, where Aristotle
attributes the account to the otherwise unknown Syennesis of Cyprus.50 Du-
minil tries to account for the silence of the Hippocratic texts on this point by
suggesting that the vascular bond between the breasts and the uterus was not
considered part of the principal network of vessels.51 Reflecting on Hippocrates’
reticence in the sixth section of Epidemics, Book Two, Galen takes the opposite
approach, falling back on the reasoning that Hippocrates is just making a note
for himself of what he would otherwise forget, with the result that he leaves out
what is most important. Galen, in any event, is left once again to fill in the gaps,
which he eventually does with great decisiveness:52

47 Epidemics ii. 6.19 (v. p. 136 L); Commentary on Hippocratesʼ ‘Epidemicsʼ, ii. 6.100 HV
(p. 387, lines 21–2 Pf). The shift from the locative to the directional preposition may have
been introduced in the translation into Arabic; Galen, in any event, clearly believes that the
veins extend to the breasts from elsewhere in the body.
48 Book ii.6.101 HV (cf. p. 387, lines 26–9 Pf).
49 Duminil 1983, 120–22.
50 See Aristotle History of Animals 3.2, 511b24–30 and On the Nature of Bones 8 (v. p. 174 L;
ed. Duminil 1998, 144, lines 7–17), with Harris 1973, 20–21; Duminil 1983, 68–71. The system
is neatly diagrammed in Harris 1973, fig. 1.
51 Duminil 1983, 122.
52 Book ii. 6.101 HV (cf. p. 387, lines 32–41 Pf).
Sympathy between Hippocrates and Galen 63

Ǩ̥Αā ƈćǨˈ̑ ɡˀʓ̒ ȵ˙ͫā ɬͲ Ⱥ̵ćΑҙҏā 53ɨˆˈͫā ȇ͵LJ̣ ȅͫΒā ɡˏ̵Αā ȅͫΒā ƈǍ͎ ɬͲ ǽ̒ΑLJ̒ ǽʓͫā ƈćǨˈͫā ƦΑā ɑͫĕć
ǽ̒ΑLJ̒ ǽʓͫā ƈćǨˈͫā ɑˬ̒ ɬͲć ɨ̤Ǩͫā ȅͫΒā ǽ̒ΑLJ̒ ǽʓͫā ƈćǨˈͫā LJ́˶Ͳ ȉˈʒ˶̒ ǽʓͫā Ƚ̀āǍ˳ͫā ɬͲ ɡˏ̵Αā ɬͲ ȅ͘āǨʓ̈
łĢLJ̿ 57ƈćǨˈͫā 56ƱǛ́ͫć ɬʉ̈ǚʔͫā ǽ͎ ƴǨʉʶʉͫLJ̑ Ȉʶʉͫ ɼˏ̇LJ̈́ ȉˈʒ˶̒ 55ǚ͘ 54ɡˏ̵Αā ȅͫΒā ȵ˙ͫā ɼʉ̤LJ͵ ɬͲ
Έāụ̈̌ ɼ˳ʉˆ͇ ɼ͛ĢLJʷͲ ǽ΀ć Ģǚˀͫā ǽ̤āǍ͵ Ǩ̇LJ̵ć ɬʉ̈ǚʔͫā ɬʉ̑ć ǚʉͫǍʓͫā ƹLJˁ͇Αā ɬʉ̑ ƛLJˀ̒ҙҏāć ɼ͛ĢLJʷ˳ͫā
.Ƚ̀āǍ˳ͫā ƱǛ΀ ǽ͎ ŃĔāǍʥͫā ǽ͎ ɼ͛ĢLJʷ˳ͫā ƦǍ˜̒ LJ́ʒʒʶ̑ć

That is to say that the veins that run downwards next to the middle bone of
the sternum join other blood vessels ascending from below from the places
from which the blood vessels that run to the uterus branch out. From these
blood vessels that descend from the region of the sternum, not a small
number branch out into the breasts, and these blood vessels constitute the
coaffection and connection between the genitals and the breasts and other
areas of the chest. This is a very strong coaffection and the cause of the
shared phenomena [mušāraka fī al-ḥawādiṯ] in these places.

So that is what Hippocrates meant to say. Yet because we need Galen to supply
the details, we end up with his own understanding of the bond between the
breast and the uterus.
We have seen that the repeated references in Epidemics, Book Two, to the
coaffection between the reproductive organs (and the genitals) and the chest
and especially between the uterus and the breasts, references that lack any in-
dication of the anatomical substructure of these sympathetic affections, create
a series of opportunities for Galen to supplement the Hippocratic text.58 In fact,

53 ɨˆˈͫā] scripsit Vagelpohl: ɨˆ͇Αҙҏā E1, M.

54 Post ɡˏ̵Αā add. Ƚ̀āǍ˳ͫā ɬͲ M.
55 ǚ͘] E1: ǚ˙͎ M.
56 āǛ́ͫć ɬʉ̈ǚʔͫā ǽ͎] E1: ƱǛ́̑ ɬʉ̈ǚ̓ ȅͫΒā M.
57 ƈćǨˈͫā] dittogr., del. M.
58 See also ii.2.77–8 HV (cf. p. 229, lines 28–32 Pf), another case where Galen invokes the
vessel between the uterus and the chest as part of his project of discovering the ‘acceptable
and convincing causeʼ in a mysterious case where a woman gives birth to a child that is
entirely fleshy and about four digits large. There are a handful of other instances in the
Commentary on Hippocratesʼ ‘Epidemicsʼ, Book Two, where it is likely that the word mušāraka
translates sympátheia or koinōnía. Two of these involve the association between the uterus
and the limbs or hips that results in sympathetic affections. At ii.3.15 HV (cf. p. 262, lines
38–9 Pf), the Warwick translation refers to ‘coaffection [mušāraka] between the limb and
the wombʼ. (Garofalo 2009, 136 modifies Pfaff’s ‘infolge der Verbindung der Nerven mit der
erkrankten Gebärmutterʼ with ‘per simpatia della parte coll’utero’.) At ii.4.72 HV (cf. p. 344,
lines 16–18 Pf), Galen refers to a discussion of the coaffection (mušāraka) of the hip or leg
and the uterus in his commentary on Hippocrates’ On the Diseases of Women. For other cases
of sympathetic affection, see ii.2.130 HV (cf. p. 244, lines 19–27 Pf) and 2.141 (cf. p. 246, lines
24–5 Pf). At ii.1.119 HV (cf. p. 184, line 34 Pf), Galen speaks of an ‘associationʼ (mušāraka)
between parts of the body; at ii.1.128 HV (cf. p. 187, line 14 Pf), of an ‘associationʼ (mušāraka)
64 Brooke Holmes

Galen himself suggests that such ‘communitiesʼ and the sympathetic affections
to which they give rise within the body should occupy a privileged place in the
mind of the physician.
On the heels of the remark about the thick vein that goes to (or is in) the
breast, we encounter the following: ‘these things have the largest part in
understandingʼ (ταῦτα μέγιϲτον ἔχει μόριον ϲυνέϲιοϲ).59 The statement is cryp-
tic, largely because it is unclear what the referent of ‘these thingsʼ (ταῦτα)
should be. Some commentators, Galen reports, believe that Hippocrates means
that the parts of the body he has just mentioned—either the veins or the breasts,
presumably—contribute greatly to the power of the mind.60 Such a reading, Ga-
len thinks, is pure madness. On his interpretation, the line functions as the cap-
stone to the preceding remarks on the breast-uterus association, confirming
the deeper resonance of that association and, ultimately, its anatomical basis.
Reading the passage as an echo of the earlier discussion of the koinōníē between
chest, breast, genitals, and voice, he recounts a series of sympathetic affections
that restate the evidence for the community between these parts of the body
in both men and women, stressing the connecting veins that he himself has
repeatedly identified as the (unspoken) ground of sympathy. In the end, it is
just these veins that Galen thinks Hippocrates is talking about when he refers
to that which contributes most to ‘understandingʼ: ‘It is best, as I have said,
to understand him to mean that what he described about the connection be-
tween the veins is useful for many medical conceptsʼ.61 That which has gone
persistently unsaid—namely, the venous relationship between the chest and the
genitals—thus becomes foundational for medicine in yet another instance of the
principle gov-erning the treatise’s composition: what is most important is taken
for granted by the text, since it is not possible that Hippocrates could ever forget
it, let alone not know it to begin with.

between the arteries and an association (mušāraka) between the arteries and the bowel; at
ii.1.129 HV (cf. p. 187, line 36 Pf), of an ‘associationʼ (mušāraka) between certain body parts
and blood vessels.
59 Epidemics ii. 6.19 (v. p. 136 L); ii.6.102 HV (cf. p. 388, lines 1–2 Pf).
60 The reading has some support from Epidemics ii. 6.32 (v. p. 138 L), where blood gathering
in the breasts foretells the onset of madness (the same material also appears at Aphorisms
5.40 [iv. p. 544 L]; see also Commentary on Hippocratesʼ ‘Aphorismsʼ 5.40 [xvii/b. pp. 832–3
K], where Galen claims to have never seen the phenomenon). Galen does not dispute the
sign here but struggles to explain it and thus focuses on attacking the interpretation of
Sabinus (Commentary on Hippocratesʼ ‘Epidemicsʼ, ii.6.162 HV [cf. p. 408, line 40–p. 409, line 11
61 Book ii.6.103 HV (cf. p. 388, lines 26–8 Pf).
Sympathy between Hippocrates and Galen 65

Why is it that Galen is so invested in vascular connectivity in his exegesis of

Epidemics, Book Two? To try to answer this question, it is worth taking a short
detour through another instance of sympathy, one that establishes a different
nexus within the body. The case sets the stage for further reflection on whether
Galen’s response to the phenomenon of sympathetic affections can tell us some-
thing about his larger exegetical project in the Commentary on Hippocratesʼ
‘Epidemicsʼ, Book Two.

Seeing and Believing: The Truth in Magnets

The case of Lycies—or Lycie: it is unclear, as Galen points out, whether the
patient is a man or a woman62—is recounted in Epidemics, Book Two, in a
predictably spare manner:

Λυκίῃ τὰ ὕϲτατα ϲπλὴν μέγαϲ, καὶ ὀδύναι καὶ πυρετὸϲ καὶ ἐϲ ὦμον ὀδύ-
ναι· καὶ ἡ φλὲψ ἡ κατὰ ϲπλῆνα ἐπ’ ἀγκῶνι ἐτέτατο· καὶ ἔϲφυζε μὲν πολλά-
κιϲ· ἔϲτι δ’ ὅτε καὶ 〈οὔ·〉 οὐκ ἐτμήθη, ἀλλ’ ἅμα ἱδρῶτι διῆλθέν τι αὐτόμα-
τον, ἔξω διιόντων· ὁ ϲπλὴν τὰ δεξιὰ ἐνετείνετο, πεῦμα ἐνεδιπλαϲιάζετο, οὐ
μὴν μέγα· παρεφέρετο, περιεϲτέλλετο· φῦϲα ἐνεοῦϲα· οὐ διῄει κάτω οὐδέν,
οὐδὲ οὔρει· ἀπέθανε. (Epidemics ii. 2.22, v. p. 94 L)

Towards the end Lycies had an enlarged spleen, as well as pains, fever,
pains towards the shoulder. The blood vessel on the side of the spleen63 was
tense at his elbow. It often throbbed; but sometimes it did not. There was
no phlebotomy, but something passed on its own together with the sweat,

62 Book ii.2.100 HV (cf. p. 235, lines 17–31 Pf), ii.2.110 HV (cf. p. 239, lines 9–19 Pf). Galen
reads the account as if the patient were male but remains agnostic. Modern editors have been
split on the sex of the patient. Smith prints the female name Lycie, but Alessi makes a good
case for printing Lycies. One decisive factor determining whether the patient is male or female
is the phrase πρὸ τοῦ τόκου (‘before childbirthʼ), which appears right after ἀπέθανε (‘she
diedʼ). Littré prints πρὸ τοῦ τόκου at the end of 2.22 (and casts the patient, accordingly, as the
female Lycie). Smith, however, despite printing Lycie, assigns the phrase to the beginning of
the next chapter (2.23), as does Alessi (who prints Lycies). Note as well that both Littré and
Smith print the phrase ἰήθη ἐλλεβόρου πόϲει Λυκίη as the first line of the chapter. But in
Galen, the subject of ἰήθη is a patient from the previous chapter, Demaenete, and the lemma
in question (ii.2.99 [cf. p. 235, lines 1–16 Pf]) begins ‘during the last days of Lycies’ illness…ʼ
Alessi follows Galen in assigning ἰήθη ἐλλεβόρου πόϲει to 2.21 and converts the nominative
Λυκίη to a dative governed by the next phrase (τὰ ὕϲτατα ϲπλὴν μέγαϲ).
63 Smith has ‘from the spleenʼ for κατὰ ϲπλῆνα. I find ‘on the side of the spleenʼ preferable,
following not only Galen’s interpretation (‘on the side of the spleenʼ, in the Warwick
translation; ‘auf der Seite der Milzʼ, in Pfaff) but also the analysis of Duminil 1983, 95. Alessi
translates ‘du côté de la rateʼ.
66 Brooke Holmes

when the excretions [?] were taking place.64 The spleen was stretched tight
along its right side; the breath doubled its pace, but without being very
deep. He became delirious, was wrapped up.65 Flatulence. Nothing passed
below, not even urine. He died.66

To the novice reader, the text is a staccato series of symptoms, whose relation-
ship to one another is opaque. From Galen’s perspective, however, we have a
case awash in sympathetic affection.67 For the shared suffering of the spleen and
the shoulder implied in the second line of the Hippocratic account, Galen, as
we have come to expect, supplies the underlying rationale. In this instance, the
affection travels not along a vein but via a kind of domino effect. The suffering
of the spleen triggers suffering in the peritoneum, which, in turn, causes suf-
fering in the diaphragm, which causes suffering in the inner membrane of the
ribs, which causes suffering in the clavicle, which makes the shoulder hurt: the
shoulder is thus joined to the spleen at fifth remove. The predominant principle
of sympathy appears to be that of proximity, and indeed, Galen a little later ex-
patiates on the phenomenon by which the spleen and the diaphragm affect one
another through contact.68
The veins remain critical, however, to grasping the symptoms described, albeit
in a slightly different capacity than we have seen thus far. The Hippocratic cue
is the reference to the tenseness of the blood vessel ‘on the side of the spleenʼ.
Galen takes this to mean, reasonably enough, that Hippocrates is referring to a
sympathetic affection of a blood vessel on the left side, where the spleen is lo-
cated, a phenomenon that he describes as sympathy ‘on the same sideʼ. Not only
does such sympathy affect the blood vessel. It also means that any nosebleeds—
often a crucial form of crisis—during illnesses of the spleen occur through the
left nostril; conversely, during illnesses of the liver (located on the right side
of the body), these symptoms occur on the right.69 What is crucial for our pur-
poses is how other physicians, according to Galen, account for the sympathetic
connectivity in play: they posit a vein that runs from the left side of the spleen
upwards in complementary fashion to that running from the right side of the

64 I follow Alessi’s translation here (‘alors que les excrétions avaient lieuʼ), with the sense
that the event described earlier in the sentence occurred at a time in the illness before the
patient was constipated (as signaled by οὐ διῄει κάτω οὐδέν, οὐδὲ οὔρει).
65 In the Warwick translation: ‘he suffered insomnia and was constipatedʼ. Galen discusses
different interpretations of the original at ii.2.109 HV (cf. p. 238, line 42–p. 239, line 9 Pf).
66 Galen’s lemma continues with what in modern editors is printed as 2.23 and 2.23b.
67 The word mušāraka occurs fourteen times from 2.101–8.
68 Book ii.2.106 HV (cf. p. 238, lines 6–8 Pf), ii.2.108 HV (cf. p. 238, lines 39–40 Pf). On
sympathy by contact elsewhere in Galen, see Siegel 1968, 369–70.
69 Book ii.2.102 HV (cf. p. 236, lines 12–19 Pf). On nosebleeds that occur in connection with
affections of the spleen, see also ii.1.183 HV (cf. p. 203, lines 19–29 Pf), ii.2.117 HV (cf. p. 240,
lines 17–19 Pf), ii.3.77 HV (cf. p. 279, lines 29–33 Pf).
Sympathy between Hippocrates and Galen 67

liver (that is, the ‘hollowʼ blood vessel). In other words, they identify a vascular
connection underlying the coordinated symptoms.70 And yet, here, for once, it
is precisely such a connection that Galen rejects, for the simple reason that ‘in
dissections we do not see this blood vessel that they saw in their dreamsʼ.71 The
dreamt-up vein is no innocent error. The problem is that when people—presum-
ably laypersons, but perhaps also less experienced physicians—learn that it does
not exist, they stop believing in the phenomenon of sympathy ‘on the same sideʼ
altogether. And this, for Galen, is to fail to believe in something that is obvious
to anyone who has seen it.
By way of explaining the nature of the doubt about sympathy here, Galen
starts by observing that it is one thing to describe what happens, another to give
the cause. Much as in the discussion of the association between the breast and
the uterus, sympathetic affections here open onto larger questions about the re-
lationship between seeing and understanding—but with a twist. For it is not just
the relationship of seeing and understanding that is at stake but the relationship
of seeing and believing: in the absence of an adequate explanation, we believe
only what we can see.
To illustrate the point, Galen offers a brief digression on the magnet, one of
the great marvels of antiquity.72 Given that the attraction exercised by magnets
could be described in terms of sympathy in the first centuries AD—as it is, ap-
propriately enough, by Galen himself in Natural Capacities—it is perhaps not
surprising that he introduces the magnet at this particular moment as some-
thing whose power is easy to see but difficult to explain.73 No one who has
witnessed its power with their own eyes, he says, doubts the phenomenon. But
those who hear of it only secondhand often do disbelieve the report because
no adequate reason for magnetic attraction is given. It is the same with sympa-
thetic affections ‘on the same sideʼ: seeing is believing, since the phenomenon
‘manifestly occursʼ, but doubt creeps in when autopsy is absent and no credible
explanation emerges to fill the void.
Remarkably, though, Galen is at a loss himself to explain such sympathetic
affections without a vein to ground the connection: all he can do is promise to

70 The hypothesis of a vessel relating affections of the spleen to the shoulder and the arm (on
the left) and those of the liver (on the right) already appears at On Diseases i. 26 (vi. p. 194 L; ed.
Wittern 1974, 78, lines 7–14), although it seems to be rejected by the author of Epidemics, Book
Two, as Duminil 1983, 95–8 argues. See also On Affections 28 (vii. p. 242 L), 32 (vii. p. 250 L),
where phlebotomy on the right and left sides is recommended for affections of the liver and
spleen, respectively.
71 Book ii.2.102 HV (cf. p. 236, lines 22–3 Pf).
72 Book ii.2.103 HV (cf. p. 236, lines 32–44 Pf).
73 For explanations of the magnet in terms of sympathy, see, for example, Clement of
Alexandria Stromateis 2.370; Galen Natural Capacities 1.14 (ii. pp. 44–51 K; Helmreich 1893,
133, line 11-138, line 21); Pliny Natural History 34.42. On the magnet as a stock marvel in
antiquity more generally, see Wallace 1996, especially 181–2.
68 Brooke Holmes

devote a future treatise to the question. For the moment, we are left with only
a scattering of symptoms that refuse to resolve into a constellation along the
lines offered by anatomical investigation. By Galen’s own reckoning, then, we
have little reason to believe the account of the case of Lycies unless we have had
firsthand experience of sympathy ‘on the same sideʼ.
The problem posed by the case of Lycies exposes something of what is at
stake in an exegesis of Epidemics, Book Two. To the extent that Hippocrates is
writing to and for himself, he does not need to persuade anyone else about the
truth of what he has seen. The text exists, rather, to help him recall his earlier
observations. It thus lacks, for the most part, explanations of why things hap-
pen the way they do. The risk, one might imagine, is that the reader who has
not witnessed everything described in the text will not necessarily believe what
it describes, unless, of course, causes are supplied. Herein lies the need for the
ideal exegete who can verify the account given by introducing an explanation.
The exegete bridges the gap between the Hippocratic text and its later readers,
not just to explain the source material but also, at another level, to guarantee its
credibility for an audience that Hippocrates never intended. If the case of Ly-
cies reflects something of a failure in this regard, it also sheds some light on the
nature of Galen’s ambitions elsewhere in the commentary.
The ideal exegete can be understood as occupying the position of the text’s
other addressee—namely, the son.74 The role of the exegete is defined in part
by knowing what Hippocrates meant: one aspect of the interpreter’s task is to
clarify the language and terminology of the text.75 But it is defined, too, by being
able to stand in the shoes of the father and to see what he saw—after all, that is
the only way that a text represented as mnemonic can trigger a glimpse of real-
ity. What sort of presence does this position imply? On the one hand, it is just
a question of seeing clinical events for oneself. On the other hand, if the son is
to offer an explanation of these events, he needs, in Galen’s view, to be able to
call upon another eyewitness experience—namely, that of dissection. For dissec-
tion is crucial to understanding and vouching for the causes that lie beneath the
surface of the body and, in parallel fashion, the surface of the text.76

74 The triangulated relationship between the son, the father’s books, and the father’s legacy
also appears at Anatomical Procedures 14.1 (ed. Duckworth 1962, 183–4), where Galen recounts
how the son of the great anatomist Numisianus, Heraclianus, hoarded his father’s books and,
despite Galen’s many attempts to ingratiate himself, never once allowed Galen to see them.
Heraclianus’s aim in not showing the books, Galen says explicitly, was ‘to secure himself in
the sole possession of all that his father leftʼ. See also Commentary on Hippocratesʼ ‘Epidemicsʼ,
ii.6.141 HV (cf. p. 400, lines 16–26 Pf), where the paternity of the text is in play.
75 See, for example, Manetti 2009, on Galen’s display of his grasp of Hippocratic linguistic usage.
76 See ii.4.5 HV (cf. p. 312, lines 10–19 Pf), where Herophilus is not content to learn from
Hippocrates but desires to see inside the body for himself. Galen rails against those who follow
Hippocrates blindly, without direct empirical knowledge, at 6.61 (cf. p. 375, lines 22–5 Pf); see
further Lloyd 1991, 402.
Sympathy between Hippocrates and Galen 69

Yet the experience of dissection is not just about offering explanations to se-
cure the truth of what the text reports: it, too, represents a ‘being presentʼ, and
it is an experience that is crucial to proving something about Hippocrates him-
self. For Galen does not simply want to demonstrate that what Hippocrates de-
scribed happened, that is, that Hippocrates reported events correctly: he wants
to show that Hippocrates had already seen for himself the causes underlying
the events that he described. What this entails for Galen, as for Hippocratising
anatomists before him, is ascribing to Hippocrates the experience of dissection.77
But what about the truth of Epidemics, Book Two, as a text, that is, as a cru-
cial supporting document for the image of Hippocrates championed by Galen?
What does it mean for Galen to be present before this truth? That is, what does
it mean for the son to believe not just in what the father saw but in the fact that
he saw, and where what is seen is not just scatterings of symptoms but the logic
behind them? Under these circumstances, the two paths to belief that we saw
in the context of the magnet—one simply seeing something happen, the other
having it explained—converge, insofar as what Galen wants to see in the text
is a causal web. By turning the anatomical body into the subtext of the original
treatise, Galen does just that: he creates the conditions under which he can ‘seeʼ
the causal understanding that he believes is latent in the text. For if Galen sees
beneath the surface of the text a fuller vision of the body, and especially the
vascular body, that he attributes to Hippocrates, he is also ‘seeingʼ the connec-
tions that Hippocrates ostensibly drew between symptoms, for the reason that
the veins function as the very materialisation of causality.
More than once we have seen that, in the cases of sympathetic affection in the
Commentary on Hippocratesʼ ‘Epidemicsʼ, Book Two, Galen seems to believe that
to supply the cause means to articulate the path of a vein relating one part of
the body to another while, in the last case, that of Lycies, to deny the presence
of a vein is, conversely, to eliminate the ground of explanation. That is, in these
cases, giving the causes of the affections becomes indistinguishable from expos-
ing the underlying anatomical connections.
What the instances of sympathetic affection make especially clear is, first,
that the more Galen can map the flotsam of the Hippocratic text onto his own
model of the body, the more coherent and, indeed, the more believable that text
becomes, not just for the reader but for Galen himself. But these instances con-

77 ‘For the true and the false of what becomes manifest from dissection are differentiated by
something by which we examine other perceptible things, namely differentiation by means
of the senses. So, just as one who has not seen the city known as Athens has not seen the
Propylaeum in it, the Kerameikos, or the other places in it, likewise one who has not performed
a dissection has not seen the arteries, veins, or other body parts or vessels. For just as a wall
surrounds a city, and walls surround houses, so, too, the skin surrounds the body of a living
being. So, whoever wants to see for himself what is beneath the skin must cut through the
skinʼ (ii.4.4 HV [cf. p. 311, lines 22–31 Pf]). On the text of the passage, see Garofalo 2009, 142.
70 Brooke Holmes

firm, too, that the very act of mapping the text along the lines of the anatomical
body validates an interpretation in which Galen is deeply invested—namely, an
interpretation that cements Hippocrates’ proper place at the origin of a tradition
of medicine organised around the enquiry into causes and anatomical expertise.
Here, Galen’s own experience with dissection and, more specifically, his mem-
ory of dissection, becomes a pivotal part of his work as a commentator, insofar
as it allows him to imagine himself when he reads as present not only before
the anatomical body but, in fact, before the logic of causes ostensibly already
witnessed by the father. That logic and, accordingly, Hippocrates’ grasp of that
logic thus acquire something of the manifest truth that characterises the veins.
The transition from seeing to believing can be seen, accordingly, as extending
beyond believing in the events described in the text to believing in the very
presence of explanation at the origins of the text, which is nothing less than
believing in Hippocrates as the father of dogmatic medicine.
The Commentary on Hippocratesʼ ‘Epidemicsʼ, Book Two, must be seen as part
of the larger exegetical project of Galen’s Hippocratic commentaries, through
which he not only lays claim to the authority that the name Hippocrates had
come to stand for but grounds it in his own understanding of the body. Yet
the nature of the original Hippocratic text creates exceptional challenges and
opportunities for this project. On the one hand, it offers what Galen thought
was the only genuine Hippocratic anatomy, especially rich in its account of
the vascular system. On the other hand, Epidemics, Book Two, is riddled with
gaping silences and glaring omissions, with the result that Galen himself must
establish, at several critical points, connections between the anatomy offered
and the cases and phenomena described or, more accurately, between the anat-
omy Hippocrates ‘reallyʼ had in mind and the rest of the text. He does so by
introducing his own vision of the networked body, albeit in the guise of the
text’s concealed substructure and the concrete enactment of its causal logic.
He enlists this vision most vigorously in instances of sympathetic affections,
whose surface appearance—symptoms scattered across the body—exaggerates
the disjointed, seemingly random quality of the text itself. By making manifest
the connections underneath these affections, Galen does not simply lend the
Hippocratic text coherence and credibility but also helps shape a father figure
for medicine whose memory Galen honours as if it were his own.

The Arabic Version of Galen’s Commentary on

Hippocrates’ ‘Epidemics’, Book Two, as a source for the
Hippocratic Text: First Remarks
Robert Alessi

At first sight, the second book of the Epidemics startles the modern reader as it
consists of diverse statements that are at different stages of elaboration. Some of
these statements are quite difficult to understand because they are not explicit.
For example, roughly in the middle of Book Two, one finds a particular katásta-
sis, that is a description of the season, weather and diseases during one period
at a particular geographic place. One also finds several elaborate nosological
descriptions, many remarks on sick people and on the weather, numerous clini-
cal observations, some general statements seemingly inferred from experiment,
and a few remarks that are barely understandable except to the author.
The Epidemics require a particular scholarly approach: in one respect, consid-
ering the nature of the topics which the author examines, the questions he for-
mulates have to be situated in the larger framework of fifth and fourth-century
discussions. But in another respect, considering that the Epidemics were based
essentially on concrete inquiries and medical experiments, the statements made
in the book have to be scrutinised. As the text is on the whole very difficult,
Galen’s Commentary is extremely helpful for establishing and interpreting the
Hippocratic text, although its Greek original is lost. This commentary allows us
to compare the Hippocratic text not only with the lemmas that form part of the
commentary but also with the commentary itself and the numerous variants or
discussions it contains that date back to Galen’s predecessors.
The following example allows us to assess the usefulness of Galen’s work for
the interpretation of the Hippocratic text. In the introduction to his commen-
tary of Epidemics, Book Six, Galen recounts the corruptions that he finds in the
Hippocratic text, which are due to earlier scholarsʼ false conjectures. Because
his text contained many such corruptions, Galen thought that it was better to
retrieve, to record and to explain the most ancient readings which he could find
in the works of past commentators1:

1 p. 3, lines 4–10 W; xvii/a.793 K.

72 Robert Alessi

〈Οὐκ οἶδ’ ὅπωϲ καὶ τοῦτο τὸ βιβλίον, ὥϲπερ καὶ ἄλλο τι τῶν τοῦ〉
〈Ἱπποκράτουϲ〉 ϲυγγραμμάτων ἐλυμήναντο πολλοὶ τῶν ἐξηγητῶν ἄλλοϲ
ἄλλωϲ, ὡϲ ἕκαϲτοϲ ἤλπιϲε πιθανῶϲ ἐξηγήϲαϲθαι, τὴν κατὰ τοῦτο λέξιν
ὑπαλλάττων, ὥϲτε ἠναγκάϲθην ἐγὼ διὰ τοῦτο τά τε παλαιότατα τῶν
ἀντιγράφων ἐπιζητῆϲαι τά τε ὑπομνήματα τῶν πρώτων ἐξηγηϲαμένων τὸ
βιβλίον, ἐν οἷϲ καὶ 〈Ζεῦξίϲ〉 ἐϲτι 〈καὶ〉 | ὁ 〈Ταραντῖνοϲ〉 καὶ ὁ 〈Ἐρυθραῖοϲ
Ἡρακλείδηϲ〉 καὶ πρὸ αὐτῶν 〈Βακχεῖόϲ〉 τε καὶ 〈Γλαυκίαϲ〉.

I do not know how this book, too, among others of Hippocrates’ treatises,
has been maltreated in different ways by many commentators under the
pretext that each of them hoped to propose a persuasive commentary, al-
tering the original reading; thus I had to retrieve the most ancient readings
and the works of those who first commented on this book as well; among
whom we find Zeuxis, Heraclides (of Erythrae and of Tarentum), and be-
fore them Baccheios and Glaukias.

In fact, Galen’s commentary on Epidemics, Book Two gives us many examples

of this remarkable method. Since the Warwick Epidemics Project provided me
with the first draft copy of their forthcoming edition of Galen’s Commentary
on Hippocrates’ ‘Epidemics’, Book Two, I began to consider the Arabic version
for my own edition of Hippocrates’ Epidemics, Book Two, which will be pub-
lished in the Collection des Universités de France (Paris, Les Belles Lettres). In
this paper, I would like to present my first remarks about this very stimulating
work that has now become available. For Greek medical studies, the Warwick
edition of Galen’s Commentary on Hippocrates’ ‘Epidemics’, Book Two is highly
relevant. The lemmas which are preserved only in Ḥunayn’s Arabic transla-
tion are of crucial importance for establishing the Greek text of Hippocrates,
since we know that these lemmas go back to a time when Galen’s text had not
yet been contaminated by the received Hippocratic text. Also, I would like to
add that this edition will allow us to gather and analyse better the abundant
Hippocratic citations which are contained in Galen’s commentary. Such a col-
lation would be all the more crucial since, at least for Books Two and Six of
the Epidemics, the Hippocratic manuscripts are known to have been influenced
by Artemidorus Capito’s edition in the first century AD.2 In other words, the
Arabic version of Galen’s commentaries is the only source from which one can
reconstruct the Hippocratic text at a stage which is prior to all other witnesses. I
will try to show through several examples how comparing the Hippocratic text
with the lemmas and discussions that date back to Galen’s predecessors allows

2 On these questions, see Manetti’s and Roselli’s edition of Hippocrates’ Epidemics, Book Six
(1982, xlii–iii), and Pfaff 1931; see also below p. 73.
The Arabic Version of Galen’s Commentary on Hippocrates’ ‘Epidemics’ 73

us to either restore the original reading (and sometimes to follow closely the
textual tradition) or restore the correct interpretation of one particular reading.3

Influence of Galen’s Commentary on the Hippocratic text

As for the Hippocratic text of Epidemics, Book Two, I will consider here, among
the manuscripts of the direct tradition, the ones of the upper part of the stemma
that are worthy of interest:
− Vaticanus Gr. 276, (V), twelfth century
− Parisinus Gr. 2140, (I), thirteenth century
− Vaticanus Gr. 277, (R), fourteenth century
− Parisinus Gr. 2142, (H) part. rec., fourteenth century
We know that these four manuscripts are to be divided into two branches: V and
its descendants and IRH. The latter three manuscripts are, directly or indirectly,
descendants of the branch of manuscript M (Marcianus Gr. 269, s. X), although
Book Two of the Epidemics is not present in Marcianus, which has a substantial
Before examining how one can consider Galen’s Arabic lemmas for editing
Hippocrates’ Epidemics, Book Two, I would like to comment on the overall re-
lationship between the two texts. The following two statements equally apply:
1. All the manuscripts of the direct tradition descend from one common ances-
tor; the influence of Galen’s Commentary on it is obvious.
2. The extant direct tradition has been influenced in turn by Artemidorus Cap-
ito’s edition, dating back to the first century AD.
Several examples allow us to assess the influence of Galen’s Commentary on
the direct tradition of Epidemics, Book Two. My first example is taken from
Epidemics ii.3.17–18, a passage which all the extant manuscripts seem to have
misplaced, but which Foes returned to its correct position in his 1595 edition.
Foes was followed by Littré, but not by Smith4:

3 On the Arabic translation of Galen’s Commentary on Hippocrates’ Epidemics, see the

very important work of Garofalo 2009, who made an extensive examination of the text, using
Madrid, Escorial, MS árabe 804 (henceforth MS E1) for the commentary on Book Two of the
Epidemics; see also Garofalo’s emendations (2010a, 255–6). On the Arabic text of Galen’s
commentaries on Books One and Three of the Epidemics, see Garofalo 2010b. I would also
like to express my gratitude to Ivan Garofalo for giving me the draft copy of an article (to be
published in 2011) about Galen’s lemmas of Epidemics, Book Two, and their Arabic translation
(Garofalo, forthcoming).
4 I quote here and below the text and apparatus from my forthcoming edition of the
Hippocratic Epidemics, Book Two.
74 Robert Alessi

3.17 […] Πρὸ τοῦ τόκου τὰ γάλακτα, τῆϲ μὲν τροφῆϲ ὑπερβαλλούϲηϲ, τῆϲ
2 δὲ 〈ὅληϲ〉 ὀκταμήνου ἀπαρτιζούϲηϲ· διὸ τὰ ἐπιμήνια ἀδελφὰ τῶν ὀκτα-
μήνων· πρὸϲ δεκάμηνον τεινόντων γενόμενα, κακόν. 3.18 Τρωμάτων ἢν
4 ἰϲχυρῶν ἐόντων οἴδημα μὴ φαίνηται μέγα, κακόν· τὰ χαῦνα, χρηϲτὸν,
τὰ ἄνω νεμόμενα, κάκιον. Οἷϲιν οἰδήματα ἐφ’ ἕλκεϲι 〈φαίνεται〉, οὐ μάλα
6 ϲπῶνται, οὐδὲ μαίνονται· […]

Apparatus: 1 Πρὸ τοῦ τόκου] scripsi; ĔҙҏǍͫā Ȉ͘ć ɡʒ͘ Gal.(Ar.): πρωτοτόκων codd. Littré:
πρὸ τόκων Smith 1 τροφῆϲ ὑπερβαλλούϲηϲ] pro 〈ὅληϲ〉 ὀκταμήνου ἀπαρτιζούϲηϲ et
item contra Gal. De Usu partium 4 77 20 (ed. Helmreich) Theoph. Prot. De corp. hum. Fab-
rica 5 38 52 (ed. Greenhill) codd. Littré 1 ὑπερβαλλούϲηϲ Gal.U Gal.(Ar.) Theoph Prot.]
μεταβαλλούϲηϲ V I1slRH Littré: μεταβαλούϲηϲ I 2 ὅληϲ] addidi e Gal. (ƴǚ͇ ƴΑāǨ˳ͫā ɡ˳˜ʓʶ̒ć)
Gal. Theoph. Prot.: om. codd. Gal.U Littré edd. 2–3 διὸ-γενόμενα, κακόν] trsp. ante οἷϲιν
οἰδήματα codd. Smith sed hic habent Foes Littré 2 ἐπιμήνια codd. Gal.] γάλακτα Gal.U
Theoph. Prot. Littré 2–3 ὀκταμήνων codd. Gal.] ἐπιμηνίων Gal.U Theoph. Prot. Littré
3 τεινόντων γενόμενα] τείνοντα Smith 3–4 Τρωμάτων-κάκιον] om. Gal. 5 νεμόμενα]
4 μενόμενα Smith.

3.17 […] Before birth, milk appears, if nutriment is in excess and a full
eight-month period is complete; therefore menstruation is the counterpart
of the eight months: stretching to the tenth month is a bad 〈sign〉. 3.18 In
case of severe wounds, if no important swelling appears, it is a bad 〈sign〉;
the loose 〈swellings〉 are good; those stretching upwards are worse. Those
who have swellings after wounds do not have much convulsions nor de-
lirium. […]

As one can see from the apparatus, the direct tradition moves part of the sen-
tence of 3.17, that is ‘διὸ τὰ ἐπιμήνια, ἀδελφὰ τῶν ὀκταμήνων· πρὸϲ δεκάμηνον
τείνοντα, κακόνʼ, before the sentence of 3.18 which starts with the words οἷϲιν
οἰδήματα. Galen’s lemmas have a lacuna in which the first lines of 3.18 are lost:
from τρωμάτων ἢν ἰϲχυρῶν ἐόντων to νεμόμενα, κακόν. There is no doubt that
this same lacuna had affected the ancestor of our four manuscripts, for in those
manuscripts, as in Galen’s lemmas, the last sentence of 3.17 is placed just before
the one in 3.18 which starts with the words οἷϲιν οἰδήματα. In my opinion, it is
likely that the copyist, who mistakenly filled the lacuna, did not copy the miss-
ing words after the last sentence of 3.17, as he should have done, but before it.
The resemblance between those sentences (γενόμενα, κακόν / νεμόμενα, κάκιον)
may have caused this mistake. I think that this simple example illustrates the
influence of Galen’s lemmas on the source of the Hippocratic manuscripts.5

5 However, as we are missing any external witness, such examples do not constitute positive
evidence of direct influence of Galen’s commentary on the Hippocratic text. For further
discussion of the influence of Galen’s lemmas on the MV branch of Hippocratic manuscripts,
The Arabic Version of Galen’s Commentary on Hippocrates’ ‘Epidemics’ 75

The second example that illustrates the relationship between Epidemics, Book
Two and Galen’s Commentary is drawn from both treatisesʼ division into ‘sec-
tions’.6 Roughly speaking, both are divided into six sections, but the section
breaks in these respective treatises do not match. Furthermore, one finds in the
Hippocratic text three ‘titles’ appended to the last three ‘sections’: ‘about veins
(περὶ φλεβῶν)’ (section 4); ‘physiognomy (φυϲιογνωμονίη)’ (section 5); and ‘on
physiognomy (φυϲιογνωμονικόϲ)’ (section 6). It is worth noting that Smith is
the first modern editor who deleted all three ‘titles’ from his edition, although
he kept the Greek numbering of the sections.7 Unfortunately, he does not give
any justification for this deletion, although these two reasons may have induced
him to remove them:
1. Sections four, five and six of Epidemics, Book Two are further divided respec-
tively into five, twenty-four and thirty-two ‘subsections’ or ‘paragraphs’, al-
though we barely find actual anatomical or physiognomonical statements in
the first or first two paragraphs of each section.
2. We cannot find any trace of the words περὶ φλεβῶν, φυϲιογνωμονίη and
φυϲιογνωμονικόϲ in Galen.
So, it is worth discussing briefly how the placement of these words connects
with the sectional division of the text of Epidemics, Books Two in not only the
manuscripts of the upper part of the stemma, but also in Galen’s Commentary.
At first sight, the six-section division of both texts shows that the section
breaks which occur in the Hippocratic text and in Galen’s Commentary seem
to be independent from each other. For example, the first section of Epidemics,
Book Two presents various statements about the relationship between diseases
and external conditions (e. g. weather), crisis, segregations etc. whereas the cor-
responding section in Galen presents the same content, with the further addi-
tion of the first nine clinical observations of Epidemics, Book Two, section two.
Section two in Galen includes the beginning of the so-called katástasis of Perin-
thus, which belongs to Epidemics, Book Two, section three in the Hippocratic
In the Hippocratic manuscripts, section breaks mostly appear in the form of
a colon, followed by a hyphen and a thin blank space. In the first three sections,
however, the manuscripts do not include any title or section numbering. Fur-
thermore, while manuscripts RH agree with the section breaks that we find in
Littré’s edition (which are found already in the 1525 Aldine edition), manuscript

from which Book Two of the Epidemics derives, see Pfaff 1931, 558–81, and 1932, 67—82, Diller
1973, 154–63 and 223–33.
6 On the particular question of the division of Galen’s commentary on Hippocrates’ Epidemics
2 into six sections, see Pormann 2008a for his examination of the Arabic manuscripts; see also
Garofalo (forthcoming, 2011). I am here focusing on the aforementioned Greek manuscripts
of Hippocrates.
7 See Smith 1994, 66, 74, 80.
76 Robert Alessi

V does not have any break mark until section 3.8 H has all the section breaks,
except the one at the beginning of section three, although it is a rather impor-
tant break, since it indicates the beginning of the so-called katástasis of Perin-
thus.9 So these differences are rather striking, since they pertain to manuscripts
which belong to the same branch. They seem to indicate that the division of this
treatise into sections was not standardised fully even at such a late stage of the
Starting from section four, the situation appears to be different: all the manu-
scripts present firstly the same title—‘on veins (περὶ φλεβῶν)’— and then the
same section number—‘section four (τμῆμα δ’)’. Moreover, section four of Ga-
len’s commentary starts at the same place. This coincidence is significant. But
much more interesting is the case of section five: all manuscripts present firstly
‘physiognomy (φυϲιογνωμονίη)’ (IRH: -ία V), but only manuscripts IRH subse-
quently have ‘section five (τμῆμα ε’)’, whilst manuscript V presents this section
numbering five lines below in Littré’s edition10 after the words ‘it cannot be
broken up (οὐκ οἷόν τε λύεϲθαι)’ (Smith), where one can also find a break mark.
In other words, the section numbering appears exactly at the place where sec-
tion five of Galen’s commentary starts.11 Of course, this arrangement cannot be
due to chance: it clearly shows that the section numbering, which only occurs
in the Hippocratic text at the beginning of sections four and five, is drawn from
the division of Galen’s Commentary. In fact, in section five, manuscript Vʼs read-
ing of the section numbering five lines below the word φυϲιογνωμονίη, which
certainly would have been interpreted as a title, leads us to assume that the
source of manuscripts IRH has moved mistakenly the numbering after the ‘title’
a few lines above. Thus, in my opinion, the reading of manuscript V already
existed in the archetype.
In section six, the manuscripts differ significantly from each other: none of
them have any section numbering; all have the word φυϲιογνωμονικόϲ (codd.:
-κόν Littré post φυϲιογν. add. δεύτεροϲ R); manuscripts V I do not present any
section break, whilst manuscripts RH have one. In Galen’s Commentary, section
six (ɼ̵ĔLJʶͫā ɼͫLJ˙˳ͫā) starts two lines below. Naturally, all the discrepancies in the
placement of these various section breaks reinforce the conclusion that the sec-
tion numbering does not belong to an early stage of the extant direct tradition;
after all, this numbering only occurs twice in the whole treatise.

8 References follow Littré’s edition.

9 Except L. V, 90.6: post θέρεοϲ add. ∼ V IR: om. H. Anyway, IRH present in section 2
several additional break marks that might have been used to distinguish some of the clinical
observations. For instance, in the passage quoted here, ms. R adds ἄρρωϲτοϲ δ’ after θέρεοϲ.
10 L. V, 128.7 = 74.7 Smith.
11 ɼʶͲLJʦͫā ɼͫLJ˙˳ͫā; this part of Galen’s commentary was already lost in Ḥunayn’s Greek
manuscripts. See Pormann 2008a.
The Arabic Version of Galen’s Commentary on Hippocrates’ ‘Epidemics’ 77

It is also obvious that so-called ‘titles’ such as ‘on veins (περὶ φλεβῶν)’, ‘phys-
iognomy (φυϲιογνωμονίη)’ or ‘on physiognomy (φυϲιογνωμονικόϲ)’ do not con-
stitute titles of whole ‘sections’ in the treatise. Certainly, we must retain these
titles in the modern editions, but we should keep in mind that they are titles of
‘paragraphs’ or, at the very most, titles of pieces of text, if not titles of selected
extracts. Although one cannot make any conclusive arguments about this sub-
ject, such titles might have been introduced into the Hippocratic text at various
stages of the tradition in order to identify more easily certain passages or pieces
of text to which the commentators used to refer. These titles could have served
as markers in this long and difficult treatise. In this sense, manuscript R, which
is likely to have been more contaminated than the others, contains more such
markers. Here is a brief account of the situation:
− L. V, 84.2: ante γυγὴ ἐκαρδιάλγει add. ἄρρωϲτοϲ α’ (‘first patient’) R. –
This is the actual beginning of ‘section 2’ (〈τμῆμα δεύτερον〉) in Littré’s
edition, where clinical observations are found. Τhe words τμῆμα δεύτερον
are not found in the manuscripts, but MS R adds the words ‘first patient
(ἄρρωϲτοϲ α’)’, which help the reader to get his bearings in the text.
− 90.7 ante τῇ τοῦ ϲκύτεωϲ add. ἄρρωϲτοϲ δ’ R – same situation with
‘fourth patient (ἄρρωϲτοϲ δ’)’.
− 100.2 ante ἐϲ Πέρινθον add. καιροῦ κατάϲταϲιϲ R – This is where the ‘third
section’ in Littré’s edition starts: καιροῦ κατάϲταϲιϲ means ‘constitution of
the season’. Actually ‘section three’ starts with the katástasis of Perinthus.
− 132.14 post φυϲιογνωμονικόϲ add. δεύτεροϲ R – in other words:
‘about physiognomony two’ where Littré’s ‘section six’ starts, after
‘physiognomony one’ of ‘section five’ as we have already seen above.
In other words, one may assume that the first two ‘titles’ were used to distinguish
certain clinical observations from others. Of particular importance is the second
title, as it occurs at a place where all the other manuscripts have a break mark.
Therefore, this addition, while obviously the result of contamination, probably
corresponds to a break that could already be found at an earlier stage of the
tradition in the archetype of the Hippocratic manuscripts. Finally, as one can see,
two other markers of the same manuscript have been used without considering
any kind of overall continuous section numbering of the treatise. For example,
one finds καιροῦ κατάϲταϲιϲ at the beginning of ‘section three’ in Littré’s
edition, and φυϲιογνωμωνικὸϲ δεύτεροϲ of section six, which is connected to
remarks of physiognomonical interest, at the beginning of ‘section six’.
78 Robert Alessi

Capito’s Edition

As I said above, the extant direct tradition of Epidemics, Book Two is completely
derived from Capito’s edition, which was produced in the first century AD.
Galen’s commentary presents a highly accurate witness to this edition. It allows
us to go beyond the vicissitudes of textual transmission and to follow closely the
story of the Hippocratic text, because Galen faithfully reported the readings of
the manuscripts.12
My first example comes form the very beginning of Epidemics, Book Two13:

1.1 Ἄνθρακεϲ θερινοὶ ἐν Κραννῶνι· ὗεν ἐν καύμαϲιν ὕδατι λάβρῳ δι’ ὅλου
2 καὶ ἐγίνετο μᾶλλον νότῳ· [καὶ] ὑπογίνονται μὲν ἐν τῷ δέρματι ἰχῶρεϲ·
ἐγκαταλαμβανόμενοι δέ, θερμαίνονται, καὶ κνηϲμὸν ἐμποιέουϲιν· εἶτα
4 φλυκταινίδεϲ ὥϲπερ πυρίκαυϲτοι ἐπανίϲταντο καὶ ὑπὸ τὸ δέρμα καίεϲθαι

Testimonia: 1–5 Ἄνθρακεϲ… ἐδόκεον] cf. Gal. De Temperamentis libri iii (ed. Helmreich
1 531 1) 1–2 Ἄνθρακεϲ… νότῳ] cf. Gal. In Hippocr. Epid. I comm. (ed. Wenkebach 17a
27 10); Gal. In Hippocr. Aphorismos comm. (ed. Kühn 17b 579 14); Gal. In Hippocr. Epid.
III comm. (ed. Wenkebach 17a 649 9) 1 〈Ἄνθρακεϲ〉… ὅλου] cf. Gal. In Hippocratis Epid.
I comm. (ed. Wenkebach 17a 36 7) 1 ὗεν… δι’ ὅλου] ibid. (17a 38 4) 2 ἐγίνετο… νότῳ]
cf. Gal. In Hippocr. Epid III comm. (ed. Wenkebach 17a 650 1-2) 2–5 [καὶ] ὑπογίνονται…
ἐδόκεον] cf. Gal. In Hippocr. Epid. VI comm. (ed. Wenkebach 17a 983 2) 2–3 [καὶ]
ὑπογίνονται… θερμαίνονται] cf. Gal. In Hippocr. Prognosticum comm. (ed. Heeg 18b
205 2).

Apparatus: 1 θερινοὶ ἐν Κραννῶνι scripsi ƦǍ͵āǨ˙̑ ƦLJ͛ ķǛͫā ǽˏʉˀͫā Ǩ˳ʤͫā (Κραννῶνι recte pro-
pos. Garofalo e ƦǍʉ͵āǨ͘ Gal.(E1), lege ƦǍ˶͵āǨ͘ uide ἐνκραννώνιοι V) Gal.] ἐν Κρανῶνι θ. R
Littré Smith Gal.E1(17a 27 10) apud Wenkebach Gal.E3 apud Wenkebach Gal.T apud
Helmreich Gal.Aph. : ἐν Κρανῶνι οἱ θ. I2H : ἐνκρανώνιοι θ. I : ἐνκραννώνιοι θ. V : ἐν
Κρανῶ οἱ θ. Gal.E3(L) 1 ὗεν Gal.T apud Helmreich Gal.E1 apud Wenckebach Gal.Aph.
ĢLJ˅ͲΑā łƹLJ̣ Gal. Littré] ὓεν I1RH : οἱ ἐν V om. Gal.E3(L) : post ὗεν add. καὶ τὰ ἑξῆϲ Gal.
E1(17a 27 10)(Q) 1 ἐν I1slRH] om. V I 1 καύμαϲιν V IRH Gal.E1 omnibus in locis apud
Wenkebach Gal.T apud Helmreich Gal.Aph.] καύματι Gal.E1(17a 36 7)(MQ) 1 λάβρῳ RH
Gal.E1 omnibus in locis apud Wenkebach Gal.E3 apud Wenkebach Gal.Aph.] λαύρῳ V
I Gal.T(codd.) Gal.E3(L) 1 δἰ ὅλου codd. Gal.E3 apud Wenkebach Gal.T apud Helmreich
Gal.Aph.] διόλου Gal.E1 apud Helmreich omnibus in locis : post δι’ ὅλου add. und es
war meiste davon bei Südwind Gal.E1(17a 36 7)(H: om. U) 2 καὶ hic scripsi ƦLJ͛ć Gal.]
trsp. post ἐγίνετο codd. Smith Gal.E3(L) primo in loco : δὲ pro καὶ post ἐγίνετο Lit-
tré Gal.T apud Helmreich Gal.Aph. : om. Gal.E1(17a 27 10) apud Wenkebach Gal.E3(O
Wenkebach) utroque in loco 2 ἐγίνετο V I1slRHpc ƦLJ͛ć Gal.] ἐγίνοντο Vsl I2sl Gal.T apud
Helmreich Gal.E3(O) utroque in loco Gal.Aph. : ἐγένετο IHac Littré Smith : ἐγένοντο Gal.
E1(17a 27 10) apud Wenkebach Gal.E3(17a 649 9)(L Wenkebach) Gal.E3(17a 650 1) apud

12 See also p. 72 above and footnote 41 below.

13 v. p. 72, lines 3–7 L; translation, with modifications by Smith 1994, 18, lines 3–8.
The Arabic Version of Galen’s Commentary on Hippocrates’ ‘Epidemics’ 79

Wenkebach 2 νότῳ V IpcRH ŁǍ˶ʤͫā ȽͲ Gal.] νότου Iac : 〈ἐγίνοντο δὲ μᾶλλον〉 ἐν νώτῳ
falso coni. Ermerins sed in tergo magis fiebant olim Calvus 2 καὶ ante ὑπογίν. deleui
e Gal.P(VRF P) 2 ὑπογίνονται Gal.T(MV) Gal.P(VP) Ǩʉˀ̈ Gal.] ὑπογίγνονται Gal.P(F) :
ὑπεγίνοντο IRH Littré Smith Gal.T apud Helmreich : ὑπεγίνετο V : οἱ πόδεϲ γίνονται
(sic) pro ὑπογίν. Gal.P(R) 2 ἐν (οὖν pro ἐν Gal.P(F) ἐν del. Ermerins) τῷ (Gal.P(PFVsl:
om. R)) δέρματι codd. Gal.P(VRP)] ὑπὸ τὸ δέρμα Gal.T apud Helmreich ǚˬʤͫā Ȉʥ̒ Gal.
3 ἐγκαταλαμβανόμενοι V IH] ἐγκατε- R -μεναι Gal.P(R) 3 θερμαίνονται Gal.P apud Heeg
Gal.E6(H Wenkebach) ɬʦ̵ ɬ˙ʓ̤ā āĕΒLJ͎ Gal.] ἐθερμαίνοντο codd. Littré Smith Gal.P(R) Gal.T
apud Helmreich Gal.E6(U) 3 κνηϲμὸν codd. Gal. (M(P)E12)] om. Gal.(E1) 3 ἐμποιέουϲιν
scripsi] ἐμποιοῦϲιν Gal.E6(ex H reposuit Wenkebach) ǚΎͫć … ɬ˙ʓ̤ā āĕΒLJ͎ Gal.] ἐνεποίεον codd.
Littré Smith ἐνεποίουν Gal.T(M) Gal.E6(U) 3 εἶτα codd. Gal.T Gal.E6] ɷʉ͎ Gal. i.e. dum ut
uid. 4 φλυκταινίδεϲ V IR Gal.E6(U)] φλυκτε- H φλύκταιναι Gal.T apud Helmreich łLJ̥LJˏ͵
Gal. 4 πυρίκαυϲτοι codd.] πυρίκαϲτοι Gal.E6(U) 4 ἐπανίϲταντο Gal.T apud Helmreich
Littré] διαν- codd. Smith ἐξαν- Gal.T(M (e ΕΠΑΝ-) œǨʦ̒ Ȉ͵LJ͛ Gal. ἀνίϲταντο Gal.E6(U).

1.1 The anthrax of summer in Crannon: during the hot weather, there were
violent and continuous rains, and this occurred more with wind from the
south — There are serous gatherings in the skin; when caught, they grow
hot and cause itching. — Then small blisters as though from burns rose up,
and seemed like burns under the skin.

As one can see, the author distinguishes two kinds of causes in describing the
anthrax of Crannon:14
1. The external causes that are reported in the past tense: weather constantly
wet (ὗεν… ὕδατι λάβρῳ δι’ ὅλου, ‘violent and continuous rains’), hot (ἐν
καύμαϲιν) and under the influence of wind from the south (καὶ μᾶλλον
2. The internal causes (ὑπογίνονται… ἐμποιέουϲιν, ‘there are… they cause’)
that are reported in the present tense.
We know positively from Galen’s commentary that all three verbs in the
present tense, ‘there are 〈serous gatherings〉 (ὑπογίνονται)’, ‘they grow hot
(θερμαίνονται)’, and ‘they cause (ἐμποιέουϲιν)’, constitute the original reading.
The author, says Galen, chose to describe in the present tense signs which
commonly accompany the appearance of anthrax: serous accumulations
in the skin (ὑπογίνονται … ἰχῶρεϲ), catching of these humours in the skin
(ἐγκαταλαμβανόμενοι δέ), inflammation and itching (κνηϲμὸν ἐμποιέουϲιν).
What follows in the past tense pertains specifically to the anthrax that appear
in Cranon.
According to Galen, all of the ancient commentators knew this original read-
ing and continued to comment on the reason why Hippocrates used different

14 For the Arabic text here and below, see ii.1.2 HV; for this passage, see also Pormann
(2008, appendix 1) who provides a sample collation of Galen’s Commentary on Hippocrates’
‘Epidemics’, Book Two, part one.
80 Robert Alessi

tenses in this passage. But, Artemidorus Capito and his disciples simplified these
different tenses and left the past tense only, which we find in all Hippocratic
manuscripts as well as in all modern editions, including that of Smith:15

ķǛͫā ȇʒʶͫā ɬ͇ ȉʥʒ̈ ŁLJʓ˜ͫā āǛ΀ Ǩʶ͎ ɬͲ ƛāǩ̈ ҙҏć ƹLJͲǚ˙ͫā Ƚʉ˳̣ LJ͎́Ǩˈ̈ ɼʦʶ˶ͫā ƱǛ΀ ƦΑā ȇʉʤˈͫāć
āćǨʉ͈ ƦΑā ȅˬ͇ ɷ̑LJʥ̿Αāć 17ťĢćǚʉͲLJ̈́ĢΑā Ƣǚ˙̒ć ɼˏˬʓʦͲ ƦLJͲģΑā ȅˬ͇ ƛǚ̒ 16ŵLJˏͫΑā ƛLJ˳ˈʓ̵ā ȅͫΒā ŴāǨ˙̑Αā LJ͇Ĕ
ǚ̈ǚ̿ ǚˬʤͫā Ȉʥ̒ Ǩʉˀ̈ ƦLJ͛ć» :ƛLJʔ˳ͫā āǛ΀ ȅˬ͇ ṳ̈̌āć ƦLJͲģ ȅˬ͇ ƛǚ̒ LJ́ˬ͛ LJ΀Ǎˬˈʤ͎ ŵLJˏͫΑҙҏā ƱǛ΀
.«ɼ˜̤ ǚͫćć ɬʦ̵ ɬ˙ʓ̤ā āĕΒā ƦLJ͛ć

It is amazing that all ancient authors knew this reading, and that those ex-
plaining this book kept on looking for the reason which prompted Hippoc-
rates to use forms indicating different times. Earlier, Artemidorus [Capito]
and his colleagues were the first who altered these forms and made them
all indicate one time like this: ‘There were serous gatherings under the
skin’ and ‘when it was congested, they grew hot and generated itching’.

This information, which is given by the ancient commentators, is of paramount

importance for modern editors. It allows them to restore an ancient reading which
Capito’s authority removed from the direct tradition in the first century AD.18
In fact, from the very first paragraph of Epidemics, Book Two, the author con-
templates the role of external causality in the development of diseases, trying
to distinguish between what should be attributed to the disease itself and what
depends on the environment. This is why time indications are present in every
passage at the beginning of each paragraph. Through word order, the author
first lays stress on what pertains to the environment and subsequently exam-
ines its influence on the development of diseases. There is a constant tendency
from the beginning of Epidemics, Book Two to mention first the elements which
refer to the environment. He does so in paragraph one: ‘during the hot weather
there was continuous rain (ὗεν ἐκ καύμαϲιν ὕδατι λάβρῳ δι’ ὅλου)’ (hot and
thoroughly wet conditions); and in paragraph two (my following example): ‘in
hot weather when it is dry (ἐν καύμαϲιν ἀνυδρίηϲ)’ (hot and dry weather), then
‘under the same conditions (ἐν τούτοιϲι δέ)’, which refers to ‘in hot weather
when it is dry’:

15 See ii.1.13 HV.

16 ŵLJˏͫΑā ƛLJ˳ˈʓ̵ā] M: ΈLJͅLJˏͫΑā ɡ˳ˈʓʶ̈ ƦΑā E1.
17 ťĢćǚʉͲLJ̈́ĢΑā] scripsi: ťćǚʉͲLJ̈́ĢΑā E1: ťćǚ˶ͲLJ̈́ĢΑā M.
18 I will discuss in my forthcoming edition the complex situation presented by the variants
of the Greek manuscripts of Galen in the other treatises: Mixtures, and the commentaries on
Hippocratesʼ ‘Prognosticʼ and Epidemics, Book Six.
The Arabic Version of Galen’s Commentary on Hippocrates’ ‘Epidemics’ 81

1.2 Ἐν καύμαϲιν ἀνυδρίηϲ οἱ πυρετοὶ ἀνίδρωτεϲ τὰ πλεῖϲτα· ἐν τούτοιϲι δέ,

2 ἢν ἐπιψεκάϲῃ, ἱδρωτικώτεροι γίνονται· κατ’ ἀρχάϲ, ταῦτα δυϲκριτώτερα
μέν 〈εἰϲιν〉 ἢ ἄλλωϲ· ἀτὰρ ἧϲϲον, εἰ μὲν εἴη διὰ ταῦτα, μὴ διὰ τῆϲ νούϲου
4 τὸν τρόπον. Οἱ καῦϲοι ἐν τῇϲι θερινῇϲι καὶ ἐν τῇϲιν ἄλλῃϲιν ὥρῃϲιν, ἐπι-
ξηραίνονται δὲ μᾶλλον θέρεοϲ.

Apparatus: 1 καύμαϲιν V I2 ut uid. H] καύμαϲι R 1 ἀνυδρίηϲ IRH] ἀνυδρίη V 1 ἀνίδρωτεϲ

V] ἀνιδρῶτεϲ IRH 1 τούτοιϲι δέ del. Ermerins et trsp. δέ pro ἐν : Ǩʥͫā ǽ͎ interpr. Gal. 1 δέ
IRH] δ’ V 2 κατ’ ἀρχάϲ V I (καταρχάϲ RH) hic scripsi sicut Gal. et aliqui interpretes olim
fecerunt] cum superioribus uerbis coniunxit Littré Smith 3 δυϲκριτώτερα V] δυϲκριτό-
IRH 3 μέν εἰϲιν scripsi ƦǍ˜̈ Gal.] μένει V IacR Smith : μένη IacH : μέν Littré Ermerins 3 ἢ
IRH LJ˳Ͳ Gal. Littré Smith] εἰ V 3 ἢ ἄλλωϲ· ἁτὰρ ἧϲϲον] del. Ermerins 3 μὲν scripsi ƦLJ͛ ȅʓͲ
āǛ΀ ȇʒʶ̑ Gal.] μὴ codd. edd. 3 μὴ scripsi ŰǨ˳ͫā ƛLJ̤ ȇʒʶ̑ ɬ˜̈ ɨͫć Gal.] ἀλλὰ codd. edd. (e
〈ΤΑΥΤ〉ΑΜ〈Η〉) 4 θερινῇϲι codd. ɼʉˏʉˀͫā łLJ͘ćΑҙҏā ǽ͎ Gal. in comm. ut u. l.] ƴĢLJʥͫā łLJ͘ćΑҙҏā ǽ͎ Gal.
(i.e. θερμῇϲι e ΘΕΡΙΝΗΙΣΙ).

1.2 In hot weather when it is dry, fevers are mostly devoid of sweat. But
under the same conditions, if there is little rain, there is more sweat. When
〈this happens〉 at the outset, the cases present some more difficult crises
than otherwise, but they were of less difficult 〈crises〉 if they came under
these conditions and not from the nature of the disease. Causus occur more
in summer; they also occur in other seasons, but are drier in summer.

To sum up, as one can see from the apparatus, Ermerins (1859–67) is the first
modern editor who pointed out that the text of the manuscripts means the op-
posite of what the author is trying to establish. For example, the author writes a
few lines below that cardialgia, which is caused by the autumnal season, is less
harmful than when the disease itself is of cardialgic nature.19 To remove the con-
tradiction, Ermerins makes a strong emendation and deletes the words ἢ ἄλλωϲ,
ἀτὰρ ἧϲϲον, whereas there is no contradiction in Galen’s lemma, about which,
of course, Ermerins knew nothing. As one can see in the apparatus presented
here, the Arabic allows one to restore the original reading in a very conserva-
tive way. In the first clause of line 3, one finds no negation in the Arabic text;
thus, one must read μέν instead of the μή of the Hippocratic manuscripts from
the Arabic ‘when it is due to this cause (āǛ΀ ȇʒʶ̑ ƦLJ͛ ȅʓͲ)’. But the second clause
is negative, as one can see from the Arabic: ‘and not 〈due〉 to the state of the
disease (ŰǨ˳ͫā ƛLJ̤ ȇʒʶ̑ ɬ˜̈ ɨͫć)’. The corresponding affirmative Greek clause
can explain easily a misreading of uncial characters: ‘μή (not)’ is confused with
‘ἀλλά (but)’.

19 Epidemics ii.1.3 HV (v. p. 72, lines 14–16 L; ed. Smith 1994, 18, lines 16–18).
82 Robert Alessi

Improving the Hippocratic Text

I would now like to comment on several examples to show how one may either
improve the Hippocratic text or our understanding of difficult passages by using
Ḥunayn’s Arabic text. My first example is related to the usefulness of Galen’s
commentary itself. It comes from a very difficult passage (Epidemics ii.1.7) about
segregations (apostásies) of humours, which reads as follows:

1.7 Ἀποϲτάϲιεϲ ἢ διὰ φλεβῶν, ἢ τόνων, ἢ δι’ ὀϲτέων, ἢ νεύρων, ἢ δέρμα-

2 τοϲ, ἢ ἐκτροπέων ἑτέρων· χρηϲταὶ δέ, αἱ κάτω τῆϲ νούϲου, οἷον κιρϲοί,
ὀϲφύοϲ βάρεα· ἐκ τῶν ἄνω, ἄριϲται δὲ αἱ μάλιϲτα κάτω καὶ αἱ κατωτέρω
4 κοιλίηϲ, καὶ προϲωτάτω ἀπὸ τῆϲ νούϲου, καὶ αἱ κατ’ ἔκρουν, οἷον αἷμα ἐκ
ῥινῶν, πύον ἐξ ὠτόϲ, 〈ἱδρώϲ,〉 πτύαλον, οὖρον, κατ’ ἔκρουν. Οἷϲι μὴ ταῦτα,
6 ἀποϲτάϲιεϲ, οἷον ὀδόντεϲ, ὀφθαλμοί, ῥίϲ[, ἱδρώϲ]. Ἀτὰρ καὶ τὰ ὑπὸ δέρμα
ἐϲ τὸ ἔξω ἀφιϲτάμενα φύματα, οἷον ταγγαὶ καὶ τὰ ἐκπυοῦντα, ἢ ἕλκοϲ, καὶ
8 τὰ τοιαῦτα ἐξανθήματα, ἢ λοποί, ἢ μάδηϲιϲ τριχῶν, ἀλφοί, λέπραι, ἢ τὰ
τοιαῦτα· ὅϲα ἀποϲτάϲιεϲ μέν εἰϲιν ἀθρόωϲ ῥέψαϲαι καὶ μὴ ἡμιρρόπωϲ, καὶ
10 ὅϲα ἄλλα εἴρηται, 〈κακόν,〉 ἢν [μὴ] ἀναξίωϲ τῆϲ περιβολῆϲ τῆϲ νούϲου,
οἷον τῇ Τημενέω ἀδελφιδῇ ἐκ νούϲου ἰϲχυρῆϲ, ἐϲ δάκτυλον ἀπεϲτήριξεν,
12 οὐχ ἱκανὸν δέξαϲθαι τὴν νοῦϲον, ἐπαλινδρόμηϲεν, ἀπέθανεν.

Testimonia: 3–4 ἄριϲται δέ-νούϲου] Cf. Gal. In Hippocratis Prognosticum comm. (ed.
Heeg 18b 216 4).

Apparatus: 1 Ἀποϲτάϲιεϲ IRH] -ϲηεϲ V 1 τόνων V I2rasRH] ȇˀˈͫLJ̑ i. e. νεύρων Gal.

1 νεύρων codd.] ĢLJ̒ćΑҙҏLJ̑ i. e. τόνων Gal. 1–2 δέρματοϲ V I2RH Gal.] δόγματοϲ I 2 ἐκτροπέων
codd. ɡʉ˳ͫā ɬͲ Gal.] om. Gal. in comm. ut u. l. 2 κιρϲοί] κριϲοί falso Artemidorus; uide
Gal. comm. 3 ὀϲφύοϲ V RH] ὀϲφῦοϲ Iras 3 ἐκ τῶν ἄνω codd.] trsp. post κάτω Langholf
e Gal. uide Medical Theories, p. 81 n. 7 3 ἄριϲται V RH] ἄριϲτα I: ἄριϲτοι Gal.P(P) 3 αἱ
(pr.) Gal.P apud Heeg ƦǍ˜̈ LJͲ ȅˀ͘Αā ɡˏ̵Αā ȅͫΒā Gal.] trsp. ante κάτω IRH Littré : om. V Smith.
3–4 καὶ αἱ–κοιλίηϲ] om. Gal.P apud Heeg 3 κατωτέρω scripsi ƦćĔ Gal.] κατωτάτω
codd. edd. 4 καὶ ante προϲωτάτω Iras 4 προϲωτάτω codd.] πορρωτάτω Gal.P(P) αἱ
πορρωτάτω Gal.P(VRF) Ƚ̀ǍͲ ǚˈ̑Αā ǽ͎ ƦLJ͛ LJͲć Gal. 4 ἀπὸ] om. Gal.P apud Heeg 4 νούϲου V
I2RH Gal.P(F)] νόϲ. I ut uid. 4 αἱ κατ᾽ ἔκρουν codd.] ǚ˳̤Αā Ǎ͎́ … ķǨʤ̈ LJͲć i. e. ἄριϲται iter.
Gal. ut uid. 4 κατ’ ἔκρουν, οἷον IRH] κατέκκρουνοι οἷον (sic) V 4 αἷμα V IpcRH] αἵμα
Iac 5 ῥινῶν scripsi] ῥινέων codd. 5 πύον V Ipc?RH] πῦον Littré : πύου Iac ut uid. 5 ἱδρώϲ
hic legit Gal. uide adn. 5 πτύαλον V IrasRH 6 ἀποϲτάϲιεϲ IRH] -ϲηεϲ V 6 ἱδρώϲ codd.
edd.] inclusi et supra reposui (uide supra l. 5) e Gal. 6 τὰ V H2] τὸ IRH 6 δέρμα V IrasRH
7 ἀφιϲτάμενα V Smith] trsp. ante ἐϲ τὸ IRH Littré 7 ταγγαί IRH] γαγγαί V ȇˀˈͫā ǚ˙ˈ̒
Gal. 7 ἐκπυοῦντα V IrasRH 7 ἢ codd. ć Gal. ut semper in hac sent.] οἷον Littré e cod. Par.
Gr. 2144 (= F) Smith 8 ἐξανθήματα I2ras 8 λοποί IRH] λόποι V Littré 8 μάδηϲιϲ V] μάδιϲιϲ
IRH 8 λέπραι Iras 9 ἀποϲτάϲιεϲ IRH] -ϲηεϲ V 9 μέν εἰϲιν V R] μὲν εἰϲὶν IH : ras. ante εἰϲιν
praebet I 9 ῥέψαϲαι V] ῥεύϲαϲαι IRH 9 ἡμιρρόπωϲ I] ἡμίρροποϲ V RH 10 εἴρηται V IRH]
εἰρέαται H2 in marg. 10 κακόν scripsi ƹǽ̶ ҨҞ͎ Gal.(M)] ȅ̵ ҨҞ͎ Gal.(E1) : ƹķĔǨͫLJʒ͎ Hallum,
Vagelpohl so ist sie doch Schädlich Pfaff : κακὰ Smith : καὶ codd. Littré 10 μὴ inclusi Gal.
The Arabic Version of Galen’s Commentary on Hippocrates’ ‘Epidemics’ 83

secutus sicut Smith ŰǨ˳ͫā Ģāǚ˙Ͳ ȇʶʥ̑ ɬ˜̈ ɨͫ ƦΒā uidelicet ἀναξίωϲ sine μή 11 Τημενέω IH
ťǍʉ͵LJͲLJ̒ Gal. Littré] Τημενίω R : Τιμενέω V Smith 11 ἀδελφιδῇ V R ut uid.] -ίδῃ I : ἀδελφίδι
Hras 11 νούϲου V] νόϲ. IRH 11 δάκτυλον V IH] δάκτολον R sed pr. -ο- puncto notatum
12 οὐχ V IH] οὐχ’ R 12 τὴν V IRpcH] τῆν Rac.

1.7 Segregations occur either through the vessels, or the sinews, or the
bones or the tendons or the skin, or other outlets. Those beneath the dis-
ease are good, such as varicose veins, heaviness in the loins. Coming from
above, the best are those that go furthest downwards, and those that go
beneath the belly and are most distant from the disease, and those that
come through outflow, as blood from the nose, pus from ear, urine, sweat,
through outflow. Those 〈patients〉 to whom this does not occur, have seg-
regations, for example in teeth, eyes, nose. There are also 〈swellings〉 under
the skin that turn outward, like scrofulas and suppurations, or ulcer and
similar eruptions, or peeling, loss of hair, white scaliness, leprosy, or the
like. Those segregations which occur massively and are not half-complete,
and all the others that have been discussed, are bad if they are inadequate
for the size of the disease, as with Temenes’ niece: from a strong disease,
〈segregation〉 settled in one toe, which was unable to receive the disease: it
ran back up and she died.

I would like to make just two remarks in this paper on this very difficult text.
The first remark is about the word ἱδρώϲ, ‘sweat’, which is given after ῥίϲ,
‘nose’, by the manuscripts but is found nowhere in Galen’s lemmas. Langholf,
who edited this passage in his book on Medical Theories in Hippocrates (1990, 81,
n. 7), rightly points out: ‘ἱδρώϲ VIHR: om. Arabs’, whereas Smith says nothing
about this variant. But, no editor has noticed that Galen could read this word in
his own manuscripts. We know from his commentary that he did not read ἱδρώϲ
after ῥίϲ but rather one line above in the list which is given from καὶ αἱ κατ’
ἔκρουν to οὖρον, κατ’ ἔκρουν, ‘and those that come through outflow, as blood
from the nose, pus from ear, urine, sweat, through outflow’ (lines 4–5 above). So,
the question is not whether we have to retain ἱδρώϲ or not, but where