British Journal for the History of Philosophy, 2014

Vol. 22, No. 5, 867–887, http://dx.doi.org/10.1080/09608788.2014.982507

A RTICLE

THE BODY AND THE POLIS: ALCMAEON ON HEALTH

1
AND DISEASE

Stavros Kouloumentas

Alcmaeon, a philosopher-cum-doctor from Croton, offers the earliest

known definition of health and disease. The aim of this paper is to
examine the formulation of his medical theory in terms of political
organization, namely the polarity between one-man rule (monarchia)
and egalitarianism (isonomia), by taking into account contemporary
philosophical and medical texts, as well as the historical context. The
paper is divided into four sections. I first overview the compendium
in which this medical theory is reported, trace the doxographical
layers, and analyse the terminology employed (I). I then focus on the
key aspects of this medical theory, including the constitution of the
body, the interaction of opposites, and the aetiology of disease (II). I
suggest that Alcmaeon’s notion of equality can be understood in
various ways, and discuss the possible interpretations in the light of
early Greek philosophy and medicine. The most likely interpretations
are that there exists a kind of equilibrium between pairs of opposites,
in addition to the equilibrium reached within each of them, and that
the bodily constituents remain in a state of permanent equilibrium
(III). Finally, I argue that Alcmaeon has in mind an egalitarian model
of distribution of shares to the bodily constituents, which are depicted
as the citizens of a tiny state whose antagonistic or collaborative
tendencies affect its functioning (IV).

KEYWORDS : Alcmaeon; health and disease; equality; powers;

Hippocratic medicine

1
This paper was presented at seminars in Humboldt – Universität zu Berlin and University
College London. I am grateful to all participants for their suggestions, as well as Chloe
Balla, Geoffrey Lloyd, Anna Marmodoro, Malcolm Schofield, David Sedley, James
Warren, and the anonymous referees of the BJHP who commented on the earlier versions
of this paper. Its completion was possible, thanks to the generous support of the research pro-
gramme ‘Medicine of the Mind – Philosophy of the Body: Discourses of Health and Well-
Being in the Ancient World’ which is funded by the Alexander von Humboldt Foundation
and is directed by Philip van der Eijk.

© 2014 BSHP
868 STAVROS KOULOUMENTAS

INTRODUCTION

In Polarity and Analogy: Two Types of Argumentation in Early Greek

Thought, Lloyd classifies the analogies attested in early Greek philosophy
and medicine into three categories: (a) social and political images, which
represent the cosmos as a state; (b) vitalist notions, which represent the
cosmos as a living organism; and (c) technological images, which rep-
resent the cosmos as an artefact.2 In analysing category (a), Lloyd
argues that the cosmos was conceived as an orderly system whose struc-
ture and functioning can be illustrated by projecting familiar images and
concepts onto a larger scale. Various aspects of the polis, an organized
whole composed of individuals who strive to establish their authority, pro-
vided the early Greek thinkers with a conceptual structure to describe the
bewildering array of natural phenomena as manifesting the same norms
and relations displayed in the human sphere: strife or compromise
between opposing parties, injustice recompensed by the infliction of pun-
ishment, rotation in office, and the allotment of prerogatives to individ-
uals. In this respect, the opposing constituents of the cosmos and the
body, its miniature counterpart, are conceptualized as human-like entities
whose behaviour displays enmity or friendship, greed or moderation,
inequity or fairness.
An excellent example of the use of a political analogy can be found in
Alcmaeon, a philosopher-cum-doctor from Croton who offers the earliest
known definition of health and disease.3 The aim of this paper is to
examine the formulation of Alcmaeon’s medical theory in terms of political
organization by taking into account contemporary philosophical and medical
texts, as well as the historical context. The paper is divided into four sections.
I first overview the compendium in which this medical theory is reported,

2
Lloyd, Polarity and Analogy, 210–303. Presocratic testimonies (A) and fragments (B) are
quoted from the handbook of Diels and Kranz.
3
There are several controversies concerning Alcmaeon: whether he is a member of the Pytha-
gorean sect or not; when he was active; whether he is a ‘natural philosopher’ or a doctor. I
cannot examine these vexed issues here, but it may be useful to summarize my position.
The extant sources indicate that Alcmaeon was familiar with some Pythagorean doctrines,
but it is clear that he put forward his own system and that most ancient reporters did not
present Alcmaeon as a Pythagorean. The sole chronological indication, which is probably
an interpolation in the Metaphysics (DK 24 A3), suggests that he was born or flourished
when Pythagoras was old. It is reported that Pythagoras arrived at Croton around 531 when
he was forty (Arist. fr. 16 Wehrli), and so Alcmaeon was born or flourished around 510.
He might have written his treatise at any time between the ages of thirty and seventy, but it
is reasonable to assume that it was composed at a late stage of his career. Although most
ancient reporters present him as a ‘natural philosopher’ or an author of a treatise On
Nature, his deep interest in the functioning of plants, animals and humans indicates the con-
siderable overlap and continuous interaction between philosophy and medicine in early Greek
thought. In this respect, he can be compared to Hippo and Diogenes of Apollonia who con-
tributed to both intellectual fields.
 THE BODY AND THE POLIS 869

trace the doxographical layers, and analyse the terminology employed (I). I
then focus on the key aspects of this medical theory, including the consti-
tution of the body, the interaction of opposites, and the aetiology of
disease (II). I suggest that Alcmaeon’s notion of equality can be understood
in various ways, and discuss the possible interpretations in the light of early
Greek philosophy and medicine (III). Finally, I argue that Alcmaeon has in
mind an egalitarian model of distribution of shares to the bodily constituents,
which are depicted as the citizens of a tiny state whose antagonistic or col-
laborative tendencies affect its functioning (IV).

THE ALCMAEON LEMMA IN THE PLACITA

Alcmaeon’s medical theory is reported in the Placita, an epitome of Theo-

phrastus’ lost treatise on the pre-Aristotelian thought, which can be dated
in the middle of the second century AD and is attributed to Aëtius.4 The
compendium is divided into five books. Each book is sub-divided into
topic-oriented chapters, and is furnished with chapter headings under
which various ‘opinions’ are arranged in separate lemmata. Each lemma is
introduced by a verb of affirmation, and is preceded with the name(s) of
the individual(s) or the group to which is attributed some doctrine formulated
in lacunose style.
The last chapter of the Placita deals with the state of the body, thus com-
pleting an elaborate examination in the structure and functioning of living
beings, the main theme of book V. Alcmaeon’s medical theory constitutes
the first lemma:

On health, disease and old age

Alcmaeon says that what maintains health is the equality of shares of the
powers (tēs men hygeias einai synektikēn tēn isonomian tō n dynameō n),
wet, dry, cold, hot, bitter, sweet, and the rest, while the predominance
among them produces disease (tēn d’ en aytois monarchian nosou
poiētikēn); for the predominance of either power is destructive (phthoropoion
gar hekaterou monarchian). Disease, as regards what brings it about, occurs
by excess of heat or coldness, while, as regards its source, it occurs from
surfeit or lack of nourishment, and, as regards its location, it occurs in the
blood or the marrow or the brain. It sometimes arises from external causes,
such as water of a certain quality, local environment, exertions, hardship, or
something similar to these. Health, by contrast, is the proportionate blending
of the qualities (tēn symmetron tōn poiōn krasin).5

4
Diels, Doxographi Graeci. A critical assessment of Diels’s reconstruction of the doxographi-
cal tradition can be found in Mansfeld and Runia, Aëtiana I.
5
Aët. V.30.1. The text printed above is based on Runia (‘The placita Ascribed to Doctors’,
245–50). It was first reconstructed by Diels (Doxographi Graeci, 442–3) in the light of a
group of kindred texts which draw from the Placita, and a slightly different version was
870 STAVROS KOULOUMENTAS

The chapter can be divided into two sections: the first three lemmata
(Alcmaeon, Diocles, Erasistratus) focus on health and disease, whereas
the last three lemmata (Parmenides, the Stoics, Asclepiades) deal with
old age. As far as the first section is concerned, the Alcmaeon lemma
supplies us with a definition of health and disease coupled with a detailed
aetiology of disease (a combination of the Aristotelian categories of sub-
stance and cause), whereas the other lemmata offer more concise expla-
nations of disease (Diocles) or health and disease (Erasistratus). A
survey of the Placita shows that it is not only the fullest lemma in this
chapter but also the longest lemma attributed to Alcmaeon, a clear indi-
cation that he was supposed to make a significant contribution to
medical theorizing.6
The fact that most lemmata refer to the doctrines of post-Theophrastean
thinkers indicates that this chapter was largely modified in the course of
transmission. Indeed, the Alcmaeon lemma is transmitted in indirect
speech, and contains no elements of the Doric and Ionic dialects in which
some fragments of Alcmaeon (DΚ 24 B1–1a, B3) are written. Moreover,
the significant textual differences between the four witnesses show that the
Alcmaeon lemma was epitomized, paraphrased, and fragmented into
pieces. A striking element in the aetiology of disease attributed to Alcmaeon
is the Aristotelian contrast between efficient (‘the primary source of the
change or rest of X’) and material (‘that out of which X is produced’)
cause (cf. Arist. Met. Ζ 6, 1032a17–8 and GA B 1, 733b31–3).7 Τhe doxo-
graphical adaptation becomes more apparent, if we consider the formulation
of Alcmaeon’s medical theory in Peripatetic and Stoic terminology (synek-
tikēn [ … ] poiētikēn [ … ] phthoropoion [ … ] poiō n), as well as the conclud-
ing remark that he describes health as ‘the proportionate blending of the
qualities’ which reformulates the definition of health as ‘the equality of

printed in the B-section of Die Fragmente der Vorsokratiker. The witnesses to the Αlcmaeon
lemma are the following: (i) ps.-Plutarch who quotes an epitomized version of the text in the
Opinions of the Philosophers 911a; (ii) Stobaeus who divides the text in two sections found in
the Selections ΙV.36.29 and ΙV.37.2; (iii) Qustā Ibn Lū qā, a translator of ps.-Plutarch’s treatise
into Arabic who offers a different version from the extant Greek text (Daiber, Aetius Arabus,
246–7; cf. Mansfeld and Runia, Aëtiana I, 157); (iv) Michael Psellus who is based on ps.-Plu-
tarch and cites the text in an extract entitled ‘Explanations to various questions’ and in the On
Omnifarious Doctrines 117.
6
The structure of the chapter suggests that Alcmaeon is ‘an archegete, a sort of Thales of medi-
cine’, but this interpretation is probably based on a strand in the doxographical tradition (Man-
sfeld, ’The Body Politic’, 93). Alcmaeon’s medical theory is not included in the extant part of
the doxography on the aetiology of disease preserved in the Anonymus Londiniensis, which
mostly draws from the Iatrika of Meno, Aristotle’s disciple, and records the doctrines of
twenty doctors and philosophers of the fifth and fourth centuries BC (Anon. Lond. IV.18-
XXI.9).
7
Diels, Doxographi Graeci, 31. Cf. the formulation of two lemmata dealing with the division
of causes: Aët. Ι.11.2 and I.11.4.
 THE BODY AND THE POLIS 871
8
shares of the powers’. Most of the other terms, on the other hand, are well-
attested in the Hippocratic Corpus, and may derive from Alcmaeon or reflect
his original wording.
What makes the Alcmaeon lemma distinctive is the strong polarity
between isonomia and monarchia, which seems to go back to Alcmaeon
himself.9 The term monarchia derives from monos (‘alone’, ‘solitary’) and
archein (‘to rule’), thus focusing on the empowered or ruling body which
is a single individual, either a king (Pi. Pyth. 4.165–6; Hdt. I.55) or a
tyrant (Sol. fr. 9.3–4 West; Thgn. 51–2), rather than a small group of
peers (oligarchy) or a large number of people (democracy). The etymology
of the term isonomia, on the other hand, is less transparent. It consists of two
components, but the second component is debatable: isos (‘equal’) and
nomos (‘law’, ‘custom’, ‘order’) or nemein (‘to allot’, ‘to distribute’).
Hence it can mean both ‘equality before the law’, namely the written and
unwritten codes accepted by a specific group, and ‘equality of shares’,
namely the distribution of power or prerogatives among peers. What sort
of idea underlies Alcmaeon’s medical theory? The extant sources indicate
that it was widely held that a sort of fair compromise or proper allocation
is required of the opposing parties which comprise an organized whole.
Despite their natural tendency to gain supremacy, which constitutes a

8
Cf. Diels, Doxographi Graeci, 223–4; Zhmud, Pythagoras and the Early Pythagoreans,
357–8; Mansfeld, ‘The Body Politic’, 79. On the Stoic division of causes into ‘initiating’, ‘sus-
taining’ and ‘auxiliary’ see SVF II.346, 351–2, but the source authors attribute various typol-
ogies of causes to the Stoics (Hankinson, Cause and Explanation in Ancient Greek Thought,
238–52). According to Galen, the Stoics were the first to speak about the ‘sustaining’ cause
(SVF II.356 = Gal. Syn. Puls. IX.458), namely the breath which consists of the active
elements, fire and air, and holds all things together (Gal. CC 1.1–3). The doctor Athenaeus,
who was influenced by the Stoics, suggests that the ‘sustaining’ cause of disease is the exces-
sive elemental changes of the breath (Gal. CC 2.1–4).
9
Cf. Ostwald, Nomos and the Beginnings, 99–100; Jouanna, Hippocrate, 460; Sassi, ‘Ordre
cosmique et isonomia’, 198. However, Mansfeld (‘The Body Politic’) has recently challenged
the Alcmaeonian origins of the two terms by arguing that they were inserted to the Alcmaeon
lemma by a doxographer who was influenced by the debate regarding the best constitution in
Herodotus’ Histories, the earliest known text in which these terms are sharply opposed to each
other, and thus reformulated the definition of health and disease. There are several objections
to this interpretation. First, Alcmaeon could not have invoked a polarity which was unfamiliar
to his contemporaries to illustrate the functioning of the body. The polarity between one-man
rule and egalitarianism was a salient feature of the political history of Magna Graecia, as
argued below (cf. n. 11–12). Second, Alcmaeon often draws analogies between microcosmic
processes and visible phenomena in order to illustrate the structure and functioning of the
former. For example, the eternal movement of the soul is patterned on the perfect orbits of
the celestial bodies (DK 24 A12) and the absorptive capacity of the embryo is likened to a
sponge (DK 24 A17). A political analogy may well be part of his project, inasmuch as this
was common in early Greek thought (cf. n. 2). Third, the various doxographers who shape
the Placita in its extant form occasionally preserve verbatim quotations, especially when
they record paradoxical ideas (e.g. Aët. I.3.4, II.20.1, III.10.2). As far as Alcmaeon is con-
cerned, a lemma dealing with the sterility of mules contains the bizarre terms thorēs and ana-
chaskein (DK 24 B3) which go back to Alcmaeon (Mansfeld and Runia, Aëtiana II, 214).
872 STAVROS KOULOUMENTAS

threat for the overall equilibrium, the opposing parties normally content
themselves with the offices assigned to them. This balance is achieved in
various ways: it may be based on the binding norms of necessity and recipro-
city (Anaximander, Heraclitus), it may reflect a mutual agreement between
antagonists (Empedocles), or it may be imposed by omnipotent agents
(Parmenides, Diogenes of Apollonia). Inasmuch as early Greek thinkers
do not seem to describe the norms which govern the functioning of the
cosmos and the body as a formal system of rules or natural laws to which
its members are obliged to adhere, it can be argued that, in Alcmaeon’s
view, all powers somehow share the rule in the body by distributing
power or prerogatives in a fair manner.10 If this is the case, the terms isokra-
tia (‘equal strength’; cf. Hdt. V.92) and isomoiria (‘equal share’; cf. Sol. fr.
34.9) can be seen as equivalent to isonomia in this case rather than the term
eynomia (‘good order’), the proper way of life in a well-functioning polis
which is often contrasted with dysnomia (‘bad constitution’ or ‘lawlessness’;
cf. Sol. fr. 4.31–2).
It is worth noting that, with the exception of Alcmaeon, the two concepts
are not attested in a medical context. The medical authors use the terms iso-
moiriē (Aër. 12), xymmetros krasis (Aph. V.62), metriōs echein (Nat. Hom.
4), and eykratō s diakeimen(ō n) (Anon. Lond. XIX.27–8 on Menecrates of
Syracuse) to express the proportionate blending of opposites, while the pre-
ponderance of one of them is described as epikrateein (Morb. Sacr. 7),
ischyein and katechein (Nat. Hom. 7), dynasteuein (VM 16), and hyperbolē
(Vict. I.32). The polarity between the two concepts reflects the contemporary
political struggles in Magna Graecia. Most poleis were ruled by powerful
tyrants connected with each other by strong ties of intermarriage. This
form of governing combined elements of both hereditary monarchy (basi-
leia) and tyranny (tyrannia), and could best be described as mo(y)narchia,
which literally means ‘one-man rule’ (note that the three concepts and
their derivatives were often used as synonyms). From the end of the sixth

10
On the limited use of the term nomos and its derivatives in early Greek philosophy see
Gagarin, ‘Greek Law and the Presocratics’. Although Anaximander (DK 12 B1) uses an
analogy that invokes the regularity of legal procedure and is formulated in the terminology
of civic laws (Sassi, ‘Anassimandro e la scrittura della “legge” cosmica’), he makes no explicit
reference to the existence of natural laws. Encroachments and retributions take place ‘in
accordance with the ordinance of time’, which is either a personified force that restores
balance in the long run or a poetical way of talking about an established pattern of behaviour
inherent in cosmic opposites. Likewise, Heraclitus (DK 22 B114) and Empedocles (DK 31
B135) mention a kind of universal law, but offer no clues as to whether it regulates the work-
ings of the cosmos and how it is connected with other directing forces. An exception is the
statement ‘all things are governed by law’ (Genit. 1) which is found at the very beginning
of a Hippocratic treatise dealing with the production and origin of sperm. However, it is
clear that the author of On Generation uses a stock phrase to attract the attention of his
readers and refers to mechanical necessity in order to explain a series of microcosmic pro-
cesses (Lonie, The Hippocratic Treatises, 103–4).
 THE BODY AND THE POLIS 873

century BC onwards, however, egalitarianism steadily gained strength, and

several poleis, such as Acragas, Syracuse and Achaean colonies, set up a
sort of democratic constitution.11 At the same time, some citizens formed oli-
garchical groups, and tried to restore the old order or set up constitutions
based on the proportionate distribution of power, an endeavour often con-
nected with the Pythagoreans who were particularly active in Croton. Politi-
cal tensions escalated in Alcmaeon’s time, and extended throughout
southern Italy.12 The ideological differences between democracy, tyranny,
and oligarchy were often adapted to a non-political context and used to
describe the way in which power is distributed among the cosmic elements
or bodily constituents.13

ΤHE MEDICAL THEORY

The Hippocratic Corpus, a heterogeneous medley of medical treatises,

mainly dating from the second half of the fifth century to the end of the
fourth century BC and displaying wide diversity in style and content,
constitutes an invaluable source for understanding the doctrines of the
doctors who flourished shortly after Alcmaeon.14 Although no Hippocratic
author mentions Alcmaeon by name, their method and interests overlap
to a great extent. Hence it is worth outlining the principal Hippocratic doc-
trines concerning health, disease and cure, and then examining how these
illuminate crucial aspects of Alcmaeon’s medical theory, including the
constitution of the body, the interaction of opposites, and the aetiology of
disease.
Generally speaking, several Hippocratic authors define health as a
physiological state consisting of a proportionate blending of bodily constituents,
which may be humours or powers or substances. There is no consistency as to

11
Robinson, The First Democracies, 73–80, 120–2. Robinson (The First Democracies, 126)
summarizes the salient features of early democracies as follows: ‘These include mechanisms
for the control of magistrates, low or nonexistent property qualifications, a representative
council, and active popular participation in juries and legislative bodies’.
12
A survey of the political history of each polis can be found in Fischer-Hansen, Nielsen, and
Ampolo, ‘Italia and Kampania’.
13
The use of concepts which bear political connotations, especially those of rule, strife and
harmony, in a medical context is sufficiently documented. The author of On Breaths, for
instance, believes that air is the lord of all beings (Flat. 3), and attempts to show that all dis-
eases occur from it. While this image is patterned on monarchical and tyrannical constitutions,
Menecrates of Syracuse argues that the body consists of two hot (blood and bile) and two cold
(breath and phlegm) elements conceptualized as opposing factions. When they are not striving
against each other and are mildly mixed (Anon. Lond. XIX.27), a human is healthy. An
example of how harmony is achieved can be found in the author On Airs, Waters, Places
who describes the temperate climate as the enforcement of the egalitarian norms in the seaso-
nal cycle (Aër. 12). Cf. Cambiano, ‘Patologia e metafora politica’.
14
For an approximate dating of each treatise, see Jouanna, Hippocrate, 527–63.
874 STAVROS KOULOUMENTAS

how many and what kinds of bodily constituents exist.15 Most Hippocratic
authors, however, stress that their effects on the body are reducible to the
main pairs of opposites, namely hot and cold, dry and wet.16 Each bodily con-
stituent displays its own strength, and is capable of affecting the body in a par-
ticular way. The preponderance of one bodily constituent entails the partial
weakening of the others, in particular of its antagonist, and so their power
may fluctuate between maximum and minimum (Hum. 14, Nat. Hom. 7, Vict.
I.3). An individual is healthy when an effective blending prevents any particular
bodily constituent from manifesting itself more than necessary (Nat. Hom. 4,
Vict. III.69, VM 14, 16, 19). Disease and pain, on the other hand, arise from
the disruption of the proper equilibrium, namely when one bodily constituent
prevails over the others or separates itself from the blending, and when a
bodily part becomes excessively hot or cold or dry or wet. These kinds of dis-
equilibrium occur for several reasons, which can be classified into two groups:
first, the environmental conditions that are contingent on changes of climate, on
winds, on air, on water quality, and on the location of a residence; second, the
state of the body that is contingent, apart from the aforementioned factors, on its
internal functions, on nourishment, on exertions, and on wounds (Aër. 1–11, Aff.
1, Aph. III.1–23, Hum. 12–9, Morb. I.2, Vict. I.2).
Several Hippocratic authors agree that health depends on the nature of each
individual, who needs a different blending of bodily constituents in a different
season, age, and place, and in accordance with his/her diet, habits, sex, and dis-
position to a certain disease (Aër. 24, Epid. I.23, Nat. Hom. 9, Salubr. 1–7, Vict.
I.32–5, VM 20). The authors of Aphorisms, Epidemics, On Internal Affections,
On Regimen, and Places in Man, for example, argue that a skilled doctor should
aim at providing a special therapeutic treatment for each patient by taking into
account the nature and development of disease, seasonal changes, and his/her
own needs. According to most Hippocratic authors, the proper method of
curing a disease is to induce the opposite effects on the body in order to counter-
balance the former disequilibrium (Flat. 1, Loc. Hom. 42, Nat. Hom. 9).
Detailed instructions are thus provided for harmonizing the state of the body
with the external destabilizing factors, since the surfeit of one bodily constituent
is moderated by the balanced increase of its antagonist (Aff. 39, Aph. II.22, Hum.
6, Vict. II.40).
Armed with this medical framework, we can now turn to Alcmaeon. In his
view, the body contains many opposite powers, including ‘wet, dry, cold,
hot, bitter, sweet, and the rest’. This list seems to be accurate, since the
first two pairs represent the four main opposites and Aristotle mentions
sweet and bitter as an example of the various polarities used by his

15
Some examples include: phlegm and bile (Aff. 1); hot and cold (Carn. 2–3); fire and water
(Vict. I.3); phlegm, blood, bile and water (Genit. 3); phlegm, blood, yellow bile and black bile
(Nat. Hom. 4–7); a vast number of humours (VM 14). An exception to these pluralistic doc-
trines is the claim that all diseases are caused by the agency of air (Flat. 2–5).
16
On these pairs of opposites, see Lloyd, ‘The Hot and the Cold’.
 THE BODY AND THE POLIS 875

predecessor in order to explain phenomena pertaining to the human sphere

(DK 24 A3). The explicit reference to other bodily constituents indicates
that Alcmaeon has no intention of giving a systematic enumeration and
analysis of all opposite powers, as Aristotle’s criticism in the Metaphysics
confirms.17 What other opposite powers Alcmaeon may have in mind are
indicated by the author of On Ancient Medicine who states that the body con-
sists of a vast number of humours, including ‘salt, bitter, sweet, acid, sour,
insipid, and countless others having powers of all kinds in quantity and
strength’ (VM 14) which are not manifest and harmful when they are prop-
erly mixed with one another. Moreover, the author of On Flesh describes the
formation of the bodily parts in terms of the four main opposites, but also
considers sweet and bitter, fatty and glutinous as bodily constituents
(Carn. 13). It should be noted that the opposite powers mentioned in the Alc-
maeon lemma operate only within the body, as far as we can judge from the
extant sources, thus representing inner substances rather than ‘first prin-
ciples’ or cosmic elements.
The bodily constituents are described as dynameis. The general meaning
of this term is ‘power’ or ‘strength’, but it also signifies a ‘capacity’ or
‘potency’ which is both active and passive (Pl. Phaedr. 270d1–7). It indi-
cates the potentiality to bring about changes in form, nature, and strength
of a correlative substance but also to undergo transformations under the
agency of something powerful. Medical authors often use this term in
order to refer to the inner substances which manifest themselves by their
own properties and activities (VM 14; Anon. Lond. XX.25–30 on Philistion
of Locri) or to express the potency of various stuffs, agents and processes
(Aër. 1, Nat. Hom. 3, Vict. II.38–9). A doctor is a master of the various
powers which act upon the body and produce a diversity of effects: he
should know the efficacy of foodstuffs, drinks, and drugs under different
circumstances, take into account the environmental conditions with refer-
ence to the constitution, habits, and needs of each individual, and find the
therapeutic and preventive measures which can counterbalance undesirable
effects and maintain equilibrium respectively (Vict. I.2). The opposite
powers can cause excessive elemental changes by exercising control over
their antagonist for ‘the things that are more hostile to each other are those
that are most opposed, cold to hot, bitter to sweet, dry to wet, and all the
rest’ (Pl. Symp. 186d6–7). The equal distribution of power between the
two members of a pair, however, results in a mutual annihilation of their
respective strength. Therefore, it is not the opposite powers themselves
that are harmful to the body, but their excess or deficiency in it.

17
Aristotle points out that it is unclear whether Alcmaeon’s doctrine of opposites influenced a
particular group of Pythagoreans or was based on their system, and then notes a significant
difference in their method. Alcmaeon made extensive use of opposites, but, in contrast to
these Pythagoreans who reduced the number of opposites to ten pairs, he picked some
random examples to illustrate the polarities displayed in the human sphere.
876 STAVROS KOULOUMENTAS

Alcmaeon places a special emphasis on the aetiology of disease, without,

however, specifying the various types of diseases and listing their respective
symptoms, as Hippocratic authors often do. His reasoning can be summar-
ized as follows: first, disease arises due to the supremacy of a power, in par-
ticular when the body becomes too hot or too cold; second, this
disequilibrium is occasioned either by surfeit or lack of foodstuffs or from
external factors, including water of a particular kind, environmental con-
ditions, exertions, hardship, and other similar causes; third, disease manifests
itself in certain bodily parts, such as the blood, the marrow, and the brain.
Alcmaeon thus accounts for the elemental changes in the body with refer-
ence to the diet of an individual, his/her physical activities, and the climatic
and topographical conditions of his/her place, an explanatory pattern which
is prominent in Hippocratic medicine.

THE NOTION OF EQUALITY IN THE BODY

The nature of the ‘shares’ or ‘offices’ that are assigned to the powers is
not defined by Alcmaeon. Each of them was probably supposed to
exhibit the same strength with its antagonist, albeit acting in a distinct
manner and manifesting itself under different circumstances. There are,
however, two crucial questions as to how equality is displayed in this
tiny state when a human is healthy: first, what sort of relationship binds
together the powers and pairs of opposites; second, whether they are at
rest or rotate in office.
Alcmaeon’s definition of health can be interpreted as reflecting three
different systems of equality: (i) all powers are equal to each other (a sort
of universal equality); (ii) each power is equal to its antagonist, but to no
other power (localized equalities within pairs of opposites); (iii) each
power is equal to its antagonist, and, in addition, there exists a kind of equi-
librium between pairs of opposites (a sort of complex equality within and
between pairs of opposites). If (i), the body suffers from the ‘predominance’
of one power over all the others; if (ii), the body suffers from the disequili-
brium within one or more pairs of opposites; if (iii), the body suffers from the
disequilibrium between pairs of opposites, which may be combined with the
disequilibrium within one or more pairs of opposites.
Interpretation (i) should be rejected. Arithmetic equality was applied to
stress the equality of opposing parties that are naturally inclined to strive
against each other to gain supremacy, such as light and darkness in Parme-
nides (DK 28 B9), Love and Strife and the four ‘roots’ in Empedocles (DK
31 B17.27–9), and day and night in Pindar (Pi. Ol. 2.61–2). It makes no
sense to argue that wet is equal to sweet, for instance, because their relation-
ship is not based on reciprocity. Each of them produces different effects on
the body and the existence of wet does not depend on sweet, in contrast to
 THE BODY AND THE POLIS 877

fire and water which interact with each other and accomplish supplementary
tasks by adhering to the norms of equilibrium (Vict. I.3).
Interpretation (ii) is more attractive than (i). Alcmaeon’s definition of
health can be understood as exemplifying his thesis that ‘most human
things go in pairs’ (DK 24 A3). Many Hippocratic authors argue that the
potency of various stuffs, agents and processes is moderated when they
are blended with their antagonist or when one induces the opposite
effects on the body. The theoretical backdrop of this method is neatly sum-
marized by the author of On Ancient Medicine who criticizes those who
postulate the four main opposites as the primary cause of disease: ‘for if
it is something hot or cold or dry or wet that harms the human, and if
the one who carries out the cure correctly must counteract cold with hot,
hot with cold, wet with dry, dry with wet, give me one whose constitution
is not strong but rather weak’ (VM 13). The fact that Alcmaeon contrasts
‘the equality of shares of the powers’ with ‘predominance’ among them,
without explicitly considering the possibility of the simultaneous domi-
nance of a few powers or pairs of opposites (expanding his political
analogy, this would be a sort of oligarchy), indicates that he principally
wishes to emphasize that the disequilibrium within any one pair of oppo-
sites suffices to cause disease.18 If excessive moisture is accumulated in
the belly, for instance, it causes uncontrolled flux throughout the body,
which is opposed to the fixation associated with dryness. This disequili-
brium initially affects the head, and gradually expands into other parts
for the body constitutes an organic unity (Loc. Hom. 1).
To be sure, interpretation (ii) may not give a full account of what Alc-
maeon intended. The equilibrium within pairs of opposites is not a sufficient
condition for preserving health, because each pair of opposites has some
strength, quantity and degree of concentration that can affect the others,
although they are not formally hostile to them. Seen from this perspective,
there should also be a kind of equilibrium between all pairs of opposites
that comprise the body. The author of On the Nature of Man, for instance,
argues that four humours exist in the body and each of them consists of
two powers, which may be present in different degrees in each season:
phlegm is cold and wet, and dominates in winter; blood is hot and wet,
and dominates in spring; yellow bile is hot and dry, and dominates in
summer; and black bile is cold and dry, and dominates in autumn (Nat.
Hom. 7). A human is healthy ‘when these are duly proportioned to one
another in blending, power and quantity, and when they are perfectly
mixed’ (Nat. Hom. 4). This presupposes a complex equilibrium based not
only on the blending of the four humours, but also on the balanced

18
Ostwald, Nomos and the Beginnings, 101. The explanatory gloss ‘for the predominance of
either power is destructive’ supports such an interpretation, but it should be credited to a dox-
ographer rather than Alcmaeon himself. Cf. Mansfeld, ‘The Body Politic’, 79, n. 9.
878 STAVROS KOULOUMENTAS

interactions between the powers that comprise them. Is there any indication
that Alcmaeon holds a similar doctrine?
An obvious problem is that Alcmaeon does not refer to humours
which contain a pair of powers, like the author of On the Nature of Man,
but to bodily constituents which cannot be reduced to something else. It is
also clear that he focuses on ‘the equality of shares of the powers’ rather
than the relationship between pairs of opposites. However, the Alcmaeon
lemma identifies six powers whose dynamics vary. The efficient cause of
disease is the excessive ‘heat or coldness’ in the body, which play a promi-
nent role in various aetiologies of disease put forward by Hippocratic authors
(VM 16, Loc. Hom. 42), Hippo (DK 38 A11), and Philolaus (DK 44 A27).
This suggests that the disequilibrium within a specific pair of opposites is
of primary importance for the state of the body, and so there is a sort of hier-
archical organization of localized equalities.19 The equilibrium between hot
and cold is more significant than those of dry and wet, sweet and bitter for the
former antagonists are envisaged as being more aggressive and powerful
than the others, should they do not hold each other in check.20 We may
thus infer that interpretation (iii) fully justifies Alcmaeon’s definition of
health.
Interpretation (iii) seems to fit well with the concluding remark in the Alc-
maeon lemma, which suggests that health is understood as ‘the proportionate
blending of the qualities’. The problem is that Alcmaeon starts with a defi-
nition of health and disease in terms of political organization, then elaborates
on the aetiology of disease, and finally gives a somewhat different definition
of health, albeit not necessarily incompatible with the first one. A reasonable
way to surmount this inconsistency is to assume that a doxographer intro-
duced this sentence, which is not preserved by Stobaeus, to summarize Alc-
maeon’s reasoning in the light of the Theophrastean interpretation. In On the
Senses, Theophrastus often notes that his predecessors understood sense per-
ception, thinking and other related functions as a proportionate blending of
bodily constituents (Theophr. Sens. 3, 12, 39–41, 58). Despite the fact that
the concept of ‘mixture’ or ‘blending’ of cosmic elements and bodily con-
stituents occupies a prominent position in early Greek philosophy (DK 28

19
The idea that a single bodily constituent or pair of opposites plays the most significant role in
the body is a key feature of several Hippocratic treatises. Τhe author of On Ancient Medicine,
for instance, attacks those who reduce the primary cause of disease to the four main opposites
(VM 1). Although there is no consensus among scholars regarding the identity of his
opponents, it is clear that, in his view, several medical authors lay special weight to the
effects of certain bodily constituents, thus depicting the body as a system whose members
are ranked according to authority. Rather, he argues that hot and cold are the least powerful
of the humours which comprise the body (VM 16–9). Cf. Schiefsky, Hippocrates, 55–62.
20
It should be noted that the reading ‘heat or coldness’ is preserved by the authors of the
ps.-Plutarchean tradition and is preferred by Diels and Runia, but Stobaeus refers to ‘heat
or wetness’ (cf. Anon. Lond. XX.35–6 on Philistion of Locri). If we trust Stobaeus, then Alc-
maeon appears to prioritize two powers which are active in different pairs of opposites.
 THE BODY AND THE POLIS 879

B16, DK 31 B8, DK 59 B4) and medicine (Nat. Hom. 3, VM 5, Vict. I.35), it

does not necessarily follow that Alcmaeon described health as a kind of pro-
portion between opposing forces. The idea that health is ‘the proportionate
blending of the qualities’ may well be a doxographical adaptation of its orig-
inal definition as ‘the equality of shares of the powers’ to later medical doc-
trines, especially those which were formulated by Aristotle (Arist. Top. Z 6,
147b7–11, Phys. H 3, 246b4–6) and Chrysippus (SVF III.471).
Another topic that invites study is whether the powers remain in a state of
permanent equilibrium or dominate successively in order to share the rule.
Both kinds of equality are documented in early Greek philosophy and medi-
cine. According to Heraclitus, a stringed bow and lyre seems to be at rest, but
an internal strife is taking place which escapes the notice of most people:
‘They do not comprehend how a thing agrees at variance with itself; it is
an attunement turning back on itself, like that of the bow and the lyre’
(DK 22 B51). Opposite tensions, namely the inward pull of the string
against the outward pull of the wood, counterbalance each other, thus produ-
cing the necessary equilibrium for the orderly functioning of a tiny system.
In Empedocles’ view, by contrast, the opposing parties involved in the
cosmic cycle rotate in office at fixed times: ‘For all these are equal and of
the same age, but each has a different honour and its own character, and
they rule in turn, as time rolls round’ (DK 31 B17.27–9). These different
kinds of equality are found in Hippocratic treatises too. In Diseases IV,
On Ancient Medicine, and On Glands the ideal state of the body is under-
stood as manifesting a permanent equilibrium between the bodily constitu-
ents. A human is thus supposed to be ‘in the best possible condition
whenever these [sc. the humours] are concocted and at rest, displaying no
power of their own’ (VM 19). The authors of On Humours, On the Nature
of Man, and On Regimen, on the other hand, describe the workings of mac-
rocosm and microcosm as a matter of alternating dominance between peers,
since each cosmic element and bodily constituent both rules the others and is
ruled by them at regular intervals. To cite a characteristic example, fire is
endowed with the capacity to move all things while water can sustain
them, ‘but in turn each masters or is mastered to the greatest maximum or
the least minimum possible’ (Vict. I.3).
It is difficult to assert with confidence what kind of equality fits best with
Alcmaeon’s medical theory for two reasons. First, the term isonomia is nor-
mally connected with a range of ideas which can be interpreted as displaying
not only a state of permanent equilibrium but also a sort of balance gained
over the course of time. It may express a kind of straightforward equality
in that some individuals distribute the goods in a fair manner (Thgn. 678)
or are allotted equal portions of an estate, like Zeus, Poseidon and Hades
who divided the cosmos into three equivalent regions (Il. 15.185–210). It
may also indicate that regularly repeated processes, such as the seasonal
cycle and the alternation between day and night, are subject to the norms
of equality (Eur. Ph. 542–8). Second, we do not know how Alcmaeon
880 STAVROS KOULOUMENTAS

conceived of the dynamics of opposites in the macrocosm, which is often

thought to be governed by the same norms as the microcosm (Vict. I.10).
In fact, his definition of health is the only known application of isonomia
in a medical context. Hence it would be helpful to consider the various con-
cepts of equality which are employed by the earliest Hippocratic authors.
According to the author of On Regimen, disease arises when the nourish-
ing ingredients which sustain humans overpower their physical activities or
vice versa. The equilibrium between foods, drinks and exertions, on the other
hand, results in health, since a balanced diet provides the body with the vital
strength which has been lost during physical activities (apo tou isazein pros
allēla hygeiē prosestin, Vict. III.69; cf. Vict. I.2). The Hippocratic treatise
makes it clear that nourishing ingredients and physical activities often
cause excessive elemental changes, such as wetness or dryness and heat or
coldness, which should be counterbalanced by inducing the opposite
effects on the body. The underlying idea is that each individual should
adjust his/her lifestyle in order to find the due balance between movement
and nourishment, as an analogical reflection of fire and water, the principles
of movement and nourishment respectively, which rotate in office (Vict. I.3–
5). The author of On Regimen thus agrees with Alcmaeon that the state of
being greater in amount or strength has negative effects on the body, but
he refers to the main factors which determine the internal condition of the
body rather than inner substances which are mentioned by Alcmaeon.
An explicit reference to the equal distribution of a bodily constituent can
be found in On Glands. The intestines contain a great amount of saturation
and the moisture under the skin, which is interpreted as both inner substance
and quality and is often connected with nourishment in Hippocratic treatises
(Loc. Hom. 1, Nat. Puer. 22, Morb. IV.34). The absorption of this internal
fluid normally causes no problems in the body, since none of the numerous
glands of the intestines can obtain an excessive amount of moisture at the
expense of the others. Rather, each of them gets a small portion, like the
peers who share goods (isotēs estin ayteēisin, Gland. 9). This suggests
that a kind of straightforward equality is applied to the members of a
bodily network, but these members are not hostile to each other as in
Alcmaeon.
There are, however, two Hippocratic authors who clearly describe the
balanced interactions between opposites as reflecting equality and note
that their imbalance brings about negative effects. The default assumption
of the author of On Airs, Waters, Places is that the climatic and topographi-
cal conditions of a place intimately affect the health and character of its
inhabitants. In giving doctors instructions as to how to predict the sorts of
diseases they may find in different places, he states that the part of Asia
which is centrally placed between hot and cold regions has the mildest
weather, the best natural resources, and the most fertile land. Its inhabitants
are of excellent physique and gentle in character for all opposites exercise
their power in a balanced manner. The temperate climate is fostered ‘when
 THE BODY AND THE POLIS 881

nothing is forcibly predominant, but equability prevails in every respect’

(alla pantos isomoiriē dynasteyēi, Aër. 12). The context suggests that the
seasonal variations are minimal in this part of Asia, which presupposes a
relatively permanent equilibrium between opposites.
In fact, the best parallel is offered by the author of On the Nature of Man
who argues against the idea that generation takes place from a unique prin-
ciple. Rather, he states that the partners should combine their respective
strength. This is understood as a dynamic equilibrium between inner sub-
stances, including hot and cold, dry and wet, in which each one cancels
out the strength of its antagonist, thus producing the proper conditions for
generation (metriō s pros allēla hexei kai isō s, Νat. Hom. 3). If one prevails
over its antagonist in the blending, generation is not possible. One might be
tempted to suppose that Alcmaeon has in mind a model of permanent equi-
librium too, since he mentions the same pairs of opposites and contrasts their
balanced interactions to their imbalance which brings about undesirable
effects. This assumption is supported by the fact that Alcmaeon’s embryol-
ogy is based on a notion of sovereignty which has similarities to his defi-
nition of disease as the ‘predominance’ of a single power. More
specifically, Alcmaeon believes that both parents contribute semen during
the production of the embryo but the latter takes the gender of the parent
whose seed happens to be more in quantity (DK 24 A14). This suggests
that a sort of strife between opposing forces takes place in the womb at
the very moment of conception and the semen of one parent gains sover-
eignty over the other, thus determining the gender of the embryo.21 Simi-
larly, a continuous strife between powers takes place in each pair of
opposites and probably between all pairs which are active in the body.
Should a temporary winner disrupt the equipoise between them and establish
its own authority, the body suffers.

THE POLITICAL ANALOGY

The most striking aspect of Alcmaeon’s medical theory is that he depicts the
state of the body as an analogical reflection of what happens in the political
sphere, an explanatory pattern which became prevalent in Greek thought.
The body and the polis are conceptualized as two self-regulating associations
composed of opposing parties, which should be balanced in the interest of
the whole. The body is in perfect condition when there exists a kind of equi-
librium between the powers which strive to gain supremacy. Likewise, the
polis flourishes when the opposing factions and individuals do not conflict
over the distribution of wealth and power. In the light of this analogy, can
we infer that Alcmaeon’s medical theory reflects his sympathies for an
egalitarian constitution?
21
On this embryological theory, see Lonie, The Hippocratic Treatises, 124–32.
882 STAVROS KOULOUMENTAS

It is necessary to clarify some points concerning the connotations of the

term isonomia, before tackling this vexed question. The text in consideration
includes one of the earliest occurrences of this term, which is usually con-
trasted with monarchy and tyranny, and, after the political reforms of
Cleisthenes in Athens, was closely associated with democracy (or sometimes
with a type of moderate oligarchy; cf. Thuc. III.62).22 We know, for
example, of two similar drinking songs that praise the tyrannicides Harmo-
dius and Aristogeiton for making the Athenians ‘equal before the law’ (iso-
nomous, PMG 893, 896) and were probably composed shortly after the
overthrow of the Peisistratids. Furthermore, in the famous constitutional
debate of the Persian aristocrats, isonomiē is explicitly opposed to one-
man rule and oligarchy (Hdt. III.80–3), and its champion proposes the estab-
lishment of a sort of democratic constitution based on the rule of the people,
the election of magistrates by lot, and the control of their official acts (Hdt.
VI.43). In a similar vein, the successor of the tyrant Polycrates calls an
assembly of all citizens and proposes to share the rule with them (Hdt.
III.142). Although these fifth-century BC texts suggest that isonomia
demands a form of egalitarian government, there is no evidence that it was
used as a mere synonym for democracy:

If it should then serve as a name for democracy, this would be a purely deriva-
tive use, made possible by the feeling that this constitution measures up so
uniquely to the norm expressed by isonomia that it can be singled out from
all others (and, hence, named) by the mere mention of the norm.
(Vlastos, ‘Isonomia politikē’, 9)
isonomia is not a name for a form of government but for the principle of
political equality, which, though it is of course more closely associated with
a democratic constitution than with any other, is not necessarily confined to it.
(Ostwald, Nomos and the Beginnings, 97)

It has been suggested that the term isonomia was initially used in aristo-
cratic circles to designate the power-sharing agreement between the fellow
elites, and was later extended to include all citizens who qualified for mili-
tary service.23 Vlastos argues that this suggestion is not corroborated by
the extant sources, and that political equality was not established in the com-
munity of professional warriors who were charged with the security of Sparta
and regarded themselves as ‘peers’.24 Vlastos is right about Sparta, but his
objection to tracing the origin of political equality back to the aristocrats’
struggle against the tyrants who seized the power can be overcome.
Vlastos assumes that the partisans of a constitution that had radically

22
The most pertinent studies include Vlastos, ‘Isonomia’, ‘Isonomia politikē’; Lévêque and
Vidal-Naquet, Clisthène l’Athénien, 25–32; Ostwald, Nomos and the Beginnings, 96–173.
23
Ehrenberg, ‘Origins of Democracy’, 530–4; cf. Vlastos, ‘Isonomia politikē’, 10, n. 1.
24
Vlastos, ‘Isonomia’, 337–47, 351–2, 365–6, ‘Isonomia politikē’, 10–2.
 THE BODY AND THE POLIS 883

different principles from aristocracy could not have adopted an aristocratic

slogan to express the spirit of a new system of government. According to
Raaflaub, however, there was no strong polarization between aristocrats
and non-aristocrats when the political reforms of Cleisthenes took place.25
In fact, the term isonomia seems to have been used in both aristocratic
and democratic circles as an alternative to one-man rule. It first served as
a slogan in the aristocrats’ struggle against tyranny, which deprived them
of their prerogatives of decision-making and rule, and gradually became
the cardinal democratic principle. Therefore, if Alcmaeon’s medical theory
betrays something about his political sympathies, we should take it as
favouring the principle of political equality in a general sense, rather than
expounding democratic ideas.
It seems likely that Alcmaeon has in mind an egalitarian model of distri-
bution of ‘shares’ or ‘offices’ to the bodily constituents, depicted as the citi-
zens of a tiny state whose antagonistic or collaborative tendencies affect its
functioning. It is difficult, however, to understand how equality is displayed
in the body, as argued above. This ambiguity complicates our effort to
unravel the political implications, if any, of Alcmaeon’s medical theory.
The crucial question is to what extent one is willing to expand his definition
of health and disease into the political sphere and infer his commitment to a
specific constitution. We may distinguish between two lines of interpret-
ation: a sceptical approach and a non-sceptical one.
To begin with the former approach, any inferences on the basis of scat-
tered pieces of evidence which are built on political imagery are highly
speculative. We cannot draw definite conclusions concerning the political
ideas of an early Greek thinker unless we know something specific about
his involvement in public affairs (e.g. the emphasis of Empedocles on the
equal status of the opposing protagonists of the cosmic cycle fits well with
the reports about his democratic beliefs). The best strategy is to ask what
is known about the socio-political activities of Alcmaeon, and then
examine whether these reports may shed some light on his medical theory.
Regrettably, the extant sources record nothing about Alcmaeon in this
regard. Nor can we determine with certainty Croton’s constitution when
Alcmaeon was active, because his precise dating is a moot point. What is
beyond doubt is that Croton was not ruled by a king or tyrant in the first
half of the fifth century BC, apart from a short period in which a tyrant
named Cleinias appears to sway the polis (Dion. Hal. Ant. Rom. 20.7.1).
This is confirmed by the fact that Alcmaeon disapproves of the absolute
dominance by a single ruler, without being apprehensive for his own
safety. A reasonable assumption is that his medical theory was formulated
after the revolt against the Pythagorean oligarchy at the end of the sixth
century BC, which resulted in the establishment of a sort of democracy in

Raaflaub and Wallace, ‘People’s Power’, 143–5, 153. On the significance of Cleisthenes see
25

Lévêque and Vidal-Naquet, Clisthène l’Athénien.

884 STAVROS KOULOUMENTAS

Croton, but an earlier date cannot be excluded.26 The polarity between one-
man rule and egalitarianism may be just a mere analogy inspired by the dis-
putes over the possession of power in Magna Graecia which is adapted into a
medical context, without conveying any political implications:

the political image was an aid to the exposition of medical phenomena, and
this does not automatically mean that every feature of the image must corre-
spond to every aspect of the thing which is called in to explain.
(Ostwald, Nomos and the Beginnings, 100–1)

One may argue, on the other hand, that the connotations of the term isonomia
in the Alcmaeon lemma permit us to infer his commitment to an egalitarian con-
stitution, or at least an aversion to monarchy and tyranny. Living in a period of
political changes and strong debates, Alcmaeon would have had a keen interest
in public affairs and proposed his own view as to how the polis should be gov-
erned. In describing the state of the body, he notes that equality, a slogan which
was closely associated with democracy, designates a positive and desirable situ-
ation. When the egalitarian norms are breached, a negative and undesirable situ-
ation arises, which is also identified with a particular form of governing.
Inasmuch as the early Greek thinkers normally describe social and natural
phenomena as forming a unified whole governed by the same norms, it
would be unreasonable to assume that Alcmaeon thought that the best political
organization was one-man rule. His medical theory may be interpreted as pro-
pagating the belief that civic stability is a matter of equal distribution of power
between opposing factions or individuals. The polis flourishes when they have
matching honours, while disorder arises when one of them rules oppressively.
It is also significant to note that Alcmaeon postulates an indefinite number of
opposites in the body. His intention is not to enumerate or specify its chief citi-
zens, like most of the Hippocratic authors, but to stress the fact that each of them
has an opposite counterpart which can prevent it from exercising a dispropor-
tionate influence on their tiny state. This suggests that the body is depicted as
an open system composed of many peers who hold each other in check, and
so equality is not limited to some privileged members but is extended to all
its citizens, regardless of their respective features and variations in strength
and quantity. Seen from this perspective, Alcmaeon should have been in
favour of an egalitarian constitution, probably democracy itself.

CONCLUSIONS

According to Alcmaeon, the state of the body depends on how power is dis-
tributed among its opposing forces, which participate in its administration

Robinson, The First Democracies, 76–7; Fischer-Hansen, Nielsen, and Ampolo, ‘Italia and
26

Kampania’, 268.
 THE BODY AND THE POLIS 885

like the citizens of a polis whose antagonistic or collaborative tendencies

affect its functioning. The preponderance of one bodily constituent is
ascribed to constitutional factors and external causes that allow it to
prevail over the others, thus causing disease. It is unclear, however, how
the egalitarian distribution of shares, which results in health, was supposed
to function. The most likely interpretations are that there exists a kind of
equilibrium between pairs of opposites, in addition to the equilibrium
reached within each of them, and that the bodily constituents remain in a
state of permanent equilibrium.
Despite these controversies, we can conclude that Alcmaeon holds a pro-
minent position in the history of early Greek thought. He applies the Ionian
idea of the continuous strife and balanced interactions between opposites to
the microcosm and explains the state of the body in rational terms. The latter
is an organized whole which is examined by specifying its constituents, the
factors which determine its condition, and the relationship between its
members. The juxtaposition of different forms of governing not only illus-
trates the dynamics of this association, but also suggests that Alcmaeon
stands in stark contrast to the systems of earlier thinkers. The framework
of epic and lyric poetry, Greek and Near Eastern theology, and Ionian phil-
osophy is patterned on the monarchical constitutions of Mycenean and Near
Eastern kingdoms. The motif is normally the absolute authority of a ruler, the
omnipotence of a supreme god and his descendants, the excellence of the
aristocrats, and the supremacy of a cosmic entity or agent. Differences
based on age, lineage, rank, and power are stressed intentionally in order
to set up a socio-political, divine and cosmic hierarchy. For his part, Alc-
maeon envisages the predominace of a single ruler as constituting a threat
for the overall equilibrium and propagates an alternative form of governing,
one based on the equal status of opposing parties. Like his contemporary
Empedocles, Alcmaeon reflects the new spirit of egalitarianism which gradu-
ally became the very principle of democracy.

Submitted 21 February 2014; revised 20 September and 24 October;

accepted 28 October
Humboldt-Universität zu Berlin

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