The Traditional Mediterranean: Essays from the Ancient to the Early Modern Era Edited by Jayoung Che and

Nicholas C. J. Pappas ISBN: 978-960-9549-21-9, 386 pages First published in 2011 by ATINER Price: Paperback: 50! (It includes Shipping and Handling) Electronic copy: 30! Table of Contents Introduction & Acknowledgements J. Che & N. C. J. Pappas PART I: Anatolian and Near Eastern Themes A Phenomenon in the Hittite Religion: Reaching God by Burning Light in the Hearth I. Tas 2. Sympoliteia and Ethnicity in Caria J. LaBuff 3. The Demise of Jewish Historiography in the Second Temple Period A. Avidov PART II: Hellenic Themes 4. Eleusis and Athens: The Fexibility of Political Structure and Regional Links in the Ancient Greek Polis J. Che 5. Solon as Prophet and Diviner: Was the Athenian Mediator and Archon of 594 BC Inspired by Mania? M. Dillon 6. The Rhetorical Purpose of the Preface (1.1-1.5) of Herodotus Histories V. Provencal PART III: Hellenistic Themes 7. Did Alexander the Great Voluntarily Curtail his Conquest of the East? E. Anson 8. The Funerary Reliefs of Byzantium as a Sign of Greek Culture M. Puddu 9. The Crisis of 48 !.C. in Egypt E. G. Mohamed PART IV: Greco-Roman Themes 10. Sixty and Older: Some Preliminary Observations on Old Age in the Greco-Roman World R.B. Kebric 11. Spear Won Prize: An Analysis of the Romanization of the Histories of Alexander the Great A. Milwicki 12. Marketing the Liberal Arts in an Age of Ambition: The Metamorphosis and Survival of Platos Academy in the Last Generation of the Roman Republic D. Wick 13. The Anatomy of a 2nd Century Bath Reconstructing the 2nd Century Greco-Roman Bath at Isthmia, Greece W. J. Batson Jr. 14. Astronomy, Medicine, and Galen: The Beginnings of Empirical Science G. Cooper PART V: Roman Social and Political Themes 15. Alcohol, Sex, and Slavery in the Roman World J. Evans 16. Sua Sponte Facere : The Problem of Legitimacy of the Unauthorized Contiones in Rome under the Republic R. M. Frolov 17. The Imperial Cult in the Roman Province of Thrace P. Andreeva Andreeva 18. Imperial Representation in the Western-Roman Empire K. Aladar PART VI: Islamic and Byzantine Themes 19. Daily Life and Districts of the Jews in Hijaz on the Advent of Islam F. Ahmadvand & A. A. Tafreshi 20. Evidence from Khalifa Ibn Khayyat on the Political Relations between the Umayyad Caliphate and Byzantium N. Gelovani 21. A Note on the Policy of the Abbasid Caliphs towards Non-Muslims H. Al-Haideri 22. What did the Ambassadors Really See? Literary and Historical Sources for a Comparative Approach of Arabic and Byzantine Technology C. Canavas PART VII: Medieval and Early Modern Themes 23. The Teaching on the Soul in Cassiodorus, Augustine and Macrobius in the Aspect of Intellectual History P. Petroff 24. Church and Superstitions in Italy at the End of the 15th Century: The Case of Bernardino Busti, Franciscan Observant F. Conti 25. The Maritime Vocation of a Mediterranean City: Messinese Dockyards in the Early Modern Age C. Gugliuzzo 26. Bernal Daz del Castillo and Diego Surez Montas: Two Soldier-Chroniclers of The Spanish Empire Y. Mikura 27. Eyewitnesses to Revolution: Western Accounts of the Ottoman Military during the Early Modern Era E. Myers 28. Medical Therapeutic Texts during the Ottoman Rule of Greece S. Oberhelman PART VII: The Legacy of the Traditional Mediterranean in Later Eras 29. From Pandoras Box to the Agora: The Problem of Thumos and the Female 1. 1

11 21 35

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263 273 283 291 301 315

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R. Almeida 30. Eros and the Sacred in the Mediterranean K. Frantzi 31. Making Sense of the Multilayered past: An Interactive Visual Interpretation of the Athenian Acropolis and the Parthenon J. Mihova 32 The Greek Perspective in the Context of the Mediterranean Spatial Organizations M. Urm! List of Contributors to this Volume

341 353 369 383

Paper Title: Astronomy, Medicine, and Galen: The Beginnings of Empirical Science First Name: Glen Middle: M. Family Name: Cooper Position and Affiliation: Assistant Professor of History at Brigham Young University, Provo, Utah, 84602 USA e-mail: glen_cooper@byu.edu Abstract: Part of the Greek miracle of the birth of science was to realize the importance of scientific theory, of which the ancient Greeks were prolific generators. Astronomy provides a clear-cut example of the Platonic research program of saving the appearances: a quintessentially well-behaved data set, and straightforward models to describe its behavior. What required a longer period and much more effort to develop was how to deal with the far more complex entities of the sublunary world of change. Here, beginning with a simple background theory, the scientist had to show what to do when the data fail to conform to that theory. Physicians, especially Galen, who were most familiar with complex data, derived elegant methods to do this, which had significant consequences for the subsequent development of science. Galens little studied treatises, The Critical Days and The Crises, provide rare examples of an ancient scientist working out a theory from empirical data. In this case the simple background theory was derived from: 1) the Stoic notion of cosmic harmony, 2) the theoretical scheme of the Hippocratic critical days, and 3) the supposed effects of the lunar phases. Galen shows why some of the data dont conform, how even a slight departure from proper treatment throws off the natural harmony. In this paper, I discuss the details of Galens efforts, and place his work in the context of the history of scientific theory-making. My remarks are derived from extensive and close study of these texts, in both Greek and Arabic.

Astronomy, Medicine, and Galen: The Beginnings of Empirical Science1 This paper addresses a paradox from the history of ancient Greek science. I shall contrast the approaches to data of astronomy on the one hand, and medicine on the other. The exact sciences of astronomy and mathematics are sometimes called the highest intellectual achievements of mankind. Yet, their very exactness entailed that they were disconnected from empirical data, which today we recognize as essential for a proper scientific theory about the disorderly world we actually live in. They dealt, rather, with idealized situations: perfect spheres, unchanging ethereal realities, etc. Medicine, however, dealt in an intimate way with chaotic data, as it faced urgent cases of life and death. As I shall argue, the honor of being the first truly empirical science should go to medicine, with the 2nd Century Greek physician Galen (d.c. 216) as its most accomplished representative. The crux of the paradox is that astronomy, through its complex mathematics, emphasizes the rational aspects of science, which are more stable than messy empirical data, and thus less likely to reflect the actual world. Greek science went through centuries of debate as to the correct approach to science, whether on the one hand wholly rational, or, on the other, to eschew theory completely, adhering strictly to the data of experience.2 This debate was motivated partly in response to the rise of skepticism as a school of thought. Galen, however, understood that scientific theory must combine empirical data (and lots of it) with a sound rational and theoretical approach. His ideal of a theoretical empirical science is illustrated in his treatise The Critical Days in which he explains the natural causes behind the Hippocratic prognostic scheme that was used in patients with fevers. I have studied this treatise extensively in Greek and Arabic, and have prepared editions of each soon to appear in publication.3 I shall proceed by giving a brief background to the paradox, and then spend the remainder of this paper on Galens scientific method. In this treatise Galen resolves a major schism in medical science among his predecessors: some, the Rationalists, downplayed or ignored empirical data entirely. Others, the Empiricists, held that all theory is misleading, and that the physician must only observe and respond to the immediate needs of the patient, basing his approach on other similar cases that he has seen in the past. By writing the DD, Galen puts into practice his theoretical discussion and refutation of both schools of thought as found in the On Medical Experience.4 Theoretical astronomy had its origin in the intellectual ferment that occurred in Fourth Century Athens. The Athenian rationalist philosopher Plato (d.347 B.C.), as part of his path-breaking rational approach to understanding our
1 2

Presented at ATINER Conference on History, Athens, Greece, December 30, 2008. See Introduction to: Galen. Three Treatises on the Nature of Science. Translated by Richard Walzer and Michael Frede. Indianapolis, IN: Hackett Publishing Company, 1985. 3 Arabic and Greek editions (forthcoming, two volumes): Glen M. Cooper, Galens Critical Days in the Graeco-Arabic Tradition, London, Ashgate. The Greek may be found in: C. G. Khn, Galeni Opera Omnia, Leipzig, (1825), vol. 9, pp. 769-941. 4 Galen, and Richard Walzer. Galen on Medical Experience: First Edition of the Arabic Version with English Translation and Notes. Oxford: Oxford, 1947.

world, gave his students at the Academy a challenging problem. The wandering planets appear to obey different laws from the fixed stars, whose motions are uniform and spherical. So, he urged his students to find the hidden factors that would account for these anomalous motions, or in Procluss terms (d. 485 A.D.), the mechanisms that would save the appearances (!"#$% & '($%)#%().1 The solution of this problem led to one of the greatest scientific research programs of all time, as Eudoxus (d.c. 347 B.C.), Hipparchus (d.c. 120 B.C.), and Ptolemy (d.c. 168 A.D.) each undertook the challenge, and the project culminated in Ptolemys hugely influential Mathematike Syntaxis, (better known as the Almagest).2 Plato, however, was not really interested in empirical data. In a revealing passage from the Republic where he discusses astronomy as an excellent discipline to train the intellect, he states that astronomy is to be studied through geometry, and the best way is to ignore the actual stars, since they confuse matters.3 Plato was interested, rather, in the eternal and unchanging basis for the phenomena in our world of change. By our way of thinking, this is an infelicitous approach to science. Greek astronomers thus employed idealized geometrical figures and uniform motions as they tried to explain the apparent wandering of the planets from simple motions.4 The Almagest of the second Century Alexandrian Greek astronomer Ptolemy represents the climax of ancient Greek astronomy. A typical model for one of the upper planets, Mars, Jupiter, and Saturn, geometrically beautiful, includes several spheres rotating uniformly at different rates, with the combined motion producing the motion of the planet. One of the drawbacks of astronomy in this tradition was that it was the servant of astrology, and that Ptolemys models for the planets motions were used merely as calculating tools to derive tables that astrologers could use without ever needing to look at the skies. Ptolemy himself characterizes his work in this way, which comprises two volumes: he explicitly states that volume 1, the Almagest, is the calculating tool for preparing astrological charts, and that volume 2, the Tetrabiblos, was the handbook for astrological interpretation. So, an astrologer would calculate the planetary positions without observation for any desired moment, and plot them on a star chart. The typical astrologers chart has twelve spaces around a circle, each space representing one of the Signs of the Zodiac. The astrologer determined the position of each planet at a given moment and plotted it on this grid. Astrology, or applied astronomy, didnt require observation, only the ability to add and subtract. The tables generated by using the Almagest were simple enough to prepare such tables. So, the paradox is as follows. Astronomical observation was used to derive a mathematical model, and the model was then used to predict planetary positions at any future point in time. This means that the original data was no longer needed. Refinements to Ptolemys system came about eventually in the
1 2

Cf. Lloyd, G. E. R. "Saving the Appearances." Classical Quarterly n.s. 28 (1978): 202-22. Ptolemy. Ptolemy's Almagest. Translated by G. J. Toomer. Princeton, NJ: Princeton University Press, 1998. 3 Republic 530b-c. 4 The Greek word planetes from which planet is derived, means wanderer.

Islamic world, not because his models gave inaccurate predictions, but because they suggested features of the universe that are physically impossible, such as the notorious equant point, which requires spheres to rotate about their own centers, but with uniform speed measured from another point, the equant. The modern approach to theory and data, known as the hypotheticodeductive model, is usually thought to be a discovery of the European Scientific Revolution of the 17th C associated with Isaac Newton.1 According to this approach, not only is a model derived from the data, but further data is used to evaluate the model and to refine it, as a matter of course, since the theory must conform to the data, and not vice versa. In essence, empirical data was now given priority over theory. However, it is worth noting that the physician Galen already in the 2nd Century was using much of this approach. The key difference between the Platonic and Galenic approaches to the data is that Galen urged a constant return to obtain new data from the patient that is required in medical treatment. The stars and planets are comparatively stable; a patients condition is not: significant changes can occur in a short time, and so the physician must observe the patient as frequently as possible, and respond accordingly. A fourday period provided the standard for observation: this allowed enough time to pass for there to be a change in the patient, but not so much that a change couldnt be responded to. Galen was the most famous and influential Greek physician of antiquity. His treatise on the Critical Days contains a surprisingly sophisticated approach to the analysis of data and the construction of scientific theory.2 Its most important feature is that Galen shows how the physician must return to the patients case, to fine-tune his prognosis and adjust his treatment. (This is in contrast to the method of the astronomers). In describing the Galenic synthesis of reason and experience I shall proceed first by defining the critical days, and then by following the steps of Galens advanced scientific method. The critical days are a regular pattern of days on which to expect a dramatic turn of the illness, called a crisis (judgment). The crisis has symptoms similar to a malarial attack, with violent shivering, severe vomiting, or other harsh symptoms. This pattern of days was used for prognosis in illnesses with fevers (because of their periodic recurrence). The critical days seem to work as a prognostic tool, but Galen wants to explain them, and thus to gain greater insight into how they can be made to serve the healing profession. One of the first steps in deriving a scientific theory from data is to notice an anomaly, something that cries out for an explanation. In this case, Galen has wondered since his youth why the significant period of weeks in patients is 3 weeks of 20 days, and not 21 days. Furthermore, the Hippocratic writings suggest that the critical days must be counted in terms of fractional days, but they do not specify what those fractions are. Lastly, there must be an underlying pattern, because the crises
1

See: Burtt, E. A. The Metaphysical Foundations of Modern Physical Science: The Scientific Thinking of Copernicus, Galileo, Newton and Their Contemporaries. Amherst, NY, 1999. 2 Cooper, Glen M. "Numbers, Prognosis, and Healing: Galen on Medical Theory." Journal of the Washington Academy of Sciences 90, no. 2 (2004): 45-60.

occur on some days more frequently than others, and on days 7, 14, and 20 most of all. The next step is to obtain a set of reliable data. Galen decides to use the data of the Epidemics, because everyone agrees that they are valid (even though theyre already nearly 6 centuries old in Galens day). At least no one could accuse Galen of selecting data from his own experience to favor his theory. But even the Epidemics data is too messy in its raw form to be useful as a basis on which to build a theory. So, this data must be reduced to a workable subset. Galen shows his sophisticated scientific understanding by postulating the existence of secondary causes that frustrate or perturb the general tendency of data. These secondary causes enable him to eliminate the outliers. In an ideal situation, if the patient were isolated from external factors that cause him anxiety and restlessness, such as fire, robbery, torrential thunderstorms and leaky roofs, quarreling neighbors and barking dogs,1 and furthermore, if he is under the exclusive care of a physician of Galens caliber, and not being treated by incompetent but well-meaning loved-ones, then the patients crises will occur according to the perfect scheme of the critical days. These secondary factors, however, exhaust the patient, making the crises comes too early or too late. Galen proposes a scientific hypothesis: that the moon, via its phases, is the cause of the pattern of the critical days. The lunar period seems to approximate the major cycle of the critical days closely, especially if one considers the lunar seasons, that is one fourth of the month, that are about one normal week in length. It was obvious to the Ancients that the Sun and Moon affected life on earth in major ways. This correlation was the basis of ancient scientific astrology. The Sun is the cause of the seasons, and is the ultimate cause of life (and death). The Moon, on the other hand, causes the tides, menstruationand by extension, affects all bodily fluids or humors. Thus, the Moon causes, among other things, fruit to ripen, corpses to putrefy, epileptics to have fits, and people to go crazy (lunatics) if exposed to too much moonlight. In sum, the Moon moderates and extends the general effects of the Sun. The moon has two periods, one of 27 1/3 days, and the other, the familiar month, is about 29 * days. How are these to be reconciled? Galen argues that during the latter period, around the time of the new moon, the moon has too little light to be effective, so he subtracts 3 days, leaving 26 * effective days. By taking an average of these two periods and dividing by 4, he arrives at the desired answer, which turns out to be 6 35/48 days. The result accords well with the data: three weeks are 20 3/16 days, and the other major critical days can be generated from this period. Thus, Galens youthful question about the three medical week period of twenty days is answered, and the other two conditions for the pattern of the critical days are satisfied. Does Galen stop there? This is the point where the ancient astronomer would stop, since he has derived the model and the means to make predictions. No, Galen returns to the data to show in greater detail why some cases deviate from the general pattern of critical days. His purpose here is to enable the
1

825.17-826.3. Note: References to the Critical Days is to C. G. Khns Galen edition, volume 9, and indicates page and line number.

physician to use this prognostic scheme by constantly comparing the ideal with the actual, and adjusting treatment as necessary to give the patient the best fighting chance for recovery. Perhaps because periodic fevers were so common in his day, Galen devoted several treatises or parts of treatises to their treatment. The very periodicity of such fevers, and the dangerous possibility of a crisis, were an invitation to develop a sophisticated prognostic scheme. Galen inherited one such scheme, the critical days, from the Hippocratics, which he refined for his own use. Galen devoted two treatises to the discussion of crises and critical days, the De crisibus (On [Medical] Crises) and the De diebus decretoriis (On the Critical Days), which I have already mentioned. The treatises Crises and the Critical Days were composed by Galen around 165 AD at the request of friends who desired a reasoned account of the Hippocratic prognostic doctrine of the critical days. Although these two books focused primarily on the diagnosis and prognosis of crises, Galen had important things to say about therapy alsoand therapy is what most distinguishes the science of astronomy from medicine. When treating critical illnesses, specific therapies come into play in relation to the periodic time scheme. The crisis is an often violent response of the body to the illnessproducing substance inside it, and a crisis was thought to be necessary in order to expel this substance. Therefore, the physician needed to monitor the patients stamina closely, and to adjust his therapy to give the patient the best chance of surviving the crisis. Periodic fevers had regular peaks of intensity known as paroxysms. The crisis usually occurred during one of these peaks and here is the secret of their prognosis: figure out the periodicity of the fever and you have a big clue as to when to expect a crisis. If, however, the crisis occurred off the natural period of the fever, then it was likely to be a bad crisis. The critical day scheme seems to be a generalization based on the most common types of periodic fevers. The closest modern analogy to the paroxysms that I know of are the peak attacks experienced by a malaria victim. A crisis would be an especially violent paroxysm, which resulted (usually) in either the death or the recovery of the patient. The opening lines of the Critical Days stress the close relationship between diagnosis, prognosis, and therapy in critical illnesses. (I quote from my own edition of the Arabic version; I could also read from the Greek, but the Arabic is clearer): 769.1 In order for the resolution of illnesses that do not diminish gradually, but that subside all at once to be trustworthy, there must occur beforehand either an obvious bodily evacuation, or an evident inflammation, because the illnesses that subside without one of these two things usually return. 769.5 Therefore, you must observe this thoroughly with extreme care, so that when you see that the illness has abated without one of these two things occurring before it subsides, then you must keep the patient under close observation and careful watch, and you must not permit him to do anything that is permitted to one whose recovery is trustworthy, neither food, nor drink, nor bathing, nor movement, nor anything else. 769.9 For in truth, if this abating illness is

trivial, [k.770] and, moreover, you administer this treatment to the patient, then he will likely recover from it completely, so that it will never return. But if the illness is severe, then it will return even if you administer this treatment to the patient, but it will not return with severity and great danger. 769.14 But if you ignore and neglect him as if he has genuinely recovered, then it will return more severe than it was in the beginning. The physician therefore must watch for signs that the illness has transformed in the required manner in order to be confident that the illness has in fact passed. For, if the signs do not appear, then the illness remains, and the therapy must be adjusted accordingly. The patient may not be released from his strict regimen until the physician is reasonably certain that he will in fact recover. Otherwise, the illness remains, and if the patient has survived at all, he must experience another crisis before he recovers. The prognosis of a crisis and the adjustment of treatment were crucial in critical illnesses, because a crisis, which is the expulsion of harmful material from the body that was thought to be causing the illness, could be dangerous. Crises occur through a violent motion in the body, sometimes manifest as rigor, vomiting, excessive sweating, nosebleed, etc. A crisis also represents the turning point of an illness, after which the patient is thought either to recover or to relapse. Crises were thought to occur more frequently on specific days, known as the critical days. These critical days were derived from an idiosyncratic way of counting four and seven day periods, described in The Critical Days. In fact, if there were no intervening factors, crises would invariably occur on these days, for as Galen argued in The Critical Days, the sequence of the critical days is caused by the lunar phases. The crisis may be observed via its effects on the body, which are discussed in great detail in the Crises. But to know whether a complete or trustworthy crisis has occurred, one must be able to say that the harmful substance has actually been neutralized by the body (usually through a process of coction or cooking). Since one cannot peer directly into the body, the signs of coction are sought in the secretions of the three major organ regions: the head (via nasal secretions), the respiratory (via the sputums), the abdominal organs (via urines and excrements). Sweating was also a vehicle for the expulsion of the illness. One sought evidence of a coalescence in these fluids: e.g. a runny nose does not represent coctionhence a complete crisisuntil it produces a more solid green matter. Or, not clear urine, but urine with a heavy sediment indicates a coction, as do solid rather than runny stools. Thus, the crisis is identified on the basis of specific signs in the patient, which means that the physician must become skilled at identifying these signs and interpreting them. In the course of his exposition, Galen describes in great detail the different kinds of secretions, which taught me more descriptive Greek words for sputums and excrements than I care to know! Theres even a shorthand method that reveals a (somewhat dubious) physiology: Galen states that the nostrils are connected to the organs of the body in such a way that a nosebleed from the right nostril indicates a crisis in the liver and the organs under the

right hypochondrium, while one from the left nostril indicates a crisis in the left abdomen, namely, the spleen and the organs near it. Crises are used for diagnosis and prognosis. They also can be used to indicate recovery or coming death. The physicians job is to know when to expect the next crisis, to ascertain its character, and to prepare the patient through therapy to face it. (Crises can be devastating). For example, suppose that crises are expected on days seven, fourteen, and twenty of the illness, and days four, eleven, and seventeen indicate the character of the approaching crisis, which is the normal pattern. If the physician determines that a crisis will come in the seventh day, he will use clues from the fourth day as to its character to adjust the patients regimen to strengthen, or at least not to overtax, the patient. Furthermore, crises have a specific temporal profilea kind of wave-formthat can, as a template, be laid over the patients case to aid in deriving both short-term and long-term prognoses, and which was critical in adjusting treatment. Every crisis, Galen claims, has four cardinal points: beginning, increase, climax, and post-climax. Much of the Crises is spent describing the various configurations of these points, how to recognize them and how to place them in specific patients cases. The Critical Days graphically shows how regimen factors into critical illnesses in another way: incorrect therapy not only can harm the patient, but it can also throw off the prognostic basis of the critical days. This happens, Galen explains, because the patients body is weakened by poor therapy, so that not only does the patient risk not being able to survive the next crisis, but, because the patient and the cosmos are so closely connected, the very scheme of the critical days is disturbed. This is why Galen states that he can guarantee that the critical day scheme will work for prognosis confidently only if he (Galen) has had exclusive control over the patients treatment from the beginning (sure!).1 The critical day scheme can also indicate whether the expected crisis will be dangerous or not.2 Knowledge of the critical day scheme is very useful for therapy since it enables the physician to infer the character of the coming crisis, and to adjust therapy, which is to say that, if he knows that the coming crisis will be a bad one, the physician will not change the patients diet as if hes already well on the path to recovery; and by the same token, if the physician knows that the coming crisis will be a safe and healthy one, he can anticipate this for maximum effect, by adjusting the patients diet to a milder form.3 In another example, a trustworthy crisis necessitates altering treatments. Galen states that:4 If the signs indicate that the crisis is trustworthy, the patient must be permitted to sweat freely (instead of measures being taken to lessen the sweats), and he should be given food, increasing it gradually. As in all patients cases, specific treatments are not to be applied unthinkingly, without rational consideration of all relevant factors in a specific

1 2

See also 825.6-825.17. From 784.1. 3 See also 869.10. 4 See 802.8.

patients case.1 In one place, Galen denounced those who let blood in all cases, simply because thats what a physician is expected to do: whoever heard of a doctor who doesnt open a vein? In another place, Galen criticized those who, as it were, play at medicine, making a show of certain procedures that are expected of a doctor, such as lifting his garment, tightening his waist, applying bandages or hot compresses, applying cautery or bleeding or cupping glasses or massage.2 Some physicians do these things, not because the patients case requires them, but because they think that theyre not practicing medicine unless they make a show of these standard treatments. No doubt Galen would have similar condemnation for later physicians who sought to provoke an artificial crisis through administering a compound of mercury. This practice, and the excessive letting of blood, gave Galenism a bad name. How close Galens assessment of his contemporary physicians is to the truth is suspect, however, given his present rhetorical purpose, which is to emphasize rational thought in treatment at the expense of other doctors. All of these specific treatments are, of course, valid when appropriately appliedbut thats not how theyre being imagined here. In the treatment of periodic illnesses as in all others, Galens ideal physician employs reasoning in conjunction with a healthy conception of Nature. Galen states his philosophy of medicine,3 which is partly Hippocratic and partly his own, but is one that weve inherited, which is: that Nature has its own periods and internal harmonies4, but she (and I deliberately personify Nature, as Galen did) needs to be helped by the physicians skillful application of scientific treatments. Knowing which therapy to apply in a specific case is the difference between a real physician and a roadside drug peddler, (or a wool combing amateur like Thessalus, the founder of medical Methodism), for a true physician is a servant of nature, and understands enough of natural philosophy in the tradition of Plato and Aristotle to be able to infer the proper course of treatment. (Hence, the connection between the words physician and the Greek word for Nature, physis. For the critical day scheme to work in healing, the physician must not only be able to prognosticate from it, but he must be skilled in therapy.5 Furthermore, the difference between a good physician and a great one like Galen (at least by his own account) is that he must be able to account for others mistakes in treatment. That is to say, a physician must be able, when called in after other doctors have botched a case, to ascertain the degree of damage theyve committed, or what the patients have done to harm themselves by not obeying their doctors, and he must be able to adjust their prognoses (and thus also their treatments) accordingly. Galen delighted (according to his selfpromoting treatise On Prognosis) in showing other doctors up by making a very public display of his ability to do this. In conclusion, Galen represents the great synthesis of rationality and empiricism for the Greek scientific tradition. Not even his older contemporary,
1 2

See 804.6. See 822.8. 3 See 822.18-823.7. 4 cf. Greek harmonic theory. 5 See 830.7-830.12.

the great astronomer Ptolemy, could make this claim. Ptolemy does draw near, however, to the level of Galens achievement when he discusses music theory, a discipline that depends very closely on personal experience, through hearing the musical tones and their harmonic relationships.1 The true role of ancient Greek medical empiricism in the development of scientific thinking is only beginning to be appreciated.

Solomon, Jon. Ptolemy Harmonics: Translation and Commentary. Leiden, Boston, Kln: Brill, 2000. See also: Barker, Andrew. Scientific Method in Ptolemy's Harmonics. Cambridge: Cambridge University Press, 2000.