ASPECTS OF THE INTERRELATIONS OF MEDICINE, MAGIC AND PHILOSOPHY IN

ANCIENT GREECE
Author(s): G.E.R. Lloyd
Source: Apeiron: A Journal for Ancient Philosophy and Science , May 1975, Vol. 9, No. 1
(May 1975), pp. 1-16

Stable URL: https://www.jstor.org/stable/40913353

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 ASPECTS OF THE INTERRELATIONS OF MEDICINE, MAGIC AND PHILOSOPHY IN ANCIENT GREECE.1

The status of medicine, advisedly defined in the Shorter Oxford English Dictionary as
both a science and an art, is an ambivalent one. Although it calls on the natural
sciences of physiology, anatomy, chemistry, biochemistry and so on, unlike them it has prac-
tical, as well as theoretical, ends in view, the alleviation and cure of disease and the
preservation and restoration of health. Being practical, it is concerned with the indivi-
dual. It studies health and disease in general, to be sure, but, as Aristotle put it in a
well-known passage, it considers not just the health of man in general, but the health of
this man: xaS* ixaaiov yap uaTpe'5eu. Yet although medicine stands to the life sciences in
a similar relationship as engineering, for instance, to some of the physical »ones , it is at
the same time unlike engineering, in turn, in that the end of medicine, health, and its con-
verse, disease, are, in important respects, matters of dispute. One finds, of course,
4
large areas of agreement, among doctors trained in the same tradition, concerning many
types of diseases at least on this point that they are diseases. But it is not only in
the field of mental health and mental illness that there remain important areas of doubt
concerning what are to be deemed abnormal or pathological conditions and concerning how,
conversely and by exclusion, health is to be defined.
But that is not the only, nor for my purposes the most important, aspect of the ambi-
valent status of medicine. In much of modern medicine treatment and diagnosis have a firm
and definite basis in one or other well-established department of the natural sciences. Mot
only the chemical composition of a particular drug, but its precise effect on the organism,
may be known, as also may the causes of a disease: thus, to take an example relevant to the
study of ancient medicine, we can nowadays distinguish unambiguously between malaria
(caused by a parasite hosted by the anopheles mosquito) , and typhoid fever (caused by a
bacillus), although both diseases may show very similar symptoms. It remains true, how-
ever, that in many cases the doctor cannot be said to possess anything that can be des-
cribed as hard-edged scientific knowledge. In their efforts to combat diseases, doctors
have always used, and will no doubt always continue to use, empirical treatments, that is
treatments which are claimed, on the basis of experience, to be efficacious, but whose
effects are not fully understood. This is so not only where little is known concerning the
side-effects of a treatment (where the Thalidomide disaster was merely one particularly
well-publicised and particularly terrible example of an all too common problem) but also
where we do not understand exactly how the specific effects that a treatment produces are
brought about. Again when we reflect that any therapy involves not just a remedy pre-
scribed, but also a patient treated, and that, even if we cannot define precisely what
effect a patient's own beliefs and expectations may have, it is clear from the study of the
use of placebos that they may have a not inconsiderable effect, this introduces yet another
element of indeterminacy in many attempted cures.
For these and other reasons, the relations between the strictly 'scientific1, and
other, elements in modern medicine are complex, and it should be acknowledged (even if some
members of the medical profession are not very ready to do so) that large areas of 20th

Apeiron Vol. IX (1975) No. 1

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century European medicine have no stronger claims to be 'scientific' than folk medicine. In-
deed when we discount the use of the term 'folk medicine* as a mere term of abuse, to convey
an adverse value judgement, the difficulty of arriving at a simple criterion to distinguish
between it and modern medicine reveals the point I wish to make. Obviously the two cannot
be differentiated merely operationally, that is in terms of their effects (for many folk
remedies are efficacious) ; nor can they by the presence or absence of a theoretical frame-
work (for folk medical beliefs often form part of elaborate and highly systematic doctrines);
nor even by their methods of verification, at least not straightforwardly since folk rem-
edies are often the fruit of, and checked by, deliberate trial and error procedures, if not
controlled experiments; nor finally can we be content with a purely sociological different-
iation. The distinction must rest on a combination of factors, and perhaps principally
on the possibility of an ultimate appeal to a body of positive knowledge - that is, as I
put it before, that the modern doctor can call on the natural sciences. But the unsatis-
factory nature of this distinction is obvious. First it is as an ultimate, and not im-
mediate, appeal that this criterion will operate. Secondly there is a major difficulty in
determining what is to count as 'positive knowledge1, for what is accepted as such will al-
ways include views that are later rejected or found to need qualification. Thirdly and
most importantly, such a criterion will still distinguish only a part, not the whole, of
modern medicine from folk medicine. The overlap between the two, or the area where no
firm or neat criterion can be appealed to, is large.
At the risk of labouring this point, let me give two brief anecdotal illustrations of
o

the interpénétration of folk and scientific beliefs in the 20th century. I had occasion
to verify the persistence of beliefs in the importance of the distinction between right and
left at the birth of my second son, who was delivered by a fully qualified midwife in Cam-
bridge in 1962. I was present at the birth, which was in my own home, and was surprised
when a little while before the birth took place the midwife announced that the baby would
be a boy. When I asked her afterwards on what basis she had said this, she replied that
the baby was on the right side of the womb and that it was usually a boy when the baby is
9
on the right. That idea, as I have indicated elsewhere, can be traced right back to Parm-
enides and was undoubtedly far older than him. Some association between males and right,
whether the right side of the womb, or the right breast, or the right testicle, or the
right eye, is extremely common in ancient Greece as in many modern societies. Where you
have the usual associations reversed, as with the Chinese, who consider the left to be Yang
and strong, the right to be Yin and weak, you also find the belief that babies on the left
are more likely to be males, an exception that for once does prove the rule. Yet evident-
ly similar beliefs may coexist with the best modern training in midwifery.
But midwives, it might be thought, are peripheral figures, not full members of the med-
ical profession. My second example comes from no less an authority that Osier, whose Prin-
ciples and Practice of Medicine was for long one of the chief text-books from which medical
students learned their clinical medicine. Osier is a mine of information for the persist-
ence, well into the 20th century, of medical beliefs many of which originated in antiquity.
One such case concerns an application of the notion of critical dfiys to pneumonia. Now-
adays, when high fevers in what the Greeks called 'acute diseases' are controlled by anti-
biotics, it is rare for a case of pneumonia to reach a crisis. But before antibiotics
were introduced, physicians had to content themselves with observing the course of the con-
dition and using their knowledge of the periodicity of the disease to make their patients
2

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as comfortable as possible. But they firmly believed, or at least they were firmly taught,
that the crisis in pneumonia is more likely to occur on the uneven days. In the latest ed-
ition of Osier's book we read: 'from the time of Hippocrates (the crisis in pneumonia) has
been thought to be more frequent on the uneven days, particularly the fifth and seventh; the
latter has the largest number of cases (Musser and Norris) . ' Theories based on a dist-
inction between odd and even days again have a very long history and this pair of opposites
too (like right and left, up and down, front and back and many others) figures in many con-
texts in Greek philosophical and medical doctrines. Now I am not questioning the evidence
brought by Drs . Musser and Norris to support their view: rather the important point is
that they chose to investigate an application of a general schema which itself is part of a
complex of beliefs with ramifications that spread far beyond even the most hospitable def-
inition of 'the art of medicine.'

These have been lengthy, but necessary, preliminaries to the topic I wish to discuss in
this paper, namely the relations between medicine, magic and philosophy (that is systematic
natural philosophy) in ancient Greece. The Greek material is particularly important for
the light it throws on the very first attempts to place medicine on a scientific basis and
to distinguish medicine explicitly from magic. Unfortunately, however, the analysis of
the development of Greek medicine has been bedevilled by a number of preconceptions and the
use of over-simple categories. Thus W.H.S. Jones on several occasions insisted on radical,
indeed one might almost say absolute, distinctions between medicine and folk-belief and
superstition on the one hand, and between medicine and philosophy on the other. In the
introduction (p. xiv) to the first volume of his Loeb edition of Hippocrates (1923) he
wrote: 'Now if we take the Hippocratic collection we find that in no treatise is there any
superstition [at that point there is a footnote: 'a possible exception is Decorum ...'I, in
many there is much "philosophy" with some sophistic rhetoric, and among the others some are
merely technical handbooks, while others show signs of a great mind, dignified and reserved
with all the severity of the Periclean period, which, without being distinctively original,
transformed the best tendencies in Greek medicine into something which has ever since been
the admiration of doctors and scientific men.' Elsewhere Jones wrote: 'Superstition was
rampant in the ancient world, and even doctors were infected by the taint. It is true
that there is no superstition in the Hippocratic collection, but it is attacked in two
treatises. This attack implies that superstition was still a real danger ... But the worst
enemy of rational medicine lay in its connections with philosophy and rhetoric . . . Medical
practice must not be based upon speculation, which, though it has its place in the progress
of medicine, must be put to the test, not in ordinary practice, but on and by "martyrs to
science".' Jones thus drew hard and fast distinctions between (1) 'superstition1, (2)
medicine and (3) philosophy. Medicine had to combat both superstition and philosophy and
was, in Jones' view, largely successful in doing so and in freeing itself from both kinds
of contaminating influence.
Now this is a subject on which we do not need to rely on pure speculation. It is not
a question of guessing, nor one of working out on a priori principles what the relationship
between these three factors must have been, since we have evidence on the problem. Even
if this is not as extensive as we might wish, we must first see how far it will take us.
Two texts are particularly instructive, the treatises On the Sacred Disease and On Ancient

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 14
Medicine, especially the former.
At first sight On the Sacred Disease appears to provide solid support for Jones1 positiv-
ist interpretation according to which what the Hippocratic doctors achieved was the refut-
ation of superstition and the substitution of rational or scientific medicine. At the very
beginning of the work the writer says: 'I am about to discuss the disease called
"sacred". It is not, in my opinion, any more divine or more sacred than other diseases,
but has a natural cause (cpúauv .. mc¿l updcpaauv) , and its supposed divine origin is due to
men's inexperience, and to their wonder at its peculiar character.1 Shortly afterwards
(ch. 2 Jones = ch. 1 Littré VI 354 12 ff.) the writer says: 'my own view is that those who
first attributed a sacred character to this malady were like the magicians (ydtyou) , purif-
iers (xaSápxau) , charlatans (ayupxau) and quacks (àXaçóves) of our own day, men who claim
great piety and superior knowledge. Being at a loss, and having no treatment which would
18
help, they concealed and sheltered themselves behind superstition, and called this ill-
19
ness sacred, in order that their utter ignorance might not be manifest.'
The author's criticisms of his opponents can be divided into three main kinds: he ac-
cuses them (1) of inconsistency, (2) of impiety and (3) of dishonesty. As an example of
the first type of criticism, he argues at VI 352 8ff. that if this disease is considered
divine because it is wonderful, then many other diseases too, which are just as amazing,
should be considered sacred, whereas this is not the case. More tellingly, he argues that
the treatments his opponents use imply that they can control the disease and that this in
turn implies that the disease is not divine. As he puts it at 358 Uff., 'he who by puri-
fications and magic can take away such an affection can also by similar means bring it on,
so that by this argument the action of godhead is disproved. ' Again he attacks certain of
their prohibitions in a passage that implies an argument of the type that later came to be
known as modus tollerisi if A, then B; but not B; therefore not A. The quacks forbade eat-
ing the flesh of goats or lying on or wearing goatskins. 'So I suppose,1 the writer says
(VI 356 15ff.), 'that no Libyan dwelling in the interior can enjoy good health, since they
lie on goat-skins and eat goats' flesh, possessing neither coverlet nor cloak nor footgear
that is not from the goat. ' And he continues with an argument similar to that at 358 Uff:
'but if to eat or apply these things engenders and increases the disease, while to refrain
works a cure, then neither is godhead to blame nor are the purifications beneficial: it is
the foods that cure or hurt, and the power of godhead disappears.'
But apart from attacking the consistency of his opponents' position, he also carries
the fight into their camp, so to speak, by criticising their notion of the divine. The
main argument here is that it is positively impious to suggest that a god would pollute any-
thing. At 362 16ff., for instance, he remarks: 'however, I hold that a man's body is not
defiled by a god, the one being utterly corrupt the other perfectly holy.' Again at 358
16ff. he argues that 'their discussions show, not piety (eúaeBeun) , as they think, but im-
piety rather, implying that the gods do not exist, and what they call piety and the divine
is, as I shall prove, impious and unholy.'
Finally he accuses them of dishonesty. They do not in fact know what causes the so-
called sacred disease, and they do not know how to treat it correctly. They conceal their
ignorance with talk of the divine 'in order that their utter ignorance might not be mani-

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fest.1 (354 17) 'By these sayings and devices they claim superior knowledge, and deceive
men by prescribing for them purifications and cleansings, most of their talk turning on the
intervention of gods and spirits (xò ôcxluóvlov) ' (358 13ff.). As for their motive, he goes
on to identify this as money: they do what they do, he suggests (360 10) , because they are
'in need of a livelihood1 ( 3uou õeóyevou) .

The writer thus engages in a many-pronged attack and some of his arguments, at least,
are not medical at all: they attack the men themselves, and not just their practices. More-
over it is essential to recognise that the writer's own position is not that no disease is
divine, but that all diseases are. His main aim is to show that the sacred disease is,
as he puts it at the beginning of ch. 5 (Jones = ch. 2 Littré*, VI 364 9ff.), 'no more divine
than any other.' In his final chapter (21 Jones = ch. 18 Littré, 394 12ff.) he expresses
himself thus: 'there is no need to put the disease in a special class and to consider it
more divine than the others; they are all divine and all human. Each has a nature (<p'5aus)
and power ( 6v5vayts) of its own; none is hopeless or incapable of treatment. ' His attit-
ude here is not one of conventional piety: it was certainly not part of traditional or pop-
22
ular Greek religious belief to consider all diseases equally divine. Rather the writer's
view stems from his conception of the divinity of the whole of nature, an idea whose origins
23
are to be sought not in popular religion, but in philosophy.
On the question of the relevance of the category of 'the divine' to medicine, the au-
thor of On the Sacred Disease may be said to outflank his opponents by broadening that notion:
the category is rendered innocuous, if not vacuous, not by being denied, but by being as-
serted universally. Then a second point at which we must be careful not to exaggerate or
misconstrue the differences between the Hippocratic writer and his opponents concerns the
treatments they used. It is clear from his account that they did not rely on spells and
incantations (èuyôat) alone, but also made suggestions, for example, about diet, even if
their advice here was negative, about what to avoid, rather than what to take. The comb-
ination o,f charms and suggestions abo'ut diet in the opponents of On the Sacred Disease cor-
responds to what we should expect if we compare the data collected by anthropologists con-
24 2 5
cerning primitive medicine, or the evidence for ancient Egyptian or Babylonian medicine.
The response to disease is often a complex one: when spells and the like are used, this is
often in conjunction with other treatments that may include drugs, dietary prescriptions
and other types of what we should consider natural remedies. That is not to say, of
course, that those remedies were viewed as such, or that any distinction between 'natural'
and 'non-natural' was drawn, by those who used them. On the contrary, we have only to re-
flect on the use of the Greek terms xaSaupw and xctòapa^s (covering both purely ritual, and
purely medical 'cleansings' or 'purgings') and of the term cpápyaxov (for 'medicines' of all
kinds, including charms) to see that the categories the Greeks themselves used are some-
27
times such as to span or blur such distinctions. Yet it remains the case that the author
of On the Sacred Disease not only has no objection in principle to some of the dietary re-
commendations proposed by his opponents, but even endorses them, adding glosses of his own
that give naturalistic accounts of why certain foods should be avoided.28
But to understand the position of this treatise it is not enough merely to analyse the
objections he brings against his opponents: we must consider the nature of the explanations
he offers in place of the ideas which he rejects. How does he explain the 'sacred disease'

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himself? His account is explicit, detailed and, in parts, surprising. 'The cause of this
affection,1 he states at the beginning of ch . 6 (Jones = ch. 3 Littré, VI 366 5ff.), 'as of
the more serious diseases generally, is the brain.1 There are <pXeßes leading up
from all over the body, and he proceeds to give a quite detailed account of these, identi-
fying two particularly important ones coming from the liver and the spleen respectively. Thus
the lower part of the one from the liver is called the hollow <pAé<|>: the upper part goes up-
wards through the right side of the diaphragm and the lung , and has a branch going to the
heart and the right arm. Concerning a branch of it that goes to the brain he says (VI 366
19ff.): 'right by the ear it hides itself, and here it branches, the thickest, largest and
most capacious part ending in the brain, another in the right ear, another in the right eye,
and the last in the nostril.1 Meanwhile the y'é<'> from the spleen is said to be similar on
29
the left hand side of the body 'but thinner and weaker. '
Now in the writer's view, the role of these cpAeßec, conventionally, though potentially
rather misleadingly , translated 'veins', is normally to carry air through the body, this air
being essential for, among other things, both sensation and consciousness. But when the
air in the veins is obstructed, especially by phlegm, the result is, first of all, that
'that part of the body where it rests becomes paralysed' (368 5f.). He describes a variety
of other conditions that may arise if the obstruction caused by the flux of phlegm is not
removed, and then applies a similar idea to the particular case of the sacred disease (372
4ff.): 'If the phlegm be cut off from these passages, but makes its descent into the veins
I have mentioned above, the patient becomes speechless and chokes; froth flows from the
mouth; he gnashes his teeth and twists his hands; the eyes roll and intelligence fails,
and in some cases excrement is discharged. . . ' and he goes on to offer a more detailed ex-
planation of each symptom in turn. Thus he prefaces his remarks about speechlessness
(VI 372 lOff.) by explaining that air inhaled through the mouth or nostrils goes first to
the brain: 'then most of it goes to the belly, though some goes to the lungs and some to
the veins. From these parts it disperses, by way of the veins, into the others. The por-
tion that goes into the belly cools it, but has no further use; but the air that goes into
the lungs and the veins is of use when it enters the cavities and the brain, thus causing
intelligence and movement of the limbs, so that when the veins are cut off from the air by
the phlegm and admit none of it, the patient is rendered speechless and senseless.' Sim-
ilar, though briefer, accounts are given of the other symptons he had mentioned. Thus
foaming at the mouth comes from the lungs; 'for when the breath fails to enter them they
foam and boil as though death were near' (374 4ff.).
The writer supports his account of the causes at work with references to observed or
supposed differences in the incidence of the sacred disease among different sections of the
population. Thus he suggests that the disease attacks those of a phlegmatic, but not those
of a bilious, constitution (368 lOff.). He notes that older people are not killed by an
attack of the disease (376 17ff.) and that young people are particularly prone (378 12ff.).
He maintains that 'the flux is to the right rather than to the left because the veins are
more capacious and more in number than on the left1 (378 lOff.). At 384 4ff. he says that
the disease occurs at the changes of the winds, 'most often when the south wind blows, then
the north wind, and then the others.' Finally at the end of his work he advances a general
aetiology of diseases (394 9ff.): 'This disease styled sacred comes from the same causes as

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others, from the things that come to and go from the body, from cold, sun, and from the
changing restlessness of winds ... Most [diseases] . are cured by the same things as caused
them... So the physician must know how, by distinguishing the seasons for individual things,
he may assign to one thing nutriment and growth, and to another diminution and harm ... Who-
ever knows how to cause in men by regimen moist or dry, hot or cold, he can cure this dis-
ease also, if he distinguish the seasons for useful treatment, without having recourse to
purifications and magic ( yotyeun) . '
The writer's theory is comprehensive and detailed and several features of it are, surely
most remarkable. First there is the extraordinary confidence with which he puts forward his
ideas. One example of this from the passage just quoted is the statement that 'most dis-
eases are cured by the same things as caused them. ' Secondly, while his physiological and
anatomical theories (that is his ideas concerning vital functions and the interactions of
the constituent substances in the body, and his account of the vascular system) are quite
full, they are also very largely imaginary. Thirdly, there is the frequent use of sche-
mata involving such pairs of opposites as phlegm and bile, hot, cold, wet, dry, old and
young, north wind and south wind, and right and left. All of these pairs can be paralleled
in other Hippocratic writers and many of them figure in the Presocratic philosophers a
Some of them again figure prominently in various contexts outside the domain of the inquiry
concerning nature. But the author of On the Sacred Disease evidently makes extensive use of
such schemata.

What this writer offers by way of an explanation of the 'sacred disease' as an alter-
native to the doctrines of the purifiers and quacks is, then, a highly dogmatic, speculative
and schematic construct. Where, one may ask, was there any evidence for the theories he
34
presented? Among the occasions when he attempts to establish his points by direct evid-
ence two are worth considering especially. At VI 384 17ff. when he is discussing the
effect of the south wind, he suggests that this can be seen by studying its effects on
things outside the body. As he puts it, 'vessels of pottery too kept in rooms or under-
ground, which are full of wine or other liquid always feel the effects of the south wind and
change their appearance to a different form. ' Quite what the writer has in mind here is
not fully clear. But this is evidently an attempt (even if perhaps an unsuccessful one) to
point to observable evidence outside the body in support of a theory about what happens in-
side it.36
My second example is even more striking. At 382 2ff. the writer sets out to support
his suggestion that the sacred disease is due to the brain being flooded with phlegm. In
an attack, he says, 'the brain is unnaturally moist, and flooded with phlegm, so that not
only do fluxes occur more frequently but the phlegm can no longer separate, nor the brain be
dried ... The truth of this,1 he continues, 'is best shown by the cattle that are attacked
by this disease, especially by the goats, which are the most common victims. If you cut
open the head you will find the brain moist, very full of dropsy and of an evil odour, where-
by you may learn that it is not a god but the disease which injures the body.' It is clear
from this passage that the idea of carrying out a post-mortem examination on an animal had
occurred to this writer, and that is quite exceptional not only for the period at which the
treatise was composed, but for any period in antiquity, since although from the fourth
century onwards, at least, there is a good deal of evidence, in Aristotle and other writers,

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for the dissection, and some also for the vivisection, of animals, post-mortem examination
to establish the cause of death or to throw light on the aetiology of diseases never became
39
a regular procedure in the ancient world. Now it is not absolutely certain that the writer
of On the Sacred Disease actually carried out the inspection he suggests: if he did not, that
would not be the first nor the last time that a test that could be carried out in practice
was treated by an ancient writer as a hypothetical exercise - a thought experiment. But if
we assume, as perhaps we may, that he did do the test he describes, the result is as inter-
esting for what is omitted as for what is included. The statement that 'you will find the
brain moist, very full of dropsy and of an evil odour1 does indeed achieve what the writer
wanted, namely to establish that the 'sacred disease1 was the result of natural causes: 'it
is not a god but the disease which injures the body. ' At the same time we should observe
that it apparently did not occur to the writer to check any of the description of the veins
leading to the brain that he confidently (not to say dogmatically) set out in chapter 6
(Jones = ch. 3 Littré, see pp. 5-6 above) . Yet much of what he presents by way of what we
should call anatomical theories could have been checked by observation. Although the poss-
ibility of direct observation, using dissection, is mentioned in this one context, at least,
in fact the writer clearly tested very few, if any, of his general anatomical doctrines by
this method.

If it is granted, as it surely must be, that many of the theories the writer offers in
place of his opponents' ideas are largely fanciful and have little or no observational sup-
port, then the confidence with which he refutes his adversaries is unlikely to have stemmed
from his use of empirical procedures. Rather he is convinced on general grounds that they
are wrong. His twin key concepts are those of nature ( <p'5aus) and cause (where he uses both
40
the term cxutlos connected with the ideas of responsibility and blame, and Ttpoqxxaus) . The
notion that gods might bring about diseases can be ruled out on a priori grounds , as a cate-
gory mistake: diseases are a matter of nature, and nature implies a regularity of cause and
effect. Although, as we have seen, he implies that what is natural is also divine, by that
move he collapses the notion of the divine into the natural and still leaves no room for any
appeal to non-natural causes to explain natural events. His main weapon is not empirical
evidence (despite the examples of this we have given) but argument. I have already men-
tioned one instance of an implicit argument of the type later known as modus tollens in the
exposure of the purifiers1 methods of treatment at 358 Uff. (pp. 4 f.). Another comes at
364 20ff. where he says: 'another strong proof that this disease is no more divine than any
other is that it affects the naturally phlegmatic, but does not attack the bilious. Yet,
if it were more divine than others, this disease ought to have attacked all equally, without
making any difference between bilious and phlegmatic' Formalising the argument, and re-
versing the order of the propositions, we have: 'if A, then B; but not B; therefore not
A.' But if we seek the origins both of the idea of nature (and of the regularity of cause
and effect that that notion implies) and of modes of argument such as that just referred to,
then again the work of the Presocratic philosophers provides the most likely answer. A sim-
ilar notion of <púaus underlies the ideas of the Milesians, in s*o far as they can be reconst-
ructed: and the first systematic (though still informal) exploitation of hypothetical argu-
ments of the type we find used in On the Sacred Disease comes, probably, in the work of the
Eleatics.

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 Our analysis suggests three main conclusions concerning On the Sacred Disease each of
which conflicts, to a greater or lesser degree, with the general thesis that Jones proposed
concerning the Hippocratics . (1) First, the contrast between this writer and his oppon-
ents is less than Jones would appear to allow (a) in that his opponents do not rely exclus-
ively on charms and purifications, but also made dietary recommendations, and (b) in that
the writer's own theories share both a certain dogmatism and a use of polar schemata with
the ideas of his opponents. (2) Secondly, empirical procedures have less to contribute to
the refutation of his opponents than has abstract argument. (3) Thirdly, the writer's
confidence in his own position stems ultimately from his confidence in the notion of <p'5ats.
So far from saying, then, with Jones, that 'the worst enemy of rational medicine lay in its
connections with philosophy (and rhetoric)1, one might argue, in this, admittedly restricted,
context at least, that in the refutation of superstition medicine rightly allied itself with
philosophy, both (a) taking its weapons of argument from philosophy, and (b) building much
of its case upon a conception of nature that first began to be made explicit by the Ionian
42
natural philosophers .
But while On the Sacred Disease suggests certain important respects in which medicine
seems indebted to philosophy, there is another side to the question of the relationship be-
tween these two. For this we may turn briefly to On Ancient Medicine. Throughout this treat-
ise, both in the refutation of the use of ùuodeaeus or postulates in medicine in ch. 1 and
chh. 13 f f., and in the attack on those who had claimed that to study medicine it was essen-
tial also to study such natural philosophical questions as the fundamental constituents of
man in ch. 20, this writer argues against what he represents as the invasion of medicine by
philosophical ideas. Thus in ch. 1 he writes: 'All who, having taken in hand to speak
or write about medicine, have postulated for their argument a postulate of their own - heat
or cold, or moisture or dryness, or any other thing they fancy - narrowing down the primary
cause of men's diseases and death by postulating one thing or two as the same cause for all,
these make obvious errors in many of their novelties. But they deserve most censure be-
cause they are dealing with an art ( xe'xvn) that really exists ... Wherefore, I considered
44
that it has no need of an empty postulate, as do insoluble mysteries, which necessarily
require the use of a postulate, if an attempt be made to discuss them, for instance the my-
steries of heaven and of the regions below. If anyone were to express his opinion about
the condition of these, it would not be plain either to the speaker himself or to the au-
dience whether the statements were true or not. For there is no test the application of'
which would bring certain knowledge.' Again in ch. 20 he argues that those who said that
a knowledge of what man consists of is an essential preliminary for the practice of medi-
cine 'raise a matter for philosophy1. He names Empedocles in particular as one who had
45
written on nature and says that what physicians and 'sophists' had said on this subject
'has less to do with medicine than it has with the art of writing'. His own view on the
matter is that 'clear knowledge of nature can be derived from no source except medicine.'
At first sight this too seems to endorse Jones' interpretation of the resistance of
medicine to philosophy. Yet in practice (as I have argued elsewhere) the actual theories
we find in On Ancient Medicine on such topics as the constituents of man or the origins of dis-
eases turn out to be much closer to the ideas of his opponents, which he says are based on
arbitrary postulates, than one might expect in view of his apparent total rejection of such

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postulates. Thus his own view of the constituents of the body is that there are many
things such as salt and bitter, sweet and acid, astringent and insipid, in us - and he is
even prepared to allot a minor role to hot, cold, wet and dry themselves. But if, once
again, as with On the Sacred Disease's arguments with his opponents, the contrast betwen On
Ancient Medicine and those he refutes is less great than he makes out, it is nevertheless the
case that this treatise has an argument with philosophy, both on the question of methods and
on that of the limitations of the knowledge that can be attained in medicine. In chapter 9
especially, the writer has this to say: 'wherefore these ills are much more complex than we
realize, requiring greater accuracy of method. For it is necessary to aim at some measure.
But no measure, neither number nor weight, can be found, reference to which would give
accurate knowledge, other than the feeling of the body... Exactness is rarely to be seen.'
Here, as in chapter 1, the writer resists the demand for certain knowledge and insists that
medicine is an art where, as he puts it, 'exactness is rarely to be seen.1 He is evidently
alive to the practical complexities of medicine and clear that, while medicine must seek
the greatest degree of accuracy possible, the only measure of 'exactness1 is bodily feeling.
The main points that emerge from a study of the aspects of these two works that we have
considered may now be summarised. First we must recognise the importance of the fact that
arguments of the type we have been discussing took place at all. The polemics of On the
Sacred Disease against the purifiers and quacks, and those of On Ancient Medicine against those
who used postulates in medicine, are important evidence of a growing awareness, in Greek
science, of problems of methods and of the boundaries between different inquiries. With
different opponents in mind, both Hippocratic writers advance towards clearer conceptions of
49
the nature and proper methods of medicine itself.
Secondly the actual differences between the positions of these Hippocratic writers and
their opponents are less than they make out (especially when we take into account their own
actual theories, as well as their methodological or programmatic statements). On the Sacred
Disease rejects the supernaturalism of the purifiers, but engages in schematic and dogmatic
speculations on its own account. The writer of On Ancient Medicine repudiates the new method
of ûïïddeais, but has to use certain arbitrary assumptions himself. On the Sacred Disease, I
suggested, used philosophy (that is philosophical modes of argument and the concept of cpuaus
first developed by the Milesians) to refute magic. One could hardly say that On Ancient
Medicine, conversely, needed magic to refute philosophy: but one might put it that in his
refutation of the notion that medicine can be exact he makes use of one idea that the puri-
fiers would presumably have shared, namely that of the practical complexities of the art of
healing.
Thirdly, we may try to define the stage that these works represent in the development
of Greek thought, while fully acknowledging that Greek thought did not develop by neat and
clearly defined stages. On the Sacred Disease rejects the notion of divine intervention in
diseases: but of course no refutation of supernaturalism is ever complete. The bound-
aries of the supernatural were and remained a battleground throughout ancient science.
Hard-hitting as his arguments are, his rejection of divine intervention did not mean that he
also rejected other types of dogmatic and schematic speculation. Nor did it mean adopt-
ing a rigorously empirical, positivistic, methodology. It is true that sustained and meti-
culous observations are recorded in some Hippocratic works, the prime example being books I

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and III of the Epidemics which set out detailed descriptions of individual medical case-
histories. But in On the Sacred Disease the chief weapon is argument. Although observation
was, in principle, possible on many questions touched on in this work, the actual appeals to
empirical data are rare. The attack on supernaturalism and the substitution of a principle
of the regularity of nature were extremely important: but once the principle of the reg-
ularity of nature was firmly accepted, it (in turn) provided a framework for theories many,
or most, of which were not (in some cases could not be) brought to the test of observation
and experiment. The 'rationality1 of early Greek medicine, as seen in On the Sacred Disease
at least, implies a fundamental philosophical assumption about natural phenomena, but did
not entail (though in some cases it could be combined with) an insistence on the need for
empirical research.
On the Sacred Disease and On Ancient Medicine mark the beginnings of an epistemological battle
that was to continue right through ancient medicine. Medicine was caught between sceptic-
ism and dogmatism, between the scepticism implied by the irreducible individuality of each
individual case (as each individual case is unique, there can be no generalisations, no con-
ception of a type of disease, even, in medicine) and the dogmatism of excessive rationalism
and schematism. It was not for nothing that one of the main medical sects of the Hellen-
istic period - and the one that numbered Hippocrates among its founding fathers - was called
the Dogmatists or Rationalists, ooyyaTLxoL or Aoylxol: while the eyueuptMou were not so much
what we should call 'empiricists' as (in certain respects at least) sceptics.52 Yet
history of certain elements in later Greek medicine is one of a recurrent epistemological
crisis, the major achievement of some of the Hippocratic texts is to have brought some of
those epistemological problems out. As so often with Greek science, certain fundamental
problems came to be identified early in the classical period, and in some respects, at least,
later discussions in antiquity had little to add to the arguments already advanced in On the
Sacred Disease and On Ancient Medicine in their attempts to define medicine as a-rex^n. In the
modern period, to be sure - as we began by noting - the scientific credentials of branches
(at least) of medicine are more firmly grounded, in that, for instance, the pathologist can
call on the results of biochemistry and chemistry. But that still leaves, we said, large
areas of medicine, both of medical theory and of medical practice, unclaimed by science, or
where the claims to be scientific have a different function and would be justified in ways
that are not so completely different from those available to, and used by, ancient Greek
doctors. Thus Jones' picture of a fully scientific medicine and of a fully scientific med-
ical man has its implausibilities when applied to the twentieth century A.D., let alone the
fifth century B.C., and just as one should not exaggerate the difference between On the Sacred
Disease and his opponents, so one should not exaggerate the difference between On the Sacred
Disease and (for example) Osier. That, however, is another story. So far as the ancient
world is concerned, the texts we have considered are, as I said, among the first in which
the relations between medicine, magic and philosophy are explicitly discussed. They help
to throw light on what happened when those relations became an issue and they show how com-
plex those relations were. It was indeed partly by contrasting itself with magic and phil-
osophy that medicine began to define its own identity and methods: but if it is important
to see what was new in that development, it is equally important not to misconstrue or over-
state the nature of that contrast or to neglect the continuing links of medicine with both.
G.E.R. Lloyd King's College, Cambridge

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Notes

1. Earlier versions of this paper were given to the History and Philosophy of Science Seminar at Cambridge
and to groups at the Universities of Bristol, London, Newcastle and Southampton. I am most grateful for
the comments made by my audiences on these occasions.
2. fThe science and art concerned with the cure, alleviation and prevention of disease, and with the res-
toration and preservation of health.1
3. <pauvexau yèv yap oúôè xnv vyCeLctv ouxws eTiuaxoueCv o uaxpós, aÀXà xnv ávSpwnou, ySXXov 6' uaws xnv xoQôe
xad' exaaxov yàp uaxpeúeu. NE 1097a Uff. It is notable that Aristotle allows that health may not con-
sist in the same state or disposition in every case, while still insisting that it will consist in a
particular disposition in each case, NE 1173a 23ff, cf. Phronesis 13, 1968, p. 76.
4. I am not competent to comment on the relative strengths and weaknesses of European and, for example,
Chinese medicine, but the layman may note an increasing professional, as well as a popular, interest in
Chinese therapeutic methods such as acupuncture, if not in Chinese pathological theories.
5. One remarkable, and controversial, example, from psychiatry, is the use of Electric Convulsive Treatment.
An example of an empirical treatment for a somatic condition is the use of colchicum for gout (a treat-
ment which can be traced back to antiquity, e.g. Alexander of Tralles Book 12,Vol.2,pp.563f f .Puschmann) .
6. However important it may be in other contexts, the distinction between a man with, and one without, modern
medical qualifications enables us, strictly speaking, merely to differentiate the agents, not their med-
ical activities and procedures as such.
7. Yet if this constitutes a difficulty for any attempt to give a full and definitive account of 'positive
knowledge1, that does not mean that we cannot use that notion at all, for example in connection with the
more aodest claim that certain propositions of chemistry and anatomy may be accepted as firmly established.
8. The survival of folk beliefs concerning disease in 20th century Europe has often been documented: see,
for example, the report of field-work carried out in France in M. Bouteiller, Chamanisme et guêrison
magique, Paris 1950.
9. 'Right and Left in Greek Philosophy1, Journal of Hellenic Studies 82, 1962, pp. 56-66, reprinted in Right
and Left, ed. Rodney Needham, Chicago 1973, pp. 167-86, and cf. Polarity and Analogy, Cambridge 1966, Part I.
10. W. Osier, The Principles and Practice of Medicine, 16th ed., edited by H.A. Christian, New York and
London 1947, p. 49.
11. The most helpful modern general discussions are L. Edelstein1 s paper, 'Greek medicine in its relation to
religion and magic1, Bulletin of the Institute of the History of Medicine 5, 1937, pp. 201-46, reprinted
in Ancient Medicine, ed. 0. and C.L. Temkin, Baltimore 1967, pp. 205-46, and G. Lanata, Medicina Magica e
■Religione Popolare in Grecia, Rome 1967.
12. Loeb Hippocrates , Vol. 2, 1923, pp. xxxviiif . Jones expressed similar views in Philosophy and Medicine
in Ancient Greece (Suppl. 8 to the Bulletin of the History of Medicine), Baltimore 1946, pp. 23 and 26ff.,
and in The Medical Writings of Anonymus Londinensis , Cambridge 1947, pp. 157ff . Cf. also, for example
W.A. Heidel, Hippocratic Medicine, its spirit and method, New York 1941, pp. 62, and 125f. (though on p.
17 Heidel notes an 'intimate connection between medicine and natural philosophy'), and L. Bourgey, Observ-
ation et expérience chez les médecins de la collection Hippocratique, Paris 1953, p. 9: 'Par ailleurs, et
la chose se trouve peut-être extraordinaire plus encore, on ne relève pas à travers les multiples courants
de la médecine laïque aucune trace, fut-elle légère, de superstition ou de magie.'
13. The most recent edition is that of H. Grensemann, Die hippokratische Sohrift "Über die heilige Krankheit" ,
Ars Medica II Band 1, Berlin 1968. Cf. also the extensive comments on the treatise in H.-W. Nörenberg,
Das Göttliche und die Natur in der Schrift über die heilige Krankheit, Bonn 1968.

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14. The two most important recent editions are those in Jones, Philosophy and Medicine in Ancient Greece (see
n.12 above) and A.J. Festugière, Hippocrate, L'ancienne médecine, Études et Commentaires IV, Paris 1948.
15. I shall use Jones1 own translations throughout, noting points of disagreement where necessary.
16. On the identification of this disease, see especially 0. Temkin, 'Views on epilepsy in the Hippocratic
period1 and fThe doctrine of epilepsy in the Hippocratic writings1, Bulletin of the Institute of the His-
tory of Medicine 1, 1933, pp. 41-4 and pp. 211-322, and The Falling Sickness, 2nd ed. Baltimore and Lon-
don 1971, pp. 15ff.: at p. 19 Temkin notes fvarious diseases were called "sacred disease" in Antiquity1
but fin the great majority of cases "the sacred disease" meant epilepsy for physicians as well as lay-
men. f

17. Cf. also the discussion of the sacred disease in the short treatise On the Diseases of Girls and the

brief rejection of the f sacred* character of the impotence afflicting certain Scythians in Airs Waters
Places ch. 22.

18. to Setov, literally fthe divine1.

19. The question of the identification of the opponents of On the Sacred Disease has been much discussed: see,
e.g., M. Wellmann, Die Fragmente der sikelischen Arzte, Berlin 1901, p. 29 n. 1, A. Delatte, La vie de
Pythagore de Diogene Laërce, Brussels 1922, p. 232, P. Boyancé*, Le culte des muses chez les philosop
grecs, Paris 1937, pp. 106f., L. Moulinier, Le pur et l'impur dans la pensée des Grecs d'Homère à Aris-
tote, Études et Commentaires XII, Paris 1952, pp. 134ff., J. Jouanna, 'Présence d'Empédocle dans la
Collection Hippocratique1 , Bulletin de l'Association Guillaume Budê 1961, pp. 460ff., W. Burkert, Lore
and Science in Ancient Pythagoreanism (English edition, translated with revisions from Weisheit und
Wissenschaft, Nürnberg 1962) Cambridge Mass. 1972, pp. 176ff., 211. The idea that they are, or include,
priests who practised 'temple-medicine1 is not supported by any evidence in On the Sacred risease itself,
although Herzog 's contrary thesis (Die Wunderheilungen von Epidauros , Philologus Suppl. XXII, Leipzig
1931, p. 149) that the Hippocratic writer himself approves of temple medicine is a faulty inference from
ch. 4 (Jones = ch. 1 Littré VI 362 lOff.) where the argument that his opponents should have brought their
patients into the temples is purely hypothetical and based on a premise (that the disease is caused by
the gods) that the writer himself rejects. Some of the procedures he describes his opponents as using
(354 19ff.) are, to be sure, strikingly similar either to practices and rules ascribed in our late
sources to the Pythagoreans (e.g. abstention from eating certain kinds of fish, Diogenes Laertius VIII 33,
Porphyry VP ch.45 ,cf .Burkert ,op.cit . ,pp. 176f )or to the claims of other Greek wonder-workers in general
and of Empedocles in particular(whose religious poem is entitled'Purifications' ,xa%ap'ioL : in Fr. 112 he
says he is consulted for the 'word to heal all kinds of diseases'; cf. Fr. Ill where he claims to be
able to control the weather, cf. On the Sacred Disease 358 19ff.). Yet much as they have in common, to
identify the opponents of On the Sacred Disease straightforwardly as Pythagoreans or (as Wellmann Sug-
gested) followers of Empedocles would be a mistake. (1) The similarities in several cases merely re-
flect popular Greek beliefs, e.g. concerning the association of black with misfortune; (2) as Boyancé,
for one, noted, whereas the Hippocratic writer's opponents suggest remedies for a particular illness,
the Pythagoreans' rules are rules for general behaviour; (3) the idea that sufferers from the disease
may be purified by blood (362 8ff.) is one that Empedocles himself, with his horror of blood-shedding,
would have repudiated (Frr. 128, 136-7, cf. also Heraclitus Fr. 5).
20. Purifications and incantations: they also prohibit baths and the use of certain foods.
21. Cf. e.g. H.W. Miller, 'The concept of the divine in De Morbo Sacro1 , Transactions and Proceedings of the
American Philological Association 84, 1953, pp. 1-15, F. Kudlien, Der Beginn des medizinischen Denkens
bei den Griechen, Zurich 1967, p. 58 and H.-W. Nörenberg, op. cit., pp. 68ff.
22. According to On the Sacred Disease itself (352 lOff.), no one wondered at such diseases as quotidian

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 fevers, tertians or quartans, or considered them sacred. The popular ideas according to which particu-
lar deities were thought of as instrumental in bringing about diseases, or certain diseases themselves
were personified (e.g. Hesiod, Works 102ff.), must be contrasted with the Hippocratic writer's view that
all diseases are divine because all are natural.

23. See e.g. Aristotle de An. 411a8 on Thaïes and Ph. 203bl3ff. on Anaximander f s Boundless; the divinity of
the elements in Empedocles (e.g. Fr. 6) and of air in Diogenes of Apollonia (e.g. Fr. 5).
24. See, for example, the full account of Zande medicine in E.E. Evans-Pr it chard, Witchcraft, Oracles and
Magic among the Azande, Oxford 1937, and cf. the general discussion in E.H. Ackerknecht, 'Natural dis-
eases and rational treatment in primitive medicine1, Bulletin of the History of Medicine 19, 1946, pp.
467-97.

25. See, for example, H.E. Sigerist, A History of Medicine Vol. 1, New York 1951, the articles by H.G. Güter-
bock ('Hittite medicine1 pp. 109-13), A.Leo Oppenheim ('Mesopotamian medicine* pp. 97-108), and J.A.
Wilson ('Medicine in ancient Egypt', pp. 114-23) all in Bulletin of the History of Medicine 36, 1962, and
P. Ghalioungui, Magic and Medical Science in Ancient Egypt, London 1963.
26. So too in Greek 'temple medicine', the God is represented as making recommendations about diet, and us-
ing drugs and surgery (though the latter usually of a miraculous kind) to effect cures, see Herzog, op.
cit. pp. 43 and 75f., and cf. E.J. and L. Edelstein, Asclepius , 2 Vols., Baltimore 1945, e.g. Vol. 2
p. 153.
27. See, for example, T. Wächter, Reinheitsvorschriften im griechischen Kult, Religionsgeschichtliche Ver-
suche und Vorarbeiten IX, Giessen 1910-1, W. Artelt, Studien zur Geschichte der Begriffe "Heilmittel"
und "Gift", Leipzig 1937, E.R. Dodds, The Greeks and the Irrational, University of California Press 1951,
pp. 35ff., 43ff., L. Moulinier, op.cit., and G. Lanata, op. cit., pp. 51ff.
28. The indicatives in the parenthetical clauses at 356 2, 3f . and 6 indicate that these contain the writer's
own views: contrast the infinitive at 356 9 where he gives one of his opponent's beliefs in oratio
obliqua.
29. The doctrine of the 'liver-vein' and the 'spleen-vein', so common in early Greek writers on anatomy, may
in some instances be seen as reflecting knowledge of the main trunks of the abdominal aorta and the in-
ferior vena cava. But whatever empirical knowledge may underlie the doctrine, this is often overlaid
by schematic notions based on right/left distinctions. Thus the overfondness for bilateral symmetry
appears in the notion of a pair of veins, one connecting the right arm with the liver, the other the
left with the spleen, which occurs in Diogenes of Apollonia and Polybus as well as in On the Sacred
Disease. On the whole subject, see C.R.S. Harris, The Heart and the Vascular System in Ancient Greek
Medicine, Oxford 1973.
30. Thus he holds that the brain is the seat of consciousness and intelligence (386 15ff.) and that fit is
the air that gives it intelligence' (390 12f.).
31. It is noteworthy that this description of the symptons of the 'sacred disease' is paraphrased by Osier
op.cit., p. 1364, in his description of Grand Mai, or major epilepsy.
32. Cf. R. Joly, Le niveau de la science hippocratique, Paris 1966, pp. 21 Iff.
33. Cf. Polarity and Analogy, Cambridge 1966, pp. 15-26.
34. As opposed, that is, to his descriptions of, for example, the sacred disease itself.
35. Jones translates yoptpnv 'shape'. But to attribute the idea that pots change their shape to the Hippo-
cratic writer seems unnecessarily difficult, when the term may mean, more simply, appearance.
36. Cf. Anaxagoras' dictum o<'>l$ àônXcov toi cpotuvóyeva on which see, e.g. Polarity and Analogy, pp. 338ff .
37. The date of this work, as of most other Hippocratic treatises, is disputed. While Diogenes of Apollo-
nia may serve as a terminus post quern, we have no reliable means of dating the work more precisely than

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 within the broad limits of the period from about 420 to 380.
38. Human, as well as animal, subjects were dissected and probably also vivisected in Alexandria in the third
century B.C., though this was never common elsewhere nor at other times. See, e.g., my Greek Science
after Aristotle, London 1973, pp. 75ff., 86ff.
39. The nearest parallel to this passage in On the Sacred Disease is, perhaps, the story told in Plutarch
Pericles ch. 6, in which Anaxagoras had the head of a one-horned ram opened in order to demonstrate that
its deformity was due to natural causes. Such a procedure, while possible, was no doubt exceptional.
40. See especially K. Deichgraber, IIPO$AEIE, Eine terminologische Studie ,Quellen und Studien zur Geschichte
der Naturwissenschaften und der Medizin III 4, Berlin 1933, K. Weidauer, Thukydides und die Hippo-
kratischen Schriften, Heidelberg 1954, pp. 8ff., 32ff., and H.-W. Nörenbere, op.cit., pp. 49ff, 61ff.

41. fIf divine, all equally: but not all equally; therefore not divine.1
42. This is not to say, of course, that the doctors agreed with the views put forward by the philosophers on
diseases in general or on the sacred disease in particular. Thus Plato1 s rationalisation, that the sac-
red disease is rightly so called because it is a disease of the sacred substance in the head (Timaeus
85ab), is quite different from the position adopted in On the Sacred Disease itself (see above pp. 4f.)
43. Once again I use Jones1 own translation from Philosophy and Medicine in Ancient Greece.
44. Reading xevñs: or fnewf reading, with Festugière and others, Mcavfis.
45. The text is, however, confused and may be corrupt, see A. Dihle, Museum Helveticum 20, 1963, pp. 145ff.
46. Tíj ypacpuxfl, which may mean (as Jones in the Loeb translation took it to mean) not 'the art of writing1,
but 'painting*.
47. Polarity and Analogy, pp. 69f .
48. On this writer's conception of Te'xvn, see, for example, F. Heinimann, 'Eine vorplatonische Theorie der
TExvn1, Museum Helveticum 18, 1961, pp. 105-30.
49. That is not to say, however, that both treatises adopt the same views either on the nature of medicine in
general, or on particular medical problems.
50. The chief examples outside medicine are astrology (and the whole field of the 'art' of divination) and
alchemy. Within medicine itself, there is ample evidence that a belief in the possibility of gods or
demons causing diseases continued among educated as well as non-educated Greeks long after the classical
period and indeed increased in late antiquity. Such a belief is alluded to by (among others) Plutarch
{De superstitione 168bc) and Plotinus (Enneads II 9 14) and it is clear from a passage in Galen's Com-
mentary on the Prognostic (CMG V 9, 2 pp. 205f. Heeg, - XVIII B 17f Kühn) that it was shared by some who
were sufficiently well read to cite Hippocrates himself as an authority for their view (doing so by mis-
interpreting, as Galen himself insists, the reference to considering 'what is divine' in Prognostic ch.l
II 112 5ff., Littré). The physicians trained in the medical schools at Cos, Cnidos and later at Alex-
andria, Pergamum and elsewhere were always in competition with (though they sometimes allied themselves
to) both those who practised folk-medicine and the temple doctors. Moreover within the medical writers
themselves there were continuing disputes on such questions as the value of dreams in diagnosis (accept-
ed by the author of the Hippocratic treatise On Regimen IV, for instance, who developed a complex theory
on the subject, and, among later writers, not only by Aelius Aristides and Artemidorus, but also by Galei}
and even of that of amulets (accepted, for example, by Rufus, Fr. 9Ú and in certain cases by Galen,
though at On the mixing and power of simple drugs VI 2, 10, XI 859 Kühn, for example, he adds a natural-
istic explanation of their effect: even Soranus who rejects them suggests that they should not be for-
bidden since they make patients more cheerful, Gyn. I 19 63, III 10 42). While medical writers down to
Galen commonly reject 'magical' practices, what they include under that heading varied from writer to
writer. Galen, in particular, was much exercised by the problem of determining the real, as opposed to

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 the supposed, effects of the mass of natural remedies used and of evaluating popular beliefs about them.
On the whole question, see especially 0. Weinreich, Antike Heilungswunder , Untersuchungen zum Wunder-
glauben der Griecher und Römer, Religionsgeschichtliche Versuche und Vorarbeiten VIII, dessen 1909-10,
L Thorndike, A History of Magic and Experimental Science , Vol. 1, New York 1923, the article of Edelstein
cited above (p. 12 n.ll), Dodds, op. cit., and A. Delatte, Herbarius9 3rd ed. Brussels 1961.
51. The survival of primitive and folk-medical beliefs in other Hippocratic works has been studied by F.
Kudlien, 'Early Greek primitive medicine', Clio Medica 3, 1968, pp. 305-36.
52. See e.g. L. Edelstein, Empirie und Skepsis in der Lehre der griechischen Empirikerschule, Quellen und
Studien zur Geschichte der Naturwissenschaften und der Medizin III 4, Berlin 1933, translated as 'Empir-
icism and Skepticism in the teaching of the Greek Empiricist School', in Ancient Medicine, Baltimore 1967,
pp. 195-203.

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