The Oxford Handbook of the Second Sophistic

by Daniel S. Richter

  Galen’s Normative Patient. Unlike the Roman bathing complexes with which Galen and other Greeks equated them, Greek gymnasia, of course, did not allow women and Galen’s ideal of gymnastic training did not apply to women, who play a marginal role in On Matters of Health and in his work generally. Galen’s normative or ideal patient reflects the Hellenic, urban, masculine, intellectual, and aristocratic values of the Second Sophistic. Case histories in which Galen portrays the character of his patient in some detail, and passages describing the ideal human temperament (or “mixture” of humors and their qualities of hot, cold, wet, and dry) are especially revealing on this point. The type of patient Galen describes most often, relates to best, and seems to consider normative (the standard from which all others deviate), is a neaniskos, a male in the prime of life, of hot and dry temperament. Galen applies the word neaniskos to men between their early twenties and age forty or so; the hot, dry temperament is typical of this life stage, and is also the most masculine temperament, contrasting with the relatively cold, wet temperament of women. A youth of this type may be especially susceptible to the emotions of anger and “distress,” lupe, a concept Galen links to intellectual activity (phrontizein and related words). He exercises in the gymnasium and Galen may use the adjective “gymnastic” to describe him.

  There is clearly a class element to this characterization. Gymnastic exercise as a way of life was available only to urban patients and only to the leisured class or, to a lesser extent, their slaves. Galen’s On Matters of Health includes advice to the slaves of rich men and other urban residents too busy to implement his full program of gymnastic exercise (6.5, 6.405K). Peasants, living in the countryside, have no access to the gymnasium at all; and Galen sometimes discusses the distinction or equivalence between gymnastic exercise (gymnasia) and “work” (erga). In one passage he describes doing agricultural labor as a form of exercise while detained in the countryside, perhaps at his estate in Campania: “we were forced to split wood for the sake of exercise [ἕνεκατοῦ γυμνάζεσθαι], and to throw barley into a mortar and crush and grind it, which every day people in the countryside were doing as work” (ἔργα, De san. tuenda 2.8, 6.133–134K). Peasants are a marginal—not normative—category of human, along with women, children, eunuchs, and overdeveloped athletes. Urban slaves, on the other hand, may be difficult to distinguish medically from their masters.

  Some of Galen’s patients are highly educated intellectuals like himself— pepaideumenoi—and these patients are most likely to be named in his stories (though Galen names few of his patients). They include Diodorus, a grammarian; Pausanias, a sophist; Eudemus, a philosopher, the subject of Galen’s longest case history and one of the patients to whom he refers most often; and Antipater, a physician. These patients tend to be men of mature age and obvious social prominence; and it is this class that includes the great rhetors, the “sophists,” of the Second Sophistic. Pausanias, whom Galen cured of nerve damage in one of his most famous stories, rates a paragraph in Philostratus’s Lives of the Sophists (VS 13). It is to this group that Galen clearly thinks he belongs.

  24.2 PAIDEIA

  “Sophists.” On the one hand, Galen’s polemics against the people he calls “sophists” are vociferous and renowned. “Sophists” are arrogant, shameless purveyors of empty bombast and semantic quibbling, ignorant of facts and disdainful of experience, observation, and truth (von Staden 1997a, 34–35). On the other hand, this should not be misinterpreted: Galen uses the word “sophists” very loosely, invoking its ancient pejorative sense and often applying it to his professional rivals; such “polemics against the ‘sophistry’ of rival ‘sophists’ ” (von Staden 1995, 50) were quite normal among the orators themselves. Galen could speak of individual “sophists,” such as Pausanias of Caesarea or Aelius Aristides, in neutral terms and without rancor, for example when they are his patients.2 The audience of intellectuals in his friend Boethus’s entourage includes two “sophists” (Hadrian of Tyre and Demetrius of Alexandria; De praecogn. 5, 14.628K), and Galen clearly valued the approval of this type of elite, educated person.

  The Liberal Arts. Galen’s intellectual values were similar to those of the sophists, and typical of his time. He praised the arts (the technai) that he calls “rational” or “noble” (logikai, semai, kalai), among which he positioned medicine; other technai he places in this category include geometry, mathematics, astronomy, music, and philosophy, and also rhetoric, all of which he thought fundamental to the education of physicians or of any cultured person. He claims for Hippocrates an expertise in geometry, rhetoric, music, and astronomy; and excoriates the detested Thessalus, founder of the reductionist Methodist sect, as lacking education in these same disciplines, and as degrading medicine to the status of shoemaking or weaving.3 Here as always Galen reflects the profoundly elitist attitudes of his culture more generally; while medicine, geometry, and shoemaking are all technai, and for some purposes can be compared, the “noble” or “liberal” technai occupy a much higher plane. Medicine was not, in Galen’s view, a banausic craft to be learned by crude apprenticeship, though this is, in fact, how it was probably taught to most people calling themselves iatroi, many of whom, in Rome, were former slaves.

  Galen’s Early Education. The medicine that Galen advocated followed the social model of learning of other elite disciplines, including rhetoric, and was available only to a very narrow aristocracy. In his effort to establish his credentials as a pepaideumenos and as an exemplary practitioner of his techne, Galen offers a fair amount of information about his own education. His father, Nicon the architect, whom he revered, home-schooled Galen through his early teens in geometry, mathematics, arithmetic—the disciplines of his profession—and also in Greek, for his father’s command of the language was impeccable.4 At the age of fourteen, Nicon handed over his son to a handpicked contingent of philosophers for his further education, one from each of the major sects (Stoic, Platonist, Peripatetic, and Epicurean). Nicon himself, Galen tells us, was responsible for his early decision, followed faithfully, never to proclaim adherence to a particular sect. Galen transmits the names of his teachers’ teachers (some of whom, though not perhaps the teachers themselves, were very illustrious), thus laying claim to the intellectual pedigree that was an indispensable element of paideia.5 Galen continued to study philosophy and claimed an identity as a philosopher for the rest of his life, arguing that the best physician is also a philosopher (the title of one of his treatises, in which Hippocrates serves as a model of the ideal) and boasting of his reputation in that discipline. Galen published many philosophical works, including a treatise in fifteen books on logical proof, now lost; commentaries on works of Plato and Aristotle; and treatises on ethics, some of which survive. He wrote a treatise On the Doctrines of Hippocrates and Plato, demonstrating the harmony of their views against those of other, later traditions with which Galen disagreed, notably Stoicism. He claimed renown as a philosopher as well as a physician among his contemporaries (Praecog. 2, 14.608K), and this may be correct (Nutton 1984).

  Galen would probably have continued along this path, but when he was sixteen, Nicon had a series of dreams in which a god—no doubt Asclepius, Pergamum’s most illustrious deity, though Galen does not say this—convinced him to change course: “exhorted by distinct dreams, he had me study medicine together with philosophy;” that is, from that point forward, Galen would study both.6

  Although Galen wrote very little—almost nothing that survives—from the years before his migration to Rome, he mentions a number of his medical teachers by name, and also the names of their teachers, and of the intellectual traditions in which they stood. His teachers represented all of the schools or “sects” that Galen would later identify as important (these are discussed in more detail below), except for the Methodists, for whom he would proclaim disdain all his life. One of Galen’s earliest teachers, still at Pergamum, was Aeschrion, an Empiricist (De simpl. medicament. temp. 11.1.34, 12.356–357K). Galen also ment
ions a Hippocratic teacher, a Pneumatist teacher, and the most important of his Pergamene teachers, Satyrus, student of Quintus, who did not count as an Empiricist but leaned that way. That is, Galen had several teachers at once, and his medical education, like his philosophical education, was eclectic from the beginning.

  The Sects. Galen often identifies medical schools or traditions by their founding figures; thus the “Erasistrateans,” followers of the early third-century physician Erasistratus, or “Asclepiadeans,” followers of Asclepiades of Bithynia, whose ideas were very influential on the later Methodist school. Some, in particular the Empiricists and the Methodists, departed radically from previously accepted principles and were named after their methods. Pneumatists too were called after the role of pneuma in their doctrine; this sect accepted Stoic theories of physics. Galen disdained to affiliate himself with any of the named sects or with the name of a founder figure, not even Hippocrates (De libr. propr. 1, 19.13K), but was proud of his training in all the major sects (De loc. affect. 3.3, 8.143–144K).

  In discussing the sects or haereseis of medicine Galen tends to identify three major competing traditions—the Empiricists, the Rationalists or Dogmatists (this a sort of catchall term for everyone not an Empiricist), and the Methodists. Empiricists traced their tradition to Philinus of Cos, a student of the famous anatomist Herophilus at Alexandria. They rejected every form of medical knowledge except experience (peira). Methods were rigorously defined and could include the experience of other physicians, as recorded in books or transmitted orally (historia). Most forms of deductive reasoning were banned, including speculation about the causes of disease or about the interior of the body generally, and anatomy was also banned.

  Methodists based their ideas of physiology on Democritus’s atomist theory of physics; bodies, as they argued, are composed of atoms and pores, and all diseases were disorders of either compaction, or flux, or a combination. This sect was founded by a shadowy figure of the first century BCE named Themison, but more popularly associated with Thessalus of Tralles, who lived under Emperor Nero and had a tomb on the Appian Way.

  Medical schools, then, were deeply implicated with philosophical traditions of epistemology, physics, logic, and so forth, while on the other hand many philosophical traditions (especially Stoicism) postulated theories about the body. For Stoics as well as for Aristotelians, for example, the rational soul or seat of intelligence was located in the heart, a position against which Galen crusaded all his life, insisting on the brain as the seat of reason. Aristotle virtually founded the practice of dissection and the discipline of comparative anatomy in Greek culture, and Peripatetics of Galen’s own time (among them Boethus, discussed below) seem to retained an enthusiastic interest in anatomy. Medicine as Galen knew and defined it was an intellectual tradition comparable to philosophy and not easily separable from it.

  Galen and the Sects. Despite Galen’s passionate commitment to anatomy, which he began to learn from Satyrus and perhaps others in Pergamum, he retained much sympathy for Empiricist methods throughout his life. The opposite was true of his attitude toward Methodism, and Galen seems never to have had a Methodist teacher. The Methodist sect was very prominent in Galen’s time and may have been the dominant tradition; certainly Galen devoted his whole life to a battle against it, and many of the doctors he mentions as rivals in his stories are Methodists. Galen presents Methodism as a reductionist sect that rejected anatomy and claimed that the art of medicine could be taught in six months, although the Methodist Soranus refers to anatomical discoveries in his surviving work on gynecology.7

  Galen did not invent the tripartite division of medicine into Empiricists, Methodists, and Dogmatists, which is also attested in Celsus (Proem. 10, 57), but he is its main surviving exponent. Nevertheless, although he often describes the intellectual history of medicine using this scheme, Galen’s own works show that it is an oversimplification. Within each sect, and especially the eclectic Dogmatist sect, were competing traditions; the term “Dogmatist” was itself not particularly meaningful except in contrast to Empiricism; and Galen often identifies rivals not by their adherence to one of these three traditional sects, or to more minor traditions such as Pneumatism, but by their descent from an intellectual forbear such as Asclepiades. While he disdained to apply any such label to himself, his own intellectual pedigree, and especially his relationship to the physician he calls Quintus, was fundamental to his education and professional identity.

  Teachers and Followers: Quintus. Quintus is known only from Galen’s writings. He practiced in Rome, where he apparently dominated the medical scene in the reign of Hadrian. Quintus seems to have been a native Pergamene, and may have been Galen’s inspiration as well as his intellectual grandfather. Although Quintus died before Galen began to study medicine, Galen sought out as many of Quintus’s students as he could, sparing no effort or expense to learn at their feet, and traveling around the eastern Mediterranean to find them. This quest eventually brought him to Alexandria, in pursuit of Numisianus, one of Quintus’s most famous students, who probably died before Galen could meet him, and who was the teacher of Pelops, Galen’s teacher at Smyrna in the years immediately after he left Pergamum. Galen did not study with all of Quintus’s students: at least two of his bitter rivals were pupils of Quintus from whom he never learned. These were Lycus, whom he never met, but whose comprehensive work on anatomy was a major challenge to Galen’s On the Usefulness of the Parts when he finally finished it around 175 CE (De libr. propr. 2, 19.20–23K), and Antigenes, one of his rivals in the case of Eudemus, a spectacular success early in Galen’s career at Rome (De praecogn. 3, 14.613K).

  Neither Quintus, nor Pelops, nor Numisianus left much in the way of surviving works for Galen to study—their works were kept secret and eventually destroyed, and Quintus in particular never wrote much to begin with.8 Galen learned a tradition that was transmitted person to person, and orally. Like rhetoric for the sophists, medical training relied not only on mastery of what was, by Galen’s time, a massive corpus of texts, mostly lost today, but also on close personal interaction with a prestigious teacher (or, in Galen’s case, a number of teachers) and on practice; for Galen and his fellow students observed their teachers treating patients and worked closely with them. Consultations and debates about specific cases or theoretical problems were normal.

  Galen on Language. Galen shared the sophists’ profound interest in language. He claimed expertise in Attic usage and in Greek usage generally, and authored many works on language, now mostly lost. One of his most significant losses in the fire that consumed the region of the Temple of Peace in 192, including Galen’s supposedly fireproof storeroom there, was his dictionary of words in the Attic comic writers; his dictionary of Attic prose writers survived the fire (though it is lost today), and ran to an astonishing 48 books. He rewrote parts of the dictionary that perished, publishing several works (now lost) on usage in certain Athenian comic writers; he particularly admired the comic poets for their command of idiomatic usage.

  Galen’s views on language were complex. He assumes an audience that was most familiar with the Atticism common among the elite of his day (and he seems to have perceived the Greek normally spoken and written by the cosmopolitan class of educated people like himself as a form of Attic). But his thoughts on the best methods of scientific expression are not easy to characterize and certainly not identical with Atticizing purity, an aesthetic he despised. He idealized the contemporary usage of the “Greeks of Asia,” which he also considered closest to the usage of Hippocrates; and recommended ordinary usage in general, in contrast to erudition for its own sake or the generation of special, technical vocabularies. In his pharmacological treatises, synonyms and local usage are especially important for identifying materia medica, and he often discusses local words and words in other languages, including Latin (Manetti 2009).

  Galen and “the Ancients.” Galen’s intellectual stance reflects the high prestige of the classical period in Second So
phistic culture. Galen attached importance to mastery of a massive tradition in medicine, philosophy, and other subjects, and engages at length and in depth with sources from the archaic period through his own time. His stance generally privileged older over newer authorities. Galen refers often to the palaioi or archaioi, and prefers the readings of the earliest Hellenistic commentators on Hippocrates, at least in those works that he intended for an outside readership. Beyond this, two authors of the classical period—Plato and Hippocrates—played a central role in Galen’s self-fashioning, and his treatise On the Opinions of Hippocrates and Plato sought to demonstrate agreement between these two greatest authorities.

  Galen considered Hippocrates the founder of medical science, and mastery of Hippocrates among the cornerstones of professional competence. By his time there was a long tradition of commentary and exegesis on the works that circulated under Hippocrates’s name, tracing back at least as far as Herophilus. Galen names eight previous commentators on Epidemics III alone (von Staden 2009, 148–149). He had learned Hippocratic interpretation from his earliest teachers, Satyrus and Pelops, though he considered Quintus and his students in general only mediocre authorities on this subject. Galen published commentaries on a large number of Hippocratic books and hoped to comment on all the works he considered genuine before he died (De ord. libr. propr. 3, 19.57K); this exegesis was a lifelong task running to dozens of ancient volumes, in most of which he sought to display his mastery not only of the Hippocratic texts themselves but of all previous commentary on them. It was one of his criticisms of the Methodists that they treated Hippocrates like any other authority, subject to criticism and attack; whereas for other medical traditions, including the Empiricists, Hippocrates was a foundational figure to be interpreted and interrogated but not rejected on any point.