Herophilus: The art of medicine in early Alexandria: edition, translation and essays

356 Pages·1989·16.59 MB·English

by  Heinrich von Staden

HEROPHILUS
The Art of Medicine in
Early Alexandria
Edition, translation dnd essays
H E IN R IC H V O N S T A D E N
Professor of Classics and Comparative Literature
Yale University
CAMBRIDGE UNIVERSITY PRESS
Cambridge
New York New Rochelle
Melbourne Sydney

Published by the Press Syndicate of the University of Cambridge
The Pitt Building, Trumpington Street, Cambridge CB2 irp
32 East 57th Street, New York, ny 10022, USA
10 Stamford Road, Oakleigh, Melbourne 3166, Australia For Tor ben and Tamds
© Cambridge University Press 1989
First published 1989
Printed in Great Britain at the University Press, Cambridge
British Library cataloguing in publication data
Staden, Heinrich von
Herophilus: The art of medicine in early Alexandria:
edition, translation and essays.
1. Herophilus
I. Title
6io,-92i4 R126.H3 /
Library of Congress cataloguing in publication data
Von Staden, Heinrich, 1939-
Herophilus: The art of medicine in early Alexandria.
Bibliography.
Includes indexes.
1. Herophilus, of Chalcedon, ca. 330 B.c.-ca. 260 b.c.
2. Medicine, Greek and Roman. 3. Medicine -
Egypt - Alexandria - History. I. Title.
R126.H373V66 1988 6io'.932 87-6406
ISBN O 52 I 23646 O
CONTENTS
Preface xi
Acknowledgements xv
Note on text, arrangement and translation xvi
List of abbreviations xxv
Sigla, editions xxviii
I · INTRODUCTION I
Alexandrian and Egyptian medicine
PART 1 · HEROPHILUS
II · LIFE 35
1. General 35
2. Date 43
texts: T i-T i 6b 50
III · WRITINGS 67
1. Context and transmission 67
2. Genuine and spurious works 72
texts: T i 7-T41 78
IV · THE PARTS OF THE ART OF MEDICINE 89
1. Historical background 89
2. Galen, Ars medica 1 103
texts: T42-T49 108
V · THEORY OF METHOD AND CAUSE I 15
texts: T5oa-T5gb 125
VI · ANATOMY I 38
1. Dissection and vivisection 139
2. Herophilus’ treatise On Anatomy 153
3. Brain and nerves 155
vii
I
viii CONTENTS CONTENTS IX
4. On Anatomy, Book 11 [?]: abdominal cavity 161 XVI · DEMETRIUS OF APAMEA 5°6
5. On Anatomy, Book hi [?]: reproductive organs 165
XVII · HEGETOR 512
6. On Anatomy, Book iv [?]: vascular anatomy 169
texts: T6oa-T 129 182 XVIII · MANTIAS 5*5
VII · PHYSIOLOGY AND PATHOLOGY 242 XIX · DIOSCURIDES PHACAS 5!9
1. Humours, faculties 242
2. Control centre, nerves 247 XX · CHRYSERMUS 523
3. Respiration 259
XXI · ZEUXIS (PHILALETHES?) 529
4. Vascular physiology; pulse-lore (On Pulses) 262
5. Male reproductive physiology; spermatogenesis 288 XXII ·ALEXANDER PHILALETHES 532
6. Herophilus’ Midwifery, gynaecology 296
XXIII ·APOLLONIUS MYS 540
7. Herophilus’ Against Common Opinions 299
8. General pathological evidence; semiotics 301
XXIV · HERACLIDES OF ERYTHRAE 555
9. Dream theory 306
texts: Ti 3o-T226d 311 xxv · ARISTOXENUS , - 559
VIII · REGIMEN AND THERAPEUTICS 397 XXVI · CYDIAS 564
1. Gymnastics
XXVII · GAIUS 566
2. Herophilus’ Regimen
3. Herophilus’ Therapeutics; general evidence XXVIII ·DEMOSTHENES PHILALETHES «0
0
4. Materia medica
5. Herophilus’ On Eyes
Appendix 579
texts: T227-260 406 Addenda 586
IX · HIPPOCRATIC EXEGESIS; VARIA 427 Bibliography 589
Index locorum 623
texts: T261-T275 432
Index of Greek words 641
General index 651
PART 2 · THE HERO PH I LEANS
(■C. 25Ο B.C.-A.D. 50)
X · HEROPHILUS AND THE HEROPHILEANS 445
texts: T276-T287 462
XI · ANDREAS 472
XII · CALLIANAX 478
XIII ’ CALLIMACHUS 480
XIV · BACCHIUS 484
XV · ZENO 5°!
PREFACE
Discussions of ancient Greek views of human beings often tend to
remain riveted to Athens - to the works of the philosophers, his­
torians, playwrights, and visual artists who. achieved prominence in
Athens. The present work requires a shift of focus from the old citadel
of learning to the new, from Athens to Alexandria, from the
undisputed centre of philosophy to the burgeoning centre of science,
from the Athenian ‘philosophy of man’ to the Alexandrian ‘science of
human beings’.
The first comprehensive presentation of the ancient evidence
concerning the extraordinary accomplishments of one of the leading
scientists of the ancient world hardly requires an apologia. Plunged
into obscurity in part by the popularity of rival schools, in part by the
durability and canonicity of Galen’s subsequent system, the first and
greatest Alexandrian representative of scientific medicine, Herophi-
lus, had to wait long for his rehabilitation. Only in the Renaissance,
when the tenacious authority of Galen became subject to sporadic
challenges, were the achievements of Alexandrian physicians such as
Herophilus accorded renewed recognition and respect. Thus the
distinguished Renaissance physician Gabriello Falloppia exclaimed
in his Observationes Anatomicae (Venice, 1561): ‘Quando Galenus
refutat Herophilum, censeo ipsum refutare Evangelium medicum’,
and ‘Herophili . . . authoritas [mV] apud me circa res anatomicas est
Evangelium.’ Other Renaissance authors, though restricted (as are
we) to a very fragmentary knowledge of Herophilus, called him ‘the
Vesalius of antiquity’, and judgments like these were sounded
increasingly as the Renaissance agon with Galen’s auctoritas spasmodi­
cally but certainly swung in favour of the ‘moderns’ (but even while
more than 600 editions of Galen’s treatises printed between 1473 and
1599 continued making Galen a powerful force in the contest). As one
classical patriarch - Galen - was vanquished, new ones had to satisfy
PREFACE xiii
XU PREFACE
with the discovery of the nerves and with the distinction between
the perennial need for the sanction of the past: Herophilus as the
motor and sensory nerves; they both displayed a keen interest in the
Gospel.
structure and functions of the brain, the heart, and the vascular
Although scholars of our century, too, have continued to recognize
system. Moreover, both wrote on ophthalmology, respiration, repro­
the scientific significance of several of the Alexandrian physicians who
ductive physiology, therapeutics, and causal theory. Even the
span the five murky centuries between Aristotle and Galen, a critical
specifics on which they lavished attention are often remarkably
edition and evaluation of the ancient evidence about the methods,
similar - for example, the relation between fever and pulse frequency.
theories, and practices of Herophilus and his followers have remained
While their pathophysiological systems display major differences, the
a desideratum. Werner Jaeger’s prediction that ‘when a critical
concept of pneuma remains central to both, and their main
collection of the extant remains ... of the doctrines of Praxagoras,
therapeutic principle - treatment by ‘contraries’ - is the same. Refer­
Erasistratus, and Herophilus has become available, the history of
ence will be made throughout this work to the relation between
Greek medicine in the period of its greatest scientific progress will have to be
Herophilean and Erasistratean medicine, but a full discussion of the
rewritten’, has been echoed by a number of modern scholars. The
relation will have to await a critical edition of all the testimonia and
Praxagorean gap - a Coan, not an Alexandrian gap - has been
fragments of Erasistratus.
closed by F. Steckerl’s edition; the present volume will, I hope,
The most notable exception to the general neglect of Alexandrian
accomplish the same for Herophilus.
medicine has been K. Deichgraber’s invaluable account of the
Since this book aims both at the non-specialist with an interest in
Empiricist school of medicine (founded in Alexandria c. 250 b.c. by a
the history of science and medicine and at the specialist, all the
renegade pupil of Herophilus). The only complete extant treatise of
ancient evidence concerning Herophilus is presented in translation
and in the original. Part i (Herophilus) aims at providing a complete Hellenistic medicine, a first-century b.c. commentary by one Apollo­
nius on the Hippocratic treatise On Joints, also belongs to the
set of texts and translations, along with interpretive essays and
Empiricist school and has been edited admirably by J. Kollesch and
comments, but Part 2 (The Herophileans) has been restricted to two
F. Kudlien. Although frequent reference is made in this volume to the
complementary purposes: first, to provide a brief account of major
Alexandrian Empiricists, my primary purpose was to fill the most
developments within the Herophilean ‘school’ after Herophilus, and
serious gap that remains in our knowledge of medicine in Alexandria,
secondly, to offer some sense of the distinctive characteristics of
viz. Herophilus and his followers; for the Empiricists the reader will
individual Herophileans. A complete enumeration of relevant
have to continue relying on Deichgraber.
ancient sources is provided in the chapters on each Herophilean in
It is my hope that the present work will not only provide access to a
Part 2, but the texts and translations have been omitted. It is hoped
significant and neglected chapter in the history of medicine, but be of
that this restrictive approach to Part 2 will render the book more
value for other reasons as well. For most scholars the main avenues of
approachable, especially for the non-specialist. (In Part 2 the
access to the ‘views of human beings’ in a given culture have tended to
boundaries suggested by ‘early Alexandria’ are occasionally violated
remain the literary, religious, and philosophical texts of the culture,
both geographically and chronologically, but the overwhelming
its political and social history, its art, and its other artefacts. Yet from
majority of texts presented here were a product of early Alexandria.)
ancient Greece to the present, scientific theories and observations,
It remains controversial whether Erasistratus belongs mainly to
too, have moulded our self-perception and self-depiction decisively.
the Alexandrian sphere, and the original intention of treating him
Scientific views, both about the nature of the external world and
and Herophilus in a single work has therefore been abandoned in
about the internal construction of humans, tend to become known
favour of separate studies. Wherever Erasistratus might have prac­
outside the scientific community, even if in popularized or distorted
tised, the similarities between his scientific interests and those of
versions, and sometimes they strongly influence attitudes and views
Herophilus are striking. Human dissection and vivisection are
displayed in non-scientific texts. From the anguished choral cry
attributed to both Herophilus and Erasistratus; both are credited
XIV PREFACE
‘much cuts to the liver’ in Aeschylus’ Agamemnon to Shakespeare’s ‘a
good sherris-sack . . . ascends me into the brain, dries me all the
foolish and dull crudy vapours which environ it’, and from Plato’s
account of the construction of the body (Timaeus) to Ezra Pound’s ACKNOW LEDGEM ENTS
‘the bone is in fact constructed | according to trigonometrical
whichwhat . . .’, a rich history of allusion, image, and fancy testifies to
the impact of scientific and, in particular, of medical theories upon It is a pleasure to record, however inadequately, my warm gratitude
non-scientific texts. Alexandria is no exception, and a number of to friends, colleagues, and institutions that offered scrutiny and
examples of the penetration of literary and philosophical texts by encouragement.
medical theories are pointed out in this volume; more examples will Some of the ideas in this book profited from being presented to
undoubtedly strike other readers of the texts presented here. audiences at Boston University, Harvard University, Johns Hopkins
It is also my hope that this work will contribute to a more balanced University, McMaster University, University of California at Los
and informed assessment of the accomplishments and complex Angeles, Wellesley College, Wesleyan University, Yale University,
character of what has come to be called the ‘Hellenistic Age’ - often and to the Society for Ancient Medicine and the American Associ­
with pejorative overtones - ever since the German schoolmaster and ation of Ancient Historians. Professors Phillip De Lacy, David
historian Johann Gustav Droysen coined the term ‘Hellenistic’ in the Furley, Geoffrey Lloyd, and Friedrich Solmsen read the manuscript
nineteenth century. Not that assessments of the Hellenistic Age have in various stages of completion and revision. They generously offered
been uniformly negative: while Nietzsche characterized Hellenistic numerous suggestions and rescued me from many a lapse. Professor
culture as feeding on degenerate ‘air that was rank and overcharged De Lacy and Professor David Sider very kindly made some of their
with Aphrodisiac odours’, Victor Ehrenberg found in it ‘a climate of unpublished manuscript collations available to me. Dr Vivian
serenity’; and while Julius Beloch described it as an epoch in which Nutton graciously provided access to his forthcoming edition of
the demi-monde saw its brightest times, Michael Rostovtzeff saw in the Galen’s De sententiis. The late Derek deSolla Price offered many useful
early Hellenistic period the birth of a sober humanitas and believed suggestions, as did several colleagues in the Yale School of Medicine
that ‘the future proved that the pride of that age in its past and (especially Dr Elisha Atkins). Mr N. G. Wilson generously shared his
present was justified’. One thing these disparate, though by no means redating of several MSS and gave the conspectus siglorum the benefit
mutually exclusive, assessments tend to have in common is their of his expert scrutiny. The sustained interest and warm support of
failure to accommodate explicitly the contributions to medical Professors Evelyn Hutchinson, Donald Kagan, and Hugh Lloyd-
science presented and analysed in this volume. (A laudable exception Jones animated the project more than once. For assistance with
is P. M. Fraser’s Ptolemaic Alexandria.) I hope it is not rash to suggest various technical aspects of preparing the manuscript I am indebted
that any scholar who wishes to do justice to the complex dimensions to Martha Achilles, Thomas Crawford, Professor Michael Poliakoff,
and achievements of the period should also become cognizant of the Brock Reeve, Dr Henry Schneiderman, and Professor David Tandy.
remarkable scientific achievement which even now has become only Many others, too numerous to mention here, have my gratitude for
partially unveiled through the fragmentary evidence presented in this their helpful suggestions. Pauline Hire of Cambridge University Press
volume. deserves special thanks for her enormous patience and constructive
help. The flaws that remain are, of course, my responsibility. Quae me
H.v.S.
fugerunt, alii facile reperient.
I owe warmest thanks to my wife, Eve Ingalls, and to our sons,
Torben and Tamas. Faith and forbearance are but two of the
magnificent gifts they have given in most generous measure.
NOTE ON TEXT, ARRANGEMENT AND TRANSLATION XVII
of Alexandria have illustrated how rapidly the supposed indirect
sources tend to usurp the attested primary evidence. Third, as Felix
Jacoby, among others, has suggested (FGrH i, p. viii), the selection of
NOTE ON
indirect testimonia tends to be as subjective and eclectic as an editor’s
notions of ‘influence’ and ‘affinity’ are. What to one critic seems a
TEXT, ARRANGEM ENT AND TRANSLATION
strong and central affinity, to another looks weak or peripheral; what
to one seems a clear genealogical line, to another is an irregular
pattern of thematic coincidences without any genetic implications. I
do not mean to question the value of scholarship on indirect sources
and on influence, but it seemed advisable first to offer a foundation on
i Criteria for inclusion
which such research must build, and to alert the reader to some
One of the more vexing problems facing an editor of fragmentary
potential indirect sources in the introductions and comments.
material is that of criteria for including and excluding texts. The
By restricting the texts to those which mention Herophilus and his
guiding principle of this volume was to restrict the edition to texts in
followers by name, I do not wish to suggest, however, that
which Herophilus or his followers are explicitly mentioned by name.
authenticity is guaranteed by the presence of a name. Some ancient
The severity of this principle will perhaps be no less controversial than
authors giving accounts of ‘Herophilean’ views may have been
was the lack of severity displayed in, for example, Hans von Arnim’s
misinformed and some, as pointed out throughout this work, were
selection of texts in Stoicorum Veterum Fragmenta or in Karl Reinhardt’s
certainly polemical, whereas others, including Galen, used Herophi­
liberal use of putative indirect testimonies to reconstruct Posidonius’
lus or one of his followers without naming them. But again, one could
philosophy. It could admittedly be argued that numerous passages in
not analyse these problems adequately until all views and observa­
Soranus, Galen, Rufus, and other writers of the Imperial period stand
tions directly and explicitly ascribed to various Herophileans by
in the shadow of early Alexandrian physicians, such as Herophilus,
ancient sources were first collected and subjected to a critical sifting.
without any explicit acknowledgement by these later authors of the
While attention is drawn to the questionable value of some such
Herophilean provenance of their theories or observations. The
texts - and to the occasional need for emending others so as to deprive
decision to confine this edition to explicitly attested material at the
them of their value - all explicitly attested tejcts that have come to my
expense of such indirect sources - to which reference is, however,
attention are included on the grounds that the reader must be
made in the introductions to (and comments on) some chapters - was
allowed to decide for her- or himself whether my conclusions about
reached on several grounds. First, I believe that an edition limited in
the value of a given text are merited. Texts included under the rubric
this way at present is the most crucial (and least misleading or
Dubia (at the end of the collection of texts in some chapters) are the
confusing) contribution to the study of early Alexandrian medicine.
ones whose authenticity or relevance I doubt very strongly.
What is lacking at present is, after all, a conservative presentation of
When Herophilus or one of his followers is referred to repeatedly in
the primary evidence on which any subsequent analysis of derivative,
a continuous passage, or when the sense of reference (for example, of
influenced, or dependent passages in authors of the Roman Imperial
pronouns) in a text would be unclear or ambiguous in the absence of a
and Byzantine periods will have to be based. Second, the inclusion of
larger context, I have thought it useful to print more than just the
large amounts of unattested but ‘influenced’ material might have
sentences explicitly mentioning a Herophilean and his views, so as to
brought with it the danger of reconstructing Herophilean theories
facilitate the reader’s understanding of the passage. In all other cases
mainly through the hypothetical victims or beneficiaries of influence,
I have tended to severity.
as has occurred, for example, with highly problematic results in
scholarship on Posidonius and on Gnosticism. Several well-known
discussions of the ‘Posidonian’ origins of treatises by Cicero and Philo
XV111 NOTE ON TEXT, ARRANGEMENT AND TRANSLATION NOTE ON TEXT, ARRANGEMENT AND TRANSLATION XIX
certainty is impossible, and the particular sequence of Herophileans I
2 Fragment and testimonium
have settled on is, therefore, to be understood only as a provisional
Where there is reason to believe that a literal quotation from an ordering device and not as a sequence on which one could insist
authentic work by Herophilus or a Herophilean is intended by an dogmatically. The existing evidence is not always unambiguous, and
ancient source, this has been indicated by inverted commas. Such further evidence might well necessitate a revision.
quotations are referred to throughout this volume as ‘fragment’ (Fr), The bulk of the ancient evidence concerns the founding master of
although I must stress that it is not possible to determine in each case the school, Herophilus. Within the large corpus of texts about him I
how closely or loosely even a putative ‘fragment’ is related to the have first provided the testimonies about his life, about the books he
original. All other texts will be referred to as ‘testimonia’ (T). wrote, about his theory of the parts of medicine, and about his views
Every editor tends to be more exhilarated by the discovery of a on method and causation. Then follow the central categories of his
‘fragment’ than by a ‘testimonium’, and I am no exception, but one medical ‘system’: anatomy, for which he was perhaps most famous
should guard against an undue exaggeration of the value of both in antiquity and in the Renaissance; physiology and pathology
fragments. While it is true that paraphrases or polemical refutations (here his area of special expertise, pulse theory, is most prominent);
of precursors’ views (and many of the testimonia in this volume are and therapeutics. These central chapters are finally followed by the
culled from such polemical contexts) tend to transform the original controversial testimonia about his interest in, and perhaps exegesis of,
texts to a greater degree, and in more ways (lexical, terminological, some Hippocratic treatises. The sequence of the central chapters,
conceptual, perspectival, etc.) than does transmission by literal from anatomy to therapeutics, seems compatible with Herophilus’
quotation, one should nevertheless remember that even if part of an own division of medicine (see Chapter iv), although it is not clear that
Alexandrian text is preserved word for word in a fragment, the he consistently separated these branches of medicine in his writings:
recovery of the true meaning of a fragment is often no easier than the anatomy and physiology would belong to the first branch (‘healthy
recovery of a theory that is being paraphrased or refuted, inasmuch as things’), pathology to the second (‘things pertaining to disease’), and
the fragment is now dislodged from its original context. In short, an therapeutics to the third (‘neutrals’).
interpretation based on fragments, while different in kind - and Perhaps the most controversial aspect of the arrangement of texts
while often based on a more transparent process of transmission — is will be the decision not to present all the ‘fragments’ together in
frequendy no less defective and partial than one based on testimonia. complete isolation from the ‘testimonia’, as, for example, in Hermann
(The non-classicist should perhaps be warned that this view will not Diels’ Fragmente der Vorsokratiker. This decision was reached only after
be shared by all classicists, but it is a conclusion which seems to be much hesitation. The reasons for the arrangement include the
substantiated by the results presented in this volume.) following: first, it is not always clear that the evidential value of a
fragment, at least in medical history, is greater than that of a
testimonium, and often the meaning of the fragment remains
3 Principles of arrangement
impenetrable in isolation. Second, in many cases the reader would
In the ordering of fragmentary evidence a number of variations tend have to perform a constant shuttle between a given fragment and the
to be possible, and no two editors are likely to opt for identical many testimonia on the same subject in order to arrive at an
sequences. A brief explanation of the principles which guided this understanding of the fragment. Third, the compromise solution
edition might therefore be useful. adopted in this volume - clustering together, within each chapter, all
The Herophileans are introduced in chronological sequence, fragments identified as belonging to a relevant book or books by
starting with Herophilus in the early third century b.c. and ending in Herophilus, and then grouping together all other evidence themati­
the mid first century a.d. with Demosthenes Philalethes (probably no cally related to these fragments - provides the reader with conve­
later than the Neronian period). In some cases chronological nient, consecutive access to all evidence on a given subject, without