This volume focuses on Aristotle’s relationship to medicine and physicians, especially in relation to ‘Hippocratic’ writings. Given the complexity of the topic and its long history, we will first provide a brief overview, surveying its historical roots, later development, and the current status quaestionis. We shall then return to the specific aims and content of this volume.
1 Aristotle and Medicine
Aristotle’s father Nicomachus was a court physician to the Macedonian king Amyntas III (reigning from c. 393 to c. 370 BCE).1 Although Nicomachus died at an early age, it is reasonable to assume that Aristotle was brought up in a medical environment and that he received some medical education (formal or informal) before he left for Athens to enter Plato’s Academy.2 Apart from this family context, medical literature at this time was accessible to lay persons as well as physicians,3 and medical topics and theories were frequently discussed among Athenian intellectuals, not least by Plato himself.4 Therefore, it comes as no surprise that Aristotle was exceptionally well acquainted with contemporary medical knowledge and literature, to the extent that he even wrote several treatises on medical topics, of which only On Sterility (Hist. an. 10) has survived.5 In addition, throughout his biological as well as ethical works, we find a striking number of medical examples and references to medicine and physicians. Yet the latter are rarely mentioned by name,6 and with only two exceptions (Hist. an. 3.2–3, see below), he never quotes their works. Instead, he most often speaks about “physicians” as a general group,7 or more specifically about “some”, “many”, or “ancient” physicians, for example.8
Aristotle was apparently well aware of the diversity among medical authorities and their theories, and also of the various sorts of medical experts in terms of their education, experience, and theoretical interests.9 For instance, in his account of the process of acquiring knowledge and skills through experience in the first book of Metaphysics, he makes it clear that in medicine as well as in any other technē, the master craftsman (architekton) is superior to a mere practitioner, for the practitioner knows the facts (hoti) and how to do things, while the master also “possesses the theory and knows the causes”.10 In other words, “art (technē) rather than experience is scientific knowledge (epistēmē)”.11 Accordingly, only some physicians and medical authors are to be considered scientists in the proper sense, and their views deserve special attention in discussions on causality and other topics pertaining to natural philosophy.
The most notable examples of Aristotle’s recognition of exceptional medical authorities can be found in the treatises collected in the Parva Naturalia. In On Prophecy in Sleep, to begin with, Aristotle asks whether some dreams can be interpreted as “signs of what happens in the body”. In support of a positive answer to this question, he reminds his readers about the opinion of medical authorities:
At any rate the distinguished (charientes) doctors, too, say that close attention should be paid to dreams. And this position can reasonably be held also by people who are not experts, but inquire into the matter to a certain extent and have a passion for knowledge (philosophousin).12
A clear distinction is drawn here between medical expert and lay person, as well as between a practical approach to medical diagnosis and a general or theoretical interest, which is conveyed by the verb philosophein.13 Yet this interest has its limitations (“to a certain extent”, ti), and philosophical inquiry does not compete with but instead overlaps with the experience and authority of the medical experts.
The relationship between medicine and natural philosophy is also addressed explicitly at the beginning of On Sensation, which opens the Parva naturalia and introduces the various topics covered in the series of treatises on phenomena common to body and soul:
It is the business of the student of nature to inquire into the first principles (archai) of health and disease. For neither health nor disease can come to be in things deprived of life. So generally speaking, most of those who study nature end by dealing with medicine, while those of the doctors who practise their art in a more philosophical manner (philosophōterōs) take their medical principles from the study of nature.14
And towards the end of On Respiration, which concludes Parva naturalia, Aristotle reformulates the idea:
As for health and disease, it is not just the business of the doctor, but also of the student of nature, to discuss their causes (aitiai) up to a point.15 But we should not fail to recognize the way in which they differ and consider different issues, since the facts show that up to a point these inquiries border one another. For those doctors who are more subtle (kompsoi) and inquisitive (periergoi)16 have something to say about the study of nature and claim to derive their principles (archai) from it, while the most distinguished (charieis) of those who study nature generally end up by considering medical principles (archai).17
In both passages, Aristotle distinguishes between medicine and physicians on the one hand and the study of nature and philosophers on the other, and he mentions the principles of health and disease as paradigmatic concepts common to both fields of expertise.18 His remarks are clearly addressed especially to students of natural science, encouraging them to study medical principles. The final sentence of the second passage (as well as the introductory passage in On Length and Shortness of Life)19 even seems to announce a philosophical discussion dedicated to health and disease (which has either been lost or was never written).20 Alternatively, it is also possible here that Aristotle is explaining and justifying his own remarks on health and other medical topics that we find throughout the Parva naturalia and other texts.21
As for the medical authorities, Aristotle states that some adopt their principles from philosophical thought instead of deriving them solely from medical experience. This practice is attested and criticized by the author of the Hippocratic On Ancient Medicine, who names Empedocles as a prime example of an influential philosophical authority, and the hot and the cold as examples of theoretical principles co-opted from philosophy by the medical authorities he has in mind. Aristotle evidently sides with the criticized physicians, and although he does clearly demarcate between the two groups, at the same time he advocates a certain reciprocal exchange of ideas between them.22
Despite the various special problems associated with these two passages and the multiplicity of modern interpretations, we may reasonably conclude that in both of them Aristotle strongly encourages his students and readers to pay attention to contemporary medicine and especially to medical theories and principles. And unless one was born to a medical family or studied in a medical school (such as the one at Cos), the most convenient way to do so was to study medical literature. This brings us to the so-called “Hippocratic Corpus”, the main body of medical literature from the Classical period.
2 Hippocrates, Hippocratic Writings and the “Hippocratic Question”
Hippocrates, the founder of the medical school at Cos, was the most celebrated and respected Greek physician of the Classical period.23 Although we have no reliable evidence that Hippocrates himself put down any of his ideas or observations in writing, a number of medical texts or accounts almost certainly circulated under his name as early as in the fourth century, if not before. According to Galen,24 Ctesias of Cnidus had already reproached Hippocrates for his method of setting a dislocated hip, attested in the Hippocratic On Joints. Plato mentions Hippocrates’ method of investigating nature as a widely known procedure in the Phaedrus (270c1–5), which may refer to passages in the Hippocratic On the Nature of Man,25 On Ancient Medicine,26 On Regimen,27 or in Airs, Waters, Places.28 According to the Anonymus Londinensis, Aristotle produced a detailed account of Hippocrates’ theory of the causes of diseases, and the detail provided in the Anonymus Londinensis closely corresponds with the account in the Hippocratic Breaths.29 Finally, Aristotle’s contemporary Diocles of Carystus criticizes Hippocrates for having admitted three kinds of fever in addition to the four traditionally recognized,30 a criticism that most likely refers to the first book of Epidemics.31
This early evidence suggests that some medical texts ascribed to Hippocrates circulated in Plato’s and Aristotle’s time, although, as van der Eijk has noted, “one gets the impression that disagreement or confusion about the precise teaching of Hippocrates existed already in the 4th c.”32 And it is perhaps this initial confusion about the authorship that paved the way for the existence of various collections of Hippocratic texts in the following centuries. The earliest evidence for a collection of texts attributed to Hippocrates comes from the early Hellenistic period, and the evidence grows over time. Bacchius of Tanagra, a disciple of Herophilus of Alexandria and a commentator and glossator of Hippocrates, attests about twenty texts attributed to Hippocrates. Three centuries later, Erotianus mentions about forty,33 and the 1526 Aldine edition (as well as most subsequent editions, including Littré) consist of 60 or so treatises. In other words, the Hippocratic Corpus is the final product of a long process of canonization with a strong accretive tendency, which gradually absorbed practically all extant non-fragmentary medical literature from the Classical period.34 Nutton goes so far as to conclude that the Hippocratic Corpus as we know it “is a renaissance construct”.35
Modern editions often claim that they represent a ‘complete’ collection of the Hippocratic texts, such as Littré’s Oeuveres complètes d’Hippocrate. However, this assertion needs qualification. “From the Early modern period onwards,” explains van der Eijk, the claim to completeness (opera omnia, œuvres complètes) seems meaningful only in the practical sense of “comprising all extant works that are known to have, at some stage of their transmission, been attributed to or associated with Hippocrates … regardless of when, by whom, on what grounds and with what justification, these attributions were made”.36 Moreover, even these allegedly ‘complete’ collections are selective and do not include all texts that have been preserved under Hippocrates’ name. For instance, Littré’s Oeuvres complètes does not incorporate Testamentum and some of the so-called Letters.37
In any case, the majority of the texts included in modern Hippocratic collections can be dated within Hippocrates’ lifetime (i.e. between the middle of the fifth and the beginning of the fourth century BCE). Some may be even older (such as Epidemics),38 and others evidently came later, i.e., from the Hellenistic and later periods, such as On the Heart, On Decorum, On the Physician, and Precepts.39 Even if we exclude from consideration all post-Aristotelian texts, the diversity of the Hippocratic writings and the variety of their (often conflicting) views and theories makes it quite impossible for all of them to have been written by a single author or even a group of authors within one school. Accordingly, Littré, for instance, believed that only 11 out of the 60 or so treatises can be ascribed to Hippocrates himself.
The so-called Hippocratic question regarding whether or not Hippocrates wrote these texts stretches back to antiquity. Galen already distinguished between authentic and inauthentic Hippocratic texts according to his “thoroughly subjective notion of what was worthy or unworthy of Hippocrates”.40 He even devoted an entire treatise to the topic (On the Authentic and Illegitimate Writings of Hippocrates), which unfortunately has been lost. Modern debate on the issue practically ceased during the second half of the twentieth century, with a number of scholars independently coming to the conclusion that none of the Hippocratic writings can with reasonable certainty be ascribed to Hippocrates.41 Accordingly, “statements prefaced by ‘Hippocrates said …’ or ‘Hippocrates knew …’, all too common in general writings about early medicine, are fundamentally misplaced”, as Craik concludes.42
This scepticism gives rise to a new dilemma. The roughly sixty medical texts in the Hippocratic Corpus have little in common (apart from their Ionian dialect and interest in medicine, diseases, or therapy)43 and none of them can be definitively ascribed to the historical Hippocrates. Yet, outside the Hippocratic Corpus, practically no other medical literature of the Classical period survives:44 there is no ‘non-Hippocratic’ medicine. Why then should we even speak about ‘Hippocratic’ medicine, or ‘Hippocratic’ physicians, accounts, and ideas?
Two different approaches have been suggested by two leading Hippocratic scholars, J. Jouanna and P. van der Eijk. Jouanna presents a rather conservative approach that acquiesces in the traditional ambiguity as follows:
And without wishing to ignore these differences and contradictions, we may speak from now on of the ‘Hippocratic physician’ in the broad sense of the phrase—indeed, for the sake of convenience, of ‘Hippocrates’—without thereby prejudging the question of authorship. The name Hippocrates signifies in fact two things. It signifies, first of all, Hippocrates the historical figure. But it also stands for the work that has been bequeathed to us under his name. For as long as this collection of medical manuscripts has been known, this ambiguity in the use of the name has been constant. It cannot really be gotten away from. The essential thing is that we are aware of it.45
Van der Eijk, by contrast, proposes a more radical solution and recommends discarding the term ‘Hippocratic’ and replacing it with less potentially misleading phrases such as ‘Classical Greek medicine’, or ‘fifth and fourth centuries Greek medicine’.46 This applies equally in the case of the Hippocratic Corpus:
Rather than continuing to refer to the ‘Hippocratic Corpus’, I would argue that the Hippocratic body needs to be dismembered in order for the individual texts to be properly contextualized and historicized and, eventually, regrouped in new mappings. That, I suggest, is one of the major challenges facing current Hippocratic scholarship.47
Our approach in this volume adopts a kind of middle position. In line with tradition, our contributors retain the adjective ‘Hippocratic’ in their references to individual texts of the Hippocratic Corpus, their authors and ideas. On the other hand, they avoid Hippocrates’ name on such occasion, except for references to the historical physician. The only exception is the title of this volume, where we take the liberty of using Hippocrates’ name in a general sense as a shorthand description of medicine and physicians preceding and contemporary with Aristotle.48 In any case, with the exception of Perilli in the first chapter (p. 27–30) none of our contributors directly address the Hippocratic question in terms of the authorship of the medical writings or the unity of the Hippocratic Corpus in general. It is rather the individual texts themselves and their content that form the focus of attention.
3 Aristotle and the Hippocratic Writings
The idea that Aristotle was “an attentive reader of Hippocrates”, as Jouanna puts it,49 goes back to Galen, who took for granted that, in some of his theories and accounts, Aristotle drew on the very same medical sources and authorities that Galen was familiar with under Hippocrates’ name. And since Galen believed that at least some of the texts were written by Hippocrates himself, he called Aristotle an “interpreter of Hippocrates’ reasoning on nature”.50 As for Hippocratic texts, given the fact that most of them can be dated before Aristotle, it is highly likely that at least some of them were already circulating in Plato’s Academy and Aristotle’s Lyceum.51 Accordingly, assuming that Aristotle, together with his colleagues and students, paid considerable attention to medical theories and their written accounts, the question arises as to whether they read and discussed the very same medical texts that we read today. Providing an overarching answer, however, is impossible: the question can only be approached in relation to individual texts.
Two significant quotes in Aristotle’s Hist. an. 3 may suggest that the most likely candidates for such texts are On the Nature of Man and On the Nature of Bones. Aristotle quotes at length two distinguished medical authorities to demonstrate that they are both wrong about the origin of blood vessels in the human body, for they both make the head (instead of the heart) the starting point of the system of vessels. The first account of vessels is ascribed to Syennesis, “the physician from Cyprus”, (Hist. an. 3.2, 511b25–30), and the second one to Polybus (Hist. an. 3.3, 512b10–513a8). Both of these accounts happen to be found in the Hippocratic On the Nature of Bones (chap. 8 and 9). Yet the possibility is weakened by the fact that the first part of the treatise (chap. 1–10) consists of a series of disjointed passages on various anatomical questions that the author may well have gathered from other sources. One possible source is On the Nature of Man, which in chap. 11 introduces the very same account of vessels that Aristotle ascribes to Polybus.52 Accordingly, it seems possible that both Aristotle and the author of On the Nature of Bones copied this specific account from On the Nature of Man, a highly original work that introduces the theory of four humours and which can also be ascribed to Polybus on the basis of the evidence in Anonymus Londinensis.53 On the other hand, one cannot exclude the possibility that the author of On the Nature of Man also borrowed this passage from some earlier source.54 In any case, it is likely that the Hippocratic versions of the second passage preserve the original wording of this authoritative medical endoxon, for they are much closer to one another than to Aristotle’s citation.55 Di Benedetto has observed that there are suggestive discrepancies between the Hippocratic versions and Aristotle’s report and that Aristotle may have made deliberate changes in his transcription.56 It is also significant that Aristotle omits the last ten lines of the account, which do not relate directly to the point at hand, and that he modifies the initial qualification of the report.57 Accordingly, despite the fact that the extant evidence does not allow us to conclude with certainty that Aristotle quoted directly from one or the other of these two particular Hippocratic treatises, it does indicate his serious engagement with (and criticism of) authoritative medical accounts. In some cases, as in the two passages discussed so far, such accounts are taken into consideration as authoritative sources in terms of evidence or theory that needs to be supplemented and refined by Aristotle’s own observations and arguments. In other cases, however, medical endoxa are mentioned anonymously alongside opinions of pre-Socratic philosophers and other thinkers relevant to Aristotle’s accounts. Occasionally, conceptions and terminology of medical origin are adopted and tacitly integrated into Aristotle’s own expositions.
As for modern discussions of this evidence, Littré recognized numerous significant parallels between the Hippocratic texts and Aristotle’s writings in the preface to his critical edition, and even concludes that they share “the same doctrines, same hypotheses, same details”.58 A few decades later, Poschenrieder listed over 30 passages in Aristotle’s biological works that he thought bore the traces of Hippocratic influence.59 Yet the proposed similarities with Hippocratic texts have been rejected by Fredrich and Balme on the basis that they represent mere “commonplaces”.60 Some have evinced a more extreme scepticism by concluding that Aristotle was “apparently unacquainted with the Hippocratic writings” and simply “not interested in medicine”.61 Nevertheless, since the pioneering work by Poschenrieder, the relevance of Hippocratic texts to Aristotle’s zoological works has been revisited more systematically by Byl and Oser-Grote, who collected hundreds of passages containing correspondences between Aristotle and the Hippocratic writings, and took these to reflect Aristotle’s dependence on these particular texts.62 Yet Oser-Grote has emphasized the lack of direct quotations from the Hippocratic writings and proposed that we should more accurately speak of a “relaxed dependence”. In addition to these comprehensive accounts, dozens of more specialized studies have been published (especially in recent decades) arguing for significant Hippocratic influence on Aristotle’s discussions of the vascular anatomy, the relationship between philosophy and medicine,63 the nature of elements and their attributes,64 the concepts of teleology and spontaneity,65 the various aspects of the generation of animals,66 issues concerning dietetics, food, and health,67 as well as sleep and dreams,68 and other topics pertaining to the philosophy of nature.69 In other areas of Aristotelian studies, the relevance of the Hippocratic literature to Aristotle’s ethical writings has recently been discussed by a number of authors.70
Despite these developments and the considerable amount of evidence adduced to support the idea that Hippocratic texts provide unique and invaluable evidence for natural science (and other fields of knowledge) prior to and contemporary with Aristotle, scepticism has remained in some quarters, especially from those who argue that Aristotle’s biological research reflects a categorically more sophisticated level of scientific methodology than medicine. Edelstein, for instance, claimed that “if one holds that biological research culminated in Aristotle’s philosophy, one must realize that the concept of the organism which acts according to purpose was the discovery of the philosopher Aristotle”. His conclusion was that, in this case, “the assumption of an influence of Greek medicine on Greek philosophy must be regarded as historically incorrect”.71 Several decades later, Richard Owen flamboyantly declared in favour of Aristotle’s achievements and originality that “zoological Science sprang from his labours, we may also say, like Minerva from the head of Jove, in a state of noble and splendid maturity”, implicitly denying the scientific significance of medical knowledge prior to Aristotle.72 And most recently, Lennox, who quotes Owen’s witticism in his entry “Aristotle’s Biology” in the Stanford Encyclopaedia of Philosophy, states that Aristotle is properly recognized as the originator of “the scientific study of life” despite the fact that “many earlier Greek natural philosophers occasionally speculated on the origins of living things and much of the Hippocratic medical corpus, which was written before or during Aristotle’s lifetime, displays a serious interest in human anatomy, physiology and pathology.”73 Before Aristotle, Lennox explains, “only a few of the Hippocratic treatises are both systematic and empirical, and their focus is almost exclusively on human health and disease”. Accordingly, no medical evidence is taken into consideration in Lennox’s account of Aristotle’s biology.
In light of this state of affairs, with enthusiastic proponents offset by radical sceptics, our volume intends to reassess the relevance of medical knowledge and literature to Aristotle. More specifically, we aim to revisit some of the previously suggested parallels and correspondences between Aristotle and the Hippocratic writings, as well to adduce new evidence and topics. Ultimately, we would like to encourage future research in this specific area of study at the crossroads between Aristotelian studies and the history of ancient medicine, a field that has flourished remarkably in recent decades and yet remains far from being exhaustively explored. Rather than presenting a systematic survey of previously published work, our volume provides a series of new case studies, each focusing on a specific discussion within the Aristotelian Corpus for which we have identified some potentially relevant precursors in the medical literature. Each of these studies focuses on a different set of texts and draws different conclusions.
In the opening chapter, Lorenzo Perilli critically examines the very title of our volume, Aristotle reads Hippocrates, and asks three crucial questions: what is meant by ‘Aristotle’, what is meant by ‘Hippocrates’, and what is meant by ‘reading and writing’ medicine in classical Greece? These three questions are explored in several steps, in which Perilli shows that neither Aristotle nor Hippocrates can be taken simply as names of concrete historical figures and that in making any claims about their relationship, one must take into account the various ways in which they can be approached and studied (e.g., Aristotle as the author of works intended for publication, Aristotle as the author of the lectures, notes, and drafts which later served as the basis of the extant writings, Aristotle of Aristotelianism, etc.). He further examines the complicated nature of medical texts, their authorship, and the process through which the Hippocratic corpus was collected. Also, in order to understand how Aristotle could have ‘read’ Hippocrates, we need to take into account Aristotle’s methodology and especially the way he works with his sources. After considering all these methodological and contextual issues, Perilli concludes that Aristotle’s interest in medical knowledge proper was functional to his more general philosophical ideas. What interested Aristotle was not so much the detailed observations and technical expertise of medical texts of the extant CH, but rather the speculative synthetic perspective, which is rarely found in medical accounts. Accordingly, he classifies medicine as an applied and subordinate practice. Perilli is sceptical about any direct influence of the medical texts on Aristotle, instead suggesting that most of the parallels can be explained by reference to shared common knowledge among the educated or to common (but no longer extant) sources.
In the second chapter, Hynek Bartoš analyses the concept of a well-balanced mixture (syn/krasis), according to which human and animal bodies need to retain a kind of balance among their elemental constituents in order to remain alive and healthy. Contrary to the usual assumption that this notion was common to all Greek medicine and could already be found among pre-Socratic philosophers, Bartoš argues that the concept originated in the second half of the fifth century BCE amidst discussion of the principles of dietetics, a relatively new and progressive branch of medicine. Having identified the dietetic origins of the idea, Bartoš tracks its history in Plato and Aristotle. He shows that Plato experiments with the medical concept and thus introduces it into philosophical discourse, while Aristotle employs it with full confidence and in conformity with the Hippocratic accounts and elaborates on it in his discussions of health, procreation, sensation, intelligence, and other key concepts of his philosophy of nature.
In the third chapter, Stavros Kouloumentas and Stasinos Stavrianeas offer a detailed discussion of some key themes of On Ancient Medicine such as the nature and constitution of bodily parts and the method of studying them, as well as Aristotle’s contribution to these topics. The authors show that, even though On Ancient Medicine is never referred to by Aristotle, there is a strong affinity between the two approaches to the problems discussed. For instance, both the ‘Hippocratic’ author and Aristotle criticise Empedocles and other medical and philosophical authors, and their criticism is based on similar grounds: the crucial point is to understand how the structures of a living being are interrelated to its functions rather than how it was shaped. Moreover, it seems that in some instances Aristotle supplements or revises the analysis of On Ancient Medicine. This indicates that Aristotle was engaged in dialogue with thinkers who shared the views articulated in the ‘Hippocratic’ treatise, if not with the text itself.
In chapter four, Sean Coughlin focuses on Aristotle’s use of the phrase “art imitates nature”. He challenges Jaeger’s teleological interpretation of the phrase and defends the claim that, for Aristotle, it does not express a novel belief about teleology, but a belief common to Aristotle and his predecessors about how artistic methods of production were first discovered and how arts progress. Coughlin traces the history of this belief from early Greek medical writings through Democritus and Plato to Aristotle. He shows that by looking at how early Greek medical and philosophical writers understood discovery and progress in the arts, we can better understand Aristotle’s expectations for a scientific investigation into nature and what motivated the method of inquiry he claims the natural scientist should adopt. One advantage of this approach is that it accounts for resemblances among Aristotle’s claim and similar ones in other writers, from Democritus to Dante.
In the fifth chapter, Claire Bubb discusses Aristotle’s account of sleep and its relation to other philosophical and medical thought of the 5th and 4th centuries. Bubb pays special attention to the fact that while previous philosophers had linked sleep with heat and blood, in Aristotle’s explanation of sleep and waking it is digestion that plays a critical role. Bubb shows that there was a wide range of medical authors who closely associate the processes of sleep and digestion, and that all basic elements of Aristotle’s theory of sleep as a digestive process were already present in the medical thinking available in his day. Even though Aristotle develops and modifies the physiology relevant to the explanation of sleep, his discussion of sleep and digestion remains remarkably consistent with the medical tradition.
In the next chapter, Sophia Connell focuses on the overlaps between the ancient medical works on women’s health and Aristotle’s discussion of these topics in the Generation of Animals and book 7 of the History of Animals. After discussing Aristotle’s methodology of natural science, she identifies a tension in Aristotle’s reproductive science, in that humans are both paradigmatic and exceptional. Connell demonstrates that in his general theory of sex difference and reproduction, Aristotle focuses on medical debates which concern only humans and which he extends to all animals. She also discusses contrasts as well as similarities with medical experts in Aristotle’s view of women’s pathological condition. While certain characteristics of women are open to reasonably straightforward Aristotelian explanations, others are more problematic and seem to indicate the strong influence of a medical framework.
Aristotle’s indebtedness to medical authors in the area of conception and pregnancy is further explored by Mariska Leunissen in chapter 7, focusing on a specific gynaecological phenomenon called wind-pregnancies. Leunissen argues that Aristotle’s accounts of this phenomenon in the History of Animals and Generation of Animals rely heavily on specific facts and opinions found in the Hippocratic On the Nature of the Child and Airs, Waters, Places. Despite Aristotle’s affirmation of the epistemological authority of women concerning the timing of conception, Leunissen demonstrates that his main source of knowledge of the facts concerning gunaikeia were the medical experts writing about these issues rather than women themselves.
Giouli Korobili discusses correspondences between the Hippocratic On Generation and On the Nature of the Child (written most likely by a single anonymous author), and Aristotle’s On Youth and Old Age, On Life and Death, and On Respiration (taken as one continuous account). She argues that Aristotle knew the contents of the two medical texts “in a form close to what has come down to us today”, and that he paid special attention to them due to the fact that the author combined medical knowledge with topics, ideas, and examples which pertained to the field of natural philosophy. Thus, both the Hippocratic and Aristotelian texts illustrate the exchange of ideas between medicine and natural philosophy, two kindred yet theoretically demarcated fields of knowledge.
Tiberiu Popa explores environmental causation in Aristotle: the way in which animals are influenced by interaction with their habitat. Even though Aristotle’s approach to the nature of particular species predominantly relies on concepts such as essence, form, and function, he also discusses the way in which determinants such as climate, location, and exposure to winds influence physical structure, biochemical mixtures, longevity, and other features. These environmental explanations can supplement those based on essential features. Popa adduces evidence that environmental explanations owe much to early medical theories and, particularly, to ideas present in the treatise Airs, Waters, Places, where environmental explanations are central. Popa discuses similarities and differences between the way in which the Hippocratic author and Aristotle deploy environmental explanations. Through this analysis, Popa offers a tentative answer to the question of whether Aristotle actually read Airs, Waters, Places. Popa concludes that while Aristotle was indeed acquainted with the main causal explanation offered in the Hippocratic text, it cannot be determined with certainty whether or not he had direct access to the text.
Karel Thein focuses on Aristotle’s Politics 7.7, which discusses the influence of climate on humans as citizens. Thein shows that even though this passage is usually compared with Plato’s Republic 4.435d–436a, the Hippocratic treatise Airs, Waters, Places seems to be a prominent source for Aristotle’s argument. Thein demonstrates that the opposition between spirit (
The role of medicine and physicians in Aristotle’s political science (including both ethics and politics) is further explored by Pierre-Marie Morel in chapter 11. Morel attempts to make sense of Aristotle’s references to medicine and physiology in his ethical and political works and argues that, although knowledge about the natural world is important for political science, it does not follow that ethical assertions epistemologically depend on natural science. Morel demonstrates how medicine and physiology supply Aristotle’s political science with objective facts about human life and nature without requiring him to accept the particular explanations of these facts by the physicians and physiologoi. In other words, although it is crucial for politicians to take into consideration the physiological aspects of moral states, neither medicine nor physiology can provide them with practical solutions or prescriptions for the political and ethical spheres.
Monte Ransom Johnson explores Aristotle’s definition of moral virtue as a mean state in book 2 of the Eudemian Ethics. He observes that in discussing the definition of moral virtue, scholars usually neglect Eudemian Ethics and focus solely on Nicomachean Ethics and so overlook the inductive form of argument in the Eudemian Ethics passage. In focusing on the inductive form of the argument, however, the reader may notice that Aristotle uses examples from arts and sciences such as gymnastic training and medicine. Yet neither in Eudemian Ethics nor in any other extant work does Aristotle supply or discuss the evidence that makes these inductive arguments clear. Monte goes on to establish that this evidence can be identified in certain Hippocratic texts, mainly On Ancient Medicine and On Regimen. He thus illustrates the influence of medicine on Aristotle’s philosophy in general and on his ethics in particular.
In the concluding chapter, Chiara Thumiger explores the relationship between medicine and the emotions. While the usual source for the study of emotions in Aristotle is his Rhetoric, she focuses rather on Problemata, a text that not only differs from Rhetoric in its understanding of the emotions, but is also in many places more akin to what Hippocratic authors had written on the subject. The chapter thus enhances our understanding of the way in which Aristotle (or rather his school) read medical authorities. Through numerous examples, Thumiger sheds light on the way in which the author(s) of Problemata approached their Hippocratic predecessors: details and experiences from clinical observations are used, developed, and expanded in relation to the emotions. At the same time, Problemata deals with much broader psychological territory, including more complex emotions and their bodily manifestations. In drawing upon the medical material to investigate the emotions, Problemata thus offers a complementary approach to the socio-cognitive view on emotion in Rhetoric.
According to some sources, Aristotle’s mother Phaestis also came from a medical family. See van der Eijk (2022) 105, Natali (2013) 8–11, Oser-Grote (2004), 17–18, and Düring (1957) 29 and 82.
In medical families, as Galen (On anatomical procedures 2.1) reports, the sons of physicians “practiced dissection from childhood under parental instructions, as they did reading and writing.” On medical education in classical antiquity, see Kudlien (1970). For details concerning Aristotle’s family and early biography, see Pellegrin (1996) and Amadio-Kenny (2021).
On the inappropriate use of medical texts by lay persons, see Aristotle, Pol. 3.16, 1287a37–41.
See Lloyd (2003) 142–175, Levin (2014), and Torres (2020, 2021a, 2021b, and 2021c).
On Aristotle’s Hist. an. 10, see van der Eijk (2005) 259–275. Other candidates would be Hist. an. 7.19–28, 602b12–605b22, and some parts of Problemata, especially in Book 1. In addition, the list of Aristotle’s works in Diogenes Laertius (5.25) includes several texts on medical topics, such as Dissections (Anatomōn), the Selection from Dissections (Eklogē anatomōn), and the Medical Issues (Iatrika). See Kollesch (1997), van der Eijk (2005) 263–264 and (2022) 107, and Perilli (in this volume).
Aristotle refers to Hippocrates as a paradigmatic physician in Politics (7.4, 1326a15–16), and he briefly refers to the practice of “Herodicus the physician” in Eudemian Ethics (7.10, 1243b24). He also mentions Alcmaeon (e.g. De an. 1.2, 405a29; Gen. an. 3.2, 752b24–26; Hist. an. 1.11, 492a14), Diogenes of Apollonia (e.g. De an. 1.2, 405a21; Hist. an. 3.2, 511b30–512b11; Gen. corr. 322b13–14), and Leophanes (Gen. an 4.1, 765a24–25), who may be implicitly included among medical authorities as well.
E.g. Hist. an. 3.4, 514b2, 5.19, 551a12–13; Eth. Eud. 2.10, 1226a34; Mete. 384a21; Pol. 7.16, 1335a40–41.
E.g. Eth. Nic. 10.9, 1180b18–19, Hist. an. 10.7, 638b15, Part. an. 4.9, 685b5.
Cf. van der Eijk 2022, 110–112.
Metaph. 1.1, 981a12–b7. If not mentioned otherwise all translations are our own.
Metaph. 1.1, 981b8–9.
Div. somn. 463a5–6. As van der Eijk (1995) persuasively argues, Aristotle is most likely referring here to the author of On Regimen.
Van der Eijk (2005) 192–193.
Sens. 1.436a17–b1, tr. Lloyd (2003) modified. Cf. Plato’s remark in the Charm. (156b3–c5) about the “good physicians” who practise their discipline from a more theoretical perspective.
Cf. Aristotle Part. an. 2.7.652b36–653a10. Representative examples of medical questions pertaining to natural philosophy are to be found in the first book of Problemata, which contains numerous parallels with Hippocratic texts: see Jouanna (1996), Thomas (2015) and Thumiger (in this volume).
The adjectives kompsoi and periergoi are both double-edged, and Aristotle (as well as Plato) mainly employs them in contexts that lend them a rather negative connotation (see Hutchinson 1988, 41, and Korobili 2022, 177–179). Nonetheless, in our passage it is more natural to render it in a positive sense, by analogy with the physicians with a more “philosophical” (philosophōterōs) approach in Sens. 1 and the charientes physicians in Div. somn. Cf. Aristotle, Protrepticus (fr. 46, trans. Düring): “All intelligent (kompsoi) physicians and most experts in physical training agree that those who are to be good physicians or trainers must have a general knowledge of nature”. In any case, it is noteworthy that the two adjectives refer to different styles of speech (Leigh 2013, 164–165, and Korobili 2022, 178), namely to the oral style (kompsos) and the written style (periergos), which clearly indicates that medical texts are considered a specific channel for the communication of medical knowledge.
Resp. 21, 480b22–30, tr. Lloyd (2003) modified.
On the relationship between medicine and natural philosophy, see Lefebvre (2019) and van der Eijk (2022, 1), who suggests that “Aristotle’s engagement with health and disease was motivated, inter alia, by the idea that the best and most effective medicine is medicine built on the foundations of Aristotelian philosophy”. See also van der Eijk (forthcoming).
Long. 464b30–33, trans. Hett (adapted): “We have previously discussed sleep and the waking state, and later on we must speak of life and death, and similarly of disease and health, as far as they appertain to natural philosophy”.
Cf. Johnson (2012) 107; Nutton (2004) 120, 356 n. 35.
Van der Eijk and Hulskamp (2010) 65.
Cf. Mihai (2016), Bartoš (2021b) and Kouloumentas-Stavrianeas (in this volume).
Regarding Aristotle’s family background and personal connections with the Macedonian court, it is worth noting that Hippocrates and his family also had close professional relationships with the kings of Macedonia. If we can believe tradition (see Galen Commentary on Hippocrates’ Nature of Man, prooem., and Suda s.v. Hippocrates [III and IV]), the first ties were made between Hippocrates and the Macedonian king Perdiccas II (448–413). Hippocrates had two sons, Thessalus and Dracon, and both followed in their father’s footsteps. Thessalus was physician to Perdiccas’ successor Archelaus (413–399), and Dracon’s son Hippocrates was physician to Roxane, the wife of Alexander the Great (336–323). Cf. Jouanna (1999) 45.
Galen, Hipp. Art. 4.40 (18a.731.9 K.).
Galen, HNH, prooem. (15.4–5 K. = Mewaldt 4.19–5.9).
Littré (1839) 295–320.
Smith (1979) 44–60, rejected by Mansfeld (1980) and Lloyd (1991), reiterated in Smith (1999). For similar views, see also Hutchinson (1988) 23, Cooksey (2010) 46, van der Eijk (2004) 188.
Mansfeld (1980). Vegetti (1965) 44–46 considers both On Ancient Medicine and Airs, Waters, Places to be the Hippocratic theory reflected by Plato. See also Bartoš (2020).
In the second part of the papyrus, the anonymous author draws on a Peripatetic doxographic source, identified in the text with Aristotle (Anon. Lond. 5.35–6.18 and 6.31–44 = Manetti 10–12 and 12–13). On the basis of Galen’s HNH (15,26–16,11 K.), Plutarch’s Quaestiones convivales (733c9 Hubert), and testimonies about the doxographic work Iatrikē sunagōgē (also called Menoneia) by Aristotle’s pupil Meno, it is commonly assumed that the author of the papyrus draws on this particular text. Yet, as Manetti (1999, 98–99) and van der Eijk (2022,15–18) argue, it is no less possible that the second part of Anon. Lond. reports on Aristotle’s lost doxographical account of the views of earlier writers on the causes of health and disease announced in the passages from the Parva naturalia (and also Part. an. 2.7 653a8–10). “As Aristotle repeatedly says […], health and disease are the business not only of the doctor, but also of the natural philosopher, at least up to the point of discussing their causes or principles. The latter is exactly what the doxography in Anonymus Londiniensis is about” (van der Eijk 2022, 18). See van der Eijk (2012) and (forthcoming) and Camden (2023) 92–104.
Diocles of Carystus (fr. 55b van der Eijk).
Jouanna (1999) 61. Van der Eijk (2016, 25 n. 17) holds the contrary view that the explicit reference to Hippocrates in fr. 55b “is very likely to be a later doxographical construction and cannot be used as evidence that Diocles was familiar with Hippocrates or regarded Aphorisms 2.34 as ‘Hippocratic’ ”. See also van der Eijk (2001) 121–122.
Van der Eijk (2016) 25.
For the complicated and rather obscure history of these early collections, see Roselli (2000), Alexander (2007), Pöppel (1959), and Beccaria (1959, 1961, and 1974). It should be noted that these collections provide variations of the corpus that vary significantly among themselves and that there are no common treatises attested in all of them. Concerning Hippocratism in antiquity and the various roles ‘Hippocrates’ played in ancient medical discussions see Manetti (2014). See also Perilli in this volume p. 27, n.3.
Cf. Craik (2015) xxiii: “The argument that equal weight ought to be accorded to surviving medical material that falls outside the Aldine edition of 1526—and it is undeniable that some works in contention did not make it into the earliest published collections—is at first sight appealing; but the fact remains that other extant material is, by comparison with the works in the recognized Corpus, sketchy and largely confined to titles or fragments.” See also van der Eijk (2016) 26 n. 19: “No strictly medical texts from the 5th and 4th c. survived beyond the ‘Hippocratic writings’ ”.
Nutton (2008) 174.
Van der Eijk (2016) 22–23 n. 10.
E.g., Epistola ad Ptolemaeum regem de hominis fabrica (Ermerins 1840/1963, 278–297), Epistula ad Ptolemaeum regem (Boissonade 1931, 422–428). For a critical edition of the Testamentum, see Sideras (2006) and Jouanna (2011).
Cf. Lane Fox (2020) who argues on historical and epigraphical grounds that Epid. 1 and 3 were written as early as 470 BCE.
For approximate dating of the individual Hippocratic texts, see Jouanna (1999) and Craik (2015).
Jouanna (1999) 62.
Cf. Mansfeld (1983), Joly (1983), Scarborough (1988), Lloyd (1991) 194–223, Craik (2015) xxi–xxiii.
Craik (2015) 286. On the other hand, the fact that there is no consensus on the Hippocratic authorship of any of the medical texts does not resolve the Hippocratic question or preclude speculations about authorship. As Craik (2015, 289) put it, “it would surely be strange if Hippocrates were to be completely absent from the corpus given his name”. In the concluding paragraphs of her book, Craik (2015, 289–290) reiterates a handful of candidates: “The case for On Fractures and On Joints is strong […] At the same time, the case for Hippocratic authorship of Prognostic is similarly strong […] However, attention must be paid to the valuable early testimony of the Menoneia (the Anonymus Londinensis papyrus) which, with some Aristotelian authority, seems to suggest Hippocratic authorship for On Winds. And again, the views expressed by Plato in Phaedrus have seemed to indicate Hippocratic authorship for On Regimen […] It is plausible to suppose that the compiler of On the Nature of Bones was (one of the writers) responsible for (parts of) Epidemics, perhaps Hippocrates himself.”
It should be noted that despite the lack of integrity across the whole corpus, there are numerous similarities and commonalities between the individual texts, which in some cases allow us to assume a single author for multiple treatises (e.g. Nat. hom. and Salubr; Fract. and Artic.; Aer. and Morb. Sacr.; Genit., Nat. Pue and Morb. 4) or to identify several groups of texts relating to a more or less clearly delimited area of expertise. For instance, Craik (2015) 287 distinguishes texts on scientific principles, on anatomy and physiology, on nosology, pathology and therapy, on surgery, on cases and signs, on gynaecology and embryology, and on guidance and ideals.
As for other extant texts that are not included in the Hippocratic corpus but may perhaps be included among medical literature preceding or contemporary with Aristotle, we should also consider Plato’s Timaeus and Theophrastus’ On Sweats, On Fatigue, and Inquiry into Plants, book 9. See van der Eijk (2016).
Jouanna (1999) 71.
Van der Eijk (2016) 18.
Van der Eijk (2016) 43.
About this and other simplifications and ambiguities concerning our title, see the discussion by Perilli in chapter one.
Jouanna (1999) 231. See also van der Eijk (2012), who asks: “Comment Hippocrate était-il vu, et lu, par Aristote?” On the basis of the evidence in Anonymus Londinensis, he argues that Aristotle “read” the treatise On Breaths and regarded it as having been written by Hippocrates.
Galen, Meth. Med. 1.2.14–16. The whole passage is quoted and commented on by Perilli (see below, p. 31)
Craik (2015) xxiii. Regarding the Hippocratic texts most likely to have been known to Aristotle, van der Eijk (2012, 1520 and 2022,10, n. 26) suggests the following works: Nat. Hom., Aph., Epid. 2, 5 and 7, Loc. Hom., VM, Morb. 2, Genit. Nat. Pue. Morb. 4, Vict., Flat., and Aër.
Cf. Jouanna (1968) 55: “Only two generations separate Aristotle from Polybus, and one can reasonably think that Aristotle, son of a doctor and himself passionate about medicine, had in his hands the work of Polybus.”
The author of the papyrus ascribes the theory of the four humours (cf. Nat. Hom. 3–4) to Polybus (An. Lond. 19 = Manetti 49.11). Yet in his report on Aristotle’s views, another passage from Nat. Hom. 9 (An. Lond. 7 = Manetti 15.15–32) is quoted and attributed to Hippocrates. Cf. Ricciardetto (2014), van der Eijk (2012), and Manetti (2011).
According to Galen (HNH, prooem. 15.9–11 K = Mewaldt 7.15–8.18), the treatise consists of many textual units stitched together. See Perilli below, p. 61 who argues that Nat. hom. exemplifies “the case of medical works consisting of originally separate textual units, possibly used by different authors and adapted to different contexts”.
Perilli (2009) 97.
Di Benedetto (1972) 233.
Both Hippocratic versions of the ‘Polybus’ account start with a qualification that what follows concerns “the widest of the vessels (hai pachytatai tōn phlebōn)”, while Aristotle presents it as an account of vessels without qualification (tōn phlebōn), cf. Althoff (1999) and Perilli (2009).
Littré (1839) I.73.
Poschenrieder (1887).
Fredrich (1899), Balme (1987a) 16, (1991) 10. Similar positions are defended by Anastassiou and Irmer (2006) as well as Perilli in chapter one.
Fredrich (1899) 78–79, Sarton (1952) 537, 561.
Byl (1980), Oser-Grote (2004).
E.g. Mihai (2016), van der Eijk (2012), Althoff (1999), Longrigg (1995).
E.g. Mirrione (2021), Popa (2021) and (2014), Betegh (2020), Macfarlane (2020), Lefebvre (2018) 286–300, Mihai (2016), Chiaradonna (2013), Cambiano (2012), van der Eijk (2012), Rashed (2005), Demont (2005), Lombard (2004), Althoff (1992), Longrigg (1993), Vizgin (1980).
E.g. Craik (2017), van der Eijk (2017), Johnson (2012), Bartoš (2010).
Dean-Jones (2023), Connell (2016), Louguet (2015), Dean-Jones (2012), van der Eijk (2007), McGowan Tress (1999), Coles (1995).
E.g. Wilkins (2015), Bartoš (2015) and (2021a), Korobili (2022).
Van der Eijk (1995).
E.g. Camden (2023), Cheng (2018) and (2015).
E.g. Francis (2011), Hutchinson (1988), Tracy (1969), Lloyd (1968), Jaeger (1957), and Wehrli (1951). Connections with Aristotle’s Politics were discussed by Jouanna (1980) and Schütrumpf (2005), and with Poetics by Janko (1992).
Edelstein (1967) 354.
Owen (1992) 91.
Lennox (2021).
Bibliography
Texts and Editions Used
Aristotle. On Youth and Old Age, On Life and Death (Long.). Trans. W.S. Hett. Cambridge MA: Harvard University Press (1964).
Aristotle. Protrepticus. Trans. I. Düring. Göteborg: Institute of Classical Studies (1961).
Anonymus Londiniensis. De Medicina, Manetti, D. (ed.). Berlin: Walter de Gruyter (2011).
Galen. Galeni in Hippocratis de natura hominis commentaria tria. Ed. J. Mewaldt. CMG 5.9.1. Leipzig: Teubner (1914).
Hippocrates. Oeuvres complètes d’Hippocrate. (L.). Ed. É. Littré. Paris: Baillière (1839–1861).
Hippocrates. Opere di Ippokrate. ed. M. Vegetti. Torino: UTET (1965).
Hippocrates. Epidemie Libro Sesto. ed. and trans. D Manetti, A. Roselli. Florence: La nuova Italia (1982).
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