2.4.1 Why Theology?
Whether we need a chapter on theological matters in a book concerned with ethics is a question answered by the manifold relations between God and human beings accompanying our lives from our creation onwards. According to Galen, paying tribute here to the well-known Platonist telos-formula homoiôsis theôi, the human being is âwise and the only godlike creature on earth.â1 In An exhortation to study the arts, this account is specified. Here Galen brings into focus what distinguishes humans from other animals by concentrating on their ability to perform a great variety of arts (technai).2 In other respects, however, Galen does not draw a clear demarcating line between human beings and animals. In contrast with the Stoics, who make that line as sharp as possible,3 he does not rule out the possibility of animals too being endowed with reason. He refers to this reason as an internal (endiathetos) reason, which lacks verbal expression.4 We have already seen how Galen allows for a gradual development from irrational or brutish to rational character traits and psychic capacities in little children.5 Hence, the human being appears as a kind of hermaphrodite between animals and God â with the clear mission to engage in those activities that make him more godlike, namely the arts.6 The tertium comparationis here does not so much seem to revolve around creativity, but is rather constituted by Godâs rationality and the fact that the arts are an expression of our rationality:7
we must know accurately the nature of the essence of every entity about which we wish to construct an art [â¦]. For a person who knows that there is not one simple form of soul in us, such as the desiderative in plants or the rational in gods, but that men have both of these and the spirited besides as a third, knows along with this the number of the virtues and how they are acquired.8
Human beings are like God because they have the rational part of the soul, and it is by using their rational capacities, including all logical methods of inquiry, that they can construct the arts and attain knowledge about things, including their own souls. Galen calls it shameful (aiskhros) to neglect the capacity within ourselves which we share with the gods (
For the art of medicine, there is still another, even more concrete way of understanding the relationship between God and human beings. For, it has been shown that Galen tends to assimilate God with the healing god Asclepius, and that the famous Phaedrus myth is lurking in the background of his notion of homoiôsis theôi.13
This invites us in section 2.4.2 to look more closely at the status of Hippocrates and Asclepius in Galenâs life, as well as at the more general relationship between art and science, religion and ethics in Galenâs thinking. And vice versa, investigations into the field of (medical) ethics bear interesting insights into religious questions.14 In this context, divination shows itself to play a major role as an important and direct connecting link between the art of medicine and the divine realm. Moreover, we will see that we need to distinguish carefully between different types of divination here.
In section 2.4.3, we will delve into another important strand in Galenâs theology, which is imbedded in his account of human nature. There we will present possible answers to the question of how the Creator shapes the human body and soul from within the body. We will see that the bodyâs elemental mixtures play a prominent part in the shaping of the soulâs character traits, and discuss how we can get a grip on our morality and be responsible for our own activities in the light of these determining factors.
In sections 2.4.4â5, similar questions are raised for the rational part of the soul. With respect to the creation of the body, we will see that its status is less âexceptionalâ than often assumed. For the soul, however, the rational part has an exceptional status, since it is by means of it that we can engage in the arts and in philosophy, and, by doing so, express our rationality and give proof of our likeness with God.
In section 2.4.6 we will deal with Galenâs epistemological caution.
2.4.2 The Best Doctor Is Also a Diviner
To start, it is worth considering Galenâs special affinity with his great predecessor Hippocrates. This affinity reveals itself in the extant â albeit not altogether undisputed15 â commentaries on the Hippocratic corpus, where those on the so-called deontological works (The Oath, Law, Physician, Decorum, Precepts) have been lost. But, as Jouanna has shown, even without these commentaries, we can form a reasonable impression of Galenâs understanding of Hippocratic medical ethics.16 To Galen, medical ethics are directly wedded to the ideal of the doctor, and especially to the life and work of his great idol Hippocrates. But in comparison with Hippocratesâs statement on the doctor-philosopher being equal to a god,17 Galenâs approach is more down to earth. He simply emphasizes the best doctorâs human virtues, with self-control, as well as the triad of love of truth, work and fellow man (philosophia, philoponia, philanthrôpia), leading the way.18 In this context, Galen presents Hippocrates as the doctor of the poor who practices his art out of pure philanthropy.19 As we have seen above, in Avoiding Distress Galen considers the contempt for wealth and all unnecessary possessions the prerequisite for a good and virtuous life.20 This is in harmony with his adaptation of the tripartite soul, in which the rational part, with help of the spirited part, needs to keep the appetites in check in order to realize its rational capacity in the best possible way. Hence, wisdom presupposes self-control, and so the best doctor, too, must restrict himself to the necessary goods in order to become wise. If one manages self-restraint, homoiôsis theôi comes within sight:
I agree with you in this, for you cannot escape eating or drinking. Nevertheless, just as, if you could live without food or drink, you would be an angel, in the same way, if you restrict yourself to what is [absolutely] necessary for the life of the body, you will come near to being an angel.21
Like all other living beings, so too the best doctor, struggling with his physical existence, can restrict his bodily needs only up to a certain point. Hence, he cannot himself become a god, as Hippocrates would have it, but at best godlike.22 We should, however, note that Galen takes the possibility of approaching the divine as closely as possible quite seriously, which is also why he deems it important for us to be aware of our influence on our psychic capacities, including the rational part of our soul,23 and to take control of our dietetic program. To drive this point home for his audience, Galen points out, right at the very outset of QAM, that we can contribute (suntelein) to our personal virtue if we take care of our daily regimen.24
Even if some doubt remains about the substance (ousia) of the soul, it is perfectly possible to understand â and QAM does its very best to contribute to this understanding â the capacities of the soul to be influenced by the bodily mixtures.25 Since, then, the bodily mixtures are changing powers of the soulâs capacities and activities, it is reasonable to call them substance (ousia) or, as Galen prefers, form (eidos).26 Accordingly, in QAM the mixture of the heart is called the spirited form (eidos) of the soul, and the mixture of the liver the desiderative, nutritive or vegetative form of the soul, respectively.27
There are good reasons to assume that the caution Galen exercises in giving definite answers about the substance of the soul is â at least for its irrational parts â not merely because of want of evidence.28 For the rational part of the soul, however, an additional reason for Galenâs caution might be formed by his rejection of all philosophical speculation which is not grounded in experience and logical reasoning.29 One probable reason for Galen to assign an exceptional status to the rational part is that, by means of it, some people can get in touch with the divine entities. In order to explain this thought, we need to delve into the moral aspects of Galenâs cosmology, where we find arguments for the idea that the rational part of the soul is most godlike.30 It is important to note that Galen connects one of the elemental qualities, namely dryness, with wisdom â and in this context also relates the wise human soul to the stars; they are characterized as being extremely dry, intelligent and of the nature of light (augoeidês).31 In this context, the psychic pneuma in the brain is said to be of the same kind as sunlight,32 and also the psychic pneuma is considered as light-like.33 This conception has the further consequence that those dietary arrangements that support the dryness in the body lead to an improvement of our intellectual capacities,34 whereas those that make the body more humid lead to forgetfulness.35 In what follows, I will not focus on the cosmological matters, but concentrate rather on the moral implications of these ideas. One such obvious implication here is that human beings can contribute to their own divine nature by following dietary rules.
The first question that should perhaps be asked is whether every human being has such a divine nature, or whether we should only be speaking about people who receive special inspiration. At first sight, Galen seems to be quite optimistic about the human capacity to inspiration. For, as we have seen in An Exhortation to Study the Arts, Galen considers the ability to perform a great variety of arts to be specifically human. Divination too numbers among these arts, and Galenâs statement suggests that, in the end, all human beings, if not deprived of their rational capacities, should be able to learn the art of divination.
We must note, however, that Galen recognizes many different forms of divination. First, there is a general distinction between a skilful and a non-skilful type. In the course of An Exhortation to Study the Arts, Galen contrasts technê with tuchê by making the latter (âherâ36 ) a very unfavourable creature, unstable, blind and stupid.37
According to this basic distinction, a divination that relies on chance can be neither skilful nor good. This becomes clear, for instance, in the example Galen gives of two birdwatchers, where a Greek and an Arabic diviner argue about the interpretation of the flight of birds. The Arab says that birds that come from the right are an omen of a womanâs recovery, while the Greek says it is birds that come from the left. When Galen asks them whether the height of the flying bird is relevant, the Greek, who is described as more skilled in his art, consults his books and confirms that this is indeed the case, adding that birds only denote recovery if they, coming from the left, fly at a middle height; when they fly higher or lower, the sign actually has the opposite meaning. Galen concludes that most of the time, the two birdwatchers will make the same prediction, since birds hardly ever fly at a middle height.38 This cheeky example shows how diviners â even if they think that they are diametrically opposed to each other â sometimes predict the same thing. Hence, it is not necessarily the content of their predictions that makes them skilful, since that can be purely accidental; what matters is whether or not they are skilled in their art. In this case, a Greek diviner is only skilled, if predicts things in a considered way which also means that he includes rational parameters in his observations.
Apart from this general distinction which Galen makes between skilful and fortuitous divination, there is much evidence that people in his time recognized many different methods used by both laypersons and experts.39 Divination can have many different faces, and not all imply contact with the divine. When the anatomist Martianus, for example, accuses him of making his prognoses by means of divination, Galen reproaches him for failing to specify the precise kind of divination he is talking about, whether birdwatching, sacrifices, chance happenings or horoscopes.40 That Galen holds a negative view on some forms of divination is clear from his open hostility towards those diviners who, when confronted with medical questions, look for help from the gods. Galen gives a vivid example of people who, upon being asked where in the body the reasoning faculty is situated, consult the gods and use divination instead of anatomy:
One should more thoroughly examine the problem of the reasoning powers of the soul, not because they appear so evident to all those who have not a distorted mind â and this applies to the question of the origin of the nerves â but that one should not have to turn to the gods to find the answer by divination, asking instead someone versed in dissection.41
It is clear, then, that one should not confuse medicine and divination, since medicine is superior to divination â not only in medical matters, but also in philosophical questions, including the question regarding the location of the soulâs reasoning power.42 Van Nuffelen has suggested that Galen, without calling the superiority of medicine into question, sees divination and medicine as two parallel arts in the sense that both are equally rational.43 In this context, he distances himself from Hankinson, who sees a dichotomy between rational medicine and irrational divination, even though divination is also an art.44 That problem can easily be solved, however, if we take into account the fact that Galen distinguishes positive from negative forms of divination. Indeed, he understands divination never to be able to replace anatomical study (nor indeed medicine or natural science as a whole). The quotation above shows that, in his understanding, people who think that divination suffices to solve questions that actually require medical science commit a fundamental error. Obviously, the bad form of divination, as mentioned in the quoted passage, is not very reliable, since tuchê plays a major role in it.
Galenâs reputation for his skills in the art of medicine also follows from the extraordinarily high rate of success for his prognoses and diagnoses, as he shows throughout On prognosis. Although colleagues sometimes jealously accuse him of divination, he thinks of himself as a person skilled in the art of medicine, and not as a brilliant and skilled diviner. Galen had obviously never studied the art of divination. Nevertheless, as we will see below, this does not take anything away from the fact that he, the skilled physician, is a diviner in the sense of one who receives clear dreams from the great Asclepius.
This may in fact be why Galen in On Prognosis protests neither the label of a diviner (mantis) given to him by Boethus, nor the way Eudemus compares him to the Pythian oracle.45 Both ascribe Galenâs quasi-infallibility, as demonstrated by an extraordinary high number of successful pro- and diagnostic showcases, to divination and not to medical skill. It has been suggested that Galen does not refute this attribution because he is simply ârelishing the reputation of being a wonder-workerâ, although he would nonetheless âalways insist that his predictions and successful treatments are all based on a sound knowledge of the medical art.â46 Galen writes that people call him a magician out of ignorance of the art of medicine.47 But why, then, does he not protest the label of a âdivinerâ? As far as I can see, the assumption of medicine and divination as polar opposites does not suffice given the complexity of the situation. It rather seems to me that Galen on the one hand does not want that which is officially called âdivinationâ, including its skilled version, to be seen as an alternative to medicine, while he on the other hand accepts that, ideally, a certain type of divination, especially divine advices coming in dreams, can supplement medicine by working as an extra tool for the exceptionally gifted physician. Galen can trust the divine advice he receives, as the example from On Bloodletting shows, and understands it to be of great help in cases where science fails to provide answers.
As a side note, one should not forget that there are still other ways in which the divine is connected with the medical art. For example, by performing anatomical dissections, the physician is implicitly worshiping the purposeful and beautiful creations of the demiurge.48 It is therefore no wonder that Galen, who lived in a world where physicians were allowed to perform dissections on animals only, wished that methodical dissections would also be allowed on humans.49 By practicing medicine, the human doctor comes closer to God, whether Asclepius, or, more generally, the creator of the bodies on which he performs his art. According to Galen, one can express oneâs connection with the divine by writing treatises like On the Usefulness of the Parts, which has the character of an ode to the divine Nature.50 In this context, it has even been argued that Galen, in presenting dissection as a way of revering God, is trying to replace conventional rituals and religious practices with a kind of purified religion for the educated person.51
The most explicit and direct form of contact between human beings and God, however, occurs by the reception of concrete divine advices in dreams.52 Echoing Platoâs Phaedrus 252câ253c, Galen clearly favours being cheerful with a providing deity over complaining about tuchê, which once again has a negative connotation here:
You could see his devotees being as cheerful as the god who leads them and never complaining about him as the adherents of Fortune do, and ever being left behind or separated [scil. from him], but following him and constantly enjoying his providence.53
In Galenâs case, the deity to whom his and his fatherâs personal divination relate and whom he honours and imitates, is the healing god Asclepius.54 As is well known, Galenâs career as a doctor was set in motion by a dream, in which Asclepius advised his father to have his son become a physician.55 Another story tells how Galen refused to accompany Marcus Aurelius on a campaign against the Germans in the year 168. He reports how Asclepius in one of his dreams told him to refrain from joining this long campaign, and how the emperor, who himself worshiped that god, then instructed him not to go.56 It is worth noting that Galen in this anecdote presents Marcus Aurelius as a person full of piety who performs obeisance (proskunein) to Asclepius, and that Galen likewise calls himself a servant or worshipper (therapeutês) of this god. These are signs that showing piety and obedience to divine instructions was part of common public behaviour, probably for the well-educated, to which even emperors were obliged. Another quite explicit report about a divine dream by Galen deals with a practical medical matter. In On Bloodletting, he makes it clear that âI was led by two clear dreams I received to the artery between the thumb and index finger of my right hand and I let the blood flow until it stopped of itself, just as the dream had ordered.â57 There are two striking similarities between this dream and the dream Galen reports about his father: first, both contain direct, realistic, practical advice; and second, both dreams are described as âclearâ, âdistinctâ or âmanifestâ (enargôs).58 This clarity can be understood to mean that a dream needs no further interpretation, but is manifest, meaningful, and significant in itself. Moreover, as I shall go on to show next, the clarity of dreams is expressive of the special intellectual and godlike condition of the rational part of the soul in the one who dreams such dreams.
If the good type of divination is an art, and if performing arts is the distinctive feature of human rationality, it follows that the rational part of the soul is responsible for the performance of this good type of divination. To be fair, it is not very likely that Galen saw divine dreaming as a part of the âartâ of divination, since he never mentions any rational parameters or rules for their interpretation, as his description of these dreams as immediately âclearâ or âmanifestâ (enargôs) suggests. I would nonetheless insist that the rational part of the soul should, in Galenâs understanding, be that which is responsible for communion with the divine realm in dreams.
In Platoâs Timaeus, however, we get a different picture. Here the appetitive part in the belly is considered to be the one that has the mantic power. The explanation offered is quite interesting. According to Plato, the mantic ability was given to the irrational part of the soul, in order that also the bad (phaulos) in us may somehow come in touch with the truth. This happens since the younger gods try to make also the mortal kind as good as possible. To Platoâs mind, no one gets in touch with this god-inspired (entheos) power when he is in full command of his intelligence (ennous), but it befalls people in their sleep (hupnos), during a disease (nosos) or by inspiration (enthusiasmos).59 Hence, the diviner (mantis) must be distinguished from the prophet (prophêtes), who rationally interprets and critically analyses the phantasms which the diviner has seen.60 That the liver, which is the most important organ in the region of the appetitive part, plays a prominent part in divination, is also reflected in the ancient Greek tradition of reading omens from the liver of sacrificed animals, like sheep. Unfortunately, we do not know how Galen thought of this practice, since the sections on divination are missing from Galenâs commentary on the Timaeus and we are forced to draw on other passages instead.
In order to demonstrate how Galen understands the rational part of the soul to be responsible for divine dreaming, we need to take a closer look at his conception of sleep and dreaming. His treatise On Regimen in Health, which probably had the most to say about the dreams of people in their everyday life, has regrettably not come down to us thus far.61 A separate work devoted to dreams, On Diagnosis from Dreams (extant in what seems to be the truncated form of an epitome),62 however, concentrates almost exclusively on the dreams of sick people from the perspective of diagnostics, which I will call âmedical dreamsâ. According to its author, âa dream shows us the condition of the bodyâ, which means that dream images can, for instance, reveal an abundance of black or yellow bile in the body, or of one or two of the four qualities.63 The author considers dreams a diagnostic tool, whose nature is nevertheless rather uncertain, among other reasons due to the difficulty involved in distinguishing between different types of dreams, namely âmedical dreamsâ, âprophetic dreamsâ and those that simply process everyday experiences.64 However, for our present enterprise, which concentrates on divine dreaming, such a treatise on âmedical dreamsâ is ultimately not very helpful. This does not mean that divine dreams have no medical impact at all, but that impact has another sense. Galenâs dream about bloodletting, for instance, has a concrete medical impact, but it is better described as a âpropheticâ dream, and not as a âdiagnosticâ dream.
Nevertheless, it is still useful to cull information about the âmedical dreamsâ, and to see what we can learn from them about the dreams of healthy people. In passages from On the affected parts and from the commentary on Hippocratesâs Prorrhetics, Galen deals with the special clarity (enargeia) of the dream images received by people who suffer from phrenitis. These people are so troubled by the things they see âclearlyâ, âdistinctlyâ or âmanifestlyâ (saphôs) that they cry out loud and try to jump out of the bed.65 It is worth noting that phrenitis is to be traced back to a very dry condition of the brain, and that, according to his own report, Galen himself once suffered from phrenitis and experienced the related intense dreams.66 From this, we might infer the following scenario for the dreams of healthy people: Even if especially clear and intense dreams are not a symptom of illness for the healthy people who have them, it is only fair to infer from their emergence that the brain of the dreaming person is especially dry. As we have seen before, dryness is also the main quality of the stars and associated with high intelligence. In the light of these observations, the fact that Galen and his father, without being ill, have clear dreams can mean two further things. One could object that saying that a person dreams enargôs and saphôs does not necessarily mean the same thing, but on the assumption that they do at least point to a certain similarity between the two cases, namely a certain realism, this can be taken as a sign that Galen and his father both have a rather dry bodily constitution. This, then, would not only be a sign of their intelligence, but might also explain why the rational part of their soul stands in special contact with the divine realm. More evidence for a connection between dryness and dreaming can be found in Galenâs theory of sleep and dreaming. According to Galen, we need to sleep because the psychic pneuma in the brain needs some rest. Fatigue is caused by a surplus of wetness and coldness in the head, which is produced by liquid nourishments or baths, for instance. After the psychic pneuma has cooled off, it searches for dryness and heat again, and thus moves into the depth of the body, where the innate heat and vital pneuma reside.67 As it seems, then, dreams occur during the psychic pneumaâs journey through the body, when it searches for rest and the restoration of the good mixture through heat and dryness. Moreover, since the psychic pneuma in the rational part of the soul is described as light-like and therefore most divine, it seems altogether reasonable to assume that it too is involved in divine dreaming.
In the following section (2.4.3) we will turn to highlight another aspect of Galenâs thought on the divine, and delve into his theory of creation. In doing so, we will see that the relationship between God and the human being already starts with the conception and creation of the human body and soul. It is God who creates us and thereby forms our morality by making our âfirst natureâ good or bad. Since the status of the rational part of the soul and the manner of its creation is less clear than Galenâs views on the status of the irrational parts of the soul, we will dedicate two separate sections (2.4.3 and 2.4.4) to these topics. First, we are going to look at the creation of the irrational soul, and afterwards at the special status of the rational part of the soul.
2.4.3 Creation from Within: Divine Causation and the Creation of the Irrational Soul
To find out more about the creation of the irrational soul, we need to delve into Galenâs theory of causation. Echoing Platoâs Phaedo (96e5â100b9), Galen in On the usefulness of the parts of the body states that the body is not the real cause (aitia) of a personâs activities:
The first cause of everything that has occurred is the purpose of its action, as Plato has pointed out somewhere. If, then, anyone asks you why you have come to the market, it is hardly admissible to pass over the real reason and give another more elegant. For it would be ridiculous if a man instead of saying that he had come to buy some article or a slave, or to meet a friend, or to sell something, should pass over all that and say that he had come to market because he had two feet capable of moving easily and supporting him in safety on the ground. He has, perhaps, given one cause, but not the real, first one; on the contrary, his is an instrumental cause, one without which [an action cannot be performed], or rather, one that is not [really] a cause. Thus Plato rightly understood the nature of cause. But in order to avoid seeming to quibble over names, I grant that there are several kinds of causes: first and most important, that for the sake of which a thing is formed; second, that by which; third, that from which; fourth, that by means of which; and fifth, if you wish, that in accordance with which. We shall expect those who are really natural philosophers to take each one of these causes into account when dealing with all the parts of the body.68
In this passage, we learn that the final cause â i.e., that for the sake of which a thing is done or created â is the most important of all causes. As Galen shows in On Antecedent Causes,69 the weaver weaves clothes in order to make protection for the body against cold and heat.70 This final cause, then, is the utility (utilitas)71 for something to occur. We go to the market in order to fulfil a need, that is, to buy or sell something or to meet somebody. The second (and likewise important) cause is the efficient cause, which Galen identifies with the creator (conditor) of a thing or an event.72 The next cause mentioned is the instrumental cause, which, strictly speaking, is not even a cause, but a kind of prerequisite or sine qua non. How we understand the instrumental cause depends on the activity we want to describe. In the case of a person walking to the market, the bones and muscles are the instruments of the movement, while in the case of the production of a bed, for example, the carpenter also needs a special toolkit apart from his own muscles and hands.73 And from what we have seen in the previous chapters, the psychic pneuma, which comes down to the muscles from the primary principle, i.e., the brain, is called the first instrument of the soul. The material cause, which is mentioned next, refers to the material components of the thing that is constituted, i.e. to the moving body itself. That means that the muscles and bones are the material causes of a walking man, while the instrumental cause is the psychic pneuma coming from the brain and moving the muscles via the motor nerves.74 The last cause mentioned, here called the cause âin accordance with whichâ (
But the location where the wood which the carpenter puts together was worked on, and the surrounding air, will be called causes only accidentally, and not in a primary sense: because since the artisan is a human being, then it is necessary for him that some place should happen to contain him. And if this is so, it is also necessary at all events that there is no solid body between him and the wood (since that would prevent him from exercising an effect upon it), and then it is clear that the intervening space must be either entirely empty, or if not empty, then at any rate occupied by some yielding body; from which it is clear that even air itself contributes to the creation of the storage vessel. You will understand this more clearly if you imagine the craftsman permeating the whole material, as its nature permeates the whole of it, and not just touching its surface as we do: in those circumstances, it is clear that the creator will not require a location, other than that of the material itself, nor other air or empty space around it. In this way, animals are created in the earth, when their creator occupies the same space as the thing created. So in order to act upon the wood, the carpenter needs an unimpeded intervening space, not insofar as he is a carpenter, but insofar as he has a body which occupies some place other than that of the material being worked on. These things, then, are accidental and have the status of prerequisites, cutting off and preventing a thingâs creation if they are not present, but contributing nothing essentially by their presence.76
This passage shows how God works with the matter given to him, and is intriguing with a view to the question of Godâs corporeality or incorporeality.77 What we learn here is that God does not create the living thing from a spatial distance. When humans, by contrast, create artefacts, they need free space, only filled with air (or some liquid), since they are impeded in their activity if a solid body gets in the way between them and their object. God, on the contrary, does not work on the surface of things from some distance, but he creates them from within. He creates living beings, some of which are created in the earth â or in the womb â without being surrounded by free space. However, we should not forget that there is also an option for human beings, too, to form bodies from within. Human beings can take care of their daily regimen. And by doing so, they, in a divine manner as it were, can create differences in their bodily mixtures and thus also in the capacities of their soul, which follow upon those mixtures and contribute (suntelein) to the soulâs virtue.78
Furthermore, the Creator is able to âpermeate the whole materialâ (transire per totam materiam) and thereby to occupy the same place as the being he is creating, which doubtlessly strikes a Stoic chord â just like the idea of an absolute mixture, which Galen takes over from them.79 Moreover, it recalls Galenâs demand that the soul stretch out (ekteinô) through the entire body.80 Here we come close to an answer to the questions that Galen usually does not dare to answer, namely the demiurgeâs corporeality or incorporeality and what the place where he resides looks like.81 If God âpermeatesâ matter and creates the things from the inside, his place (or at least one of his places) is within the matter, and inside the living beings. Is God then a corporeal entity? What does it mean that he permeates matter?
In the following passage from On the Usefulness of the Parts, which is again an analysis of the five causes (aitiai), we get some idea of what God is doing in the matter, at the hand of the example of the creation of the arteries and veins in the lung:
For we do not speak about one kind of cause within the range of all causes, but about all kinds, [and] one is the first and also the most important one, which is better the way it is, and after this [follow] the instrumental and the material causes, which the demiurge uses in order to lead each of the things that come into being to its better form, making the arteries of the lung loose-textured and the veins dense for the reason I have given. Since it was better to create them in this way, he generated the veins [of the lung] from the arterial parts of the heart and the arteries from the venous parts. Since it was necessary to supply both vessels with suitable material, he opened the arteries into the pneumatic ventricle, and the veins into the other one. Since it was better to provide the vessels with a shape, which is less easily injured, he made them round. As they had to be made out of matter and by means of instruments, he, by mixing the moist with the dry, made a certain humour out of them like wax, which can easily take an impression, and used this matter as the basis for the organs that are going to come into being. After he had mingled the hot and the cold, he got them ready as efficient instruments for the matter, and by means of them he dried out some of the matter with heat, and stiffened some [of it] with cold, and further by mixing these he produced some [of it] as a well-mixed pneuma; and afterwards by breathing through the matter and channelling it in this way, he made a long, hollow vessel, and poured out more of the matter, when it was better for the vessel to be thick, and less when it was better to be thin. In this account you will find all the causes, those derived from the end, the maker, the instruments, the material, and the form.82
First, the demiurge chooses the right place for the vessels, always having the final goal of his activity in mind, namely to make things better.83 This final goal or cause is also the reason why the Creator provides the vessels with a certain shape (skheÌma), which again reveals the proximity of the formal and final cause, as noted above. And as we have also seen before, the material and instrumental causes are once again considered as conditiones sine qua non for creation. To undermine their necessity, the verb ekhreÌn is used to show that the vessels must be created out of matter (huleÌ) and with the help of certain instruments (organa). With the next step, we are thrown into the middle of the creation process. In contrast to the god of Moses, who creates his own matter, as we will see below, Galenâs demiurge does not create but rather shapes the matter by taking over the four elemental qualities. First, he takes over the moist and the dry, and mixes them in order to get a wax-like humour, which he then uses as matter for building the organs. This process of mixing together two of the four elemental qualities (i.e., moisture and dryness) obviously refers to the material cause. Next, the demiurge is said to take the two remaining qualities (i.e., the hot and the cold) and to use them as the efficient instruments (organa drastika). That means that he dries out some (to men ti) of the matter with the help of the warm, and stiffens another part (to de ti) of it by means of the cold, and furthermore creates a well-mixed pneuma out of yet another part (to de ti) of the matter.84 We can see that Galen splits up the elemental qualities into two groups. The wet and the dry seem to make the material cause, while the hot and the cold work as instruments or instrumental causes by means of which the matter is formed in a certain way. There is a shaping power (diaplastikeÌ dunamis) within the matter, which shapes it in order to build and form the organs with the aid of the different mixtures. The last step, however, is the most complex. Now the demiurge is said to channel the matter with his breath. It is likely that this breath is identical with the well-mixed pneuma mentioned before, but it might also refer to a different type of pneuma. Regardless, it is clear that the vessel walls are made out of the two types of matter already mentioned (i.e., the dried and stiffened matter). That some walls are thicker and others thinner apparently depends on how much matter the demiurge has poured out. The wording (and especially the prefix dia) of the phrase âbreathing through and channelling the matterâ (
The UP contains no further information on the source from which the demiurge gets the qualities he is mixing. In the Timaeus, the younger gods are said to âborrowâ the elements from the cosmos,88 but the above passage reveals nothing about their origin. In UP, Galenâs demiurge coincides with the innate nature of the living being and creates the living things, their organs as well as the vital pneuma, qua his formative or shaping power (diaplastikeÌ̱ dunamis) from within.
However, it is worth noting that in On Mixtures, Galen raises yet another option for the way the process of creation may work. Besides the inner cause of formation, which works through the mixtures, he mentions another â divine and ingenious â causal power of formation. The distinction is embedded in a critique of those thinkers who make rash assumptions about the whole body from just one of its parts. In order to analyse the mixture of a body that is not completely homogenous, one has to look at every single part of it.89 From a human body with big wet eyes, for example, it is wrong to conclude that the whole body is wet. Others wrongly interpret big eyes as a sign of a general hot constitution of the body. Such people insist that excessive heat during an early stage of the construction of an animal leads to an enlargement of all the passageways, like the eyes, the ears and the mouth.90 According to Galen,
both these arguments are wrong, and for the same reason: that they both base a statement about the body as a whole on the state of a single part. A second mistake is that they do not put into mind that the shaping faculty in nature is that of a craftsman and forms the parts in accordance with the character traits of the soul. This was a point on which even Aristotle was in some doubt: should this power not be attributed to some more divine cause, rather than just to hot, cold, dry, and wet? Certainly, those who rush to make rash statements on this greatest of issues, and explain construction purely in terms of the humoral qualities, are not right. The latter are surely only the instruments, whereas the cause responsible for construction is something different from them. It is, however, possible even without engaging in enquiries of this kind to find out whether a mixture is wet, dry, cold, or hot, as has already been discussed. But these people ignore the specific indications, and then start talking about wider matters, which require a considerable length of inquiry, and which have up to this day continued to baffle the best philosophers. Now, just because children tend to be more snub-nosed, and people in their prime more hook-nosed, it does not follow that we should consider all snub-nosed individuals to be wet and all hook-nosed to be dry. It is also possible, then, that this kind of feature is the work of the power that constructs us, rather than of mixture. If it were also an indication of the mixture, it would only be relevant to that in the nose, not to that of the whole body.91
Galen distinguishes two causal components by which the body parts are shaped. It is clear that they are formed by means of the humoral qualities, but it is wrong to treat them as self-efficient causes. As we have seen before in On Antecedent Causes, and confirmed here, Galen considers the qualities â especially the hot and the cold â to be instruments by means of which the demiurge creates different mixtures of matter with which he forms the body parts.92 That is to say that the efficient cause is the natural and divine shaping faculty of a craftsman who forms the body parts in accordance with the character traits of the soul (
Galen surprisingly goes on to tackle the problem from yet another side, and assumes that âit is also possible [â¦] that this kind of feature [i.e., the feature of being hook-nosed] is the work of the power that constructs us, rather than (mallon ê) of mixtureâ. Galen seems to want to say that the divine power, which constructs the human body, may at times work like a sculptor, as it were, who forms body parts independently from the mixture. As such, we are left with two alternative ways for explaining how the creator forms the animals: by means of the mixture, and as a free sculptor. Before we tackle this problem, however, we still need to consider another relevant passage.
That passage takes us to the construction of an embryo. Here Galen questions whether the semen alone can be the cause of the embryoâs construction:
And so I confess that I do not know the cause of construction of the foetus. For I observe in this construction the utmost intelligence and power, and I cannot allow that the soul in the seed, which Aristotle calls vegetative and Plato desiderative, and which the Stoics consider not to be soul at all, but nature, constructs the foetus, since this kind of soul is not only not intelligent, but entirely devoid of reason; nor, however, can I entirely distance myself from that opinion, in view of the similarity of the offspring to the parents.93
Here the seed, which is an elemental mixture, is said to fall short of being the cause of the construction of the foetus, because it only has the vegetative or appetitive soul. Since the creation of a human being requires the wisdom of the constructing power, the unintelligent seed cannot be responsible for it â even though Galen admits that family resemblance speaks to the contrary. If we compare this passage to the passage from On Mixtures cited above, we see that Galen still flirts more explicitly with the option of a divine power, while reckoning semen as nature and not as soul.
To sum up, in UP, which was presumably written between 169 and 176,94 Galen takes the connection between the causal power of the demiurge and the elemental mixture for granted. He considers the elements to be the instruments of the demiurge, who mixes them and then builds and shapes the organs by their means. He does not mention the option of a sculptor-god who works without using the elemental mixtures as his instruments. In On Mixtures, which should probably be dated to 169â180, Galen refers to the possibility of a sculptor-god who shapes certain organs independently from the mixtures, while still placing great emphasis on the mixtures as the Creatorâs usual instruments and trying to make the mixtures theory as strong as possible. In The Formation of the Foetus, however, the sculptor-god and the semen (which likewise is a mixture) are taken as two different options for explaining the process of creation. Here, Galen considers the semen as unintelligent, and rather opts for an intelligent and divine power which constructs the embryo. He makes a distinction between nature and soul which does not come up in the other passages we have examined, where the mixtures are used as divine instruments. But we should note that these differences might also follow from the special status of semen, which Galen understands to be connected with the vegetative soul and which he might consider as somehow unworthy of having divine power, even though we do see some slight tendencies in him here to attribute some genetic meaning to the semen.95
It is beyond the scope of this book to offer a definitive solution to the problem of why Galen in some of his works combines the work of the demiurge with that of the mixture and in others rather emphasizes the difference between them. Maybe it is also due to the differing aims of the works in question that he sometimes places greater emphasis on the divine influence on the mixture, and at other times tries to keep the Creator and the mixtures apart. However, from what we have seen, the assumption of an independent sculptor-god who can work apart from the mixtures would not fit into the framework of human nature as Galen usually presents it. It is therefore no wonder that he avoids giving an account of how such an independent sculptor-god might exercise his power. We should probably add here that a practicing physician has no need for lengthy, complex and philosophically demanding inquiries about God or the Creator. To determine whether the mixture of an organ is wetter, drier, hotter or colder, it suffices to rely on oneâs well-trained senses and logical reasoning capacities. Suffice it to say that the practicing physician need not feel ashamed if he has no answers to offer to questions such as these.
Returning finally to ethics, we note how important it is to recall that God creates the living beings with the potentiality to form a living being of a given species in such a way that it can best realize its specific activities. The initial mixtures of the body are the elements of all other bodily substances like humours, pneuma and innate heat, and determine, at least to a certain extent, the living being. Given that God aims at the best world, the fact that the initial constitution of the individual can be either good or bad is astonishing, and all the more so since the inborn mixtures are essential to the living beingâs morality:
For those who hold that all human beings are receptive to virtue (which is equivalent to saying that no one is born naturally bad), and those who hold that none chooses justice for its own sake, both see only one half of the human nature. For not everyone is naturally hostile to justice, nor is everyone naturally a friend to it â and in each case they have become as they are through the mixtures of their bodies.96
According to this passage, some people are naturally receptive to virtue and other people are not. Hence, a one-sided view on the human race as either good or bad is clearly wrong. And since the initial mixture is created by God, it is not within our power to determine whether we are born with a mixture that makes us either receptive or unreceptive to virtue. This, however, does not mean that people cannot be blamed for what they are. On the contrary, Galen stresses the need to censure and blame the wicked and to embrace and accept the good. According to his view, we refuse what is bad with a certain taken-for-grantedness and automatism, that is to say, âwithout investigating whether it is originated or not (nor whether something else has made it so or whether it has brought it about like it itself)â97 â just as we destroy venomous insects.98 And with a view to human beings, Galen says that âit is reasonable that we hate those men who are wicked, without considering the cause which makes them so; and conversely, we accept and love those who are good, whether they have become so from their nature, or from education and teaching, or from choice and training.â99 This means that the question about the origin of our behaviour is less important than the behaviour itself.100 We are censured for what we do, without further consideration of the reasons why we do what we do. This, however, leaves open the option that the reasons why some people are inclined to virtue while others are inclined to vice cannot only be found in our âfirst natureâ, but are also in our âsecond natureâ, that is, in our education and many other external influences.
As we have seen in section 2.2.1 above, it is simply impossible to change the make-up of a person born âincurably wickedâ to the contrary. We should note that Galen offers no further statements about this type of person in the above passage, and that we also do not learn how and for what reasons the fatal mixtures in their bodies arise. Neither do we learn here why such people exist, which also means that the question of why God creates bad people is left unanswered. But we should note that Galenâs God is not almighty. That he cannot make all people equally good results from the âgivensâ of matter, which is an imperfect basis for creation:
For the latter [i.e., Moses], it seems enough to say that God simply willed the arrangement of matter and instantaneously it was arranged; for he believes everything to be possible with God, even should he wish to make a bull or a horse out of ashes. We however do not hold this; we say that certain things are impossible by nature and that God does not attempt such things at all but that he chooses the best out of the possibilities of becoming.101
As we can see here, the creator is not only an idealist but also a realist. He accepts that he has to deal with what nature and matter (hulê) in particular allow him to realize, which is why he does not even try to make impossible things possible. One could therefore say that his wisdom consists, at least in part, in his understanding and acceptance of those laws that nature inviolably establishes, and not in the attempt to change or govern them. Such acceptance does not appear to be a disadvantage at all, for the outcome of the creatorâs efforts is nonetheless the best of all possible worlds.102 The sheer impossibility of creating a perfect world results from the âgivensâ of matter, which are an imperfect basis for creation. And nature supplies this matter as a prerequisite and determines the rules of the game by which God has to play.
This yields the consequence that perhaps also the Bad â just like the Good â has its place and purpose in the cosmos, in the same way venomous insects have a certain purpose in the world.
Moreover, there is the option that, though we are born with a general tendency towards either virtue or vice which, without any further external influences, would predetermine our character with certainty, there still is a latitude within the make-up of the mixtures. In QAM, Galen places great weight on the fact that our mixtures can be influenced and changed by means of dietetics. It makes perfect sense, then, to rely on this latitude or âindividual variationâ of the mixtures, which can be changed for the better. As such, dietetics proves to be the key to human self-guidance and virtue.103
2.4.4 The Special Status of the Rational Soul
It is worth subjecting the rational part of the soul to separate scrutiny here. For the question of whether Galen is an advocate of the mixture theory or whether some other idea of an independent sculptor-god is at work in the background, the rational part has a special status. In some works, this question seems to be connected with Galenâs adoption of the tripartition of the soul, which sometimes appears as a bipartition into irrational and rational parts. In QAM, we get plenty of examples which make clear that the mixtures of the body create the observable differences in the character of the soul. And also in On Mixtures, the mixtures of the four elemental qualities play a central role in the constitution of the body and in the possibility for the functions of the soul to perform well.104 As we have seen in chapter 1.3, Galen in Medical Art traces different character traits of the spirited soul back to different mixtures of the heart, more precisely to the different ratios among the four elemental qualities within this mixture. For example, proneness to anger is generally connected to a hotter heart, and anger lasts longer when the heat is combined with dryness, but becomes more ephemeral when combined with wetness.105 Not only the irrational parts of our soul, but also the rational part is heavily influenced by the changes in the body, including those that occur during affections like anger, distress or fright, which heat up or cool down the innate heat and the pneuma in the heart and the arteries, and with it the brain and the rest of the organism.106 It is clear, then, that the humoral mixtures bear an enormous impact on the activities of the soul.
As we have seen, Galen states in QAM that the substance of the two irrational parts of the soul can be fully explained by the theory of the mixtures, but he hesitates to say the same about the rational part of the soul. There Galen leaves no doubt that the spirited and the appetitive part are identical with the mixture of the organs in which they are seated.107 Moreover, he takes it for granted here that these parts are mortal and perish at death.108 When we consider the rational part of the soul, however, the situation proves to be more complex. Galen avoids making a decision on whether this part too is mortal.109 He avoids giving a definite answer here, since he considers it unclear whether the substance of the rational part is the mixture of the brain. When asked about the status of the rational part, he abstains from all positive claims. Moreover, regarding the Platonic assumption that the rational part of the soul is immortal, he observes:
Now, if the reasoning form of the soul is mortal, it too will be a particular mixture, [namely] of the brain, and thus all the forms and parts of the soul will have their capacities dependent on the mixture â that is, on the substance of the soul; but if it is immortal, as is Platoâs view, he would have done well, himself, to write an explanation as to why it is separated when the brain is greatly cooled, or excessively heated, dried or moistened â in the same way that he wrote the other matters relevant to it. For death takes place, according to Plato, when the soul is separated from the body.110
The basic question in this passage is whether the rational soul is mortal or immortal. To build his argument, Galen makes the immortality and mortality of each part dependent on whether or not it is a mixture of the natural body in which it resides. According to Plato, the spirited and the appetitive parts are mortal, and it is clear, Galen says, that they are the mixture of the heart and the liver, respectively. If the rational part of the soul is mortal, it follows that it too will be a mixture, namely of the brain. But we do not know whether or not the rational soul is mortal, and for the moment we must be content to show the rational soulâs dependence on the brain. Everyone can observe that severe qualitative changes in the mixture of the brain force the soul to separate from the body. The implicit conclusion here seems to be that, if severe changes in the mixture of the brain bear so much impact on the soul that they can even force a separation, one can assume that the rational part of the soul is the mixture of the brain. Galen presents the argument as a thought experiment, with a clear goal. All empirical facts clearly oppose Platoâs assumption of the immortality of the rational soul.
It makes sense in this context to consult the Phaedo.111 Unfortunately, we lack Galenâs response to Cebesâs objection to Socratesâs claim that the soul is one and immortal, although Galen does refer to the Phaedo on several other occasions.112 According to Simmias, the soul is the harmony of the body, and ceases when it ceases.113 Socrates then proceeds to give several arguments to prove why the soul cannot be a harmony of the body.114 The assumption that the soul is a harmony of the body115 is quite similar to the assumption that it is a mixture of the body, and it is a pity that Galen does not deal with either these or other arguments for the immortality of the soul from Platoâs Phaedo in the context of QAM.116 If we take a closer look at the passage quoted above, it strikes us that Galen does not further question Platoâs definition of death as the separation of body and soul, which implies that both â i.e., the body and the rational soul â can be separated into two genuinely distinct entities or substances. It is clear, however, that the theory of separation contradicts Galenâs premise that the substance of the rational part of the soul is the mixture of the brain (i.e., a mixture of the brainâs elemental qualities), while it does not appear to be all that far-fetched to interpret the relationship between them in terms of mere dependence.
I would now like to show the degree to which the theory of separation contradicts the theory of mixture. There are four basic principles in the nature of men, namely extreme forms of cold, dryness, heat and moisture.117 These are the smallest parts of the whole, and if one wants to divide them further, this can only happen conceptually by saying that, on the most basic, elemental level, there is some substance in the sense of a substrate (hupokeimenon) which is able to accept changes, that is, replacements of qualities which are the active principles of that change or replacement.118 But when it comes to natural phenomena, the four elemental qualities always exist as mixtures, which are necessarily instantiated in a material body. As Hankinson puts it: âFor Galen, in opposition to the Stoics, the qualities are not bodies as such, although they are bodily: they are ways bodies can be, properties of bodies.â119 This goes for everything that exists. The same principle is also valid with respect to the two irrational parts of the soul, each of which is the form (eidos) of a natural body, namely the heart and the liver, and each of which is by itself a mixture of the elemental qualities. If, then, body and soul form a divine and thus complete mixture, they cannot be separated again as wholes. Just as it is impossible to âextract whole eggs, sifted flour, and granulated sugar from the cakeâ (to use an example from Hankinson120 ), so too it is plainly impossible to extract body and soul and then to receive two complete things (i.e., a body and a soul) instead of the compound. It thus follows that, if the rational part of the soul is the mixture brain, it cannot be separated from it.121 In consideration of these facts, one clearly ought to expect Galen to oppose the premise that death is the separation of body and (rational) soul, and instead expect him to argue that death occurs when the composite of body and soul is destroyed.
That is, in fact, exactly what Galen does elsewhere. Usually he considers death a destruction or dissolution (lusis) of the substance of the soul.122 Elsewhere, he speaks of the destruction of the tension (tonos) of the vital pneuma, which is seated in the heart and connected with the spirited part of the soul.123 However, it is interesting to see that Galen, when he speaks about the psychic pneuma and its tension, does not mention the option of lusis. With respect to this type of pneuma, he only mentions that it can leave the ventricles of the brain and that this temporary loss causes immobility and senselessness. The tension (tonos) of the psychic pneuma can drop (katapiptein) when the pneuma leaves the brain, but as soon as the psychic pneuma returns, also the psychic functions come back.124 Galen argues that the psychic pneuma cannot be the substance of the soul, but only its first instrument, since its loss does not lead to death.125 The later Neoplatonic tradition debated whether a separation of body and soul is possible during lifetime, and Porphyry in particular answered this question in the affirmative.126 In a way, Galen is submitting a medical explanation to the debate, by pointing to the fact that a temporary loss of psychic pneuma causes a temporary separation of the rational faculties from the body. That is to say that Galen allows for a âtemporary separationâ, as it were, of body and soul during lifetime. However, he does not discuss the option of a permanent loss of the psychic pneuma leading to death, nor does he specify what would happen with the pneuma if a permanent separation should occur. Given the complexity of all these different considerations, it is hardly surprising that Galen leaves the question of the rational part of the soul being the mixture of the brain or, alternatively, some separable entity undecided. In the following section, we will see that there are yet other reasons for the caution he exercises in making statements on that score.
2.4.5 The Rational Soul and Its Deputies
Galen considers the rational part of the soul wise, divine and most god-like. Especially his references to the process of the creation of human beings in the Timaeus are interesting here. According to Platoâs Timaeus, the demiurge, after he has mixed together the world soul, is said to mix individual souls from what is left, in the same number as the stars, and thereafter to allot a soul to each star.127 He then entrusts the younger gods with the task of taking an immortal principle (athanaton archeÌn) for a mortal being (thneÌtou zôou), and of taking earth, water and air to build the human body, into which the immortal soul is then to be tied.128 In the course of this process of incorporation, the immortal soul is so confused by the stream of nourishment and so overwhelmed by the sense perceptions that it becomes mindless (anous).129 Only when the stream of nourishment (tropheÌ) and growth decreases, does the soul become rational (emphrona) again.130 From these passages, one can infer that the missing element, which is not used for the construction of the body (i.e., fire), forms the immortal principle and is taken from the stars. This appears indeed to be how Galen understands the matter, since in QAM he considers the rational soul to owe its dry and hot nature to the stars131 and the most extreme dryness to cause the highest intelligence.132 Moreover, in his Commentary on the Hippocratic Epidemics, Galen borrows Platoâs idea of the rational soul being bound within the head:
I am convinced that the pneuma in the cavities of the brain is the first of the instruments of the soul, though it would be rash for me in stating this to call it the substance (ousia) of the soul. Yet whether it is through the mixture of the four elements that the whole nature of the brain has reached this peculiar mode of being, in virtue of which it is the director of the animalâs sensation and voluntary motion and imagination and memory and thinking, or whether there is some other incorporeal power that has been bound within (endeitai)133 the brain by that which has created us and that will be separated from us when we die, I cannot provide a solid scientific demonstration.134
After Galen has excluded the option of the psychic pneuma as the substance of the soul, he offers two further possibilities for the connection between the rational part of the soul and the brain. Either the rational soul with all its peculiar functions comes to be with the mixture of the four elements in the brain, or there is âsome other incorporeal powerâ, bound within the brain by the creator and separated again at death. Here Galen states that he has no âsolid scientific demonstrationâ (apodeixin bebaian) to determine whether the rational part comes from without. And given his strategy from QAM, it seems clear that showing the rational capacitiesâ dependence on the mixture of the brain does not meet the conditions of a solid demonstration proving that also the rational soul is that mixture.
This brings us to the positive claims regarding the rational part of the soul. According to Galen, the soul moves the body by means of some dunamis:
With regard to the substance of the psychic capacities, I know, like all men, that we have a soul, because we clearly see the activities performed by the body, walking and running and sometimes also wrestling, and sense perception of many kinds, and because we understand that there are certain causes of these actions, on the basis of a natural axiom trusted by all of us, according to which we consider nothing to happen without cause; but because we do not know what the cause of these actions is, we postulate a name based on the [subject] being able to do the things that it does, a capacity (dunamin) as the efficient cause of each of the things that happen.135
The argument here is as follows: We know that the soul exists, because we can observe its affections and activities.136 And given the unquestioned principle that every event must have a cause, also the affections and activities of the soul must have a cause.137 But because we cannot say much about this cause (i.e., the soul and its substance), we make a capacity (dunamis) responsible for the observed effects.138 This dunamis â and the same holds true, in fact, for the psychic pneuma, which Galen calls its first instrument (prôton organon) as we have seen above139 â is not the substance of the soul.
According to Galen, we have no idea whether the substance to which the dunamis belongs is corporeal or incorporeal. For this reason, we need the dunamis as a power that is peculiar (idios) to the substance to which it belongs, to show how the body can be moved.140 As we have seen above,141 Galen has the tendency at times to identify the innate heat, which moves into and out from the heart during affections, with the soul-capacity (psuchikeÌ dunamis), or at least to use the two terms interchangeably.142 It is difficult to understand how exactly the soul-capacity relates to the substance, and Galen too states that dunamis is a notoriously difficult term and a controversial topic among philosophers:
And yet many of the philosophers are confused on this point, because they have an indistinctly conceived notion of âcapacityâ. For they seem to me to imagine capacities as if they were some object inhabiting the substances in much the same way that we inhabit our houses, not realizing that, of everything that comes about there is an effective cause, conceived according to its relation to something; and there is an appellation, specifically and it itself, of this cause as a thing of certain kind, but the capacity of what comes about is in the state related to what comes about from it; and therefore we say that the substance has as many capacities as activities; for example we say that aloe has a capacity of cleansing and toning the mouth of the stomach, of agglutinating bleeding wounds, of cicatrizing grazes, and of drying the wetness of the eyelids â without there being some other thing that performs each of these actions apart from the aloe itself. For it is the aloe that does these things, and it is because it is capable of doing them that it has been said of it that it has these âcapacitiesâ as many as the actions.143
In this passage, Galen says, among other things, that it is a misunderstanding to suppose that the dunameis are âinhabiting the substance, in the same way that we inhabit our housesâ (33,19â20 M.). To say that the dunameis somehow inhabit the substance is misleading, because it suggests that the dunamis and the substance are two separate things. But in fact, it is the substance itself that performs the activities which it can perform.144 Those who speak about dunamis as a thing distinct from substance do not realize that it does not exist without its efficient cause, which is the substance. This is also the reason why one ought to speak about a dunamis exclusively in relational terms (pros ti).145 Hence, a dunamis is a logical construction, a kind of deputy, which we need because the substance can neither be observed by itself (kathâ heautên) nor on its own (idia).146 The substance remains an object of pure thought, which we can experience only through its many visible effects. Therefore, the only possible way of investigation is to start with the observable facts, and then, with the aid of the logical principle that every event has a cause, to go on to conclude that this cause must be the underlying substance of the being, including its inseparable dunamis, so as to produce exactly those effects that we are about to observe. To put it in a nutshell, Galen needs the concept of dunamis to bridge the gap between the rational soul, of which we cannot determine whether it is corporeal or incorporeal, and the material body.
2.4.6 Galenâs Epistemological Caution
It is interesting to note that Galenâs reflections on the rational part of the soul show striking similarities with his thoughts on God. Galen thinks that, just as we cannot know the substance of the soul,147 so too we have no positive knowledge about the substance of God.148 His similar stance on these matters has sometimes been labelled agnosticism,149 or aporia,150 but could also be described as mere caution about assuming a position on issues that we cannot experience. To avoid misunderstandings, it should first be noted that the common definition of agnosticism as the view that âwe do not know whether there is a god or notâ151 is of no help here. For, unlike Protagoras, for instance, to whom Galen refers in the second chapter of On my own Opinions,152 Galen never calls into question the existence of God. On the contrary, he insists that we know that he exists, since all the surrounding beautiful and useful creations, including our own body, bear witness to his ingenious creative power. In terms of his profession, the practicing physician is by definition faithful to God. Since Godâs works are full of beauty in every single detail, dissection becomes an act of piety.153 To put it in even stronger terms, we can be absolutely sure that God exists from the fact that we live in the best of all possible worlds.154 To bolster this thesis, Galen, in his extended work On the Usefulness of the Parts, repeatedly shows against Erasistratus and Asclepiades that there are no useless body parts.155 His argumentation obviously endorses the credo that nature does nothing in vain, while even Aristotle, the pioneer of this dogma, is more willing to allow for exceptions here than Galen.156 The creator not only shows his great justice through his actions, for instance by healing people and saving their lives at sea. Some passages of UP suggest that Galen also sees the justice of nature reflected in the equal distribution of organs in the body.157 This is reminiscent of Aristotleâs notion of justice as being opposed to a desire for maldistribution.158 However, one must clearly note that neither Aristotle nor Galen understand justice to be identical with an equal number of parts, but rather with an equality in function or ability. And vice versa, an uneven number of organs in the body only appears to be a sign of an unjust distribution. In Galen, this becomes clear when he explains the function of the fifth lobe of the lung:
Surely it is fitting that you should extol this work of a just Nature, which, when viewed with the senses alone without the aid of reason, might seem unjust, but which is most truly just if ever anything was; for Nature has chosen equality not of appearance but of ability, and to do this is the work of a justice that is true and divine.159
The definition of justice as equality of ability (dunamis) instead of appearance (phantasia) implies that justice is not necessarily recognizable to the senses, but demands a serious study of anatomy as well as reasoning. The fifth lobe of the lung exists in order to assist the vena cava, which is placed on the same side of the body.160 Moreover, Galen agrees with Aristotleâs account of the size and position of the middle finger. This finger is longer than the others, which appears to be a sign of inequality, but, as Aristotle says, âthis is rightly so; for it is mainly by the central part of the encircling grasp that a tool must be held when put to use.â161 It is the relation to practice (ergasia) that is determinative for the appearance of a thing. Galen shows his agreement by asking a rhetorical question: âWas it [i.e., the size of the middle finger] not because it is better for their tips to fall in the same line when they grasp large bodies or try to hold small objects or liquids?â162
Another way people misunderstand divine justice with respect to the body is when they look at an organâs mere position. In this context, Galen aims to debunk the theories of those who cite the middle position of the heart as evidence for their cardiocentric view. As we can infer from Galenâs refutation, those people also argue that an even distribution of the dunameis of the heart depends on its central position, which he considers neither scientific nor sufficient as an explanation.163 It may be somewhat confusing to find Galen arguing at length in UP that the heart is not on the left side, where its beating can be felt, but in the very centre of the thorax, and explaining why this is so,164 while he in his anatomical works locates the heart more on the left side of the body.165 In PHP, it is not the middle position between the right or left side of the body that is at stake, but the position of the heart within the thorax. Galen writes that the navel is central with respect to the whole animal, while the heart is found above the centre.166 Hence, the position of the heart is relative to the perspective and the standards one sets.167 From this we can conclude that divine justice is a rationally informed virtue, which is guided by the function of an organ and can effect the elaborate creation of a purposeful cosmos. But even though Galen insists that nature does nothing in vain, he would not deny the existence of chance with respect to the coming-to-be of certain body parts.168 In a regularly formed organism, however, chance has no chance, so to speak.169
With a view to the standard definition of agnosticism, then, Galen is the opposite of an agnostic, for he never calls Godâs existence into question. Yet those who call Galen an agnostic criticize him for failing to answer the most difficult question of all, namely the question concerning substance, be it of God or the soul.170 As we will see, when Galen gives his own view on these matters, he simply refuses to answer the questions that relate directly to the substance (ousia) of God. In a prominent passage, he addresses his own views on these questions:
I declare I do not know whether the universe is uncreated or created and whether or not there is anything outside it. Since I disclaim knowledge of such things, it will be clear that I do so also with regard to the nature of the creator (deÌmiourgos) of everything in the universe, i.e. whether he is corporeal or incorporeal, and still more with regard to the place in which he resides. So about the gods, too, I profess doubt (aporein), as Protagoras did, or I say also in their case that I do not know what their substance is like but that I do know that they exist from their actions. They are the designers of the constitution of all animals. They warn us about future events through significant utterances, omens and dreams. The god who is revered in my own birthplace Pergamon [scil. Asclepius] showed his power and providence on many occasions but also b curing me once. I know from experience both the providence and the power of the Dioscuri at sea. However, people are in my opinion in no way hindered by the fact that they are ignorant of the substance of the gods, but I decided to honour them following ancestral tradition and in line with the advice given by Socrates to obey the orders of the Pythian one [scil. Apollo]. This is the attitude I take towards religious matters.171
In this key passage, Galen refuses to answer questions of which he has no knowledge (agnoein): Are the gods corporeal or incorporeal? Where are they located, and what is their substance like? We cannot answer those questions with certainty, since we do not know the answer. What we do know (gignôskein)172 is that they exist, and this knowledge is gained from the experience of their works (erga), such as their intervention at sea, their acts of healing and other acts that reveal their power and providence. The similarity with what Galen writes about the soul (or, more specifically, about the rational part of the soul) is quite apparent. As we have seen in the preceding chapters, we know that the soul exists from its observable performances (i.e., its affections and activities), but its ontological status remains unknown.173
At this point, it is helpful to include some general observations about Galenâs epistemology. On the whole, Galenâs silence regarding the substance (ousia) of the soul and God is motivated by his epistemological background. As is well known, Galen does not side with any one of the major medical schools in his days, and also in the âMethodenstreitâ he rejects the doctrines of the rationalists, the empiricists and the Methodists.174 But just because he does not follow one of those schools, this does not mean that he rejects all of their insights. Rather, it turns out that he, in search of a compromise, makes moves in different directions, and selects and combines different elements from different schools. Frede has argued that Galen in some of his treatises shows âa considerable amount of sympathy for empiricism,â175 but at the same time ârejects empiricism quite emphatically so as to leave no room for doubt as to whether he is a rationalist.â176 Galen criticizes the empiricists for different reasons: They have no interest in dissection and anatomical experimentation, but base their knowledge merely on the accumulation of clinical data, sometimes allowing for a method called the âtransition to the similar.â177 But the main reason for his rejection is their refusal of the rational or logical method (methodos logikeÌ).178 That Galen himself makes excessive use of logical methods like distinctions or definitions,179 which form a key part of the rationalistâs methods, still does not make him a rationalist in the scholastic sense.180 As it seems, Galen â in his attempt to come to compromise â has a share in the methods of the empiricist as well as the rationalist, without being himself a member of either one of those schools. Galen describes the difference between the two competing schools as follows: âBut whence the knowledge of these things is arrived at, is no longer a matter of general agreement. For some (i.e., the empiricists) say that experience alone suffices for the art, whereas others (i.e., the rationalists) claim that reason, too, to no small degree contributes to it.â181 In Fredeâs interpretation, Galen situates the difference between the two schools particularly in the way general medical knowledge is acquired. In Galenâs view, we always need both roots of knowledge: reason and experience. Both are necessary to find or invent, judge and confirm, any true claim. More specifically, we first find a truth by means of reason, and then test it with the help of experience.182 This strong duo leaves no space for any kind of dogmatic speculation.183
With these general ideas in mind, we clearly see that the above principle is of no help for the vexed question of the substance of the soul. For, with logic we can immediately infer the soulâs existence from its observable activities, but then we get into trouble if we are invited to prove what the soul is by experience. It is clear that the substance of the soul as such is not subject to experience. The only thing we can do is to make logical conclusions about what the soul is from its effects. When we look at little children who differ in their actions and affections and behave temperately or gluttonously, timidly or bravely, we can infer, as Galen makes clear in QAM, that one personâs substance is different from that of another. Children differ not onlin in actions and affections, but also in the capacities (dunameis) of the three forms of their souls,184 and â since capacity and substance are ontologically identical â â[â¦] from this it will be possible to deduce (sullogizesthai) that they do not all have the same nature of soul; and it is quite evident that in discussions of this type, the word ânatureâ means the same as the word âsubstanceâ.â185
2.4.7 Concluding Remarks
The aim of chapter 2.4 was to cast some light on the divine in Galenâs ethics and his account of human nature.
In section 2.4.1, we concentrated on the topic of divination. As we saw, the good physician, in his attempt to understand, dissect and analyse the human body and thereby to worship the creations of the demiurge, plays a key role in Galenâs medico-philosophical worldview. It is the good physician in whom the concepts of homoiôsis theôi and divination merge. As I have argued, Galen distinguishes skilful from non-skilful types of divination. The latter type is considered bad, since it relies on mere chance and unduly aims to replace the medical art by misinterpreting its role through the exaggeration and absolutization of its healing power and of its diagnostic and prognostic abilities.
By contrast, Galen shows his esteem for the other forms of divination when he ranks them among the arts and considers the ability to practice different arts to be distinctively human. Regardless of this distinction, Galen deems yet another type of divination best. This special type, in which Galen himself takes part, reveals itself in dreams, and offers correct, practical medical advice and instructions from his ancestral god Asclepius. In the best situation, such divination comes on top of a rationally informed and scientific medical art, and offers the gifted physician an extra tool, thereby coalescing with the art of medicine.
Next, we concentrated on the divine in Galenâs account of human nature. In that account, we found two accounts of the generation of living things. When Galen in On the Usefulness of the Parts deals with the creation of the arteries in the heart, the Creator is said to permeate matter and to use the elemental qualities as instruments in order to form the organs and to create the vital pneuma. In On Antecedent Causes, he says that the instrumental cause is strictly speaking not a cause, but rather a prerequisite or sine qua non for the coming-to-be of an event or thing. Accordingly, the demiurge is the efficient cause of the creation of the human being and the mixture is the instrument, and both are needed for the success of the creational act. As we can infer from QAM, by forming the mixtures and organs from within the matter, the Creator also generates the general make-up of the character traits of the irrational parts of the soul, which are said to be identical with the mixtures of the liver and the heart.
In other works, however, Galen flirts with the option of a sculptor-god who forms and builds the body parts without using the mixtures. In On Mixtures, he sets the elemental mixture apart from the divine shaping faculty without referring to the possibility of an instrumental relation between the two. There Galen rather seems to waver between the option of either the divine mixture or the demiurge being responsible for the formation of the human body. But as we saw, he never goes into detail about how such a sculptor-god might work, and rather puts more effort into his defence of the theory of a divine elemental mixture. With a view to ethics, it is important to observe that God plays a major part in the question of morality, since it is he who equips human beings with an initial mixture of their bodies and souls â and hence, it is he who makes them originally good or bad. But as we saw,186 there is a certain latitude within the mixtures that constitute our âsecond natureâ, as it were, which we can influence by means of dietetics and various forms of education. This is the influence which we as moral beings should exercise.
When it comes to the rational part of the soul, we saw that Galen is more cautious about and vague regarding its corporeality or incorporeality, as well as the related issue of its mortality or immortality. But in spite of his insistence that he does not âdareâ to offer definitive answers to these questions, his argumentation in QAM shows a clear tendency to approach the rational part of the soul in a way similar to the way he addresses the two other parts of the soul, namely by identifying their substance with the mixture of their corporeal seat.
From there, we drew a comparison from Galenâs approach to the rational part of the soul to his approach to the divine. There is an interesting analogy between Galenâs insistence that he has no knowledge about the substance of the rational part of the soul and about the divine. But, as we saw, even in QAM as his most physicalist work, where he confidently identifies the appetitive and spirited parts of the soul with the organs in which they reside, Galen does not completely discard the possibility of a distinction between the rational part of the soul and the brain. In the fragments from his commentary on Platoâs Timaeus, Galen flirts with the idea that the rational part of the soul is not fully defined by the mixture of the brain. There and elsewhere, he emphasizes the special resemblance between the substance of the rational part of the soul and the stars. In this context, the four qualities are split up into two groups. Even though there is no dualism between body and soul in the classical sense here, Galen does allow for some kind of elemental dualism between two groups of elements: the hot and the dry, which are light-like and divine, are more associated with the soul; and the cold and the wet, which are more associated with the body. The more a human being manages to dry out his or her mixture by means of study, exercises and diet, the more he or she will become like the stars. Other evidence for the rational partâs separability from the body can be derived from the function of the psychic pneuma, which moves the living being, enables sensation and is called the first instrument of the soul. It differs from the vital pneuma in quality and substance by its more rarefied form and by its description as sun-like, as we have seen.187 If we look at Galenâs definition of death, this distinction becomes still more meaningful. Galen defines death as the destruction or dissolution (lusis) of bodily strength and vital pneuma, but avoids speaking of dissolution and death with respect to the psychic pneuma. Instead, he only mentions the option of a temporary loss of pneuma, followed by a loss of sensation and motion. The tension (tonos) of the psychic pneuma can drop when the pneuma leaves the brain, but when it returns, all psychic functions likewise return. It therefore seems that Galen allows for a âtemporary separationâ, as it were, of body and soul during lifetime.
In the light of this chapter, Galenâs so-called âagnosticismâ regarding the substance of the rational part of the soul seems to be grounded in his strong conviction regarding the special resemblance between the rational capacity of human beings and the divine. It is clear that the best physician, who is also a real philosopher and uses the rational capacities, including all logical methods of inquiry, in order to practice the art of medicine and to attain knowledge about medical matters, has a special likeness with God. In the end, the divine instructions regarding medical affairs in dreams, and certainly Asclepiusâs advice to Galenâs father that his son should become a physician, are the ultimate signs of Godâs favourable regard on his profession. Galen singled out Asclepius and decided to follow him, in line with Platoâs image in the Phaedrus of the parade of the gods, from which one is advised to select oneâs personal god.188 We can therefore conclude that the notion of homoiôsis theôi serves as both the universal and personal ethical and medical guiding principle in Galenâs life.
Protr. 84,1â85,15 Boudon.
Cf. Pohlenz (1948), 40.
Cf. Protr. 84,1â12 Boudon. The distinction between an internal (logos endiathetos) and an external reason (logos prophorikos) likewise goes back to the Stoics; cf. Pohlenz (1939). But in contrast with Galen, the Stoics, by calling animals aloga, do not attribute reason to them. In their interpretation, human speech alone is a reflection of thought, while the voice of animals is something different; cf. Pohlenz (1948), 39â40, 185. It is interesting to see that Galen takes over the Stoic distinction between internal and external reason, but then deviates fundamentally from their view by suggesting that also animals might be endowed with the logos endiathetos.
Cf. Mor. 45 Kraus. There, too, Galen points to the performance of arts as a distinctively human capacity.
In his list of the arts, Galen begins with the natural arts of the animals, like weaving and swimming, and moves on to medicine, archery, music, prophecy, geometry and astronomy, until he reaches philosophy at the peak. Cf. Protr. 84,1â85,15 Boudon.
This is in line with Hippocrates Decorum IV: âFor everything that has been done artistically has been performed as the result of reasoning.â
PHP IX.6 584, 32â8 De Lacy.
This is probably the best translation for the term â
In the introduction to this book, we discussed the possibility that Galen had a negative view on philosophy. We saw that he often reproaches the members of the philosophic sects of his days for lacking in logical training and everyday knowledge based on perception. Here, by contrast, it is clear that there is a philosophy that he does esteem quite highly.
Cf. Tim 44d6â8.
Cf. in Tim. frg. 15 118,3 Larrain; PHP IX.9 598,28â66,1 De Lacy.
Cf. Phaedr. 252câ253c. On the influence of the Phaedrus myth on Galenâs religious thought, see Tieleman (2016), 28â9.
On the relation between medicine and religion, see the study of Nutton (2004).
There are some fragments on The Oath, which have survived in Arabic and are considered authentic by Nutton (1990), (1995), (2009) and Strohmaier (1970), although their authenticity has been questioned by Rosenthal (1956). On this debate, cf. also Meyerhof (1929), 73, and Jouanna (2012), 263, n. 7. See also the Introduction above.
Cf. Decorum V, and see Jouanna (2012), 280ff.
Cf. Jouanna (2012), 280.
âGalen could also find praise for the love of effort in one of the two deontological treatises of the Hippocratic Corpus known to him, Law. Indeed, the
Cf. Jouanna (2012), 278.
See section 2.3.3 above.
Cf. Mor. 40 Kraus.
As Kraus and Walzer (1951) have pointed out, the translation âangelsâ is probably a Christian (or Islamic) interpretation of the Greek words theoi or daimones in the Arabic epitome.
On the question as to whether Galen had a medical program for the intellect, cf. Jouanna (2009).
Cf. QAM 32,9â11 Müller = IV 768 Kühn.
As it was brought to my attention by my anonymous referee, Hankinson (2006) has remarked that the title of Galenâs QAM is âartfully indeterminateâ and suggests that hepontai might (but need not) indicate causal consequence, which is a view that, given the content of QAM, is rather inexplicable to me.
For a more detailed account of Galenâs shift from ousia to eidos, see chapter 1.3 above.
Cf. QAM 44,6â18 Müller = IV 782â3 Kühn.
Vinkesteijn (2019) offers good evidence from QAM and Prop.Plac. to indicate that Galen is in the end much more outspoken on the substance of the soul than commonly accepted.
Cf. Aff.Dig. 50,20â51,3; 51,11â20; 52,4â11 De Boer (V 73â74; 75; 76 Kühn).
For a detailed analysis of the conception of the soul as a dry, hot and light-like substance, see Vinkesteijn (2023), 217â220.
Cf. QAM 43,10â44,2 Müller = IV 781â82 Kühn and 47,9â18 Müller = IV 786 Kühn.
Cf. Sem. 136,7â9 De Lacy = IV 584â5 Kühn, Loc.Aff. VIII. 66,9â67,6 Kühn; PHP VII 474,3â7 De Lacy = V 642 Kühn.
Cf. PHP VII 474,22â9 De Lacy = V 643â4 Kühn.
As Vinkesteijn (2023) puts it: âUnder the assumption that the relative dryness of the substance of the rational soul determines its intellectual capacities, it seems reasonable for philosophers to try and change their substance to become drier. This would involve, as we have seen, the soul becoming more active, closer to its original nature, hot and dry, exuding light and intelligence like the heavenly bodies do.â (p. 221).
Cf. QAM 42,8â17 Müller = IV 780 Kühn.
Galen describes tuchê as a woman.
Cf. Protr. 2,2â13 Boudon.
Cf. HVA 1.15 129,12â130,17 Helmreich; for this passage, I am indebted to van Nuffelen (2014), 340â1.
From the extensive scholarship on this topic, see especially Johnston (2008) and (2015).
Cf. De praecogn. 3,6â16 = 84,1â86,30 Nutton.
Vegetti (2015) offers an in-depth criticism of Van Nuffelenâs view that Galen sees medicine and divination as parallel arts. Vegetti Galenâs critique clearly calls to mind the reproach on divination in the Hippocratic treatise On the Sacred Disease, in which the author emphasizes that the so-called sacred disease, like every other disease, has a natural cause. Note that in MM X 207 and 209 Kühn. Galen grounds the parallel between Asclepius and the ideal doctor on the use of logical methods and technical conjecture, and not on dreams and divination. On this see Chiaradonna (2023), esp. 417â18. I owe many thanks to my anonymous referee who draw my attention to these passages. On the different concepts of theology in this work, cf. Van der Eijk (1990).
âIn fact, for Galen, divination is as ârationalâ as medicine (in that it relies on principles and knowledge), but not as accurate and powerful in matters of health. Moreover, his acceptance of divination as an art, even in relation to medical matters, does not indicate that the boundaries between both arts were blurred in his mind: on the contrary, divination has its own principles and handbooks, just as medicine. Precisely this allows him to set both clearly apart, and argue, obviously given his own position as a doctor, for the superiority of medicine.â Van Nuffelen (2014), 342.
See Van Nuffelen (2014), 340â2 and Hankinson (2005), 158â161.
Cf. Praen. 3, 88,1â7 Nutton, III 618â9 Kühn.
Lloyd (2009), 125.
Cf. Praen. 5, 94,8â19 Nutton, III 625,3â6 Kühn.
Cf. Tieleman (2016), 19 and see UP III.10 I.174 Helmreich = 237 KuÌhn.
According to Mattern (2013), 72, âmedical writers such as Celsus and Galen not only believed in the value of human dissection but, to Galen, it became a holy grail of sortsâ.
Citing Brock (1929), May (in the introduction to UP) writes that âas she [scil. nature] assumes the creative role, she becomes, in fact, Platoâs Demiurge, to be praised and worshiped as Godâ; see May (1968), 10.
See Strohmaier (1965).
Galenâs special relationship with Asclepius has been characterized as his personal religion; cf. Tieleman (2016), 22â9, esp. 17.
Protr. 3.3, 87,13â8 Boudon.
As Tieleman (2016) has pointed out: â⦠at 252câ253c, the souls in the procession are portrayed as aspiring to become more and more like the particular gods whom they revere, by adopting their particular customs, habits and ways of living. Each of the souls that follows a particular god in the procession âlives, so far as he is able, honouring and imitating that godâ â which is precisely what Galen did in his relationship with Asclepius.â (28).
Cf. Praen. 2, 76,29â78,2 Nutton, XIV 608,12 Kühn, De ord. libr. suor. 4, SM II, 88 MuÌller.
Cf. Lib.Prop. XIX 18â19 Kühn = SM II, p. 99 MuÌller.
Cf. Praen. 2, 76,29â78,2 Nutton, XIV 608,12 Kühn.
Cf. Tim. 71dâe.
Cf. Tim. 71eâ72a.
Galen himself refers to this treatise when he remarks that he says more about dreams in it. Cf. In Hipp.Epid. I comment. 108,2â3 Wenkebach = XVIIa 214 Kühn.
DD is generally considered spurious, although it has also reasonably been described as a compilation or excerpt of Galenâs work. This is made more likely by the massive overlaps between DD and parts of Galenâs Commentary on the Hippocratic Epidemics I. Cf. Guidorizzi (1973), 96; Oberhelman (1983), 40 n. 28, Hulskamp (2013), 55.
See DD 103,1â4 Guidorizzi = XVIIa 832 Kühn.
Cf. DD 103,13â104,3; 104,21â6 Guidorizzi = XVIIa 833 Kühn, and see Hulskamp (2013), 56.
Cf. In Hipp. Prorrhet. comment. 1.5. 10,20â24 Diels = XVI 525 Kühn and Loc.Aff. VIII 227 Kühn.
Cf. Loc.Aff. VIII 227 Kühn.
Cf. Caus.Symp. VII 141 Kühn, 143 Kühn, Loc.Aff. VIII 162 Kühn; Dignot. ex insom. VI 834 Kühn.
De causis procatarcticis (= CP). Hankinson, R. J.; Galen. On antecedent causes. Ed. with an introd., transl. and comm. Cambridge 1998. (Cambridge classical texts and commentaries. 35.).
Cf. Caus. Prot. (59) 90,5â8 Hankinson.
Caus. Prot. (71) 94,11 Hankinson.
Cf. Caus. Prot. (67) 92,19 Hankinson.
Cf. Caus. Prot. (68) 92,25â94,3.
Cf. UP I 32,23â33,15 Helmreich, and see the discussion in chapter 1.1.
See CP 67, 92,17â21 Hankinson, where Galen leaves out the formal cause and deals with only four causes.
CP 78â89, 96,15â100,11 Hankinson, transl. Hankinson with slight adaptation.
Cf. Plac.Prop. 2, 172.31â173.11 Boudon-Pietrobelli, as cited above.
Cf. QAM 32,9â11 Müller; IV 768 Kühn.
Cf. Temp. 34,5â11 Helmreich, I 562,17â563,6 Kühn.
Cf. QAM 39,3â4 Müller = IV 776 Kühn.
Ibid.
To my anonymous referee I owe the helpful advice that it should be noted that Galenâs views on the demiurge are similar and at least partly indebted to those of the Middle-Platonist Atticus, who strongly emphasized that divine causation comes about through deliberation and craftsmanlike reasoning. On this, see Chiaradonna (2018), esp. 331â38, and Michalewski (2024), 46ff.
That the hot and the cold are used as active instruments to form matter, while the dry and the moist seem to be rather passive elemental qualities here, is not fully in line with what we find in Galenâs other writings. For example, in one of the fragments of his commentary on the Timaeus, the elements based on cold (i.e., earth and water) are said to be more material, while those based on heat (i.e., fire and air) are described as more active; cf. in Tim. Schröder (1934) 10â11. In Character Traits, Galen similarly writes that âcold produces laziness, immobility and weaknessâ, while âheat produces energy, movement, and the strength to actâ; see Mor. 27, 15â16 Kraus. Transl. Davies.
Cf. UP III 393.23â394.6 Kühn, and see the details in sections 1.1â3.
Cf. Ut.Resp. IV 505 Kühn; in Tim. 25 156,1â8 Larrain.
Cf. UP III 393.23â394.6 Kühn. On the process of that transformation, see Rocca (2003), 64â5.
âHis children gave heed to their Fatherâs command and obeyed it. They took the immortal principle of the mortal living creature, and imitating their own Maker, they borrowed from the Cosmos portions of fire and earth and water and air, as if meaning to pay them back, and the portions so taken they cemented together; but it was not with those indissoluble bonds wherewith they themselves were joined that they fastened together the portions but with numerous pegs, invisible for smallness â¦â
âWhere the mixture is uneven, so that it is not the same in each part, it is illogical to draw a conclusion about the whole from the nature of a single part.â
Cf. Temp. 79,6â11 Helmreich, I 635,2â6 Kühn.
Cf. UP III 470,7â471,16 Kühn. cited above.
For this dating, see Boudon-Millot (2012), 351â74.
Galen sometimes considers the testicles as a fourth principle apart from brain, heart and liver; cf. Ars Med., 1. 319 KuÌhn, and Sem. 4. 585 KuÌhn. Cf. also Kollesch (1988) 215â229.
QAM 73,20â74,1 Müller = IV 815, 5â7 Kühn.
Cf. QAM 74,1â4 Müller = IV 815,7â10 Kühn.
This, however, does not mean that there is no difference between the errors that occur from affections and intellectual errors. As we have seen in chapter 2.3, the difference between these two types of errors does not lie in their result, but in the reasons why they are committed. It is only with respect to punishment that the origin of bad behavior is less important than the behavior itself.
âYou donât have to show, heroically and implausibly, that his work is absolutely the best of all logically or conceptually possible worlds; you simply have to establish that itâs pretty nearly the best of all causally possible ones.â Hankinson (1989), 225.
For the theory of mixtures in connection with other body parts, cf. van der Eijk (2020).
Cf. Temp. 35.27â36.1 Helmreich = I 565,13â16 Kühn; 42,8â43.9 Helmreich = I 576,14â577,8 Kühn. On the function of the mixtures and their causal influence on the body at different levels, see Van der Eijk (2020). For a new and convincing interpretation of the text in favour of a literal understanding of the stronger thesis of the work â i.e., that the substance of the soul is the mixture of the body â and for a solution as to how this approach can be reconciled with the later De Propriis Placitis, which is commonly seen as Galenâs most agnostic work, see the ground breaking studies by Vinkesteijn (2019) and (2023).
Cf. Ars Med. I 334,8â11 Kühn.
Cf. chapters 1.1â3 above, and Trompeter (2018).
Cf. QAM 37.16â21 MuÌller = IV 774 KuÌhn. Vinkesteijn comments with a view to this passage: âNow we can perhaps start to think of a different way in which the soul is seated âinâ the organs. That is to say, in the sense that there are substances in the organ that are cause of the activities which we qualify as psychic.â Vinkesteijn (2019), 10. See our discussion below.
Cf. QAM 36.16â8 Müller = IV 773 Kühn.
Cf. QAM 36.9â16 Müller = IV 772â3 Kühn.
It is worth noting that the reference to Platoâs Phaedo is only part of the story, since the soul as harmonia theory plays a key role in the Peripatetic tradition and Galen was certainly aware of these debates as shows his reference to Andronicus in QAM. For further details, see Chiaradonna, (2021) and Caston (1997). I owe this advice to my anonymous referee.
Galen refers to Phaed. 70E in MM X 771â72 Kühn, to Phaed. 96â99 in UP 338â39 Helmreich, and to 100E in Diff.Puls. VIII 597â8 Kühn; cf. De Lacy (1972), 30.
Cf. Phaed. 85dâ86e. The theory of the soul as a harmony also comes up in Aristotleâs De Anima 1.4.
Socratesâs arguments against the harmony theory are the following: a) It has been shown that the soul has an a priori knowledge; this is not compatible with the idea that it is the harmony of the body. b) If the soul were the harmony of the body, unharmonious, bad-tempered people could not exist. c) If the soul were the harmony of the body, there could be no struggle between soul and body, nor such virtues as temperance. Cf. Phaed. 91câ95a.
On these issues the reference to Platoâs Phaedo is only part of the story, since the soul as harmonia theory plays a key role in the Peripatetic tradition and Galen was certainly aware of these debates as shows his reference to Andronicus in QAM. For further details of the discussion, see Chiaradonna (2018). Thanks to my anonymous referee for this reference. Generally on the harmonia theory of the soul cf. Caston (1997).
In PHP V.3 310,9â20 De Lacy, the issue that body and soul can be in either harmony or disharmony is addressed â albeit with reference to the Sophist 227d13â228b1. There, the conflict of the soulâs parts with one another is defined as a disease of the soul, while its harmony and mutual proportion is defined as health. Here, the body-soul relationship is described in terms of a mere analogy and not in causal terms, and whether and how body and soul are connected is not actually discussed.
For the following paragraph, I am highly indebted to James Hankinson (2017): âSubstance, Element, Quality, Mixture: Galenâs Physics and His Hippocratic Inheritanceâ in: Aitia 7.2, Ãtudes sur le De elementis de Galien, 1â39.
See HNH XV 29â31 Kühn = 17,22â18,15 Mewald, cf. Hankinson (2017), 15.
Hankinson (2017), 16.
Hankinson (2017), 25.
Cf. Temp. 34,5â15 Helmreich = I 562,17â563,9 Kühn.
Cf. Loc.Aff. VIII 301,14â302,5 Kühn.
Cf. Caus.Symp. 193,15â18. On death and vital tonos, cf. Trompeter (2016).
Cf. Loc.Aff. VIII 232,15â233,6 Kühn.
Cf. PHP VII.3, 442,36â444,11 De Lacy and MM X 841 Kühn.
Cf. Smith (1974).
Cf. Tim. 41e.
Cf. Tim. 42eâ43b.
Cf. Tim. 43bâ44b.
Cf. Tim. 44b1â7.
Cf. QAM 43,19â20 MuÌller = IV 782 Kühn; 47,14â6 MuÌller = IV 786 Kühn.
Cf. QAM 43,15â16 MuÌller = IV 782 Kühn. In his interpretation of the passage from the Timaeus outlined above, Galen concentrates on those parts in which Plato addresses the influence of nourishment, while leaving out the discussion of sense perception. Moreover, he interprets tropheÌ in the narrow sense of the eating and drinking of adults, whereas Plato in the course of the Timaeus seems to understand this term as the general upbringing of children. Galenâs narrow interpretation of the passage has been called a âtendentious reading of the textâ: âYet that involves not just a narrow, but a tendentious, reading of the text â even of the text Galen quotes â as becomes clear if the whole passage is taken together.â Lloyd (1988), 21.
I have opted for the translation âbind withinâ (
See Frede (2003), 94: âWe know that there is a soul, because the soul makes us do the things we as living beings do, like walk or run. But we do not know what it is, and hence also do not know what it does such that as a result of it we walk and run and do all the other things living beings do. Hence, we introduce powers named after the observable effects of its activity, of its exercise of its power, for instance the natural powersâ.
Cf. Prop.Plac. 14.1, p. 128 Garofalo and Lami = 187.14â22 Boudon-Pietrobelli.
As Vinkesteijn puts it: âThe fact that the activities are there proves that soul exists as their cause (just as, for Galen, the existence of well-designed creatures proves that an intelligent creator exists), but because we do not know what soul itself is, we name the causes of the activities in terms of capacities, while it is really the substance that is the cause.â Vinkesteijn (2019), 19.
Cf. PHP VII.3, 442,36â444,11 De Lacy; Hipp.Epid. VI 5.5 271.9â18.
Cf. QAM 33,24 Müller = IV 769,16 Kühn.
See chapter 1.3 above.
Cf. Caus. Symp. VII 191,4â193,4 Kühn.
Cf. Vinkesteijn (2019), 5â6; Hankinson (2003), 51; Tieleman (2003), 144â51.
In Aristotle, the category pros ti as it is discussed in Cat. 6a36â8b24 refers to things that only exist towards something else. This would mean that the thing to be described (in our case, this is the term dunamis) is as such incomplete and exists only in relation to the thing to which it relates (in our case, this would be ousia). On the Aristotelian category of pros ti, see Studtmann (2018) 2.2.3.
On the meaning of dunamis in QAM, see also Trompeter (2013), 209â15.
Cf. Prop.Plac. 3.1, p. 64 Garofalo and Lami = 173.16â18 Boudon-Pietrobelli; 7.1, p. 86 = 179.28â9; 15.1, pp. 136â8 = 188 27â30.
Cf. Prop.Plac. 2, 172.31â173.11 Boudon-Pietrobelli cited below.
Schiefsky (2012), 337 n. 27 assigns an âofficial agnosticism on the question of the substance (ousia) of the soulâ to Galen. Cf. also Garcia-Ballester (2002), 130. For a further discussion of Galenâs agnosticism, see below.
Cf. Singer (2014), 15.
Hepburn, Ronald W. (2005), 92 [1967, 56]. âAgnosticismâ. In Donald M. Borchert (ed.). The Encyclopedia of Philosophy.
Cf. Protagoras Fr. B4 DK, cf. Tieleman (2018), 460â1.
Cf. Tieleman (2016), 19, with reference to UP III. 10, p. 237 KuÌhn, vol. I, p. 174 Helmreich.
Cf. UP I 173â9. As Hankinson puts it: âNature not only does nothing in vain for Galen, but it also arranges things in the best possible way.â Hankinson (1989), 214.
Cf. Nat. Fac. 2, 44â5, 91â2.
Cf. Hankinson (1994), 1767â8.
âNature would be unjust, bestowing equal parts, similar in every respect, on things that are unequal and dissimilar.â
Cf. Williams (1980), Curzer (1995).
Cf. UP III 309 Kühn.
Cf. UP I,61â2 Helmreich = III 767 Kühn, transl. May.
Cf. PHP II.4 118,18â33 De Lacy.
Cf. UP III 304 Kühn.
Cf. Anat. admin. VII.7.
Cf. PHP II.4. 116,34â118,17 De Lacy.
In its attempt to show the ambiguity of appearances, this discussion is somewhat reminiscent of Platoâs example of the three fingers in Resp. 523a ff.
hoc enim est id quod a casu, scilicet nullus gratia. De Caus. Prot. (70) 94,7â8 Hankinson.
Zeller has stated that it does not matter to Galen whether the world is built by a god or by mere chance, if only it has full purpose (cf. Zeller (1923), 862). But as we have seen, for Galen purposefulness without a divine creator is impossible.
Cf., e.g., Ballester (2002), 19, and Schiefsky (2012), 337 n. 27.
Galen distinguishes between things that we have knowledge of (gignôskein), things that are merely plausible (pithanos) and things that are fully unlike (atopia). Cf. Vinkesteijn (2019), who refers to Hipp. Elem. 86.14 De Lacy (= i. 442 KuÌhn); and see also Chiaradonna (2014) and Tieleman (2018).
See Prop.Plac. 14.1, p. 128 Garofalo and Lami = 187.14â22 Boudon-Pietrobelli.
Cf. Lib.Prop. 1: XIX 13 [SM II95]. Cf. Frede (1981), 72.
Cf. On Medical Experience and Subfiguratio empirica.
Cf. Frede (1981), 73.
Cf. Tieleman (2016), 17.
Galen makes this point at the beginning of On Medical Experience; cf. Frede in Nutton (1981), 73.
Cf. Tieleman (2016), 18.
âGalen is a rationalist, he does regard himself as a rationalist, but he does reject the particular kind of rationalism adopted by the rationalists.â Frede (1981), 73, with reference to De differentiis febrium I 3: VII 282. It should be noted that the degree to which something like a ârationalist schoolâ actually existed is a subject of debate. As Kudlien, citing Diepgen, has pointed out, the ârationalistsâ or âdogmatistsâ cannot, strictly speaking, be called a âschoolâ. Rather, âdogmatistsâ are all post-Hippocratic physicians who developed a theoretical and speculative kind of medicine, in departure from those who relied on experience only. See Kudlien (1965), REA Suppl. X, cols. 179â180.
Cf. Frede (1981), 75, who refers to De probis pravisque sucis 14: VI 814 = CMG V 4,2, 429; in Hipp. epid. I comm. I praef. XVII A 13; De comp. med. sec. gen. VI.7: XIII 887, and Tieleman (2016), 18.
Cf. Tieleman (2013), 103.
Cf. QAM 32, 14â33,7 Müller = IV 768â9 Kühn. See the discussion in Singer (2013), 375 n. 10, who finds Galenâs introduction of the tripartition âsurreptitiousâ, and sees contradictions with Mor. 28â30 Kraus, where we learn that the rational part of the soul is developed rather late in youth.
In section 2.2.1 Natural Character Traits and the Determination of Character we have discussed to which degree we have an influence on our inborn nature. There we have seen that while we according to Galen cannot change our natural character traits into their very opposite, we have a gradual influence on our character by means of our initial choice, which part of the soul we aim to train and strengthen.
Moreover, the psychic pneuma in the head is said to have a very different nature from all other pneumatic structures in the body; cf. UP III 323,11â13 Kühn.
See Tieleman (2016), 28â9.