Without leaving their city, Romans in the latter part of the second century B.C. were able to hear leading intellectuals from the Greek world. Perhaps the dwellers by the Tiber felt some pride that their city now exerted an attraction for these cultural stars as great as that of Pergamum, Alexandria, or Antioch; if so, it is one of history’s little ironies that we now remember thinkers like Panaetius chiefly for their influence on the Roman governing class, and that we must piece together their doctrines from scattered notices in the writings of later, and often lesser, compilers.
Asclepiades of Bithynia, whose importance and date Elizabeth Rawson has recently established, belongs to this group of Hellenistic intellectuals at Rome in the generation of Panaetius. He began as a rhetorician but turned to medicine and established a successful practice which employed gentle therapies justified by a physiology designed to make sense to those with some grounding in Hellenistic philosophy. Asclepiades’ physiology and the philosophy behind it are of interest to anyone who hopes to understand the complex interactions of theory and practice in Hellenistic medicine or the ways in which Greek thought penetrated Roman culture.
Asclepiades maintained that disease occurred when something disrupted the normal flow through the body’s pores of small particles, which he probably called ἄναρμοι ὄγκοι. On this much our sources agree, and then questions begin. What relation links Asclepiades’ ἄναρμοι ὄγκοι to the atoms of Democritus, Epicurus, and Lucretius? How did Asclepiades use his theory to explain diseases? Are our sources correct in finding antecedents of the later Methodist school of medicine in Asclepiades’ doctrines? The more we discover the complexities of Hellenistic and Roman thought and the importance of medicine in its fabric, the more Asclepiades looks like a crucial figure, whom we need to place in the context of natural philosophy and medicine before and after his own time.
Vallance has attempted just such a placing. Because I do not think he has altogether succeeded, and because I shall have to point out some ways in which his effort is flawed, I need to say right away that this is a useful book, and that I look forward to Vallance’s article on Asclepiades in the forthcoming ANRW volume (II.37,1) on Roman medicine, and to his promised collection of the ancient fragments of Asclepiades. The Lost Theory, to its credit, does not claim to be the last word on Asclepiades, and perhaps it is best read in the spirit with which we approach articles in journals; in the expectation, that is, that much of what we read will be subject to later correction, and that we are being allowed to view some interesting byproducts of an important work in progress or to hear one side of a dialogue. This book has virtues, to which I shall return. Vallance devotes over half his book to the question of Asclepiades’ relation to ancient atomism. Two long chapters deal first with the ἄναρμοι ὄγκοι, and then with void. In the first, Vallance argues that all mentions of ἄναρμοι ὄγκοι, corpuscula, or other bodies in our ancient sources for Asclepiades’ doctrine refer to a single kind of fundamental and infinitely divisible particle; that Asclepiades did not take over the Epicurean version of atomism; and that Galen is “perverse or up to something more than a little strange” (p. 45) when he suggests that Asclepiades did. In attempting to establish the first and most fundamental of these propositions, Vallance finds himself compelled to explain away the testimony of Caelius Aurelianus, Sextus Empiricus, and Galen, our three principal sources for Asclepiades’ doctrine. I give two examples, from Caelius first and then from Sextus.
Caelius Aurelianus, De Morbis Acutis I.105, provides some of the best information we have about Asclepiades’ corpuscles: primordia namque corporis primo constituerat atomos, secunda corpuscula intellectu sensa sine ulla qualitate solita, atque ex initio comitata, aeternum moventia. In his edition of 1950, Israel Drabkin questioned secunda and suggested secundo to balance primo in the first clause. No matter whether we keep secunda or adopt secundo, the effect, as Drabkin says, is the same: “to distinguish the atoms and corpuscles in the system of Asclepiades,” at least as reported by Caelius. Because Drabkin believed that Asclepiades had not made such a distinction, he invoked the fact that one early printed edition of Caelius omits secunda to justify bracketing the word. It was impossible, in his opinion, to decide whether the “mistake” had been made by Caelius or “a post-Caelian corrector.” (Since we depend entirely on early editions for our knowledge of most of De Morbis Acutis, Drabkin’s decision to bracket secunda is not as poorly supported as it would be if manuscripts survived.)
Secunda is an obstinate paradosis, and Drabkin’s reservations about it have not been shared by more recent interpreters. In his 1980 study of Heraclides Ponticus, H. B. Gottschalk argued that secunda marks the corpuscula as a second order of particles less fundamental than the atomi. The late Gerhard Bendz, who knew the text of Caelius Aurelianus as well as any scholar of modern times, retained secunda unbracketed in the new Corpus Medicorum Latinorum edition of Caelius, which appeared too late for Vallance to consult. Secunda/-o, then, stands, and with it the distinction in our text of Caelius between Asclepiades’atomi and his corpuscula.
As the passage just quoted continues, Caelius speaks of particles called fragmenta : quae (the antecedent is corpuscula) suo incursu offensa mutuis ictibus in infinita partium fragmenta solvantur magnitudine atque schemate differentia; quae rursum eundo sibi adiecta vel coniuncta omnia faciant sensibilia, vim in semet mutationis habentia, aut per magnitudinem sui aut per multitudinem aut per schema aut per ordinem. The corpuscula, that is, strike together and dissolve into fragmenta, which recombine to make up the perceptible world.
Are the fragmenta in Caelius’ report a fundamentally different kind of particle from the corpuscula, or do fragmenta and corpuscula constitute two different stages in the division and recombination of one fundamental particle? What relation do the atomi bear to fragmenta or corpuscula ? Answers to these questions can come only from an attempt to discover the exact meaning of Caelius’ words. Latin, notoriously ill-suited to philosophy, struggles against its small store of words to construct meaning by juxtaposition, metaphor, and context. An expression that means one thing in history may mean another in elegy. Understanding is often a matter of discovering the right context. Yet real ambiguity is rare, even though Latin sentences echo with the ghosts of possible meanings. Vallance, however, believes that if a sentence might mean something, it may, and he has unwisely attempted to separate Caelius’ report from its philosophical context.
The corpuscula are perceptible to the intellect (and so presumably not to the senses) and lack accustomed or usual ( solita) quality. The fragmenta differ in size and shape. Are size and shape qualities? For Aristotle, of course, size came under the category quantity, not quality, but Caelius’solita may suggest that he wants us to take qualitas in a common-or-garden sense, to include size; LSJ cite Babrius and Aesop to confirm that ποιότης could be so taken.
It seems to me more likely, however, that Caelius’sine ulla qualitate solita belongs in the context of philosophical questions about change and identity. These questions stood at the center of ancient medical thought, for disease poses the problem of change and identity in an especially urgent form. A person is healthy one day, ill the next. The signs of disease are changes in the person’s appearance, excreta, and behavior. How can we be justified in asserting that the diseased person before us today, changed in so many respects, is the same individual whom we saw in health yesterday? If a diseased person has been restored to health, what has changed? Aristotle (e.g. Met. 9, esp. 1046b) was not the only philosopher to use the physician’s art to illustrate philosophical problems raised by change.
For their part, physicians used the philosophers’ arguments about change to understand the dynamic processes of health and disease. In this dialogue of physician with philosopher, both sides devoted considerable thought to the predication called “quality,” its relation to substrate, disposition, and other philosophical predications of existence on the one hand, and on the other to traditional dichotomies like hot and cold, wet and dry, or bitter and sweet. Galen begins On the Natural Faculties with a discussion of theories of change in quality (κατὰ τὴν ποιότητα κινεῖσθαι). Hippocrates, he says, was the first physician and philosopher to recognize that all change can be explained as the interaction of four qualities, the hot, cold, dry, and moist.
Corpuscular theories like that of Asclepiades stood in opposition to the Hippocratic scheme of elements and qualities. As part of their opposing argument, advocates of corpuscular physiologies had to offer an account of qualitative change; in fact, the difficulty of explaining how an individual could change in quality was one stimulus behind the creation of atomistic theories. It remained difficult to explain how individuals having qualities could arise from fundamental particles lacking those qualities. As Caelius presents it, Asclepiades’ distinction between fragmenta or atomi and corpuscula seems directed at explaining how change can take place and how bodies without quality can produce individuals capable of qualitative change.
Something of this debate about qualitative change, I feel sure, lies behind Caelius’ “usual quality.” Vallance says little about the debate, even at points where it looms large in the texts before him. On pp. 31-32, for example, he puzzles over the relation between “passion” and “quality” in two passages of Sextus Empiricus. Some attention to Aristotle, De Generatione et Corruptione 322b-326b and the later history of the concepts put forward there might have clarified Sextus’ remarks.
The quality-less corpuscula, the context of Caelius’ statements suggests, are distinct from the qualified fragmenta. The fragmenta, further, are the same as the atomi which Caelius’ text distinguished from corpuscula. According to our best sources, size and shape, the two characteristics of the fragmenta, also characterize Democritean atoms. Aristotle as reported by Simplicius (DK 68A 37) declares that Democritean atoms had παντοίας μορφὰς καὶ σχήματα παντοῖα καὶ κατὰ μέγεθος διαφοράς. Aetius (DK 68A 47) reports that Democritus’ atoms had μέγεθός τε καὶ σχῆμα, and although he may be wrong when he goes on to assert that they did not have weight, he is certainly right about their two primary characteristics. Most decisively, Caelius uses the word atomos for the fragmenta. As Vallance himself acknowledges (p. 25), there are “no cases of atomus being applied specifically to non-Abderite or Epicurean particles.”
In short: the transmitted text of Caelius makes a clear distinction between atomi and corpuscula in the doctrine of Asclepiades. The corpuscula lack qualities; the particles called fragmenta have at least some. The characteristics of the fragmenta are those of Abderite atoms. Everywhere else in Latin, the word atomus refers to Abderite atoms. It is hard to deny that the fragmenta in Caelius’ report of Asclepiades’ doctrine are identical to the atomi and different from the corpuscula.
Vallance denies it. Relentlessly he bends and prunes Caelius’ testimony until it conforms to his belief that Asclepiades posited only one kind of fundamental and infinitely divisible particle. Although Vallance never proposes in so many words that the troubling secunda, or the emendation of it to secundo, be deleted from Caelius’ text, he follows Drabkin by imprisoning them in brackets and omitting them from his interpretation. “The lack of a connective between atomos and [ secunda ] corpuscula,” Vallance writes (p. 20), “could just as easily lead us to expect that the second clause contains an explanation of the first.” But the circumstance that a Latin sentence might have a certain meaning does not entail that it does, and secunda/-o is there to make it clear that corpuscula are distinct from atomos. The philosophical context reinforces this distinction.
With Caelius now dragged into his camp, Vallance can move on to deal with other troublesome bits of evidence. In a summary of Asclepiades’ explanation of fever at Adversus Mathematicos 3.5, Sextus Empiricus says that Asclepiades used three hypotheses in explaining the blockage that caused fever. The second of these concerns us here: δευτέρᾳ δὲ ὅτι πάντοθεν ὑγροῦ μέρη καὶ πνεύματος ἐκ λόγῳ θεωρητῶν ὄγκων συνηράνισται δι’ αἰῶνος ἀνηρεμήτων.
Sextus seems to mention two kinds of particles, μέρη and ὄγκοι, but Vallance will not allow him to do so. Here is what he says (p. 27): “The text suggests to me that Sextus is simply trying to say that bodily fluids and pneuma are made from the corpuscles. The ‘parts’ (μέρη) are, in my view, to be understood as the corpuscles themselves.” This interpretation strains at a reasonably clear text. The perfect συνηράνισται must mean “have gathered themselves together” or, as the middle voice of συνερανίζω commonly does, “have received contributions from.” The μέρη or fragmenta are shaken loose ( mutuis ictibus … solvantur), as Caelius explained, from colliding ὄγκοι or corpuscula. When these ὄγκοι a rejoined by others of an appropriate kind, they combine to form new ὄγκοι.
Asclepiades’ second hypothesis to explain fevers, according to Sextus, was that “from all sides fragments of fluid and spirit have received contributions from (or have gathered themselves together out of) eternally restless bodies perceptible to reason.” I do not see why, if this process involves only one kind of particle, our sources give us a consistently bifurcated terminology in Greek and Latin. The μέρη correspond to Caelius’fragmenta, the λόγῳ θεωρητῶν ὄγκων to his corpuscula intellectu sensa, and δι’ αἰῶνος ἀνηρεμήτων to aeternum moventia. Nor does it stretch language to say that when μέρη have been joined by other μέρη to form new ὄγκοι, they have “received contributions from” the previous ὄγκοι from which the newcomers came. An exact parallel for this use of συνηράνισται appears in Galen’s In Hippocratis Aphorismos Commentarii, XVIIIa.193 Kühn: φαίνεται γοῦν ὅτι καὶ ταῦτα [i.e. some of the manuscripts of Hippocrates’Aphorisms ] συνηράνισται μοχθηρῶς ἐκ πολλῶν Ἱπποκρατείων ἀποφάσεων συγκείμενα παρεφθαρμένως; the witnesses to the text of the Aphorisms current in Galen’s day, that is, had received contributions from many collections of Hippocratean sententiae. As the aphorisms retain their identity in and are distinct from the various collections which they form, so the μέρη retain their identity in various ὄγκοι.
On p. 26 Vallance offers a translation of Sextus’ δευτέρᾳ δὲ ὅτι πάντοθεν ὑγροῦ μέρη καὶ πνεύματος ἐκ λόγῳ θεωρητῶν ὄγκων συνηράνισται δι’ αἰῶνος ἀνηρεμήτων that is not far wide of the mark: “second that parts of moisture and pneuma are gathered together from all sides out of intelligible corpuscles which are in permanent motion.” By the time he explains these words on p. 28, however, they have come to suggest something else: “Sextus may be making the more specific point that ‘parts of fluid and pneuma’ are augmented (συνερανίζω—’contribute jointly’, LSJ) from all parts of the body (παντόθεν [ sic ]) by theoretical corpuscles which are in constant motion.” Insofar as “augmented” suggests the accretion of parts to an already compound body, it begs the question, for it implies what Vallance wants to prove, that the μέρη are the same as the ὄγκοι.
This casual and selective approach to the ancient evidence continues into Vallance’s chapter on void. On p. 97, for example, we read in one paragraph that humoris fluor, celer ac parvi temporis, means “a flow of liquid, acute and brief,” and in the next that rheumatismus sive fluor parvi temporis means “an acute flux or flow.” How exactly does Vallance understand parvi temporis ? On p. 56 Vallance quotes Caelius Aurelianus, De Morbis Acutis I.106: fieri etiam vias ex complexione corpusculorum intellectu sensas, magnitudine atque schemate differentes, per quas sucorum ductus solito meatu percurrens, si nullo fuerit impedimento retentus, sanitas maneat, impeditus vero statione corpusculorum morbos efficiat.“The lack of any mention of void in this passage,” Vallance says, “is rather puzzling.” Yet on the very next page (57) he quotes in a footnote a passage from Galen ( De Causis Morborum VII.1-2 Kühn) in which Galen criticizes his opponents, among them those who hold that “void is woven into every compound of the body” (κενόν τι παραπεπλέχθαι πάσῃ σώματος συγκρίσει). Vallance, perhaps because he is skeptical about Galen’s use of an Asclepiadean brush to tar his Methodist opponents, makes no effort to use Galen’s παραπεπλέχθαι to illuminate Caelius’complexione corpusculorum. There is nothing puzzling in Caelius’ failure to mention void. He is talking about ὄγκοι and πόροι, not the atoms and void that subsist in those more complex particles and passages whose structure creates health and disease. As Vallance himself later observes (p. 122), “Void there may have been, but it is of no interest to our sources.”
Although Vallance’s handling of crucial pieces of ancient evidence makes it impossible to accept his account of the relation between Asclepiades’ physiology and ancient atomism, it does not weaken every part of his argument. Vallance recognizes that Galen uses condemnation of Asclepiades’ physiology as a club to beat his Methodist rivals, and this insight allows him to give a nuanced picture of the connections between Asclepiades and the Methodist school, and between Asclepiades and Erasistratus. Medical Methodism, Vallance shows, was a simplification of Asclepiades’ system, which was itself a simplification of Erasistratus’. The Methodists abandoned the complicated and difficult notion of the “affected place,” and so incurred the wrath of that theory’s most eloquent proponent, Galen. (Readers of Vallance’s discussion of this point may note the absence of reference to Almuth Gelpke’s admirable study of the “affected place” in Galen.) Vallance’s insightful account, which deemphasizes the importance of atomism to this line of intellectual descent, matches the evidence better than the strong thesis of Stückelberger, who sees Erasistratus as a thoroughgoing atomist who absorbed Democritean ideas from his teacher, Chrysippus of Cnidos.
Vallance advances our understanding in other ways. He makes a persuasive case for understanding ἄναρμος as “weak” or “loosely held together.” In his explanation of how the concept of “blockage” was used to explain the disease called phrenitis, he convincingly reconciles seemingly contradictory accounts in Caelius and Galen. And he rightly insists that Caelius and Galen, as well as Asclepiades, must be read as physicians employing philosophy in the service of medicine, not as philosophers whose examples happen to be medical. “Asclepiades’ corpuscular hypothesis must be seen in its medical context if we are to make any sense of it” (p. 130).
So it must. But for Asclepiades, as for all the medical writers of the Roman period, philosophy provided the conceptual tools with which the medical context was constructed. Galen insists that medicine is impossible without philosophy. It is tempting to read against his strident, overbearing polemics and to seek in our written sources what can never be found, a medical theory free of philosophical quibbles. It is also evident that too many scholars have regarded ancient medical thought as little more than a practical reflex of philosophy and denied it any independent value. Vallance, unfortunately, has yielded to the temptation to bash Galen and reacted too strongly to previous scholars’ overemphasis on philosophy. Where the medical context can guide us to new understandings of Asclepiades, Vallance points the way. But where philosophy tangles itself inextricably in medical theory, he can see only part of the path ahead.
MENTIONED IN THE REVIEW
G. Bendz (ed.), I. Pape (tr.), Caelii Aureliani Celerum Passionum libri III, Tardanum Passionum libri V (Caelius Aurelianus, Akute Krankheiten, Buch IIII. Chronische Krankheiten, Buch I-V). Teil I: Akute Krankheiten I-III, Chronische Krankheiten I-II (Berlin 1990).
I. Drabkin (ed., tr.), Caelius Aurelianus On Acute Diseases and On Chronic Diseases (Berlin 1950).
A. Gelpke, Das Konzept des erkrankten Ortes in Galens “De Locis Affectis” (Zürich 1987)
H. B. Gottschalk, Heraclides of Pontus (Oxford 1980).
E. Rawson, “The Life and Death of Asclepiades of Bithynia,”Classical Quarterly 32 (1982) 358-70.
______, Intellectual Life in the Late Roman Republic (London 1985).
A. Stückelberger, Vestigea Democritea: Die Rezeption der Lehre von den Atomen in der antiken Naturwissenschaft und Medizin (Basel 1984).