The Hippocratic Treatise On Glands. Studies in Ancient Medicine v. 36

Let me begin this review the way Elizabeth M. Craik begins her The Hippocratic Treatise On Glands, by quoting a modern medical assessment of the Hippocratic On Glands : “The modern scientist stands amazed before the innovative concepts expounded in this ancient medical document. Indeed, the functional anatomy of the lymphatic system and lymph nodes emerges with impressive precision. . . . the author provides an absolutely modern interpretation of their physiopathological significance.”¹ Galen was not as impressed. In the Hippocratic Articulations 11, discussing cauterization in the axilla, the author remarks: “In another work there will be an account of the glands as a whole ( περὶ ἀδένων οὐλομελίης), what they are and what sort of things they signify and can effect in what parts of the body”.² This sounds like a description of the Hippocratic On Glands, which begins: “On glands as a whole” ( περὶ δὲ ἀδένων οὐλομελίης). This would seem to be the work referred to in Articulations. But Galen, commenting on Articulations, claims: “The complete nature of the nature of glands, which he promised to explain elsewhere, he called οὐλομελίης, yet such a book of Hippocrates on glands as a whole is not extant. But one of the more recent Hippocrateans wrote a short booklet inscribed ‘Hippocrates on glands as a whole’, which falls far short of the genuine Hippocratic writings in both language and thought. . .” (18A.379 K).

Modern scholars of ancient medicine have tended, more or less enthusiastically, to agree with Galen that the author of On Glands is not the same as the author of Articulations, and most agree that the former is a later and inferior work.³ Craik’s The Hippocratic Treatise On Glands contains not only a new edition of the Greek text, with translation, of this brief work, but also a lengthy introduction and commentary that, among other things, demonstrate (are far as that is possible) that Galen is wrong.

This slim volume is organized as follows: Introduction (pp. 1-57), Bibliography (59-64), Text & Translation (65-81), Commentary (83-154), Diagrams (155-57), and Indexes (159-69). The Introduction contains four parts: I. Overview (further divided into A. Content and B. Expression); II. Place in the Hippocratic Corpus; III. Place in Scientific and Medical History (further divided into A. Ancient and B. Modern); IV. Text and Translation. The Introduction is lengthy (in relation to the brevity of the treatise it discusses), complete, and uniformly superb. I shall focus my discussion of it on parts II and III-A.

In the second part of the Introduction, Craik sketches certain connections between On Glands and a number of other works in the Hippocratic corpus, e.g., Ancient Medicine, The Art, Airs, Waters, Places, Sacred Diseases, and Places in Man. These sketches are, she says, merely of “similarities, resonances, echoes in a wide range of rather disparate works: common elements in content and expression suggestive of connections, more or less close, but not indicative of common authorship”. Craik next turns to “a different and much more significant range of parallels evident in a large group of related texts devoted in a theoretical fashion to issues of obstetrics and gynaecology, and especially to topics in embryology and pregnancy” (p. 22): the set of treatises Generation, Nature of the Child, and Diseases 4, as well as (to a lesser extent) Diseases of Girls, Diseases of Women, and Infertile Women. The bulk of this part of the Introduction is devoted to the close affinities between On Glands and these works. Here, for example, is one of many arguments demonstrating the connection between On Glands and these treatises:

It is even more significant that On Glands contains several passages, obscure in isolated context, but clarified by other works in the group, and especially by the lengthy exposition in Diseases 4 of theories of physiological function and pathological change (see on 7, 11, 14). Thus the brief and cryptic statement that the body ‘sends all kinds of vapours up to the head’ (see on 7.2) is made clear by the extended description of the presumed pathology, based on the vaporizing effect of heat, which forced fluids in the body to ascend to the head ( Morb. 4.51 [7.584 L.]). (p. 32)

If one follows Craik’s lead (to On Glands 7, 11, 14, and to the relevant commentary) one will find further and ample support for her claims. She concludes this part of the Introduction by pointing out that, although it is usually not fruitful to speculate on the common authorship of works in the Hippocratic treatises, ” On Glands is a rare case, in that it can be assigned to a grouping; though paradoxically to an unexpected, and unexpectedly early, one” (p. 35), namely, Generation, Nature of the Child, and Diseases 4.

In Part III, section A, of the Introduction—on the place of On Glands in ancient scientific and medical history—Craik does an equally admirable job of locating On Glands in its context in ancient philosophy and science (apart from the Hippocratic tradition). Connections are made (among the Presocratics) to Alcmaeon, Empedocles, Diogenes of Apollonia, and especially Democritus, and among medical writers, to Dexippos, Menekrates, and Eryximachus. Moving ahead in the history, also discussed are connections to Aristotle’s biology and the Aristotelian Problemata, and (even further ahead) to Galen and Celsus. (Scholars interested in this history will not be disappointed when they turn to the commentary, which is stuffed with such connections and parallels.) Craik concludes this section:

The presence of influences or interrelations from all over the Greek world are pervasive in On Glands, as in the other works of the same author. He is familiar not only with early seminal or key texts associated with Hippocrates . . . , but also with early work of west Greek tradition. He is an important and original thinker, who occupies a pivotal place linking the thought of the Presocratics and the study conducted in the Academy and Lyceum. The date of writing may plausibly be placed in the early decades of the fourth century. (p. 45).

The text of On Glands depends most of all on the twelfth century manuscript Vaticanus graecus 276 (V), which is the source of the surviving (fifteenth and sixteenth century) recentiores: Monacensis graecus 71 (Mo), Parisinus graecus 2146 (ξ Parisinus graecus 2255 (ἐ, and Holkhamensis graecus 282 (Ho). These mss. are discussed briefly at the end of the Introduction. In the case of V, Craik depended on the collations of Joly, supplemented by the work of other scholars. Her new edition of the text includes a full apparatus criticus, judging by which Craik provides 25 emendations or suggested possible readings—a fairly large number, for eight pages of text. But, as she explains, “The text is marred by the intrusion of material which breaks sense and syntax” (pp. 53-54), and so the editor’s work is cut out for her.

I have one minor quibble with the text. On the first page of the Introduction, Craik refers to “the opening words and the resulting title of On Glands” (p. 1)—that is, the title of this work, I assume, simply comes from the opening words of the treatise ( περὶ ἀδένων οὐλομελίης). But there is no title at the beginning of the text nor is there any mention of one (or its absence) in the apparatus criticus (see p. 67) or in the commentary’s discussion of the opening line (see 83-84).⁴ If none of the manuscripts includes a title, περὶ ἀδένων οὐλομελίης should have been printed as the title in pointed brackets, with the apparatus criticus indicating that it is omitted in all manuscripts, and listing the first editor to include it (and perhaps the name of the earliest ancient author to refer to the work by title). Of course, if some of the manuscripts do include the title, that should be indicated. But let me stress that this is a minor complaint, and is not meant to detract from the value of this new edition of On Glands.

As for the facing English translation, it is accurate, consistent in its rendering of key terms, and as readable as a commitment to accuracy allows. For Craik (quite wisely, I think) does not smooth over the occasionally jarring and fragmented nature of the Greek. The only part of the translation that seemed on the whole unsatisfactory (and this may be more an issue of the state of the text than of the translation) is the first line of the brief section XV. After accepting a fairly radical emendation of Ermerins, and herself deleting a string of four words, the resulting text is translated: “And other affections of the brain, cases of delirium and of madness, and all are dangerous, and the brain suffers [and the other glands].”⁵ This is unintelligible. There is in fact an argument for bracketing all of XV as a later insertion (see the commentary pp. 145-46).

The bulk of the present volume is the commentary—72 pages on eight pages of text. It is simply superb. For each of the 17 sections of On Glands, the commentary begins with a concise summary of the content. The rest of the discussion is divided into parts each of which is headed by a lemma (a Greek word(s) from the text, and its translation). Each part is rich in discussion of textual problems, issues of interpretation, parallels to other ancient works (in the Hippocratic corpus or by other ancient scientists and philosophers), and even at times the medical accuracy of the Hippocratic author’s claims. This commentary is clearly the work of someone with a profound understanding of both the language and content of the Hippocratic corpus, and ancient Greek medicine generally. Craik’s Hippocratic Treatise On Glands is precisely the kind of volume I wish I possessed for each of the treatises in the Hippocratic corpus.⁶

Notes

1. E. Crivellato, L. Travan, and D. Ribatti, “The Hippocratic treatise “On Glands”: the first document on lymphoid tissue and lymph nodes,” Leukemia 21 (2007): 591-92 (quoted in Craik, p. vii).

2. All translations are from the volume under review, except for the Galen-passage later in this paragraph (which is my own) and the translation in n. 5.

3. For a brief summary of views, see Craik, pp. 15-16.

4. Cf. Paul Potter’s text with translation for the Loeb Classical Library (1995), which gives the title περὶ ἀδένων οὐλομελίης (with the minimalist translation Glands).

5. Cf. Potter’s translation (of the text of the mss.): “Other diseases too are affections of the brain—derangements and delirious states—and all these things are dangerous. Both the brain and the other glands suffer. . . . “

6. Thus, we can be grateful for Craik’s two other works of this nature: Hippocrates : Places in Man (Oxford University Press, 1998) and Two Hippocratic Treatises On Sight and On Anatomy (Leiden: Brill, 2006).