Heart, brain, blood, pneuma 123
natural philosophy, such as the so-called four primary qualities hot, cold,
dry and wet. By contrast, he adopted a predominantly empirical approach
to medicine, which in his view was tantamount to dietetics, the theory
of healthy living. His approach was based on insights into the wholesome
effects of food, insights that had been passed down from generation to
generation and refined by experimentation. He even went so far as to claim
that in reality physics does not form the basis for medicine, but medicine
for physics.
The question of to what extent a doctor should be concerned with, or
even build on, principles derived from physics (or metaphysics) remained a
matter of dispute throughout antiquity. What made the problem even more
urgent was that in many areas of controversy, such as that on the location
of the mind, it remained unclear to what extent these could be resolved on
empirical grounds. The doctor’s desire to build views concerning the correct
diagnosis and treatment of psychosomatic disorders such asmania, epilepsy,
lethargy,melancholiaandphrenitison a presupposition about the location
of the psychic faculties affected, which could not be proved empirically,
differed according to his willingness to accept such principles, which were
sometimes complimentarily, sometimes condescendingly labelled ‘philo-
sophical’.^10 This group of doctors with a profoundly philosophical interest
included, for instance, Diocles of Carystus (fourth centurybce) and the
author of the Hippocratic workOn the Sacred Disease(end fifth century
bce). They corresponded to an ideal proclaimed first by Aristotle and later
by Galen, namely that of the ‘civilised’ or ‘distinguished’ physician, who is
both a competent doctor and a philosopher skilled in physics, logic, and
rhetoric.^11 Caelius Aurelianus’ derogatory remark shows that this ideal was
by no means beyond dispute. Yet in this dispute, too, the variety of views
on the matter was much wider than his general characterisation suggests.
It is therefore highly likely that Caelius Aurelianus’ presentation intends to
exaggerate the differences in opinion between the doctors mentioned, in
order to make his own view stand out more clearly and simply against the
background of confusion generated by others.
These introductory observations may suffice to provide an outline of the
debate on the seat of the mind, which was the subject of fierce dispute
(^10) The first time the wordphilosophiais attested in Greek literature is in ch. 20 of the Hippocratic
writingOn Ancient Medicine( 1. 620 L.). The word is used in a clearly negative sense, to describe
the practice of scrounging from physics, which is rejected by the author. The name Empedocles is
mentioned in this context.
(^11) For this Aristotelian ideal see below, ch. 6 ,pp. 193 – 7. Galen wrote a separate treatise entitled and
devoted to the proposition thatThe Best Physician is also a Philosopher(i.e. skilled in logic, physics,
and ethics; see 1. 53 – 63 K.).