134 Hippocratic Corpus and Diocles of Carystus
This explanation shows a strong similarity to the one inOn Breaths,yet
without mentioning blood. The main argument is that epilepsy is viewed
as tightness of the chest or suffocation generated by the obstruction of
the airways: the ‘passage through which breath flows’ is unlikely to refer
to anything else but the windpipe. One air current, the air saturated by
food vapours, obstructs the other, respiration. Aristotle does not speak
about disorders in perception that are among the symptoms of epilepsy
(and which apparently can be explained as analogous to the state of sleep,
that is, as a result of the heat of the heart becoming chilled). Nor does
he speak about other symptoms characteristic of epileptic fits. Yet he does
make selective use of empirical data by stating that young children are
particularly prone to the disease (a widely known fact in antiquity) and
that the disease often manifests itself during sleep.
Lastly, the views of Diocles and his contemporary Praxagoras should be
discussed. Both consider the heart to be the seat of the mind, but both also
attribute an important role to the brain and to the mediation between the
two by what they call ‘psychicpneuma’:
Praxagoras says that it [i.e. epilepsy] occurs around the thick artery, when phleg-
matic humours form within it; these form bubbles and obstruct the passage of the
psychic breath coming from the heart, and in this way this [the breath] causes the
body to be agitated and seized by spasms; when the bubbles die down, the affection
stops.
Diocles himself, too, thinks that it is an obstruction occurring around the
same place, and that for the rest it happens in the same way as Praxagoras says it
occurs...^36
Compared toOn the Sacred Diseaseit is significant that Diocles and Praxago-
ras consider the heart, not the brain, to be the starting-point for the psy-
chicpneuma. In all other respects the explanations are virtually identical:
the basic thought is that the passages through which the breath flows are
obstructed or blocked; the obstruction is caused by phlegm (phlegma).
Furthermore, Diocles and Praxagoras are the only doctors from the period
concerned of whom we know some of the therapeutic measures they took
in case the disease occurred. The authors ofOn the Sacred DiseaseandOn
Breathsrestrict themselves to some very general remarks on curing the dis-
ease (by restoring the balance between the four primary qualities hot, cold,
dry and wet; curing it by means of contrasting qualities). Diocles, on the
other hand, is known to have based his treatment on the type of cause he
established for the disease: purgative measures to removephlegma, walking
(^36) ‘Anonymus Parisinus’ 3 (published by I. Garofalo ( 1997 )); tr. van der Eijk ( 2000 a) 177.