Athe ̄naios, practicing in Rome, opened a new avenue in medical thinking, loosely and
variously defined by Gale ̄n, most explicitly as pneumatike ̄ (Diff. Puls. 3, 4 [8.646, 756 K.]) and
its members as pneumatikoi (ibid. [8.674, 749 K.]), on the basis of the role of pneuma in
their physiological system. According to Gale ̄n, such physicians were especially well-
qualified in general medicine, particularly with regard to fever (Febr. Diff. 1 [7.295 K.]).
Among those deserving his deepest esteem was Athe ̄naios himself (Sympt. Caus. 2 [7.174 K.]).
According to Athe ̄naios, reasoning from theories of nature alone is the basis of medicine
(Gale ̄n, Elem. Hipp. 1 [1.457–486 K.]; ps.-Gale ̄n, Intro. 14.676–677, 698 K.; ps.-Gale ̄n, Def.,
19.356 K.), contrary both to those relying on tradition, and to A B,
who valued reason and experience (logos and peira). Athe ̄naios’ theory was based on
Stoicism, particularly regarding the role of fire both in the kosmos and in physiology.
Again contrary to Askle ̄piade ̄s, Athe ̄naios opted for an incorporeal biological theory. He
believed that the body is made of four elemental properties (stoikheia: heat, cold, dry and
moist), which Gale ̄n found unclearly defined, but Athe ̄naios claimed were evident (enarge ̄)
and not requiring demonstration. Athe ̄naios variously called the stoikheia “qualities” (poi-
ote ̄tes), “powers” (dunameis), and “bodies” (so ̄mata). Gale ̄n found it unclear whether the bodies
composed of these four elements were homoiomerous. Two of these elementary qualities
are active (poie ̄tika: heat and cold), two are material (hulika: dry and wet). A fifth element,
pneuma, holding the qualities together and contained in the blood, generates cardiac
movement. It circulates through the heart and the arteries, stimulating their expansion, a
natural and involuntary movement. Heat thus moves from the heart and returns to it
(Gale ̄n, Diff. Puls. 4 [8.755–756 K.]). As a result, the source and directing principle of
human life (he ̄gemonikon) is located in the heart (Gale ̄n, MM 13 [10.929 K.]).
Athe ̄naios defined health as an equilibrium (eukrasia) of pneuma and the four elements
(MM 7 [1.523 K.]). The equilibrium between the pneuma and four elements is created by
the tension (tonos) between them (Gale ̄n, Diff. Puls. 3 [8.646 K.]). The pneuma is thus
responsible for both health and disease (ps.-Gale ̄n, Intro. 14.699 K.), the latter being a
disequilibrium (duskrasia). Diseases are caused by substances altering the quantity or the
quality of either the pneuma or of the elements.
Athe ̄naios dedicated no specific work to articulate his theory (ps.-Gale ̄n, Def., 19.347 K.),
and none of his writings, or even their titles, survives. Gale ̄n refers to the 24th book of an
unnamed treatise (Sympt. Caus. 2 [7.165 K.]), and quotes an enema (through A-
, in CMLoc 9.5 [13.296 K.]), and a medical formula (through A P.,
in CMGen 5.3 [13.847 K.]). Gale ̄n connects Athe ̄naios’ work on embryology with A-
(Gale ̄n, De Semine, passim).
Gale ̄n admired Athe ̄naios (Tremor [7.609 K.]), and agreed with him except on quotidian
fever (Febr. Diff. 1 [7.295 K.]). Nevertheless he criticized him, principally for his vagaries
regarding the four stoikheia (Elem. Hipp. 1 [1.457, 460 K.]). Athe ̄naios’ theory reached its
zenith with A, but evolved very early toward a more synthetic system absorbing
elements from other contemporary schools, leading to the so-called episunthetic or eclectic
school (ps.-Gale ̄n, Def. 19.353 K.) supposedly created by Agathinos, and followed by
A and L A.
Wellmann (1895); RE 2.2 (1896) 2034–2036 (#24), Idem; Kudlien (1962); Idem (1968) 1097–1098; KP
1.703, Idem; DSB 1.324–325, J.S. Kieffer; Harris (1973) 237–242; Smith (1979) 231–234; OCD3 203,
V. Nutton; BNP 2 (2003) 244–245, Idem.
Alain Touwaide
ATHE ̄NAIOS OF ATTALEIA