The Encyclopedia of Ancient Natural Scientists: The Greek tradition and its many heirs

(Ron) #1

distinction is made in terms of theoretical commitment (or the lack of it). Rationalists
believe that medicine must have a sound theoretical basis; doctors must understand the
etiology of diseases, in terms of the disruptions they represent to proper physical function-
ing, in order to be able to treat them. Empiricists, by contrast, think all such theorizing
about the “hidden conditions” of the body to be both ill-founded and pointless (they point
to the “undecidable disputes” of the theoreticians as evidence of this): doctors can derive all
the knowledge they need by carefully observing and recording similar sets of symptoms and
antecedent circumstances, and determining by trial and error what works and what does not
in the case of each syndrome. Methodists suppose that all diseases fall into one of three
phenomenally-determinable general types, constricted, relaxed, and mixed, which indicate
in themselves appropriate therapies. Gale ̄n has no time for Methodism (it has no recog-
nizable method at all, he says); but while he is committed, as the Rationalists are, to
there being a true physical account of the circumstances underlying disease, he is quite
prepared to allow that Empiricism, within limits, can be perfectly successful (On Sects
1.72–73 K.); and he holds that all medical claims must pass examination at the tribunal of
experience, peira.
But although Gale ̄n professes independence from sectarian affiliation (which he likens
to slavery), he holds that the proper medical method was discovered by his great hero
H. Gale ̄n’s “Hippokrate ̄s” is a complex, semi-mythical figure; and Gale ̄n’s
“Hippokratism’ is thus a good deal more original than Gale ̄n himself often allows. Still, he
contends that Hippokrate ̄s ( pre-eminently in Nature of Man) showed both what sort of physi-
cal theory was required for successful medicine and also how to establish it. He rebuts the
Empiricists’ contention that the Rationalists’ disputes exemplify the poverty of their
method by asserting roundly that it simply indicates the incompetence of most Rationalists.
Moreover, this is logical incompetence: they can neither construct sound arguments them-
selves nor recognize and refute them when propounded by others: so they fall hopelessly
into error and sophistry. Gale ̄n believes that one can aspire to proper theoretical practice
only given talent for and constant practice in the “logical methods,” the formal logics and
demonstrative theories of A and the Stoics, the Platonic method of analysis by
division, and the “method of the geometers.” Gale ̄n wrote a massive work On Demonstration,
numerous texts on Stoic and Peripatetic logic, now lost, as a well as a surviving Introduction
to Logic showing him to be aware, uniquely, of the non-syllogistic nature of most mathemati-
cal reasoning. Armed with all of this, the doctor must first discover, by analysis of ordinary
conceptions, the basic meaning of such terms as “health” and “disease.” He must then seek
to discover the true physical theory underlying physiology. He claims, in Elements according to
Hippokrate ̄s, that Hippokrate ̄s demonstrated the fundamental nature of Hot, Cold, Wet and
Dry, physiologically associated with the four humors: yellow bile (Hot-Dry), black bile
(Cold-Dry), blood (Hot-Wet) and phlegm (Cold-Wet); see also On Mixtures. Gale ̄n utilizes
Hippokratean physics (allied with certain conceptual truths such as “opposites cure oppos-
ites” and “nothing occurs without a cause”) to determine what, as a matter of physical fact,
is discordant with any particular distemper; this involves empirical testing (the ultimate
criterion for all qualitative analysis is perception), on the basis of which he will derive a
“therapeutic indication” of what ought to be done.
Gale ̄n outlines this method at great length in On the Therapeutic Method – but it is also
evident throughout his clinical and diagnostic oeuvre. The empirical component accounts for
the importance he accords anatomical knowledge, always confirmed on the basis of per-
sonal dissective experience. His anatomy ( preserved in Anatomical Procedures and some smaller


GALE ̄N OF PERGAMON
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