Early greek primitive medicine

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Clio Medica, Vol. 3, pp. 305-336, 1968. Pergamon Press. Printed in Great Britain. Early Greek Primitive Medicine FRIDOLF KUDLIEN WHEN used in connection with the ancient Greeks and, moreover, with their highly praised medicine, the word “primitive” does not shock us so inevitably as it did our parents. By such a term we may simply envisage an irrational (but by no means purely magic!) portion of early Greek medicine, a portion which was originally, it is true, neither imagined nor practised by regular physicians (nor by regular priests) and which, in fact, reminds us of many parallels to what we call strictly “primitive medicine”. It is, however, not our purpose to demonstrate here those parallels as such—the interested reader may eventually do this by himself. We are concerned primarily with the early Greeks alone, and with their mentality. But there are other parallels or connections which must be discussed. In her recent pamphlet Medicina magica e religione popolare in Grecia fino all’eta di Ippocrate (Roma 1967), the classical philologist Giuliana Lanata has provided us with some valuable, well-founded insights into this kind of early Greek “medicine”. In Lanata’s view, Greek medicina magica is a ‘filone nettamente distinto” which has its own rights and field, at least in comparison with Greek medicina scientifica (1.c., p.17). Given the author’s starting point, this view is acceptable and even correct in some sense: regards matters from the viewpoint of this very enlightened Hippocratic physician, Lanata wants to illustrate the background to what in the Hippocratic treatise De morbo sacro (ch. 1) is opposed in such well-known and intriguing words. If one it becomes clear that there was no connection whatsoever between those two “filoni” of early Greek medicine. On the other hand, a real and deep-rooted communication between the two “filoni”, although so different in themselves, cannot be overlooked or denied. In focusing our interest upon this communication, we may add to Lanata’s survey a not unimportant aspect. Yet another result is perhaps to be expected: as Miss Lanata rightly states, it may be doubted whether regular Greek medicine in later times was completely untouched by any influences coming from medicina magica and, therefore, was fully rational in and by itself, as is suggested, for instance, by Ludwig Edelstein’s brilliant discussion on the relations of Greek medicine to religion and magic (see Lanata, 1.c., p.15 with note 6). For our part, we shall find that even old Greek medicine, that is to say “Hippocratic” medicine of either Cnidian or Coan THE “IATROMANTIS” provenance, was not so free of primitive or prerational heritage as one would be inclined to assume in the light of De morbo sacro. If this is so, it may eventually provoke a new urge to re-examine the widespread belief in the inborn rationalism of Greek medicine. I. We have a Greek term which, for us, seems to characterize most fittingly the representative of primitive medicine: we mean “iatromantis” as being a “‘physicianA

Accordingly, their profession could include far more than In Greece, medicine-men could bear several names which were to some seer”. This term is to be found in the oldest of the three great Attic tragedians, Aeschylus; as far as we can recognize, he alone uses it. But there is no reason to assume that Aeschylus himself coined the term “jatromantis”. On the other hand, being apparently a rare word, “iatromantis” may not have been a generally accepted term? extent unspecific. healing of diseases (the same holds good for the medicine-men of primitive tribes), the more so in very ancient times. Hence the word ““iatromantis’ may be regarded as an attempt to find a more specific name for Greek medicine-men.* Be that as it may, we intend to consider—leaving aside the possibly wider field of Greek medicinemen—only their “medical” aspects, which can be investigated in some typical, famous figures.’ But before doing so, we must note a further limitation: In this study we are not concerned with matters of the kind which Erwin Rohde has discussed under the heading “Iatromantik”.° Rohde is speaking of dead heroes, whose graves could have been frequented for finding “aid in disease, or revelation of future events”. But this combination of duties assigned to a single person is the very point we are interested in. What has to be borne in mind is that these medicine-men were just ordinary persons, i.e. neither heroes nor gods, although feeling sometimes as gods (as, for instance, Empedocles) or becoming closely related to Apollo. How is the Greek iatromantis to be fairly defined? Is Neustadt’s definition (“a Greek medicine-man who recognized and bans the demons of illness”’?) sufhcient? Let us start, so that we have some fixed points, from Aeschylus’ description as well as from the etymological meaning of the word. In the Hicetidae (v. 262ff ) an iatromantis is mentioned by his personal name: Apis. Concerning this mythical personality (not to be confused with the Egyptian holy bull Apis, as was done in late antiquity) there exist several saga-variants.® In the Aeschylean version alone, Apis is presented as a son of Apollo (in the Eumenidae, v. 62f, Apollo himself is called an iatromantis). In this version, Apis is a “purifier” of all kinds of calamity, who comes from distant countries. Thus we have found some traits which may be characteristic for the iatromantis: while the god Apollo was connected with the physicians, not only via Asclepius (his son), but also directly,° he has been brought together (be it originally or by later mythical contaminations) with medicine-men likewise. In so far, the medicine-man seems to be, for the Greeks as well as for other people, a kind of ancestor or, say, elder brother of the regular physician. As to the etymological shape of the term “iatromantis”’, the meaning of its second half “mantis” is now fully illuminated: Apollo, a god of prophecy par excellence, is at the same time an iatromantis too, a as the motif of coming (or being called) from afar. “prophet and purifier of the houses” (Aeschylus Eumenidae, v. 62f). Such ritualmagic “purifications” will be found to be characteristic for the iatromantis, as well Another son of Apollo, Aristaeus, is represented in a certain saga-version as a “trained” physician and prophet (see below p. 322). Although he (as well as his colleagues whom we shall discuss) is never explicitly called “iatromantis”, he was so in fact. We hear of him, called an “‘averter of plagues” in a certain case. Further more, his person helps to reveal a new specifically iatromantic trait: Aristaeus is a man who disappeared from the sight of men. In its varying forms (as to classical

kain Early Greek Primitive Medicine “journey” antiquity, for instance, the bodily vanishing into the earth*® as well as the typical of of the soul), this feature seems to be, for modern specialists, a sign shamanism.!! ? who came Another veritable iatromantis and, so to speak, shaman, was Abaris! he could be from afar. Usually he carried an arrow or even rode on it. Hence was in fact an viewed, on the one hand, as being connected with Apollo (who to a Siberian archer); on the other hand, just by this feature Abaris comes very near diseases; as such, shaman.!3 He was a prophet as well as a purifier of plagues and he was once called to Sparta. shaman-like A very “Grossmeister” (to use Rohde’s expression) among the not explicitly iatromanteis was the famous Cretan Epimenides.'* As it seems, he was features believed to be connected with Apollo; apart from this, nearly all iatromantic h all countries; can be found in his person: coming from afar, he wandered throug him against a and a purifier, e.g. of diseases (the Athenians called he was a seer finally, plague which was said to have been caused by the Cylonian sacrilege!*); y”, which he suffered from long ecstasies or “disappearings”. His plague “therap s as well as a is reported in detail by Diogenes Laertius, was cathartic in a religiou magic sense, not unlike that of Aristaeus (see below, p. 321). of a special importance for Before discussing, then, two personalities who are nteis: iatroma of our purpose, we should like to mention briefly some other names n women There was Bakis who had purified, by Apollo’s order, the ill (mad) Sparta is also another (which reminds us of Melampus’ treatment of the Proitidae).1° There a “medical named Polyidos (“the much-knowing”), a seer who is said to have made are, it is true, observation”? Finally, we should not overlook some persons who ly iatromantic neither called “iatromanteis” nor described in the light of typical nteis. For instance, traits and deeds, but who may well have been in fact iatroma since his sister was !® the personal name there is Althaimenes who disappeared from the sight of men.!* His man Althaimenes may have been a “healer” too, the more so may be connected calls for attention: since the river Althainos was explicitly a “healing river’’, who formed a highly praised family of prophets, whose surname ding importance to with the Greek verb “‘iainein” in its special meaning “‘heal’’.?° First, Melampus antis’’ Iamidae named Apemosyne (“freedom from ailments”). We may recall also the But now we have to speak of two persons who are of outstan and “iatros”, that is to say between primitive and regular medicine. us since they act, within the Greek area, as a kind of bridge between “jatrom he was a purifier whose practices are somewhat clearer to “a seer who invente us than those of his Likewise, must be presented here. He was a seer who was “beloved” of Apollo.?! ;? on the other, he was viewed as a religious or magic character on the one colleagues. As to these practices, there is something quite remarkable: ical procedures of hand, Melampus used (as did, for instance, Epimenides) cathart d this treatthus “purging” the maidens of their madness.24 Originally, sense, he is said a medical treatment based on drugs and purgatives”.”” In this black to have treated the daughters of Proitos with a plant, namely the famous hellebore, d to believe ment was certainly a rather magic one; all “black” vegetables were Black belong to “‘subterranean beings”, serving, therefore, as magic apotropaea.?5 medicine hellebore, however, is also a real and effective cathartic which regular ar, against took over as a “rationalized” remedy against madness (in particul

soil?®). The physical effects of black hellebore may have been detected empirically- “melancholy” which itself, as a mental concept, stems originally from a preration in so far, it is true Melampus may rightly be named, at least in a symbolic wa the “inventor” of Greek internal drug therapy—a man who stands, so to speal between two different worlds. Finally, Empedocles (you Empedocles is likewise an iatromantis whose position is to be sought, perhaF RER: within the border-area between prerational and rational or regula medicine. Asan latromantis. he was a very latecomer in time and place. Comin, from afar, he wandered aj] spe e “flourishing cities” (cf. fr. B 112, ed. Diels Kranz) which received him enthusiastically. He was a purifier who wrote a poen “Purifications”? (Katharmoi) and he was able, furthermore, to foretell the futur and to help with any Bene (fr. B 112). As he stated himself, physicians (ietrol, and seers (manteis) belong to the same area (fr. B 146). may remember the famous and miraculous tales of his death) was removed from the sight of men.?” One of his deeds must now be mentioned especially: as a purifier, he had to aid a city on which a plague had fallen. In this case, Empedocles’ therapy (in contrast to that of his colleague Epimenides) was not a magico-religious, but a surprisingly “modern” one, in so far as he diverted some rivers and, by doing 50, eliminated the natural causes of the plague by natural means.2 While emphasizing here the particular role of Melampus and Empedocles in comparison with the other iatromanteis, we need not consider the (real or alleged) connections between them and Örphism or Pythagorism or, in other words, their in the relationship of the iatromantis to the regular physician. For this, it must be exact place in the history of Greek culture and philosophy. We are merely interested far beyond the field of rational thinking and remembered that originally (and as late as in Homer) internal medicine as such was rational practice.” Such ste seemed to be caused by supernatural beings who located, for the ancient Greeks, alone, then, could heal them. A man who wished to be active in this field, hadat first to seek for a path towards the supernatural sphere, hence becoming first no! an iatros but an iatromantis, Internal therapy was restricted, therefore, to magi religious methods.3° In the course of a slow development, this field of therapy may have been augmented by drugs (plants) which either the supernatural beings had “donated” to an elect man (as, for instance, in the case of the famous herb “madly” in Homer’s Odyssey) or which "perhaps an iatromantis had discovered for himself internal diseases as such corresponded, in general, to this mental level (see below (3), to be effective (as with Melampus and black hellebore). The main conceptol Among all supernatura] beings Apollo stood apparently in the closest connecton with this kind of “medicine”. | For the empirical luis But, as has been Said previously, Apollo was likewise connected with the oldst regular Greek physicians, namely the (Homeric) surgeons. ly on mere experience. Nevertheless, in the field of internal diseases (which are; of traumatology the Surgeons relied to a far higher degree than the iatromantis, their “hidden” causes and processes of a somewhat ambiguous character), surgophysicians and iatromanteis may avi been in some gradually increasing rival. In fact, both were travelling all over the country, and both were called inly of healers in ancient Greece. Since regular medicine was seeking for rational, it, patients. There was, then, a continuous confrontation between these different types

Early Greek Primitive Medicine (“Naturphilosophie”). On the other hand, the iatromantis may also have played natural explanations and treatments of internal as well as traumatic diseases, regular physicians needed mental support from without, that is to say from philosophy an important part as a mental guide for the regular physician, at least in regard to therapeutic concepts and means. In these circumstances, it seems inevitable that there came a moment when Greek regular medicine felt urged to emancipate itself from its mental predecessors or helpers. Hippocrates “separated medicine from philosophy’, as Celsus’ wellknown, and somewhat symbolic formula runs. The Hippocratic author of On ancient medicine (ch. 20) demonstrates very well how radically such a separation from philosophy was propagated.3! This physician is one of a few who quote a “Naturphilosoph” by name—and it is Empedocles against whom he is speaking! Thereby, it becomes clear enough that Empedocles had failed to be accepted as a colleague by these self-confident, rational physicians (although he has been viewed, since later Antiquity, as a philosopher and physician). In fact, Empedocles was undoubtedly a “Naturphilosoph” (who had written On Nature), and this was a cogent reason for eliminating him from the newly constituted “techne iatrike”. On the other hand, he was not primarily a physician but an iatromantis, that is to say the representative of a type of medicine which had to be rejected, as radically as the ‘‘philosophic” type, by the new medicine (see Hippocrates De morbo sacro, ch. 1). Perhaps it is the (who gave so much to the new medicine) stood on the very border line most fascinating (or should we say tragic?) feature of Empedocles’ career that he between such different and even hostile types—iatromantis, ‘Naturphilosoph”, iatros. Here we meet, for the first time, that kind of confrontation which is our special concern in this study. There are two ‘filoni nettamente distinti”, as G. Lanata has put it, but the situation is still not correctly described by this phrase. Within the old Greek medicine as a whole, the two “filoni”’ could have been close neighbours or even inmates of the same house (although Hippocratic physicians certainly would not have liked to see or express it in this way). As we proceed we shall come to recognize the situation better after examining some passages from Cnidian medicine (see below §3). Coan medicine, it is true, felt explicitly free from any prerational heritage, and especially from any iatromantic kinship. But was it free? If we put this question here, we should at least not forget the following: As a real prophet, the iatromantis had to know “the present and the future and the past”, as did the Homeric Kalchas (see Ilias, I, 70) who was a “mantis” (ibid., v. 92), or as did the divinely inspired poet Hesiod (Theogony, v. 31 and 38). Beyond this, it seems to be a very old, and very genuine, claim of the real shaman to know “the future, the past, and everything which is taking place in the present”? In almost identical words the Hippocratic author of the famous Prognostikon (ch. 1), who was, perhaps, Hippocrates himself, claims the same knowledge, as far as the foretelling strictly concerns the medical jurisdiction. Let us say, then, that the old Hippocratic physician in this respect must be called a fully rationalized mantis who concentrates “Rationalization,” however, must not always mean upon medicine alone. “rationalism” in itself; a prerational heritage may undergo many kinds of transformation without its essence being totally extinguished. Thus, for the scholar there is a serious need for cautious research in this difficult field; at any rate, for such a

je sip (and timplifying) colours “plack” or “white” are strictly to be RARLYOREEK GONGEPTS OF DISEASE IN THE LIGHT OF Likewise, it is known to medical within a primitive Al histori aw Well ay anthro ologists, are awarebethat strange events which \cultureintemal diseases are a believed to y ig ones, \ underiood ay merel being only What in hove cultures all events of such kind (internal diseases is a very group d them) are believed to be caused supernaturally, It to send a ea thata god or demon who is offended by men is provoked (Similar Punlshment, Thus. such events came to be conceived as sequels May, an a punishment for a (religious or moral) crime. Some one. | that i810 Otherwise the kind o Mn Which has been committed was obvious, skilled persons, won hadto be tought for with the aid of some especially ue, thiconcept of sin-punishment correlatio is a rather comm Ie offer n explanation and also indicate the n possibilities of cure.on that all early several medica] historians seem to be inclined to assume tion, must operate if diseas When based on the idea of supernatural causa prejudice which ‘moral o legal Categories “ein?” and “punishment” (a early cultures blt undertandable in so far as we are all participants of Christian culture!) induden the rink of slurring over the obvious fact that lover, e fatality, Imisfortwen (as, for instance 4 internal discase) as a simpl ple of a related \king lorihe "eason or feeling uilty of A “sin”, As an exam al Homit’s idea of internal diseases.” Here, the Spanish medic lgo’s Vetation il early Greek innen cantepiti I may quote P, Lain Entra historian heek conepti as, for example, that of “ate”, which is said, in the authorita- | of on men “for having ly exchustely of a divine sunishment Which is inflicted in regard to he morallaw", One din find the same one-sided view also is no hint of the word is used in Homer as denoting \k-Englit xicon of Liddell and Scott, to have been “mostly sent as the Int of guity ahnen”, Asena there ‘certain Me of mind whic| h is Cad supernaturally; hunishmat, for and interpreDodds Is Commented very well on such failures of insight his "This dasieal Philologist Ake the proper merit of having used, | anthroplogical methods and findings: In my opinion, it is especially hat he wd such anthro ee ical concepts as “shame culture” and “guilt sur Archaic situation.” Thereby, the following Hor elucidting the sa s are primarily \ unequiveally clear: within a certain culture, all thing man who suffer: ‘public MON; one is not sa ad who “loses face”, A community and the others in front o! \ strange" Who behaves stran ely will be isolated within the er this situation mentally, such a community tries to eliminate s, ‘ashamed of this man—he in a of the other lh, ‘Thisom be regarded ag the simplest form of “shame cultu \order tovast supernatura hk, the "© event from its own body and soul by assuming a re” practisec r sense, : \vironn® Of which Homer too, was à member, In its prope

purpose the simple (and simplifying) colours “black” or “white” are strictly to be avoided. 2. EARLY GREEK CONCEPTS OF DISEA SE IN THE LIGHT OF “SHAME CULTURE” AND “GUILT CULTURE” Medical historians, as well as anthropologists, are aware that within a primitive or ancient culture internal diseases are usually believed to be strange events which cannot be understood as merely natural ones, Likewise, it is known historians that in those cultures all events of such kind (internal diseases to medical being only a special group of them) are believed to be caused supernaturally. It is a very common idea that a god or demon who is offended by men is provoked to send a disease or similar punishment. Thus, such events came to be conceive d as sequels of a “‘sin’’, that is to say, as a punishment for a (religious or moral) crime. Sometimes, the kind of sin which has been committed was obvious. Otherwise the alleged reason had to be sought for with the aid of some especially skilled persons, who might offer an explanation and also indicate the possibilities of cure. It is true, this concept of sin-punishment correlation is a rather common one. However, several medical historians seem to be inclined to assume that all early ural causation concepts of disease, when based on the idea of supernat , must operate with the moral or legal categorie s “sin” and “punishm ent” prejudice which may be well understandable in so far as we are all participants of (a Christian culture!). This, however, includes the risk of slurring over the obvious fact that early cultures regarded misfortunes (as, for instance, an internal disease) without asking for the reason or feeling guilty of a “sin”, As as a simple fatality, an example of a related inflicted misinterpretation of early Greek disease-c oncepts, I may quote P, Lain Entralgo’s discussion of Homer’s idea of internal diseases." Here, the Spanish medical historian is speaking exclusively of a divine punishment which is on men “for having broken the moral law”. One can find the same one-sided view also in regard to similar Greek concepts as, for example, that of “ate”, which is said, in the authoritative Greek-English Lexicon of Liddell and Scott, to have been “mostly sent as the is no hint of punishment of guilty rashness”. Actually, the word is used in Homer as denoting of insight and interpresimply a certain state of mind which is caused supernaturally; there guilt or punishment. E. R. Dodds has commented very well on such failures tation.** as “shame culture” In my opinion, it is especially This classical philologist has the proper merit of having used, for his purpose, anthropological methods and findings. fruitful that he used such anthropological concepts and “guilt culture” for elucidating the Homeric and Archaic situation .* Thereby, the following becomes unequivocally clear: within a certain culture, all things are primarily ruled by public opinion; one is not tolerated who “loses face”. A man who suffers anything strange, or who behaves strangely, will be isolated within the community. One is “ashamed”? of this man—he in front of the others, and the others in front of him. In order to master this situation mentally, such a community tries to eliminate, ral so to speak, the strange event from its own body and soul by assuming a supernatu culture” practised In its proper sense,a causation. This can be regarded as the simplest form of “shame in an environment of which Homer too, was a member,

Early Greek Primitive Medicine Thus, there are two cultural attitudes in “guilt culture” is different in so far as its participants, facing any kind of “strange” event, also feel guilty of a sin. They ask with a moral overtone for the reason or sense of the “strange” event which is, consequently, for them not only a fatality, but a kind of punishment or revenge. which we are interested, here, in connection with early Greek disease-concepts from Homeric times onwards until about 400 B.c. In fact, we will have to speak of nonmedical concepts, and even this only in so far as such concepts are based on the As was said above, we suggest that several medical historians seem to overlook idea of supernatural intervention. In contrast to the iatromantis, the regular Greek physician was not (or, at best, in polemics) concerned with such ideas and concepts; within his techne iatrike, he wished to handle things in a strictly rational manner. the strong difference between the idea of “disease as fatality” and that of “disease a vast theme within a small monograph to devote the major part of it to Christian as punishment”. Furthermore, it must be stated that even in so related a book as W. v. Siebenthal’s Krankheit als Folge der Sünde (Hannover, 1950) almost nothing is said on pre-Christian Greece. It may be justified for an author who has to discuss times, but even so, there is no reason to ignore almost totally the forerunners or Accepting, as I do, the scientific categories of “shame culture” and: counterparts of Christian ideas within classical antiquity (see, for this, v. Siebenthal, l.c., p.47f). In the circumstances Lain Entralgo as well as v. Siebenthal have provided us with a rather distorted picture. Let us try, then, to find out the real situation. “guilt culture” and their relevance to the early Greek situation, we can diagnose in Homer the following: In book XIII of the Ilias (v. 663ff), Euchenor, in accordance with the prophecies of his seer-father Polyidos (for whom see above p. 307), was allowed to choose between death by “withering from a painful disease at home” or of death for escaping from the “abominable/hateful (stygere) disease”. Here, the death on the battlefield. Of course, the nobleman Euchenor chooses the latter kind leading symptom of shame culture is given with the frank estimation of an internal disease as such (‘“abominable/hateful”). There is no word as to the cause of disease. But that does not mean that the poet would have had in mind, here, a natural cause of disease. Such an etiology we must take as being quite incongruous for him or for the culture described by him. Further evidence will help to strengthen At first glance things in Book XI of the Odyssey (v. 170fF) do not seem so clear: our assumption that, in the case of Euchenor’s foretold disease, the general idea of any kind of supernatural causation can be taken as the predominating one. As you see, “guilt” or “punishment” are totally absent. in Hades, Odysseus is speaking, as a visitor, to his dead mother, asking her for the kind and cause of her death. He himself thinks it was either a “long illness” or an arrow, sent by Artemis to kill the old woman. Is there any justification for remembering the famous scene in Ilias, Book I, where Apollo sends a deadly plague by arrows? Did Artemis too cause diseases in such a way? That would be an error which is easily corrected: Artemis causes death, not through illness, but immediately by her arrows. This becomes sufficiently clear by v. 173 and v. 199f (“neither she killed me by her soft arrows, nor a disease came upon me”). As to a disease, Odysseus’ mother states that thereby the vital energy is absorbed “mostly in form of an abominable/hateful withering” (v. 200f). By the word “mostly” it may have been emphasized that this is the common kind of end for an average human life, and

especially for aged people. Regarding (his, remarkable that Odysseus’ mother emphatically rejects this of death to have been her own (v. 202f); in her opinion, she y her beloved son. This remark as well as the adjective “abonjleatly expressing from Artemis. ‘The death by a “broken hejindividual variant an aversion for any chronic internal disease, em to be typical for a shame cultur:*e the wound alone is heprefore, old people or women who cannot be active on the battlgilled by an arrow matter), The adjective «gyontinues to be a of the “honest death”, Although not beiny, once again the idea of supernatural causation should be rgilnating; likewise, “guilt” and “punishment” are not to he me In book V of the Odyssey (v. 394ff), a ‘suffering from an internal illness and “withering for a long {yy A abominable/ hateful demon”. Here, the supernatural cent, not as a god, but as a demon who can either send the illngnt CASE) be himself the personified illness (which I would | different aspects characteristic symptom of shame culture, ment” are still of the same Gods as disease-causers are to be found jj /lias and Odyssey. non-existent. In book IX of the Odyssey (vy, 3994 ), Poewily wounded by Poseidon”, After this, the Cyclopes leave h (he ruling idea is Odysseus, complains in a loud voice, When all sides, showing a great interest in what has happened to ywers them by the words ‘ ‘Nobody’ (a name cunning Odyghiit!) is killing me by tricks, and not by force”, Say the Cyclopitt violence to you, as a man who lives like a hermit—there jupe from a disease which was sent by the mighty Zeus, Syn your own father clearly recognizable: for Homer as well as (i by him, internal (the less so if they are sent by a god go mjunnot treat or heal diseases are usually caused by supernatural cape from them such a disease. ‘Therefore, the communi with resignation, abandoning the patient who is practicallylure! Still, internal diseases continue to be seen as a mere |} onnection to such categories as “guilt” and “punishment An exceptional case is the scene in boy Apollo is presented as sending by arrows an illness to the Gite points to note: Although in its immediate causation a wiht an an internal disease (“infection’’!), Furthermore, this name “nousos” (v. 10) as well as the special term “loimyilh in Homer, here alone, Finally, only here do guilt and ihe stage: Apollo is angry, since Agamemnon has offended (ll) and, therein, the god himself. After having fulfilled the dypi and purifications), the god is appeased, and the disease q Among the ritual purifications, the Greek army has to ungllawater (v. 313F). How should this be interpreted from oyilli#t words: do we find here, and here alone, a Homeric ey!

Early Greek Primitive Medicine Perhaps the following reflection can lead us to a correct judgement: apart from the concept of “guilt” as such, a genuine “guilt culture” must be characterised by consciousness of the moral and juridical implications. The participants of such a culture must think automatically of these implications, and must interpret and evaluate a related case exactly in this sense. There is no hint, however, of such an attitude in the first book of the Jlias. Apollo’s anger is not an “objective” one, concerning a deed which Apollo estimates to be objectively unjust or immoral; in (“atimazein”, v. 11). After having suffered, then, a “shame”, Apollo’s reaction is contrast, the god has been insulted by the violation of his personal honour mostly typical for shame culture.3* Beyond this, in regard to the plague-scene of tion-scene, v. 31439). In the circumstances, it seems to be incorrect if one under- Ilias I, one should not forget the magic or primitive overtones (being manifest, for instance, in the arrows which cause a disease—see below p. 324—or in the purificastands, as Lain Entralgo does,*° the purification as well as the plague itself to be evidence of a “realistic” or “naturalistic”? outlook of the Homeric Greeks; or if one thinks, in this case, of “somatic hygiene” or “bodily symptoms” (which are not mentioned in Homer, as is fully evident*') or, finally, of an actual “diagnosis of a bodily (instead of a moral) uncleanness”. This is a factual misinterpretation of Homer (so vague a term as “loimos” should have been sufficient warning to avoid any too “realistic” interpretation). For the plague-scene, then, the label “shame culture” is as fitting as it had proved to be in the previously discussed cases. Thus, the Homeric disease-concept appears to be uniform in principle: explicitly or not, an internal disease is a mere fatality which is supernaturally caused and cannot be explained or treated by men alone, in a rational manner. For Homer, neither the peculiar kind of causation nor the peculiar kind of disease is under discussion; there is only an evaluation of the event as being “abominable/hateful”. There is but one exception: the plague which was sent for punishment can be appeased by sacrifices and magico-religious purifications,‘? since the god’s personal honour has been restored sufficiently.4* Here the general lack of any more deeply We must now leave Homer to approach the very sphere of guilt culture as it founded consciousness of moral and juridical implications may be evident. has been sketched previously. In Hesiod and Solon, the disease-concept is fundamentally different from that found in Homer. Intentionally I said “different” instead of “changed”, since I am not willing to foster the impression that guilt culture, at least, in ancient Greece, may have represented a later stage of development. True, shame culture seems to be, seen objectively, the more primitive form. That being so, one may certainly come to the conclusion that guilt culture was a descendant of shame culture. However, the presumable descent must have taken place long before the Greek epoch of history. As for the Greek situation, Homer belongs, without any doubt, exclusively to shame culture, and this is a quite remarkable fact. On the other hand, there is no justification at all for dating Hesiod later than Homer just because Hesiod was a participant of a guilt culture, and Homer of a shame culture. The chronological relationship between Homer and Hesiod culture and guilt culture could have been, as we shall see, the closest neighbours continues to be a more or less open question; perhaps the rural poet was not the younger, at least in relation to the poet of the Odyssey. Be that as it may, shame in time and place.

Before coming to Hesiod and, with him, to a regular guilt culture, I want to present the particularly interesting case of a sick hero who is mentioned already in Homer’s /lias and discussed, then, in more detail by Greek tragedy: Philoctetes. In book II of the Ilias (v. 718ff), the so-called “ship-catalogue”’ tells us that Philoctetes, being a commander of seven ships and, furthermore, a famous archer, suffers from a “bad wound” which had been caused by the bite of an “evil watersnake”, The Achaeans had left him in Lemnos; but they would soon come to “remember the lord Philoctetes’’. Nevertheless, Philoctetes’ fellows went to the battle under a new commander, “missing”, however, “their former leader”. First, there is a simple wound such as was treated, for instance, by the surgeons Podalirius or Machaon (who are mentioned immediately afterwards in the ship-catalogue). But in Philoctetes’ case, no treatment is mentioned at all, Consequently, the matter seems to be handled a priori as a bad illness; hence, Philoctetes was to be isolated at the island of Lemnos. This is in full accordance with the attitude of shame culture; the same holds good for the apparent lack of any sympathy or compassion for the sick hero. But there remains something questionable about this special case, just because it was, originally, a simple wound, although caused, it is true, by a poisoned bite and not by a weapon. Furthermore, Homer’s record is obviously extraordinarily incomplete; finally there is that cryptic remark on Philoctetes as one to be “remembered in the near future’’. Other testimonies can provide us with more information on the case of Philoctetes,** the nature of his illness as well as its causation, Being sick for several years at Lemnos, Philoctetes had become lame; furthermore, a horrible stench came from his wound (see Sophocles’ Philoctetes, v, 1032), Beyond this, the watersnake had not been a common, but a holy one, acting as a guardian of the sacred place of the nymph Chryse (1.c., v. 1326ff ). Thus, Philoctetes’ disease becomes clearer to us, at least in the context of a shame culture: lameness as well as a bad odour must of course have been exceedingly “shameful” things which immediately forced the affected person to be isolated. They were sent to Philoctetes by the bite of a snake, since he had offended a supernatural being or a taboo (sacred place). On the other hand, Philoctetes’ disease stood in a special light as being part of a divine plan (see Sophocles, 1.c., v. 191ff ). After having fulfilled this plan, Philoctetes would recover by the medical treatment of Podalirius and Machaon (Sophocles 1. c., v. 133f) or even of Asclepius himself (1.c., v. 1437f). In Sophocles’ delineation, those features, although originally stemming from a shame culture (you may recall the case of offended Apollo), are transformed into those of a guilt culture. As it seems to me, such a transformation was to be brought about by two new factors, that is to say, by an articulate consciousness of right or wrong (in a fully moral or juridical sense) and, as well, by an articulate pity, both playing indeed an important part within the Sophoclean tragedy. For the pity, one may compare the choral songs (esp. v. 169ff ) where the lonely sufferer, being abandoned by his companions, is deplored with deep compassion. In regard to the consciousness of right and wrong, shame culture as such would have been content to state that a sacred place had been offended by Philoctetes (the consequence hac to be the personal anger of the divine being affected), and, therefore, an illness wa: sent as a punishment. Sophocles, however, demonstrates a deepened insight

Early Greek Primitive Medicine 315 and, in so far, an unjustly suffering one. The patient himself frankly expresses this Being the subject of a divine plan, Philoctetes is, in reality, an innocently guilty man— by accusing the “demons” or gods as the really guilty beings who had fostered the injustice (see e.g. v. 446ff). When the concept of guilt is “deepened”’ in such a way (as was done, in general, by post-Homeric thinkers), Philoctetes’ case, together with its double-faced concept of disease, has a particular fascination for us. Later, we shall meet the same phenomenon while discussing Orestes’ disease as it has been In Greek literature, we find it delineated by Euripides (see below p. 317). But for the moment, we must concentrate upon the disease-concept which is the most typical and common one in a guilt culture. first constituted in Hesiod’s poems. Within the mythical genealogy of the Theogony (v. 226f ), the diseases (named as “tearful pains”#) are ranged among the daughters of the “abominable/hateful Eris (i.e. Struggle)”. This “epitheton ornans” we know very well from Homer, that is to say, from a regular shame culture. But in Hesiod, it is Eris, the mother of diseases, who is qualified by this adjective. Setting aside all mythical or demonic overtones, there seems to be, in and with the ‘‘personality” of Eris, a starting-point for another disease-concept, a concept which could be based (being, at any rate, not identical with Homer’s*’). on moral or juridical presumptions,*° and which may have been expressed by the great moralist Hesiod himself as well as by the spirit of his time and environment In the In the Works and Days, then, two different myths contain two disease-concepts which, while by no means identical, resemble each other very closely. coming automatically by day and night to human beings and silently bringing harm famous Pandora-myth, the ‘‘nousoi” are demons who escaped from Pandora’s box, to them (v. 102-4). At first glance, this concept seems to be the same as in Odyssey, book V, where a disease demon is tormenting his victim (see above, p. 312). But Putting the question, then, why Hesiod gives more, and more important, details (v. 90-92): In ancient times, men lived “without evil, distress and bad diseases”. (and Zeus’ consequent reaction) were the ultimate reasons: Zeus was angered by were men expelled from that paradise, we learn from Hesiod that Prometheus’ deed Prometheus’ well-known deed (v. 47 and 53); thus he imagined “‘a sudden trick for which there was no remedy” to be a punishment for the human race (v. 83). The difference between the anger of Zeus and Apollo is that Zeus has not been offended must punish “very painfully you and future men” (v. 56). in his personal honour: Prometheus had deceived him (v. 48), and he had stolen something (v. 51 and 55); this is a crime for which Zeus, the god of justice (v. 36), As early as in the Pandora-myth, it is evident, we find a moral and juridical consciousness which fosters the idea that internal diseases function as punishment for a “sin”, and even for an inherited one. By the demonic overtones or by Zeus’ “trick”? one should not be led to assume that here we are dealing with a shame culture. As a legitimate part of a guilt culture, Hesiod’s disease-concept becomes entirely clear in the myth of the Golden Age (Works and Days, v. 225ff ): The moral city, practising the “even” right, lives without trouble; for instance, no “ate’’ comes to its inhabitants, and everybody is in good health—“the women give birth to children who look like their parents” (v. 235). This is by no means an allusion (no monsters!), as becomes evident from the following delineation of the immoral, to adultery and its consequences, but stands as a typical example of public health

sufferings, many ni 238ff): “To th — y Zeus brought from heaven em, plague. as well as hunger e are decimated, and the women cannot bear?” (v. 242-244).48 Herewith, thePeopl disease-concept of a shame culture seems to be finally absorbed by that of a guilt culture, After being either a mere fatality or a one of personal revenge, discas € is now a punishment whieh jy comprehended gen interpreted in a fully mora ! and juridical sense, The Groeks ei | Hesiod’s just quoted verses to be so typical, in this connection, that in his mo treatise On Justice the Stoic hi : Yheuel (hem as weighty some degree) from that of Hesiod in Works and Days: when il inhabitants are Philosopher Chrysippus used testimony.*? In his Eunomia (fr. 3, ed, Diehl ), Solon, the Attic statenman, Mage, antd poet, : N : occupies a standpoint which is, in principle, not different (although modified in Dike, the goddess acti an the punisher; immoral (“covetous and thievish") and its leaders unjust the ely will be destined to suffer much misfortune (Lc. v, 611). “there comes an inevitable wound (v. 17). Thereby the disease appears, so to speak, in an ambiguous and glimmering light: as a punishment) It does not act in so simple and concrete @ way as in Hesiod. On the one hand, Its special term is originally a “wound”, but can serve also as a metaphor means (which Pi internal for disease’’50); on the other hand, it seems to he active as a kind of “macrocosmic disease” within human society, that is to nay as discord, struggle, revolt (v. 19ff). Apparently a very old mythical mode of thought it taken over here into old Greek Polis-Ethics, for demonstrating the idea that within the “body” of the Polis, the bodies of all its citizens are connected with each other in closest interdependence, Within such a half-mythical thinking, an internal disease (which is, at any rate, caused by hidden Processes) must become in itwell vo to speak, an immoral event. ‘Thus, it could not continue to be regarded na a Mere fatality, as a mere shameful thing the Consequence of which is isolation, NOW people were to regard it as a result of moral weakness and, furthermore, of 4 “gin! committed through this weakness; in these cireumstances, the internal clique could be conceived as a punishment which the affected person “had himself to thank for’’.> AL tale point let us pause the problems 10 far. Homer, on the one side, and Hesiod/Solontoonreview the other, have been discugged our witnemon to demonstrate the differences between shame culture and guilt culture as far jw disease concepts are concerned. As was said before, the concept of shame culture may be understood, with some justification, ay the more primitive one But (hia does not imply that the guilt culture’s concept, then completely ousted its « predecemor””, so that one could draw a clear-cut line between two different phases of development. On the contrary, the two concepts could continue to coexist as neighbours or even brothers. In any case, the idea of a mere and reasonless fatal must have been felt, at long last, to be insufficient, Once given the ex regnod hen of retaliation (which, for our theme, had been originally connected jn + (he primitive idea of a broken taboo, or of a Personally offended superhuman being): À trend towards a (juridically based) moralisation necessarily follows? Let un onee more observe this development in concentrating upon the phenomenon of mental illness (which As far as the ancient Greeks are concerned, one can may be taken as a border-line case of an internal disease ag much)! ‚ For primitive people, the idea of a supernatural causation of mental disturbance is a rather common one.

Early Greek Primitive Medicine recognize in Homer some hints of this undifferentiated idea.53 Moreover, it seems to me that in regard to the shame culture’s attitude towards the phenomenon of mental disturbance, some old rules of conduct, as formulated (for early Greek Polis) by the so-called seven sages, are of great importance: “When you are speaking, don’t move your arms—this is ‘mad’ ”; or “don’t speak quickly—this may be a Consequently, he whose behaviour differs in such a way, may easily come under sign of madness””.5* A madman’s behaviour is strange and differs from the normal. suspicion of being mad!55 In these circumstances, disease and ‘‘mores’ (not moral man became mad ‘perhaps because of Apis” (Herod. III, 33), since the king had or ethics, but etiquette) are to be seen in the closest connection. Concerning the categories “sin” and “punishment” and their relation to mental disturbances, one may look up Herodotus’ remarks about King Cambyses: This offended the Egyptian god (III, 29). Here is a clear parallel to Apollo in the Ilias. In the same vein, “many Greeks” (or “the Athenians” or “the Argives”) upheld the opinion that, in the case of King Cleomenes’ madness, the violation of a sacred place (located either in Eleusis or in Argos) had been responsible (Herod. VI, 75). As one is well aware, simple shame culture-concepts of this kind seem to have been very current among the ancient Greeks. In considering the attitude towards mental disturbance in a regular guilt culture, we meet again (as was the case with Philoctetes) with a typical figure from old Greek myth being discussed in Greek tragedy of the fifth century B.c. One of the most famous mythical madmen was Orestes; a highly instructive delineation of his illness is to be found in Euripides.5° In the Euripidean Orestes there are contained all those features (except the concept of mere fatality) which are important within the two cultures: the demonic causation of madness found its personification in the related illness has something “highly shameful” in itself (v. 10); Orestesis “ashamed’’ Eumenidae (revenge-goddesses) by whom Orestes “is drivenin fear” (v. 38). The In his disgusting exterior habit, the sick Orestes is described quite realistically in to face his sister and to trouble her with his sufferings, and he begs her to have no sympathy for him (v. 281-283). Thereby, his isolation becomes fully manifest. v. 219ff. But it is by no means the exterior aspect of the matter or, in other words, the “mores’” of the sick man which are primarily under discussion here. Granted the guilt of Orestes, his disease acts as a punishment. Orestes has not offended the personal honour of a superhuman being, but he has committed a crime which is grave for human as well as divine justice; he has murdered his mother. In that respect, his guilt is fundamentally different from that of Philoctetes. Nevertheless, both are alike because they are innocent technically in spite of their actual deeds. In Orestes’ case, too, a god (Apollo) must be reckoned unjust and guilty, since he had incited Orestes to become his mother’s murderer (she, on her part, had been the murderer of her husband), Accordingly, it is a case which springs from a vendetta (see Euripides, v. 27ff, 76, etc.). In the circumstances, Orestes (as well as Philoctetes) deserves a sympathy which could relieve him from isolation, and which, indeed,is given to him with great intensity by the chorus (v. 323ff ) and by his sister Electra. Now let us return to the more general lines of our theme. In the fifth century B.c. the non-medical concepts of disease were those of a regular guilt culture; that is Consequently, if people were exclusively interested in the to say, they were more or less moralised, apart from an eventual persistence of some shame culture traits.

moral and juridical aspects of an affected casejhe sick person necessarily continued to be isolated. For this, Plato is a crediblewitness, ‘The manner in which he moralises the internal disease (see his Politeia, 15-409), excludes, it is true, any idea lato may have been influenced by a of supernatural causation (in this connection, prolonged and widespread discussion; see bew p, 319). On the other hand, a “thoroughly ill person” cannot be, for Plato, member of a community which is morally and juridically well-established (1. ¢,406, e, HT). Such a man must be a burden simply on account of his existence, ad, further, because of the possibility of his creating a progeny like himself (407, d5ff), Since he is "bad by nature”, in body as well as in soul, the community shuld let him die or even kill him; by no means should such a man be given medal treatment (405-409 passim, esp. 410 a MF). If we consider how Plato here discusses both medicine and public justice, in the closest connection, and if, furthermore, we recall (he fact that Plato usually (on the basis of a main concept which nay be called psychosomatic) suggests that chronic internal diseases are in some wy immoral, we shall agree that, for Plato, the moralisation of the internal diseag must have been a problem of the greatest political and social importance. Aj well as the explicit viewpoint, the implications of such a concept may be evidentenough already in Plato's text. While Plato ignores the transcendent aspect of the natter, his contemporary Lysias points explicitly to it,” in a way which we may call ‘yeactionary’’."" ‘There was, in Athens, trial of having violated a sacred place5®), wascalled as a witness in a trial in which a club named “Kakodaimonistai”, whose hobby was “to laugh at the gods and our laws”, As it seems, the club’s members were influenced by the Sophistie movement. Now, Kinesias, being a poet and the club’s head (he had once been accused ina Lysias had to participate as a lawyer. In his speech, Lysias atticked this Kinesias with the following arguments: All the godless companions of Kinesias were already the gods with a chronic disease, thereby proving that it was by nomeans the affected gone to ruin “as it is apt for such fellows’. Kinesias, however, was punished by person’s offspring, but the guilty himself who must pay for his tas, “We all have in common to die or to be ill in a normal fashion (nomimos), But since anyone drags along and dies every day without being able to come to Ma life's very end, this may be appropriate only to men of Kinesias' character”, Plato as well as Lysias seem to be witnesges in a prolongel discussion which The hemes and motifs must have come to its culminating point in the fifth century mund in which, for instance, the great tragedians had also been participants. illness Lysias is alluding, say, to the problem of original sin nd the offspring’s of this discussion may have been quite traditional, When in thi ease of Kinesias’ liability, a question comes under discussion which had been actınl indeed as early tragedians are claiming something which so far had not yet ben diseussed at all, as in Solon’s days: must the community to which the perpetratorila erime belongs, be punished for the crime (as had been the old rule)? Or waild it not be more just to punish the perpetrator himself, and him alone ?%° Another related problem which was to be demonstrated extremely well by the different between murder and manslaughter, concerned the “innocent” perpetrator. Hayng been discussed 5! this problem became manifest within the special in early Greece for a long time, context of our theme, in such figures as Philoctetes and Oresti, Here the great or had been rejected explicitly by conservative-minded thinkerjjich as Plato: the

Early Greek Primitive Medicine first, only the sufferer’s This was to sympathy with, and the care for an “innocently punished sick man”. we have learned be justified by a differentiation between “deed” and “guilt”, as ed to the from Sophocles and Euripides. But even so, the odium which attach internal disease was far from being totally removed; at what you believ becomes even clearer: “In reality, you see nothing of isolation was relieved. ing Electra’s In Euripides’ Orestes, however, there is a further argument justify e is suffering sympathy with the sick brother: the sister wishes to stay with him—h but only fancy from periodical attacks of madness— because “you are not really ill Electra’s opinion you are” (1.c., v. 314). In the very moment of an attack (v. 259), e is fully evident to you”. mpt to rationalize It seems to me that this is an extraordinarily remarkable atte le even with all its insuffi(or even overcome) an irrational inheritance— remarkab mes evident course, Orestes is a sick man; if not otherwise, his illness beco ciencies: of tion itself which by his accepting his fancies as reality.“ But it was the cultural tradi from! Given these had given the leading ideas for such a fancy as Orestes is suffering ficient in itself, gains a circumstances, Electra’s encouragement, although insuf ) attempt to sweep aside peculiar importance, since we must take it as a (desperate moral implications some deeply rooted cultural attitudes—at least in so far as the by denying the of her brother’s illness could be suppressed within the sister’s mind very existence of an illness. the one but failed to was rejec by no means overcome By ignoring or suppressing a problem, however, one has the idea of a natural it mentally. The very solution could only be reached when ed as the idea of supercausation of internal diseases was as vigorously emphasiz ted. Since Plato spoke of “bodies being sick by nature”, he did cations, natural causation, together with its moral and legal impli e) we can find a Herodotus’ remarks on Cambyses’ madness (see abov century B.c.? In do the other. Now, what about the great historians of the fifth further “From birth etiology which is mentioned besides that of a supernatural character: der which people onwards, Cambyses is said to have suffered from a serious disor rstandable if a man whose call ‘holy’. At any rate, it would be thoroughly unde ed as an intentional body is ill, suffers in his mind likewise”. Can this be recogniz ot but state that and conscious step forward, away from the old concept? We cann ioned, as an alleged Herodotus seems to have evaded a clear decision since he ment cion as “holy”, that etiological factor, an illness which itself had been under suspi r explicitly a is to say, a supernaturally caused one. At any rate, he fails to prefe “natural” explanation. Attic plague. The same holds good for Thucydides’ famous description of the geographically as For this historian, the plague’s origin lies indeed in obscurity, different opinions well as medically. Thucydides contents himself by quoting some found. As it seems, among which the idea of a supernatural causation is not to be ®*—but actually, he Thucydides himself would not have put forward such an idea has no opinion at all in this case. indeed the first This being so, some old Hippocratic physicians may have been ses (this, it is true, not only to plead for definite natural causes of internal disea any kind of irrational Presocratic philosophers did also), but also to refuse explicitly

explanation. If not in polemics, they did not speak of fatality, guilt and punishment. But it seems to be a fair question (which must remain unanswered, because of the lack of related testimonies) to ask if at the end of the fifth century B.c. all Greek physicians were agreed on this point. In the circumstances, we should be particularly cautious in regard to a too one-sided interpretation. There is at least one instance to be reminded of: old Hippocratic physicians were sometimes reluctant Certainly their arguments (if any arguments were to treat chronic diseases. advanced) sound rational. But on the other hand, there must have been (as Plato and Lysias suggest) many people whose beliefs about such diseases were quite opposite to those of the enlightened medical authors of De morbo sacro or De aere aquis locis. The burden of cultural tradition lay heavily on all Greeks, including their physicians. Remembering this we may be better aware of the real intellectual progress which is documented as individual instances by individual physicians; we must not overlook the relativity which seems to be inherent in the idea of progress. 3. PRIMITIVE AND CNIDIAN NOSOLOGY In the two foregoing sections, we have tried to demonstrate some concrete medicine, such hints of a hidden but nevertheless persistent working of prerational patterns and concepts of early Greek primitive medicine. Thereby, we came to the conclusion that this inheritance on the whole could not have been fully overcome or eliminated by regular physicians. There must have been a kind of confrontation which continued at least below the surface. In Coan (or genuinely “Hippocratic”) inheritance may sometimes be discovered indirectly, that is to say in the rationalizing (but not rational!) arguments of related physicians. But there is, on the other hand, a direct confrontation of primitive and regular medicine; we can observe it not in Coan but, rather clearly, in Cnidian medicine. For our purpose, Cnidian nosology is to be studied at first-hand in the books peri nouson (On Diseases). In the following paragraphs, then, we deal with three particularly interesting examples of Cnidian nosology, and go on to discuss their primitive roots. (a) The desiccating sickness Among the curious descriptions of curiously named diseases which are contained in the 2nd book of peri nouson,°5 one can find the “so-called desiccating (auante) sickness”. The patient is unable to sustain either hunger or food; he suffers from headaches; he withers; he suffers from burning inner heat; over the whole body, he has the feeling as if needles are pricking him (these are the most significant symptoms). Since this description is an authentic piece of early Greek medical literature (which as such has on the whole been praised so often as being rational in principle), we must ask whether the Cnidian author has given here simple clinical facts observed by him without any prejudice, so that his description could eventually be identified with the aid of modern medical knowledge. In his translation, Littré speaks of ‘a kind of hypochondria”; Kapferer-Sticker suggest a “Magersucht caused by a stagnation of all excretory functions and by a weakness of digestion; in Liddell and Scott’s representative Greek-English Lexicon, our case is taken for an “atrophy” (s.v. auante). In the circumstances, one apparently needs a more detailed interpretation of the case and its background in order to prevent serious

Early Greek Primitive Medicine misunderstandings among medical historians, classical philologists or even physicians. In my opinion, this case must be seen in a light which is primarily different from that of any rational medical knowledge. Cnidian School of medicine.°® Modern scholars incline to the opinion that in some First, we must recall that the four books of peri nouson have come down to us under the name of Hippocrates, belonging actually not to the Coan, but to the degree Cnidian medicine is more primitive than Coan or, in other words, that G. Lanata’s expression®®). As a first example, the “desiccating sickness’ may help Cnidian medicine has taken over many prerational concepts without sufficient cautiousness or criticism.97 This being so, we may be allowed to assume that at least a few pieces of the 2nd book p. nouson offer documentary evidence for the confrontation of regular Greek medicine with early Greek “medicina magica” (to use to illustrate this confrontation in more detail. by the heat”. At first glance, this description sounds thoroughly rational—but at In his Works and Days Hesiod tells us about the effects of midsummer upon human beings (v. 586-588): “Women are (then) mad with love but men are weak, since Sirius‘? desiccates (azei) the head and the knees; the body is dried (aualeos) first glance only. Why, we may well ask, are women mad with love just in the dog-days? Why, moreover, is it just the head and the knees which suffer especially from Sirius’ effects? Finally, why are males alone “very weak”? Or is there another possible interpretation, and did Hesiod believe men as well as women to be weak, that is to say sick, since women suffer especially in the head (= mind), and men in the limbs (= bodily) ? Perhaps we can go further in this direction: for several primitive folk (e.g. the Tunguses) and in popular belief, head as well as knees could play an important part as an alleged seat of the soul, thus possessing a great magico-mythical dignity.7° If the Hesiodic verses point to an analogous idea in early Greek culture, they may reader about a kind of very serious “psychosomatic disorder”, together with its have been written, in a mentality which is close to the primitive, for informing the alleged etiology and symptoms. The Hesiodic verses were imitated by early Greek lyric poets (e.g. Alcaeus, cf. fr. 94, ed. Diehl, esp. v. 4f). There is, for our purpose, only a small detail to be remarked, namely that Alcaeus says the sick people are “thin” (leptoi), not “weak”. Since Hesiod gave us a quite detailed account of Sirius’ effects upon human beings, Homer, in contrast, knows the “dog of Orion” to be a “bad sign” but, otherwise, simply remarks that Sirius “brings a lot of heat to miserable men” (Ilias, XXII, 30f). In Homer’s context, the Greek word “pyretos” (which later means the heat of fever) seems to oscillate rather vaguely between, say, macrocosmic and microcosmic heat. Other evidence which may be useful for the further elucidation of the problems and questions Hesiod has raised comes from a much later time; but in fact, the Argonautica of the Hellenistic poet Apollonius Rhodius are full of very old mythical data. In book II (v. 518-526) the following is told: “When Sirius burned (ephlegen) from heaven, . . . they called for this man (sc. Aristaeus), . . . being a protector against plague . . . And he built a big altar for Zeus Icmaeus (i.e. for Zeus the Cronos-son Zeus himself”. rain-god) and made, in the mountains, sacrifices to that star Sirius and to the

Here, the great droufile event) seems to be conceived not only | experience which undoubtedly had been filtures) but as being itself a plague, The “peems to offer firmer evidence here than in Hmay be inclined to suppose that the “seirjas meant, originally, as a kind of demonic pdatively late, being created ad hoc ag a metapr such Greek words as ‘‘astrobles” (or | he sense of “mad”. In this case, a protector he must sacrifice to Sirius (as the Causer) ag yer), Aristaeus, son of Apollo, had learned tey from the Muses (Apoll. Rhod,, l.c.,v, 5 latromantis in the sense discussed above,” fed the “desic cating sickness” within a prerahieh eonceived this phenomenon ag being an The following testimid date can tell us something more about gknem’’, In a few verses of the Ps, Hesiodimpparently corrupt (v. 149-153; see ed, Ryail that Bris deprives humans of their reason: ind their last home in “black” earth, In thi’ (Seiriou azaleoio) seem to be connected, x black, perhap s by being burnt) as well ay wt die, Since it had been stated in the first ghat the desicc ating Sirius influences Primaribw, that in fact the idea of mental disturbanme verses from the lyric poet Ibycus (fr, 6, lint about this point: “In my corpse, Eros doelaze, rushing along (like?) the Thracian Born manini sin) of the love-goddess, being darkind from beginning onwards”, Apart from me of the wording, we can say that on the Blrlun (thoug h not so named) is on the stenting’ is given to madness; as we are await even primarily ?) came an erotic one, This appi days, women were “mad with love” (see Hehe Inter poet Ibycus used a traditional metapvet, however, undoubtedly from the apry lively) mode of thought, on which we Ag together, like a mosaic, a few literary fi Finally, we can, fortit Who has left some primitive traits of the “di, who was himself both physician (and, ain Physicians) and iatromantis (see above),l, ed, Diels-Kranz) we hear that “Murder ares!) and desiccating diseases (auchmerai novare strolling in the

Early Greek Primitive Medicine darkness in Ate’s meadow”. Here, the demonistic aspect of the “desiccating sickness” is given its clearest shape. In Empedocles’ description, the “demons” of desiccating sickness belong to the “crowds of other evil spirits”, thus being akin to ‘ “Murder and Anger” (for which see the following paragraph) as well as to macrocosmic misfortunes (inundations; as it seems to me, the putrefactions are of the macrocosmic kind—and not merely of a medical nature—here). On the other “melankouros Asapheia” in fr. B 122). Finally, they are connected with “darkness”; hand, they belong to “Ate” who is a personified mental disturbance which comes from without’? (in this connection one may remember also Empedocles’ for this, one may think of Ibycus’ “black love-madness” and of the “black” earth in Ps. Hesiod’s somewhat cryptic verses.” What general conclusions can we draw from our literary fragments? Like other early cultures, the early Greeks knew something about that “plague of drought’’ which comes from the macrocosm and bears heavily on human as well as animal a very different way of viewing and dealing with these things: for instance, one or vegetable life. Viewed in a merely empirical or rational way, this event was bound to a certain season (midsummer, dog days) and to a certain star’s rise (Sirius). But additionally there could be, for the Greeks no less than for other ancient cultures, could feel obliged to sacrifice to Sirius. Consequently the idea of demonic personification comes to play its part; here, a shaman-like personality is the fittest one to act. As for Sirius, there are indeed cogent reasons for assuming that this “dog-star”’ Homeric times.” This being so, and in regard to several ancient non-Greek had been connected, or even identified, with a dog-like being already in preparallels for animal-shaped star-demons,’5 this may fairly indicate a primitive As it was with the “personality” (star or demon) of Sirius, his effects, too, could animal demonism. In Sirius’ case, however, the Greeks thought not only of animal but also of human personification; for them Sirius was sometimes conceived as a ’® female superhuman being. be seen in a twofold way: of course, one can simply observe that in the dog days the was pictured in Hesiod’s verses); this is a matter of mere experience and rationalism. heat is extremely “desiccating”, weakening physically as well as psychically (as it The same holds good for observing that, during a drought (and the subsequent rainy season), plagues arise with the greatest ease. But for early Greeks, Sirius’ desiccating force could have a far wider meaning. In its “personality” as well as in its effects, this star was indeed seen as a very demon of plagues and diseases?7: everyone who was struck by Sirius, withered and/or became mad, in a general or special (erotic) sense. On the whole, the “desiccation”? meant not only a serious illness (instead of a mere weakness) but a mysterious danger to life which leads, as stances, we cannot be surprised to find that some Greek words for “become desicit seems, with some inevitability to death (see Ps. Hesiod’s Shield). In the circumcated” as, for instance, ‘azesthai’ and ‘auainesthai’, were generally used as metaphors for denoting not only a psychosomatic ailment (see e.g. Hesiod’s Theogony, v. 99, where a deeply grieved man is “desiccated in his heart”), but also a veritable dying (cf. Sophocles’ Electra, v. 819 and Philoctetes, v. 954). At any rate, this phenomenon is a rather uncanny, threatening matter which may be rightly connected with “darkness”. If there is any help at all against it, this help must come, for early

Greek as well as primitive mentality, from an jatromantis or medicine-man who performs, in a magic-religious way, a purificati With such a cultural background, je pe to the regular medical treatise p. nouson II and its ch. 66. In h. . 1 the mneantime we gained, I hope, a deeper insight into the overtones and implications which are involved in this chapter’s contents. Thus, we may be better prepared for accepting the assertion that this old Gnidian physician must have inherited, at least in the Case of ch, 66, a cultural tradition which in its mental structure stems from a prerationa] or irrational domain. This seems to be the reason why the Cnidian is speaking of the so-called desiccating sickness. In the light of our non-medical evidence, we are now able to understand why, in the Cnidian description, the “burning heat” (phlogia), the “withering” (which is explained, here, by the inability to take mld inpen and the headache must have been, so to speak, leading symptoms, Nor should the patient’s feeling of “being pricked with needles over the whole body” be interpreted primarily in a rational way, that is to say, as a subjective Sensation which the Cnidian physician may have mentioned as an accidental observation, True, in our “prerational” testimonies this symptom was not to be found; but as such it is absolutely appropriate in this context, and even of actual importance here, if we recall two general facts: First, it is a well-known and very old idea that an intere disease will be shot or carried by arrows (by supernatural beings) into the body where it is “pricking”, then, from within.?® Secondly, Sirius is sometimes ee not only as an archer, but as Some other symptoms which occurred in our non-medical testimonies are an arrow (or stick?; the Greek word “rhabdos” can also mean “needle” 79). mentioned by the Cnidian Physician, not in ch, 66, but in some neighbouring chapters, which are apparently in a close (and not merely local) relation to that on the “‘desiccating sickness”. Thus, concerning the “darkness” you may look up ch. 72 (the patient “flies from light and loves the darkness’) or ch. 73, which deals with the “dark” (respectively the “black”) sickness, Since these two chapters touch Since, furthermore, one must remember that the black bile’s main and the circle of the famous but strange “black bile” and its child “melancholy”, lovemadness (being an “atrabilious” main symptom of melancholy) comes at the medical stage. elementary quality was believed the “dry” one, the chs. 72 and 73 may be called, so to speak, the missing links in Cnidian nosology in so far as the entire “family” of the desiccating sickness is concerned, #0 We must conclude, then, that in the mind of the old Gnidian physician of p. nouson IT (or, at least, of the chapters we are interested in) the related diseases (the “desiccating”, the “black” and go on) are not clearly defined, but confused, since they overlap each other, so that a more or less homogenous disease entity is mentioned under different categories and namens Or, in other words: a single morbid phenomenon tended to be taken as an isolated sickness itself"! In my an a re IT has opinion, this seems to be mostly significant in regard to a certain mental level which was reached at a certain point of the el f early Greek regular medicine, d Once again, we must recall the fact a explicitly used a non-medical and apparently prerational disease-term (“the so-called desiccating sickness”, as jt runs in his own words), Furthermore, in regard to our fragmentary but, neverth clearly recognizable “primitive” background, the Cnidian author turns out prend prerationally influenced, not only

Early Greek Primitive Medicine with regard to the name, but also with regard to the description of the desiccating sickness. We may be allowed to suppose that the patient’s case of p. nouson IT 66 had been observed and written down during the first half of the fifth century B.c. True, there were in Greece, then, no iatromanteis, if we exclude the single late#2 Instead of this, regular comer Empedocles and a few very low-grade tricksters. physicians had gained the field of wounds as well as that of internal diseases. But there were, apparently, Greek patients who could face an internal disease with a more or less “primitive” mentality. As for the case of p. nouson II 66, we are not “psychopathologic”) element. At any rate, the Cnidian physician felt no qualms able to identify, in a modern sense, the underlying disease as such; we cannot but assume that there must have been some “psychic” (to avoid the misleading term at describing diseases and symptoms in a mentality which was not so different from that of a layman. Thus, we come to assume that the Cnidian’s nosologic or pathologic system had not yet reached that stability which would enable him to describe this type of disease as (bodily or mental) derangements caused by humours and bound to seasons—as was the case, shortly after that, within the framework of Coan-Hippocratic epidemiology. ** Indeed, it may be called a remarkable step forwards that, in comparison with the iatromantic mode of treatment, Cnidian physicians had developed some therapeutic methods which were based on empirical grounds (as to the desiccated sickness, walks are prescribed, for instance; for the drinking of ass-milk, however, see below p. 329). Moreover, the Cnidian clinical descriptions may even reveal, if examined closely, some faint attempt to gain an individual or critical standpoint: the patient fancies he is pricked with needles, as the Cnidian ch. 66 formulates it. On the other vomited mass the earth “is rising”.®* To sum up: the Cnidian’s mental level turns hand, in ch. 73 the author states with a nearly shocking naivety that by a “black” (perhaps consciously and with full intention) any supernatural influence upon out to be that of a rather unstable naivety. Indeed, this physician does not mention diseases. But actually he avoids not only the supernatural, but any etiology whatsoever! Thus, he may be characterized as a true contemporary of Herodotus, whose etiological “reticence” we have already mentioned. We may recall, in this connection, Herodotus’ well-known methodical principle which runs, in his own words, “legein ta legomena = retell the told stories”. In Cnidian nosology the prerational inheritance which every early Greek physician was confronted with, was neither eliminated nor sufficiently rationalized. This seems to be a fairly interesting fact which may help to make evident the development of early Greek regular medicine in its different stages. We must be thankful to the capricious literary tradition for having preserved such a valuable tones: when the midsummer is governed by Boreas and the dog days are especially testimony concerning the “naive” stage of confrontation between Greek “medicina scientifica” and “medicina magica”. A few decades later, the situation has changed thoroughly in Coan medicine. In the old Hippocratic treatise De aere aquis locis (ch. 10). the influence of Sirius and the dog days upon the desiccating sickness is still to be found, but in a fully rationalized form and without any irrational overrainless, this will be harmful for “bilious types”. Such people, then, will become extremely desiccated (‘anaxerainontai’); and also cases of “melancholy” may occur. Here, we meet again the desiccating sickness, together with its sister melancholy.

At length, the But now, the bile is named as a bodily, this disease which by and in stuff concrete is conceived to operate. As a microcos in connection be to believed is bile element, mic with macrocosmic elements and el ementary qualities as well as with seasons, weathers and constellations. Hence Sirius and “desiccation” became free of any strange or irrational taint. Concerning therapeutics, a physician who was guided by such a concept had to put the question whether, given a bilious irregularity (be it lack or a change of quality in the bile) caused by the influence of the dog days, the affected patients should be treated at Sirius’ time with the usual purgatives. In fact, in the Aphorisms (book IV, nr, 5) jt is stated that, during the dog days, “purgations by drugs are painful”, For such a onsideration, we will seek in vain in the Cnidian treatise (which recommends. for he desiccating sickness, the treatment by purgatives without any scruple or caulon), Since in this point CoanHippocratic medicine must be named progresive and rational (or, at least, rationalized), such a judgement—and this is also he case, conversely, with Cnidian “primitiveness’’— cannot be taken as a generali binding one," intercourse between “rational” and ‘4 irrational’ must have been in the classical Greek area a more complex and more fluctuatingone than current formulas usually imply.*® On the other hand, we mu St be as callous as possible in disentangling the mutually interwoven connections, On the ‘hole, Gnidian medicine seems to be more, and even particularly, apt for such a prpose. Having found in it some traits which are “primitive” in the sense discustd above, we do not feel shocked either by the adjective or by the fact as such, lrue, within the field of classical loristic material (which are said to “obimcure (Greek individuality”) may be of antiquity Wilamowitz’ verdict against com aris taken from ethnological or folkthe irrationalities in early Greek medicine byhe methods of Freudian psychoenduring methodical importance, so far asa geval approach is concerned.57 But given a theme such as ours, at least a momedary glance at regular primitive medicine is scarcely to be avoided, sn As to (nearly Greek situation, our point of view seems to be, in our opinion, More prof than any attempt to interpret analysis.*° For a very long time, of Course, It early Greeks had ceased to be “savages”; but neither the early Greeks es i vilable savage people can be taken, Just because of the (for us) somewhat Puzzlingdaracter of their mental concepts, to have been ““psychopaths”. Never-theless-Vhy should we attribute to the ancient Greeks an immunity from ‘Präamitive' nes of thought which we do not find in any society open to our direct ©bservalii?"* (E. R. Dodds.) (6) The ‘murder’ -illness Furthermore » As was stated above (p. 315), Hesie our filGreek witness for a moralization €], » of the (internal) disease, has presented in his Tony (v. 226ff) the “abominable/ hateful” Eris as being the mother of many Üdren, among whom there were in thew family are to be reckoned the included the diseases. (Phomhi Kotos) may be seen veritable “Murders and Manslaughters” ( Phora «oi kai Moktasiai, v. 228) which come to be the à brothers and sisters of th © diseesases, Iressed in a less mythical, or less personified, manner: murder is the ge quel ofmity and struggle which in themselves are caused by the “negative Pa incipl'hich is personified, in Hesiod, as the “Night.”% In an even more Persa «onified, tl is to say, more demonistic way than Hesiod’s, “Murder and Anger’?

Early Greek Primitive Medicine evil demons (‘keres’, as the Greek term runs); in just this way, Empedocles has presented them, together with the diseases, as “strolling to and fro in the darkness in Ate’s meadow” (see above p. 322f.). Here we find some forms of a very old, and very primitive, mode of thought; they may be on the way towards becoming rationalized and thinking abstractly (that is to say, on the path towards philosophy), without being able to conceal their mythical, magic and demonic roots. As early as this, the idea could grow up that there was no remedy but a magico-religious purification which had to be performed a murderer is ill (insane) or, conversely, that an insane person is likely to become a murderer. For us, Orestes’ case served to demonstrate how such a concept could become concrete in ancient Greece. With the case of the furious Ajax, we find another possibility: Ajax himself is filled with anger; he becomes overwhelmed by Ate and commits, then a cruel murder among cattle and men. It is evident that, within this primitive area of concepts, murder as well as madness and darkness are closely connected to each other. As long as people clung to the idea of an external or supernatural causation of the “dark murder-madness’’, by a competent person as, for instance, an iatromantis (it may be significant that Empedocles’ verses on “phonos” stem from his poem Purifications!). On the other hand, it was possible, for the same mentality too, to conceive the idea of an internal causation of black murder-illness. Eventually, one could conceive a “black” agent which came to work within the human body, either intruding into it from without or stemming even from the inner organism itself. At this moment, the glimmering concept of “melancholy” once again comes to our mind. With its constitutive etymological elements, ‘‘melan cholia” alludes to the “black” as well as either to the “anger” (cholos) or to a material stuff (chole = bile, that is to say, a bitter ;°? for early Greek liquor). In fact, furious Ajax has been an “angry melancholic” imagination, Ajax’s “medical” case had to be connected with as famous a physician as the Homeric Podaleirius.® When he was dead, then, Ajax’s corpse was “blowing as aeriform (perhaps, there is an analogous case in the Ilias when angry Agamemout” something black.°* Since this “black” seems to have been imagined, apparently, >), its material quality had non’s diaphragmatic region becomes filled with “black” Proitus to whom the iatromantic Melampus prescribed a portion of black hellebore been even more condensed in the case of the mad (or melancholic) daughters of (see above p. 307f.), that is to say, an emetic purgative. The very reason for such a treatment may have been seen, in accordance with a mode of thought which is inclined to “sympathetic magic” (Frazer), just in the colour of black hellebore by which an alleged black stuff (or, in other words, an alleged black “bile’’) could be driven out from the mad maidens’ bodies. Here the very sphere of medicine is touched. Such concepts as that of black bile, and emetics such as black hellebore, belong to the main inventory of medicine. True, in so far as early Greek regular medicine (at least that of Coan Hippocratic provenance) is concerned with a rational explanation and treatment of internal diseases, it may be expected a priori that such primitive concepts as the purely demonistic one are more or less out of sight and consciousness, even in the ambiguous case of melancholy with all its implications. The more remarkable must be, for us, ch. 67 of the Cnidian treatise p. nouson II, where “the so called murder fever (pyretos ho phonodes)” is under discussion. As to the Greek adjective “phonodes”’, modern

translators (as, for instgih Lexicon of Liddell Scott Jones iv.) “murderous”? (i.e. disastrous), In my good only for the (perhaps later) Hipymost harmless (cuthestatoi) fevers” re kotatoi)” ones. For the “murder fever” kground of the matter, as represented hyd not be overlooked, At any rate, he @ving inherited here, as was the case witlisease concept together with its appropri Case, in ch. 67 one cannot rely on the ml nosology; in ch, 67, too, there is no exjive to conclude that our Cnidian phyiel representative of old Cnidian medicineor, say, naive, in grouping and interpret (maybe for this reason alone) to we the mere term. In fact, one symptom // seems to be a veritable “primitive” eth the “needlepricks”), Just at the begi) the eye-brows We (of the patient) seem to ]uetance, that a rational-minded observeint kind? may be even more Nurprientioned as an exceedingly important 4 pocraticum, a symptom which is ha any rational, that is to say, physlogn@n for granted here (the specific expreumbrows seem to possess a strange dignity dding consent” (see e.g. Mias, I, 520), enge grandeur. The angry Ajax, then, “iye-brows, thus concealing his eyes" like find anger as well as darkness connecy@me mysterious meaning. ‘The Homerie the late Greek physician Aretacus?! joging eye-brows”, for noting the mos dule disease (the so-called “elephas”, the identical with modern “elephantiayiy “Ike the swift 463), pr o (a poetic expyer, Mias, XII, Knitted brows, serpy) which is itself akin to night, darkness, foe interpreting the “lowering brows" ofte say, in a not primarily rational Way, When we find “thick” brows especially,* Summing up all these features, th'murder-fever” as well as for one of jyhe language of modern medicine shouldemphasized. If necessary, we may speal'è At any rate,

Early Greek Primitive Medicine it is a peculiar cultural mentality which creates such clinical pictures and terms, In the Corpus Hippocraticum there is another testimony concerning the murder- ‘the basis of which does not indicate clear-headed observation. fever, in which murder as such gains a real actuality: we have in mind a passage in the short fragment On Virgins’ Diseases, a treatise (or more correctly, part of a however, turns out to be, on the whole, much more enlightened than the physician treatise) which seems to be also of Cnidian provenance. This fragment’s author, of p. nouson II: in the fragment, there is a vigorous pleading for a natural explanation there is, for the strange (bodily or mental) symptoms of the affected cases, a medical of the different kinds of demon-fear; furthermore, there are polemics (like those in De morbo sacro) against the “manteis” who are deceiving female patients; finally, etiology. Nevertheless, one of the author’s statements seems to have a strong attraction in the light of our theme: during the “so-called errant fevers” from which women or girls suffer in certain circumstances, the patient is said to become “‘mad from the inflammation (oxyphlegmasia); from the putrefaction (sepedon), she becomes bloodthirsty (phona) ; from the dark, she becomes fearful’’.°° Undoubtedly, this has the very flair of primitive medicine which we have learned, now, to observe in such elements as “the dark” or “the putrefaction” (remember that Empedocles presented “Sepedon” among the evil demons; see above, p. 322f.), or “the murder”. Of course, death is familiarly allied to this horrible circle, be it a natural death or a manipulated one, that is to say, murder or suicide (in regard to suicide, one can find in the text of On Virgins’ Diseases an interesting testimony for what modern anthropologists usually call “thanatomania’”’1). After all, the Cnidian author of On Virgins’ Diseases, although attempting a rational, medical etiology as well as keeping an explicit and fundamental distance from any kind of irrational medicine, has in fact not yet succeeded in fully abandoning his primitive inheritance. Finally, it may not be overlooked that even in Cnidian therapeutics (which seems to be, on the whole, the most rational part of Cnidian medicine) some traces of a prerational or magic stock are to be found. First, I would like to call attention to the fact that both in the cases of murder-fever and of desiccating sickness, a drink of asses’ milk is recommended without commentary. Of course, the physician must in general be interested in easily digestible food; in so far, the prescription of milk may look well-founded. But for what reason must it be the milk of an ass? In ancient Greece, neither asses’ milk nor cows’ milk were common; both became so only in Roman times.1°! Far more common was the milk of mares, sheep, or goats. In the circumstances, it seems to be striking enough that asses’ milk is relatively often mentioned in medical literature especially because of an alleged purgative force.!° Since this kind of milk was given as a purgative in cases of such “demonic” diseases as murder-fever or desiccating sickness, we may be justified in thinking that the purgation, here, was not originally on a rational basis, but a magic katharsis. If this is so, we should remember the remarkable fact that the so-called Empusae or the Mormo (both Greek “ghosts” par excellence) were conceived as ass-legged.195 Thus, asses’ milk may have been a kind of homoeopathic counterspell which was used in an alleged case of demonic obsession (similia similibus!) just before Cnidian medicine ‘‘rationalized” it. As a final example, I would like to mention a remedy procedure which is not to be found either in Cnidian or in Coan medicine, although rather closely connected

with the clinical phenomena which we enni! Diseases. In this latter case we are reminded of the well Imwipt of suffocatio uteri, which is based on the assumption that tleumndering “animal within an animal”, can provoke by its mente” symptoms as anxiety, syncope and so on. Now, it seemio lyegting that some Greek physicians are said to have treated lig ili a kind of musictherapy: As Soranus tells us in his gynecologia]it Corpus Medicorum Graecorum, vol. IV, p. 112, line 22ff ), in suda ibed the sound of flutes and drums, and Xenophon (perhaps ikenindrian physician who was a pupil of Praxagoras) recommeıledie, to produce the noise of metallic instruments (by “whetting'or, [hose physicians believed (as, certainly, common people di) |g’? uterus would return to its proper place when forced yi) manipulations. To a modern mind, the treatment savours wthipy’’ but such an explanation would bring things into false « sijerapective. As an element in any type of medical treatment, (le wtruments belongs, times, the sound of metal had played its nri\ery apotropaic or to be precise, primarily to the family of ayy From very early magic means of averting demons or other ip} means was finally factory manner. inherited by regular medicine, which ratimgiln n scarcely satis(c) The “bad sorrow-illness” The third, and final, example of the print Gnidian nosology concerns an illness (discussed under the aboy, nouson II, 72) the symptoms of which are, in the main, indi]ent suffers from “stinging” pains in the intestines; he lovey qyhle visions (“someseems to be times, the dead people”). That his “dizayphyyards’? of melancholy” an especially significant sign in regard to (haf to which all the Cnidian diseases so far diss cusslonely connected. After all, we come easily to assume thy ‘way also originally conceived as being personified, that is to gion, In old Greek j of the sons of one mythology “Phrontis” occurs as a perseyal Phrixos bore it.!°° In the circumstances, ite goincidence that one of Phrontis’ brothers was named ** Mel right in supposing that “Melas” originally had to name t he twe find ourselves, once again, in a familiar environment: pdl north wind, who apparently played so significant a part vvigjleoncepts. A male “personal” demon “Sorrow” may have been nothing bte way only another of, the already menyy many aspect of the same uncanny, “cold”, deal, names. To realize the mode of action Atossa’s tioned symptom of a “‘stinging”’ or “sci aydelpful. In words “sorrow (phrontis) scratches my hengedy, The Persians v. 161), an original demonic idea may |} this idea became undoubtedly a rather meaningless COX nn} onand perhaps € But there was, apparently, also a %ÿm } remember the jwill in Greece, too. Concerning non-Gree=

TEE TT Early Greek Primitive Medicine famous “Frau Sorge” in Goethe’s Faust. In this tragedy (v. 11 384fF), she is conceived as a veritable disease demon. By her breathing on him,!°8 the old Dr. Faust becomes blind, being exposed, then, to darkness (!). Without being able to discuss, here, the problem of the sources which Goethe had used for delineating Frau Sorge, we are justified in stating that this woman-demon is conceived by him in a thoroughly “primitive” manner. In folklore of German provenance there are evil spirits and disease demons who fully correspond to “Frau Sorge’s” type.!°° As to the early Greek situation, one may remember the “frequent sorrows (merimnai)” by which be the case with the above quoted Aeschylean verses, the Homeric language, too, people “are moved to and fro” (Homeric Hymnus in Mercurium, v. 44). As seemed to may have preserved, here, an idea which had not yet become a mere façon de parler. This may be sufficient for clearing up the mental background of the “bad illness sorrow”. In our opinion, in this case, too, the Cnidian physician has taken over a prerational concept without achieving an appropriate rationalization. In this connection, Coan medicine again was the superior. Here, the two words “phrontis” and “‘merimnai’’ lack any demonic tinge. On the contrary, they mean a fully rational “care for” and are able, therewith, to serve positively within medical language as special terms for a kind of “psychic gymnastics”.110 As for such a stage NOTES This may be said for those readers who are inclined to take “magic” in the precise but very refined sense J. G. Frazer has given to the word (excluding any kind of of mental development, the Cnidian physician was far from having approached it.!!! 1. supernatural intervention), Correctly speaking, early Greek medicine as well as primitive medicine sensu stricto is “magico-religious” (see E. H. AcKERKNECHT, Bull. Hist. Med., 11, 504 (1942). Nevertheless, Aeschylus’ metaphorical use in the Agamemnon (v. 1621) may demonstrate that the word cannot have been an extremely rare one. Besides the four terms which the Hippocratic author of “De morbo sacro” (ch. 1) is enumerating—magoi; kathartai; agyrtai; alazones—, we may recall such words as ‘““mantis” or ‘‘goés’’. 2. 3. This also applies to the word ‘“‘anemokoites” or “wind-banisher” (cp. Lanata, l.c., p. 66f) which denotes explicitly an activity which can be taken as another See Neusrapt’s very brief article in: Pauty-Wissowa Real-Encyclopädie, etc, vol. IX, 1, 802 (1914). In his classic work Psyche, vol. I, p. 184-186 (see also the index, vol. II, p. 435, s.v. “Tatromantik’”). Sapientiae (Harper Torchbook Edition, 1965), ch. I, §§ 5 and 6 (to quote a few examples from the vast literature). some Greek iatromanteis are enumerated; see also F. W. CoRNFORD, Principium single aspect of the medicine-man’s complex profession, See K. MEuLrs masterly paper “Scythica” (in: Hermes, 70, 137ff (1935), where 4, 5. 6. 7. See oe re “Apis”, nr. 6, in: PauLy-WissowA RE, vol. I, 2 (1894). See, for instance, Euripides’ Alcestis, v. 970, according to which Apollo “has donated” References for the following are to be found in Ronpe, /.c., vol. II, p. 91, n. 1. See E. R. Dopps, The Greeks and the Irrational, Berkeley/Los Angeles,* 1964, p. 141 Cf. H. FiNDEISEN, Schamanentum, Stuttgart, 1957, p. 236, n. 1. the remedies to the Asclepiads (i.e. the physicians) without any intermediaries. 8. 9. See Roupe, l.c., vol. I, p. 113ff (for Aristaeus, ibid., p. 116, n. 3). 11. 10. 12. below, n. 78 and 79). and 161, n. 34 (as to arrows or needles within old Greek disease-concepts, see

See H. Diets, in: Sitzungsberichte Akademie Berlin, 1891, part I, p. 387ff and Ronpe l.c., vol. II, p. 96f. a See DIoGENEs LAERTIUS, I, 110. See ROHDE, /.c., vol. II, p. 70, n. 1. See H. HERTER, in: Rheinisches Museum f. Philologie, 108, 198 (1965). See ROHDE, /.c., vol. I, p. 116, n. 1. “althainesthai” means “heal”; cf. Rome, vol, I, p. 185, n. 1. For the Iamidae, see the article in: PauLy-WissowA RE, vol. IX, 1, 685fF (1914). See RoHDE, vol. II, p. 52, n. 2. Cf. APOLLODORUS Bibliotheke, book II, $ 29, APOLLODORUS, /.c., II, 27. See RoHDe, vol. II, p. 51, n. 3. In later Greek medicine (cf. Arrrarus in: Corp. Medic. (see Ronpe, vol. II, p. 406f); by them, one is able to “wash away” (apomattein) Some testimonies are to be found in Roun, vol. I, p. 226, n. 3, vol. II, p. 76, n. 1 and p. 406. Black hellebo re (someti mes named ‘“Melam podion” ), togethe r with “black bile” and “melancholy”, belongs both to prerati onal and rationa l Greek medicine (see ch. IV, § 1 of my book Der Beginn des medizini schen Denkens bei den Griechen, Zürich/ Stuttgart, 1967). It would be worthwhile, I think, to write the history of such drugs, which, as a prerational inheritance, were taken over by regular Greek medicin in a process of gradual “rationalization”. To mention a further example: scilla ande fig are, among the ancient Greeks, magico-religious cathartica of a very old origin any uncleanness. Graec., vol. IL, p. 101, line 14 and 17) these drugs, having been in the meantime sufficie l.c.—see note 5—p. 96). 4 ntly “rationalized” (remember their irritati ng effects on the skin!), are used in a completely unchanged way in the treatment of “lethargos” (a disease which, in its concept and name, may be itself very “primitive” since it seems to have been connected, originally, with the idea of demonic obsession), 27. See Diocenes LAERTIUS, VIII, 68/9. 28. See Diogenes LAERTIUS, VIII, 70. 239% See my above-quoted book, chapters II and III. 30. See my book, p. 32-34. 31. See my book, p. 39f. Dar See CASTRÉN, Nordische Reisen und Forschungen, vol, IV, p. 256 (quoted by Cornrorp 4 sing an illness (without any nosologic differentiation) i PROS Loox: die believe Polyph EE AR Maportant mnagito.religiala UE emus to be mad, I cannot agree with him. As it seems to me, the Cyclopes are simply diagno When Dodds states (l.c., p. 67 with note 18) that the Cyclopes See ch. IV, § 5, of my above-quoted book, Dodds is explicitly referring to Ruth Benedict), ERA See the end of the Ist and the whole 2nd cha dda In his book, Heilkunde in geschichtlicher Entscheidung, Salzburg (Wort und Antwort vol. 15), p. 40-43. 7 34. See ch. 1 of Dopps’ above-mentioned book (cf. n. 13), Furthermore, one may look up K. Larre’s excellent paper “Schuld und Sünde in der griechischen Religion” which is now reprinted in the same authors Kleine Schriften, München, 1968, p. 3ff (for “ate’’ as mere fatality, see ibid., p. 4), 7 39, 36. 97. 38. 39. 100 See Dopps, l.c., p. 32. See, for this, Dopps, p. 54, n. 39; for sea-w pureative, Didi à 900, Les pi 43. 41. J. Grimm (in his monograph Die literarische Darstellung der Pest in der und in der Romania, München. 1965, p. 25f) is quite right, stating that HomerAntike leaves a blank where we should expect a realistic description of the plague.

One may remember also the See Dire, /.c., p. 15f and Apkıns, l.c., p. 102# and 124ff; for Dracon and the offspring of a sick man is to be interpreted; at any rate, it is not merely a ‘‘medical’’ statement.) For the dramatic function of Orestes’ disease within the Euripidean tragedy Orestes you may compare W. D. Smrrn’s paper in: Hermes, 95, 291{F (1967). Lysias, fr. 53, ed. ScHEIBE. See Dopps, /.c., p. 188f. See Dopps, /.c., p. 200, n. 61. See, for that, Dire, /.c., p. 15 and A. W. H. Apxins, Merit and Responsibility, Oxford, 2965, p. 68f and 138ff. (in this light, too, Plato’s above-quoted statement concerning and 38; p. 22, line 24f). shameful disease” (see EuRIPIDES, Orestes., v. 10 and Dros. LAERT., /.c., p. 17, line 27f “laughing” philosopher Democritus who was consequently believed, by the Abderits, to be mad (see, for instance the Ps. Hippocratic Letters, nr. IOF L.). In the same manner, an “impertinent tongue” is, for primitive community-ethics, like a “highly (see Pythagoras, in Drogo. LAERT., l.c., p. 210, 1, 3). To the same category may belong the ban on loud laughter or “exalted distemper” See Dopps, L.c., p. 67. Chilon, in Diogenes LAERTIUS (p. 17, line 40f, ed. Cobet) ; Bias, ibid., p. 22, line 24f. See, in general, A. DruLe, Die Goldene Regel, Göttingen, 1962 (e.g. p. 14fF). (fr. 292, ed. Nauck?: “‘nosoi authairetoi’’). One can find this in Solon, /.c., implicitly and in Euripides explicitly formulated up Diogenes LAERTIUS, VIII, 70.) See Stoicorum Veterum Fragmenta, vol. II, nr. 1175, ed. v. Arnım. See Pindar’s “autophyta helkea” (“self-grown wounds”) in Pyth. III, v. 47. Originally, they had been taken as a mere fatality. (For the Greeks, one may look In folbiore, monsters and miscarriages are usually connected with a plague. Wehrli). has been ignored in modern monographs on Greek ethics (for which I quote the names of Ed. Schwartz, J. Ferguson, A. W. H. Adkins, A. Dihle, L. Pearson, F. In v. 227, instead of “limos (hunger)” the variant ““loimos (plague)” is given; this seems to be, however, nothing but a mistake of a copyist. In his book Der listensinnende Trug des Gottes (Göttingen, 1952), K. DEICHGRÄBER is of the same opinion (ibid., p. 149, note to p. 87). For Eris as a causer of illness, one may look up Ps. Hesıop’s Shield, v. 149ff (see above p. 322); for Murder and Anger as brothers or sisters of the disease, cf. Empedocles, fr. B 121 and above p. 326). Solon’s metaphorical use of ‘‘disease” and the connection between disease and (civil) war is discussed above p. 316. Here we may add the remark that the phenomenon of the “moralised disease”, although being apparently important in the ethical thinking of classical antiquity, edition, vol. 1, Berlin, 1860, p. 193ff. concept. For this, one may look up the introduction of SCHNEIDEWIN-NAuck’s Sophoclesthe plague-scene itself, apart from a few peculiar traits, is integrated in a common L. EDELSTEIN does not convince us (cf. Ancient Medicine, Selected Papers of L.E., Baltimore, 1967, p. 225, n. 67); see for this Dodds (above n. 39). Lain Entralgo is once again mistaken in assuming, from the plague-scene, that Homer’s disease-concept on the whole was concentrated primarily on the bodily manifestation, and secondarily on the supernatural causation of an internal disease (lc, p. 45f). One cannot generalize the situation of the plague-scene; conversely, In denying the magic character of the purification in Ilias, book I, v. 312ff, Early Greek Primitive Medicine 42. 43. 44, 45. 46. AT, 56. 57. 58. 59, 60. 61. 62. “involuntary murder”, see K. Larte’s article on ‘‘Mord” (now reprinted in: Kleine Schriften, München, 1968, p. 382ff ). Later physicians or philosophers usually interpreted such fancies as sequels of a disturbance of the imaginative power which had been caused by “melancholy” or “mania”; see, for instance, Chrysippus (Stoicorum Veterum Fragmenta, vol. II, p. 22,

1, 10ff ed. v. Arnim) who explicitly refers to Electra’s above-quoted utterances. For an otherwise insufficient attempt to test such a phenomenon as fancies, you may compare the Cnidian author of p, nouson I who was perhaps a slightly older contemporary of Euripides: This physician describes, without any alleged etiology, some patients who “see horrible visions, and even sometimes the dead”. Elsewhere, the same physician speaks, like Electra, of the patient's “fancy”. Here we meet, from the side of medicine, with a mental attitude which is apparently identical with that “the words II 64 by that of Electra (for the Cnidian physician, see above $ 3). ET. NC Lions recent (p, nouson isease” above-quoted book, p. 78f. en - sHi line 3ff ) or at least closely connected with the sun (see GUNDEL, l.c.,p. 342, line 57ff). Apparently, Sirius has to stand here as a substitute for he sun and the sun’s radiance which is, of course, extremely intense during the dog days. In old Egyptian as well as in Greco-Roman texts, Sirius was held to be either itself a sun (see GUNDEL in: Paury-Wissowa Real-Encyclopädie d. class. Altertumsw,, vol. III, A 1, 1927, p. 323, entirely the Cnidian peri nouson and its (more or less apparent) “magic” Mois. book, p. 87. 17 For her purpose, Miss Lanata perhaps would have done better not to overlook As to the Cnidian treatises of the Cor paper in: Glass. Quart. N.S., 15, 1-30 Toet to treat once more the question of the old Hippocratic religious attitude without any prejudice whatsoever. IJ, 73) which I made in my I, 73) religion and magic”) fails to convince me on the whole, Perhaps it would be fruitful the related problems (as given in his paper on “Greek medicine in its relation to religious attitude is concerned. On the other hand, L, Edelstein’s interpretation of Bourgey has collected, any discrepancies could be found as far as the personal as I likewise cannot follow the Opinion that in the Hippocratic testimonies which with Bourgey’s opinion (/.c., p. 113, n. 5) that the religious attitude of the author of De morbo sacro is more “authentic” than that of the author of De aere aquis locis, The well-known testimonies are enumerated by L, Bourory, Observation et experience chez les médecins de la collection Hippocratique Paris 1953 p. 114, n. 1. I cannot agree express Thucydides’ own opinion”, which Pericles exhorts the Athenians to endure the illness as divine will, do not 63. J. GRIMM (l.c., p. 35, n. 2) is certainly right in stating 64. 65. 66. 67. 68. 69. 70. 1931/2, p. 1570-1572 and W. D. MONTGoMERY’S quite unsatisfactory remarks in: Cf. K. Mrurr in his above-quoted (see n 5) paper, now reprinted in: Herodot. Eine Auswahl aus der neueren Forschung, a Ww Noad: linchen, 1962, p. 462. Furthermore, see BÄCHTHOLD-STÄUBLI, Handwörlerbuch des deutschen Aberglaubens, vol. IV, goreism. See GuNDEL, /.c., p. 317, line 28 ff, See GUNDEL, /.c., p. 322, line 35£f. As a female being, Sirius is to be fou d + cael agree with Lanata in supposing f an tradition, as represented of Pythagoreism—at any rate, shamanism must not have been bound to Pytha. that Empedocles had inherited this demonistic concept of disease by the influence concerning early Greek disease-demons. See also, for Empedocles, fr. B 121, G. LANATA, le, p. 34f, with further literature Ann. Med. Hist, 3rd series, vol. I, 393f (1939) 71. For Aristaeus as being, perhaps, identical with Aristeas of Proconnesus (who was a “miracle man” too), cf. the interesting reflections of Ru. CARPENTER, Folk Tale, Fiction and Saga in the Homeric Epics, Berkeley/Los Angeles,’ 1964, p. 162. See Dopps, /.c., p. 2-8 and above p. 310, 72 73. 74, 79: for us, by Apollonius Rhodius (see ed Fido for this GUNDEL, l.c., p. 318 line 64ff. For etymological as well as other HD He between Sirius and Sirens, se H. HERTER in: Rheinische Jahrbücher für Volkskunde, 1, 121f (1950) and K. Larre’ short paper “Die Sirenen” (firstly published 1951, now reprinted in: Kleine Schriften

See H. Herrer, bei py 112, discussed in connection just with the north-win d (Boreas), seems to in the light of our prerational testimonies (see above, n. 76) where thisbe remarkable “dark” wind played a rather irrational part. I explicitly agree with Lanata’s (l.c., p. 15) principal reservations as to “pan-rational” interpretation of Greek medicine (see also my book, pp. Edelstein’s 88 and 100). the famous old Coan treatise De aere acquis locis ch. 10, the desiccati ng sickness is old tradition. Or let us inspect once more the desiccating sickness: physicians imagine sexual intercourse to be a “desiccating” event (seewhy do Coan e.g. Epidem. V 72)? Beyond any rational explanations (as, for instance, a loss of moistness ), it seems to me that in the background the old idea of “drought-plague”’, with its main symptom of love-madness, is still alive. Since ancient times, love, sexual intercour se, dry black bile and melancholy are bound together as a unit. This apparent ly is the reason why in later medicine Sirius, sexual instinct and ‘“head-si ckness” brought together as they were in Hesiod (see ARETAEUS, Corp. Med. Graec., are still vol. p. 148, line 28 and the Lexicon of Suda s.v. “tenge’’). Finally, the fact that in II, In my book, p. 126, I have discussed a Coan example for insufficiently rationalized See my book, p. 78f. reports concerning a demonically caused epidemic disease. old Roman concept of divinities to be a close parallel to this kind of primitive mentality (see, for that, K. Larre, Kleine Schriften, München, 1968, S. 88f ). See M. P. Nitsson, Geschichte der griech. Religion, vol. I (3rd ed.), p. 615. A. J. Fesruaière’s recent paper on Hippocratic and demonic epidemics (in: Wiener Studien, vol. 79, 157-164 (1966)) seems to be more attractiv e in its title than in its content, since it compares Hippocrates not with pre-Hippocratic but with Byzantin e II, 84): An illness as such could only be conceive d in its separate manifestations; there is no idea whatsoever of nosological units. Mutatis mutandis, we can take the tion of Medicine, New York, 1944) or, for instance, old Egyptian medicine (see Herodotu s “specialization” in primitive medicine (see in general G. Rosen, The Specialisa This reminds us of the Cnidian “enumera tion”? of diseases (“Kidney -disease, nr. 1; nr. 2” and so on). In a wider connection, we must remembe r here the famous up my above-quoted book, ch. IV, § 1. As to black bile, melancholy and its peculiarities in the light of prerational medicine , one may look See GUNDEL, l.c., p. 320, line 17ff. “needle-stings” in p. nouson II, see the chapters 72 and 73. g” disease-demons in ancient Greece, see HERTER, /.c., p. 126, with n. 44. For further Prometheus, v. 596-598 (quoted by LANATA, /.c., p. 30, n. 56). Since Aeschylean verses the illness “touches” (échrie) the patient, in Homer’s in the Odyssey (V 395f) the disease-demon “scratches” (échrae) his victim. For “touchin p. 343, line 4ff. One may recall Apollo’s ‘‘infectious” arrow-shots and, furtherm ore, Aeschylus For Sirius in connection with plagues, see GUNDEL, /.c., p. 336, line Off (Egyptian as well as Greco-Roman references); for Sirius as to particular diseases, see ibid., sickness”. Sophoclean “Antigone” (v. 415-421): Here, the strong heat of midday as well as a sudden hurricane (typhos) are said to have caused a “divine sickness” . Manifestl the poet is using current ideas which stem from the complex of our ““desicca y, ting Handwörterbuch d. dtsch. Aberglaubens, vol. VIII (Leipzig/Berlin, 1936/7), p. 1577f. Now we can fully understand, too, a passage from the guardian’s report in the which contains in itself both the motifs of the arrow-shot (for this München, 1968, p. 106-111). If the Sirens were bad “Mittagsfrauen” and, on the other hand, were similar, being demons with wings and claws, to the storm-lik Harpyiae, one may call the above-quoted poem of Ibycus and, especially, the (note fully evident) allusion to the “Thracia n Boreas”. For a demonic disease-concept see below in the text) and the hurricane (or north-wind), one may look up BAcHTHOLD-STAuBLI’s Early Greek Primitive Medicine TI. 78. 14; 80. 81. 82, 83. 84.

90, 91, Vai One j ;may look Up, for Sta n, FRANKEL, Dicht i bl. Fridolf Kudlien + i yay de la science hippocratiqu e, the symptoms of whieh thi'Rineh in the body; witherin N nea, “ns feren, magic death-illness sì heat; stinging pain as described in p a ace ants “pe the so-called voodooslen |.» Gue: of e g iccating sickness e this connection, Especially, there mus t be he nir apo lgi s, 44, 169 ff (1942), “ ar > - (Bach yogi je, pis . aw e D wish to let an su one ‘it he Vaa n tae T e r penn ge pP: 70f), dai Nolden Bough, abro . ed. London, Cf. the interestin but FL pe ae. Socal Philologin «+ 5,ce+ the Int Introd roducta “Vlechentums, New York, 1951, ion e ta « Berlin, 1860, p. 44€, sa Al ion of SCHNEIDEWIN-NAU CK, See especially the fam ous discussion in Kumansxy.p ille ) Problemata and the mee + 16ff and 89f, , . 1771£, ‘ IE Ng on”, ee, for this, , my rem ong! zu . ( bdo Aberglaubens, vol. IT, 1929/30 See BÂCHTHOLD-Sr A Un} N . ure eu m h our special purpose, remarks about the dead A; rr “ ‘especially Sophocles the “aeriform” Nat | e Denn ) n 1 cn | i 1, 771, nr. 1 (194 t), una bd278, a adie, sea à “lait” o p nouson II, 73 (Which jhe ease of the “black disease 2 sickn ess) the vomited « Ki fever and desiccating Cf. PAULY-WissowA” Rea For the Corpus Hippocratie)l sara itn S60fF Si “ue ‘Melancholy, New York, 93, See my book, p, 39, 94, Cf. Kupuien, Cy p. 85, 9; Cf. Kupuren, Le, p. 83f. 96, See Hip roc rar ns, Aph ori sm À 97. See Corpus Medico rum Crae cosi! 98, Sce BAc Hro LbSTA URL I Ha ‘on, 99, Vol . VII u © À I, p.A 468, LipITTRR 100, By this occasion, | recall to, Abyglaubens, vol. I, 1927, p. 704. 101, 102, are to be found Sor, for that also referen ty, "aneme” and See PAULY-Wissow a, 103, 104, 105, 106, See H. Usenur, Kleine Schri Vi See, se references, RonRE ny) 107, 108, 109, 110, 111, The concept of a « he anch\ of the related consmel e rn. (1063) of becoming poor and Handbuch der erichtlic en Ap N as In J, und zum Leitfäden bei Gerti} Arzt, BrrNT's Systematische. Wundärzte, Rechtsgelehrt 4 (Ath ed,), p. 170.