Method in Galen

Method in Galen 1 have discussed the four methods of ancient philosophy namely demonstration, division, resolution, and composition. But first, 1 glance at logic, which «discovers the pnnciples of medical treatment*. Method in pathology discovers &e afTected parts of the bodp and nosology, athe syrnptoms of diseases and their causes.. In therapeutics, method ~discovers drugs appropnate to speciñc diseases*. The leader in al1 things pertaining to method is Hippocrates. BIBLID [0211-9536(1995) 15; 41461 Fecha de aceptación: 18 de febrero de 1994 Despite awareness of the importante of pÉ190805 in Galen, «a thorough investigation of his methodology is still lacking» (1); as Jonathan Barnes points out, «a serious answer to the question of method would require long labours and a large volurne» (2). The present paper does not aim to be comprehensive: many of Galen's statements on method are perfunctory or banal, and can safely be ignored. 1 plan to concentrate on the really crucial passages relating inter alia to the four methods of ancient philosophy, viz. demonstration, division, resolution and composition. Galen's main work on these subjects is lost: the De demonstratiune. It has been partially reconstmcted (*) A. O. Professor, Institut für Geschichte der Medizin und Pharmazie der ChristianAlbrechts-Universitat zu Kiel. Brunswiker Str.2, D-2300 Kiel 1. (1) TEMKIN, Owsei (1973). Gakmism; rise and decline of a medical philosqhy, Ithaca, Come11 Univ. Press, p. 28, who then provides a bnef outline of Galen's views on method (pp. 28-30), (2) BARNES, Jonathan (1991). Galen on logic and therapy. In: Kudlien, Fridolf; Durling, Richard (eds.). GakmS Method of Healing. Proaedings of th 1982 Gah symposium, Leiden, EJ. Bnll, p. 80. DYNMS. Acta H* M. Sci. Hist. IUw., 15, 1995, 41-46. 42 RICHARD DURLMG by Iwan von MüIler (3) í?om references scattered úiroughout Galen's vast oeuvre. It included a discwsion of scientific method (4). First, we must emphasise the heuristic role of logic which discovers the principies of medical treatment [Meth. med. X p. '764.1516 K.] . In pathology, too, there exists a method by using which one can discover the affected parts of the body [Loc. afJ: VIII p. 120.10-11 K.] . This method discovers also the symptom of diseases [An in a*. sang. mt. IV p. 728.17-18 K.] and their causes [De symptmn. caus. W p. 102.5-6 K.]. It is a pide to whole organs [De morb. di8 VI p. 879.18880.1 K.]. It enables us to study the functions of the body (5), their use [Meth. med. X p. 398.810 R] and their powers (6). We must judge each drug according to the methods often discussed by Galen [De simpl. med. temp. et fac. XI p. 641.891. Drugs are compounded methodically (7), but no dogmatic physician has yet written in a. articulate manner about the compounding of drugs [De comp. md. pm gen. XIII p. 463.12-14 K.]. Galen has much to say on the so-called «demonstrative method. [De const. art. med. ad Patrophil. 1 p. 266.7 R]. He refers to those not exercised in apodeictic methods, and thus not provided with a criterion of truth and error (8). One must adopt the premises supplied by the scientific method, and examine and judge them in the light of sense-perception [De plac. Hipp. et Plat. CMG V 4,1,2, p. 148.2-41. It is the peculiar property of scientific method to employ scientific premises (Ifippaza) [ibidm, p. 430.6 71. Galen speaks in the same work of those who neither know what scientific method is, nor practise it [ibidem, p. 432.8-9,281. In De usu partium he refers to those uninitiated (P~Pfihou~) into scientific method (9). Elsewhere he (3) MÜLLER, Iwan von (1895). Über Galens Werk von wissenschaftlichen Beweis. Abh. d. Berliner Alzad. d. Wss, 20, 403478. (4) De pluc. Hzpp. et Plut. CMG V, 4, 1, 2, p. 102.26; De szmpl. med. temp. et fac. XI 632.4 8; De sed. Scr. Min. 111, p. 33.131. (5) De usu part. I p. 12.20-23 Helmr.; $ ihd. 457.9-10. (6) De comp. med. per gen. XIII p. 861.2-3 K; cf: Meth. med. X p. 962.2-3 R; In Hzpp. Epid. VZ comment. CMG V 10, 2, 2, p. 341.28-29, al. (7) De comp. med. per gen. XIII p. 29.7, $ 334.11-14. (8) De di8 resp. VI1 833.1315 R; cf: De szmpl. md. temp. et fac. XII p. 3.11 R (9) Deusupart. Ip. 196.10 Helmr.; $ Depecc. dign. CMGV4, 1, 1; 44.2324; De szmpl. med. temp. et fac. XI 465.3. Method in Galen 43 mentions the previous literature on the subjea [De pea dign. CMG V 4,1,1 p. 46.1-21. He also notes that Hippocrates was the ñrst physician to find the correct method(s) (10). Galen wiIl adopt the methods he handed down to posterity (11). He speaks elsewhere of the «Hippocratic and true methodn of curing hoUow wounds [Meth. d. X p. 173.17-18 K.] , and of those who welcome the <dlippocratic method* [ihidem, p. 309.17-181. Hippocrates is our leader in all things pertaining to method ibzdem, p. 346.15161. Hippocrates and Plato's methods are to be imitated by Galen (12). Hippocrates handed down the elements of the method of the (medical) art (l3), when he enuntiated the principie that «contraries cure contraries.. Plato is to be admired not only for discussing method, albeit briefly, but also for exercising it [De plac. Hipib. et Plat. CMG V 4,1,2 p. 602.7-91. Plato advised us to discover the nature of the soul according to the methods Hippocrates had used to investigate the body. A moot question was which Hippocratic book Plato had praised for its author's method [In He. de nat. h. comrnent. CMG V 9,l 19.5-6 cf: ibidem, p. 55.14151. Plato discussed method in his Phibbus (1 5). Second in importante after scientific demonstration or proof comes the method of division (4 GtatpÉoeo~ ~ÉIYoGo~ 4 Gtatpezt~fi (16) pÉhS05) (19. Plato discussed the methods of division (18) and composition (4 ~VVIYETLK~ pÉIYo805) [De Plac. Hipp. et Plat. CMG V 4,1,2, p. 568.2-31. As Philipp De Lacy has written: athis method ... tells us how to pass by division from the first and most general class through the intermediate differentiae to units that no longer adrnit of division» (19). As applied to medicine, divisive and (10) De morb. temp. VD p. 438.1617 R; cf: In Hzpp. De rnctu acut. comment. CMG V 9, 1 p. 122.67; In Hipp. Epd. VI commt. CMG V 10, 2, 2 p. 272.34. (11) De usu part. 1, 15.1920 Helrnr.; cf: De san. tuenda CMG V 4, 2 p. 137.11-12. (12) De plac. Hipp. et Plat. CMG V 4, 1, 2, p. 336.31-32, cf: 584.20-21. (13) De Plac. Hipp. et Plat. CMG V 4, 1, 2 p. 516.191. (14) Meth. md. X p. 14.67 K; cf: In Hzpp. de nat. hom. cmmt. CMG V 9, 1 p. 54.410. (15) Meth. md. X p. 26.45 K.; cf: De plac. Hzpp. et Plat. CMG V 4, 1, 2, p. 582.31-32. (16) De morb. dzff VI p. 847.5-6 K. (17) De dzfJ: resp. VI1 p. 895.5-6 k; Meth. md. X p. 26.2-3 K. (18) De ioc. a# VI11 736.15 K.; $ De Plac. Hi@. et Plat. CMG V, 4, 1, 2, p. 566.10-12 (19) DE LACY, Phillip (1966). Plato and the Method of the Arts. In: Wallach, Luitpold (ed.) In tk Classical Tradition: Litera? and Histmzcal Studies in Honor of Hany Caplan, Ithaca, Cornell Univ. Press, p. 123. compository methods enable us to determine the multitude of differentiae in the pulse [De dign. puk Vm pp. 601.24,10,12-13; 602.1 K.] . Galen has much to say on logiml method Without it neither Theophrastus nor Aristotle would have written anythmg [An in arter. sang. umt. IV p. 729.6-8 K.]. Ignorance is due to lack of exercise in logical method (20). The latter is an adjunct to experience [De dign. puls. VIII p. 857.12-15 K.]. Herophilus teaches expenence rather than logical method (21). Logical method, as Galen's disciples know, contributes greatly to the discovery of drugs. He who discovers drugs according to logical method comes to the search of (the patient's) diathesis [De comp. med. secundum loc. XIII p. 128.1415 K.]. If logic finds the compound medicines, expenence tests their virtue [De comp. d. pergen. >(m p. 376.2-25 K] . One cannot compound medicines without logical method [ibidem, p. 706.1819 K]. Logical methods are contrasted with irrational expenment [Meth. med. X p. 31.1 K.]. One must train oneself in logical method, in order to know how many diseases there are [@od qbt. med. sit etiam phil. Scr. Min. 11 p. 6.10-13.1 Galen says comparatively little about resolution (fi &vahuztic.il pÉ60605) [De dign. pecc. CMGV 4,1,1 pp. 59.45; 55.141. Analysis or resolution teaches us how to construct e.g. a c@sydra or sundial, and success or failure is clearly proved by results [ibidem, p. 59.25261. Some philosophers spoke of analysis, as an ascent through intermediates to the first criterion [ibidem, p. 54.10-11, 24251. Such a method is employed in geometry, arithrnetic, and astronomical calculations [ibidem, p. 47.12-141 . Synthesis and analysis are combined at De animi cuiuslibet peccatmm dignotione et curatione [CMG V 4,1,1 p. 55.8, 15 £€l. Galen says little too about composition, but probably discussed it in his now lost book De Demonstratione. There is a glancing reference to O~V~ETLKI) pÉ60605 at De placitis Hippocratis et Platonis [CMG V 4,1,2 p. 568.2-31 (23). (20) De symp. caw. VI1 p. 280.10-11 R; Meth. md. X p. 916.7-8 K.; De simpl. md. ternp. et fac. XII p. 5.1, al K. (21) De pues. ex puls. IX p. 278.910 K.; cf: STADEN, Heinrich von (1989). Herophilw. The Art @Medicine in Early Akxandna, Carnbridge, Cambridge U.P., p. 126. (22) De comp. md. secundum loc. XII p. 894.9-895.1 K.; cf: De comp. md. per gen. XIII p. 594.1415 K. (23) C$ De phc. Hipp. et Plat. CMG V 4, 1, 2 p. 102.26-28; MÜLLER, Iwan von (1895) @, DWAIWS. Acta Hkp. Md. Sa. Hkt. 111w., 15, 1995, 41-46. Method in Galen 45 Therapeutic method is discussed repeatedly, especially, of course, in Galen's Methudus mzdm.di. Teshng the therapeutic method, the physician wili discover the places affected together with the patient's diathais [De loc. a8 VIII 64.1-3 K.]. Crucial is the rule that all unnatural states are nired by their contraries [Meth. d. X p.768.6-8 K] . Besides the Methodus mzdm.di there are frequent references to therapeutic method also in Galen's pharmacological treatises (24). Finally, we should mention universal (~a66hou) methods (25). Such universal methods do not sufñce for accurate knowledge [Meth. med. X p. 608.1415 K.]. One should be trained in particulars [ibidm, p. 628.12-13, 1617; 629.5-61. The problem remained how to apply universal methods to particular cases. Constant practise is required (26). One must trah throughout life. But one is secure in the knowledge that finding something methodically is better than relying on naked experience [Meth. med. X p. 183.10-11 K.] «For rhetoricians, too, it is not enough to learn the method for dividing every case, but to the knowledge of method they add practise also. 1 would wish therefore that the man who claims to be scientific first te11 me the method he employs for his scientific demonstrations and then show how he has been trained in it» [De plac. Hipp. et Plat. CMG V 4,1,2 p. 112.28321. 1 hope not to have duplicated unduly the fine study on logic and medicine by Professor Jonathan Barnes. My remarks are primarily meant to stimulate scientists to study ancient methodologies. b¿ió~ (LSJ 111.3) = method, system. 6605 is frequently used in connection with heuristic, e.g. KOLV~ ¿i'&p(po~Épo~~ 080~ 735 E~~ÉOEOS (28). Hippocrates cit. fn. 3). See also the brief reference to Plato at De plac. Hipp. et Plat. CMG V 4, 1, 2 p. 568.2-3. (24) E.g Meth. med. ad Glaucon. XI p. 358.15-16; 376.4; 572.7-9; De comp. med. secundum loc. XII p. 614.8-9. (25) De loc. a@ VI11 p. 216.9-10 K.; Meth. med. X p. 322.15 K. (26) CJ De loc. aff VI11 p. 123.11-18, De const. art. med. ad Patrophil. 1 p. 245.1-2, 5-6 K. (27) Op. cit. fn. 2, pp. 50-102. (28) De san. tuenda, CMG V 4, 2, p. 3.9: $ De plac. Hipp. et Plat. CMG V 4, 1, 2, p. 182.2022; De dz@ resp. VI1 pp. 909.2; 912.1-2 K.; De loc. aff VI11 pp. 8.34; 146.8-9; 147.1113; 148.3-4 K.; De dign. puls. p. 786.10-11 K.; Dep-aes. ex puls. IX p. 223.35 K.; Meth. med. X p. 1010.16 K.; Meth. med. ad Glaucon. XI p. 159.9-10 K.; In Hipp. De victu acut. was the first to use the «right way* (29) Galen mentions sthe logical wayn 8605 = pÉiY0805 throughout (30). commt. CMG V 9, 1 p. 159.9; In Hz.. Pfogn. comment. CMG V 9, 2, p. 343.27-28; In Hz.. E*. Il7mment. CMGV 10, 1, p. 19.7-8; De u&. Scr.min. 11 p, 116.11-12, al. (29) Meth. med. X pp. 117.17-18; 118.34; 632.4, al K (30) De loc. a# VI11 p. 158.7-8 and De comp. med. per gen. XII p. 888.5. Galen speaks of this way of Hippocrates [Meth. med. p. 172.2-31. DYACAMIS. A& Hzsp. Md. Sci. Hkt. iüw., 15, 1995, 4146.