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Author(s): R. J. Hankinson
Source: Phronesis, Vol. 32, No. 3 (1987), pp. 329-348
Published by: BRILL
Stable URL: http://www.jstor.org/stable/4182286 .
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329
330
331
14
104.
See Med.Exp. chs. 16-7, pp. 114-19Walzer; cf. Barnes, "Medicine, Experience and
Logic", in Barnes et al. (edd.) Science and Speculation,Cambridge(1982).
17 Has this doctor's word been reliable in the past? Does his testimony cohere of other,
already tested parts of the theory? See Subf.Emp. 8, 65.28-69.28 D.
16
332
333
theoremof transitionalsuccess:cases of transitionto the similarare themselves similarjust in thatthey aresuchcases;I havethe rightto be confident
aboutthisparticularapplicationof transition,because,beinga transition,it
is itself relevantlysimilarto previouscases which have yielded successful
outcomes:
So Logical transferencebased on the nature of things lays hold of knowledge by
means of indication. But the Empirical variety relies on what is discovered by
experience'9, not because it is persuasive or plausible that the similar should be
productive of something similar, or require similar things, or undergo similar
things; it is not because of this, or anything else of this sort, that they think it
justifiable to make the transference, but on the basis of the fact that they have
discovered by experience that similar things behave in this way (Subf.Emp. 9,
70. 10-20 D).
Finally in this regard it is worth noting that transition forms part of the
334
2. Causesand Signs
It might be thought, then, that Empiricistswould have no use for causal
analysis, for the attempt to discern a hidden pattern of operation that
underliesthe phenomenaof the world. And that, as we shall discover, is
substantiallythe case. However, the pictureis obscured,and to an extent
confused,by the factthatit is statedwithsome regularityin oursourcesthat
the Empiricistsdid allow one type of cause, namely antecedent2lor
evident22causes into their conception of the collection of symptoms,or
if
OUuvbp?o
Furthermore,it is preciselythis willingnessto allow the significanceof
antecedentcauses that differentiatesthe Empiricistfrom the Methodical
Doctors. The Methodists,in a move which Sextus Empiricusapprovingly
describes as paradigmaticallyPyrrhonian(PH 1 236-41), refuse to either
affirmor deny the existence of hidden states of the body, and hold that
causes, if indeed there are such things, are of no therapeuticimportance
whatsoever23.Galen illustratesthe differencein a passageof SI (I 88-89):
someone sufferingfrom a dog-bite visits an Empiricistand a Methodist.
The Empiricistwillquestionhimcarefullyaboutthe circumstancesin which
the bite was incurred,and will be interestedin the fact that the dog was
foaming at the mouth; by contrast, the Methodist will be completely
unconcerned about how the condition arose, and will simply treat the
wound by sewing it up again. Galen's point, of course, is that bites differ
from dog to dog, accordingto whetherthe dog in question is reasonably
sane, or seriouslyrabid. The Methodistcompletelyignoreswhat he considers to be such peripheraland unimportantissues.
CQoxatcaQx?lxdL:
see SI 1 74, 88; MM X 244.
22Celsus, Med. Pr. 27; on the connections between the concepts of antecedence and
evidence, see my "Evidence, Externalityand Antecedence", Phronesis 32, 1987.
23 Sf1 84-5; [?Gal.] Ther.XIV 278; and
[?Gal.] De OptimaSecta (Opt.Sect.) 1 170. This
evidence is supported by Celsus, Med. Pr. 54, 57; these sources must be used with care,
however; medical Methodismproperbegan in the firstcenturywith Thessalus (although
it owed much to the previous work of Themison: on the relation of Themison to
Methodism, see Edelstein, "Medical Methodism" in Ancient Medicine, Baltimore
(1967)), and Galen regularlyuses the term "Thessalian"as a synonym for "Methodist"
(e.g. at MM X 390, 909ff.); however, it is clear that Methodismdeveloped and became
more complex in the years after Thessalus:the survivingworksof Soranusdemonstratea
tolerance, if a limited tolerance, of causal theorising (Gyn. 3 6, 3 7, 3 40 = CMG IV
97.7ff., 97.21ff., 119.2ff.): on these issues, see Frede, "On the Method of the So-called
Methodical School of Medicine", in Barnes et al., op. cit. (1982); and G.E.R. Lloyd,
Science, Folkloreand Ideology, Cambridge(1983) 192-6. Celsus refers more cautiously,
and perhaps more accurately, to the "followers of Themison".
21
335
Now, Galen explicitlysays that the Empiricisthere acceptsacncaaLiowhat he rejects are hiddencauses and hypotheses'bout the
xataQXtLXa:
internalstatesof the body24:thisis confirmedby the followingpassagefrom
Celsus:
On the other hand, those who style themselves "Empiricists"on the grounds of
their adherence to experience, embrace evident causes on the one hand as being
necessary, but they claim that the search for obscure causes and naturalactions is
utterly superfluous, as their nature is not graspable(Med., Pr. 27)
24This underlies the general Empiricistrejection of anatomy:see Galen's On Anatomical Procedures(AA) 11288-9; but as one might expect there was no uniform Empiricist
line on the issue.
25 The examples suggest beyond doubt that Hunain's "salient causes" are atta
7rQoxataQxTLxt.
26 CP survives only in a mediaeval Latin translationdone by Niccolo da Reggio; it is
edited by Kurt Bardong as CMG Supp. II; I have prepared a new critical edition with
English translationand commentary,which will be publishedby Van Gorcum in 1988.
n For Erasistratus'sattack, see CP I 10, 3.18-22 Bardong, and VI 46, 13.8-12 Bardong;
the argument(that if anythingis genuinelya cause it must never fail to exercise its causal
powers) is directly attributedto Erasistratusby Celsus, Med. Pr. 54; for its use by the
Sceptics, see M 9 242-3.
336
1 236-41, it seems improbable that the surname is completely misleading. In fact, the
resolution of this problem seems to me to have importantimplicationsfor the current
debate on the general scope of PyrrhonianScepticism:as to whether, in Barnes' terms,
Pyrrhonianswere sober or drunk, rusticor urbane (3. Barnes, "Ancient Scepticismand
Causation", in M.F. Burnyeat, (ed.) The Skeptical Tradition,Berkeley (1983): for the
debate, see M. Frede, "Des Skeptikers Meinungen", Neue Hefte fiir Geschichte der
Philosophie 15/6, 1979; M.F. Bumyeat "Can the Skeptic Live his Skepticism?" in
Burnyeat, (ed.) op. cit., (1983); and J. Barnes, "The Beliefs of a Pyrrhonist",Proceedings of the CambridgePhilological Society, 28, 1982. Furthermore,Diogenes Laertius's
list of Pyrrhoniansat 9 115-6 contains several Empiricists;and see also Subf.Emp. 4
49.27; 7 65.8; 8 67.2; 9 69.33; 11 82.3; 84.1, 84.1113, 84.31; 1287.23 D, all on Menodotus.
Cassius is described at Subf. Emp. as
ruVQQWVELO;(see
Pr. 69); and general connections of style, if not perhaps of substance, between the
Sceptics and the Empiricistsare assertedat the very outset of Subf Emp. (1 42.12-17 D).
" PH 1 59, 112, 114, 164-5; 2 32-3.
30SI I 75; cf. Nat.Fac. II 52; MM X 142; Subf.Emp. 12, 90.5 D employs the term in a
slightly different context. See also Celsus, Med. Pr. 28:
Non posse vero conprehendipatere ex eorum, qui de his disputarunt,discordia,cum
de ista re neque inter sapientiae professores, neque inter ipsos medicos conveniat.
337
One needs to be carefulhere: the Pyrrhonistsdo not of course say firmlythat there are
no such things as indicative sign-inferences:that would be illegitimate negative dogmatism. But Sextus at least spends more time reviewingthe case for the prosecutionthan
that of the defence.
32 The Stoics carefully distinguished different classes of 6u5i1ka:some things are
(such as whetherthe numbersof starsis odd or even); some
altogether (x6O6t~) d&bXlka
("as the city of Athens is to me now"); and some
are temporarily(ae6g xacDov)&6bqka
are naturally(OoaEL)&6v-ka("the skin containsintelligiblepores"): PH 2 97-8; M 8 14547; at ib. 316-7, Sextus produces a different classification, in which the numberof the
stars is said to be naturallynon-evident. It is not clear what if anything turns on this
Sextan indeterminacy. In the medical texts, similar distinctions are drawn at [Gal.]
Def.Med. XIX 394; and especially [Gal.] Hipp.Alim. XV 303, where the writer dis31
tinguishes atcrLaLn7Qo,6'kot and atiuLaL ov' 7Qo64XoL (on which see further below),
338
339
So the Empiricistdiffersgreatlyfrom the person "qui irrationalemeruditionem pertractat"(Subf.Emp.7 64.12-14D); but he also has no time for
the Dogmatists'talk of naturalconnectionsin things. He will, though, on
this accountuse "redditionescausarum",and a certaintype of demonstration. The sortof thingGalenhas in mindis indicatedin the next few lines:if
a patient visits a doctor with a dislocationaccompaniedby a wound, and
asks for the limb to be reset, the Empiricistdoctor will refuse, on the
groundsthat it has been regularlyobservedthatsuch attemptsunderthese
circumstancesresult in spasm. In assertingthis, Galen's Empiricistcan
avoidmakinganyclaimsabout"assecutiologica",or "naturalis";he relies
solely and simplyon "evidensobservatio"and "memoria".Of course, the
story is complicatedwhen transitionto the similarputs in an appearance;
See Subf.Emp. 5 53.22-25; 6 55.27-56.3, 56.15-19: "utimurautem nominibusmaxime
quidem si possibile fuerit secundumgrecorumconsuetudinem".
40 PH 1 195, 207; cf. M 11 18-19.
41 Cf. CP VI 37, 13.12ff;MM X 43-44, 61, 62, 139; Diff. Puls. VIII 493-7, 567-74, 641-43;
Plen. VII 521; Tum.Pr.Nat. VII 705ff.; Diff.Resp. VII 758-60; Soph. XIV 587.
42 Cf. also ?ps.-Gal. Syn.Puls. IX 458.
43 Cf. Sextus on the aetiologising of the Dogmatists: PH 1 180.
44 Plausibly back-translatedby Deichgraeber as &no66oEtSatr(wv.
39
340
but for all that, the Empiricistcan still claim that he's simply going by
regularities: he has no need of the type of theoretical sub-structure
favouredby the Dogmatists.
All this seems to suggestthe followingpicture.The Empiricists,among
other things, hold these principles:
(1)There is no need to searchfor naturalconnectionsin things;
(2)Observationof regularconjunctionsof event-types (suitablysupplemented by ^otoQia and TO
to 6,otou RLET66aoLc)supplyall we
need in the way of epistemologicaljustification;
(3)Consequentlyit is possible to infer45from the occurrenceof one
evident event to the occurrenceof some furtherevent;
(4)Thereis no point in makingan unnecessaryfussaboutterminology;
(5)It is in order to offer accountsof causes;
(6)The Empiricistmakes use of antecedentcauses;
(7)It is appropriateto adopt a Pyrrhonianattitude to antecedent
causes.
Before we go any further,it shouldbe noted that the phrase"redditiones
causarum"mightmean not that the Empiricistcan supplycausalaccounts,
but ratherthat he can give reasons for why he behaves the way he does
(refusingto reset the dislocatedlimb); and that interpretationis perhaps
lent support by the subsequentcontrastwith the randomprocedureof a
completely irrationalphysician.But even if that is the properway to read
Galen's text here, there is ample evidence elsewhere (collected above) to
supportthe claim that in some sense the Empiricistswere preparedto talk
of causes, or ratherof antecedentcauses.
That set of principleslooks to be fairlystraightforwardly
inconsistent.
How can you adopt a Pyrrhonianattitude to antecedent causes, yet be
preparedto offer causalaccounts,if the only type of causeyou'reprepared
to allow is the antecedent variety? Before attemptingto dissolve that
apparent inconsistency, and show how and why the Empiricistscould
consistentlyand interestinglyhold that set of principles,I wantto consider
brieflya differentpossible accountof the matter, if only to dispose of it.
I have suggested above that Empiricism,particularlyin regardto such
theoreticalmattersas the statusand extensionof transitionto the similar,
underwenta developmentduringthe five hundredyearsor so of its active
life. Indeed, it wouldbe most implausibleif some suchdevelopmentdid not
take place: the Empiricistsare, afterall, committedto the idea of progress,
and the steady accumulationof knowledgeand revisionof previousviews;
4s
341
342
47
343
344
51
S2 aLTLw ne(66Ta:
345
53 That is, that they really are causes of the events in question, ratherthan simply being
regularlycorrelated with them in some way.
54 This formulation has excited some comment: I do not mean anything technically
sophisticatedby it. Ratherthe point is simplythat Empiricistsand Dogmatistsreferto the
same events as "antecedentcauses":but the term "antecedentcause" in the mouthof an
Empiricist has a different sense than the one it would have for a Dogmatist: this is the
point of invoking the Fregean distinction below.
ss E.g. a containing cause (a[TLov ouVEXUx6v), or a preceding cause (a-rLov
n(oiyot5AEvov):for this Stoic (or at least Stoic-influenced)terminologyin medicine, see
Galen's On Containing Causes (another text which survives only in Latin and Arabic
versions), ch. 2, CMG Supp. Or. II, p. 134;and see MichaelFrede'sarticle"The Original
Notion of Cause", in Barneset al. (edd.) Doubt and Dogmatism, Oxford (1980), and my
own "Evidence, Externalityand Antecedence", Phronesis32, 1987.
1%I am gratefulto JonathanBames for suggestingclarificationsto my account, both here
and elsewhere in the text.
346
draw on Frege), have the same (or generally the same) reference for
but they have a radicallydifferentsense.
Empiricistsand Dogmatists57;
5. Empiricismand Scepticism
If this account is correct, then the medical Empiricistturns out to be
he has
remarkablylike the "soberSceptic"discernedbyJonathanBarnes58:
beliefsof a sort, if relativelymodestones, aboutphenomenalmatters;he is
happy to use ordinary terminology for them; and he sides with P(og,
common-sense.His sign-theoryis impeccablyPyrrhonianin its credentials;
and the sense in which he embraces antecedent causes turns out to be
completelycompatiblewith the Pyrrhonianpositionof suspendingjudgement about "all the non-evidentobjects of scientificenquiry"(PH 1 13).
This is not of course enough to show that medical Empiricistswere
thoroughgoingPyrrhonians,even supposingagreementcould be reached
on what it was to be a thoroughgoingPyrrhonianin the firstplace. Sextus's
critiqueof the Empiricists'snegativedogmatismat PH 1 136-41mightstill
go through:there might well have been Empiricistswho did "positively
affirm the inapprehensibilityof the non-evident"(ib. 236), and to that
extent abandonedthe genuine Pyrrhonianpath of doubt in favourof the
harderline of the Academics59.That impressionis strengthenedby the use
the Empiricistsapparentlymake of the Academic criterialnotion of T'o
nLOav6v:SI I 756. But for all that, it makes sense to think of them as
Pyrrhoniansin this regardat least. As regardsthe supposedexistence of
esotericcausalconnectionsin objects, they will replythattheirsciencehas
no use for that sort of thing; and whetheror not they exist is in any case
undeterminable.
If these conclusionsare right, then, the Empiriciststurnout after all to
5VAt least for the good ones, whose therapies and diagnosticsare, accordingto Galen,
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