TWO HIPPOCRATIC TREATISES

ON SIGHT AND ON ANATOMY

STUDIES IN
ANCIENT MEDICINE
EDITED BY
JOHN SCARBOROUGH
PHILIP J. VAN DER EIJK
ANN HANSON
NANCY SIRAISI
VOLUME 33
TWO HIPPOCRATIC TREATISES
ON SIGHT
AND
ON ANATOMY
Edited and Translated
with Introduction and Commentary
BY
ELIZABETH M. CRAIK
LEIDEN

BOSTON
2006
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CONTENTS
Preface and Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
part i. on sight
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
I. Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
II. Transmission and Reception. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
III. Content and Expression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
IV. Place in the Hippocratic Corpus: Provenance and Date. . . . . 15
V. Place in the History of Ophthalmology. . . . . . . . . . . . . . . . . . . . . . . . 19
References and Abbreviations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Conspectus Siglorum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Text and Translation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Commentary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Glossary of Ophthalmological Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Diagrams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
1. The Eye: anterior view. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
2. The Head: lateral view . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
3. Section of the Eyeball . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
part ii. on anatomy
The Hippocratic Treatise On Anatomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
References and Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Text and Translation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Commentary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
I. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
II. Anat. and the HC: content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
III. Anat. and the HC: expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
IV. The Demokritean dimension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
V. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
vi contents
Appendix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Index of Authors and Texts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
General Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
PREFACE AND ACKNOWLEDGEMENTS
The two short texts published here, both transmitted in the Hippo-
cratic Corpus but surely neither by the historical Hippocrates, are very
dierent in nature and origins. On Sight is a sketchy surgical manual
on eye aictions, perhaps originating in North Africa, and On Anatomy
an allusive account of basic human anatomy with evident Demokritean
connections.
I am very grateful to Cambridge University Press for permission to
republish here with slight alterations in presentation my article The
Hippocratic Treatise On Anatomy from Classical Quarterly 48 (1998), 135
167. The original pagination is indicated. An Appendix has been added
to take account of a new Bud text: M.-P. Duminil, Hippocrate: CUF t.
8, Ulc., Oss., Cor, Anat. (Paris, 1998). The background to On Sight is dis-
cussed in my paper The Hippocratic Treatise Peri Opsios in Hippocrates
in Context, edited by P.J. van der Eijk (Leiden, 2005), 191207; I hope
readers will refer to this for amplication.
I need not repeat all the acknowledgements made in note 1 of On
Anatomy, but wish to reiterate thanks to the Wellcome Trust for the
award of a research leave fellowship, which gave temporary relief from
a demanding post at the University of St. Andrews, and facilitated
a change in research direction. After a brief return to St. Andrews,
I took up a post at Kyoto University in 1997. Work on the treatise
On Sight was begun in Kyoto just before retirement in 2002. I have
beneted from the comments of participants at several seminars in
Japan, especially from those of Professor Noburu Notomi, who sup-
ported presentation of the work in its very rst and very last stages at
Kyushu University in spring 2002 and at Keio University in autumn
2005. From September 2003 to September 2005 I held at the Uni-
versity of St. Andrews an Emeritus Research Fellowship, awarded by
the Leverhulme Trust, to complete this book. I am most grateful to
the Trust for their support, which enabled me to spend some time in
London at the Wellcome Trust Centre for the History of Medicine
at UCL and to make brief visits to Cambridge, Oxford, Paris, Flo-
rence, Modena, Rome and Venice to collate manuscripts. I express
viii preface and acknowledgements
thanks to all the hard-working librarians who have given indispens-
able aid.
I am particularly grateful to two scholars who made time to read and
comment on a complete draft: Professor Vivian Nutton and Professor
Philip van der Eijk. Professor Nutton saved me from Galenic error and
Professor van der Eijk suggested that the work might be published in
this series. I owe special thanks also to Dr Thomas Rtten who gave
generous help with the manuscript tradition just when I most needed
it. Professor Heinrich von Staden provided valuable bibliographical
aid. In medical matters, I have been fortunate to be able to call on
colleagues in the Bute Medical School, University of St. Andrews: Mr
Robin Clark read sections of the commentary at various stages and
gave much practical guidance and Dr David Sinclair organized and
led a useful seminar on the anatomy of the eye. Above all, Dr Susan
Whiten has provided essential information at many points and has
very kindly supplied the diagrams, adapted from her book The Flesh
and Bones of Anatomy (forthcoming, Elsevier Press). Mr David Spalton,
a consultant ophthalmic surgeon in London with a special interest in
cataract surgery, communicated his general views of the text.
Finally, I wish to thank Dr John Ball of IT services, University of
St. Andrews, for adroit rescue from several technological impasses, and
to express my gratitude to all at Brill involved in the execution of this
complex task.
part i
ON SIGHT
INTRODUCTION
I. Title
The titles given to Hippocratic works seem in some cases to be based
on later commentators supercial impressions of their content. The
title i in itself gives little idea of the actual content of the
treatise; it was doubtless adopted because the rst words are l
and the word is soon repeated, in 2. Similarly, the treatise now
called Bonesthough it begins with the word or bones and with
an enumeration of the bones in the bodyis really about the vessels,
and was known to Galen as Vessels, attached to Mochlicon (linguarum
Hippocratis explicatio 19. 128 K.). In view of the initial plural, we might
have expected a plural rather than a singular for the title; and indeed
the manuscripts vary in the title given at the end, some having r
u i oi. The term used three times in the workin 1
(plural), 2 (singular) and 8 (singular)can be either abstract or con-
crete in sense. In the former case, it is always singular vision (the
sense in 2 and 8), while in the latter it may be singular or plural, with
reference to the seeing organ, eye(s) or to the central seeing part
of the eye, that is iris with pupil (the sense in 1; cf. Loc. Hom. 13.6
[6.302 L.]; Epid. 4. 30 [5.174 L.]); or perhaps pupil alone, though for
this the word j was available. It can also mean dream, a particular
thing seen (Hdt. 3. 30, 8. 54 etc.). This range of meanings is paral-
leled by 0j, sense of hearing, ear, something heard. The term
is more often abstract than concrete in the Hippocratic Corpus
(as de Arte. 11 [6.20 L.]). Translators and commentators have wrestled
with the sense. Most opt for a title based simply on vision such as, de
visu, de la vision; but the meticulous Foesius preferred de videndi acie,
and this choice of title is ossied in the standard modern abbreviation,
Vid. Ac. It is dicult to nd a single translation acceptable through-
out: vision or sight can serve for both abstract and concrete senses,
but become impossible when a plural is required. The translation Organ
of Sight conveys the full range of meaning, but is somewhat cumber-
4 introduction
some; accordingly, for ease of reference, the title is here rendered simply
On Sight.
1
II. Transmission and Reception
On Sight occupies a mere four pages of Greek in the modern printed
text.
2
The treatise is brief and allusive in content; in addition, the
text is seriously corrupt. In part, the pervasive corruption lies in the
technical nature of the work, which deals with procedures naturally
unfamiliar to scribes, as indeed to scholars. In part, it lies simply in
visual or aural error on the part of scribes, liable to make mistakes
when faced with dicult and unfamiliar material, and liable to treat
such a short piece as relatively unworthy of attention. Sichel laments
the tat de mutilation tel quil est impossible de reconstituer un texte
irrprochable; Ermerins nds both the corrupt state of the text and
its technical content such obstacles to comprehension that he declines
to translate large parts of it; Joly concurs that les problmes ne
comportent pas de solution tranche.
3
A further problem is that, while there is no shortage of mss contain-
ing the work, the tradition is uniform and so uniformly corrupt.
4
The
extant tradition depends entirely, directly or indirectly, on the tenth
century ms M (Marcianus 269). In the absence of evidence from the
separate strand of the tradition represented by V (Vaticanus gr. 276,
twelfth century) and mss descended from V such as C, much used by
Littr (Parisinus gr. 2146), the deep-seated corruption in the text with
its single medieval source is intractable. We may contrast the tradi-
tion of, for instance, Epidemics 7.
5
Sichel knew readings of M through
information from Daremberg, but did not recognise Ms early date, pri-
ority and relative importance. Similarly Ermerins knew M only indi-
rectly, through readings communicated by Cobet. Sichel collated and
recorded the readings of the recentiores, especially the Parisian recentiores,
with great thoroughness. Ermerins supplemented Sichels critical appa-
1
See Craik, 2005; cf. Montfort, 2003, 4650.
2
Sichel ap. Littr 9, 152161 (1861); Ermerins 3, 279283 (1864); Joly, CUF 13, 168
171 (1978).
3
Sichel 152; Ermerins Praefatio XLXLI; Joly 163.
4
See Diels, 1905 and 1907.
5
But see Jouanna, 2000, 9597 on closeness of M and V.
introduction 5
ratus with information from one further ms in the Netherlands. Joly
collated M and relied on Sichel for the rest.
For this edition, I have seen almost all mss (see conspectus siglorum).
Several minor mistakes in Jolys representation of the text of M have
been corrected (i 1.2; , 2.1; article j to be included, 3.3; article
j to be omitted, 7; you to be omitted, 9.2; 0 but to be
omitted, 9.3).
6
Such variations as preference in M for uncontracted
verbal forms, for i rather than i and for o rather
than o are not recorded in the critical apparatus. On checking
Sichels apparatus for the recentiores, I nd many instances where the
punctuation is wrongly recorded. This is unsurprising, as versions of
the punctuation vary greatly (especially in relation to headings or quasi
introductory material) and are frequently awry, betraying a complete
lack of comprehension on the part of scribes: there is a tendency to
reduce the text to staccato bursts of short clauses, or apparent semantic
units, which are devoid of overall syntactic sense. I have not thought
it worthwhile to record these dierent versions, which have no interest
except as a means of suggesting links among the recentiores. Scrutiny of
the mss merely reinforces the impression of careless transmission. It
is remarkable that several obvious errors in M go almost universally
uncorrected: 0, 1.1; 0j, 1.2; i_ , 4.1.
There is an almost total lack of marginalia (even in mss where these
abound for other works) and such glosses as do exist are banal in
the extreme (in G, u glossed r, 3.2). There is, however, a
general regard for marking new topics: a red initial letter or a small
space precedes a separation into chapters similar to that adumbrated
in notes by Cornarius, then pioneered in his text by van der Linden,
rened by Iugler and followed in modern editions. M has a sizeable
space only before 7 init. but has slight spaces before each of the repeated
r then conjunctions in 3.1; while there is not complete unanimity
in the recentiores over the existence or placing of these sense divisions
there is most general agreement over the start of our chapters 7, 8 and
9 R, however, has spacing before 4, 7 and 8 and Laur. only before 6
and 8.
In M, f. 212 starts with the words o o0 3.3 and ends with
the words ri r, 7.1. At both points, where scribal inattention is
explicable, the text is particularly problematical and can be understood
6
Cf. Anastassiou, 1980.
6 introduction
only with substantial extension and emendation. In defence of the
scribe of Mgenerally known to be faithful and reliableit may be
added that many readings emended by editors are perfectly acceptable
in the context of the rough and elliptical Greek of this work. (See on 1.1,
2.1, 4.1 etc.) Although the precise nature of the relation of the later mss
to M and to one another is much debated and there is no agreement on
details of classication, the general lines of aliation are clear. The mss
H and I are both close to M, either through faithful copying oras has
been suggestedbecause they share a common (lost) source; they are
in turn the basis of the later tradition. The consensus view that I had
a great inuence on the later traditionfor instance being source of F,
source in turn of G, source in turn of Zis corroborated in the case of
this work. That dierent sources can be seen in R is clear also: R agrees
more often with H (and is familiar with the second hand in H) but, at
the same time, shares several readings with I. There is no evidence
from this treatise that R had access to signicant material extraneous to
the tradition of MHI. Detail in the critical apparatus is conned to the
readings of M, H, I, R.
7
(See further on o0, 1.1; iu, 3.3; ,
6.1; i o0, 9.1; o, 9.1; 0 o r, 9.2.)
In the nal analysis, precise textual study is of no help whatsoever in
retrieving the original lost text of this work. As elsewhere, it may be sus-
pected that scribes were more concerned with general delity to con-
tent than with an exact record. In this edition and commentary, clues
to the source and nature of corruption are sought in other Hippocratic
works, and in parallel passages of Celsus and Galen. This is, of course,
a hazardous enterprise. It must be stressed that, where emendations are
suggested on this basis, they lay no claim to verbatim restitution of the
lost original; rather to recovery of the lost gist expressed in wording
which is possible and plausible. The only justication is that manifest
nonsense is here converted to patent sense tting its context.
Earlier editors and translators made distinctive contributions, in line
with their work on other Hippocratic treatises. Both Calvus and Cor-
narius, generally conservative and literal, used translation as a means
of explication and interpretation. Calvus, using the ms W at Rome
in 1512, made the obvious correction of i_ to i_, 4.1 and
recorded the variant, or intelligent conjecture, u for i, 4.2;
see also on the signicance of the translation scapulares scapulars, 3.1.
7
On M, see esp. Jouanna, 2000; on H, esp. Duminil, 1998, 28.
introduction 7
Cornarius annotations, comprising both observations and corrections
made in his personal copy of the Aldine text of 1526, survive, as was
realised by Sichel, who checked and recorded his notes in the copy
at Gttingen; from this it is possible to see the use Cornarius made
of further ms sources (as r0o for r0i, 3.4).
8
Foesius, thanks to
an inuential patron, had access to three mss held in the royal library
at Fontainebleau where they were transferred in 1544 and catalogued in
1550; he had also seen the Vatican ms now known as R.
9
Foesius printed
a text in line with the current vulgate, but permitted himself deviations
from this in translation and comment; see on 4 and 7. Van der Linden
followed Foesius but not slavishly; he was familiar with Ermerins ms
Q. The philological value of these early printed texts lies primarily in
the access of scholars then to a wider range of manuscript sources than
we now possess (see app. crit.). In practice, however, the sources they
cite add little to our knowledge and do not mitigate our dependence
on M. The medical value of these early printed texts is considerable,
especially for such surgical works as On Sight. All contributors were
practising doctors who had personal experience of bloodletting and
cuppingand of such activities before Harveys work of 1628 changed
our perception of the blood vessels and their course in the body; see
especially on 3.1.
It has commonly been asserted that there is no ancient reference to
On Sight, which would authenticate its place in the Hippocratic Corpus
of antiquity.
10
This negative view has now been contested with regard
to the Galenic gloss 0, relevant to 4.1.
11
To this can certainly be
added Erotians gloss i, relevant to 6 and possibly also 0_ u rele-
vant to 4.1. Both fall in the appropriate position in Erotians list: in the
third category, Therapeutics, placed with the lost work On Wounds and
Missiles, between Head Wounds preceding and Fractures with Articulations
following; see also for r 2 and 5, for o, 3.4, and for
6.1. That many words glossed by Galen are present in the treatise con-
rms that the vocabulary has a Hippocratic, if at times recondite, char-
acter (see on 2, 4, 6, 7 and 9). Hesychios too contains much of relevance
to the work (see on 2, 3 and 4).
8
See now the thorough treatment of Montfort, 2003.
9
Foesius, preface lectori candido; Omont, 1888.
10
Joly 163; Nachmanson, 1917, XIX.
11
Anastassiou and Irmer, 1997.
8 introduction
III. Content and Expression
Short workswe may compare the still shorter On Anatomy and the
somewhat longer Dentitionare peculiarly dicult to interpret, and
to place in the wider context of the Hippocratic Corpus and other
writings. To argue that dierent works of the Corpus belong together, a
conjunction of similar content and similar language is required. Many
associations in content can be explained simply by access to a common
pool of knowledge, from which items might be taken and reworked.
Unless it is unusually esoteric, or there is a high concentration of
coincident elements, content is not a reliable indicator. Language may
be somewhat more reliable, though here too caution in interpretation
is imperative. Where such elements as vocabulary, or grammatical and
syntactical features, or use and frequency of particles and pronouns are
sharedespecially where these are distinctive or non-standardthey
may be pointers to a common tradition.
On Sight is a manual of surgery, giving instructions for surgical proce-
dures to be followed and, to a lesser extent, for drugs to be applied
in dierent ocular aections or diseases or, rather, to treat dierent
sets of ocular symptoms. Retrospective diagnosis of Hippocratic cases is
always hazardous, but here the conditions can be more or less plausibly
identied as follows: cataract (1), weeping sores and their complication
ectropion (2), trachoma and its eects (4), papilloma or chalazion (5),
night vision (7), recurrent seasonal allergy or conjunctivitis (9). The
procedures are: cautery of the vessels (1.1, 2; 3) or of the eyelid (4), cut-
ting and/or scraping of the eyelid (5), letting blood by phlebotomy or
cupping (3; 7; 9), cutting the scalp (4.2), trephination of the skull (8),
purging the head and/or the body generally (1.1, 2; 4; 7; 9), applying
ointments and poultices (6; 9). All these procedures, some gentle and
others drastic, are boldly indicated, but care and caution are likewise
enjoined.
The rst requirement of a surgeon is a secure knowledge of the
anatomy of the parts on which he operates. We might expect this
knowledge to be expressed in technical language. However, our author
displays no awareness of the complexity of the eyes anatomy. Few
technical terms are used, apart from the repeated already noted.
No word, apart from , is used for pupil, iris or cornea and there is
no reference to the nature or number of membranes (coats or
tunics) of the eye; this contrasts with reference to three membranes in
introduction 9
Places in Man.
12
There is frequent reference to the r eyelid (2;
4.1; 5 bis; 6 bis), but no word except 0i hair for eyelash (5). The
rather vague o circle, ring is used for the eyeball and the
rather general cartilage or o esh for the inside of the
eyelid (4.1). The author operates not only on the eyelids but also on
the head more generally, and here his knowledge seems more extensive,
though it is still not technical in expression. He cuts into the r
bregma or the vertex in two dierent procedures, either in order to
release blood, or in order to gain access to the skull for trephination
(4.2; 8). Apart from bregma, no anatomical terms are used for parts of
the head. The skull is simply or the bone (3.1, 2, 4; 8). The r
vessels are important to his practices (1.1; 3.1, 3 ter; 9. 1), but there is
only one indication of particular vessels and their location, and that is
unclear (3.1).
Despite the disconcerting absence of anatomical nomenclature, our
doctor was evidently familiar with the general anatomy of the head,
knowing where to cut and how to trephine: he would know exactly
where the bone of the skull was thickest and exactly where the esh of
the scalp was thinnest, and be able to trace the location of the sutures
and of the inion, occipital protuberance; he would have some idea of
the course of the main blood vessels. Even in Head Wounds, rather vague
terms are used for regions of the head: j top or vertex is not a
well-dened anatomical term, and the words for forehead, and brows
are somewhat vague also.
13
Use of the term 0 behind to indicate
posterior orientation in the body seems to show a nascent striving for
precision (3.1 bis; cf. 0, 1. 2, and r0, 2). The paucity of
anatomical terminology may indicate simply that the surgeon was not
concerned, or not here concerned, with names for bodily parts; it need
not suggest ignorance of these, far less inability to operate safely and
eectively.
The authors pathology, like his anatomy, is almost devoid of techni-
cal terminology and the lack of nosological specication is striking. The
rather crude term 0i0 be destroyed describes loss of sight
(1.1; 8). The only abstract noun for a disease is ophthalmia (9), in gen-
eral usage applied indiscriminately to eye trouble; to this we may add a
case designation suerer from night blindness (7). The absence of such
terms for sight impairment as 0u (appropriate to 1) and 0-
12
See Craik, 1998, 105.
13
Cf. Hanson, 1999, 99.
10 introduction
(appropriate to 8) common even in non-medical authors, and the
absence of any reference to treatment of eye injuries, is remarkable. In
this practical work, prognosis is more important than diagnosis. Diag-
nosis is by appearance (1) or by the patients report of discomfort (6)
or of loss of vision (8). In practice, the physician considers two broad
categories: problems where the eye, but not the eyesight, is aected (2)
and problems where the eyesight, but not apparently the eye, is aected
(8); he dierentiates between sudden and gradual loss of sight (1) and
between child and adult patients (2). The writer seems familiar with
a wide range of problems, even if he does not apply names to them.
This may be a merit: in practice, many eye conditions display similar
symptoms, or take many forms; for example, conjunctivitisperhaps
the most common of all eye diseasesmay be classied as catarrhal,
purulent etc; and trachoma has many complications, including trichi-
asis and entropion. If the author has any knowledge of terms for the
diseases here described, he does not display it. We cannot assume that
names were unknown or unavailable; it may be simply that the author
is not concerned with nomenclature and that the modern quest for
nomenclature and denitions is bound to be of limited success.
The author is no more concerned to expound his views on physi-
ology than on anatomy and pathology. However, it is evident from his
practicespurging the head and body, cauterising the vesselsthat he
subscribes to this common theory: that ux of peccant matter (usually
viewed as phlegm) from the head is the major cause of disease in gen-
eral, and that such matter concentrated at the eyes is the cause of the
most common eye disorders. It is evident too that he subscribes to a
renement of this, postulating two dierent types of ux from two dif-
ferent parts of the head to two dierent locations in the body (here,
two dierent regions of the eye): supercial upper ux, from the area
above the skull, or the scalp, and deep lower ux, from the area under
the skull, or the brain. The uids mentioned, apart from blood, are
moisture (removed on trephination, 8) and ichor uid
with a watery or bloody appearance (4.1). There is some awareness of
pulsation in the vessels (3). It is apparent that the author believes that
an excess of matter in the head ows down through the vessels, and
that this noxious ux can be arrested by cautery or venesection. This
was the desired eect. As to the actual eect, it must be supposed that
he cured some of the people at least some of the time, as his practice
would depend on his establishing a reputation and securing the respect
of physicians and the trust of patients.
introduction 11
The text, then, is not about anatomy, physiology or pathology, but
about surgery and therapy with especial emphasis on cautery. Cautery
was commonly used to arrest haemorrhage, to burn o excess tissues,
to lance abscesses and, as in On Sight, to eliminate noxious bodily mois-
ture. It would have the additional unappreciated benet of combating
infection. Cautery, like cupping, might be dry (a less invasive treatment
involving no break in the skin and no bleeding) or wet. In dry cautery,
the instrument is used simply to apply gentle warmth to the body, com-
monly but not always to the blood vessels. Even when the instrument
is used to address the vessels, it may just be placed alongside (-
burn beside, 3.3) apparently with a view to changing the consis-
tency or the movement of their contents. Alternatively, in wet cautery,
the instrument is placed across them ( burn over, 3.3 quater;
cf. treatment of the eyelids, 4.1) apparently with the intent of actually
breaking the wall of the vesselsurely vein, not arteryor even sever-
ing it. In both wet and dry procedures, sponges might inserted between
the surgeons instrument and the patients skin ( burn in
and down), possibly in an attempt to mitigate the pain, to control the
severity of the heat, or to mop up blood (but see further on 3.2). Simi-
larly, in dry cupping, the cupping instrument is applied to the surface of
the skin and left there, with the aim of drawing out noxious stu from
the unbroken skin by suction, while in wet cupping the skin is broken
or scaried in order to remove blood or noxious matter from a vessel
or elsewhere. Thus, the verb , lit. burn, med. cauterise does not
necessarily or always involve extreme heat, far less branding and scar-
ring; it is simply heat, using a cauterising instrument. The practices of
cutting and cautery are often allied, as alternative or successive ways to
address a problem: to drain or burn out an excess of uid, reducing it
by incision or by application of heat; to stop ow by creating a barrier.
Celsus too viewed these as alternative ways to eliminate noxious matter
from the vessels.
Many elements in the doctors pharmacopoea are everyday items
from the domestic store cupboard, such as olive oil (3.3), garlic (7) and
honey, applied (3.2) or ingested (7). Sponges and ne wool are also
part of his stock-in-trade (3, 4.1). In preparation, an ointment must
be in consistency like myssotos, a culinary paste (6); the simile conveys
a homely atmosphere. Similarly, the verb used of thoroughly heated
cauterising instruments well-roasted (3.2) is one with a regular culinary
nuance. It may be that the doctor simply requisitioned items, such as
sponges, from the patients kitchen. Such improvisation is commended
12 introduction
in Articulations (Artic. 7 [4.86 L.]). However, there is evidence too of
specialist supplies. The most commonly named specic is a derivative of
copper, evidently copper sulphate, perennially favoured to treat certain
ulcerative eye conditions, such as trachoma: ower of
copper (4.1, 6; slightly dierent terminology in 5). A second ingredient
in an eye salve, specied without indication of quantities or proportions,
is unripe grape juice. This is a seasonal item but there may have
been procedures (?ancillary to wine manufacture), to preserve it for use
throughout the year (6). Arum root, used in cautery, would be more
readily stored (3.2).
The preparation of an eye ointment detailed (6) demands a grind-
stone (or perhaps rather a pestle and mortar), a strainer, and a special
container of red copper. The couch where the patient is positioned in
preparation for surgery (3.1) would ideally be one regularly used by the
doctor performing the operation and appropriately positioned, height
and light source being important considerations, but might be rather a
piece of ordinary household furniture which came to hand. Cupping
vessels are explicitly mentioned once (9.1) and required by implication
elsewhere (7); scalpels would be required in order to let blood (3.1, 9.1)
and to cut into the scalp (4.2, 8), and a sawing instrument would be
needed for trephination (8). A scraping instrument or rasp, or material
of some unspecied sort is needed to scrape the lids (2; 4. 1, 2) and
another special blade is needed to thin them (4.2). Finally, dierent
instruments for cautery either of metal (3.1) or of wood (4.1) are used;
these are sometimes required to be delicate (not thick, 1). A means of
heating these would also be required. The absence of technical terms
for instruments is as marked as the absence of anatomical and other
medical terminology noted above. The eye surgery seen in Paul of Aig-
ina is described in very dierent terms, with such dedicated instruments
as a raspatory to treat the eyelids and
knife to excise a pterygium and many others (Paul 3. 23, 6. 15 etc.)
The drugs to be used for the most routine treatments are not speci-
ed: it is taken for granted that the doctor will know how to purge the
head by nasal insertions and the body by laxatives (1.1, 2; 4. 2; 7; 9.1);
exceptionally, elaterion lit. driver is once indicated for drastic purging
(7). It is assumed too that he will know which applications will have a
particular eect, such as astringent (, 9.2), and what drug will
be eective to stop a ow of blood (, 4.2). When poultices are
indicated, their composition is left to the doctors discretion (9). The
shorthand give the further treatment, i.e. continue to treat as appro-
introduction 13
priate (iu o o, 5) presupposes practical experience. There
is some evidence of observation, though this is somewhat subjective
in character (comments on dierent colours of the seeing part of the
eye, 1); the doctor sets store by signs (change in nature of discharge,
4.1). There is some evidence also of careful interrogation of the patient
(comments on whether the onset of the aection has been sudden or
gradual, and with or without apparent cause, 1); the patients report
of symptoms may condition the choice of treatment deemed appropri-
ate (presence or absence of pain, that is of headache, 9). Some store is
laid on seasonal factors (in ophthalmia, 9). The patients diet may be
restricted and his environment monitored (in ophthalmia, 9).
The instructions given are often expressed in a peremptory and
authoritative fashion. The doctor treats (t, 2; also ij0, 8 and
i, 1.1, iu, 5) and the patient is on the receiving end of treat-
ment (o, 1.1, 3.3). Instructions are condent, often expressed in
terms of what should be done (j one should 1.1; 3.3 bis; 4.1, 2;
8). The clinical approach throughout is pragmatic. It is important to
recognise cases where treatment would be useless (0 0 ui -
r 0r you could not help by any action at all, 2). The doctors
concern is with what will or will not work; hence repetition of the verb
r it is benecial (1.2 bis; 9.1 bis, 2 quarter, 3 bis). There is much
room for discretion: letting blood helps in some cases of ophthalmia
(9.1) and poultices are helpful in certain specied circumstances (9.2).
Although the doctor must act decisively (iu strongly in cautery,
3.3; u o as much as possible in pressure for cupping, 7) he
must also act with due care and caution (0u u o0u o
considering the actual eyes, 2; jij 0i heat gently, 3.1;
j o o 0r u the esh as much as you can,
very gently, 5.1; with care, 4; 5.1). He must recognise
the signs which indicate that it is time to stop scraping the lids (4.1),
and know what follow-up procedures are appropriate (4.2). Long-term
treatment seems to be envisaged; thus the processes of vascular healing
after cautery and of lid repair and regrowth after scraping seem to be
monitored (3; 4. 2).
Where injunctions are given for procedures to be followed, the ad-
dress is sometimes direct, in the second person: you could not aid,
when you cauterise, when you scrape, you should pour (2; 3.3;
4.1; 6); jussive innitives with nominative participles are particularly
common (2; 3.1 and 2 repeatedly; 4; 5; 6; 7). A favoured syntactical
structure is a chain of loosely linked participles, indicating successive
14 introduction
steps in treatment or preparations for treatment, used in conjunction
with jussive innitives. There is much use of the adverb then to
indicate clearly successive stages in procedures to be followed. Verbal
expressions it is benecial and it is expedient are much used also
( and discussed above; cf. 4. 2). Jussive subjunctives
too are used: once of the practitioner (6), once of an aide (3.1) and once
of the patient (7.1).
The work begins abruptly, with asyndeton, and the use of
such (sc. such as before) indicates loss of context. The end is simi-
larly abrupt and the editorial thesis of Joly and others that the text is a
mere disjointed fragment is plausible. The extreme brevity of the sur-
viving text and the fact that it considers relatively few eye diseases add
to the impression that we are dealing with a lacunose piece, possibly an
excerpt from, or partial summary of, a much larger work. The extent
and nature of textual corruption is consonant with this possibility: there
are lacunae even in the text as transmitted (especially in 3, 7 and 9, but
probably not between 2 and 3, pace Sichel and others). Although the
sporadic use of headings or quasi-introductory phrases (the basis of the
modern division into chapters) may be vestigial evidence of a degree
of organisation, some major transitions in thought are unmarked (3
init.). Within several chapters the content is uneven, surgical instruc-
tions sitting incongruously alongside general comments and advice: the
presence of such disparate material is particularly marked in 3 and 9.
Overall, the work is a series of disconnected jottings, elliptical, allusive,
and telegraphic in expression.
The syntax is primitive and inelegant. Paratactic sentence structures
predominate. Subordinate clauses, where used, are not well integrated
but appended in a loose agglomeration (2). There is a marked tendency
to careless or otiose repetition, especially repetition of the demonstra-
tive pronoun (1, 6, 9), and there may be a trace of Doric idiom (neuter
plural noun with verb in plural, 3.4). These features are typical of early
Greek prose writing. In addition, the grammatical forms are rough,
functional and unidiomatic to the point of solecism, with particular
oddities in the use of prepositions.
14
The vocabulary is functional. How-
ever one salient feature is a tendency to employ compound verbs. In
some instances, these are semantically signicant, conveying precise
surgical nuances ( and discussed above); in others
14
See Craik, 2005, 204205.
introduction 15
the compound is used where the simple verb would suce (,
, , , ).
The content, with its stress on practical instruction and disregard of
matters not germane to that immediate concern, suggests a target audi-
ence of trainee physicians. The form, with its strongly didactic tone,
in conjunction with loosely juxtaposed clauses and truncated elliptical
expression, suggests the format of notes intended to accompany a set of
lectures or demonstrations. While such notes may be made and kept by
pupils as well as teachers, our treatise seems to mirror the attitudes of
one giving, not receiving, instruction: the magisterial, authoritative and
abrupt expression seems to be directed at a learner, receiving instruc-
tion from an experienced practitioner. Surgery above all must be taught
by demonstration and participation; the work we have may have origi-
nated as a relatively unimportant adjunct to the manual business.
IV. Place in the Hippocratic Corpus; Provenance and Date
Much medical writing is essentially derivative and repetitive in char-
acter. Even modern textbooks can be shown to parrot one another,
especially where factual material is presented. In antiquity, where it was
impossible to establish prior claim by denitive publication, where the
notion of plagiarism was lacking, and where medical scientists worked
in collaborative or combative groups, such repetition is inevitable. It
may be said that all the Hippocratic works are mixed and derivative
to some degree, and that few, if any, are original in an accepted lit-
erary sense: the words redactor rather than author and compile
rather than compose are appropriate. The integrity of the Hippocratic
canon has been increasingly questioned, to a point where it has been
suggested that the very concept of a Corpus is awed:
15
while individ-
ual Hippocratic writings have much in common and can be regarded
as groups or clusters, it is possible to parallel much of the content of the
Hippocratic Corpus in fragments of many medical authors, including
those whose views are summarised in the papyrus known as Anonymus
Londinensis, and in fragments of the Presocratics, as well as in the Aris-
totelian Corpus. (For Vid. Ac. and the Aristotelian Problemata, see espe-
cially on 1, 2 and 9.) It remains likely that there was direct interaction
15
See Nutton, 2004, 6166; van der Eijk, forthcoming.
16 introduction
between some of the authors represented in the Hippocratic Corpus
and the quest for anities remains meaningful.
It is immediately evident that there are general similarities in On
Sight with the practices and so with the expression and vocabulary of
such surgical works as Articulations and Sores, also with the surgical pro-
cedures in the gynaecological and nosological treatisesthough none
of these works is so uncompromisingly surgical in content or so aggres-
sively peremptory in expression as On Sight. Unsurprisingly, there are
particular resemblances with works featuring cautery; for instance, the
term for a cauterising instrument occurs only in On Sight and
in Internal Aections.
The extreme brevity and rugged idiom of On Sight compound the
diculties of making such comparisons. However, there is no doubt
that in both content (on eye ux and on cautery) and expression (style,
syntax and grammar) On Sight particularly resembles Places in Man. The
author of Places in Man seems to have a particular interest in the eye:
dierent kinds of ocular ux are classied at length and treatments are
specied: eye salves (13.1, 2 [6.298, 300 L.]); purging the body by ene-
mas and laxatives (13.1, 4 [6.298, 300 L.]); purging the head by errhines
(13.2, 4 [6.300 L.]); cautery of the vessels in the temples (13.7 [6.302 L.]);
and, in an extreme case, making incisions in the scalp to the bone (13.5
[6.300 L.]). Similarly, in On Sight, according to type of symptoms, the
treatments are: eye salves (6; 9.2, 3); purging the body (7.1; 9.1); purging
the head (1.1, 2; 7.1; 9.1); cautery of the vessels (1.1, 2; 3.14) and incis-
ing the scalp (4.2; 8). There is also cautery almost up to the bone of
the skull (3.12). In both works too, trephining is practised, as is vene-
section or cupping. Treatment of the eyelids as prescribed in On Sight
is by similar methods; that is, by surgical cutting and burning, and by
ointments or lotions. In both works, detailed instructions are given as
to how cautery of the vessels should be performed. These instructions
are given in similar terminology and with a similar emphasis in content
(Loc. Hom. 40 [6.330 L.]; Vid. Ac. 3).
The theory of ux from the head, underlying the therapy advocated
for eye conditions, is explicitly presented in Places in Man and implicitly
present in On Sight (especially in 9, in language similar to that of Glands,
a treatise close in details of its theoretical stance to Places in Man). The
same theory can be seen, in dierent guises, in other works which are
concerned with symptoms and therapy of diseases stemming from the
head, notably in Diseases 2, Internal Aections and Aections, and notably
where cautery is the preferred practice. In both Places in Man and
introduction 17
Glands: it is the marrow which carries noxious ux to lower parts of
the body (Gland. 11, 14 [8.564, 570 L.]). Similarly, in Koan Prognoses, a
list of diseases not found before puberty includes
ux in the back (Coac. 5. 502 [5.700 L.]) and in Internal Aections, two
types of phthisis are related to abnormal functioning of the marrow: in
one, the marrow becomes lled with blood (or the hollow vessels lled
with bile and phlegm) and in the other, the marrow becomes dry, with
blockage in the small vessels from the brainhere, cautery of the neck
is prescribed (Int. 12, 13 [7.192, 200 L.]; cf. Loc. Hom. 21 [6.312 L.]).
There is a further nexus of associations with treatises which detail
ingredients and preparation of recipe cures, Aections, Regimen in Acute
Diseases, Diseases of Women 1; Aections is unusual in referring to a work
on drugs sometimes called pharmakitis (A. 15, 23, 28, 40 [6.224, 234,
240, 250 L.]) sometimes ta pharmaka (A. 4, 18, 29 [6.212, 228, 240 L.]).
(It is usually supposed that a particular treatise is intended. However,
the dierent modes of allusion seem to suggest a uid body of mate-
rial; and as in Greek idiom the denite article is frequently used in
place of a possessive pronoun, it may be that the meaning is your
rather than therecipe book, the reader being enjoined to refer to his
les on drugs.) There are marked anities also with Prorrhetic 2 (1820
[9.44, 46, 48 L.], theoretical prognosis for eye conditions) and with cer-
tain passages of Epidemics (practical treatment of eye conditions). Other
passing or incidental similarities can be identied: belief in the impor-
tance of the seasons in the aetiology of disease, pervasively evident in
Airs, Waters and Places and seen intermittently in Epidemics and Aphorisms
features in the treatment of ophthalmia at the end of On Sight. The
procedures of the treatise can be paralleled in various works: Hippo-
cratic surgeons cut dierent parts of the head for dierent supposed
conditions, with dierent purposes, in dierent ways and with dierent
follow-up procedures. The main expedients are, briey: a single cut in
order to saw or pierce the bone, usually treatment for skull fracture but
also to release unwanted moisture; a single cut, usually in the forehead
or the bregma to release excessive or noxious matter; multiple cuts in
the scalp, to release excessive or noxious matter. The recommendations
in Physician that if only one cut is required, incision should be swift;
while if several are required, incision should be slow indicate a general
interest in such surgery (Medic. 5 [9.212 L.]).
The author of Aections, while discussing head diseases, states his
intention to write separately on diseases of the eye (A. 5 [6.214 L.]);
he further, while treating diseases of the belly, states his intention to
18 introduction
write on cases of suppuration, of phthisis and of gynaecological ail-
ments (A. 33 [6.244 L.]). Inevitably, there has been speculation on
common authorship, and inevitably On Sight is a contender for the work
supposedly projected on the eye.
16
The range of works proposed by
the author of Aections resembles the range proposed by the author of
Articulations, and the question of interrelated authorship between major
and minor works resembles that between Articulations and Glands. It is
very likely that Hippocratic authors, who had to be versatile in their
clinical practice, chose to be versatile in their written output also. But
establishing common authorshipas opposed simply to common inu-
ence and interactionis an elusive and perhaps ultimately impossible
goal. Although On Sight has some common content with Aections, com-
mon expression suggests rather a grouping with Places in Man, Glands,
Fractures, Articulations, parts of Epidemics and some of the gynaecological
works. The abrupt manner is reminiscent of the aphoristic works, espe-
cially of the unpolished Koan Prognoses and there are some similarities in
vocabulary also with this collection.
17
The treatise is dated to the end of the fth or beginning of the fourth
century by Joly, on the basis of its supposed Knidian content, espe-
cially the stress on cautery, traditionally associated with the name of
Euryphon and regarded as a Knidian practice; but cautery may more
properly be regarded as an ancient practice, persisting in pockets every-
where.
18
It has been argued, on the basis of language, that Places in
Man is an early work, originating in Italy or in Sicily.
19
In view of the
similarities noted, it may be suggested that On Sight has a similar date
and provenance. It may then be conjectured that the author had al-
iations with the west Greek thinkers Alkmaion of Kroton and Empe-
dokles of Akragas, both known to have taken a particular interest in
the eye. However, although thinkers with an interest in the workings of
the eye and doctors with an interest in diseases of the eye might well
have found their activities complementary, the severely practical tone
of On Sight militates against direct comparison with these highly theo-
retical and philosophical writers. Although Alkmaion was said to have
dissected the eye, it is unlikely that this bears any relation to the activi-
16
See Rodriguez Alfageme, 1993 on use of particles in A. and Vid. Ac.; also Craik,
2005.
17
See Craik, 2002, 288, n. 3; also 2005.
18
Joly 164; Thivel, 1981, 281282.
19
Craik, 1998, esp. 22, 2829, 33.
introduction 19
ties of our doctor: even if true, the dissection was doubtless of an animal
(just as Demokritos from Thracian Abdera was said to have dissected
animals, cutting into the bregma, with an interest in sense perception).
20
Another possible source for the work is north Africa: there is good
fth century evidence that Egypt produced the best ophthalmologists;
papyri conrm an earlier specialist interest in ophthalmology; Libyan
Kyrene was a prominent medical centre. Trachoma, a disease given
much attention in On Sight, has a peculiar association with Egypt. If the
piece is based on the work of someone whose rst language was not
Greek and who was not entirely at home with the idiom, the vagaries
in expression are more explicable.
21
V. Place in the History of Ophthalmology
Modern works, aimed to assist the hard-pressed family doctor in diag-
nosis of ocular problems, suggest that the rst distinction should be
between gradual and sudden loss of sight, and that each of these sub-
divisions should then be classied further on an anatomical basis, work-
ing posteriorly from cornea to retina to choroid and optic nerves. And
in ophthalmic pathology, topics are generally grouped together with
reference to the part aected. Unable to examine the inside of the eye
and unaware of its full complexity, the ancient practitioner uses a more
crude yardstick, and thinks primarily in terms of ocular ux.
In the development of ophthalmology in antiquity, increasing ana-
tomical knowledge is evident and well documented.
22
In the Hellenis-
tic period great advances were made by Herophilos and Erasistratos:
Herophilos had a particular interest in vision and the connections
between eye and brain; also in the structure of the eye, where he dis-
tinguished four membranes.
23
But still, the theory of ux and therapy
based on it continued to survive and pervade ancient ophthalmology
centuries later. Both Galen and Celsus, despite awareness of the huge
advances in ocular anatomy and physiology initiated by Herophilos and
developed by Demosthenes Philalethes, and despite practical advances
in surgical techniques, subscribe to the same general scheme of beliefs
20
Lloyd, 1975.
21
For detailed argument, see Craik, 2005.
22
For general discussion, see Hirschberg, 1899 and Magnus, 1901.
23
See von Staden, 1989, 570576.
20 introduction
as their Hippocratic predecessors. (A rare attempt to classify eye trou-
bles with reference to the parts aected survives in the pseudo-Galenic
introductio seu medicus 14. 767777 K.; in this classicationthough not
in discussion of theory or description of treatmentthe anatomical
advances of the great Alexandrians are apparent.)
Already Alkmaion put forward theories of sense perception based on
the concept of ducts leading from brain to eye (DK 24 A 5 = Thphr. de
sens. 25) and similar concepts of psychophysiology can be seen not only
in the Hippocratic Corpus (Loc. Hom. 1.3, 2.2 [6.276, 280 L.]; Carn. 17
[8.604 L.]), but also in the works of Aristotle (GA B 6. 744a8 and else-
where).
24
Both the supposed route and the postulated function of these
ducts were variously understood. Certainly there was progress towards
understanding of the location and importance of the optic nerve, and
certainly it came to be envisaged that pneuma breath was conveyed
from brain to eye (as already supposed, Morb. Sacr. 7 [6.374 L.]). But the
theory of ducts or channels from the head has a much wider and
simpler, more material, signicance. The related theories of physiol-
ogy, that optical wellbeing depended on the proper functioning of the
ducts, which conveyed pure moisture to the healthy eye, and pathol-
ogy, that the sight was aected if the ducts became blocked or ooded
or conveyed peccant moisture to the diseased eye, can be seen perva-
sively in Greek medical texts of all eras. These theories are allied with
the common general theory of a downward ux from the
head to various parts of the body through various channels, includ-
ing channels linking the brain, via the cerebral or spinal uid, to the
lower body (Epid. 2. 4. 2 [5.126 L.]; Oss. 12 [9.182 L.]). Eects on the
eye are described both in the Hippocratic Corpus (eye and lungs, Aer.
10 [2.46 L.]; cf. Aph. 3. 12 [4.490 L.]) and in related medical authors
(eye, ear, and nose in Dexippos, Anon. Lond. XII. 2226; eye and
joints in Diokles fr. 137; night blindness caused by moisture and excess,
Arist. GA 5. 1).
Formulations in Galenic texts, though expressed in more sophisti-
cated language, belong fundamentally to the same perception as that
prevailing in the Hippocratic era. Thus, the author of Places in Man
states that little vessels from the brain nourish the eye with pure
moisture but extinguish the organs of sight if
they happen to dry up (Loc. Hom. 2.2 [6.280 L.]), while Galen tells us
24
On Aristotle, see von Staden, 1989, 157, n. 54; on Diokles, see van der Eijk II,
2001, 267.
introduction 21
that when, in spite of no apparent disease aecting the eye, it happens
that 00 j oj i0 the sense of sight is lost, the cause
is a 0 a nerve or a duct from the brain swelling, damaged or
blocked by a ux of moist matter (de locis aectis, 8. 218 K.; cf. on various
destinations of a deuxion the pseudo-Galenic introductio seu medicus 14.
742 K. and on the dierent eects of moisture in dierent parts of the
headbelow skin, below bone, between membrane and boneibid. 14.
782 K.). Commenting on the Hippocratic Prognostic (Prog. 2 [2.114 L.],
an account of signs to be detected in the eyes of patients), Galen inter-
prets through extensive paraphrase but still writes of ux carried down
from the head and gives its aetiology as j0 excess or some kind
of j inammation or phlegmatic content in the brain.
Further, the same theories with the same rationale persist, perpetu-
ated by Oreibasios and others, even in Paul of Aigina, who describes
the cause of eye ailments as an acrid deuxion and makes a clear
distinction between types situated above or below the skull.
25
Surgical
procedures too remain constant over the centuries. The operations per-
formed in On Sight, other Hippocratic works and the Aristotelian Prob-
lemata (cautery of the vessels in the temples, 0 u u u
thickening upi.e. reducing the width ofthe channels of the
uids and scarication of the scalp) are paralleled in evidence from
papyri for excising the temples and other areas of the scalp.
26
Paul of
Aigina describes attempts to dissipate or evacuate peccant matter by
applying a cupping instrument to the back of the head, by scarication,
by applying leeches to the temples and by poultices.
27
Galen and Celsus, in conjunction with such Hippocratic writers as
the authors of Prorrhetic 2, Diseases 2 and Places in Man, provide direct
aid to understanding the abbreviated and allusive content of On Sight
(see on 1, 3, 9) or have indirect corroborative relevance to it (see on 4,
6, and especially 7). This is evidence for the long currency and inher-
ent conservatism of the physiological theories and surgical procedures
concerned, rather than for direct inuence of the earlier texts, though
it seems likely that Celsus drew directly at least on Prorrhetic 2.
28
In gen-
eral, Galenor contemporaries whose work has found its way into the
Galenic corpusfavoured non-invasive procedures in treating the eye.
25
See Adams I 1844, 411412; III 1847, 248.
26
See Marganne, 1994, esp. 114.
27
Adams I 1844, 420421.
28
See Pardon, 2005.
22 introduction
Thus his remedy for accumulated rheum is simple: the problem is to
be removed by a soft sponge with warm water (de remediis parabilibus,
14. 341 K.). He approves the simple Hippocratic recommendations of
the aphoristic textsneat wine, baths, vapour baths, phlebotomy, purg-
ing (Aph. 6. 31 [4.570 L.])and regards the physicians role as merely
to aid nature (cf. the view that spontaneous diarrhoea gives relief in
ophthalmia, Coac. 2. 220 [5.632 L.]). According to a later (Arabic) ver-
sion, he lauded practitioners who cured by drugs alone, rather than by
excision, not only growths such as pterygion and chalazion but also
serious eye diseases such as cataract and trachoma (de optimo medico
cognoscendo, CMG Suppl. Orientale 4. 10. 2). Trepanation was known but
rarely practised.
29
Celsus is much more interventionist. Archaeological
nds of surgical kits, especially from Roman Gaul, conrm the evi-
dence of Celsus for the practice of eye surgery; according to one mod-
ern ophthalmologistwriting before a further spectacular nd near
Lyonthese could almost still be used.
30
Most of the conditions addressed (though not by name) in On Sight
are of central and perennial importance in the history of ophthal-
mology: cataract, glaucoma, trachoma, recurrent conjunctivitis, night
blindness. All of these conditions were addressed by Susruta, to whom
is attributed a series of works in classical Sanskrit; this composition
has its origins several centuries BC, but betrays several historical layers
and dierent hands. The works show formidable clinical skill, includ-
ing knowledge of how to couch cataracts, dislodging the lens of the eye.
Like the surgeon of our treatise, Susruta favoured the use of general
purgatives before starting specic ocular treatment; treatments used by
both include scarication, venesection, cautery in the temporal region,
use of copper sulphate for trachoma, prescription of (cooked) goat or
sheep liver eaten with honey for night blindness and prescription of
unguents mixed in a copper vessel; advice given by both is to avoid
smoke, re and bright lights.
31
The ophthalmologists of ancient Egypt
(known from Ebers papyrus, c. 1500BC) knew a similar range of dis-
eases and practised some of the same responses. In Kahun 1, in a
gynaecological context, a meal of fresh (possibly raw) liver is pre-
scribed for a patient suering loss of vision and neck pain. In Ebers 351,
29
Rocca, 2003, 266, n. 1.
30
Dolus, 1968; on the nd of 1975 see Feugre, Knzl, Weisser, 1985 and Jackson,
1996, 2249.
31
See Biyadhar, 1939, 1947; Wujastyk, 2003, 6364.
introduction 23
roasted ox liver is to be pressed to the eyes for sharu disease, regarded
by some editors as night blindness.
32
The names of many ophthalmologists over the centuries are associ-
ated with advancements in the understanding of and controversies over
therapeutic methods for cataract and glaucoma. Celsus had attempted
surgery for cataract in its early stages. Even after Rufus systematised
the distinction between the two diseases, they were frequently spoken
of together, and not clearly dierentiated.
33
Paul of Aigina regarded
cataract as sometimes curable, glaucoma as always incurable.
34
Cat-
aract surgery was long a hit and miss aair, frequently the province
of itinerant barbers, not of professional surgeons. Palliative couching
remained the standard method until the middle of the eighteenth cen-
tury, when a cataract was rst successfully extracted by Daviel (in 1752);
however, controversy still centred on the true nature of cataract (a dis-
ease of the lens or a structure in front of the lens) and so on the rival
methods, some declaring fragmentation or discission was always to be
preferred to extraction. Failure in skill and purulent infection were long
hazards.
35
In the nineteenth century, the initiation of iridectomy for
glaucoma was a notable advance.
36
However, the annals of the new pro-
fessional bodies concerned with ophthalmology continue to be domi-
nated by the question of how best to treat these two dominant diseases.
Even today glaucoma and senile cataract, together with senile macu-
lar lesions and myopic chorioretinal atrophy, can be viewed as major
causes of blindness and it is conceded that the underlying aetiology of
these and many other eye disorders remains obscure.
37
Trachoma too has generated a vast literature.
38
The condition be-
came prevalent in England in the early nineteenth century. Troops
who had served in the Napoleonic wars were carriers and suerers. In
London, a special institution for blind ex-army personnel suering from
Egyptian ophthalmia (a misleading designation) was foundedthis
later developed into Moorelds Eye Hospitaland ophthalmologists
32
See for the evidence Hirschberg, 1899, 119; Nunn, 1996, 200 and for dierent
estimates of its signicance Marganne, 1993 and Craik, 2005.
33
Marganne, 1979.
34
Adams I 1844, 420.
35
Blodi, 1996; on the designation cataract, see Fischer, 2000.
36
Kronfeld, 1996.
37
Cf. Sorsby, 1963, 505.
38
For a general survey, see Tower, 1963; on late antiquity, see Savage-Smith, 1984,
2000.
24 introduction
vied with one another to discover a cure for the condition.
39
Trachoma
has a tendency to associations with military operations, though this
may be merely because of the overcrowding common in armies. It may
have been carried to Greece from Egypt. However, it is not conned to
these regions: there was an epidemic of Asian origin in Japan in 1897,
aecting soldiers of the recent Sino-Japanese war.
Treatment by scraping (to allow the release of noxious matter) and
burning (to sterilize and accelerate wound closure) followed by appli-
cation of a copper-based salve (as an astringent and haemostatic) re-
mained standard until the twentieth century. Sichel adumbrates the
history of medical fashions in recognising and addressing this condition
and nds the method described in On Sight still fort ecace et gnrale-
ment usite. According to Duke-Elder, writing on this immense sub-
ject, copper still excelled, used as blue stone, a pointed crystal of cop-
per sulphate held in a wooden holder and used for daily scouring of
the lids. Other expedients were scarication with a knife and subse-
quent strong massage with antiseptics; or rubbing with a curette, hard
brush or sandpaper; or attack on groups of blebs by galvanocautery
essentially detergent and caustic substances.
40
A bizarre misinterpretation of a passage in On Sight led to a noto-
rious dispute over the proper means of scarifying the eyelids. Wool-
house was a successful but highly controversial oculist of France and
England in the late seventeenth to early eighteenth century. His career
embraced extremes of eectiveness in practical operation and failure
in conceptual understanding: on the one hand he performed iridec-
tomy and restored patients sight; on the other he opposed the view that
cataract was situated in the crystalline lens. Claiming a unique under-
standing of the Hippocratic method where a spindle was employed, he
used a teasle or thistle-like plant to perform surgery which he termed
technically ophthalmoxusis or more popularly degourdissement, degon-
ement on the internal surface of upper and lower lids for trachoma
and many other conditions. He attracted both disciples (most notably
B.D. Mauchart, professor of ophthalmology at Tubingen) who followed
his practices, and enemies who regarded him as a charlatan operating
for personal prot.
41
39
On William Adams (later knighted as Sir William Rawson), John Cunningham
Saunders and John Vetch, see Gorin, 1982, 73.
40
Sichel 123, 148; Duke-Elder II 1938, 1593, 1619, 1622; cf. Lawson, 1903, 535.
41
See Haller, 1755, 315338 and Triller, 1766, 72 for trenchant criticism.
introduction 25
Night blindness (7), a deciency disease aecting the sight, is another
important perennial condition. In general men are more susceptible
to night blindness than women and, even among children, boys more
prone than girls.
42
Hippocratic authors knew this: the author of Pror-
rhetic 2 is correct, though too categorical, in dierentiating between the
sexes; in Epidemics 6, where night blindness is seen especially in chil-
dren, the dierent developments and mutations of the disease in men
and women are noted, and the author conjectures that the reasons for
the relative incidence were that women were intrinsically less suscepti-
ble, or that women were more conned indoors.
rheum in the eyes (2on the term see on 2.1) is indicative
of underlying infection, which might have many precipitating causes
and which, in the absence of good preventative hygiene and of drugs
which could serve as antibiotics, must have been common and incur-
able. The inexorable progress of chronic eye disease to complete loss of
sight can be seen from successive plays of Aristophanes, where Neok-
leides is mercilessly and unsympathetically portrayed: in around 392 he
is simply blear-eyed (Eccles. 254, 398); and in 388 he is com-
pletely blind, hoping for a miracle cure from Asklepios (Ploutos 665,
717725). Archedamos too was characterized as blear-eyed (Ar. Ran.
588, cf. Lys. 14. 25). A dierentiation is imputed to the eyes of males
and females in On Sight, and more explicitly in Prorrhetic 2. This may
not be altogether fanciful, especially as the additional symptom ulcer-
ation is attributed by the author to women; but may rather indicate
vigilant observation. It is now recognised (rst noted in 1870 and con-
rmed by further studies) that there is a type of purulent conjunctivi-
tis typical of young girls in which there is an association between pri-
mary vulvo-vaginitis and secondary conjunctivitis, or conjunctival gon-
orrhea.
43
When Helmholtz in 1850 demonstrated the ophthalmoscope to the
Physical Society of Berlin, exploration of the inner eye became possible
for the rst time. This completely altered understanding of the function
of the eye and made obsolete the work of manyincluding Sichel, the
editor of On Sight for Littr, who had been working for many years
on a book entitled Iconographie Ophthalmologique without knowledge of
the fundus.
44
Many failed to capitalise on the new technology, which
42
Jayle et al., 1959, 176.
43
See Duke-Elder II 1938, 1579.
44
On Sichel as a tragic person see Gorin, 1982, 8485.
26 introduction
only gradually became accepted.
45
In modern ophthalmology the slit-
lamp (a combination light and microscope for examination of the eye)
is ubiquitous; but of course our surgeon saw only what could be seen
with the naked eye.
Some of the areas selected for cutting and cautery by the physician
of On Sight (3) coincide with the points targeted by modern oriental
practitioners treating eye disorders by acupuncture or (especially) mox-
ibustion, and their practices have a very long history.
46
Of course there
is a ready explanation for these similarities in treatment: as human
physiology is constant, it is intrinsically probable that doctors of dif-
ferent societies at dierent times should treat similar aictions in a
similar way simply because they separately have discovered an eec-
tive treatment on an empirical practical basis. After all, doctors do
not cut and burn for fun, but in the hope of a cure; and they do not
advocate treatments which never work, or at least seem to work. Even
today, the reasons for the undoubted eectiveness of the practice of
acumoxa is not understood; the treatment seems to stimulate the body
to resist disease and to become stronger, but its workings, especially
in relation to particular diseases, where it acts not merely as a pallia-
tive but actually as a remedy, are mysterious. It has been suggested
that acupuncture raises the red corpuscle count and enhances blood
circulation; that it stimulates the nervous system (perhaps through spe-
cic neurological reactions between parts treated and parts aected);
that it provokes responses in the cerebral cortex which in turn react
on the organs. It is possible to review anatomical data seeming to vin-
dicate some of our surgeons ideas and practices: there is an external
blood supply to the skull by the temporal arteries; there is a direct
link of cerebro-spinal uid to the eyeball through the optic nerve.
47
In
visual function, the ocular blood circulation is fundamentally important
and systemic diseases undoubtedly aect the complex physiology of the
eye.
Disputes over the proper methods in ophthalmology permeate works
of the nineteenth century: even such an apparently simple question as
the desirability of exclusion of light was still debated, as were the pros
and cons of dividing or opening the temporal artery, the choice of scis-
sors or knife for surgery and the choice of agents or procedures to treat
45
Duke-Elder, 1958.
46
For discussion, see Craik, forthcoming; see also Charlevoix, 1754.
47
On the orbital blood supply, see Spalton et al., 2005, 674675, g. 20.7 and 20. 8.
introduction 27
the palpebral surface.
48
Trepanation was still sometimes practised to
alleviate cerebral seizures accompanied by sight loss, through drainage
of pus collected between bone and dura.
49
In the early years of the
twentieth century, many of the procedures found in On Sight were still
advocated: local blood-letting (scarication and cupping at the temples;
bleeding by leeches); application of heat; cautery by a burnt wood
needle; grattage and swabbage for trachoma, with instruction to rub
with gauze wrapped in a wooden spatula, after bleeding had completely
stopped; and for night blindness ingestion of liver of ox, goat or sheep
fried in oil and well seasoned (5 to 10 ounces, three times a day).
50
For
this reason, the selected reference books cited here are drawn from a
range of dates, roughly a generation apart. The most modern author-
ity noted is David Spalton, a distinguished consultant ophthalmologist
who was kind enough to scan this commentary in draft form. He con-
cluded: It seems he described a number of diseases and one can only
guess at what the modern diagnosis is; in some ways this does not seem
important as the treatment was the same.
48
Vetch, 1820, 1617, 3839, 81 etc.
49
Hirschberg I 1982 (tr. Blodi), 93, n. 403.
50
Wood, 1909, 7879, 7980, 81, 83, 801.
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CIH Colloque International Hippocratique
CMG Corpus Medicorum Graecorum
CUF Collection des Universits de France (Association G. Bud)
DK H. Diels and W. Kranz, Die Fragmente der Vorsokratiker (6th edn,
Berlin and Zurich, 1952)
DR C. Daremberg and C.E. Ruelle, Oeuvres de Rufus dphse (Paris,
1879)
Duke-Elder Sir W.S. Duke-Elder, Text-Book of Ophthalmology (London,
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Gal. Galen, cited with volume and page ref. to C.G. Khn, Claudii
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CONSPECTUS SIGLORUM
memorantur in app. crit.:
M Marcianus gr. 269, s. X
H Parisinus gr. 2142, pars antiquior, s. XII
I Parisinus gr. 2140, s. XIII
R Vaticanus gr. 277, s. XIV
memorantur in comm.:
Ca Cantabrig. Caius Coll. 50, s. XV
E Parisinus gr. 2255, s. XV
F Parisinus gr. 2144, s. XIV
G Parisinus gr. 2141, s. XV
J Parisinus gr. 2143, s. XIV
K Parisinus gr. 2145, s. XV
Laur. Laurentianus 74, 1, s. XV
Mut. Mutinens. Estensis gr. 220, s. XV
O Baroccianus 204, s. XV
Q Vossianus fol. 10, s. XVI
U Urbinas 68, s. XIV
W Vaticanus gr. 278, a. 1512
Z Parisinus gr. 2148, s. XVI
non vidi:
Haun. Hauniens. Gl. Kgl. 224, s. XVI
Mo. Monacensis gr. 71, s. XV
TEXT
I
1. l l 0r. 0 r i . ri
i. i ro r. 0 r i u. l r 0-
t . o r _u _ 0i. i -
o o r o0 r _u _ I 0o. u r
5 j 0i j j i i o r j 0 o0
0. i i 0 t ri .
2. l r u j i i j 0r. j r r_ r
r. r_ r_ 0i j r r_ r
i rr ro. r oj i o o o i o. i
10 0 0 oj r. r r u i o 0 o 0
o0 0j. i 0. 0 r 0r. r r u_ 0
i o0 j j i r u 0 r 0r. u
j i. u j 0t.
II
1. o i r t o0t. j r ru u r
15 00u. j 0i j. j 0. 0 0 ui r 0r.
1 `o i fere codd. | 0 edd.: 0 codd. 2 u
codd.: u Heidel 4 r _u _ I 0o M fere recc.: r _ u
_ 0o I R: I om. Asulanus: r _ u _ forsitan delendum
Joly 5 o0 MHI: 0u0 H
2
R fere recc. 6 0 codd.: 0o fortasse
novit Foesius | M: recc. 8 r_ r_ M H
2
I:
r_ r_ H 9 i (i. r) recc: i M | post
ro lacunam indicant Iugler et Sichel | oj i o o o MH (sed del. i H
2
):
oj o o r o IR 10 0 Ermerins: r MIR: r H fere recc.
11 0 MH: 0 H
2
IR fere recc. 1112 0 i o0 MH: o0 i
0 H
2
: o0i i 0 IR fere recc. 13 0t edd.: 0j
codd. 14 o i Craik: MH: i IR fere recc. 15 0j M (vel
0i) recc.: 0j Joly | j 0 MI fere recc.: i 0 HR | ui M:
ui recc.: ur Joly | 0r van der Linden: 00r codd.
TRANSLATION
1
I
1. As for the visual parts, destroyed, when these become spontaneously
lapis-like, they become so all of a sudden, and once they do become
so, there is no such treatment. As for those which become sea-like, they
are destroyed gradually, over a long time, and often the second eye is
destroyed a long time later. Of this person, one should purge the head
and cauterise the vessels; and if he has this done at the beginning, the
trouble is arrested and does not go on to get worse.
2. In cases where the parts are intermediate between lapis-like and sea-
like: if they become so when someone is young, they settle down when
he gets older; if they become so when someone is older than seven
years, he sees quite well things which are really big and bright, and
he sees ahead, but not clearly, and whatever he sets right in front of
the eye, he sees that too, but nothing else. For this person, cautery and
purging the head is benecial. It is not benecial to let blood in these
people, either in the lapis-like or the sea-like case.
II
1. In the case of sores in the eyes, where the visual part is sound, in
younger people, whether the person is female or male, you could not
help by any action at all, as long as the body is still growing. But when it
1
() indicates addition of material to amplify translation; [] indicates editorial
deletion of intrusive content from text; indicates editorial insertion to text
40 text
r 0 u u r. o r r 0o. 0u u o0-
u o o r u. u. j j t0. i
ri r0 j r.
III
1. r 0j. o r ri. i 0i 0 u i-
5 j i. r r rr. r j0 o i
r. t r 0. r i r i i ji
0i. o 0 j j i i. r r 0 i.
j j i. i r i or 0.
2. r r0i jr ri. j 0 o
10 0_u _u or_ j r r _u i_ i. r
u r0i ri. r 0 0 r u. r0r
j ro.
3. o r r u j u. ro rr j ro.
oi r j r i u i j i. i u o
15 00 rr j r r j o o0. 0 o
j o. i r j u. j j u u. o
j iu ri. j u 0.
4. l ro l 0 o0t o ri. l 0i
or i i. ro r o r r r.
20 u 0u i ri. i r0i i o 0. i
u 0 i. r 0 rr i j
0i i j0. oi r i i _u u o 0 0j.
12 0u u o0u Ermerins: 0r_ _ u o0_ u codd. 2 u MHIR:
u Asulanus | t0 codd.: r0 Triller 4 0 codd.: r van
der Linden 45 i MHIR: i fere recc. 5 r j0
codd.: j0 (del. r) Ermerins 6 i fere recc.: i M
8 i 0 codd.: del. Ermerins 9 MHIR: i Foesius ex
Fevr. ms novit | post ri lac. in ras. I 11 r MHR: r r I fere recc.
13 j u del. Ermerins 1415 o 00 o o0 Craik: o o0
o o0 codd.: o o0 (del. o o0) Ermerins: o o0 (del. o)
o0 Joly 17 iu MI: lu HR, Foesius ex Fevr. ms novit 18 o
HIR: o aut u M (?cum corr.): o recc. nonnulli: o Foesius ex Fevr. et
reg. mss novit 20 r0i MHIR: r0o Cornarius 21 0 codd.:
0 Foesius ex Serv. ms novit: 0 Ermerins | i recc.:
i M | r 0 fere recc.: r j M 22 oi r i codd.: oi i (del.
r) Joly | i codd.: r i Ermerins | 0 fere recc.: j M
text 41
is no longer growing, considering the actual eyes, attenuate the eyelids,
scraping, if you think they need this too, and cauterising from the inner
part, but not with white-hot instruments.
III
1. Then (set the patient) on a couch from which he can lean with his
hands; get his legs outstretched; tie on (a ligature). Let someone hold his
waist. Then trace the vessels of (= running to) the back, and examine
from behind. Then cauterise with thick (metal) instruments and heat
gently, so that there is no haemorrhage as you cauterise. Let blood in
advance, if it seems the right course. Cauterise towards the bone (=
skull) from behind.
2. Then put in place a sponge soaked in olive oil. Cauterise over it,
but not right up to the bone. If the patient accepts the sponge with
the instrument, put in place another, better-oiled, and cauterise over it.
Then moisten arum (root?) with honey, and put this on the eschars (=
scabs).
3. When you have cauterised by or through a vessel, once the scab
has fallen o, the vessel is stretched and swollen and apparently full
just as before. And it beats when the ux comes from above, but if
the patient has been cauterised when the ux comes from below he
experiences all this to a lesser degree. You must cauterise through (the
vessel) again, if you did not cauterise through (it) the rst time. You
should cauterise over sponges strongly, especially in the case of a vessel
which haemorrhages.
4. Scabs which are relatively well browned fall o quickly. Scars in
cautery towards the bone turn out better. When the sores are healed,
the scars are swollen and raised and red compared with the rest (of the
esh) and look as if they will remain raised, until time has passed. It is
the same when the head is cauterised or the chest or in all the body,
wherever there is cautery.
42 text
IV
1. o r u r o00. u ii_ i_. u_. 0_u.
i 0 r. 0j j o 0 o00 -
j u . t r o 0j j u-
. 0 r i r. 0o iu lu j u.
5 r j u u o. o 00 ri 0. u_
0t.
2. I r j u i j u. o l ro rr-
i 0r j o r i o. o j o 0
r. o r i 0j. j i _u ri_ o_.
10 I r u r i o j j 0j.
V
1. o r o u j u. o 0u j o
o 0r u. I r r r0 j -
r. j u u i. j _u 00 o_u _u -
t. o r 0r j ro. iu o o.
VI
15 1. o r r 0 i r. 00 0 u
0 i, [r r 0i 00] i
j i 0 0 i u o. r
0r r i i t. r r _u r0_u
r. oi 0i. r 0 o r u
20 r. ro 0j. i t j0.
1 u codd.: u i i Sichel: lacunam indicat Ermerins | i_ recc. non-
nulli: i_ MHIR 2 0 o00 del. Ermerins 3 codd.:
or Ermerins | o 0j Anastassiou: o 0 codd.: o 0
Ermerins 4 r MHR: rr H
2
I fere recc. 5 j fere codd.:
om. R 56 u_ 0t codd.: 0t (del. u_ ) Ermerins 7 (bis)
codd.: del. Ermerins | u M: i fere recc. 9 _u ri_ o_ codd.:
ri_ o_ Ermerins 10 u codd.: o Ermerins | i o
codd.: del. Ermerins 1112 o o codd.: o u 0 Joly 14 o o
recc.: o i M: u o o indicat Calvus 15 MHR: I | 00
Ermerins: 00 codd. 16 r r 0i 00 codd.: del. Craik |
codd.: Foesius 17 o MHR: o I: recc. nonnulli
text 43
IV
1. When you scrape the lids of the eye, scrape with soft clean Milesian
wool, winding it round the spindle(-shaped instrument), with care for
the actual eyeball; do not cauterise through, up to the cartilage. It is
a sign when there is enough scraping that it is no longer bright blood
which comes, but bloody or watery matter. Then you should rub on
one of the liquid drugs containing ower of copper.
2. Afterwardswith regard to the procedure of scraping and the pro-
cedure of cauterywhen the scabs fall o and the wounds have been
cleaned and it is growing, then make a cut through the front of the
head. When the blood ows out, one should anoint the wound with a
drug to stop bleeding. Afterwards, it is appropriate also to purge the
head in all cases.
V
1. When the eyelids are thicker than is natural, cut away the esh below,
as much you can, very gently and afterwards cauterise over the eyelid,
not with white-hot instruments, with care for the point where the lashes
grow, or apply heated very ne ower (of copper). When the scab falls
o, give the further treatment.
VI
1. Whenever the eyelids are itchy and there is an irritation, rub a piece
of ower of copper on a grindstone, [then rub the patients eyelid] and
at that time rub the akes of copper as ne as possible. Then you must
pour alongside (the akes) the strained juice of unripe grapes and rub
smooth; then pour the rest (of the grape pulp) alongside (the other
ingredients) into (a vessel of) red copper and gradually rub together
until it is like myssotos in consistency. Then, when it has dried, rub
smooth and apply.
44 text
VII
1. o o r rj. i j j 0r-
0. i o 0r u o. r t .
ri r r r o uo t r
u 0 u i j u i j .
VIII
5 1. j l o0i t r 0i j . u_ j
o r. ri. ri or. 0-
I. ij0 i I t i.
IX
1. o0i j ri i ri r o0 j i
j o i o0. i i r u. i 0i -
10 r r u u 0o. i u o o r.
t oi 0. i I . t0 r r _. 0
0 i i u 0 u. o. 0 ri o o.
0 r 0o.
2. j r j j. 0 o r. o ou j r-
15 u. 0 u u rr. 0 r. io 0u.
i ro o r o j ou r 0j. j
ou j u o j ro 0 o. r
o u o o 0 j r.
1 o o r IR: o o r M fere recc.: o-
o r Foesius ex Serv. ms novit | j j recc.: j M
2 o Foesius ex Serv. ms novit: o codd. 34 r r o
uo t r u 0 u i j u i j Craik: r
r o j u t r u 0 u i j u codd. 5 j
Craik: j codd.: i Joly | 0i Craik: 0i codd 8 ri
fere recc.: ri H: rr I: r ii 9 i o0 MHR: i I |
i M: i u Ermerins 11 _ fere codd.: Foesius ex Serv. ms novit 12 o-
Foesius ex Serv. ms novit: i MI: HR: i Cornarius:
o Joly 14 0 o r MIR: rj 0 r H 1415 ru-
codd.: ru Asulanus 15 0 u codd.: i 0 Ermerins: 0 Joly |
rr fere codd.: 0r nonnulli 1517 0 r. io 0u.
i ro o r o j ou r 0j. j ou j u-
o j ro Craik: 0 r. io 0u i o o r
o j ou r ro j ou u i 0j o j
ro codd. 18 o 0 R: o j M: o j H: o 0
text 45
VII
1. (Treatment for) night blindness: let him drink as drug elaterion and
let his head be purged; cut into the neck; exert as much pressure as
possible for a long time; release; dip in honey and give to swallow one
or two raw cloves of garlic as big as possible and ox liver.
VIII
1. If somehow the eyes, though sound, are destroyed in their visual
faculty, you should treat this case by cutting into the forehead, folding
back the skin, sawing the bone and removing the moisture. In this way,
they are cured.
IX
1. In the case of opthalmia recurring annually and locally, purging of
the head and purging of the lower belly are benecial. If he should
have the physique, drawing blood is benecial for some troubles of this
kind, and cupping vessels applied to the blood vessels. Food: a little
bread and water to drink. He should lie in the dark, away from smoke,
re and other bright things, on his side, sometimes to the right and
sometimes to the left.
2. Do not moisten the head, for it is not benecial. A poultice is not
benecial if there is no pain, but apparently continuing ux, while the
swellings are not painful. And when astringent drugs have been used as
ointments for pain, and the pain does not abate after the application
of the drug, then it is benecial to apply any of the poultices you think
may be benecial.
46 text
3. 0r r r u . o o t.
0 o o o0 t o o 0r u u
. j r 0 0 o 0i o o i-
. u r j r. o 0 0 j o r
5 t0.
2 o o0 r MI fere recc.: r o o0 H | o. 0r M: o.
0 r H: o 0 0r I 4 o 0 0 MH fere recc.: o 0 0
H
2
IR: o 0 0 Cornarius 5 i vel r u i vel r
i `o vel r u i oi habent nonnulli
text 47
3. It is not benecial to gaze continuously for a long time, for the
eye, unable to contend with the brightness, summons a tear. It is not
benecial either to keep the eyes closed for a long time, especially if
there is a hot ux. For pent-up tears cause heat. (Even) if the ux does
not persist, it is benecial to apply as ointment a drying substance.
COMMENTARY
I
Three deleterious conditions are detailed, all with reference to per-
ceived change in the colour of the visual parts. (On the sense
of the term, see Introduction I.) No names are applied to these con-
ditions. In each case, description of the salient symptom in terms of
colour is followed by brief comment, outline prognosis and recom-
mended treatment, if any: (i) lapis-like, sudden unprovoked onset, no
treatment avails; (ii) sea-like, gradual onset, second eye often aected
later, early treatment by cautery and purging is eective; (iii) an inter-
mediate colour, the young recover within seven years but older people
do not, cautery and purging are palliatives. Attempts by commentators
to isolate and identify these conditions in modern terms are tentative
and inconclusive. Foesius notes qualis in suusione aut glaucomate contingit,
such as happens in cataract or glaucoma. Sichel suggests that (i) is
glaucoma and (ii) cataract, but nds the rest of the passage trs-obscur
et peu prs inintelligible. Ermerins is uncertain about glaucoma,
favouring rather cataract in its dierent manifestations and dierent
stages. Joly outlines further candidates, but is ultimately non-committal:
(i) Il pourrait sagir du glaucome, mais alors, cest la corne qui est
aecte Sil sagit de lirits, cest bien la pupille qui est en cause,
mais elle devient diorme et gris fonc; (ii) On pense la cataracte
non reconnue comme telle et donc avec traitement hors de propos.
Sil sagissait en ralit de la corne, ce serait une kratite; (iii)
Distinction assez illusoire. Il faut songer soit la cataracte soit une
kratite
1
In truth, it is dicult to advance beyond these judgments. Condition
(i), coming on suddenly and without apparent cause, does not seem to
t either cataract or glaucoma, as both usually come on slowly and
1
Foesius I 736, n. 1; Sichel 137138; Ermerins Prolegomena XL; Joly 173 in successive
notes complmentaires.
50 commentary
insidiously. (However, occasionally in cataract the second eye deterio-
rates rapidly after the rst has done so slowly; and the onset of glau-
coma can be sudden, giving rise to the acute crisis of detached retina,
which manifests as greyness, the retina hanging into the eye like a grey
balloon.) Also, although glaucoma is marked by a greenish reex in
the early stages, this passes and the cardinal sign is not the colour
of the pupil at all, but the fact that the eye is solid and hard. Con-
dition (ii), with its gradual development, one eye frequently following
the other, ts the common pathology of cataract. Condition (iii), with
its elusive intermediate coloration and the subdivision according to
age of patient a, young and b, older is more complex. Condition (iii) b
again ts cataract, which is typically a disease of the elderly (though
it can present at any age, and can be congenital); condition (iii) a,
where recovery is said to occur, seems to correspond rather to intra-
ocular inammation, whether inammation of the corneakeratitis
or inammation of the iris and ciliary bodyiritis, iridocyclitis. (Kerati-
tis is a disease, usually short-lived, of youth and adolescence and iritis is
common in such systemic diseases as diabetes. In both, haziness of the
eye is a feature.)
2
It is surprising that grey does not feature in our authors
choice of palette, as it does in Prorrhetic 2 (Prorrh. 2. 20 [9.48 L.]). Sim-
ilarly, in other treatments of the diseases of old age, both theoretical in
Aphorisms and practical in Epidemics, words of this root occur (0-
i cases of dimness and u cases of glaucous eyes, Aph. 3.
31 [4.502 L.]; ru0 j , the eyes were glaucous, case of an
old woman with miscellaneous other troubles, Epid. 4. 30 [5.174 L.]).
Of course, despite the term glaucous, none of these passages implies
the particular condition of glaucoma, which at this time could not have
been dierentiated from cataract. Rufus is the rst physician known
to have recognized the dierence (frg. 116 DR), seen later in Oreiba-
sios, Paul of Aigina and others.
3
In practice, glaucoma and cataract fre-
quently coexist in the elderly, cataract being an almost inevitable ulti-
mate complication of glaucoma. In Galenic works the two conditions
are frequently discussed together; both are seen as aections arising
without external precipitating injury.
2
See Lawson, 1903, 134136; Duke-Elder II 1938, 18771944, esp. 18791890; Bed-
ford, 1971, 5051, gs 30, 31 and 9091, gs 60, 61; Trobe and Hackel, 2002, 109110,
180181; Spalton et al., 2005, 350, g. 11. 38, 225, g. 8. 6 and 248, g. 8. 55.
3
Marganne, 1979.
commentary 51
The author correctly observes that changes in colour are diagnosti-
cally signicant and he makes a commendable eort to classify three
conditions, viewed by him as distinct and dierent, by adding further
information. This is a good methodological starting point, but it is only
a starting point. It is not clear even whether the perceived changes are
thought to aect pupil alone or pupil and iris or cornea or the eye more
generally. The modern potential for dierential diagnosis is vast; for
instance if we suppose the reference to be to the area of the eyes, rather
than to the eyeball, a further candidate for (iii) is hemangioma, a soft
bluish swelling in the eyelid caused by a benign and often self-limiting
tumour. In any case, the coloration in the three conditions is so vaguely
described as to render them indistinguishable. Any physician would be
hard put to it to dierentiate between conditions by verbal description
alone: colour photography is an invaluable adjunct in the modern text-
book or online database: thus, haziness is a term commonly applied
to many dierent conditions, including cataract, glaucoma and kera-
titis.
The author of Prorrhetic 2 likewise lists three colour changesspe-
cically with reference to the pupilbut regards all three con-
ditions as hopeless: l r u j 0r
j o. 0r where pupils become grey or silvery or lapis-
colour, nothing can be done, Prorrh. 2. 20 [9.48 L.]. The colour cor-
respondences are inexact: even the word translated lapis-colour is not
identical in formation to the term lapis-like in our case (i) and the cor-
respondence of silvery and grey to our cases (ii) and (iii) is at best
rudimentary (see further below). It may be that a single condition is
envisaged in Prorrhetic 2, and the author, striving for precision, oers
three alternative descriptions for a colour or range of colours which he
nds hard to describe. Certainly, when Celsus searches for colour words
to describe the pathology of the eye, it is in an attempt to discriminate
between dierent types or stages of suusio cataract: the distinction is
an important determinant of whether particular cases are sanabiles cur-
able and so of whether and when surgery should be attempted. In
Celsus scheme, again tri-partite, there is hope if the cataract is small
and has colorem marinae aquae vel ferri nitentis the colour of sea-water
or of gleaming metal; the situation is worse if it is large and caeruleus
dark-blue (7.1314). Broadly, Celsus scheme corresponds with that of
On Sight: (i) dark-blue in both is bad; (ii) sea-colour in both is not so
bad; (iii) intermediate in On Sight (? corresponding with metal-colour in
Celsus) is likewise not so bad.
52 commentary
The treatment prescribed here is consonant with that advocated
throughout the work. Purging the head (that is, irrigation by errhines,
drugs inserted in the nose) is recommended also at 4.2 and 7; cautery
(that is, application of heated instruments to the aected parts or to the
vessels) is advised also at 2, 4.12, 5, 7 as well as being the subject of
the long section 3; phlebotomy (that is, letting blood by cutting the
vessels) here abjured is the preferred treatment at 7 and cautiously
admitted at 9.1. From the stress on nasal purging, it can be seen
that the author of On Sight subscribes to the common view that in
disease noxious stu might be diverted from one part of the body
(eyes) to an orice (nose) for expulsion. Implicitly, the conditions so
treated are attributed to a ux of noxious matter descending from
the head and aecting the eye. It is notable that Celsus too regarded
letting blood from the forehead or the nostrils, cautery of the vessels in
the temples, and expulsion of phlegm by gargling, as well as smoke-
inhalations and acrid ointments, as benecial in the early stages of
cataract, when it could be treated medicamentis by drugs without need
for surgery, imperative later; signicantly, he sums up victus optimus est
qui pituitam extenuat, that regimen is best, which can thin down phlegm
(6. 6. 35).
The author plunges in medias res, with asyndeton particularly remark-
able in the rst sentence. The syntax is predominantly paratactic, bro-
ken by one temporal clause, one indenite relative and three simi-
larly phrased conditional clauses. Antithetical sentences and clauses
are favoured: j r r_ j r r_ and oj r. r-
r u. The nal u u is similar in balanced eect. The
rst sentence is clumsily repetitious in phrasing, i-
ro r. The verb 0i0 too is repeated three
times. There is conspicuous redundant repetition of pronouns, espe-
cially demonstrative pronouns: u (or, as commonly emended, -
u). u. 0. i 0. u_. u. The alliteration of
0i j i and 0 i o0 j j
suggests a mantra of the trainee physician, but may be simply fortu-
itous. The repetition o r _u _ seems to seek empha-
sis and 0o is a gnomic aorist. In section 2, where an attempt is
made to describe precisely the nature and degree of sight loss, dierent
points are made in a jerky sequence: big bright things visible; vision
straight ahead impaired and peripheral vision lost; things brought close
visible.
commentary 53
1. 0r 0i 0o destroyed destroyed
destroyed (or, perhaps, damaged damaged damaged): this
sense of 0i0 (passive) indicates pathological decline to an
irretrievable point. Here of blindness (cf. 8 below; also Pl. R. 517a
and, of deafness, Hdt. 1. 38), the verb is common in the gynaecological
treatises of abortion or miscarriage; in Places of Man it is used of severe
pain (change and destruction of the appropriate nature of any bodily
part is the origin of bodily pain, Loc. Hom. 42.1 [6.334 L.]) and in Koan
Prognoses, of facial collapse (destruction of the face a mortal sign, unless
caused by the reversible conditions sleeplessness, starvation or stomach
upset, Coac. 2. 209 [5.628 L.]).
0 spontaneously, without discernible precipitating cause (cf.
Foesius Oeconomia 0o sponte magisque naturae vi quam morbi, spon-
taneously and more by action of nature than of disease).
4
Both adjec-
tive and adverb are favoured in the HC (one hundred occurrences),
frequently opposed to expressions involving cause. The r
solitarium implies an opposition to damage where the cause can be
determined. All mss have the incorrect form 0, evidence of the
mechanical copying which typies the tradition of On Sight.
i lapis-like, like lapis lazuli, bluish, dark blue: Greek col-
our terms are notoriously dicult to translate.
5
LSJ renders t
bluish grey with the explicatory addition in glaucoma; the addition
begs the question. (On dierentiation between cataract and glaucoma,
see Introduction V.) o (contracted 0) is the regular adjec-
tive indicating composition of, or more commonly similarity to, u
a dark-blue enamel or lapis lazuli; Latin caeruleus is equivalent. Already
in Homer, usage is wide: of hair, ships, clouds, sea; later, the adjec-
tive was used to qualify minerals, owers, birds, or objects of striking
blue colour. Sometimes sheen or texture, rather than hue, seems to be
implied. (See Demokritos, DK 68 A 135 = Thphr. de sens. 77; Aristotle
col. 796a18.) 0 coexisted with the less common form ()-
j, lit. like u (dierentiated by Demokritos, loc. cit.); from Euripi-
dean usage of the sea (Hel. 179, cf. 1502; also j, E. Alc. 261) it is
evident that the distinction made by the author from 0j sea-
like will be hard to dene. But, unlike 0j following, t
4
See also Iugler, 1792, 50.
5
See Maxwell-Stuart, 1981, esp. 16; also Platnauer, 1921, 161.
54 commentary
is not a regular colour term and the formation of t is itself pecu-
liar. The formation -t is an adjectival sux (feminine) which in some
cases became substantival. In the HC, such adjectives are applied espe-
cially to r vessel (e.g. lt. jt) and to types of dis-
ease, or in some cases to both (t disease of the spleen Morb. 1.
3 [6.144 L.], but vessel at the spleen Morb. 1. 26, 28 [6.194, 196 L.]; A.
20 [6.230 L.]). Some terms seem to bypass the adjectival stage, and are
found only as substantives: the transition can be seen in passages where
adjectival and substantival usage coexist (r 0i i to a wast-
ing disease of the kidney, Int. 15 [7.204 L.] followed by 0 r i-
from the kidney disease, Int. 18 [7.210 L.]). Some names for ill-
nesses have no adjectival analogues: for example, t. t. 0-
0t, phrenitis, pleuritis and arthritis. The rst two were regarded
as traditional names for acute diseases (given by the 0t ancients,
Acut. 5 [2.260 L.]); if the view that it is an old form is correct, later writ-
ers were adapting and extending pre-existing formations. The practice
had a long future, the sux being rmly embedded in English and
other European languages to denote a disease with local inammation
(tonsillitis etc.). The development in ancient usage is part of the gen-
eral development of technical terms, not only in medicine but in other
sciences also.
6
Another range of -t technical terms relates to miner-
als, and another still to plants. Both can be seen in the HC, especially
in the gynaecological treatises (minerals t. t and vegetable
matter ot earth-almond). In some such formations, the idea of
similarity is apparent (e.g. t sponge-like applied both to stone
and plant) but this similarity rarely relates to colour: thus, 0t, sc.
0, is a vine with white grapes, but the colour element is already
there initially, and so too with t. sc. 0. a grass-green stone.
7
ri all of a sudden, suddenly: this adverb is more common
in the HC than the synonymous ri (eighty-eight versus fty-
eight occurrences; there are also eight of the adjective ri).
Patterns of preference in such ordinary vocabulary, where choice may
be subconscious, can be signicant in establishing groups of works of
common provenance. An authors usage tends not to be for one or
the other exclusively but ri is preferred in the gynaecological
6
For other such formations, see Kretschmer and Locker, 1963, 324326.
7
See Langslow, 2000, 270271, on the lexicalist versus derivationalist controversy
in the development of suxes, and the argument, 274, that a sux can exhibit a kind
of polysemy.
commentary 55
texts; and exclusively used in Internal Aections and Diseases 2 (ten and
ve occurrences respectively).
8
0 r i u there is so such treatment (sc. as that previously
described): Ms u, nominative singular with i, is altered by
editors following Heidel to u, dative plural, sc. with dative
plural of .
9
However, Ms reading can stand if we suppose, as is
intrinsically probable, that our text followed on prescriptive material
now lost. (But cf. u 0o. 9.1, with reference to the topic of
ophthalmia, newly introduced.) Such a designation of treatment found
to be eective, in terms of same or similar treatment useful for dierent
cases, is prevalent in the surgical treatises Fractures and Articulations (Fract.
10 [3.450 L.]; Artic. 19, 31, 38, 62 [4.132, 146, 166, 268 L.]). Ermerins
keeps u but paraphrases in translation, non est curatio, quae malum
superare valeat, there is no treatment eective to surmount the trouble.
0t sea-like: here the formation to express similitude is reg-
ular. The sux -j occurs in the HC of likeness in a general or
abstract sense (00j. 0j man-like, godlike); also con-
cretely with regard to shape (j spoon-like); or as perceived
by the sense of touch, with respect to hardness (0j stone-like),
texture (j sponge-like), or temperature (j ery);
or the sense of sight, especially with respect to colour (j
lead-like, j like pomegranate peel, j like glass).
10
The incidence of the sux is marked in the gynaecological treatises, in
Articulations and in Internal Aections, and several formations, like 0-
j here, are unique to a single treatise: j ribbon-like
and j fat-like only in Articulations, j head-like only
in Internal Aections; j a kind of root and j a kind
of plant only in Nature of Woman (Artic. 47, 78 [4.202, 312 L.]; Int. 6, 27
[7.180, 238 L.]; Nat. Mul. 32, 33 [7.358, 370 L.]). With this grouping
there is an outlier, 0j, unique to Airs, Waters and Places. Some-
times the -j sux accompanies or replaces the -u sux, which
seems to be a special medical variant on it, generally but not always
indicative of a pathological condition:
11
exceptionally, Xenophon uses
8
Cf. Craik, 1998, 189.
9
Heidel, 1914, 193.
10
See Kretschmer and Locker, 1963, 228231.
11
Op de Hipt, 1972.
56 commentary
00u in the sense well-jointed (X. Cyn. 4. 1). The Latin sux -osus
which combines the characteristics of both Greek suxes, expressing
both pathology and similitude may be compared.
12
The two formations
may coexist, as in the case of j and u: there are
twelve Hippocratic instances of each, the former in the gynaecological
works, Diseases 4, Regimen 3 and Drugs; the latter in Epidemics 2, 4, 5, 7
and Koan Prognoses.
o r _u _ gradually, over a long time: the identical
pairing of adverbial phrases occurs in Prorrhetic 2 (Prorrh. 2. 43 [9.74 L.]),
of skin diseases.
u of this person: the demonstrative regularly refers to the patient,
especially in contexts where patients with dierent conditions, requiring
dierent treatment, are discussed.
0i j j i i o r purge the head and
cauterise the vessels: the physician is presumed to know what drug to
use in purging the head (for the recommendation cf. 4. 2 and 7. 1) and
where and how to perform cautery (cf. 2. 1, 4. 12, 5, 7. 1 and especially
3. 14). Purging the head was such a routine matter (commonly a
treatment for eye ux, as Loc. Hom. 13. 2, 4 [6.300 L.]) that specication
of drugs is rare; but it is known that celery juice, onion (juice), myrrh
and ower of copper were among materials used (Morb. 2. 19, 22, 25
[7.34, 38, 40 L.]).
j 0 o0 0 and if he has this done at the beginning: sc.
the beginning of the treatment, or of the problem. In H o0 is written
but corrected to 0u0 a synonymous lectio facilior; this reading (in
W, tr. Calvus si curetur if treated, followed also by Cornarius) prepon-
derates in the tradition. The expression 0 (or o) o is used
both in description of symptoms and (more rarely, as here) in descrip-
tion of treatment; the two senses can coincide in close proximity (Epid.
5. 8 [5.208 L.]). In the latter sense, it is used especially of postulated
treatment, which if followed would be or would have been successful
(cf. Epid. 5. 7 [5.208 L.]; Epid. 5. 26 [5.226 L.]; Nat. Mul. 13 [7.330 L.];
Mul. 2. 112 [8.242 L.]).
12
See Langslow, 2000, 340342.
commentary 57
i the trouble is arrested: the verb is used similarly, of
arresting phlegm (Morb. 3. 1 [7.118 L.]), bile (Int. 35 [7.252 L.]) or pain
(Int. 51 [7.292 L.]).
i 0 t ri does not go on to get worse: the
corollary expression ri i (of amelioration) is used in the case
histories of Epidemics. bad, a common enough word in Greek,
is considerably less common in the HC than might have been expected
(sixty-one occurrences, of which twenty-ve are in Koan Prognoses; there
is a cluster also in Fractures and Articulations).
2. l r u intermediate: sc. the visual parts.
r_ r_ r_ r_ r rr ro
when someone is young older when someone is older than seven
years: the genitive is comparative. A disease aecting the eyes, and
commonly recurring in the seventh or fourteenth year, is described in
Diseases 2 (Morb. 2. 12 [7.20 L.]). The period suggests a belief in the
importance of the number seven associated with ancient, especially
Pythagorean, numerology: seven days is commonly signicant in the
description of fevers. Sichel, following Jugler, supposes a lacuna after
rr ro, but the fractured nature of the Greek precludes condence.
There is probably some minor corruption: the mss punctuate variously
(some having a sense break after r oj sees quite well) and
disagree on connectives (i or r or even, unidiomatically, both).
0i settle down: the change from the simple i0 to the
compound 0i0 seems to be merely stylistic variatio. For the
sense, cf. 0 o00 r the condition of the eye (bloodshot
and weeping) settled down (Epid. 7. 11 [5.384 L.]).
0 0 ahead, in front: this is a slightly odd expression, the
preposition, lit. from, being otiose in conjunction with the sux con-
veying the same sense, from. However, we may compare Plato i
0 r j still searching ahead, lit. to (the area) from
the front (Sph. 258c). The implication here is loss of peripheral vision:
the patient sees ahead, but only ahead and even that not well. A sec-
ond point is made in the next sentence: the patient is short-sighted.
Compare the description of the u short-sighted person in the Aris-
totelian Problemata: he brings things up close towards him in order to see
58 commentary
them, whereas the u aged person removes things to a distance
from him (Probl. 31. 25, 959b).
u in these people or patients: demonstrative, as above.
Phlebotomy is more commonly expressed by 0i 0 i
genitive (VC 18 [3.250 L.]; cf. A. 22 [6.234 L.]).
j 0t in the sea-like case: the dative is read for the unani-
mously incorrect accusative of the mss.
II
It is stated that a certain condition which may appear in childhood is
to be left alone until the suerer is fully grown, then treated by surgery
to the eyelid. The rst consideration is that the transmitted text gives
nonsense. The opening words r t o0t as to the
eye in the eyes are meaningless, and the ensuing genitive absolute,
introducing sight merely compounds the diculty. Sichel nds
the chapter trs-obscur; he translates, Quant la vision des yeux, la
pupille ayant conserv son tat normal but notes that there is no
parallel for in the sense of vision; his diagnosis is une ambly-
opie amaurotique survenant sur des individus jeunes Ermerins too
comments on the diculty of the passage; following Foesius verbatim he
translates et oculorum visum, cum videndi acies sana fuerit and the vision
of the eyes, when the eyesight is sound , but notes that it is not at all
clear what is intended by the , and declines to attempt identica-
tion of the disease. Joly translates (but without justication) Quant la
vue elle-meme, la pupille tant saine and comments that this prob-
lem might be une myopie, laquelle se stabilise aprs la croissance;
he notes that the treatment envisaged might occasionally be eective in
serious cases, en provoquant une vasodilation.
13
The word , said
by LSJ to be poetic and rare in prose, is in itself unexceptional, being
Ionic rather than poetic (seventy-three occurrences in the HC and in
some works, such as Prorrhetic 1, preferred to o0).
A simple emendation, corroborated by Hippocratic parallels, notably
in Prorrhetic 2 (Prorrh. 2. 18 [9.44, 46 L.] discussed below), gives perfect
sense: o i r t o0t as to sores in the eyes. The
13
Sichel 138; Ermerins Prolegomena XL; Joly 173, notes complmentaires.
commentary 59
corruption is readily explained, on grounds both of visual similarity,
which would be especially marked at the majuscule stage,
14
and of
intrinsic plausibility, a technical term being supplanted by a common
word, apparently suitable in context. The emendation has the added
merit that it provides a quasi-heading at the start of a new topic, as is
common in such nosological accounts (cf. the emphatic rst words of 1,
5, 7 and 9).
The term j with the common diminutive form i refers to
noxious matter collecting in or owing from the eyes: rheum, dis-
charge, secretions. Properly speaking, rheum is not a disease but a
symptom. Here, it can be viewed as a protracted irritation in the eye
which might lead to any one of a range of chronic conditions: the char-
acteristic symptoms of conjunctivitis (soreness, grittiness, eyelids sticking
together overnight with secretions at lid margins) and of blepharitis (red
eyelids with scaling along the margins) are essentially similar to condi-
tions such as entropion, where the lower lid is rolled over and the lashes
irritate the eye, and ectropion or eversion of the lids, where there is
similar concomitant irritation.
15
For the latter there is copious archaeo-
logical evidence.
16
In Prorrhetic 2 (Prorrh. 2. 18 [9.44, 46 L.]), echoed as i o
i 0o (sc. o ) small sores around the sight in Koan Prog-
noses (Coac. 2. 214 [5.630 L.]) there is a long and detailed discussion
of o0i u eyes suering sores, where dierent develop-
ments of such a condition are considered. In this passage, j (singu-
lar) is a key word, repeated eight times, cf. the diminutive i (plural)
of Koan Prognoses. Throughout the passage, attention is paid to the
nature of the discharge, which may be mingled with tears, white and
soft (prognosis good) or yellow and livid (prognosis bad) or dry (prog-
nosis pain, but short-lived) and also to the type of swelling, with regard
to its size, pain and dryness, and to the type of tears, with regard to
their heat and salty quality. In sum, the doctor should consider o r
0 o00 r the stu owing from the eye. The feared out-
come is r a lesion, ulceration which might aect both pupil and
lids (i j r0j i t o) and in extreme
cases j rupture of the eye; this is described in the ensuing chapter
and is evidently prolapse of the eye contents, seen today only in major
14
Cf. Jouanna, 2000, 98 for such corruption in M and mss derived from M.
15
See Bedford, 1971, 4243, gs 26, 26a, 4445, gs 27, 27a and 136137, g. 94;
Trobe and Hackel, 2002, 34, 58, 6364; Spalton et al., 2005, 107.
16
Chaviara-Karahaliou, 1990, 138; Gourevitch and Grmek, 1990, 5860.
60 commentary
eye accidents. The account in Prorrhetic 2 is surely one of the sources,
and probably the main source, for Celsus account of the complications
of inammation of the eye (see especially 6. 6. 10, 6. 6. 31). Celsus may
be familiar also with On Sight in listing many dierent types of vesicae
growths on the upper eyelids and allowing for some which generally
occur in children (7. 7. 3).
A precise prediction is made for cases where the swelling subsides
but tears persist and discharge continues: in the case of men there will
be eversion of the eyelids (lit. turning away: the same verb rr
is commonly used of the womb leaving its proper place); in the case of
women and children, both ulceration and eversion of the lids (cf. the
dierentiation between male and female patients in On Sight). Thus, the
constant shedding of teary matter, not in itself problematical, leads to
problematical complications. Similarly, the appearance of sores in the
region of the pupils is declared a bad sign in parallel passages of Prog-
nostic, a treatise possibly by the same author as Prorrhetic 2, as in Koan
Prognoses (j, Prog. 2 [2.116 L.] and i, Coac. 2. 214 [5.630 L.]).
Symptoms of spring ophthalmias detailed in Epidemics 1 include stream-
ing, pain, and troublesome o i small sores (Epid. 1. 2. 4.
[2.616 L.]).
A succinct but clear description of eye troubles is found in Ancient
Medicine, there embedded in an account of the pathological eects of
ux to nose, eyes and throat, i.e. chest (VM 1819 [1.612, 616 L.]).
The processes in the three uxes are presented as parallel, with par-
allel features.
17
The account in Ancient Medicine has strong similarities
with material in Prorrhetic 2: emphasis on discharge called j, ulcer-
ation of the eyelid (here clearly the lower lid, as it is stated that ulcer-
ation may extend to the cheek), ulceration in the eye ( 0i j
u the tunic around the sight, i.e. the sclerotic membrane);
symptoms of streaming, pain and inammation. There is one salient
dierence: in Ancient Medicine, the formation of a sore is viewed as the
resolution of the problem, release coming through coction and thick-
ening of the streaming matter (r 0 o u 0j i r-
u i j 0 0u j). More commonly, as in On Sight
and Prorrhetic 2, the sores themselves are viewed as problematical or
potentially so. But in the Aristotelian Problemata, tears in eye pain are
described as cold, because r 0 , the unconcocted
17
On the sequence, see Craik, 1998, 138 and on parallelisms Jouanna, 1990, 199,
n. 3; 200, nn. 5, 6.
commentary 61
is cold (Probl. 31. 23, 959b20). The theory of ux follows similar lines
in many treatises. In Places in Man, treatment for ux to the eyes with
attendant ocular ulceration and rupture aims to remove o -
coagulated tear or coagulated material from
the eye (Loc. Hom. 13.1, 7 [6.298, 302 L.]). In Glands, matter in ux from
the brain, causing disease if it is not removed, is uniquely designated
u impurities, purgations (Gland. 12 [8.564 L.]): it may be sus-
pected that this apparent hapax legomenon is in fact another corruption of
i, this time by an aural error of a notoriously common type. (The
language is similar to that of VM: verb rt below in 12 [8.566 L.] and
r 0i, a reference to coction, above in 11 [8.564 L.].) Dexip-
pos of Kos held similar views of disease-inducing ux: bile and phlegm
melt and in more liquid form lead to ichors and sweats which putrefy
and thicken, bringing j. u. jtroubles in ears, nose and
eyes (Anon. Lond. XII. 2226).
In this section, strongly didactic, the pupil reader is directly ad-
dressed with second person singular verbs, as in the warning 0 0
ui (where Joly needlessly emends to ur) but he must work
using his own discretion j j t0. Imperatival innitives
and nominative participles again occur: o u. u
i ri. The syntax is jerky, with conditional and temporal clauses
piled up, and with a genitive absolute (rare in this work) equivalent to a
conditional clause awkwardly preceding another genitive phrase.
1. o i in the case of sores: the term was widely used in a
metaphorical sense (most famously applied by Pericles to the island Aig-
ina seen in relation to the Peiraieus, Arist. Rh. 1411a15, Plu. Per. 8) and
proverbially (Ar. Nu. 327); the prevalence doubtless reects a high inci-
dence of eye disease. Lexicographers (but not Erotian, who often fails
to help where help is most needed) explain. Hesychios glosses the plural
as l i u 0u u o0u t o collections
of matter xed about the corners of the eyes and as rr u
o0u 00i impurities owing from the eyes, and the singu-
lar as r o0t o. 00i white moist
stu gathered in the eyes, impure matter (Latte, 1953, 592, 593). The
terms o or are cognate, the latter used of bleary eyes (as
Mul. 2. 116, 119 [8.250, 258 L.] and Mul. 1. 105 [8.228 L.]), the former
used of blear-eyed people (cf. Hesychios on these forms). Galen glosses
i u i i bleary: bleared and moist (linguarum Hip-
pocratis explicatio, 19. 91 K.). See also Pollux Onom. 2. 4. 65 and 4. 25. 184
62 commentary
for the inclusion of j and 0 in eye diseases and LSJ on cognate
forms from EM. Hesychios glosses o u blear: mucus and
0 0. 0 to have bleary mucus: to be bleary, blear-
eyed (Latte, 1953, 378) are a telling indication that peccant matter from
eyes and nose was viewed as essentially the same; furthermore the gloss
o 0 (Latte, 1953, 569) is probably an error for u. This can
be seen too in the standard medical view that noxious stu at the eyes
could be expelled through the nose. (But u has a wider semantic
range than j. Though generally used of nasal mucus, it can refer to
other body uids also.)
18
j r ru where the visual part is sound: i.e. provided it
does not aect the sight or, in the terminology of 1 above, where the
organ is not destroyed.
u r 00u in younger people: here, till mid teens, when
growth is complete. The change from plural to singular (ad sensum) is
readily acceptable.
j 0i j. j 0 whether the person is female or male: Ms
0i can stand, as 00 is common gender (cf. Lys. 1. 15). The
injunction to wait until adulthood before attempting surgery is sensible;
a similar policy, similarly expressed can be seen in Articulations (Artic. 62
[4.264 L.]).
0u u o0u o considering the actual eyes: the dative
singular of the mss could be understood as considering (the patients)
eyelids with his (the operators) eyebut this is intolerably otioseor
as with (i.e. as well as) the eye, considering the eyelidsbut this is
cumbersome. Neither interpretation makes acceptable sense. Further,
the verb r0 consider is invariably followed by the accusative
(or by a preposition) in the HC and the plural rather than singular
of eye is required. For these reasons, Ermerins emendation of the
unidiomatic dative singular to the accusative dual is very attractive,
though the dual number is rare in the HC, occurring only in the
gynaecological works and in Epidemics 5. The verb is used in a similar
sense to o0 below, 5.
18
See Craik, 1998, 19, 127.
commentary 63
o r u attenuate (rene, reduce) the eyelids: make -
thin, as opposed to u thick (cf. 5 init.) On the recommended
procedures, scraping if necessary (here perhaps with a needle rather
than a scalpel) and cautery, see on 4 below.
r0 from the inner part: here, from the inner part of the eyelid,
that is the inner corner of the eye (pace Joly en dedans; this would
require giving the sense evert to u). The author writes with
standard anatomical precision: with this term compare 0, 3.1 (bis)
and o0, 3.3 of directions in the body.
j r not with white-hot instruments: the injunction that
the instruments should not be too hot is sensible for the delicate eye
area; elsewhere instruments are to be very hot, for armpit (Artic. 11
[4.106 L.]) or rectum (Haem. 2 [6.436 L.]); cf. also Steril. 222 [8.430 L.].
Erotian ( 18) glosses r (same case as here and 5 below),
but probably with reference to Articulations (Artic. 11 [4.106 L.]); also
(T 34) o r j white-hot instruments, but probably with
reference to Haemorrhoids (Haem. 2 [6.436 L.]).
19
III
The subject of this chapter is cautery of the vessels; but the crucial
information about which vessels, in which part of the body, are to
be cauterized is unclear, and the expected information about the rea-
sons for the procedure is lacking. It must be conceded that the tran-
sition from discussion of miscellaneous ways to address particular eye
problems in Chapters 1 and 2 above to detailed surgical instructions
for an unspecied general problem, where the eye is not even men-
tioned, in Chapter 3 is abrupt and the introductory word then lacks
context. However, the immediately preceding phrase ri j -
r cauterising, but not with white-hot instruments clearly leads
to, even if it does not actually introduce, the excursus on cautery; the
connection is clear enough in this authors loose, almost stream of con-
sciousness, manner. It is possible that, if oral discourse was the orig-
inal medium, the mention of cautery prompted a learners question,
which is answered at length. Or, if we think in terms of written compo-
19
Nachmanson, 1917, 381, 645; 439, 484.
64 commentary
sition, it may be that the whole chapter has been lifted from a work
on cautery, without proper adaptation to its new position. That such
manuals existed is intrinsically probable. The close resemblance of
material here with passages of Places in Man (Loc. Hom. 13 and 40 [6.302
and 330 L.]) in both content and expression suggests at least a common
stock of lore, and possibly a common written source.
Sichel comments that we have prceptes gnraux sur le mode
dexcution de lustion des veines, asserting (wrongly, see below) that
cautery in the back is taken as an example, comme applicable
un plus grand nombre de maladies and (rightly) that cautery in all
parts of the body is believed to follow the same principles. He won-
ders, following Cornarius, whether the chapter is somehow misplaced.
Ermerins allows cautery to be relevant because of its use in ophthal-
mology, but nds the sense awkward and has recourse to some emen-
dation and extensive deletion. Joly sees no relevance in the chapter,
commenting dismissively Ce chapitre semble gar dans une oeuvre
dophtalmologie.
20
It is here argued that cautery of the vessels in the
back of the head and neck is intended, and that the purpose is to arrest
a ux of noxious matter primarily aecting the eyes and secondarily
threatening lower parts of the body. Our surgeon, who clearly allows
for uniformity in the general practice of cautery at the end of the chap-
ter, was doubtless familiar with dierent procedures, for dierent con-
ditions, but his main concern is surely with ophthalmology.
The eects on the eyes of two types of ux (cf. Places in Man 1.3, 13.3
[6.276, 300 L.]) are here allusively indicated: ux A (supercial, mucus-
like in content, coursing from the scalp to the temples, with potential to
stray further, if unchecked) and ux B (deep, salty in content, coursing
from the brain to the inner corners of the eyes, with potential to
stray dangerously further if uncheckedand viewed as hard to arrest).
In ancient ophthalmology, cautery of the vessels of the temples was
a routine treatment for ux A; in the case of ux B, other vessels
were addressed, the aim always being to prevent peccant matter from
spreading further down the body. In Places in Man the vessels which
press on the eye, those which constantly beat and are situated between
ear and brow are cauterised (Loc. Hom. 13.7 [6.302 L.]). In Diseases 2
these vessels are cauterized, but treatment extends comprehensively to
six other vessels of the head: two alongside the ears, two at the inner
corners of the eyes, and two
20
Sichel 139; Ermerins Prolegomena XL and 280, n. 3; Joly 169, n. 1.
commentary 65
behind the head on either side at the occiput (Morb. 2. 12. 6;
cf. 2. 1 and 2. 8 [7.22 L.; 7.8, 10 L.]). In addition, cautery of the neck
was practised in order to stop the progress of noxious matter to the
esh 0 behind by the vertebrae and to divert it to the nose for
expulsion (Loc. Hom. 21.1 [6.312 L.]). The usage of 0 behind in
these passages to indicate the back of the head or neck, rather than the
back itself, parallels usage here; similarly a contrast between r0
and 0 with reference to the front and back of the head can be
seen in Head Wounds (VC 2, 3 [3.192, 194 L.]).
It is important to note that the adjective t with or without
the substantive is commonly applied to the spinal uid, rather
than to the blood vessels of the back (Artic. 45, 46, 47 etc. [4.190, 196,
202 L.]; Mochl. 1 [4.342 L.]; Gland. 11, 14 [8.564, 570 L.]); and while
or may refer to the sacrum (usually as l or) it is not used
of the backbone generally. Thus, the vessels loosely designated of the
back may be more precisely designated as the vessels which run from
head to neck and to back, that is those through which the t
marrow or spinal uid was believed to course from the brain
to the lower body. The simple term or lit. bone is commonly used
of the skull, where context makes it clear that the skull is intended (as
throughout Head Wounds): the term o cranium occurs only twice
in the HC (lower jaw joins the cranium at the temples, VC 2 [3.190 L.];
see also Epid. 7. 124 [5.468 L.]), though it may have been popularly used
(cf. E. Cy. 683). It may be added that the bones of the neck, the cervical
vertebrae, were recognised to be continuous with those of the back.
Conrmation that the authors concern is with specialist matters of
ophthalmology comes from Celsus. Several points in Celsus account
of eye therapy pick up and illumine passages of On Sight, where the
narrative is compressed and allusive to the point of unintelligibility,
notably the phrases having bound and having traced: Celsus explains
how a ligature is placed round the patients neck, and how the vessels
of the temples and the top of the head are marked with black ink (7. 7.
15 H). Further, Celsus leisurely explanation permits emendation of the
puzzling repeated phrase from below in 3.4. In an extended discussion
of treatments for phlegm descending from the head to the eyes (7. 7. 15),
Celsus distinguishes between a ux of phlegm from the upper vessels
that lie between skull and scalp, i.e. above the skull; and a ux of
phlegm from the lower vessels that lie between skull and membrane
of the brain, i.e. below the skull. The rst case is common and readily
treated, the second is serious and intractable. The reason for this is
66 commentary
that the vessels in the rst case are accessible (above the skull, coursing
to the temples) whereas in the second they are inaccessible (below the
skull, coursing from brain to eye). Celsus allows for the possibility of
ux from both sources simultaneously.
Celsus is quite emphatic that this knowledge is widespread, and that
procedures to arrest the ow of phlegm by treating the vessels are
a matter of common and universal practice, celebrated not only in
Greece but among other peoples too, to the extent that no part of
medicine is more widely practised throughout the world. While the
aim was universal, a wide range of diverse procedures was used in
dierent communities and at dierent dates to attain it: some made
a series of incisions at various points in the scalp; some used cautery
at various points instead or as well. This considerable local variation
in the choice of the precise point to be targeted is corroborated by the
evidence of other medical authors, and by papyri of ophthalmological
content.
21
In some societies too the procedure was routinely applied to
neonates (among the Ethiopians, Severus ap. Aetius 7. 93) or to young
children (at the age of four years, among the Libyans, Hdt. 4. 187. 2),
while in others it was a response to a pathological state.
A Galenic work supplements and veries the substance of Celsus
account. In a late section of de methodo medendi, a vast compilation in 14
books occupying over 1, 000 pages in Khns edition, similar views on
aetiology and therapy are propounded. As it is the head which sends
0 ux to the eyes, the head must be treated rst; sometimes ux
comes from the brain and sometimes from the vessels; when it comes
from deep 0t pockets (sc. in the brain) it is hard to treat; the
general treatment is by phlebotomy. Detailed instructions for this are
given: shave the head; carefully address the vessels oi behind and
those by the ears and those in the forehead and brows; cut those which
beat most; it is better to apply a rope (, lit. noose) before cutting.
It is explicitly stated that some doctors cut out part of the vessels in the
belief that this is the only eective treatment (10. 937942 K.). The
vessels treated are those in the back of the head, in the region of the
ears, and those in the temples. There is not much reference to cautery
in Galen; but he does recommend cautery ri u r
o0u for eye ux (introductio seu medicus 14. 782 K.).
Celsus gives an account of two positions adopted for eye surgery:
the patient may be seated on a chair facing the doctor (surgery on the
21
See Marganne, 1994, esp. 147172, with gs 1318.
commentary 67
right eye), or have his back to the doctor and his head resting on the
doctors lap (surgery on the left eye); the two positions are designed to
give good light and easy access for a right-handed practioner (7. 7. 4).
The second of these two positions resembles that of On Sight. In any
case, the general intent of our surgeons preparations is now clear and
the scene in the surgery can be visualized as follows. The patient lies
prone, legs extended, on a couch, probably leaning on the oor with
his hands in such a way that the head is below the level of the trunk,
causing the vessels in the head to become engorged and so more visible.
His waist is heldpresumably to keep the patient in place, or to press
him hard downby someone, who may be the doctors attendant or
perhaps a member of the patients household. The surgeon is sitting (or
standing, depending on the height of the couch) alongside or slightly in
front, where he can reach over the head of the patient, in such a way
that he can apply a ligature to the neck, trace the precise location of
the vessels of the head (in the crown and occiput; also beside the ears,
in the temples and in the neck)or perhaps even the entire course of
the vessels is to be traced for purposes of didactic demonstrationand
then operate with instruments handed to him by an assistant.
The language is entirely in accord with the rest of the work. The
sentence structures are primarily paratactic. Nominative aorist partici-
ples are used in conjunction with jussive innitives. There is asyndeton
(especially in 4). Triadic expressions are used of the swelling of the ves-
sels in 3 and, with variatio, in 4. Several unidiomatic or elliptical expres-
sions (j 0 o 0_u _u or_. oi r. 0 o
j o. j u 0. o 0) may arise
simply from the functional nature of the work, or from distortion in
transmission, or may betray imperfect linguistic knowledge on the part
of the writer. Although the language is consistent, there is a certain
unevenness of content. Sections 12 are uncompromisingly surgical,
clearly indicating a series of steps to be followed by the doctor, each
introduced by r next. Sections 34 contain more general com-
ments and advice, some of it aphoristic in character. A similar uneven-
ness characterizes Chapter 9 below.
1. r then: editors agree in supposing a lacuna before the rst
of the ve then conjunctions; but in this breathless composition the
Greek can readily be understood as it stands as a series of memos.
There is a double parenthesis after the rst then conjunction, which
is recapitulated in the second: Then (having bound, having stretched
68 commentary
out the legs, having set below a couch from which he can lean with
his hands)let someone hold his waistthen The aorist participles
indicate preparatory actions, and the associated innitives main pro-
cedures (in reverse order: see translation): 0j. ri. 0i
followed by j0. t then in section 2 r0i followed
by ri and u by r0r. This is a series of technical
instructions, to be followed in a precise sequence. A similar use of piled
up participles can be seen at 7.1 and 8.1 below; a similar use of then
can be seen in 6 below (three times repeated). The use of in 4.1
and I in 4.2 is also sequential but less precise.
0j lit. having bound: the verb applies not to the patient himself
but to the ligature. Similar expressions are used of attaching sponges
or swabs (as in preparations for succussion, Mul. 2. 144 [8.318 L.],
Steril. 248 [8.460 L.]) and of the related process of applying a bandage
as a tourniquet to arrest any uncontrolled bleeding after venesection
(see practical instructions on what to do if bleeding continues after
phlebotomy, Ulc. 26 [6.430 L.]; more theoretical comments on the use
of ligatures when cutting, especially in the arm, Medic. 8 [9.214 L.];
explanation of dierent types of ligatures either to accelerate or to
arrest bleeding, Epid. 2. 3. 14 [5.116 L.]). Hesychios glosses a range of
cognate words 0r. 0j. 0o (0 up with root r
bind) all with reference to garlands etc. tied on the head (Latte, 1953,
149); the prex may suggest attention to the upper part of the body.
ri lit. having outstretched: cf. Mul. 2. 144 [8.316 L.]. These two
rst instructions are reminiscent of the many passages in Fractures and
Articulations which specify that when bandaging is carried out the limbs
must be in a particular position for treatment; either straight, as in the
case of the leg, or exed, as in the case of the arm (cf. Fract. 15 [3.470,
472 L.]).
i 0 u j a couch from which he can lean: editors
have unanimously disregarded the preposition 0 from, understand-
ing it as, or even emending it to, ri on; Joly, for example, following
Sichel verbatim, translates on lui fait prendre avec les mains un point
dappui sur le siege o il est assis However, it is clear that the patient
leans not on, but from, the couch. The couch is not here a special sur-
gical appliance, like an operating table; the word is the ordinary one for
a household seat. Other Hippocratic passages where a couch is spec-
commentary 69
ied are in Physician (general requirements, Medic. 2 [9.206 L.]), Articu-
lations (for a patient with dislocated shoulder, Artic. 7 [4.92 L.]) and in
the gynaecological treatises (for birthing, fomentations and other proce-
dures).
r r rr: let someone hold his waist: there may be an
implicit metaphor from wrestling (cf. Ar. Nu. 1043, with scholiast);
22
but
the literal sense predominates. Simply, the patients movements are to
be restrained. Explicit instructions that the patient be kept immobile
are given with regard to surgery for haemorrhoids (Haem. 2 [6.438 L.])
or where pus is to be expelled (Morb. 2. 47b. 4 [7.70 L.]). The mss
are at variance over punctuation, and the reference of j i.
Instead of referring to the patients hands, leaning from the couch, this
would, with a comma after i, refer to the assistants hands,
holding the patient. For in the sense (doctors) assistant, cf. Artic. 16
[4.128 L.].
j0 o i r. t r 0 trace the ves-
sels of (= running to) the back, and examine from behind: Sichel recog-
nises that the terse instruction intends marquer avec une substance
colorante telle que lencre but does not refer to the corroborative mat-
ter in Celsus (cited above). The tautology of the insistent stress on the
location behind and on surgery behind troubles Ermerins, who com-
ments testily that one would hardly look for these vessels r0
from the front; Joly nds that les derniers mots ne semblent pas don-
ner un sens satisfaisant. Foesius too found the reading obscure: he took
the passage to treat ustionem venarum quae sunt in dorso cautery of the
vessels of the back but he did perceptively note that this is an odd des-
ignation for the upper part of the back and seems to have understood
that the neck (rather than the back) is intended, in commenting that
in urendo venas colli tendines et nervos vitari volunt in cautery of the ves-
sels, they wish the tendons of the neck and the nerves to be avoided;
Aristotle had warned of the dangers of hitting a neuron while cauteriz-
ing the vessels (HA 3. 5).
23
As Foesius notes, Calvus translates scapulares
and may have known a reading ui in the shoulders; however,
he, or an early emendator, may simply be trying to alleviate a per-
ceived problem. As argued above, the solution lies in the precise sense
22
See Iugler, 1792.
23
Sichel 139; Ermerins 280; Joly 169, n. 2; Foesius I 736, n. 4.
70 commentary
of i not of the back but rather coursing to the back. The
verb i occurs six times in the HC but only here in the mid-
dle form. The simple form is common, with over two hundred occur-
rences and the middle of the simple verb is used in a way similar to
use of the compound here in Fractures (Fract. 3 and 5 [3.422, 434 L.]).
The usage is in line with the authors general preference for compound
verbs.
r i with thick (or wide) instruments: such instruments
are to be used, because of their slower and gentler action. It can
be seen from other passages describing the practice of cautery that
dierent types of instruments were regarded as appropriate in dierent
situations (see especially Artic. 11 [4.106 L.]; Int. 18, 28 [7.212, 242 L.]).
Cauterising instruments were most usually made of metal (as clearly
here, j lit. iron; 3.2 j lit. burner is not inconsistent,
but simply a more general term). They might also be of wood dipped
in hot oil as in Internal Aections (boxwood spindles, Int. 28 [7.242 L.])
or of vegetable matter of certain types (cf. the material used in oriental
moxibustion).
ji 0i heat gently: gentle application of heat would be
less likely to cause haemorrhage; compare the similar general passage
on the practice of cautery in Places in Man (Loc. Hom. 40 [6.330 L.]).
r r 0 i. j j i let blood in advance,
if it seems the right course: a cautious approach to blood-letting is
apparent throughout this work. As cautery and phlebotomy fullled
broadly similar functions (to reduce unwanted bodily moisture or elim-
inate eshy tissue), it seems that individual practitioners or corporate
groups favoured use of one or the other method. The use of the term
proper circumstances indicates adherence to the standard prac-
tice of studying the relevant circumstances of the patients condition (cf.
i r u, 9.1 below; 0 i 0i j j 00j, Morb. 2.
73 [7.112 L.]). After a discussion of kairos in medicine the author of Dis-
eases 1 gives examples of improper treatment. Cutting and burning are
included: the doctor should not use these methods inappropriately, and
if using them should not fall short in length and depth of surgery (Morb.
1. 56 [6.146, 148, 150 L.]). The prex - in advance, beforehand is
commonly used in expressions of preparatory surgical procedures, such
as o fumigate beforehand.
commentary 71
i r or 0 cauterise towards the bone from
behind: this nal instruction of section 1 is reminiscent of the most
eective treatment, according to Celsus, which was the Afrorum curatio
the therapy practised by the Africans, in which verticem usque ad os
adurunt they burn the crown of the head right through to the bone.
However, perhaps the point to be targeted here is not the j
crown, or top of the head; but rather the ii, occiput or a point
at the base of the skull (cf. Morb. 2. 12 [7.22 L.], noted above).
2. This further phase of the treatment indicates how to continue cau-
tery by applying a sponge impregnated with olive oil. The purpose of
the sponge is not made clear. It might be interposed to protect the esh
from the instrument (as a sponge is placed over a cauterized area in the
mouth for protection when the patient is eating, Morb. 2. 32 [7.50 L.]),
or used as absorbent material to mop up (cf. Artic. 38 [4.168 L.]), but
is more probably intended to allow deeper penetration by the oil.
Foesius supposes that the sponge is used alone as an alternative to
the metal (spongiam oleo fervente tinctam intelligo, qua ustio at I understand
this as a sponge dipped in boiling oil, to carry out the cautery) but
this ignores _ i_, a phrase certainly dicult in context and
deleted by Ermerins as an absurd insertion.
24
Sichel, followed verbatim
by Joly, translates si lponge adhre au cautre, but adhere would
be a very strange sense for r0. The verb is common in
the sense accept (LSJ I) or admit (LSJ II) of a patient accepting or
tolerating a particular type of food or drink (especially in Epidemics;
see Epid. 7. 43 [5.410 L.] etc.); it is particularly used in the context of
a doctor experimenting and adapting treatment to a patient: o 0
o r (with reference to the patient) u (with
reference to the doctor) trying whatever she will tolerate (especially in
the gynaecological works; see Nat. Mul. 40 [7.384 L.] etc.). It is unclear
why the patient might not tolerate the sponge: perhaps it would make
the cautery more bulky and uncomfortable over a wider area; perhaps
hot oil would be more unbearable even than hot metal. There is a
(remote) possibility that sponge refers to a special kind of fungus used
in cautery; it has been suggested that this fungus was known to have an
eect such as that of penicillin.
25
24
Foesius I 688 and 736, n. 6.
25
Nielsen, 1974, 8386.
72 commentary
Later arum coated with honey is applied. Arum was used to close
wounds and in various eye troubles (Diosc. 2. 167). The telegraphic
prose fails to specify which part of the arum plant is to be used (proba-
bly the root, as usually elsewhere),
26
or in what form (probably ground
up, as usually elsewhere), or in what quantity. We may contrast a pas-
sage in Diseases 2, where the precise amount of pulverised arum root is
specied, to be used in combination with salt, honey and other ingre-
dients in an orally administered medicine for a lung complaint (Morb.
2. 47.2 [7.66 L.]). There are parallels in Aections for the use of fabric in
conjunction with the cauterising instrument (A. 29, 31 [6.242, 244 L.]).
sponge: the variant i recorded by Foesius is doubtless
inuenced by the diminutives following.
ri cauterise over: the unusual double compound, lit. cau-
terise in and down shows the preference for compound forms already
noted. This type of compound has the following distribution: very
noticeable in Places in Man (rj. rr and r-
o, rr. rr); marked in the gynaecological
works (r0o. r0i. r0i. ri) two occur-
rences in Acute Diseases (ri. ri); one each in Epi-
demics 4 and Regimen 1 (ri).
j (little) instrument (for cautery): the diminutive is hapax in
the HC, while i little sponge following is common. Diminu-
tives are especially frequent in the gynaecological works, but there is a
related crop in some of the surgical works; e.g. of nineteen Hippocratic
occurrences of i lead all are gynaecological except for a few
in Articulations and Mochlicon, and one in Fistulas.
r u moisten with honey: The addition of r (I and mss
derived from I) does not aect the sense. G has the typically unhelpful
gloss r.
ro eschar: throughout, 3. 2, 3. 4; 4. 2; 5, this word, lit. hearth or
re is used in a transferred sense of the scab or cicatrice formed on
wounds after cautery; cf. Celsus 5. 26. 33C.
27
26
See Petrequin I 1877, 377, n. 21.
27
See Chadwick, 1996, 114.
commentary 73
3. Section 3 begins with predictions for what can be expected after
cautery, when the cicatrice falls o. These instructions, with stress on
the need to cauterize thoroughly (or rather right across
or right through) are close to those of Places in Man (Loc. Hom. 40
[6.330 L.]). The verbs and describe not incision
but section right through the vessel (and on the importance of the point
of section, see Haem. 5 [6.440 L.] and Artic. 68 [4.282 L.] with Mochl. 34
[4.376 L.]).
28
The latter part of section 3 returns to consider conditions
of cautery itself; after this intervention, section 4 continues discussion
of the aftermath of surgery in a somewhat repetitive fashion. The sense
of lit. in the same way is quite unclear (the same as before;
the same as it ought to be; the same as in some other unspecied case;
or perhaps the same throughout, i.e. evenly). Nor is it clear whether
the appearance of the vessels, described as stretched or extended and
full or swollen, is being presented as a desirable and normal or an
undesirable and abnormal state. The similar description in 4 seems to
be of a good condition, after healing. The verb is used of the vessels
both in health (Oss. etc.) and in sickness (in a type of phthisis, vessels
and some are very red, Int. 12 [7.194 L.]; in a type of
dropsy, vessels throughout the body, black and thick, Int. 26
[7.234 L.]; in a type of jaundice, vessels throughout the body,
pale and unnaturally big and thick, while other vessels blackish
in colour, Int. 36 [7.256 L.]; cf. also Acut. Sp. 5 and 7 [2.406 and 424 L.]).
Here, the beating of the pulse in the vessels seems to indicate conditions
requiring surgery, rather than the normal condition of the patient after
recovery. Abnormal beating of the pulse is commonly regarded as a
pathological symptom, as in Epidemics 7 (pulse in the brows a sign of
fever, Epid. 7. 3 [5.368 L.]) and especially in Diseases 2 (two passages
where, as here, swelling is mentioned in conjunction with beating, Morb.
2. 4.1, 2 and 15.1 [7.10 and 28 L.] and a passage where it is enjoined
that cautery should continue until the beating of the vessels is arrested,
Morb. 2. 12.6 [7.22 L.]). Pulsation with sight loss is a symptom displayed
by stroke patients (Morb. 2. 8 and 25 [7.16 and 38 L.]; Morb. 3.
3 [7.120 L.]).
from above from below: with the reading
the repeated below is problematical.
28
See Petrequin I 1877, 351, n. 6.
74 commentary
Where we have two closely placed phrases, parallel in expression, we
expect them to be parallel in sense also. Ermerins emends the rst
expression and deletes the second; he also reads femi-
nine for masculine (sc. ), and translates similiter vena tenditur, et inata
est et pulsat, quia ab inferiore est id, quod inuit; sin perusta est, haec omnia
minus patitur, the vessel is similarly stretched and swollen and it beats
because the matter which ows in comes from below; but if it is thor-
oughly cauterised it sues all this to a lesser degree. Sichel does not
emend and translates very loosely: lorsque le sang aue de bas en
haut une partie infrieure du dos. But the point of this is quite
unclear. Joly emends the second expression by deleting , then essen-
tially follows Sichels translation, elle bat lorsque le sang aue de
bas en haut; si la cauterization profonde est faite en bas (du dos), tout
cela a lieu un moindre degr ; he explains, with acknowledge-
ment to Thivel, that cautery was being eected at as low a point as
possible in the body in order to prevent the upwards return of pec-
cant humours.
29
Certainly, the verb frequently suggests the ow
of noxious stu (Gland. 3 [8.558 L.], Ulc. 24 [6.428 L.] and VM 19.1
[1.616 L.]); certainly too, care was frequently taken in selection of the
best point for surgery, with a view to stopping disease going to another
point in the body (Int. 18 [7.210 L.]; cf. Morb. 3. 15 and 16 [7.140 and
142 L.]); and the supposed reference to a ux of peccant matter down-
wards in the body is consistent with the authors pathological stance.
But if this is the point, the expression is unduly contorted, and there
remains a lack of parallelism between two apparently corollary expres-
sions.
With the emendation proposed the reference is to two opposed
locations, rather than to two identical locations. The reference is to ux
from the upper part of the head, or ux from the lower part. Flux from
the upper part runs to the temples, and so the pulse is a good diagnostic
indicator; ux from the lower part (the brain) runs to the inner corners
of the eyes, and so the pulse is not signicant in diagnosis (Loc. Hom.
13.3 [6.300 L.]; Celsus 7. 7. 15).
4. General statements on the ideal conditions of the eschars or scabs
and on the healing process conclude this section on cautery. The rst
two sentences break the ow somewhat and are rejected as marginal
29
Joly 169, n. 3.
commentary 75
notes by Ermerins. The terms ro scabs, cicatrices, r le-
sions, wounds and 0i scars are interrelated, following one other
in sequence; in Places in Man, instructions are given for the use of drugs
to ensure that, after eye surgery, the lesion is drawn together, and the
nal scar slight (Loc. Hom. 13.7 [6.302 L.]). From the gloss (Souda) of
eschars as t r hollow wounds, it may be seen that following
cauterisation scabs tended to remain depressed.
o quickly: the mss are oddly confused over the form of this com-
mon adverb. In M, the end of the word is blurred. While most recc.
read o, there is evidence also for o (Ca. Mut.) and o (E).
Erotians gloss 15 o r related by Nachmanson to the lost
work on Wounds from Missiles may be related rather to On Sight.
30
ro o r r r when the sores are healed: the plural
verb after neuter plural subject may be a trace of Doric idiom.
31
r0i i 0j i are red look as if they
will remain raised: the future participle is suspected by several editors,
on the grounds that it seems to make no sense; but Ermerins u
0 as if about to break out and Foesius 0-
about to break out are no better. Sichel takes the subject to be
r vessels; rather it is 0i wounds (sc. on vessels), there being
an easy mental transition from r sores to 0i wounds. The
expression is typically loose and the reference of the fem. adj. red may
be to any of the fem. nouns in the vicinityu, r or r-
.
o 0 0 j wherever there is cautery: some doctors who put their
faith in cautery seem to have practised it wholesale. Thus, Euryphon,
named as an archetypal practitioner, was mocked in comedy as burning
his patients all over the body (Pl. Com., fr. 652 K.). Comprehensive
cautery is recommended for several cases in Internal Aections. In the
case of a kidney disease believed to course from head to throat to spine
to feet and back again (with bloodshot eyes as one symptom), cautery
was indicated at shoulder, hip-joints, buttocks, thighs and various points
in the lower leg (Int. 18 [7.212 L.]). And to counter supposed dryness of
30
Nachmanson, 1917, 85 and 1918, 367.
31
Cf. Craik, 1998, 2223.
76 commentary
the spinal uid (attributed to blockage in the small vessels leading to
the marrow, and in the passage from the brain) the instructions are
to cauterise multiple regions of the body with multiple (some twenty
in all) eschars: sacrum, back and neck (Int. 13 [7.200 L.]). Cautery
of the chest or side was regularly undertaken to eliminate empyema,
a complication of many diseases aecting the lung. Cautery of the
back was relatively rare. Cautery of the upper back was indicated,
with cautery of the chest, in certain cases (Morb. 2. 53.4 [7.82 L.]; cf.
also Morb. 2. 62 [7.96 L.]); this was sometimes a last resort (Int. 1 and
cf. 2, 8 [7.172, 174, 186 L.]). Diseases supposedly aecting the back were
subject to much speculation: dropsy, phthisis and even pleurisy might
be canvassed (Morb. 3. 16 [7.144 L.] and Morb. 2. 56 [7.88 L.]; also,
more theoretical in slant, Loc. Hom. 15, 2123 [6.308, 312, 314 L.] and
Gland. 14 [8.570 L.].) It was recognised that the nexus of blood vessels
in the back was complex (Oss. 14 [9.186 L.]). Celsus too viewed surgery
on the vessels as essentially the same, wherever in the body it had to be
practised (7. 31).
IV
In the rst section, procedures to scrape and cauterise the eyelid are
outlined, precautions are indicated and drugs for post-operative treat-
ment are specied. The second section seems to specify follow-up pro-
cedures, cutting into the forehead and purging the head; the former
procedure is elsewhere prescribed as a drastic last resort, and the latter
is usually the rst rather than the nal recourse. It is strange that, after
the lids have healed, further surgery is proposed: it may be suspected
that the text is corrupt, and that part of the second section is misplaced
or intrusive. The treatment described in the rst section is regarded by
Sichel, followed by Joly, as a response to ulceration caused by trachoma.
Sichel devotes much space to discussion of this chapter and the next,
which he takes with it: the subject is un traitement chirurgical rationnel
des granulations palpbrales or paupires trachomateuses. Ermerins
is non-committal on the nature of the disease, allowing merely agitur
de palpebrarum rasione et ustione the subject is scraping and cauterizing
the eyelids; he links the chapter rather with what precedes in Chap-
ter 3. However, this is achieved at the expense of drastic emendation
(see below on eyeball and on carti-
lage). Joly, like Sichel, nds the treatment impressive: Tout ce chapitre
commentary 77
qui traite indubitablement des granulations du trachoma, est trs
judicieux dans sa prcision et ses conseils.
32
The term trachoma, in origin a general word for roughness, has
become a specic term applied to the highly contagious trachoma
virus and its ravages. Trachoma is a chronic destructive inammation
of the conjunctiva, characterized by the formation of granules on the
eyelid; it typically starts in the conjunctival fold of the upper lid, but
eventually involves the cornea and the deeper tissues of the lid.
33
It
was probably endemic in ancient Egypt and familiar throughout the
Greco-Roman world. Trachoma, though now virtually unknown in
developed countries with good hygiene, remains the most common
cause of blindness in the world as a whole. It is unlikely that the Greek
doctors were able to distinguish between trachoma of this specic kind
and other kinds of inammation or ulceration of the eyelids, viewed
as a concomitant of protracted eye disease. Certainly, they treated
the symptoms of the trouble without awareness of its viral origin (the
causative agent, chlamydia trachomatis, not being identied till 1962)
and contagious character. Sichels argument that condition and cure
were known in antiquity, rather than being discovered by William
Adams in the nineteenth century is thus only partly valid.
There is no certain Hippocratic parallel to our passage. The term
, concrete a rough condition does not occur in the HC,
though related forms are found: rough patches once (Epid.
2. 3. 1 [5.102 L.]), and irritation twice (Acut. 60 [= 16,
2.356 L.] and Mochl. 42 [= 41, 4.392 L.]). The abstract noun -
roughness occurs also, as does the adjective rough, but
most commonly of tongue or mouth and never of the eyelids. How-
ever, several passages may be relevant to the pathology of trachoma.
One is a rather vague description of the complications of a serious dis-
ease where there are pustules and rashes on the brow such that one
eyelid grows into the other and there is acute swelling (Acut. Sp. 26
[= 10, 2.446 L.]); another is a brief reference to trichiasis, which is a
recognized consequence of trachoma (Acut. Sp. 61 [= 29, 2.516 L.]); still
another is a description of a purulent eye disease, with deep sores and
ulceration of the eye (Epid. 4. 44 [5.184 L.]); nally a reference to pro-
32
Sichel 140148, at 140 and 141; Ermerins Prolegomena XL and commentary 281;
Joly 170, n. 1. Iugler, 1792 devotes nine pages to 3 and a mere page to 4.
33
See Duke-Elder II 1934, 15931628; Spalton et al., 2005, general description 102
103 and illustration of stages 103104, gs 4. 3641.
78 commentary
tracted dry opthalmias causing internal and external growths on the
eyelids, aecting the sight and known as 0 gs is reminiscent not
only of the eects of trachoma but also of the term u, later used
of the disease (Epid. 3. 3. 7 [3.84 L.]; cf. Scribonius Largus 37).
34
There is no direct parallel, either, which might explain the ratio-
nale for the follow-up procedures described in the second section: cut-
ting into the forehead and purging the head. However, a comparison
with Places in Man (Loc. Hom. 13 [6.300 L.]) seems to show similar ideas
and practices to those implicit here, perhaps in response to the same
condition. In a discussion of ux to the eyes, the most extended treat-
ment (13.35) is of a condition where mucoid material has accumu-
lated between esh and skull, leading to r sores on the head. The
explicit statement that there is no ulceration on the eyelid (0 r0-
o r) suggests that such ulceration might have been expected,
or perhaps that the condition is a variant on one where such ulceration
featured. The treatment is mild purging of the head and purging below;
if the noxious stu is not eliminated through a natural orice the doc-
tor is instructed to cut into the head, right up to the bone, with a view
to getting it out. There are similarities also with Diseases 2 (Morb. 2. 13
[7.22 L.], in a passage following the disease discussed above in rela-
tion to Vid. Ac. 3). For a disease where there are r sores on the
head (cf. Loc. Hom. above) the treatment is to purge and if that fails to
t o cut cuts (cf. o j o 0 r here,
Vid. Ac. 4; o r 8 below is dierent, being a pre-
lude to trephining) in the head, anoint, then plaster with wool, wine, oil
and cypress, that is, with anti-haemorrhaging drugs; similarly, to arrest
bleeding sawdust of cypress is one ingredient specied in Fistulas (Fist.
9.3 [6.456 L.]). The idea of the doctor in On Sight may be that removal
of nasty stu from the top of the head will prevent its descent to the
eyes and so recurrence of trachoma.
It may be added that the supposed pathology of ux of peccant
matter from inner or outer parts of the head leads to treatment of
many diseases by various types of incision which show some features in
common with the treatment here: water in the head treated by cutting
into bregma and piercing bone (Morb. 2. 15; cf. 8.1 below [7.28, 30 L.]);
vessels overfull of blood treated by cutting into forehead and applying
a pad of greasy wool (Morb. 2. 18 [7.32 L.]). Finally, we may compare
the treatment prescribed in Aections for a disease characterized by pain
34
See Pearlmann, 1969, 1072.
commentary 79
and dizziness in the head: the rst recourse is to cleanse the head, and
let blood from the nostrils or from the forehead; if this brings no relief,
then the doctor must cut the head or cauterize the vessels in a circular
motion (A. 2 [6.210 L.]). A passage in the Aristotelian Problemata shows
the universality of such treatments for excess or moisture leading
to ux to the eyes (Probl. 31). Later, the specic names periskythismos
and hypospathismos were given to surgical cutting at dierent points in
the head, to arrest ux (with a generally circular conguration, as in
Aections).
35
Celsus was aware of many of the complexities of diseases aecting
the eyelids: carbuncles could arise from inammation, sometimes on
the eyes, sometimes on the lids (6. 6. 10). And he treats of variations
in the development of trachoma: aspritudo roughness (Greek trachoma)
follows inammation but also induces inammation (6. 6. 26). Celsus
subscribes to the view that a discharge of rheum is a concomitant of tra-
choma (7. 7. 15). A common treatment was to scrape the hard and thick
lids with a g-leaf, a rasp or a scalpel, and then to rub medicaments
on the under-surface; but Celsus himself advocates rather appropriate
diet, exercise, baths and fomentations. Dioscorides recommends a series
of specics for trachoma; these include g leaves, unripe grape juice
and, in various forms, copper. Galen too addressed the problems of tra-
choma, which he regarded as a dicult condition, almost impossible to
treat, and outlined expedients of dierent doctors; these include cleans-
ing drugs, scraping and wiping away the oozing stu with a sponge (de
compositione medicamentorum secundum locos, 12. 709711 K.)
The language contains direct address to the doctor, in the second
person: o r u and j u . As above, nominative par-
ticiples and innitives are used, u r. The demonstra-
tive pronoun is redundantly repeated, u_ 0t (deleted by
Ermerins, who often fails to recognize this idiom) and I r u-
.
36
1. o r u u when you scrape scrape: after the tem-
poral clause and jussive innitive, the ensuing words refer to proce-
dures not of scraping but of cautery. Editors have either postulated a
lacuna after u (Ermerins) or have inserted words to clarify the tran-
35
For full details of types of cutting, and late medical sources detailing these, see
Marganne, 1994, 152167; for a succinct description, see Jackson, 1996, 2247.
36
See Craik, 1998, 23, n. 28.
80 commentary
sition from scraping to cautery: i i Sichel and u ri
Triller. However, perhaps the transmitted text can stand on the suppo-
sition that the general condensation and ellipse typical of this work has
led to a tacit move from scraping to cautery and so to an apparent
conation of these techniques. The verb u scratch, scrape, saw
occurs twenty-eight times in the HC, most frequently in the general
non-medical sense of grate, applied to recipe ingredients, especially
in the gynaecological treatises (fteen occurrences) but also in technical
medical senses, applied to abrasions in the body causing discomfort (A.
23 [6.234 L.]; Morb. 3. 11 [7.130 L.]) or, as here, to the medical proce-
dure of abrading, especially bone (VC 14, 19 [3.236, 252 L.]; Morb. 2. 24
[7.38 L.]). The instrument j rasp is typically used on bone (VC
14, 19 [3.236, 254 L.]).
ii_ i_ u_ 0_u with soft clean Milesian wool: this mate-
rial was regarded as especially ne. Though specied only here and in
Infertile Women (Steril. 221 [8.426 L.]), it was nevertheless probably the
material of choice where it was available. Strabo remarks (12. 8. 16)
that Laodikeia remarkably produced wool superior in softness even to
that of Miletos. Egyptian cotton was similarly prized (Morb. 2. 33, cf. 35
[7.50, 52 L.]). Soft clean wool is required for bandages and poultices in
many passages of the surgical and gynaecological works. Although wool
was not generally used for the apparent purpose here (cf. specication
of linen for use on the eyes and sponges for use on wounds, Medic. 2
[9.208 L.]) whether swabbing (if cutting) or protection from direct con-
tact with the instrument (if cautery), the use of wool in bandaging after
surgery on the head may be parallel. Erotians gloss 25 0_u ri_
_u _u related by Nachmanson to the lost work on Wounds from
Missiles may be related rather to On Sight: the case is the same, though
the ordering of words is dierent.
37
The most natural meaning of u
applied to wool is soft; but an alternative sense is eecy or (apt to
the context) compacted; see LSJ s.v. u (B) 3, perhaps cognate with
i pack tightly together. Hesychios glosses as both soft
and r compacted (Latte, 1953, 793).
i 0 r winding it round the spindle(-shaped instru-
ment): the spindle is a spindle-shaped instrument for cautery (cf. 0-
37
See Nachmanson, 1917, 365 and 1918, 66.
commentary 81
r r i 0o o r r r cauterise with
boxwood spindles, dipping them in boiling oil, Int. 28 [7.242 L.]).
Galens gloss 0 0 i l j. 0o
i u 0 r not only that useful in weaving but also the
wood of the instrument (linguarum Hippocratis explicatio, 19. 86 K.) with
the same case as On Sight, not as Internal Aections, probably refers to
our treatise and so indicates that the work was known to Galen.
38
The
verb winding is oddly suggestive of winding on wool for spinning. The
purpose of the action is the same as that of the pledget of cotton-wool
recommended by Duke-Elder.
A famous, or rather infamous, interpretation of 0 not as
spindle but as 0i spindle-thistle (on which see Thphr. HP 6.
46, etc.; cf. Hesychios 0i 00u a prickly plant,
Latte, 1953, 275) is discussed at length by the commentators Iugler and
Sichel; also by the learned medical authors Haller and Triller.
39
(See
also Introduction.) There is no real basis for the alternative interpreta-
tion; but an expression in Epidemics o 0o (Epid. 5.
25 [5.224 L.]) was cited as corroboration for the sense thistle. The
expression there is ambiguous, as the word lit. vertebra
may be applied to anything which resembles a vertebra in shape; here,
a stone extracted from the vagina of an elderly patient (who had pre-
sumably put it there as a child) is described as as big as the whorl of a
spindle or as big as the head of a spindle-thistle.
0j j o 0 o00 with care for the
actual eyeball: the verb is similarly used in 5 below; also, in the same
participial expression, in other treatises where delicate surgical proce-
dures are performed (trephining VC 18, cf. 21 [3.250, 258 L.], Mochl. 35
[4.378 L.]; vapour bath Morb. 2. 26.3, 47b. 3 [7.42, 68 L.]; fumigation
Mul. 1. 75 [8.164 L.]; incision Mul. 1. 70 [8.148 L.]) or hazardous pre-
scriptions made (Loc. Hom. 13 [6.300 L.], A. 33 [6.244 L.] and cf. A.
11, 12, 13 [6.218, 220 L.]).
40
More generally, it may be used, as below
9, of the patient guarding against such adverse weather conditions as
too much wind, sun etc. (Morb. 2. 15.3, 2. 50.5, 2. 51.5 [7.28, 78, 80 L.];
Morb. 3. 2 [7.120 L.]; Vict. 4. 90 [6.656 L.]; Int. 9 [7.188 L.]). The term
o might be used of various ring-shaped bodily parts, such as the
38
See Iugler, 1792, 66; Anastassiou and Irmer, 1997, 458459.
39
Iugler, 1792, 6069; Haller, 1755, 315338; Triller I 1766, 463485.
40
See Petrequin I 1877, 509 with n. 8 and II 1878, 604 with n. 8.
82 commentary
sutura coronalis and the sphincter ani (Pollux 2. 39 and 211). Ermerins
deletes 0 o00 of the eye and understands the ring to be the
coronal suture of the skull; he further reads below or bone (sc.
skull) for cartilage. He then interprets the pasasage as
referring to cautery in the head, around the coronal suture. There are
indeed ancient parallels for such cautery (especially in Aretaeus); and
they may be relevant to Chapter 4.1, but not to this passage. Here the
o is simply the eyeball or globe though in later authors it is
more specically applied to the limbus, the rim of the cornea where it
joins the sclerotic (Gal. Commentary on Prognostic, 18 (2). 47 K. and Ruf.
Onom. 26).
41
j u do not cauterize through, up to the
cartilage: is used of any bodily cartilage, either general (Aph. 6.
19 [4.568 L.]) or particular, such as that in the chest in the area of the
breastbone (Epid. 7. 3 [5.370 L.]), in the nose (Loc. Hom. 3 [6.280 L.]),
or in the ear (Artic. 40 [4.176 L.]). Here, it refers to the tarsal plates,
dense connective tissue in the lids, curved to conform with the shape
of the globe of the eye; these resemble cartilage in consistency, being
composed of densely compacted collagen and elastic bres.
42
In essence,
this means, do not cauterize too deeply (verb i) and Sichel
comments on the danger attending such surgical procedures on the eye,
danger quaujourdhui nous connaissons susament.
43
The syntax, j
with aorist subjunctive, is a prohibition, not a subordinate nal clause.
jt it is a sign: a guide to signs, especially bad or mortal signs, is
a standard feature of many Hippocratic treatises, especially Prognostic,
Prorrhetic 2 and Koan Prognoses.
o 0j j u when there is enough scraping: the subjunc-
tive is required.
44
The verb be enough is usually, but not invariably,
impersonal and followed, as here, by the genitive case. It occurs only
eight times in the HC (elsewhere once each in Aer., Fract., Mochl., VC,
Mul. 1 and twice in Steril.).
41
See Magnus I 1998 (tr. Waugh), 4748 on the possible translations margin, rim,
or conjunctiva all nally rejected in favour of eyeball.
42
Duke-Elder I 1932, 207.
43
Sichel 141.
44
See Anastassiou, 1980 and cf. GMT 192. 2.
commentary 83
i bright blood: the adjective (bright of lights,
1.2; 9.1 and 3) is especially used of the uids present in the healthy
eye, perhaps associated with the common belief that re was present
in the eye. It is a bad sign when the eyes lack brightness (Mul. 2. 116
[8.250 L.]). The related idea of reection in the eye is evident in the
verbs ri, Loc. Hom. 3.3 [6.280 L.] and i, Morb. 2.
1 [7.8 L.]. In the latter passage, the adjective bright is three times
repeated: when phlegm penetrates the vessels of the eye, the brightness
in the eye is not as bright and there is not the same reective quality
as when it was bright and pure. Cf. also the explanation of sight as a
reection of light and all bright things and its corollary that anything
which is not bright is not so reected, Carn. 17.1 [8.606 L.]. These ideas
may be related to those of Alkmaion (DK 24 A 5 = Thphr. de sens.
26; A 10 = Aet. 4. 13. 12) and Empedokles (DK 31 B 84 = Arist. de
sens. 437b23).
45
In Platos Timaios the eyes are said to conduct light by
means of the pure re which ows through them, a re which does
not burn but gives light to the eyes (Pl. Ti. 45b246a2; 58c), and in the
Aristotelian Problemata, there is re in the eyes, but re without heat,
and for this reason the eye has no sensation of cold (31.22, 959b15). The
bright eye is pure and healthy; and the bright blood of the eye is pure
and healthy. The adjective is applied to blood twice in Koan Prognoses
(7. 593 and 611 [5.722 and 726 L.]); it is applied also to urine, likewise
bright and pure in health (Epid. 7. 80; cf. 7. 78 [5.436, 434 L.]).
iu iu j u bloody or watery matter: ichor, in Homer
the blood of the gods, is in the HC body uids altered in some way,
usually noxious in character. Here we might have expected the transi-
tion to be from (bad) oozing matter to (good) bright blood, not, as the
text has it, vice versa. Thus Foesius, though keeping the vulgate read-
ing, expresses reservations and notes, satis tamen derasam esse palpebram
apparet, si pro cruenta et aquosa sanie, sanguis sincerus et purus euat, the lid
seems to be suciently abraded if in place of bloody and watery stu
clear pure blood ows out.
46
It has been argued that ichor can describe
blood serum oozing from a wound after the ow of blood; and that
such usage, where ichor is not harmful (found also in Ulcers, Diseases of
Women and Heart) may indicate a later date for the work.
47
However, the
45
See Longrigg, 1993, 5860 and 72.
46
Foesius I 736.
47
Duminil, 1977, 74 and 76.
84 commentary
distinction seems to me anachronistic, and alien to ancient ideas. Galen
glosses u o (linguarum Hippocratis explicatio, 19. 148 K.).
u u o. o 00 ri 0. u_u 0t
rub on one of the liquid drugs (lotion, or a runny paste or ointment)
containing ower of copper: the doctor is expected to be familiar with
the range of drugs available. Calvus translation liquido medicamento, in
quo aeris os sit, with a liquid drug containing ower of copper, is fol-
lowed in essence by later translators and here. The expression, however,
is odd and the use of o where is peculiar (hence Foesius comment
fortasse legendum such as should perhaps be read);
48
also u-
_ is tautologous. It may be that we should amplify the expression to
translate, rather, rub on some liquid drug: where ower of copper is
available, use that.
Lotions of copper salts (both sulphate of copper, popularly known as
blue stone, and nitrate of copper) are powerful astringents and haemo-
statics, especially useful in eye diseases in antiquity and modern times
(Morb. 3, frequently and see also Dioscorides 5. 77; the Galenic de simpli-
cium medicamentorum temperamentis ac facultatibus 12. 242 K.; de compositione
medicamentorum secundum locos, 12. 701 K.). There is an extensive literature
on the subject of therapy by copper.
49
Flower of copper is oxidized cop-
per, or copper oxide, formed in the smelting process: water was poured
on the hot melted metal to make it set more quickly and the small par-
ticles which spattered out in response to sudden cooling were known as
owers.
50
The lack of specication of quantity or weight in the ingre-
dients is usual; in any case, minerals were liable to variation due to
inherent impurities and vagaries in processing.
0t rub on: Joly translates faire une onction; but the idea of
friction or massage is certainly present in the verb, by contrast with
i below (cf., in a similar context, Morb. 2. 13 [7.24 L.] and,
more generally, O. 17, 23, 24 [3.322, 328, 332 L.]). The prex 0-
literally throughout is semantically otiose, unless perhaps it implies
repetition and improvement (see LSJ on the prex in composition of
verbal forms). The verb is repeated in 6 below, applied both to patient
48
Foesius I 736, n. 10.
49
See Majno, 1991, 490, n. 85; Douthwaite, 1963, 370.; Nielsen, 1974; Nutton,
1985, 143; BMD s.v. copper.
50
See Nielson, 1974, 42; cf. Majno, 1991, 490, n. 85.
commentary 85
(for which cf. Mul. 2. 185 [8.366 L.], Artic. 9 [4.102 L.], Morb. 3. 10
[7.130 L.]) and medication (for which cf. Mul. 1. 109 [8.232 L.], Morb. 3.
17 [7.156 L.], Ulc. 12 [6.412 L.]).
2. I r afterwards, later on: the adverb, twice repeated here
(cf. 5 below), intends a dierent time-scale from r then in 3 above.
The collocation is uncommon; Ermerins emends in 5 and tinkers in 4.
However the repetition of the demonstrative should be retained and
the extension to all cases is appropriate.
j u i j u with regard to the procedure of
scraping and the procedure of cautery: the expression, though peculiar
is readily understood.
o 0r j o r i o when the wounds
have been cleaned and it (sc. o esh) is growing: perfect partici-
ple is used with present subjunctive. This sentence is another instance
of the compression so evident throughout the work. The sense implicit
is that wounds must be properly cleaned to avoid premature forma-
tion of granulation tissue and with it premature closure over bulging
esh. An explicit statement in Head Wounds elucidates: When it has
been cleaned, the wound should become quite dry; for in this way it
would become sound most quickly, the growing esh being dry and
not moist, and in this way the wound would have no excess esh (VC
15 [3.244 L.]; cf. Ulc. 6, 8 [6.404, 406 L.] with Galens exposition in
de methodo medendi, 10. 281 K.; also Loc. Hom. 38 [6.328 L.] on tech-
niques to heal wounds which have closed prematurely).
51
Proper heal-
ing of wounds on the eyelids must have been particularly problematical:
trachoma was liable to leave permanent scarring. The language here
resembles that of Head Wounds and Ulcers: o grow occurs in
both as a technical term of knitting tissue.
o j o 0 r make a cut (lit. cut a cut, cognate
accusative) through the front of the head: the bregma, simply glossed
by Hesychios as the middle of the head (Latte, 1953, 345), is the
point formed by the intersection of the sagittal and coronal sutures,
that is the anterior fontanelle, where the bones of the newborn do not
make full contact with each other. As it is the point in the vault of
51
See Petrequin I 1877, 274, n. 3; also Craik 1998, 193195.
86 commentary
the skull where the bone is thinnest and weakest, and where there is
least and thinnest esh, wounds there are especially dangerous (VC 2,
cf. 13 [3.188, 230 L.]). Incidence of the anatomical term bregma in
the HC (not in Loc. Hom.) is as follows: Morb. 2 (six times); Mul. 1 and
2 (twice each); VC (four times), also Epid. 5, 6, 7; Prorrh. 1 and Coac.
Foesius translates sectionem per sinciput facere make an incision in the top
of the head and comments haec videtur esse quaedam 00
species this seems to be a sort of hypospathismos; this reference to a
type of eye operation common in late antiquity was overlooked by later
commentators.
52
_u ri_ o_ with a drug to stop bleeding: LSJ for staunch-
ing blood; Sichel quon met sur les plaies rcentes perhaps echoing
Foesius, medicamento quod cruentis vulneribus imponitur;
53
Joly, qui larrte.
The denite article suggests one particular drug and perhaps this is
intended, there being one par excellence (cypress favoured in the same
operation, Morb. 2. 13; but ne salt followed by compress, 18 [7.24,
32 L.]). Ermerins deletes the article, adding instead . If we follow this
reasoning, _u understood as contracted might be kept, with change
only in word order (cf. u u o above, 4.1; also o
0 0 read by Cornarius below, 9.3). The blood is apparently
staunched as soon as the wound is made; similarly cutting and immedi-
ate healing is the treatment for the stricken in the laconic instructions
of Diseases 2 (i 00 r i rj 0j i -
0i o i i00 i j cut into the bregma and when
the blood ows bring the edges together and bind them up, Morb. 2.
25 [7.40 L.]; cf. Morb. 3. 3 [7.122 L.]). The vasculature of the scalp is
such that bleeding from even shallow wounds is profuse, the blood ves-
sels tending to remain open when cut, especially in the arteries, which
anastomose freely with one another.
j j 0j purge the head: the reason for this is to stop
further noxious matter descending from head to eyes, and to allow
noxious matter in the eyes to descend to and be eliminated from
the nose. Calvus, translating omnium ultimum negotium est, last of all it
is appropriate, regards o as neuter (of treatments), rather than
masculine (of patients).
52
Foesius I 688, 736, n. 11.
53
Foesius I 689.
commentary 87
V
Corrective cutting and cautery are applied to the eyelid, when it is
thicker than is natural. Editors attempts to identify this condition
conict. Foesius comments huic vitium simile medicis dicitur, a
trouble similar to this is called ptilosis by doctors. Sichel believes that
this chapter too relates to trachoma, surtout aux granulations trs-
volumineuses, fongiformes ou sarcomateuses; if this is correct, the topic
may be loosely connected with the idea of excess tissue forming in
the healing process, 4.2. Ermerins remains agnostic: de palpebris iusto
crassioribus; sed quo vitio crassae factae sint, non constat, on lids which are
quite thick; but it is not clear by what trouble they are made so. Joly
takes the condition to be une conjonctivite printanire bien dcrite
and understands the operation to be on the lower lid not, as in 4, to the
upper lid.
54
Indeed, the authors vague description militates against precise iden-
tication. But perhaps pterygion (a bro-vascular membrane arising at
the inner corner of the lower lid, sometimes growing over the cornea
and impeding vision) has more claim to consideration than Foesius
ptilosis (a disease of the lids where the edges are swollen and inamed
and the lashes fall o) as the former is a Hippocratic term and the lat-
ter is not. (But admittedly there is a paucity of Hippocratic, though a
multitude of Galenic, parallels.) The condition pterygion is briey men-
tioned in Prorrhetic 2 (Prorrh. 2. 20 [9.48 L.]). Reference in Diseases 2 to
a condition where the eyelids seem to overhang, or be pendulous, and
where the vision is blurred is probably unrelated (Morb. 2. 19 [7.32 L.];
cf. also Int. 4 [7.178 L.]).
Celsus accurately describes the formation of a pterygion, Lat. unguis,
and recommends that it be cut out if it has become established and cras-
situdo thickness has developed through time (7. 7. 4). Galenic sources
(many of doubtful attribution, but it is the date which is relevant here)
give a very long list of eye troubles, classied according to location:
aections inside the lids include roughness and thickness, aections
outside the lids include pustules and aections at the inner corners of
the lids include pterygion; there is also a trouble where the lids seem
rather swollen and constantly stream (introductio seu medicus, 14. 767 K,
771 K.; on pterygion cf. also de remediis parabilibus, 14. 410 K.; de tumoribus
54
Foesius I 736, n. 12; Sichel 143; Ermerins XL; Joly 173.
88 commentary
praeter naturam, 7. 732 K.; on ptilosis cf. de methodo medendi 10. 1004 K.)
In addition to pterygion many types of palpebro-conjunctival cysts or
lesions might be said to cause thickness in the lid. Common conditions
of this type include conjunctival papilloma (typically lower lid), where
there is a tumour or an overgrowth of skin along the lid marginsuch
growths are not harmful, but are usually removed for cosmetic rea-
sons by simple excision, not extending deeply into the tissues; and cha-
lazion (typically upper lid), which is a chronic inammatory granuloma
caused primarily by the retention of secretion from a tarsal glandthe
regular treatment is incision and curettage.
55
The expression is inelegant and the connection jerky. The initial
words, with asyndeton, indicate the problem to be treated; a second
phrase in loose apposition indicates the treatment, expressed in two
phases by nominatives with innitives in instructions. Finally, an adver-
bial clause is followed by general instruction for ongoing therapy. Once
again, nominative participles with jussive innitives are employed to
express instructions, 0u r0 -
t.
1. u j u thicker than is natural: the term u nature,
ubiquitous in Hippocratic medicine, is used in two distinct ways in this
short section: rst of the nature appropriate to a bodily part (the eye-
lid, its size) and second of the intrinsic character of a bodily part (the
eyelashes, their position or perhaps their delicacy). Sichels interpre-
tation of the second u in a concrete sense recalling the root u
grow, intending the point where the lashes grow or have their roots,
tr. limplantation des cils, is here followed;
56
but a reference to the
delicacy of the eyelashes, in the sense that they are easily scorched,
would be appropriate also. The term r eyelash (Ar., Arist., X.)
is unnecessary as in context hair is clear.
o 0u j o o 0r u cut away
the esh below (lit. as to the area below) as much as you can, very
gently. This is yet another instance of odd, compressed expression and
emendation is unnecessary. The location o below is ambiguous:
55
See Duke-Elder V 1952, 49764981, 50315033; Bedford, 1971, 166167, gs 118
120; Trobe and Hackel, 2002, 9, 98; Spalton et al., 2005, 48 with g. 2. 36, 49 with g. 2.
39, 51 with g. 2. 45, 106 with g. 4. 44.
56
Cf. already Foesius I 736, n. 13.
commentary 89
reference might be to the lower lid, or to the lower part of the upper lid,
or simply to the area below the growth. Caution is constantly enjoined:
the doctor must work very gently, with instruments which are not too
hot (clearly here metal; perhaps a reason not to link this chapter with
the preceding one on trachoma, treated by wooden instruments) and
taking care (see on 2 above for avoidance of white-hot instruments,
and for considering).
r0 cauterise over: the compound expresses a precise operation.
The variation between ri cauterise over, i cauterise by
(3.3), i cauterise through (3.3, four times repeated; 4.1) and the
simple verb i (1.1; 3.1, three times repeated) is not for stylistic eect
but has important semantic weight. Similarly, in Head Wounds there is
signicant variation in the verbs used of trephination: i trephine
used without regard to depth, i trephine through used to
indicate complete perforation of the bone to the dura and ri
trephine out (commonly with 0t take away) used to indicate
trephine and remove.
57
_u 00 o_u _u t apply heated very ne ower (of
copper): the adjective (5 and 6) may refer to quality (ne) or
quantity (slight); here surely the former, in the sense nely ground.
58
The verb r is used seven times in the HC but the only parallel
for the sense apply is in Sores (rj t, Ulc. 14
[6.418 L.]).
iu o o give the further treatment: i.e. continue the usual
treatment. Foesius, following Cornarius, keeps this text, but translates
as if reading [u] o o sc. r, treat like other lesions.
59
The verb
iu is especially favoured in the surgical works Articulations, Fractures
and Head Wounds though not conned to these (cf. o o iu
r. VC 14 [3.242 L.]). Similar expressions are: ij0 u i o
o, Int. 24 [7.228 L.]; o o 0t, Coac. 3. 483 [5.692 L.]; o
o 0u, Mul. 2. 110 [8.238 L.].
57
Cf. Hanson 1999, 117.
58
See Petrequin II 1888, 180, n. 3 on Fract. 26 [3.502 L.].
59
Foesius I 689, 736, n. 13.
90 commentary
VI
Instructions are given on the preparation of a salve for irritation of
the eyelid. Sichel sums up the condition as ophthalmie catarrhale
avec rosion, having introduced it more elaborately as conjonctivite
frquente, due aux vicissitudes de la temprature atmosphrique
qui est accompagne de dmangeaisons, drosion des angles, etc.
Ermerins succinctly notes palpebrarum psoriasis et pruritus memorantur, rash
and irritation of the lids are discussed and Joly simply states blphar-
ite.
60
The interrelation of terminology for various forms of eye irrita-
tion can be clearly seen in the pseudo-Galenic denition of -
, lit. dry ophthalmia as a condition where the inner corners of the
eye are rough and inamed with red lids, acrid tears, ulcration, rough-
ness and, related to the term used here, are showing irri-
tation (introductio seu medicus, 14. 769 K.) Blepharitis, an extremely com-
mon disease, is now viewed as taking two main forms: simple squamous
(scaly) blepharitis and more complex purulent follicular blepharitis.
61
The ingredients and preparation of the recipe for this salve have
certain correspondences with those for eye-pastes detailed in Acute Dis-
eases and in Diseases of Women 1 (grape juice, burnt copper, grindstone
and phrase , all in Acut. Sp. 6566 [5.520 L.]; grape juice
in Mul. 1. 102105 [8.224, 226, 228 L.]; cf., for lesions of the head,
grape juice, ower of copper, and use of red copper vessel, in Ulc. 12,
cf. 17 [6.412, 420 L.]); but there are some features peculiar to On Sight,
especially in vocabulary: the term little lump is a Hippocratic
hapax legomenon, as is scale. The extreme compression typical of
On Sight renders the sense obscure; but parallels permit the ampli-
cation essential for comprehension. (See translation.) There is copious
evidence, especially from Roman antiquity, of a huge demand for eye-
salves and an extensive industry in their manufacture, marketing and
distribution. Celsus lists at length the recipes of many dierent doctors.
The section is carelessly written, with careless overuse of the verb
, used alike of preparation of ingredients and application to the
patient:
. Various steps in the preparation are distinguished by use of
introductory then, next (cf. 3.1 above). Nominative participles
60
Sichel 159, 148; Ermerins XL; Joly 170.
61
Duke-Elder V 1952, 49494968; Bedford, 1971, 42, gs 26 and 26a; Trobe and
Hackel, 2002, 34, 5960; Spalton et al., 2005, 107.
commentary 91
and jussive innitives are again prevalent, varied by the jussive sub-
junctive r you must pour. o whenever, introducing the
section, is used only here in On Sight; perhaps the conjunction indicates
the common incidence of blepharitis and the frequency with which the
physician would prescribe this treatment.
o r r 0 i r whenever the eyelids are
itchy and there is an irritation: elsewhere, the verb 0 is used of
bladder discomfort (Aph. 4. 77 [4.530 L.]; Nat. Hom. 14 [6.66 L.]) and the
substantive is used of lung conditions (Loc. Hom. 14.8 [6.306 L.];
Morb. 2. 58.1 [7.90 L.]). The synonymous seen in I and mss
derived from I may be an old variant. is more common in the
HC (twenty occurrences against eight of and one of j) and
is used in Prorrhetic 2, seen here to have many resonances with On Sight,
of irritation in the forehead associated with dim vision and redness in
the eyes (Prorrh. 2. 30 [9.60 L.]). However, the occurrence of or
j in works which have other anities in vocabulary with On Sight
(Morb. 2, Loc. Hom., gynaecological treatises) is in its favour. Also,
is dicilior being glossed by the more common by Erotian ( 2,
from Epidemics 5), Galen (linguarum Hippocratis explicatio, 19. 125 K.; cf. 112
K.) and Hesychios (Latte II 730, 92).
62
00 0 u 0 i lit. having rubbed a piece
of ower of copper on a grindstone: the only other occurrence of
0 grindstone in the HC is in recipes for watery eyes in the two
passages of Acute Diseases noted above ash ground with fat
and oo j sour grape juice; r
burnt copper mixed with saron and sweet wine (Acut. Sp. 65 and 66
[= 32, 33, 2.520 L.]).
r r 0i 00 lit. then having rubbed his eye-
lid: this phrase should be deleted, as instructions for use of the paste
ought not to precede instructions for mixing it; also the reference of
00 (? the patient) is unclear. Ermerins, who regards the passage as
hopelessly corrupt, suggests (but does not print) emendation of the verb
to rr having turned over and deletion of 00 i .
62
See Jouanna 1983, 110, 102; Craik 1998, 149.
92 commentary
i j i 0 0 i u o and at that
time rub the akes of copper as ne as possible: the word for akes
is hapax in the HC. Foesius in Oeconomia, in an aside s.v. u
from Epidemics, relates Erotian 13 0 j i to this
passage.
63
The accusative case and the placing of the gloss in Erotian
provide strong support for this judgment, which has gone unnoticed
by later commentators, including Nachmanson who is unjustiably
sceptical that relates to On Sight on the grounds that the work
is not cited by Erotian: this is circular argument and general lack of
citations can be readily explained by the shortness of the work. Duminil
on Ulc. 13. 1 [6.416 L.] with no justication but citing Erotian reads
i for codd. i.
64
Galen glosses o I ri t o
0o (linguarum Hippocratis explicatio, 19. 118 K.); that Galen cites usage
in Places in Man shows another instance of convergence in vocabulary.
r 0r r i i t then you
must pour alongside (the akes) the strained juice of unripe grapes, and
rub smooth: that is, make a well in the dry ingredients and pour in
the liquid ones. The adjective smooth, twice repeated, is proleptic.
The phrase is formulaic in such instructions, seen especially in the
gynaecological and surgical treatises (Ulc., Fist., Haem.) and in Internal
Aections. The same form of the verb (r pour, aorist r) can be
seen in Aections, in a recipe for an emetic mixing melicrat with vinegar,
and the same expression t, administer to drink, occurs in
both works (A. 15 [6.224 L.], Vid. Ac. 7). In a salve mentioned by
Aristophanes, garlic, g-juice and spurge are key ingredients (Ar. Pl.
665). Grape-juice, a mild astringent, is a standard ingredient in recipes
for eye salves. That Galen cites it as a Hippocratic specic for the eyes
may indicate familiarity with On Sight (de methodo medendi, 10. 940 K., de
compositione medicamentorum secundum locos, 12. 702 K.; cf. commentary on
Acut., 15. 916 K.) Dioskorides describes the process of pressing unripe
grapes to extract the juice in early summer, then leaving it in the
sun to evaporate; he regards it as a good treatment for rough eyelids.
Acetic acid was a common ingredient in collyria, frequently mixed with
copper compounds, then ltered and evaporated to form crystals.
65
63
See also Foesius I 736, n. 15 on aeris squamam scale of copper, as of a sh or a
serpent, used to treat ulceration of the lids.
64
Nachmanson 1917, 360; Duminil, 1998, 63; see also 43.
65
See Nielson, 1974, 2628, 50.
commentary 93
r r _u r0_u r then pour the rest (of the
grape pulp) alongside (the other ingredients) into (a vessel of) red cop-
per: red copper is frequently specied as the appropriate material for
mixing such salves, the intent being to enhance the copper content of
the mixture; there is an extended set of instructions in Galen and the
further injunction that the prepared mixture should be stored in a cop-
per box (de compositione medicamentorum secundum locos, 12. 709711, 738).
myssotos: a savoury dish based on garlic or onion (Galen
linguarum Hippocratis explicatio, 19. 124 K.; Loc. Hom. 47. 5 [6.346 L.]; Epid.
2. 6. 28 [5.138 L.]); on its consistency cf. Ulc. 12, 17 [6.412, 420 L.].
ro 0j when it has dried: that the procedure, here tele-
scoped, would take several days is indicated in parallel passages.
VII
The treatment of night blindness, an anomaly of vision marked by
impairment of dark adaptation, is outlined. Night blindness takes two
main forms, distinguished in a modern account which could almost be
a translation of Galens formulation (introductio sive medicus, 14. 776 K.;
cf. linguarum Hippocratis explicatio, 19. 124 K.), as day-blindness, where
the patient sees poorly in good illuminations and normally in the dusk
and night-blindness, where vision in moderate illumination is good,
but in feeble illumination it is decient.
66
The converse formulation,
followed by Sichelnyctalopie as ccit de jour, vision de nuit and
hmralopie as ccit de nuit, vision de jouris confusingly current
also.
67
Night blindness is not a substantive disease, but a symptom asso-
ciated with deciency of vitamin A (sometimes called the ophthalmic
vitamin), which is present in animal fats such as milk, butter and eggs;
and, above all, in liver. Night blindness can occur both in individu-
als suering from any condition which depletes blood vitamins, espe-
cially such febrile conditions as pneumonia, pulmonary tuberculosis or
malaria; and also in communities aected by famine or severe mal-
nutrition. In ancient medicine, symptoms such as night blindness and
even fever were frequently regarded and treated as diseases in their own
66
Duke-Elder I 1932, 973; see also II 1938, 1423 and Jayle et al., 1959.
67
See Sichel 149.
94 commentary
right. There was, however, much awareness of, and interest in, the ways
in which dierent diseases might interact, developing or mutating into
something apparently dierent, and the Hippocratic doctors were fully
aware of the typical associative context of night blindness, recognizing
the ways in which it tended to accompany other illnesses; also, more
generally, the ways in which the eye might be aected by complications
in other apparently unrelated diseases.
68
The text of this short chapter is compressed, or, rather, truncated and
corrupt. There are two main problems, relating to two aspects of the
prescribed treatment, which is expressed in a series of superlatives: rst
(surgical), two things are done to the patients neck as much as possible
and for a very long time, but Ms having broken is nonsense
and having pressed is unclear; second (dietary), the patient is
to eat a lot of raw liver with honey, but this injunction is both intrin-
sically improbable and quite unparalleled, and further the expression
is unclear. Sichel keeps but describes the verb as obscure and
probably corrupt; he takes it in the sense of lappui des ventouses scari-
es. Ermerins reads having cut but leaves the entire sec-
tion untranslated, dismissing it as locus male scriptus a badly transcribed
passage and more severely totus locus pessime se habet the whole passage
is in a dreadful condition; in the introduction he commits himself only
to the curt nyctalopis curatio describitur a treatment for night-blindness
is described. Joly marks the verb with daggers of corruption, and
attempts no translation.
69
The second problem has attracted consider-
able scholarly interest. The loosely appended expression one or two is
unclear, as is the reference of very big. Debate has centred on
whether one or two huge ox livers are to be eaten (so Joly, il faut faire
avaler, crus et tremps dans du miel, un ou deux foies de boeuf, aussi
gros que possible), whether one huge ox liver is to be eaten one or two
times (so Sichel, il faut faire manger, une ou deux fois, un foie de boeuf
cru aussi gros que possible, tremp dans du miel), or in one or two
portions (so Ermerins, who suggests the insertion of portion).
70
The diculties may be resolved by comparison with content in
other treatises (especially Diseases 2, Prorrhetic 2 and Epidemics 6; but
also Diseases 3, Epidemics 2, Koan Prognoses, Prognostic and Places in Man).
In particular, from the association of night blindness with the disease
68
See Grmek, 1980, 221.
69
Sichel 150; Ermerins XL; Joly 171.
70
See also Bier, 1928 and Gourevitch, 1980.
commentary 95
known as the choker it is possible to put the treatment here
prescribed in a wider context. (This disease is commonly likened to
diphtheria and frequently translated angina or quinsy but as its main
distinguishing symptomand distinctive etymological derivation, lit.
dog-stranglingis a sensation of choking, it is here designated simply
the choker.)
71
We can emend and expand the text to give a sense
in accord with parallel treatments of night blindness and associated
conditions in the HC and other sources. However, while the text may
be satisfactorily explicated in this way, and it is clear that something has
been lost, restoration is oered for example only. It does, however, seem
certain that a reference to garlic has dropped out. The two aspects of
the therapy prescribed are: rst, cupping (as Sichel perceived, on the
basis of medical probability, but without emendation or argument); and
second, a dietary rgime of (raw) garlic and (cooked) liver.
The condition of night vision is discussed in Prorrhetic 2 (Prorrh. 2. 33
and 34 [9.64, 66 L.]) from a theoretical standpoint: it tends to aect
boys and young men, who sometimes recover spontaneously in seven
months time; elimination of noxious matter, especially downwards, is
benecial; patients with this disease or a ux of tears of long dura-
tion should be asked if they suered headache before these concretions.
As in On Sight, it is explicitly stated that purging is useful in therapy,
and implicitly supposed that bodily xation is signicant in aetiology.
A more pragmatic approach to the condition is found in Epidemics 6
(Epid. 6. 7.1 [5.332 L.]): night blindness is associated in a particular year
with painful ophthalmias and with other symptoms or ailments, above
all, with coughs, pneumonia and chokers.
72
The doctor of Epidemics
6 found the array of symptoms intractable. Treatments essayed, with-
out great success, included laxatives, emetics and phlebotomy, includ-
ing surgery on the tongue. Among the patients some endured great
pain, especially those who suered from swollen vessels in the tem-
ples and the neck. Night blindness is associated with a similar range
of unpleasant symptoms in a shorter account in Epidemics 4 (Epid. 4. 52
[5.192 L.]): ears and mouth are aected (toothache and mouth ulcers);
there is cough, fever and digestive disorders. The association between
eye trouble and the choker appears also in Epidemics 2 (Epid. 2. 6. 12
[5.134 L.]), in the brief instructions carry out phlebotomy for the chok-
71
See Grmek, 1989, 337338; cf. Craik, 1998, 185186.
72
Littr used the phrase le toux de Printhe for the pathology; see also Grmek,
1980.
96 commentary
ing disease and for opthalmia. Also, there is a full clinical description
of symptoms apparent in the choker: the focus here is on appear-
ance of, and sensations in, neck, throat and jaws (Epid. 2. 2. 24 [5.94,
96 L.]).
There are many other references to the same disease, or rather,
perceived group of diseases. In Koan Prognoses (Coac. 2. 357372 [5.660,
662 L.]), many bad or mortal signs are specied in the group of diseases
designated o o the choker types: much attention is paid
to observation of throat (internal) and neck (external) and when the
disease turns to the lung, suerers either die in seven days or become
purulent; in Prognostic (Prog. 23 [2.174 L.]) ulceration of the throat is
a similarly bad sign. Bleeding from the neck is there regarded as the
safest and best course but it is recognized that there are dangers in the
treatment as well as in the condition itself. Writing on throat ulceration,
the author refers to the risks attendant in cutting the uvula; the verbs
used are 0o0 and 0o0 (discussed further below).
In Aections also (A. 4 [6.212 L.]), the verb o is used of the
same operation: if the swelling of the uvula does not go down, the
treatment is 0 j j j. u o u.
i 0 i 0r u t. i 0o oi 0
0 r, after shaving the back of the head, apply two cupping
vessels, draw o as much blood as possible and draw backwards the
ow of phlegm; then, if there is still no amelioration, the knife is
applied, o i_ o. having cut with a knife
cut. In Diseases 3 (Morb. 3. 10 [7.128, 130 L.]) discussion of the choker
leads to treatment of o, a variant on the choker: for this,
phlebotomy of vessels in the chest, bleeding from the arms (if the
patient is strong enough), incision of the vessels under the tongue
and purging with elaterion are all prescribed; this meshes with material
following on treatment of the choker in Diseases 2. Similarly, in Regimen
in Acute Diseases (Acut. Sp. 910 [= 6, 2.412 L.]) therapy of two forms
of the choker is by phlebotomy of vessels in the arms and under
the tongue. Purgation by elaterion and bleeding from the arm are both
prescribed also in Places in Man (Loc. Hom. 30 [6.322 L.]).
In Diseases 2, several kinds of choker are discussed and dierenti-
ated. These passages provide illumination of the treatment adumbrated
in our treatise. In the rst brief mention of the choker in Diseases 2
(Morb. 2. 9 [7.16 L.]), only one type is noted. Its locus is in the jaws
and the area of the neck, sometimes also under the tongue or some-
what above the chest. In the ensuing section, the author proceeds to
commentary 97
discuss the clearly related disease j the grape, where surgery
on the swollen uvula is imperative.
73
In the second part of Diseases
2, three dierent types of the choker are discussed at some length
and followed by a discussion of the grape. In these three instances of
the choker, the dierences lie in symptoms, development and, accord-
ingly, therapy indicated, also to some extent in the supposed aetiol-
ogy and site of the trouble. The treatment in the rst type (Morb. 2.
26.2 [7.40 L.]) is to apply a cupping vessel to the rst cervical ver-
tebra, then after shaving the hair beside the ears, to apply cupping
there, and once pressure is established, to leave the cupping vessel in
place for as long a time as possible ( r _u -
j_ u j i rj 0i j u
r0 t0 u t ).
74
Extensive follow-up treatment
includes purging by suppositories or enema. The treatment in the sec-
ond type (Morb. 2. 27 [7.42 L.]) is to apply a cupping vessel as in the
rst, then to apply a sponge soaked in hot water to neck and jaws;
again, there are extensive further recommendations in which a new
element is the prescription, where empyema is developing, of a bedtime
snack of raw garlic, as many cloves as possible ( uo r
u t) accompanied by neat strong wine. In both cases, fumiga-
tion too is practised. The third type (Morb. 2. 28 [7.46 L.]) diers from
the others: it is less serious; treatment is by dietary manipulation and
application of poultices. Also, the back of the tongue is aected.
75
In
this respect, it seems to serve as a transition to the grape, the sub-
ject of the ensuing section (Morb. 2. 29 [7.46 L.]); there too the jaws
are swollen but the main problem lies in the uvula, which must be
pressed against the palate and its extremity cut (0r t
0).
From these parallels in the treatment of the choker, which in inci-
dence is associated with night blindness in Epidemics 6, it is evident that
the procedures so peremptorily indicated in our text are application
of cupping and consumption of raw garlic. Blood-letting (phlebotomy
or venesection) was a favoured Hippocratic recourse in many diseases;
butin part because it was so familiar, in part because it was a tech-
nique learned by observation rather than by readingfew descrip-
tions of it survive. Celsus exceptionally gives a description, stressing
73
See Jouanna, 1983, 222223, n. 6; 140, n. 8.
74
On the text, see Jouanna, 1983, 232233, n. 1.
75
See Jouanna, 1983, 235, n. 7.
98 commentary
its importance in diseases which, like the choker, constrict the throat
(2. 10. 117). The use of honey-coated garlicpresumably the honey
intended to make the garlic more palatable, or easier to swallow, like
a sugar-coated pillis repeated in a prescription to purge a strong
patient overcome by fever brought on by fatigue or by a journey in
the section on fevers in Diseases 2: 0 r r o (Morb.
2. 43.3 [7.60 L.]). In a long series of cleaning-out prescriptions found in
Internal Aections, all vegetables save garlic are proscribed; of garlic the
patient is to eat as many (but it is not clear whether the plural indicates
cloves or heads) as possible, raw, baked or boiled: u t -
r i uo i oo i r0o (Int. 21 [7.220 L.]). Garlic, especially
when eaten raw, was widely regarded as having laxative and diuretic
properties (A. 54[6.264 L.], Vict. 2. 54 [6.556 L.]; on honey cf. A.
58 [6.266 L.]). One element remains to be explained: the presence of
(?raw) ox liver.
I can discover no case of a patient being made to eat raw liver, with
or without honey. It is not used even in poultices or pessaries, though
various unlikely and unappealing animal applications are specied,
especially in the gynaecological works. Thus, bull bile is common (see
Mul. 1. 75 [= 84, 8.168, 206 L.], Nat. Mul. 32 [7.362 L.]) and in one
place we nd the specication of dry bull bile with ne honey (Ulc.
12, 13 [6.414 L.]). Other parts used are ox marrow with almonds
and our boiled in water to form a paste for use as an ointment (Nat.
Mul. 100 [7.416 L.]; cf. Mul. 1. 34 [8.82 L.], and perhaps 90 [8.214 L.]
ox esh, an ingredient in a pessary). In another passage, a pessary
as emmenagogue includes pig and ox bile mixed with honey (Mul.
1. 74 [8.156 L.]). The poultices prescribed for the choker were of
a less unpleasant type: our boiled with wine and olive oil (Morb. 2.
28.3 [7.46 L.]) or a mixture including elaterion and honey (Mul. 1. 97
[8.224 L.], close in context to recipes for eye ointments at 102 and 105
[8.224, 228 L.]). Emendation such as i r r o j
u o (or o) r u 0 u i j
u jr prescribe as a poultice raw ox liver, dipping it in honey,
as big as possible, for one or two days might be considered; but it is
unlikely that poultices are relevant here.
The regular treatment for night blindness, authenticated in a wide
range of later sourcesHerophilos, Celsus, Paul of Aigina, Aretaeus,
Galen and Plinywas to give a meal of liver, while using the cooking
steam or juices as an eye-lotion (gravy from roasting, de compositione
medicamentorum secundum locos, Gal. 12. 802 K; wine used in boiling, Plin.
commentary 99
NH 28. 47).
76
Frequently, goats liver is specied, perhaps because the
goat was supposed to have good night vision (billy-goat to be preferred,
Celsus 6. 6. 38). While there may be an element of sympathetic magic
in the prescription, there is also a sound nutritional basis, which could
not have been understood but which could have been appreciated
through years of empirical observation and pragmatic prescription.
Night-blindness is caused by a deciency of vitamin A, and liver is
a rich source of that vitamin (hence the cod liver oil, once forced
into children). Liver is occasionally prescribed in the HC for other
conditions: in Diseases of Women foods prescribed to correct a red ux
include ox or goat liver cooked in the ashes (Mul. 2. 110 [8.236 L.]). A
prescription to control a ux of menstrual blood and one to control a
putative ux of some other kind of blood might be thought parallel.
The association here traced between the choker and night-blind-
ness in the Hippocratic Corpus continued in later medical writers:
Aretaeus describes two forms and two methods of treatment of the
choker. As in On Sight, cupping and purging feature. Treatment is
drastic: to cut the vessel in the elbow and to make the incision quite
large ( ) so that the blood ows
freelyand he admits that some patients have died under the knife
or incise similarly in the leg or elsewhere in the arm; then to administer
elaterion, said to be the drug of choice, to purge the patient (CA 7).
There is a slight awkwardness in that the subject of the rst sentence,
with its two jussive clauses (a construction used only here in the work)
is the patient, while the subject of the second sentence, with three nom-
inative participles followed by an imperatival innitive (with another
participle dipping loosely attached and a further explanatory
innitive to swallow dependent on it), is the doctor; but the
sense is clear and the jerky Greek is characteristic of the work.
(treatment for) night blindness: the etymology of the
word, lit. blind in vision at night involves a tautology. The punctua-
tion, which varies wildly in later mss, is managed dierently by dier-
ent editors. Sichel reads a drug for the suerer
from night blindness. Ermerins objects, as not just drugs but all medendi
methodus method of treatment is involved; he argues that some such
word as treatment must be understood after the initial genitive.
76
For a review of the evidence, see already Foesius I 736; also von Staden, 1989,
423426; Gourevitch, 1980, 178182.
100 commentary
Foesius, followed as frequently by Van der Linden, suggests emendation
to the nominative, to create a sentence, o o r
rj.
77
o rj drug elaterion: the term (lit. driver) is used
generally of any drug with laxative properties; also specically of one
such drug, based on an extract of wild cucumber (Galen linguarum Hip-
pocratis explicatio, 19. 97 K.)
78
The writer, usually concerned with surgery
and not with internal treatment, only here recommends purging of the
body (sc. by use of laxatives); purging of the head (sc. by nasal inser-
tions) is prescribed also 1.2 and 4.1. But, as noted above, purging is a
regular element in treatment recommended for the choker. Ermerins
regards the stress on treatment rather than prognosis as a suspicious
aspect of the section.
j j 0r0 lit. let him be purged as to his head: the
patient is the subject of the verb which may be passive (as trans-
lated: doctor is agent) or middle (translate purge his head for himself :
patient is agent).
o lit. having cut: Ms reading o having broken (a
verb usually applied to fractures of bones) gives unacceptable sense. It
has been suggested that the aorist is not from o break but
from o draw down (sc. the head, so that the patient could drink
juices from liver);
79
however aor. 1 j is implausibly rare for the
regular j and no 0 verb takes that form in the HC. The
reading o has some authority, being known to Foesius, who
however retains Ms reading, tr. pertundito strike hard.
80
That it is
correct is evident once the context (cutting the skin in preparation
for the application of cupping vessels in the process of wet cupping) is
understood. The simple verb o is used for incision with a scalpel
in Aections (the head, A. 2; the uvula, A. 4 [6.210 L.]), Internal Aections
(vessels in the groin, Int. 21; the elbows, Int. 37 [7.220, 258 L.]) and
in the surgical treatise Sores (aor. part. pass. the part incised, Ulc. 24
[6.428 L.]). The simple verb i lance is similarly used (Morb. 2.
77
Ermerins 282; Foesius I 736, n. 16.
78
Cf. Craik, 1998, 172.
79
Montfort, 2003, 44.
80
Foesius I 736, n. 17.
commentary 101
18, 25, 36 [7.32, 40, 52 L.]), as is the compound 0o (vessel in
the arm, Morb.1. 28 [6.196 L.]; uvula, Prog. 23 [2.178 L.]). While there
is no Hippocratic parallel for o, the formation is similar to
r (twelve occurrences, including Ulc. 22 [6.426 L.] and Morb.
2. 13, 15, 27 [7.24, 28, 44 L.]). The prex - is apt for the surgeons
hand bearing down on his patient; similar formations are u
(cut or lance swellings, varices etc., Ulc. 24, 25 [6.428, 430 L.]; break
the skin, avoided where dry-cupping is to be practised, Loc. Hom. 12.1
and 22 [6.298, 314 L.]), and 0 (draw o blood, Loc. Hom. 30
[6.322 L.]).
81
u o as much as possible: the phrase is common in prescrip-
tions or instructions for preparation (cf. VC 13 [3.228 L.], Loc. Hom. 27
[6.318 L.]).
r ri exert pressure release: the pedestrian verb r
press corresponds to the colourful 0i squeeze tight, com-
press in one of the parallel passages of Diseases 2 (Morb. 2. 26 [7.40 L.]).
The corollary process, letting go, is expressed with the same verb ri-
in Fractures, with reference to releasing the pressure of splints (Fract.
21 [3.486 L.]). Cornarius ingeniously but erroneously expands r
to _u r, supposing that the reference is to a regimen of light or
fasting diet.
82
t to swallow: the compound is rare, but occurs also in Diseases
of Women 1 and 2.
VIII
Trephining, or trephination, trepanation, is recommended for a case of
blindness not attributable, from the diagnosticians point of view, to any
discernible problem in the eyes. Sichel, perhaps following Foesius des-
ignation (hoc vitium oculi Graecis dicitur cum oculis bene habentibus
videndi acies laborat, this eye trouble, when, though the eyes are sound
the vision is aected, is called amaurosis by the Greeks) summarises
81
See Iugler, 1792, 44 and 73 for ingenious suggestions: u. u. -
i.
82
See rebuttal, Foesius I 736, n. 17.
102 commentary
amaurose traite par la trpanation; Ermerins makes no judgement
on the nature of the disease: quis morbus sit, de quo agit, nescio, I do not
know what is the disease concerned; Joly, perhaps quoting Hrode, his
adviser on specialist ophthalmic matters, comments utile dans les cas
de processus expansif intracranien, cette intervention nergique serait
nfaste dans les autres.
83
It remains peculiarly dicult to diagnose and
treat the cause of deteriorating eyesight, there being many causes
some hereditary, some age-relatedfor loss of vision in an eye which
remains normal in appearance. Our doctors rst assumption is ocu-
lar ux: from the instruction, to trephine and remove moisture, it is
evident that the supposed cause is a ux of moisture from the head,
aecting the eyes; it is evident too that the moisture is envisaged to be
deep in the head, under the bone. (On two types of ux, see 3.3; on
treatment of supercial ux, see 4 above.)
The Hippocratic doctors had recourse to trephining, surgery in
which a sawing or piercing instrument was applied to the bone of the
skull, in a variety of circumstances. The most common was in cases of
fracture, or head injury (VC passim, especially 9 on indications and 21 on
technique [3.210, 256 L.]; Loc. Hom. 32 [6.324 L.]). In general, trephin-
ing has three broad motivations: rst, to treat fractures by draining a
dangerous blood clot, or by disimpacting the fragments for removal;
second, to remove dead bone exposed in a wound; third, to look for
pus when fever and headache suggest its presence under the skull.
84
The
third is similar to that here, and to Galens use of trepanation to relieve
pressure by draining a phlegmatous lesion on the head (Hippocratis de
medici ocina liber et Galeni in eum commentarius, 18B. 808 K.).
85
For other types of head surgery, cutting with a single incision or with
multiple incisions into the bregma, see above on 4. The procedures
applied here are readily paralleled in Diseases 2. In the rst part of
that treatise (Morb. 2. 1 [7.8 L.]), the cause of disease is summarily
indicated in terms of the head overheating, causing phlegm to melt and
cause ux in various parts of the body, notably parts of the head (eyes,
throat etc.); several cases are outlined (Morb. 2. 111 [7.818 L.]), then
elaborated in the second, more developed, part of the work (Morb. 2. 12
83
Foesius I 736, n. 19; Sichel 159; Ermerins XL; Joly 174. Cf. also Hirschberg I 1982
(tr. Blodi), 133 on the daring treatment of amaurosis by trephining the skull and draining
cerebrospinal uid.
84
Martin, 2003, 329330.
85
See Rocca, 2003, 257.
commentary 103
[7.18 L.] onwards). In that part a patient who is suering from pain
in the region of the eyes and disturbed vision (0u) is given
the same treatment as the patient in On Sight 8, that is treatment to
pierce the bone, thereby releasing uid pressing on the brain (Morb. 2.
15 [7.28 L.]; cf. Celsus 8. 3; Galen linguarum Hippocratis explicatio, 19. 129
K.).
86
In Places in Man, ux from the brain, that is ux of salty uid, by
contrast with the noxious mucoid matter involved in ux from the top
of the head is believed to cause blindness (Loc. Hom. 13.3; cf. 2.2 [6.300,
278 L.]); conversely, in On Sight the sight is unaected.
As above, there is an accumulation of participles indicating stages in
treatment (cut, move skin, saw bone, remove moisture). At the same
time, there is a change from imperatival innitives to j, expressed
or understood, with accusative and innitive. The formula so they
are cured is common to Places in Man and Diseases 2 (Loc. Hom. 13.5
[6.300 L.], Morb. 2. 32 [7.50 L.]). The same adjective sound is used of
sight (similarly in 2) and of patient (similarly in 3.4).
1. j l o0i t r 0i j if somehow the
eyes, though sound, are destroyed in their visual faculty: Joly, retaining
dative and 0i optative, emends j to i to correct the
syntax of the conditional clause, tr. if someones eyes, though sound,
should destroy the visual faculty. However, this formulation (i with
optative, suggesting an unlikely case), though regular and almost for-
mulaic in the expression i j ij0 in Places in Man, is odd
in the context of this work where the regular expression throughout
is j with subjunctive, just as all temporal clauses are introduced with
ro or o. A further oddity is that would occur only here in
On Sight of the prospective patient and the statement that the healthy
eyes destroy the eyesight is very awkward. The emendation suggested
here corrects these anomalies, and the verb 0i0 is passive as
in 1 above.
ri folding back: the verb r lit. skin, ay suggests
skinning an animal, as, of a sheep, in Haemorrhoids (Haem. 4 [6.440 L.]).
But it is the mot juste for an operation such as this where tissues
are neatly separated from bone. Paul of Aigina uses the compound
r in describing a similar operation on the scalp (Paul Aeg. 6. 6;
86
For procedures of piercing vs sawing, see Jouanna, 1983, 228, n. 6.
104 commentary
see LSJ s.v. 2, anat., separate by avulsion, Herophil. ap. Gal.
de anatomicis administrationibus 2. 349 K. and cf. ibid. 2. 719 K. for the
sense strip o the scalp, expose, lay bare, in dissection.) The formation
, with its double prex, is in keeping with this authors
expression. Similar verbs in the surgical treatises are
rupture again in Fistulas and where the sense of the prex
is uncertain, in Fractures.
87
removing the moisture: the moisture is mois-
ture from the brain; cf. , lit. water, in the related procedure, Morb.
2. 15 [7.26 L.].
IX
The nal chapter deals with ophthalmia as a seasonal disorder. Sichel
uses the expression ophthalmie pidmique as a heading, and elab-
orates Il sagit ici des ophthalmies pidmiques, dtermines par les
variations brusques de la temprature atmosphrique, pidmies encore
si frquentes de nos jours. Elles sobservent surtout lors des change-
ments des saisons. Ermerins, similarly, and with his usual strictures
against the character of the writing sums up the content as de lip-
pitudine annua et epidemia; de tumore cum dolore et sine dolore in eo morbo; deinde
uxionis absentia in illo. Puto saltem de his rebus agi in capite pessime descripto.
On seasonal and epidemic ophthalmia; on swelling with and without
pain in that disease; then on the absence of ux in it. At least, I think
these are the topics discussed in a very badly transcribed chapter. Joly
repeats Sichels ophthalmie pidmique, adding in a note, Il pourrait
sagir dune allergie.
88
The rst two sections (of which the second has
suered serious textual corruption, here addressed by comparison with
parallel passages in Galen and in Celsus) oer a series of general pre-
cepts for the treatment of cases of ophthalmia; 3 is more general still,
apparently moving from treatment of seasonal ophthalmia to aphoristic
comments applicable not only to this eye ailment but to many oth-
ers. These general comments seem out of place in the work, but they
may arise from an inherent ambiguity in the term ophthalmia, applied
equally to a specic or a general eye ailment.
87
See Petrequin II 1888, 139, n. 6 and 7, tirer en bas or en arrire or soi.
88
Sichel 159, 150; Ermerins XLI; Joly 171, 174.
commentary 105
The ophthalmia of On Sight may correspond to the modern hay
fever (allergic rhinitis characterized by a blocked, runny nose and itchy
watering eyes) brought on in sensitive people by histamine release on
exposure to the pollen of grasses, trees and other plants, and now rou-
tinely treated by antihistamines and steroid sprays. There are some
three million suerers each year in the UK alone.
89
However, the
prevalence of allergic reaction as a diagnosis is a relatively recent phe-
nomenon; and it may be that we should here think more generally of
vernal and aestival conjunctivitis. The aetiology of this is uncertain,
and allergic reaction is only one theory; it is common, with a strik-
ing seasonal pattern, in the Mediterranean littoral, where it may be
attributed to such environmental factors as dusty conditions aggravated
by dry heat and where simple palliative measures to protect the eyes
from dust, heat and sun are the standard response.
90
Ophthalmia, often used in the plural, is a general term for eye
ailments in the HC and other ancient medical texts. Thus, in Prorrhetic
2 the word is used of all types of eye disease, whether of long or short
duration (Prorrh. 2. 21 [9.48 L.]). In Glands, it is applied, in an all-
embracing way, to the condition which results from a ux to the eyes
and causes the visual parts to swell (Gland. 13 [8.568 L.]). In Diseases 1,
ophthalmia is included in a list of diseases which are not in themselves
fatal; in grouping eye aections with such joint diseases as kedmata,
podagre, ischias and arthritis the physician seems to show an awareness
of their inherent anity (Morb. 1. 3 [6.144 L.]). Ophthalmias are linked
with ux or streaming eyes in Epidemics 1 (Epid. 1. 2. 4 [2.616 L.]) and
the term is used in various treatises of seasonal eye irritations, vernal
(Aph. 3. 12 [4.490 L.]), aestival (Aer. 10 [2.42 L.]) or autumnal (Aph. 3. 14
[4.492 L.]; Epid. 7. 45 [5.412 L.]: in the latter case, treatment includes
phlebotomy and purging the head, as in Vid. Ac.). The association
with the disease known as the choker has already been noted and
the curative recommendation for both ophthalmia and the choker
in Epidemics 2 is, as here, phlebotomy (Epid. 2. 6. 12 [5.134 L.]). In
the Aristotelian Problemata the question of seasonal summer fevers and
ophthalmias is addressed (Probl. 1. 8, 859b). It is stated that ophthalmias
come about when excess stu in the head melts (
89
See BMD, s. v.
90
Duke-Elder II 1938, 16971699, 1705; Trobe and Hackel, 2002, 6368; Spalton et
al., 2005, 118, gs 5. 4 and 5. 5 for allergic conjunctivitis and 120, g. 5. 6 for vernal
keratoconjunctivitis.
106 commentary
) and is followed by fever; for heat in the body is
fever and heat in the eyes is ophthalmia. Here again ophthalmia is a
key word for eye trouble from its most common source, ux. Also in the
Problemata the question is raised why some people who have suered
from ophthalmia see more clearly; and it is speculated that their eyes
have been cleansed through tears, as the secretion which forms on the
eye covers the sight (31. 9, 958b; cf. also 2 above).
Ophthalmia is the rst mentioned eye disease in the list of the lex-
icographer Pollux (Poll. 2. 4. 65; cf. 4. 25. 184). In Galenic texts, oph-
thalmia is discussed in many passages; the expression
so-called ophthalmias suggests that it is regarded as a tech-
nical term or perhaps rather as a catch-all (de compositione medicamentorum
secundum locos, 12. 702 K.). These include a description of ophthalmia as
the most common eye disorder (ibid. 12. 711714 K.); an account of its
symptoms as reddening of the white, swelling of the eyelids, and pain
when the eyes are closed, or touched; also a prescription (bathing the
eyes with rosewater) for summer ophthalmias and three prescriptions
(including ower of copper, softened in honey) for ointments to treat
protracted ophthalmia (de remediis parabilibus 14. 342, 343 K.; cf. introduc-
tio seu medicus, 14. 768 K.). Galen, adding material to the Hippocratic
account of unfavourable signs in the eye (Prog. 2 [2.114 L.]) instances
ophthalmia, with drunkenness, as causing reddening of the whites of
the eyes (in Hippocratis Prognosticon commentaria 1. 10 = Heeg, CMG 5. 9.
2, 222).
91
Celsus deals at great length with lippitudo (Greek ophthalmia, in both
a general and a specic sense), rst named in a list of spring diseases
stemming from umoris motu movement of moisture (2. 1. 6). In his
subsequent discussion of the notae signs which allow prognosis: tumor
swelling, pituita discharge, lacrima tear and dolor pain all feature
(6. 6. 1); he regards lippitudo as an illness with an obvious (unstated)
cause (proem 30). The ordering of topics is similar to that in On Sight:
where there is inammation, the patient should lie in bed, in a dark
place, and take no food and even, if possible, no drink; bleeding is
recommended in appropriate cases (si in fronte venae tument, si rmo corpore
materies superest if the vessels in the forehead are swollen; if there is
superuous matter in a robust frame); poultices may be applied to the
vessels (ut compressis venis pituitae impetum cohibeat in order to control the
91
See Savage-Smith, 1984, 177 with n. 55.
commentary 107
surge of phlegm by compression of the vessels) or to the surface of the
eye itself. It is recognized (6. 6. 8D) that failure to recover from the
pain, inammation and ow of matter is a common eventuality.
In de remediis parabilibus (14. 342344 K.) Galen has several sections
on eye troubles, including one on summer ophthalmias, which are
protracted in character. The treatment for ux from the eyes (ri u
o u o0u u) is in the rst instance little to eat
and water to drink; avoidance of all company; avoidance also of strong
odours, dust, smoke and light from sun and lamp. If the ux persists
and there is additionally pain, phlebotomy and complete fasting is
prescribed, to be followed by applications (r0r) and poultices
(o) of plant matter such as green vine leaves mixed with
wine and ne our. The ordering of topics is again similar to that here,
and there is the same stress on the appropriateness of poultices when
pain supervenes.
From these parallel passages in Celsus and Galen (neither necessarily
directly dependent on On Sight, but both drawing on a stock of mate-
rial, more or less homogeneous in character) the corruption in section 2
can be addressed. The rst sentence is not problematical, but thereafter
the Greek is confused and the sense unclear. After this point, Ermerins
oers no translation, noting certum est hunc locum vitiis scatere it is cer-
tain that this passage is full of errors and merely making tentative
suggestions for emendation. It is here argued that the main problem
is disruption in the ordering of the text and that the correct sequence
of words can be restored once the sequence of thought is appreciated.
The general drift of our passage is that the relation between pain, dis-
charge and swelling is important in diagnosis, a point stressed not only
by Celsus and Galen but also by the author of Prorrhetic 2 (Prorrh. 2.
18 [9.44 L.]), and that the relation between ointments and poultices is
important in therapy. The presence or absence of pain is given par-
ticular emphasis. However, there is an erratic move from the topic of
painless swellings (which should not be poulticed) and painful swellings
(which may be poulticed after ointments have been tried, if these prove
ineective). Some manipulation of word order with slight alteration
of punctuation and modest emendation gives good sense, in accord
with that of Celsus and Galen. In palaeographical terms, the disrup-
tion can readily be explained: delete o (wrongly written because of
o following), read ro (misplaced by the intrusive o); read -
0j for the meaningless 0j and insert negative j before
u.
108 commentary
The style remains telegraphic, with simple sentence structure broken
by a few conditional or temporal subordinate clauses. Bald or incom-
plete sentences have the air of jottings, or rough notes. The verb r-
is used repeatedly (eight times; cf. 1 above, twice), without regard for
stylistic variation. As in 1 above, the alliteration of o0 i
may be consciously aected, or merely formulaic. The sudden end, like
the disconnected beginning, conrms the impression that the work was
not written as a co-ordinated whole, but is a series of notes intended for
personal use or limited circulation.
1. ri i ri recurring annually and locally: Ms nonsensi-
cal r ii is evidently a corruption of ri, a reading known to
or originating with Cornarius. The adjective restored is otherwise not
found in the HC; but gains support from Platos rr j ill-
nesses recurring annually (Pl. R. 405c). The adjective rj is sur-
prisingly rare in the HC, and rare enough to be glossed by Hesychios.
It occurs most frequently (four times) in Internal Aections, a treatise seen
here to have certain other features in common with On Sight in both
content and expression, applied there to types of phlegm and to jaun-
dice; elsewhere it is found only in Epidemics 7 (Epid. 7. 59 [5.424 L.]) and
in one of the late letters (Ep. 17 [9.354 L.]).
92
o0 j i j o i o0 purging of the head
and purging of the lower belly: the second o0 purging found in
MHR is lost in I and mss descended from I.
i r u if he should have the physique (lit. the body): bleeding
is prescribed in addition to the less invasive purging of head and body
for those patients who are strong enough to withstand it. Foesius
translation si corpus sanguine redundet if the body has too much blood
reects the rationale of his own contemporary practice of bloodletting.
93
The phrase is odd in expression, but attention to the patients physique
is commonly recommended: with regard to administering food and
drink in Aections (A. 47 [6.258 L.]), to phlebotomy in Regimen in Acute
Diseases (Acut. Sp. 3 [= 2, 2.398 L.]) and to purging head and body, and
drawing blood from arms in Diseases 2 (Morb. 2. 73 [7.112 L.]). (The
previous section, Morb. 2. 72 [7.108, 110 L.], deals with phrenitis a
92
Cf. Jouanna, 1974, 242, n. 2.
93
Foesius I 689.
commentary 109
condition where, as at Vid. Ac. 9 the patient shuns the light; also as at
Vid. Ac. 9 head and belly are to be purged and few foods allowed.) Such
variation in treatment, at the physicians discretion, is a feature of the
practical and surgical treatises, commonly expressed in the formulation
r it is benecial for (Epid. 5. 68, 7. 65 [5.244, 430 L.];
Fract. 4 [3.430 L.]; VC 19 [3.254 L.]).
r u u 0o for some troubles of this kind: the
expression indicates that the author views opthalmia as having dier-
ent manifestations, which might respond dierently to treatment; this
reects a transition from ophthalmia as a specic condition, to oph-
thalmia as a general ailment. Galen glosses 0j troubles as a
synonym for j diseases (linguarum Hippocratis explicatio, 19. 74
K.) The incidence in the HC is wide, with a particular concentration
in Koan Prognoses (seventy-one of one hundred and ninety-four occur-
rences).
t food: the prescription of only a little bread and just water to
drink, in conjunction with the advice not to moisten the head, suggests
a regime of reducing the patient, the natural consequence of a supposi-
tion that the illness is precipitated by an excess of moisture accumulat-
ing in the head.
r _. 0 0 i i u 0 u in the dark,
away from smoke, re and other bright things: the injunctions seem
sensible; on avoidance of light, cf. Hebd. 35 [8.657 L.]; of smoke, cf.
Morb. 3. 2 and 16 [7.120, 148 L.]. Joly follows Jouanna in remarking
that this instruction is unique to these works, but observes that the
context in Morb. 3 is not ophthalmological.
94
Avoidance of smoke as
an irritant to the eyes and of light as damaging the eyes feature also in
the Aristotelian Problemata (31. 21, 28, 959b).
o on his side: the injunction that the patient lie on his side
seems otiose (but perhaps lying on the back would make it more dif-
cult to avoid light). Joly reads o, nominative in place of Ms
i, genitive plural. Cornarius suggested i, adverb and van
der Linden o, accusative. This last gives most idiomatic Greek:
accusative and innitive, in instructions to the patient (not nomina-
94
Joly 174; Jouanna, 1974, 491, n. 4.
110 commentary
tive and innitive in address to the physician). The manuscript error
of omega for omicron is a common one, explicable both visually and
aurally. Foesius knew ms evidence for o, but retained i
translating ex obliquo obliquely.
95
Though the adjective is very com-
monly opposed to o0 straight, there seems little point to this sense
here; we may contrast a passage in Articulations, where the patient must
sit sideways on a high chair for the practical reason that his arm can
go over the back of the chair, in readiness for treatment of a dislocated
shoulder (Artic. 7 [4.92 L.]).
2. That the head should not be moistened (sc. with water, or oil, or
soothing lotions) again indicates the supposed presence of ux from
the head; this might be aggravated by addition of uids, even exter-
nally, and the ensuing mention of swelling further suggests the pres-
ence of noxious or excessive or misplaced matter. But there are else-
where instructions not to wet the head, even when other parts are being
bathed (Morb. 3. 6, 16 [7.124, 148 L.]; Int. 7 [7.184 L.]; A. 26, 27 and
cf. 37 [6.238, 246 L.]). The injunction not to moisten head wounds
occurs categorically in Head Wounds (VC 13 [3.230 L.]) and, more gen-
erally, with reference to any wounds, in Sores (Ulc. 1 [6.400 L.]; cf. also
Artic. 40 [4.172 L.]). In these passages too, the context involves a move
from proscription of moisture to the question of poultices. The surgical
injunctions of Sores further resemble those of On Sight in recommending
a very light diet, with water to drink (or I r,
Ulc. 1 [6.400 L.]; reiterated i j r i or i r
I, Ulc. 24 [6.428 L.]).
0 o r for it is not benecial: the variant rj 0 -
r gives the same sense and is important only in establishing the
divergence in the later tradition between mss derived from H and mss
derived from I. Similarly below, the inclusion or omission of is
indierent semantically. Scribes were probably unconcerned with such
minor dierences.
o poultice or plaster: the term embraces all kinds of cura-
tive materials plastered on the skin, sometimes but not always con-
tained in a fabric bandage.
96
95
Foesius I 689.
96
See Petrequin I 1887, 243, n. 1 and 483, n. 3; also Duminil, 1998, 51, n. 3.
commentary 111
oj j ru. 0 u u rr if there is no pain, but
apparently continuing ux: for the genitive absolute, cf. ij j
in the absence of swelling, Ulc. 10 [6.408 L.]. Joly reads
0, which might refer to a persistent, but useless, ow of discharge,
or of tears. The verb rr has two main senses (apparently rather
contradictory; but both involve a recognized usage of the prepositional
prex and ambiguity is rare): prevail, continue or pause, stop.
Both senses are found in the HC: the former is surely intended here.
The term 0 may be used both of ux (abstract) and of content
of ux such as discharge (concrete); sometimes there is a shift from
abstract to concrete (as Loc. Hom. 13 [6.298 L.], both generally of ux
to the eyes and particularly of a type of discharge). The phrase here
clearly anticipates the genitive absolute in the nal sentence, possibly
misplaced, of 9.3.
io 0u while the swellings are not painful: this phrase is
tautologous after oj j ru, but the repetition is not untoward
in the Greek of On Sight. Flux and pain go together in many contexts
(cf. 0r 0 u i j ou, when both ux and
pain have passed, Morb. 2. 19 [7.34 L.].)
r o astringent drugs: see VC 14 [3.236 L.] (vinegar); A.
38 [6.248 L.] (for suppuration); Mul. 1. 74 [8.158 L.] (0 i to
draw blood) and cf. Mul. 2. 165 [8.344 L.], Nat. Mul. 24 [7.342 L.],
Morb. 2. 47 [7.66 L.]. The doctor is supposed to know which drugs
would act in appropriate ways: astringent agents, as here, or drying
agents, as below.
The verb i0 be separated is very rare and there is no
other Hippocratic usage; further the sense is inapposite. The proposed
i0 treat gives the precise sense required. The verb occurs
in Aections, Prognostic and Diseases of Women 2 (Mul. 2. 111 [8.240 L.]),
while the related substantive occurs in Epidemics 2 (Epid. 2.
3. 2 [5.104 L.]); the incidence is in accord with the general pattern of
vocabulary in On Sight.
o j ro after the application (of ointment): the substantive
is a hapax. But the verb ii is found in Nature of Woman. Similarly
we nd o just below, 9.3; Galen glosses o r
o (linguarum Hippocratis explicatio, 19. 148 K.). The otiose r- and
112 commentary
- prexes are in accord with the stylistic preferences of our writer;
and once again this preference links On Sight linguistically with a lim-
ited group of treatises. The following may be compared: iu (Loc.
Hom.; Mul. 1 and 2; Prorrh. 2); io (Artic.); io (Mul. 1);
io (Nat. Mul. only, 14 occurrences); ii (Loc. Hom.); i-
0o and i0 (VC); io (Oss.); io (Morb. 2); i-
0r (Artic.; Fist.; gynaecological works). The sux - or - is also of
interest. Medical terms of this formation describe the use of procedures
in treatment; whereas words of - formation denote the procedure
itself. Examples are io and i. 0i and 0i, i and
i. (Compare also the hapax i Loc. Hom. 47. 8 [6.346 L.],
and note the exception i0 of a medical condition.) Where the
medical usage is not a coinage, but depends on a more general word
which predated it, that general word continues to exist and there is
no formation in -. Examples are and , o
and o. Similarly, in Latin, -tio as a sux has some stylistic or
technical signicance; and -tura is used in medical parlance.
97
3. t summons: the verb occurs only ve times in the HC
(here, and in Fract., Epid. 6, Prorrh. 1, and Coac.). Advice to keep the eyes
neither open for too long nor shut for too long might seem to apply in
all circumstances, not just in the case of this ailment. However, Sichel
nds here a mark of the experienced practitioner and Joly a judicious
recommendation to avoid secondary infection.
98
The emphasis on the
nature of the matter in ux continues (cf. Prorrh. 2. 18 [9.44 L.], echoed
Celsus 6. 6. 1, hot is bad; Loc. Hom. 13 [6.300 L.], pent-up matter is
dangerous).
i pent-up: the verb occurs (passive, most often of urination)
in the surgical treatises, Epidemics and elsewhere (but not in theoretical
works on ux and xation). The nal sentence (on the presence of
discharge) seems to belong earlier (in 9. 2, see above); here it is a
tangential return to a previous topic.
o 0 0 a drying substance: drying ointments would include
poultices intended to draw o noxious moisture. For a drying drug
applied in the case of slight ow, cf. Loc. Hom. 13.2 [6.300 L.].
97
Cf. Langslow, 2000, 292, 300.
98
Sichel 151; Joly 174.
GLOSSARY OF OPHTHALMOLOGICAL TERMS
Blepharitis inammation of the lid margins
Canthus angle at outer (lateral) and inner (medial) corners of
eyelid
Cararact disease of the lens marked by opacity in the lens or lens
capsule
Chalazion painless cyst developing in tarsal gland
Choroid vascular layer between sclera and retina
Ciliary body part of the eye connecting iris and choroid
Conjunctiva mucous membrane lining the marginal edges and the
inner aspect of the lids and covering the cornea
Conjunctivitis inammation of the conjunctiva
Cornea anterior transparent part of sclerotic membrane
Ectropion eversion of the lid margin (usually lower lid), condition
when the lid is turned away from the eyeball, exposing
the conjunctiva
Entropion inversion of the lid margin (usually lower lid), condition
when the lid is turned towards the eyeball, causing
irritation to the cornea from the lashes
Eyelids upper and lower tissue, serving to cover and protect the
eye, with lashes on their margin
Fundus point on retina, opposite pupil, through which nerve
bres and blood vessels travel
Glaucoma disorder (or group of disorders) characterised by high
intraocular pressure due to build up of aqueous humour
in the eye
Iris the coloured portion of the eye, perforated by the pupil
Keratitis inammation of the cornea
Lens colourless body contained in capsule behind iris, involved
in transmission of light to retina
Limbus junction between (opaque) sclera and (clear) cornea
Papilloma overgrowth of skin
Pterygium conjunctival lesion, triangular fold of tissue growing from
nasal area over the cornea
Pupil the central aperture (black to the naked eye) of the iris
Retina sensitive layer (innermost of three coats of the eye)
involved in transmission of nerve impulses to the brain
Sclera, sclerotic the white portion of the eye, a tough encapsulating
brous membrane (outermost of three coats of the eye)
Tarsus, tarsal plate plate of brous tissue supporting the eyelid
114 glossary of ophthalmological terms
Trachoma serious infectious keratoconjunctivitis
Trichiasis condition of ingrowing eyelashes, allied with entropion
Visual cortex part of the brain which processes information from the
eye
DIAGRAMS
Diagram 1. The Eye: anterior view
Diagram 2. The Head: lateral view
116 diagrams
Diagram 3. Section of the eyeball
part ii
ON ANATOMY
[page 135]
THE HIPPOCRATIC TREATISE ON ANATOMY
1
Anatomy is the basis of medical discourse (Hipp. Loc. Hom. 2 [6.278 L.])
Introduction
On Anatomy (Anat.) is the shortest treatise preserved in the Hippocratic
Corpus (HC). It describes the internal conguration of the human
trunk. The account is for the most part descriptive, function being
largely disregarded and speculation completely eschewed. Though sys-
tematic it is unsophisticated: two orices for ingestion are linked by
miscellaneous organs, vesssels, and viscera to two orices for evacua-
tion. There is a clear progression in two parallel sections: rst, trachea
to lung, lung described, location of heart, heart described, kidneys to
bladder, bladder described, bladder to genitals, conclusion; and second,
oesophagus to belly, location of diaphragm, location of spleen, location
1
Appreciative thanks are due to the director and trustees of the Wellcome Trust
for the award of a research leave fellowship which released me from arduous teach-
ing duties at the University of St. Andrews to pursue work on the Hippocratic trea-
tise Places in Man (ed., tr., and comm., forthcoming, Oxford University Press). This
paper is a parergon of that work. I am most grateful to Professor Vivian Nutton (WIHM
and University College London), who rst drew On Anatomy to my attention and who
commented most helpfully on drafts of this paper at successive stages. I am grate-
ful also to Mr James Longrigg (University of Newcastle-upon-Tyne) for advice on the
pre-Socratic background, to Sir Kenneth Dover (St. Andrews) for comments on the
style of the piece, and to Professor Jacques Jouanna (Sorbonne) for invaluable aid
in checking and communicating the readings of the ms V. Assistance of a dierent
but equally important kind was aorded by those who answered my countless (doubt-
less often silly) anatomical questions with great good sense and good humour; espe-
cially Dr Donald Coid, whose copy of Grays Anatomy has now become even more
thumbed and tattered; Dr Ann Dally, who introduced me to the ways of Wimpole
Street; and Dr Susan Whiten, who, with Mr Robin Clark, gave me an unforget-
table and highly instructive tour of visual aids in the Department of Anatomy at St.
Andrews. Without the encouragement and support of all these friends, I should never
have completed this paper. In the nal stages, it was improved by the comments of
the referee (anonymous) and the editors (Stephen Heyworth and Christopher Col-
lard) of CQ. For any remaining errors or misapprehensions, I am alone responsible.
120 the hippocratic treatise on anatomy
[page 135 // page 136]
and description of belly (close to liver), belly to intestine/colon, colon
to rectum and anus, conclusion. The fragment oers good basic topo-
graphical or regional anatomy (the organs studied as they lie in rela-
tionship with one another in the dierent regions of the body). That
the work is concerned with human anatomy is certain from the precise
description of lung and liver, with features peculiar to human organs;
and is corroborated by frequent references to comparative anatomy,
with which familiarity is apparently assumed. Such anatomical knowl-
edge, based on extensive observation of animals (probably sacricial
victims as well as laboratory specimens), may have been corroborated
by some human dissection, perhaps of the aborted foetus or exposed
infant, in conjunction with opportunistic observation of war wounded
and accident victims. While the syntax is bald, telegraphic, and asyn-
detic, the vocabulary is recondite, and poetic. There is erratic omis-
sion of the article and recurrent use of compendious comparisons.
These features suggest that Anat. may be an abridgement of a fuller
and more owery account; this hypothesis is supported by several pas-
sages where erroneous or unclear information apparently results from
excessive compression or // imperfect comprehension of a source. The
vocabulary is markedly Demokritean and there are strong anities with
Ep. 23, the supposititious letter of Demokritos to Hippocrates on the
nature of man. As there are similarities also, both in content and in
expression, with Oss., a composite work which is related in turn to Epid.
2, case histories of patients in Thrace and adjacent regions, and with
the similarly located Epid. 6, the putative earlier version(s) of Anat. may
plausibly be attributed to a North Greek strand of scientic and medi-
cal endeavour. In this paper a new text is presented, followed by trans-
lation, commentary, and discussion incorporating conclusions on origin
and date. At the same time, the paper has a wider thrust, concerning
the development of ancient anatomical knowledge and scientic ter-
minology. The conclusions have important implications for our under-
standing of the formation of the HC, both as originally composed and
as subsequently constituted.
the hippocratic treatise on anatomy 121
[page 136 // page 137]
References and Abbreviations
V Vatican gr. 276 twelfth century
Anat. is preserved in a further six mss, all recentiores and apparently without
independent value. See H. Diels, Die Handschriften der antiken rzte, Teil I (1905),
p. 31 and also B. Alexanderson, Die hippokratische Schrift Prognostikon (Gteborg,
1963), pp. 70, 7778, 110. These are:
Paris 2146 and Paris 2255 = C and E on which Littr relied.
Bologna 3632.
Holkham 282, now in Oxford (by the same hand as Paris 2146).
Munich 71.
Vatican, Palatine 192.
Calvus Latin translation of Hippocratic writings (1525, preceding
Aldine editio princeps of Asolanus, 1526).
Cornarius ed. and Latin trans. (Basle, 1538).
Foesius ed. and Latin trans. (Frankfurt, 1595; also Oeconomia,
Frankfurt, 1588).
van der Linden ed. and Latin trans. (Leiden, 1665).
Triller Opuscula Medica vol. 2, 1st edn (Leiden, 1728); and 2nd
edn (Leipzig, 1766): medico-philological commentary
on Anat., intended as specimen for complete Hippocratic
edition.
Littr ed. and French trans. (Paris, 18391861; Anat. occupies 8.
536541, published 1853).
Ermerins ed. and Latin trans. (Utrecht, 18511864; Anat. occupies 3.
287288, published 1864).
BVD Blacks Veterinary Dictionary (14th edn, 1982).
GA Grays Anatomy (30th edn, 1949).
DK H. Diels & W. Kranz, Die Fragmente der Vorsokratiker (10th edn,
1961).
DR C. Daremberg and E. Ruelle, Oeuvres de Rufus dphse (Paris,
1879).
HC Hippocratic Corpus.
Ibycus, TLG computer search of TLG database.
K. C.G. Khn, Claudii Galeni Opera Omnia (Leipzig, 18211830).
Abbreviations for ancient authors and works (including Hippocratic treatises)
follow LiddellScott-Jones. //
The following modern works are referred to by authors name and date:
M.-P. Duminil, La description des vaisseaux dans les chapitres 1119 du trait
de la Nature des Os, Hippocratica (Paris, 1980), 135148.
122 the hippocratic treatise on anatomy
[page 137]
L. Edelstein, The History of Anatomy in Antiquity, Ancient Medicine: Selected
Papers of Ludwig Edelstein, edd. O. and E.L. Temkin (Baltimore, 1967; rst
German publication, 1932), pp. 247301.
W.A. Greenhill, Adversaria Medico-Philologica, British and Foreign Medico-chi-
rurgical Review 3438 (18641866).
C.R.S. Harris, The Heart and the Vascular System in Ancient Greek Medicine (Oxford,
1973).
J. Irigoin, La formation du vocabulaire de lanatomie en grec: du mycnien
aux principaux traits de la collection hippocratique, Hippocratica (Paris,
1980), 247257.
J. Jouanna, Hippocrate (Paris, 1992).
G.E.R. Lloyd, The Development of Greek Anatomical Terminology, Science,
Folklore and Ideology (Cambridge, 1983), pp. 149167.
J. Longrigg, Greek Rational Medicine (London, 1993).
I.M. Lonie, The Hippocratic Treatises On Generation, On the Nature of the Child,
Diseases IV: A Commentary (Berlin and New York, 1981).
J. Mansfeld, The Pseudo-Hippocratic Tract (Assen, 1971).
R.B. Onians, The Origins of European Thought (Cambridge, 1952).
F. Skoda, Mdecine ancienne et mtaphore (Paris, 1988).
W.D. Smith, The Hippocratic Tradition (Ithaca, NY and London, 1979).
W.D. Smith, Hippocrates: Pseudepigraphic Writings (Leiden, 1990).
H. von Staden, Herophilus. The Art of Medicine in Early Alexandria (Cambridge,
1989).
O. Temkin, Hippocrates as the Physician of Democritus, Gesnerus 42 (1985)
455464.
ON ANATOMY
TEXT AND TRANSLATION
[page 138 // page 139]
TEXT
i 0j
2
I
1. 'i r rr r0 j r r r 0
u 0. i r ot. u r -
r ri 0j.
5 2. 0 r o u t j r. r r o
0o. r u r. 0 j r u. i
j u. i ou r. u ru 0u-
.
3. r_ 0r_ j i r0i. r 0u
10 o _u. ' r i r j i j 0j. i o
i r o r. j u j r.
4. r j oi r r t 0 0. lr
r r u 0. u r u. 0 r u. r
i i. ' r r j r ri o o
15 u 0i.
3 ot V: ot van der Linden 34 r Ermerins: r V
5 t Ermerins: t V 56 r r o 0o V:
r i o 0 vel 0i vel o 0 r Cornarius: r
r o o i o 0o van der Linden: r r o o i r o
0o Ermerins 6 u Ermerins: u V 7 ou
Foesius: or V: 0u van der Linden: o Littr 78 0u
Foesius: ru r 0u V 1011 i j 0j. i o i edd.:
o i V: i r 0j. i o j i van der Linden 12
oi V: oi van der Linden | 0 V: j Triller 14 i
Ermerins: r V 15 u recc.: V
2
A Bud text by M.-P. Duminil is promised.
[page 140]
TRANSLATION
I
1. The trachea, taking its origin from each side of the throat, ends at
the top of the lung; it is composed of similar rings [to other creatures],
the circular parts touching one another on the surface.
2. The actual lung, inclined towards the left, lls the chest cavity. The
lung has ve projecting parts, which they call lobes; it has an ashen
colour, is punctuated by dark spots, and is in nature like a honey-comb.
3. In the middle of it the heart is situated: it is rounder than [that of] all
creatures. From the heart to the liver a large tube goes down, and with
the tube the vessel called the great vessel, by means of which the entire
frame is nourished.
4. The liver has a similarity to [that of] all other creatures, but is more
blood-suused than [that of] others. It has two projecting parts, which
they call gates; it lies in the right part [of the body]. From the liver a
slanting vessel extends to the parts below the kidneys.
126 text
[page 138 // page 139]
5. i r oi. j j r ri j. ' r
r oi r r 0 j u t.
6. u r u u i o. 0 u r or
r.
5 7. i o r r 0o r r u rj0.
II
8. io r 0 u j 0j u r i 0.
o j i ri j i r.
9. r 0o0 0 j r u. ' r j
0. r r 0j. j 0o rr o i
10 .
10. i r j r 0u r 0j ri
u. ' r i r r o. . r
0 r u. r r ru. o r r
. u j o j j i.
15 11. ' r r 0 i0. o 0r r. r
0 i u.
12. o r 0 j u o.
1 j V: i Triller 2 r 0 van der Linden: 0 V 3 r0
u r or Craik: r0 u j i V: ro0 r u j
i recc.: r r u j i Triller: r0 r u j i o Littr: r
r j u r r Ermerins 5 u V: u Ermerins 7 ri j
V: ru vel rj Cornarius ap. Foesium | r edd.: r V
8 ru edd.: u V 9 o edd.: o_u V 11 0j V:
0r recc.: 0i van der Linden: 0r Triller 12 ap. Foesium:
V 13 r V: r van der Linden 14 V: u recc. |
i recc.: i V 15 V: u recc. | 0r V: 0r van
der Linden 1516 r 0 V: i r 0 van der Linden 17 Post o
lacunae signa Ermerins: fortasse o Craik
text 127
[page 140]
5. The kidneys are similar [to other creatures] and in colour are like
[those of] sheep. From them slanting ducts reach to the top edge of the
bladder.
6. The bladder is all sinewy and large. At a distance from the bladder
come, centrally, the genitals.
7. In these six parts [bodily] nature has been arranged internally in the
middle.
II
8. The oesophagus, taking its origin from the tongue, ends at the belly;
they call it mouth for the putrefying belly.
9. From the backbone, behind the liver, comes the diaphragm. On the
false side, I mean the left, the spleen begins, and extends, similar to a
footprint.
10. The belly, lying beside the liver, on the left side, is all sinewy. From
the belly comes the intestine, which is similar [to other creatures], long,
no less than twelve cubits, in coils entangled in folds. Some call it the
colon, and by it the passage of the food occurs.
11. From the colon comes last the rectum, which has eshy tissue, and
which ends at the extremity of the anus.
12. The rest, nature has organized.
[page 141]
COMMENTARY
1. On the trachea see GA 1270, 1275: The trachea, or windpipe, is
a cartilaginous and membranous tube continued downward from
the lower part of the larynx The cartilages vary from sixteen
to twenty in number. Each is an imperfect ring which occupies the
anterior two-thirds or so of the circumference of the trachea. Two or
more of the cartilages often unite, partially or completely. The author,
then, is correct about the rings and about the rings touching one
another. Nothing, however, is said about the branching of the windpipe
into the right and left extrapulmonary bronchi, which lead separately
to right and left lung.
: in Greek medicine, the term (or ,
whence trachea; cf. Celsus arteria aspera) eventually prevailed for the
trachea or windpipe. But in the HC the terminology of trachea and
bronchial tubes is ambiguous and inconsistent, even within individual
treatises and, at times, within individual sections of them (cf. Int. 1
[7.166 L.] on , , and all connected with the
lung). The term is used not only of the bronchial tubes but
generally of the area between throat and lung and, conversely,
may be applied to the bronchial tubes; also the two terms may be found
together (as Loc. Hom. 3.5, 10.1, 14.2, 14.7 [6.282, 294, 304, 306 L.],
where is trachea and , or by tacit substitution ,
are bronchial tubes). In the HC, the trachea is rarely simply
(but see Epid. 7.12 and 25 [5.388, 394 L.]). Most commonly, the term
is, like , applied to the important hollow bodily tubes,
ducts, or vessels through which uids (not only blood) were believed
to course, and is analogous to the term applied to the solid
links in the body, i.e. tendons, sinews, muscles, ligaments as well as
(occasionally) nerves. In some passages is ambiguously used,
both of trachea and of vessel (Epid. 2.4.1 [5.122 L.] ~ Oss. 5 [9.170 L.]).
In a later distinction, generally agreed to have been formalised by
Praxagoras, the arteries were believed to convey and the veins
blood through the body. Thus, in accord with Rufus explanation (Anat.
130 commentary
[page 141 // page 142]
65, 183 DR) that the r carry blood and the 0i blood to some
extent but rather 0 air, Pollux (2.5) denes 0i as paths for
air analogous to r, for blood. The connection between 0i as
trachea and as artery is probably that both were regarded (rightly in
the case of the former) as conveying air. The derivation is uncertain.
Possibilities are from i lift, presumably because the lungs seemed
suspended by the trachea, and the heart by the aorta (which, however,
itself must be from 0r suspend); or from 0i t, presum-
ably because the 0i seemed to t parts of the body together (and
for this notion, cf. Oss. 1 [9.168 L.], the intestines j); as did the
00, joints.
3
r rr r0: this term is not used elsewhere in the HC,
but is common in late medical writers.
4
It is glossed (s.v. u0) by
Hsch. As a technical locative term, it does not dier in sense from the
common term o (cf. Rufus o r j u0 Onom. 62, 141
DR) or occasional term o this being the interior of the o
or 0j (but both of these are used for other narrow parts also, such as
the neck of the bladder or of the womb). Pollux dierentiates between
o, start of oesophagus and o, of trachea (2.4.207). //
Unsurprisingly, the adjective ro, each (of two) is especially
common in bodily description (legs, kidneys Carn. 5 [8.590 L.]); but the
usage here, of each [side of the] throat is unexpected. However, from
o o r 00 ro r0 i r0 0r r, Gland. 7
[8.560 L.] (cf. rr0, Gland. 4 [8.558 L.]), it seems that the throat
was regarded as essentially bipartite, possibly because of its connection,
in breathing, with the two nasal passages. (o is occasionally used
in the plural, as 0 j o o o, Mochl. 39 [4.386 L.].)
j r r: the technical expression r with reference
to trachea has the same signicance as the more general term 0j in
the parallel description of oesophagus in 8 below, i.e. starting-point,
inception. Like the related terms 0, excrescence, protuber-
ance (for which ri is a common manuscript variant) and o-
, it is common in anatomical contexts, especially in Artic., Fract.
and Mochl.; also Oss. (e.g. Artic. 45 [4.190 L.], Fract. 12 [3.460 L.], Mochl. 1
[4.340 L.]; Oss. passim). The terms are typically but not exclusively
3
See Greenhill (18641866), Irigoin (1980).
4
Ibycus, TLG: Aretaeus, Aetius, Galen, and Oribasius.
commentary 131
[page 142]
medical or biological. The circumlocution j r r, with
abstract noun plus t0 standing for verb with same root as the
noun, recurs in 8 below, j 0j u = verb 0, as 0-
o, 9. This is by stylistic preference, the verb being available as
alternative: as 0r, Loc. Hom. 3.6 [6.282 L.] and ru,
Oss. 4 [9.170 L.].
r 0 u: the substantival form top point, extremity,
edge is used again below, r 0 i: this use is uncommon
in Attic Greek, but is a regular alternative in the HC, particularly for
bodily extremities, as in plural o 0, Acut. 30 [= 9, 2.290 L.]; and
repeatedly in Artic. The adjectival form is here used once (0 -
j, 5).
The singular form u is dominant in the HC (and the rare
plural is both preceded and followed by the singular, Gland. 14 [8.568,
570 L.]). From the expression the top of the lung, and the use through-
out of the singular, it is evident that the author regarded the lung as a
single joined organ, as indeed did Aristotle (HA 1.16.495b; PA 669b).
The original form u gave way to u presumably because
of a supposed connection with 0: from the heroic age the lung
was known to be vital to life (Hom. Il. 4.528 etc.).
5
0: this verb, repeated three times in this short piece (1, trachea
ending at lung; 8, oesophagus at belly; 11, rectum at anus) is regularly
used of the location of bodily parts in the anatomical treatises. For the
use of the preposition r, cf. t0 r below, 5.
i r ot: the sense of i is evident, but the
expression, forerunner of the modern term cricoid cartilage, is un-
usual in Greek. Pollux (1.94, on rings for ships hawsers) regards i
as poetic for i or u. Elsewhere in the HC, the noun occurs
only in Mochl. 41 [4.392 L.], where it denotes a loop attached to a
piece of apparatus (0 in the excerpted text, Fract. 30 [3.520 L.]).
The compound verb r occurs Oss. 18 [9.194 L.] in the phrase
ri j 00 (glossed Erotian E 38 rr). Celsus
expression constat ex circulis quibusdam (4.1.3) shares the metaphor. For
the compound verb, of bodily composition, see Fract. 9 [3.448 L.] //
5
Maladies of the lung and respiratory tract occupy much space in the HC: see
especially Int. init. [7.166 L.] and Loc. Hom. 14 [6.302 L.].
132 commentary
[page 143]
(foot and hand composed of many small bones); and see t0 below
(4, position of liver and 5, position of ureters; also t0 (10, belly
in relation to liver).
The concatenation of terms ot. oi. o.
o. o (connected respectively with rings of trachea,
1; with liver, 4; with kidneys, 5; with spleen, 9; with intestine, 10) is
arresting;
6
and we may add ri (connected with the kidneys, 5):
throughout, the author is concerned with comparisons, expressed in
consistent terminology. In scientic writing, technical terms are liable
to be repeated; indeed, variation can be misleading and obscure the
sense. Suda (s.v. ) glosses: o 'j o i
j. i rr r r 0 rt l i 'i -
u. Other late commentators (Philoponus, Eustathius), per-
haps using the same source, reiterate this information on the Abderite
sense of (j. r. 0r. o. u), and there
is good evidence that and related words were favoured by
Demokritos; see further below. Whatever the authentic Hellenic char-
acter of the other words allusively mentioned in the Suda, it seems
unduly harsh to imply that the semantic extension of (Ionic for
Attic 0) form is not admissible Greek. It seems rather to have
been a matter of stylistic preference; cf. E. El. 772 (in hendiadys with
) also H.F. 130, Supp. 94. The sense shape is dominant: see Arist.
Metaph. 985b16, identication with j, also Hdt. 5.58, of letters, and
Artic. 62 [4.268 L.], of boots; but coexists with more abstract usage, as
in Septim. passim. Hsch. glosses 0 i0, compare,
precisely in line with the sense of the related words here.
u r r ri 0j: neither j cir-
cular nor ri level, plane occurs elsewhere in the HC. The
former term, which Hsch. glosses as r. r, is used
6
Following van der Linden, Triller emends the two occurrences of o- to o-.
However, this is unnecessary, as the dierence between o- words (from o one
and the same) and o- words (from ot like, resembling) is not always strictly
maintained; except that whereas o- words can mean similar, o- words cannot
mean the same. Thus oj (close in nuance to o here) can mean either
of like form or uniform; and coexists with oj, which must mean of like
form. In our passage, no instance of o imperatively demands the sense of
sameness rather than similarity; and only one (the case of the spleen) demands the
sense of similarity rather than sameness. The Greek is ambiguous, but reference to
comparative anatomy (rings like [those in other animals]) is more probable than to a
series of rings; see further below.
commentary 133
[page 143 // page 144]
by Empedokles (DK 31 B 27.4 = Plu. Mor. 926d; cited also Stob.).
7
The term ri is common in many of the pre-Socratics, including
Philolaus, Pythagoras, Anaximander as well as Demokritos, typically in
mathematical contexts (as Demokritos DK 68 B 155 = Plu. Mor. 1079e).
The vocabulary of this phrase is somewhat alien to the HC, with tech-
nical terms of general scientic writing rather than of medicine. Rufus,
arguing for the primacy of medical terminology by analogy with learn-
ing methods in other skills, cites geometry, where the pupil rst learns
j i j i ri, point, line, and plane (Onom. 5 =
133134 DR).
The manuscript reading r is retained by early editors
(glossed jr. r, i.e. attached). Without 0j this
would be acceptable Greek; but as the text stands it is impossibly awk-
ward. The nominative singular feminine of the // participle was doubt-
less scribal error, following r r and failing to antic-
ipate the change to the genitive absolute construction.
2. On the colour, mottling and texture of the lung, see GA 1285: The
substance of the lung is of a light, porous, spongy texture in adult
life the colour is a dark slaty-grey, mottled in patches. (The lung is
rose-pink in all young creatures; the characteristic dark pigmentation,
in animals as in humans, is due to breathing an impure atmosphere.)
There can be no doubt that the author here describes human anatomi-
cal features: ve lobes; in fact two (superior and inferior) in the left lung
and three (superior, middle and inferior) in the right. The conguration
of lobes in the lung is peculiar to dierent creatures: in the Equidae the
lung is not divided into lobes at all; in cattle the lungs are divided into
lobes by deep ssures, the left lung having three and the right lung four
or ve lobes; in the pig the left lung is like that of the ox while the right
has an additional apical lobe, itself often in two parts; in the dog each
lung has three large lobes, but the right has a small extra lobe and there
may be one or more accessory lobes in either lung (BVD, s.v. lung).
0 r o u: this initial expression contrasts with the bald
resumption of comment, often without even the article, on other organs
(liver, bladder, kidneys) picked up from preceding sentences. But cf.
0j r (vessel), Oss. 12 [9.182 L.], bis.
7
Ibycus, TLG: 46 occurrences, most Hellenistic or later, but found in Hesiod,
Aischylos and Plato.
134 commentary
[page 144 // page 145]
t j r: the triple compound is a remarkable for-
mation.
8
Double - compounds are common enough (32 instances,
many occurring several times over, in the HC); and is a verb
commonly made compound (in the HC as 0. r. r-
. ). But the triple compound with - is unparalleled
in the medical treatises of the HC, though note r Ep. 23
[9.394 L.].
r lit. tortoise is used by extension of things of tortoise shell,
commonly the lyre; or of tortoise shape, as arched parts of the body,
typically as here the chest and cf. E. El. 837 of a bull; cf. also Pollux
2.177 u explained arched part of the back. See also u
(of the chin), Ep. 23 [9.394 L.]. As arched is a somewhat inappropriate
descriptive term for the chest (even the chest when a deep breath has
been taken), the metaphor may rather relate (i) to similarity with a
tortoise shell, protecting vital parts of the body; for the idea, though
coupled with anatomical misconceptions, cf. o 0u . r
_u j o de Arte 10 [6.18 L.]; or (ii) to similarity with the
lyre, through a realization that the voice comes from, and is somehow
amplied by, the chest: cf. the idea that the lung is hollow, with the
u source of the voice, Morb. 4.56 [7.604 L.]. The usage of i0
chest throughout Loc. Hom. (3.6; 10.1, 2; 14.1, 5, 10 [6.282, 294, 302,
304, 308 L.]) shows the same metaphor.
r r o 0o: the phrase inclined (lit. turned) to the left
9
seems at rst sight to give an inaccurate description of the position
of the two lungs and to conict with the authors awareness (evident
in what ensues) of the central position of the heart. Ermerins sug-
gests turned to the right and to the left, on the supposition that
a phrase has been lost; Cornarius tentative emendations (see appa-
ratus) would give a similar sense, turned to both sides. Triller inge-
niously // moots r r 0j. adapted to drawing, on
the grounds that the purpose of the lungs is inhalation; it is not clear
whether he intended to be particle or elided neuter plural article;
but neither is possible Greek. (Van der Lindens emendation r
pierced, for r, turned, is to be rejected, as it would antic-
ipate 0u, honey-combed, if, as is likely, this is to be read
8
Hence Triller tr. coadimplet, following Cornarius in preference to Foesius implet.
9
r0 is a common verb of orientation in the body, not only of bodily parts;
but also of disease, pain, bile, phlegm, etc.
commentary 135
[page 145]
below; and description of the position of the lungs is more appropriate
here than description of their appearance.) Littr rejects any emenda-
tion, on the grounds that in ancient anatomical texts there is room for
les erreurs materielles et les fausses opinions. But there are two other
possibilities. (i) The text is sound and the author not in error. As noted
above, the author implies there is only one lung; and viewed in this
way the lung may be regarded as turned to the left: there is a more
acute angle on the left side than on the right, due to the position of
the heart (see GA 1286), so that (GA 1290) the right lung is shorter
though broaderthan the left. We may then retain the manuscript
reading and translate inclined towards the left, deected to the left.
(ii) A phrase describing the position of the heart has been misapplied to
the lungs, possibly through telescoping of a source. Cf. the description
of the human heart, contrasted with that of other creatures, i
o 0u i, Arist. P.A. 665b666b.
r u: the term u occurs only here ap-
plied to the eminences or elevations of the lung (i) and of the
liver (u); it implies a simple form u, not found either.
The word is thus doubly recondite, prex being added to rare or
invented form. j occurs frequently in the HC as elsewhere with
the meaning top, as of bladder, 5 below; and especially as crown of
head, as Loc. Hom. 3 [6.280 L.]; but the only usage of j similar
to this passage, and the anity is striking, is in the description of
vessels in the region of the liver, one said to pass o u u
i 0 r between the tops [of the lobes] and the skin, Oss. 18
[9.194 L.].
0 j r : this is the rst of ve comments on nomencla-
ture in Anat.: here, projections of lung; cf. projections of liver 0 r-
u, oesophagus o j i ri j i r-
, intestine o r r , and the vessel o r.
With this information there is clear awareness of possible variation in
terminology (r some) and perhaps of etymological rationale for ter-
minology (especially if the emendation ru or rj is
adopted, 8). The author is setting out the accepted terminology, which
they use, with a slightly didactic tone (j. j i).
i i u. i ou r. u ru
0u: the appearance of the lung is described in three succes-
136 commentary
[page 145 // page 146]
sive participial phrases loosely strung together, the rst two relating to
colour and the third to nature, character (here perhaps close to tex-
ture).
(i) The rst description ashen is clear. Although r is a hapax,
the word r ash occurs in the gynaecological treatises of the HC.
(ii) The second description is textually uncertain. The word i-
spots (glossed Hsch. i) is not used elsewhere in the
HC and r, punctuated, lit. pricked out, is metaphori-
cal, though readily understood; it is used of the pricking of pain Morb.
2.59 [7.92 L.]. The adjective or is not credible Greek; palaeo-
graphically, the slightest change mooted (by Triller) is to or-
// or or supposed to be equivalent to ou. But
Triller himself rejects these fanciful forms in favour of Foesius ou-
. The various conjectures ou (Foesius), 0u (van der
Linden), o (Littr)all reasonably close to the non-word o-
rmean, respectively, dark, foamy, and protruding. Of these
the rst seems anatomically best and alone is paralleled in the HC,
Progn. 24 [2.184 L.], of darkness before the eyes.
10
(iii) In the third phrase, the word division r 0u has otiose
and misplaced r; and the single word 0u like ash merely
replicates ashen just before. Foesius emendation 0u honey-
combed gives an unusual word, in keeping with the authors elaborate
vocabulary. It is attributed to Demokritos, in zoological and embryolog-
ical writings (DK 68 A 155, citation from Ael. HN 12.20, on the for-
mation of horn). Hsch. glosses 0u u i i. i
0. The most salient characteristic of the lung is generally thought
to be its spongy texture; cf. Oss. 13 [9.186 L.], V.M. 22 and many later
medical writers, including Celsus 4.1.3 [1.626 L.], spongiosum.
3. The author is correct that the heart is in the middle of the lung (i.e.
between the lungs), but the allegation that the human heart is peculiarly
round cannot be sustained. The heart is in fact neither round, nor
heart-shaped; but rather amorphous, or somewhat pouch-shaped (GA
697 g. 678). The reference to the two descending parts (i j
i r o) is probably to the prominent vessels, the aorta and
vena cava: see GA 1415, g. 1230.
10
As Foesius translated notis cavernosis compunctus, it seems that he nally elected to
emend with a word meaning cavernous, perhaps 0u.
commentary 137
[page 146 // page 147]
r0i: this compound does not occur elsewhere in the HC,
though the simple lu is common, often used of a bone sitting in
place, Fract., Artic.; and there are seventeen other Hippocratic r-
compounds.
11
The sense of the verb here is close to that in Ep. 23
[9.394 L.], i of eyes (cf. r0j, of eyes, Epid. 2.2.24
[5.96 L.]), rr of kidneys and rr of bladder,
12
and
also the notion of the heart as ruler, i i. Cf. also the
descriptions of the heart ri u r 0 u o
ji r, Oss. 19 [9.196 L.]; and i r r o t r-
u 0i j u, Arist. P. A. 665b666b.
13
r o _u: the Greek expression is slightly illogi-
cal; lit., rounder than all creatures. Hence Ermerins suggests o
u r _u_ (i.e. of all animal organs). But there is a compendious
comparison (cf. hair like the graces, sc. the graces hair); and in all
creatures, other is readily understood, i.e. rounder than that of any
other creature. Similar comparisons are made below, 4 and 5. For this
universal anatomy, cf. 0 r 00 0i i o 0
_u, Carn. 1 [8.584 L.]. The alleged roundness of the human heart
may be based simply on a view that roundness is a good state; cf. Pl.
Ti. 33 b, c, the is spherical because the // sphere is the most
perfect of shapes; circular motion is connected with rational activity.
Other descriptions of the heart are: j r oi i, Cord. 1
[9.80 L.] and j Ep. 23 [9.394 L.]; but somewhat rounded,
Arist. H.A. 496.
i j r o: two links between heart and liver are
indicated. But the terminology is opaque and the brevity and baldness
of this text of uncertain date and context renders identication prob-
lematical. First, it must be stressed that there is no particular emphasis
on the links: the author is simply describing the area between heart
11
The verb r0u is common in post-classical, especially ecclesiastical, writers
(Ibycus, TLG: 47 occurrences, headed by 7 in Nicephorus Gregoras,); but there are good
fth century antecedents. Euripides uses it of establishing a cult image, t 0
'0u r00 0i. I.T. 978 and employs 0u with similar nuance,
I.T. 1481; cf. also Ba. 1339.
12
So earlier editors; but Smith (1990) corrects to rr and rr.
13
For the compound verb, there is a parallel in a Demokritean citation, with regard
to dream images deeply penetrating the body r00 o i o u
i o u, DK 68 A 77 = Plu. Mor. 734f.
138 commentary
[page 147]
and liver. There is no indication that either heart or liver is peculiarly
important in bodily function. The two links are: (i) i j and
(ii) r o r, by which the whole body is nurtured. -
i is any tube (commonly but by no means exclusively the aorta) or
system of tubes (commonly the bronchial tubes); and j may mean
many a or big (cf. Hsch. u o 0i 0 r). r o com-
monly refers to the vena cava; but the term could be simply general and
descriptive rather than technical and specic. If j were to be added,
the technical use would be certain, but nothing can be deduced from
its omission in this terse work. On r as a possible aid to identi-
cation, see below. Other descriptions (in dierent authors of dierent
dates) of the aorta are as 0i o. i. o0j. t. -
j, and of the vena cava are as r i. o. jt.
But the vena cava is sometimes designated 0i, perceived to be dif-
ferent from the other r (by reason of its character, economically
described by Triller cum ratione tunicae, tum ratione motus et pulsus) and
Galen uses the term o (with or without the addition u)
for the portal vein, which is, after the vena cava, the bodys largest.
The identication which best ts the tenor of the treatise, with its
careful attention to location and strict paring down to essentials is
as follows: (i) =aorta and (ii) = vena cava, with j and o
synonymous, and the dierence between the adjectives only a matter of
stylistic variatio. This seems the simplest interpretation, consonant both
with the Greek text and the salient anatomical links in the thoracic
cavity. And cf. the very similar u o i t r 0 j
i j r u 0i j r i r, Carn. 5 [8.590 L.].
Here too the statement that vessels come from the heart may be
a matter of simple observation, not necessarily precluding the view
that (other) vessels come from the head. Aristotle orders his material
similarly (transition from heart to vessels, P.A. 667b) but the tenor is very
dierent, as the fundamental importance of the heart is recognised; as
also in the sophistic treatise on nutriment, i u j. i
0u i r u 00 r o i t 0 i
0i o u 0. Alim. 31 [9.110 L.].
14
//
14
But several other identications have been canvassed:
1. (i) = ducts and (ii) = vena cava. The i j of the mss is taken by LSJ
to be an imaginary system of ducts connecting the heart with the liver; similarly Littr
translates beaucoup de tuyaux. Harris (1973), pp. 8283 is impressed by the contrast
between i j and the great vein; and translates many a bronchia [= artery?]
nding here a double system of blood vessels centred on the heart, with veins and
commentary 139
[page 148]
j u j r: the word j is used four times
elsewhere in the treatises of the HC: 1, of premature infants (j
roemendation of codd. Septim. 1 [7.436 L.]), 2 = 3 of a
body after death ( 0 u j Hebd. 52 [8.673 L.] = Aph 8.8.
[1.402 L.]); 4, l 0o u. t 0 j Cord. 7
[9.84 L.], as well as in the [Demokritean] letter, Ep. 18 [9.384 L.], 0-
i 0 j. In all these instances, the word is the body either in
the abstract or in its non-living state (before birth or after death).
The term is much used by Demokritos: DK 68 A 152 = Ael. N.H.
6.60 of the embryo; B 37, B 57, B 187, B 223, B 270, B 288 (all
Stobaios citations), of corporeal opposed to mental or spiritual being.
15
The statement that the whole frame is nourished or nurtured by the
great vessel opens up further problems. The verb may allude to the
common conception of blood passing to dierent parts of the body
and distributing nourishment as needed. For this common idea, cf.
[vessels] l r o o, Loc. Hom. 3.6 [6.282 L.]; also the vessel
i r which r , Oss. 16 [9.190 L.].
The conception that the vena cava played an important part in this
life-giving process might have arisen from the observation that the vena
cava collapses on death.
arteries clearly distinguished. But the trouble with this is that even if i may
represent a plurality, r (o) does not; and it is hard to extract a system from
a tube; also the vessels are not centred on the heart, but merely leading from it. In
short, a distinction between veins and arteries cannot be read into this bald text.
2. (i) = vena cava and (ii) = aorta. Objection: aorta is rarely described as r,
though for this designation, cf. Carn. 5.2 [8.590 L.], quoted above.
3. (i) = vena cava and (ii) = portal vein. Triller compares Aristotles u
o _u j u u r r j r r u. j r i and, while
admitting that vena cava is usually that called o, argues that j (spatiosam,
amplam, maximam) may here be a substituted descriptive term.
4. (i) = (ii), both refer to vena cava, with emendation of i to i (adj.,
deep). This is the emendation of Caspar Homan adopted by van der Linden (see
apparatus). Objection: Greek is awkward, and anyway there is no real need to emend.
5. (i) = vena hepatica and (ii) = vena cava inferior. Ermerins (taking his starting
point from van der Linden, who however restricted the reference to a single deep vein,
the great vein) reads j o and supposes the reference is to two veins, the vena
hepatica and the cava inferior.
Interpretations 3, 4, 5 seem open to the fundamental objection that the location is
too low in the body to be right; 2 is terminologically awkward; 1 presses the Greek into
excessively advanced anatomical knowledge.
15
It occurs many times in Ti. Locr., a prcis of Pl. Ti. preserved in some Platonic
mss, apparently (so Taylor ed., 1928) in an attempt to give a supercial Pythagorean
colouring to the work. It becomes extremely common in post-classical Greek, for
instance in Eusebius (Ibycus, TLG).
140 commentary
[page 148 // page 149]
But if the author is here working from an aborted foetus, a particular
vessel which linked via umbilical cord to placenta, might seem to
nourish the frame.
16
Cf. the notion expressed that nutriment is breath
in the lung, food in the belly while j r 0r j o 0
ri j o o, Alim. 30 [9.110 L.].
4. The author describes the situation and character of the liver, also the
number of lobes. Cf. GA 1400, The liver is situated in the upper and
right parts of the abdominal cavity owing to its great vascularity,
wounds of the liver cause considerable haemorrhage. The liver is
divided into a large right and a much smaller left lobe. Once again,
there is no doubt that human anatomy is being discussed. The liver
varies greatly in character in dierent kinds of animal; the horse liver
has three lobes; the ox only one distinct lobe; the sheep is similar;
the pig has four main lobes and the dog six or seven lobes (BVD, s.v.
liver). The slanting vessel // is probably to be identied with the portal
vein, which conveys blood to the liver from the intestines (GA 854 and
855, g. 787); it follows the downward course here implied and overlies
(is anterior to) the vena cava. Another candidate is the splenic artery
which is remarkable for the tortuosity of its course (GA 779), but this
goes across the body rather than downwards.
oi r r t 0 0. lr r r u
0: the second half of the sentence qualies the rst half; the liver
is similar (r) in general to the livers of all other animals, but dierent
(r) in relative bloodiness.
17
Cf. Aristotle o r j u
i u _u i u i0u r u i, P.A. 673b29;
also Herophilos on the liver 0 oi 0 o r 0
16
Trillers emendation (above n. 14.3) has some such rationale: the umbilical vein by
which revera infantis corpusculum nutritur could readily be associated with the portal vein.
However, Triller does not exclude the vena cava in this connection; and the latter is
rendered likely by the fact that the course of blood from placenta is through umbilical
vein to ductus venosus to inferior vena cava; before, at birth, the ductus venosus
collapses with the collapse of the umbilical vein; see C.W.F. Burnett, The Anatomy and
Physiology of Obstetrics (London, 1953), pp. 129134. It is not impossible that there was
some observation of this if the aborted foetus was examined (though observation of the
ductus venosus is not recorded until the sixteenth century).
17
Trillers emendation j to all other livers is made on the grounds that the
human liver, though resembling that of some animals, such as cow and sheep, is not
like that of all other creatures; but this objection seems to be met by the qualication in
the second part of the sentence.
commentary 141
[page 149]
(von Staden, 1989, 182183). An alternative interpretation is possible:
to all other organs of the body. Aristotle comments that heart and
other organs all have lj u and are lo j j,
also that the spleen is lj (P.A. 647a, 670b); but he regards the
heart as even more bloody than the liver, r j lu
o j i u o (P. A. 637b). In view of the authors
stress on comparative anatomy, the former interpretation is preferable.
For the bloody character of the liver, cf. r, V.M. 22 [1.632 L.];
i, Empedokles DK 31 B 150 = Plu. Mor. 683e. The bloody
nature of the liver might be perceived without the theory that it was
crucial in the distribution of the blood through the body. The associated
vein is j l j i r r as Oss. 7 and 12 [9.172,
182 L.]. Of fteen instances of l in the HC, four are in Oss. 7
and 12 [9.172, 182184 L.]. lj is more common, with seventy-
three occurrences in the HC; but is applied to wounds, not to vessels.
u r u. 0 r u: the projecting parts here
called gates are more commonly called lobes (as in the case of the
lung), while the term gate is normally applied not (as here) to an
eminence, but to a depression or indentation, especially the ssure
through which the portal vein enters (see von Staden, 1989, 229). There
are several such indentations, the two main ones being the points of
entry of the vena cava inferior and the portal vein (GA 1405, g. 1221).
The term gate is dismissed by Rufus as appropriate to augury, not to
human anatomy (and the distinguishing features of animal livers were
well known from minute examination in the course of augury follow-
ing animal sacrice; of all the organs it must have been most generally
familiarsee e.g. E. El. 828sqq.); Rufus also states that the term gates
was applied by old doctors to the attachment to the vena cava inferior
(Anat. 28, 175 DR). It is possible that the odd terminology is the result
of drastic summarization: the excrescences have been given the name
gates, instead of lobes, while some description of gates is lost. Dieren-
tiation is clearly implied Oss. 10 [9.180 L.] = Epid. 2.4.1 [5.122 L.] ri
u i , and cf. Pl. Ti. 71c12 o u. Hsch.
has both terms: u ro and 0 0 j.
The number of lobes is variously given. Rufus believed there were
four or ve. Whereas in Oss. 10 [9.180 L.] a single lobe is envisaged, it is
clearly stated in Oss. 1 [9.168 L.] that there are ve (j r i)
and in Oss. 18 [9.192 L.]as here in Anat.that there are two (in the
expressions jt and u u u). The
142 commentary
[page 149 // page 150]
minor // excrescences of the caudate lobe and the quadrate lobe (GA
1405, g. 1221) perhaps confused the issue; but inspection of dierent
species would lead to dierent conclusions.
r i i: i (neut. sg.) is Ermerins emendation
of r (fem. pl.) and makes the liver lie on the right of the body,
rather than the gates on the right of the liver. The general statement
is in accord with the rudimentary anatomical description of the text.
18
j r ri o o u 0i: the adjective, not used
elsewhere in the HC, is used by Demokritos (so DK 68 A 37 = Simp.
in cael. 294.33, and, allegedly based on Aristotle, 132 = Thphr. C.P.
67.2); and is extremely common in a wide range of other authors of all
dates. Hsch. glosses by . u.
19
The expression o o
is compressed, sc. r. The compound verb is used only twice in the
HC, here and (in a temporal sense) Epid. 4.7 [5.146 L.], though both
i and 0i are very common.
20
5. The author describes the kidneys, of which (GA 1418) The corti-
cal substance is reddish-brown in colour. The ureters are correctly
described as slanting, each being (GA 1422) a thick-walled, narrow,
cylindrical tube which runs downwards and medially and crosses
various parts before (1423) nally the ureters run obliquely through
the wall of the bladder. The position of the ureters relative to each
other varies from 2.5cm to about 5cm, according to whether the blad-
der is contracted or distended (GA 1429); and their position relative to
18
Triller, keeping r, argues that the phrase does not relate to location at all,
either of the organ or of its gates, but to function: in his view means not dexter
but receptorius, acceptorius, from root r and describes the place which receives
succum chylosum and puts it in the receptacle of the liver. There is some slight support
for this ingenious idea from Hsch. s.v. i u r _u j u o t 0u
r ; and perhaps from Hsch. attribution to Demokritos of usage of the verb
to describe blood vessels i r _u u r i (DK 68 B 135).
However, Trillers interpretation is to be rejected for these reasons: is so familiar
in other senses, clearly suggests a denite location in the body (cf. title of Loc.
Hom.); and the writer of this treatise is concerned throughout with description, not with
function.
19
Triller regards this vessel as the descending vena cava (j Galen de ven et art
diss.); but a vessel other than the great one, argued above to be the vena cava, seems
intended.
20
There is some usage of 0i in Aristotle and Plato and much in later Greek;
it is favoured by Joannes Chrysostom, Galen, Eusebius, and Simplicius (Ibycus, TLG).
commentary 143
[page 150 // page 151]
the internal urethral orice varies correspondingly. The author regards
the ureters as reaching the top of the bladder, in accord with his top-
to-bottom presentation of anatomy. As their actual position (GA 1425,
g. 1243) is rather reaching the edge, the translation top edge is
appropriate.
i r oi. j j r ri j: as in the case
of the liver, it is not immediately clear what is meant by the similarity
of the kidneys; oi, sc. i = (of the liver) oi r. In
view of the apparent stress on comparative anatomy, the most likely
explanation is like the kidneys of other creatures; cf. the observation of
Aristotle (correct only of the unborn infant in utero) that human kidneys
are o t i 0 ot u l u o i u
0 u , P.A. 671b. But other possibilities are: like each
other (as they obviously are) or like other organs; cf. i i i
l i r i u u. Oss. 4 [9.170 L.]. Comments
on shape and colour are // pervasive in such descriptions; cf. Rufus,
j t. 0 u, Anat. 51, 181 DR. Here, the ensuing
comparison helps to resolve the question. Whereas in the case of the
liver the ensuing phrase qualies the likeness, in the case of the kidneys
it amplies: the kidneys have a similarity to those of other creatures,
and further in colour they are like sheep, i.e. (in another compendious
or compressed comparison) the kidneys are like [those of] sheep in
colour. Cornarius, Foesius, and van der Linden all took j j with
oi, i.e. renes vero colore inter se similes (Foesius tr.) and continued
by understanding the ensuing comparison with reference to apples,
malorum speciem prae se ferunt (Foesius tr.). Clearly, their translation is
based on the perception that the kidneys are like apples in shape, rather
than in colour; but necessitates deletion of r. The interpretation of
the ambiguous j as sheep not apples begins with Triller;
21
it
greatly aids the sense and it may now be noted that in the HC the
sense sheep predominates over the sense apple (15 to 12). The noun
sometimes refers to animals generally, as Hsch. notes j u r
o o o. ro r o i i. Erotian
refers the cognate adjective to sheep, 56, r i_ 0i 0
i_. j o o . Treatment by mutton fat, Nat. Mul. 32
21
The interpretation is commended by A. von Haller, Bibliotheca Anatomica (Zurich
17741777), vol. 1, p. 20. Trillers emendation of j to i is not necessary;
though it would render the animal sense certain rather than probable.
144 commentary
[page 151 // page 152]
[7.366 L.] etc. and by boiled mutton, Morb. 2.69 [7.106 L.] etc. are
described by use of the word. ri is epic and exclusively poetic,
cf. Parmenides DK 28 B 8. 43 = Simp. In Ph. 144.29. It serves as a
synonymous alternative to oi, also used in a simile, 9 below.
The variatio avoids immediate repetition in a single sentence.
oi r r 0 j u t: Hsch. and Suda
gloss o as j. Elsewhere the ureters are or occasionally
r. The preposition, added by van der Linden, is required. In a
very similar expression of progress from larynx to bladder, uid is said
to go r 0 u, Oss. 1 [9.168 L.]; cf. also Rufus, o
j u o.
6. The author completes the downward description with a brief ac-
count of the bladder and its outlet.
u u i o: cf. vesica nervosa, Celsus 4.1.11. The adjective
u is an epic and Ionic (though not in Herodotos) form for o
all.
22
r or: the emendation suggested is based on Vs reading, un-
known to Littr and others, who based emendations on the corrupt
recc.
23
It gives the required sense, completing the description of the
trunk (cf. Rufus, thorax extends 0 u // i u ii): some
reference to the nal point outside the body is required, by analogy
with 11 below. Centrally is in accord with the constant reference to
the position of the bodily parts throughout. or is palaeographically
close to V; but other candidates, giving similar content, might be
22
Triller punctuates u r u. u. i o, tr. vesica quae nervosa,
constrictiva est et expansiva. There is some force in his assertion that res ipsa id postulat;
but the parallels for this extraordinary meaning attributed to u are not altogether
convincing: Hsch. glosses s.v. u r and scholiast Ar. Ran. 1067 u
associated with i. it, viz. coarctare, complicare, in angustum cogere.
23
Earlier emendations (see apparatus) may be briey considered: the interpretation
of Triller (with reference to the sphincter, tr. The constriction of the bladder is deep
within) involves a level of detail out of keeping with the rest of the treatise; that of Lit-
tr (tr. From a distance is the working of the bladder for the purpose for which it exists)
involves obscure sense and unidiomatic expression; that of Ermerins (tr. From the blad-
der there is a channel outside) gives good sense, but is very distant from the mss. (Triller
emends on the basis of Galens gloss r r o0 and interprets on the basis of the
Suda j o ii.e. ambitus, circulus, orbiculus, commenting in ima vesicae parte
sive cervice, orbiculus quidam, sive orbicularis est ambiens quidam musculus a natura formata est.)
commentary 145
[page 152]
(cf. the course of the vessels r u i r 0, Oss.
17 [9.192 L.], and r r u i r ii r
, Ep. 23 [9.396 L.]) or i, e.g. ot r u or o
(after that) i r (cf. ii_ , Ep. 23 [9.396 L.]). Or if a
reference to the urinary tract is postulated, we might consider o,
e.g. 0r0 r u o r. Or the adverb o0 may be
lost (cf. o0 0 oo, A. 15 [6.224 L.]). In any case, reference
as throughout is primarily, and probably exclusively, to the male body.
7. The author sums up the previous description: the six parts are
apparently trachea, lung, heart, liver, kidneys, bladder; and o r r
in 7 seems at rst sight to correspond with o r 0 in 12. Seven,
not six, was a signicant number for Pythagoreans and others. In the
numerology of anatomical lists, seven is regular; six is quite anomalous.
If not fortuitous, it may result from a deliberately paradoxical count,
or more probably from counting the kidneys as one, instead of as
two. The list of seven vital organs (o) was typically tongue,
heart, lung, liver, spleen, two kidneys; the bladder included here would
normally belong rather in a list of organs transporting food and breath.
While this kind of listing is particularly common in post-Posidonian
literature,
24
there are pre-Socratic antecedents also; and in the HC
see especially Carn. (where heart, lung, liver, spleen, and kidneys form
a group, 59 [8.590596 L.], as do trachea, oesophagus, belly, and
intestines, leading to bladder and rectum, 3 [8.586 L.]).
0 r, r: the two phrases are in apposition, and j r u
is not intended. Similar prepositional expressions are used in Oss.: o
r, 10, o r, 12, r r, 16 and cf. r, 17 [9.180, 182,
190, 192 L.].
u rj0: the concepts and u are ubiquitous in philo-
sophical and scientic writing, with subtly changing senses and nu-
ances. One expects the allusive phrases u rj0, 7 and j u
o, 12 to be parallel statements, giving parallel conclusions. But
there are two dierences: the omission of the article in 7, though this
may be insignicant in the context of this bald work, where the article
is commonly absent; and the change from the passive voice in 7 to the
24
On such lists, and their possible importance as a source for Hebd., see Mansfeld
(1971), pp. 197202.
146 commentary
[page 152 // page 153]
middle in 12. (A small and tempting emendation from o, which
must be aorist middle, to o, which is ambivalent as imper-
fect middle or passive, would eliminate the latter problem; the change
from aorist passive to imperfect passive would be much less trouble-
some to consistent sense than the change from passive to middle form.)
The sense in 7 seems to be the body, the bodily organism, concrete,
i.e. j r u sc. 0 u; for which cf. 0 r o o
j u 0 j, VM 22 [1.630 L.] and especially two passages
u i u 00u and r r t j u o-
0r, Cord. 7 and 8 [9.84 L.]. It approaches the somewhat more
abstract sense, bodily nature, evinced for example Hebd. 5 [8.636 L.] //
(human); Artic. 13 [4.116 L.] (human vs. animal); Nat. Mul. 1 [7.312 L.]
(female); and is at some great distance (though there is commonly a
microcosm ~ macrocosm analogy) from the wide sense of such pas-
sages as u r o 0i , Vict. 1.11 [6.486 L.]. See
further on 12 below.
8. The author here starts again (similar descriptions of origin and
end of oesophagus as of trachea); and goes on to give a rudimentary
description of the digestive process, 811. The description is anatomi-
cally correct. The oesophagus, or gullet, is a muscular canal extend-
ing from the pharynx to the stomach. It begins in the neck at the
lower border of the cricoid cartilage (GA 1340 and 1341, g. 1167). The
implied physiology is, however, mistaken: the oesophagus is apparently
seen as the start of a parallel process of ingestion and excretion: air
(and, presumably, some uid) via trachea ~ food via oesophagus.
io: the term occurs also Loc. Hom. 3 and 20 [6.282, 312 L.];
but not elsewhere in the HC.
25
Galens gloss (19. 125 K.) probably
relates to Loc. Hom., not, as Foesius supposes, to Anat. The more usual
term for oesophagus is the second given here, . e.g. Cord. 2
[9.80 L.], Alim. 25 [9.106 L.], Morb. 4.56 [7.608 L.]. This occurs already
in Homer (o o 0r0 base of neck, Il. 17.47; cf. Il. 3.292
and 19.266, throat of sacricial victims). Rufus cites both terms _u r o
i i o o i j i o. i io Onom.
157, 155 DR.
26
25
The derivation is doubtless (Irigoin, 1980) from i+t, i.e. transporting
what is eaten.
26
In the HC, the term is applied also to the mouth of the womb. Only
commentary 147
[page 153 // page 154]
r i ri j i: Erotian K 35 denes i as 0
j 0 o 0i. i j 0 0u r ri. i j j
0j. Usage with reference both to upper cavity (chest) and to lower
cavity (abdomen), these being separated by the diaphragm, is ubiqui-
tous in the HC. The sense of the preposition ri is unclear; it is either
towards (LSJ I.3b and c), or in respect of (LSJ III.4). The idea that
digestion involved putrefactionfood being digested by a putrefying
process and nutriment then conveyed to the liver for conversion into
bloodwas commonly associated with Empedokles (o r j -
j i0 'j r j, DK 31 A 77 = Galen de
def.med., 19.372 K.); Galen regarded it as old-fashioned, o
j j0 u t 0o 0 t 0 jt 0
r (DK ibid. = in Hipp. Aph. 6.1, 18A.8 K.; cf. also j r r r
i j u 'j t DK 31 B 81 = Plu. Quaest.Nat.
912c; cf. DK 31 B 61 = Simplicius; and see Longrigg, 1993, 74). There
are further traces of this notion in the expression i 0 unputri-
ed food occurring in A., Vict. 3, Morb. 1. Emendations to rj or
ru are therefore unnecessary. The idea of putrefaction was
important in early Greek attempts to explain change and development
of various kinds, including the formation of the world and animal life
(Demokritos, DK 68 B 5 = Diod. 1.7.3; cf. Carn. 3 [8.586 L.], also Pl.
Phd. 96b). In medicine, the proper healing of wounds and maturation
of illnesses depended on the formation and expulsion of pus or similar
matter (e.g. Loc. Hom.). //
9. The locations of diaphragm and of spleen are cursorily and some-
what inaccurately indicated. The author does not know, or does not
care, about the precise inter-relation of these anatomical features, being
concerned only with general proximity. The diaphragm is a dome-
shaped, musculobrous septum which separates the thoracic from the
abdominal cavity, its convex upper surface forming the oor of the for-
mer, and its concave upper surface the roof of the latter The muscu-
lar bres may be grouped according to their origins into three parts
sternal, costal, and vertebral (GA 567). While the diaphragm might be
described as coming from the backbone, in the sense that the verte-
bral part is linked with the lumbar vertebrae by two pillars or crura
(GA 568), this is scarcely its salient positional feature and it is connected
later, as in NT, Soranus, and Galen, did the word take over as stomach, a sense rmly
xed in Latin and hence modern European languages.
148 commentary
[page 154]
equally with ribs and with sternum. Furthermore, the diaphragm cer-
tainly lies above, not behind, the liver. The spleen is situated princi-
pally in the left hypochondriac region of the abdomen lies between
the fundus of the stomach and the diaphragm and is of an oblong at-
tened form (GA 1476). With correction and amplication of the text we
might state that the diaphragm separates the spleen from the left lung
and pleura, and from the ninth, tenth, and eleventh ribs.
r 0o0 0 j r u: the term 00 is
properly the backbone or spine, for which the general o back is
commonly used. The former term occurs in Artic. and Mochl. but rarely
elsewhere in the HC (apart from Oss.n., but not init.only in Morb.
2 and Mul. 1). Demokritos uses the word in a riddling sentence, r o
_u i0u 00 0 r DK 68 B 151 = Plu. Sympos. 643c; cf. also
Diog. Apoll. DK 64 B 6 = Simp. In Ph. 153.13. The account in Anat.
seems to be a garbled version of material which is much more clearly
presented elsewhere in the HC: j 0j o0
u. r r u _u j 0 0 i i Epid.
2.4.1 [5.122 L.]; verbatim also in the account of Oss. 10 [9.180 L.]. The
liver was generally described as below the diaphragm, as already by
Homer, j i (Il. 11.579; cf. von Staden, 1989, 228). The
term r, applied to the lung in Homer (Onians, 1952), later denotes
the diaphragm, important in the respiratory function, as well of course
as the thinking faculty.
r r j 0. r r 0j. j 0o r: Aris-
totle linked the spleen with the liver, and described the location of both
with reference to the diaphragm: (liver below the diaphragm on the
right, spleen on the left) H.A. 496b15 and (spleen a false liver) P.A.
669b28. The two are treated as parallel also by Rufus (spleen and liver
below lung, liver on right and spleen ri r u_) Anat. 28,
175 DR; cf. also the description of the spleen, 0r I. 0
r iu, Ep. 23 [9.396 L.].
This is the only instance where the rst person is used in the passage,
and it may be contrasted with the third person used in the repeated
statements of nomenclature. The most likely explanation is that the
author is attempting personal exegesis of his source, my interpreta-
tion is . In doing so, he introduces a misunderstanding, possibly
through compression or misunderstanding of his source, which prob-
ably referred to the false ribs, or to the spleen as a false liver. The
commentary 149
[page 154 // page 155]
word 0, false, lit. bastard, is regularly applied to the false ribs,
the ve ribs not connected with the sternum so called in contrast with
the seven true ribs so connected, dened 0 r i l j i-
r Ruf. Onom. 94, 145 DR. Confusion can arise //
through the ambiguity of j, rib or side. There is no instance
where the meaning left is imperatively demanded for 0 (and LSJ
does not recognize this sense), but the expressions o j 0 -
j, with reference to the direction of vessels, Oss. 14 [9.188 L.] and
i j 0 j, with reference to the site of pain, Judic. 51
[9.292 L.] are doubtful, as is the description by Pollux of the j
j 0 o. j r 0t i j j
(2.4.207). The spleen itself is described as false by Aristotle, i.e. use-
less, by comparison with the concomitant liver (PA 669b and cf. 0
r iu, Ep. 23 [9.396 L.]; somewhat similarly, the moon was
said to give a bastard light, compared with the sun, Ph. 1.628).
o i : Rufus uses the same analogy, with similar ter-
minology t o j o 0u . -
ri j 00i_ i Anat. 28, 175 DR. Such similes are
common in anatomical contexts: Oss.; Cord. 1, 5, 10 [9.80, 84, 86 L.].
10. Belly (stomach) and intestine are described. Although the belly
might loosely be said to lie beside the liver on the left, more properly it
lies inclined to the left below both liver and spleen. The stomach is the
most dilated part of the digestive tube, and is situated between the end
of the oesophagus and the beginning of the small intestine. It lies in the
epigastric, umbilical, and left hypochondriac regions of the abdomen,
and occupies a recess bounded by the upper abdominal viscera, and
completed in front and on the left side by the anterior abdominal wall
and the diaphragm (GA 13621363). The adjective sinewy is apt: the
wall of the stomach consists of four coats: serous, muscular, areolar and
mucous and the muscular coat has three layers of muscular bres
(GA 1367).
0u r 0j r u: 0u, lit. good-
omened is used for left by a common euphemism; cf., in an anatom-
ical context (embryology), Epid. 6.4.21 [5.312 L.] and also Empedokles
DK 31 A 83 = Athen. 3.78; cf. also Rufus, quoted above. The bladder is
similarly u u, 6 above. The sense of sinewy is in both cases
probably elastic, subject to dilatation. Rufus uses the same adjective
150 commentary
[page 155 // page 156]
of parts of the belly, Anat. 10, 178 DR and 42, 179 DR. But the word
is appropriate also to appearance, as the empty stomach has promi-
nent folds and wrinkles.
27
The adjective 0j has evidently the
same sense as u above, 3. But it occurs elsewhere in the HC only
Cord. 8 [9.86 L.] (heart as a whole, opposed to its component parts).
The sbs. 0i or 0i occurs Alim. 23 [9.106 L.] (with ref-
erence to the whole body, opposed to r part of it) and several
times in the phrase i 0r 0i on glands in general. This
appears in the treatise Glands itself in 1 (the rst sentence of the work)
and in 7 [8.556, 560 L.] as well as the version of the title given in
ms V; and with reference to a work on glands (possibly the surviving
Glands) in Artic. 11 [4.108 L.] and in Galen 18A.379 K. There is an
occurrence also in Ep. 18 [9.382 L.], where it is urged by Demokritos
that doctors should assess aictions not only by inspection but by gaug-
ing u 0u and should treat o0 0i 0 j.
It has a scientic avour in the Pythagorean equation of number j
0i 0 // 00, with the totality of the heavens, DK 58
B 27 = Arist. Metaph. 1092b26. Hsch. glosses 0i 0 on
the whole.
r o: the term r is applied to the entire lower
digestive tract, i.e. both the small intestine (comprising duodenum,
jejunum, ileum) and the large intestine (caecum, appendix, colon ter-
minating in rectum and anal canal); only occasionally is such an expres-
sion as o r 0 rr used (as, with reference to an enema,
Acut. 19 [= 6, 2.264 L.]). Like words for belly, stomach, with which it
is commonly linked (j, Carn. 3 and 6 [8.586, 594 L.]; u, Carn.
13 [8.600 L.]; i Morb. 4.54 [7.596 L.]) it is extended in usage to
cover a large visceral region. Rufus regards the j as the upper
belly and the as the lower, Onom. 169173, 156157 DR. The
similarity is left unexplained, but is illumined by two parallel pas-
sages (again from Oss. and Epid.) where human and canine intestines
are compared: o r i. j r r u u.
0 r r u 0 j o j r, Oss. 1 [9.168 L.]
(note compendious comparison, as Anat. 3, 4, 5); and with slight vari-
ation o r i . i r, Epid. 6.4.6 [5.308 L.]. It seems
that, through compression of his source, the author fails to explain the
27
Trillers emendation 0r, tr. cicatricatus or rugis incisus imports a needlessly
explicit reference to this aspect.
commentary 151
[page 156 // page 157]
similarity intended, namely to the viscera of the dog. Cf. BVD, The
large intestine [of the dog] has a course somewhat like that of man.
. r 0 r u: Foesius for is
guaranteed by the sense (as all the intestine is included) and the word
order (as description, not denition, is here required). The length of the
intestine is correctly estimated (twelve cubits being ve to six metres)
and the description is accurate: The small intestine is a convoluted
tube about 6.5 metres long with a short curved portion and a long
greatly coiled part. The large intestine is about 1.5 metres long (GA
1370, 1372, 1380).
28
r r ru: r is a hapax in the HC
(though rj is found, Morb. 4.40 [7.560 L.], with reference to
convoluted vessels), and rt too is a hapax (though it is quite
common, used for instances of intestines, Mul. 2; of humours, Morb.
4; and various other compound forms occur). Hsch. glosses ru
j j. The expression of Ep. 23 [9.396 L.] is close: i-
t i i r. Cf. also i o r i j u ri-
, Oss. 18 [9.194 L.]. Celsus expression is similar: in sinus vehementer
implicitum, 4.1.7. The term folds is used in the HC only here and, of
the womb, Nat. Pue. (also verb of membranes, ibid.). In literary
contexts, it is regularly applied to folds of the female body, especially
the bosom and the womb.
o r r : there are similar comments on divergent ter-
minology Morb. Sacr. 17 [6.392 L.] (r a misnomer for diaphragm)
and Carn. 4 [8.588 L.] ( a misnomer for spinal marrow). That
, read by V, not u, is the correct form is guaranteed by an
Aristophanic pun on the verb o (future middle) t 0 0-
u i o i t rr i t o 0 //
0, Eq. 455.
29
11. Colon, rectum and anus are briey described.
28
Reference to the length of the intestine was a common element in lists of the seven
organs transporting food and breath; see Mansfeld (1971), p. 197.
29
Pollux nds an etymological link, involving digestive suering, 2.209; for other
fanciful etymologies based on an original meaning j food for , see Ath.
262a.
152 commentary
[page 157]
r 0 i0: the same verb is found as in 6, 9, 10. The
adjective i0 is exclusively poetic, though t0 is used also in
prose. The term 0 occurs Oss. 3, 9, 14, 17 [9.170 L.]; also Carn. 3
[8.586 L.].
o 0r r: lit. having abundant esh. Van der Lindens
emendation 0r (commonly adopted) is unnecessary, as -
0j is just as common as 0j and gives comparable sense
(Ibycus, TLG). His addition of i would give a smoother connection,
but is not necessary in this telegraphic style. For the sense, cf. 0 0
r 0 00 i j 0j, Fist. 1 [6.448 L.].
r 0 i u: for the expression (neuter of adjective,
used substantivally, followed by genitive), cf. 1 above. In the HC, the
term u is used elsewhere only in Haem. Galen glosses u,
i, 19.92 K.
12. A summing up apparently parallel to that of 7 ends the second
part of the description. Ermerins belief that there is a lacuna nam non
absolvitur sed abrumpitur periodus may be correct; but the abruptness does
not of itself necessarily indicate this, as the syntax is somewhat fractured
throughout.
o 0 j u o: the sense of u in 7 above is [bodily]
nature, a concrete and passive entity which is organized by something
external to itself, sc. perhaps universal nature; here the sense of j u
is [universal] nature, an abstract and active principle which organizes
something, sc. apparently the body. (Cf. Rufus r00 j r
t r j u 0r i oi Anat. 2, 169 DR; and the
view that men are r u, Ep. 11 [9.326 L.].) Neither sense is
dicult; but the switch from one to the other is generally felt to be
awkward; however, there is a similar shift in Ep. 23, discussed further
below. If the two passages are parallel, the other parts of the body
(oesophagus, stomach, diaphragm, spleen, intestine, colon) described
811 are parallel to the six parts (trachea, lung, heart, liver, kidneys,
bladder) enumerated 16. But the phrase may refer to further material,
passed over (cf. Arist. Po. 1449a28). Or o 0 might be adverbial,
as to other parts (not specied). Other possibilities are that a reference
to other creatures or to other works (cf. Carn. n. [8.614 L.]) has
been lost; or even that u in Anat. 7 and 12 is shorthand for [sc. my
commentary 153
[page 157]
treatise on the] nature [of the body], with oblique reference to some
other work where he has explored other matters and reference in the
verb to his own embellished style.
[page 157 // page 158]
DISCUSSION
I. Background
The origins of Greek anatomy lie in the Homeric epics, which display
an extensive knowlege of the eects of battle wounds on dierent bodily
parts. Attempts at systematic description begin with the pre-Socratics,
still imbued with the attitudes and forms of early verse writing. Analysis
of the body into the dierent components skin, esh, bones, and viscera
linked by hollow channels or vessels conveying uids (primarily
conveying blood) and by solid threads (termed and // including
cords, sinews, ligaments, nerves, muscles) had a long currency, with lit-
tle apparent consensus.
30
Outline surveys such as Anat. must have been
composed throughout antiquity, and constantly copied, corrected, imi-
tated, and excerpted.
It is always dicult to assess the extent and nature of inuence
or interaction in such cases of common content of a factual nature,
especially where the very existence of direct contact (rather than the use
of common sources) must be in doubt. The brevity of the fragment adds
to the problem of the universality of its subject matter. Other writers
follow the same descriptive sequence from top downwards, with the
trunk regularly treated as an entity. More specically, discussion of the
organs regularly centres on location, size, and colour. Judgement must
rest not only on scrutiny of content but on an inevitably somewhat
subjective assessment of similarities in approach, arrangement, and
expression. The problem of intertextuality within the HC is acute;
and even more so when later authors, such as Celsus and Rufus, are
considered.
Indirect evidence for the presence of Anat. in versions of the HC
circulating in antiquity (or, rather, in the putative versions which can
30
Even in the Pneumatic school of medicine, inuenced by Posidonius and the
Stoics, the seven and the seven were dened in various ways;
see Mansfeld (1971).
156 discussion
[page 158 // page 159]
be reconstructed from the lists of glosses constructed by grammarians
and others) is scanty. The list of Erotian (dating from the time of
Nero, c. A.D. 50, and referring to many earlier authorities, including
Bakcheios, Epikles, and Herakleides) includes no words from Anat., but
the brevity of the treatise may account for this. Galen glosses no words
from Anat. either (unless relates to Anat.; but Loc. Hom., from
which many other terms are glossed, is a much more likely source). The
loss of Galens comments on Hippocratic anatomy (advertised De Plac.
Hipp. et Plat. 6.8) is unfortunate, but there is no doubt some truth in his
assertion that practical demonstration took the place of written treatises
on anatomy.
31
There is some reason to suppose that Celsus, writing an outline of
human anatomy (4.1.113) and Rufus of Ephesus, writing an account
of anatomical terminology (Onom.), knew the work. But the evidence is
not unequivocal. Celsus is concerned with sedes of parts of the body;
and especially their relative positions. Thus, such terms as incipiunt,
fertur and descendens are used, 3. And the description is practical,
stressing colour, the ureters being albae, 10; or texture, the lung being
spongiosus, 4. Nomenclature features: nominant, 3; Graeci vocant, 10.
Celsus (like many others, including the author of Ep. 23) includes the
head, 2; before describing the parallel itinera of aspera arteria to lung
and of stomachus to ventriculus, 3. Lung, heart, and diaphragm are
briey mentioned, 4; then liver, gall-bladder, spleen, kidneys, 5. From
this outline of the viscerum sedes, Celsus goes on to the digestive
process and the dierent parts from oesophagus and stomach, 6, to
bowels, 7. The course of the ureters from kidneys to bladder is outlined,
10, and the bladder itself described, 11. One salient dierence of content
between Celsus and the writer of Anat. (but a feature in common with
Ep. 23) is that he pays attention to dierences in male and female
anatomical layout: dierences in bladder, 11, are mentioned before a
description of womb and reproductive system, 1213. Several phrases in
Celsus are close enough to phrases in Anat. to qualify as translation or at
least paraphrase. The most striking parallels in phraseology are these:
constat ex circulis quibusdam (of // trachea: note metaphor, toned down
by quibusdam and correspondence circulus ~ ); is spongiosus (of
lung: note the initial pronoun); in sinus vehementer implicitum (of intestine:
note correspondence sinus ~ ); vesica nervosa (of bladder).
31
On the tradition, see Smith (1979) and von Staden (1989); on terminology see
Lloyd (1983) and Skoda (1988).
discussion 157
[page 159]
Rufus aims at a correct account of anatomical terminology, rather
than at the consecutive description seen in Celsus. The closest parallels
to Anat. in expression are these: lung colour is i ,
the spleen resembles a footprint, and the term u0 is used.
Pollux provides no independent evidence and was probably utilising
Rufus directly in compiling the medical section of his great lexicon.
In the case of Hsch., several glosses suggest familiarity with Anat.,
or at least with a work or works employing similar diction: r,
0u and o are glossed. There is, then, some reason to
suppose that Celsus and Rufus, as well as later lexicographers, knew
Anat.; but none to conrm that it was then regarded as Hippocratic.
II. Anat. and the HC: content
There is no parallel in the HC for the narrowly anatomical content
of Anat., with its exclusion of physiology and pathology. Elsewhere,
attempts at anatomy are incorporated in general schemes (Loc. Hom.),
or are allied with theory (Carn.) or address physical function (Cord., Oss.)
or are embedded in discussion of treatment (Epid., Artic., Fract., Mochl.).
But how, and indeed whether, the work continued is unknown; and the
similar precision of Oss. 1 [9.168 L.] and Loc. Hom. 6 [6.284 L.], which
list bones, gives way to more elaborate and leisurely expression. The
titles of treatises often give little clue to their actual content: the author
of Carn., a work primarily on the viscera, refers to his own earlier work
on the vessels, i r u u u ii , Carn.
5 [8.590 L.]; and promises future work on the essential character of
the human constitution, based on the number seven, j r u j
0o ru o r 0, Carn. n. [8.614 L.] The work itself
deals in a wide-ranging way with the formation of lungs, liver, spleen,
kidneys; also esh, limbs, nails, teeth, hair and the senses hearing,
smell, sight, and speech. Mochl. begins or u [4.340 L.] and Oss.,
with implied comparative anatomy, 0 jt 0i r 00u or
o0 [9.168 L.]. But overall, the subject of Oss. is not bones at
all, but vessels.
The nature of many Hippocratic treatises raises fundamental ques-
tions of authorship: they may have been the common property of a
professional group, pooling ideas and information in an age innocent
of concepts of plagiarism and publication, though not immune from
professional rivalries. Oss. is a composite text, stitched together from
158 discussion
[page 159 // page 160]
heterogeneous and even inconsistent elements and some of its content
is identical with passages in Epid. 2.
32
The treatise is an amalgam of
bits, some of which are replicated elsewhere: Oss. 8 [9.174 L.] = Arist.
H.A. 3.3, where Aristotle gives his source as Syennesis of Cyprus; Oss.
9 [9.176 L.] = Nat. Hom. 11 [6.58 L.]; Oss. 47 and Oss. 10 [9.170, 172,
178 L.] = Epid. 2.4.1 [5.120 L.]. The last part of Oss. has been identi-
ed with the treatise on vessels mentioned by Galen as an appendage
to Mochl., r _u i u o t _u _u, Galen 19.128
K. However, it is likely that the rst person throughout represents the
same editorial voice. In Epid. also there are repetitions and other ele-
ments which make unity of authorship highly unlikely and suggest a
process of redaction and compilation: either editorial activity carried
out by a single author or case notes from // dierent hands, recording
impressions of dierent doctors. Mochl. is a summary of Artic. and Fract.,
carefully executed and often keeping the original expression. Another
common element is the presence of disagreement (as Anat. 10, on termi-
nology) or polemic: 0 u u iu Fract. 3 [3.422 L.]; cf. also
polemic against Herodikos, Epid. 6.3.18 [5.302 L.]. It is in this scheme
that Anat. has some place. Anat. has anities of content particularly with
Oss. (and conrms the relationship between Oss. and Epid. 2); also with
Epid. 6: see on 3, 4, 5, and especially on 9 (liver and diaphragm), and 10
(intestines).
Anat. comprises a description of the internal conguration of the
human trunk. The precision is exemplary. The continuous schematic
arrangement is evident in the repeated 0six times, four with r,
one with ri and one alone; or rtwice, one with r and one alone.
It is precise in its stress on start and nish (r. 0j. 0); on
situation, orientation, and extent (t0. r0. i0); on size,
shape, and colour; and particularly on relative position in the body
top, bottom, front, back, right, left, or middlecf. proximal, distal,
anterior, posterior etc. (0. o. 0. . 0. r.
0u). The treatise records organs and viscera, i.e. in Greek terms
o. Flesh, bones and cords are not mentioned at all, and ves-
sels are mentioned only incidentally, as links. The author is writing a
comparative study, expounding human anatomy by reference to the
anatomy of mammals in general, with which he takes his readers to
be familiar: see on 1, 3, 4, 5, and 10. Simply, he is following the proce-
32
This was already noted by Littr; see now Duminil (1980) for analysis of structure
and content.
discussion 159
[page 160 // page 161]
dure recommended by Aristotle (H.A. 1.16.494b2124): in the absence
of dissection, it is necessary to refer to animals similar to man to
understand human anatomy. Aristotle examined many dierent mam-
mals (e.g. hare, deer, mouse, hyena, ass, leopard, weasel, all listed P.A.
667a; seal and ox, ibid., 671b) and Herophilos still depended largely on
comparative anatomy, despite the availability to him of humans (von
Staden, 1989, 182183). Other Hippocratic authors refer to animals,
either in general, as 0 r 00 0i i o 0 _u,
Carn. 1 [8.584 L.]; and u i t 0 _u 0, with ref-
erence to two halves of the brain, Morb. Sacr. 3 [6.366 L.]; or with ref-
erence to particular animals: the ox (thighbone), Artic. 8 [4.94 L.]; the
pig (lung), Cord. 2 [9.80 L.]; the dog (intestines), Epid. 6.4.6 [5.308 L.]
and Oss. 1 [9.168 L.]; cf. also Demokritos study of dog and pig embry-
ology DK 68 A 151 = Ael. N.A. 12.16 (cf. Nat. Pue. 31 [7.540 L.]) and
the vignette of Demokritos at home, surrounded by heaps of animal
carcases, which he is laying out and dissecting in order to examine
their o, with a view to assessing the signicance of j, Ep. 17
[9.350 L.].
It may be supposed that Anat. belongs to a period when dissection
was not practised on human cadavers, a period when knowledge was
gleaned from observation of butchered sacricial victims (of which the
o were particularly familiar) and from animal dissection; and
that knowledge of the interior of the human body would depend on
chance supplementary ndings from observation of injuries to citizens
on the battleeld (cf. V.C.) or to slaves in industrial accidents, such
as must have occurred in mills and mines. That dissection of human
cadavers was not practised in mainland Greece in the fth and fourth
centuries has been cogently argued often enough; but perhaps classi-
cal scholars make insucient allowance for medical curiosity.
33
Exam-
ination of aborted foetuses or stillborn infants might have been rela-
tively easy (cf. on 3); and conventions obtaining in such semi-barbarous
regions as Thrace may have diered from those of Athens. Certainly
many // intellectuals, including Herodotos and Demokritos, travelled to
Egypt, where they had opportunities to observe the anatomical proce-
dures involved in mummication (cf. Hdt. 2.86). Theoretical modica-
tion too might obtrude (cf. view of the heart, 3).
33
See Edelstein (1932, tr. 1967; but Edelstein suggests in a cryptic footnote that
Demokritos may have been an exception and this notion has a bearing on Anat.), Lloyd
(1975), Longrigg (1993).
160 discussion
[page 161]
Although Anat. is remarkably free from explicit theoretical comment
or doctrinal content, some views which are implicit can be extracted.
From the pathway postulated trachea-lung-kidneys-bladder, it seems
that the writer believes that some uid enters the body via the tra-
chea. This view is explicitly and forcefully expounded by the author of
Cord., and supposedly corroborated by an experiment which involves
dissecting a pig, after giving it coloured uid to drink (Cord. 2 [9.80 L.]).
The author of Oss. init. shares this view: r o o i
o o r u i 0i 0 r u r 0
u, Oss. 1 [9.168 L.]; though a somewhat dierent (or perhaps
merely more detailed) route is postulated in the drink-kidneys-bladder
sequence which follows, Oss. 4 [9.170 L.]; similarly drink, air, and blood
all pass through the lung, Oss. 13 [9.184 L.]. The expression of Oss. 1
[9.168 L.] is close to that of Anat. 5; and the postulated route of uids
is the same. The belief that uid could enter the body via the trachea
seems to be implied in the medical orthodoxy regarding treatments for
lung disorders (among the most common of all Hippocratic ailments
and ranging from mild infections of the respiratory tract to pneumo-
nia): warm drinks are recommended to render the lung moist and so
to dislodge pus, Morb. 3.16 [7.142 L.]; drink is required to moisten
the lung and encourage expectoration, Morb. 1.28 [6.196 L.]; liquid
medicine is to be administered to clear pus when the lung dries out,
A. 9 [6.216 L.]; trouble ensues if the lung dries up i 0i-
, Loc. Hom. 26 [6.316 L.]. (And the medical view was generally known:
Alcaeus frg. 94; Euripides frg. 983 N.) But the matter was controversial:
it is disputed by Aristotle (P.A. 664b) and with an emphatic introductory
verb ru argued that uids pass not to the lung but to the -
i, Morb. 4.56 [7.606 L.].
34
The parallel working of bladder and belly
is similarly presented elsewhere in the HC and in other medical writ-
ings: e.g. i and u parallel Morb. 4.38 [7.556 L.] and Acut. Sp.
15 [2.474 L.]; u and r parallel Mul. 1.34 [8.80 L.] al.; 0
and u parallel Carn. 3 [8.586 L.]; u r o l i -
i i 0t, de Arte 10 [6.16 L.]; also i r j 0 u
j 0 i r j j 0t j o
0, Anon. Lond. 24.1820 and the necessary parts j r j
j i j i 00, also o o i o u
io, Arist. P.A. 655b and 664a.
34
See Lonie (1981), pp. 361 sqq.
discussion 161
[page 161 // page 162]
Despite the broad accuracy and precision of the work, it displays
only the most rudimentary knowledge of the bodys workings.
35
The
descriptions of the regions between heart and liver, liver and kidneys
are just that, descriptions; and there is no indication whatsoever that
the importance of heart and liver is recognised. There is no justication
for imputing to the author the perception that the heart has a peculiarly
important place as centre of the vascular system; see on 3. Despite
detailed reference to the lobes of the lung and of the liver (the latter
somewhat confused), there is nothing on the chambers of the heart and
no awareness of the hearts complex structure. Similarly, the statement
that the liver is may, but need not, imply a view
of the liver as producer of blood for the rest of the body; and the
interpretation of the vessel which nurtures the body is problematical.
The references to the belly as takes a primitive view of the
digestive process, reminiscent of Empedokles; and the adjective applied
to the liver, blood-suused, has an Empedoklean analogue
also. //
Sometimes, the writer of Anat. seems to be at a loss or mistaken:
see on 2, 4, 9. These lapses might result from misunderstanding of a
technical source by a writer or excerptor without technical knowledge
or from hastily and carelessly executed summary. Compression seems
to lead to unclear exposition and even to the elision of essentials: see on
9 and 10, where the parallel versions of Oss., in conjunction with Epid. 2
and Epid. 6, help to elucidate the sense. The consistent use of the third
person may imply that the writer is not himself a medical expert, or is
distancing himself from other practitioners; the rst person is used only
once and introduces an error: see on 9. Treatises evidently written by
practitioners tend to use the rst person plural in giving nomenclature
for anatomical or diagnostic terms (V.M. 19 [1.618 L.]of yellow bile;
Carn. 17 of the tunic of the eye, cf. 2 [8.606, 584 L.]); whereas more
rhetorical treatises tend to use the third person (de Arte 10 [6.16 L.] of
muscle). But there is a wide range from rm to tentative expression and
the common use of the passive militates against generalization: veins
are described, as Anat. 3, in such expressions as
, Oss. 7 [9.172 L.] and , Loc.
Hom. 3.5 [6.282 L.].
35
Trillers commentary constantly superimposes his own knowledge on the text.
162 discussion
[page 162]
There is nothing in the content to suggest any knowledge of the
advances made in Alexandria; and nothing to suggest familiarity even
with Aristotelian biology. In particular, the ignorance of the structure
and function of the heart suggests a date before the research activities
of the Lyceum.
III. Anat. and the HC: expression
The vocabulary of Anat. has many unusual features, which, like the con-
tent, show anities with Oss. A common concentration of anatomical
terms in anatomical works has no implications for direct connections,
far less for common authorship or shared school of thought. However,
the use of dierent terms for the same parts of the body can be sig-
nicant; and it is noteable that the author of Anat. shares a preference
for 00 with the author of Oss. n. [9.182 sqq. L.] (ten instances
1119: 12, 13, 14, 15, 16; ve instances 18), as opposed to the author
of Oss. init. [9.168 sqq. L.], who like the author of Mochl. and Artic.
uses o (nine instances 110; three instances 1, 3; two instances 7;
two instances 9, 10). In general usage, there are further parallels with
Oss. and with Epid. 2 and 6: see especially on 2, 3, 4, 7, 9, 10. Such
coincidences in general medical terms and in non-technical vocabu-
lary become cumulatively signicant, especially when these are allied
with common ground in doctrinal content. On the basis of this ana-
lysis, Anat. can be rmly aligned with Oss., and with certain parts of
Epidemics; also to some extent with Mochl. and with Carn. Clearly the
author sought out a recondite vocabulary; and it is in the nature of
this that many words are not commonly found elsewhere. In some
instances, the parallel usage is entirely from verse; i0 last is com-
mon but exclusively poetic and ri is epic.
The poetic texture is reinforced by the use of simile (see on 9) and
gurative language (j. r0i); these devices how-
ever are typical of anatomical writing in general. There are runs of
dactylic rhythm (u r, with synizesis, r r- and
-r r o 0o), and some attempt seems to be made to
end sentences with spondees, molossi, or still longer sequences of long
syllables (0j. 0u. o _u. rj0. u).
These are all features of early prose style, inuenced by epic patterns
of expression; and in material of this kind the rhythm (like the stress on
countinglobes of lung, gates of liver, six key partsand on naming
discussion 163
[page 162 // page 163]
they call) might originally have served as an aide-mmoire. Another fea-
ture of the stylistic register belonging to // early prose style is the use
of abstract noun plus verb r, in preference to a verb of the same
root.
While the vocabulary is recondite, the syntax is uncontrived, with
compound rather than complex sentences. Such loosely connected
writing is typical of early prose. Connection is simple (r and i) after
asyndeton in the rst sentence. Like Mochl., the terse summary Oss.
init., and the compressed annotations of Epid., it eschews words which
are semantically otiose, such as the denite article and the verb to be.
The general, apparently arbitrary, omission of the article in Anat. is
remarkable: it is usually omitted with such adjectives as 0, r,
0, and, most obviously, in the case of the bodily parts.
36
This charac-
terizes summaries, but is a common feature also of the aphoristic style
aected by Herakleitos; and is seen also in certain Hippocratic texts,
such as Alim. Similarly the compendious comparisons recurrent in the
text characterize both terse and poetic writing styles. Anat. is bald, yet
still stylistically arresting.
Resemblances with Demokritos are explored in the next section.
However, there are certain resemblances too with other pre-Socratics:
j and 0u are certainly used by Empedokles; as are ri-
and 0r by Parmenides (both in the same fragment, DK 28
B 8, lines 43 and 5 = Simp. In Ph. 144.29); and ri by many writers
on scientic subjects. However, these may be chance ndings. Caution
may be induced by the reection that two of the more colourful, and
apparently recondite, anatomical terms of Anat. occur in Euripides: r-
(El. 837) and 00 (El. 492 and Tro. 117). Euripides shows some
precision in anatomical knowledge; the rst datable use of the term
i r is in Ion 1011. As in the case of content, nothing in language
is incompatible with an early date, and the stylistic register is that of
early prose.
36
Comparison of usage in Mochl. shows that in paraphrasing Artic., the author often
repeats the base text almost verbatim while omitting such otiose words as the denite
article: e.g. Mochl. 8 [4.354 L.] (0 without article) ~ Artic. 18 [4.132 L.] (0
with article). But it is omitted in both model and prcis, Mochl. 12 [4.356 L.] ~ Artic.
22 [4.134 L.]; and in Fract. 4 0 j t is followed in the next section by r
t 0 [4.430, 432 L.]. Similarly, in the compressed annotations of Epid., 0 is
commonly used without the article (6.1.3, 4.19 [5.266, 156 L.]); cf. also r 0 u,
Oss. 1 and r 0 r, Oss. 5 [9.168, 170 L.].
164 discussion
[page 163 // page 164]
IV. The Demokritean dimension
An anity of Anat. with the work of Demokritos of Abdera
37
was long
ago noted.
38
Strong, and relatively early, traditions linked Demokritos
with Hippocrates: Celsus described Hippocrates as pupil of Demokri-
tos (Proem 8; there are similar accounts in the later Vitae of Soranos,
Tzetzes, and Suda). Demokritos was a most prolic writer on a great
range of scientic subjects. Many of his works have titles similar to
those of Hippocratic treatises: i 00u u j i .
i j j o.
39
He was much revered in later antiquity. But
there are pressing // problems of authenticity: many citations are not
of Demokritos but of Demokrates, and there were allegedly early forg-
eries, detected by Kallimachos.
40
The extant fragments indicate that
the style of Demokritos was sometimes functional, sometimes elabo-
rate, but certain recurrent distinctive features can be isolated: a liking
for compound words and compound verbs, and a tendency to poetic
idiom with neologisms.
41
Certain catchwords recurrent in the citations
suggest that he was a natural target for imitation, forgery, and pas-
tiche. The key idea of similarity, expressed in the root , may
be seen as peculiarly Demokritean. In addition to treatises on the sub-
ject i u u and i 0u (on dier-
ent dispositions and on changing dispositions DK 68 B 8a and 139;
37
This was a highly prosperous region, with an important trade in grain: evidently
it had its own cultural as well as economic vitality; but of this little direct evidence
survives. Like Demokritos, the sophist Protagoras came from Abdera. (Demokritos is
never described as a sophist, though in many respects his intellectual activity corre-
sponds to that typical in the sophistic movement. For some reason, he did not interest
Plato.)
38
See already Triller (1766), p. 258, who regarded the author as aut ipsum Democritum
aut alium Abderitum philosophum; echoed more sceptically by Ermerins (1864), Prolegom-
ena to Anat., XLII, nding a sophistic attempt Democriti personam induere.
39
Cf. also the descriptions of Demokritos searching out 00i 00i u-
, Ep. 17 [9.378 L.], as an interpreter of u and , Ep. 20 [9.386 L.], and as
the writer of i u 00u, Ep. 23 [9.394 L.]. There are some seventy titles,
according to Diogenes Laertius, DK 68 A 33 = D.L. 9.4549; but on the sources of
D.L. see the sceptical remarks of W.K.C. Guthrie, History of Greek Philosophy (Cambridge,
1965), vol. II, p. 388, n. 1.
40
See RE s.v. Bolos of Mende on later attempts to lend respectability to spurious
writings by arrogating the name of Demokritos; cf. especially Plu. Sympos. 641b.
41
Roman critics admired Demokritos style, nding it poetic. Cicero describes him
as ornate locutus (DK 68 A 34 = Cic. de orat. 1.11.49). There is considerable evidence that
he aected an arcane vocabulary: Kallimachos compiled a i u i -
u i o and Hegesianax wrote a work i j 0 i r.
discussion 165
[page 164 // page 165]
cf. also Ep. 18 n. [9.382 L.]), there are incidental references in many
fragmentswhich cannot all be inventions of forgers or of writers of
pasticheto the terms 0 (DK 68 B 197 = Stob. 3.4.70), -
0 (B 33 = Clem.Strom. 4.151 = Stob. 2.31.65), and ri (B 7
= Sext. 7.137). That is pervasive in his physical system may be
seen in the argument that colour arises from elements mixed j
i 0_ u i j (DK 68 A 125 = Aet. 1.15.8). Demokritos does
seem to have been preoccupied with the idea of form, and especially
of sameness in form; cf. oj, DK 68 A 128 = Aet. 4.19.13 and
ot A 135 = Thphr. de sens. 50; also ot A 61 = Simp.
in cael. 569, cf. i o i j t i o r0
o A 37 = Simp. ibid. 294; and o B 164 = S.E. M. 7.116;
note too his view that the j of man is recognizable _ u j
i _u u B 165 = Arist. PA 640b.
42
(See also on 2, 3, and 4 for
Demokritean usage.)
Supposed relations between Hippocrates and Demokritos are de-
scribed in the Hippocratic letters.
43
The letters fall into three distinct
groups: 1017, 1821 and 2224. Ep. 23, the Demokritean letter to Hip-
pocrates i u 00u is particularly relevant to this discus-
sion; but there is much of signicance also in 1017, in 18, and in 20.
In Epp. 1017, the main voice is that of Hippocrates, called to Abdera
to treat the supposedly mad Demokritos. There are several comments
on i j u the richness of nature, and Ep. 17 ends with the
designation of Demokritos as 00i 00i u ru-
i j, tracking down and considering the true nature of
man [9.378 L.].
Epp. 1821, which purport to be an exchange between Demokritos
and Hippocrates // (18 from Demokritos; the others from Hippocrates)
seem to have been composed for the express purpose of displaying
knowledge of the corpora of these two writers. In Ep. 18 the expression
i rt t [9.382 L.] is followed up by clear reference
42
Perhaps this preoccupation of Demokritos in some degree anticipates the Aris-
totelian attempt to distinguish parts of the body as or or 0r, the latter
being such as hand, face which do not by division become two of the same thing, HA
1.1 init. But we need not look beyond the HC to nd similar ideas in circulation; cf.
o0i Loc. Hom. 1 [6.278 L.] (of the organic unity of the body), o Vict.
1.6 [6.478 L.] and o Nat. Hom. 3 [6.38 L.]. Rather, the abstract principle of
sameness and dierence, with respect to shape and colour, is here given pragmatic
implementation in study of the colour and shape of the bodily organs.
43
On the letters, see Smith (1990), edition with translation and commentary, espe-
cially pp. 102105 on Ep. 23; see also Littr IX. 392; DK 68 C 6; Temkin (1985).
166 discussion
[page 165]
to the titles of works by Demokritos.
44
This letter ends with a posi-
tive concatenation of Demokritean vocabulary, in the recommendation
that the doctor should consider 0u 0i 0 j
[9.382 L.]. Ep. 19 (general statements on madness), Ep. 20 (on the place
of chance in medicine), and Ep. 21 (on the use of hellebore) have ele-
ments demonstrably lifted from the HC, with some misunderstandings
and additions imported by the excerptor;
45
and doubtless Demokritean
elements are similarly present throughout 18.
Epp. 2224 have a dierent manuscript tradition from the other
letters.
46
The content is somewhat mixed: in Ep. 22 Hippocrates writes
to his son Thessalos, urging the study of mathematics on the grounds
that it is closely allied with medicine; Ep. 23 is the Demokritean letter
which concerns us here; in 24 Hippocrates writes to King Demetrios,
recommending ways to maintain health. Ep. 24 is prefaced by the
statement r o i j 00i u
r i_ 0j o r 0 o 0i
[9.398 L.]. (It has been supposed that this is a reference to Ep. 23.
This seems unlikely, as Ep. 23, the odd one out in this rather ragged
sequence, is Demokritean. It may be rather that Anat., which has strong
anities in content and expression with Ep. 23, was known and referred
to by the author of Ep. 24, who believed the work to be Hippocratic.)
The preamble of Ep. 23, leading in to the anatomical discourse, is
regarded by Smith as detachable.
47
This preamble justies the study
of medicine by all, on the grounds that bodily malaise aects mental
function. The proem is taken to be Demokritean in the second to third
centuries A.D.: the words of the letter i r o j 0u
0r. ij r u o 0t [9.394 L.] are reiter-
ated in ij r o o u 0r. i
r j 0u 0t (DK 68 B 31 = Clem. Paed. 1.6, conceiv-
ably an independent source drawing not on the letter but on a work
of Demokritos, the source also of the letter; the connection with Ep.
23 is noted DK ad loc.). There are some striking similarities in phrase-
ology between this letter and Anat.: i (of the faculty of sight)
~ r0i (of the heart), u (of the chin) ~ r (chest),
lt i i r ~ r r r ru-
44
See Smith (1990), p. 93, n. 1.
45
See ibid., p. 95, n. 1 and p. 99, n. 1.
46
Ibid., p. 42.
47
The author borrowed the anatomy and composed the proem; cf. 32 detachable
philosophic proem.
discussion 167
[page 165 // page 166]
(similar expressions of inestines), u u (both of bladder).
Similarities in spirit are even more striking. It is particularly remarkable
that the nuances of the concepts and u are parallel, and
allied with the pervasive concept of order in or aptness to bodily
function, and to the craft in design of the living organism. There is even
a parallel change in use of u. At the beginning of the anatomical
description, we nd u 00i j 0i r j
(same sense as Anat. 7); and at the end j r 0u r t u
rr o o r (same sense as Anat. 12 [9.394,
398 L.]). (In the latter passage, Ermerins reads u, linking this
genitive with r t: this attractive emendation tones down but does
not alter the abstract sense of u.) There is in Ep. 23 much stress on
the notion that the organs are fashioned or marshalled by nature to
serve [the nature of] the body; u I u (sex organs)
and 0r i u // (stomach and intestines),
until death ends their service; cf. here rj0 and o. In the
letter the nouns and i, the verb rr, and
the expressions of the bodily parts 0i u 0 (hair),
jr 0j (trachea and oesophagus), r (chin)
are more elaborate than, but similar in spirit to, Anat. 7 and 12. These
ideas accord well with known Demokritean views of man governed by
divinity, the two being microcosm and macrocosm, as r _u 00u_
_u _ o i, and of origins in general as
ru o where . j. 0j play a part
(DK 68 B 34 = David Prol. 38.14 and A 38 = Simp. In Ph. 28.15).
However, with these similarities in phraseology and spirit, there are
fundamental divergences. The overall tenor is completely dierent:
the letter is mannered and pompous, whereas Anat., despite its poetic
touches, is spare and functional. There are dierences too in attitude
to bodily function, and in anatomical sophistication. In the letter, the
organs are the seat of the emotions (the heart of anger, the liver of
desire). The letter is full of theoretical notions, whereas Anat. is prac-
tical and descriptive. Furthermore, whereas the anatomy of Anat. is
primitive, and contains no elements which suggest a post-classical date
(though, unlike the letter, Anat. gives such precise details as the number
of lobes in lungs and liver), that of Ep. 23 displays insights which seem
to follow the work of Herophilos and Erasistratos. These are listed by
Smith as: the comment on the uselessness of the spleen; the descrip-
tion of the bladder, woven from vessels; the concept that swallowing is
accompanied by a shove; the insight that the brain directs the limbs
168 discussion
[page 166 // page 167]
via the nerves.
48
To these may be added: it is , not drink, which
enters by the trachea; the term lungs, not sg. lung, is used; the heart is
not round, but conical and in general there is attention to, and some
understanding of, function.
The two texts, Ep. 23 and Anat., are related in a complex fashion.
The most plausible hypothesis is that both are derived, directly or
indirectly, from the same Demokritean text, but by writers with entirely
dierent purposes. That there are Demokritean elements in Anat. is
assured. But Demokritean need not mean by Demokritos. Nothing
militates against the supposition that this is an excerpt of a genuine
work by Demokritos; but it might be a pre-Alexandrian forgery (to
be linked with those allegedly detected by Kallimachos), or a later
pastiche (to be linked with the epistolary tradition). However, the theory
of guileless abridgement seems more probable. As the comparative
anatomy which features so prominently in Anat. belongs not with Ep.
23 (though cf. the presentation of Demokritos in Ep. 18) but with Oss.
and Epid. 2, it may be supposed that the writer is adapting more than
one text. The doctor(s) involved in the writing or compilation of Epid.
2, 4 and 6 practised at Abdera, Ainos, and other such northern centres.
The common elements in expression between these, Oss., Anat., and
the works of Demokritos is some indication of interaction between
Hippocratics and Demokriteans in fth-century Thrace; and between
their later imitators. This can only be glimpsed, hardly reconstructed.
49
V. Conclusion
This extraordinary little piece has found its way into the HC by acci-
dent. It is an // unoriginal and uncritical summary of earlier anatom-
ical works, incorporating Demokritean material. There is a nexus of
related Hippocratic texts, most notably Oss. The date of the anony-
mous redactor is indeterminate, but may be as early as the fourth cen-
tury. The treatise is a unique testimonial to the nature and extent of
ancient anatomical knowledge, and an important document linking the
lost Demokritean corpus with certain Hippocratic texts.
48
Smith (1990), p. 33.
49
See Jouanna (1992), pp. 4850 on Hippocrates connections with North Greece
and pp. 3637 on Hippocrates and Demokritos; also Longrigg (1993), pp. 6669, 9397
on Demokritean ideas in the HC.
APPENDIX
M.-P. Duminil, Hippocrate: CUF t. 8, Ulc., Oss., Cor, Anat. (Paris, 1998)
appeared soon after the rst publication of this article in Classical Quar-
terly. It is not uncommon in scholarship that a text or subject long
neglected is simultaneously the subject of more than one study. It is
proper that, on republication of my article, some account is taken of
Duminils work.
Ds text, as is conventional in the Bud series, is prefaced by a
short general introduction (Notice) and accompanied by a translation,
with only a few notes. Accordingly, Ds treatment is necessarily much
less detailed than my own; on the whole it is descriptive rather than
evaluative. In the Notice, D discusses title (found to be inappropriate,
as the work gives a partial rather than a detailed study of anatomy)
and content (found to be biological rather than medical). Parallels with
Demokritos and others are noted; but D places more emphasis on
similarities with (pseudo-) Rufus of Ephesus. The manuscript tradition
is then briey described.
I do not discuss dierences which do not aect the sense, such as Ds
preference for contracted forms, e.g. u not r, and for -
rather than - forms. Otherwise, the main dierences in the two texts
are as follows:
(I. 1 = Ds 1) D keeps nominative singular r V while
I, following Ermerins, emend to genitive plural r (for
reasons, which I still think valid, see commentary 143144). I note
that D translates as if reading the genitive plural.
(I.4 = Ds 3) D keeps i V while I, following Ermerins,
emend to i (for reasons, which I still think valid, see com-
mentary 150).
(I. 5 = Ds 4) D reads oi t 0 [j] u-
i while I read oi r r 0 j
u t. Ds deletion of the substantive on the grounds of
tautology seems odd, and it still seems to me that the preposition
170 appendix
is required; Ds preference for i a rare form of the third
person plural may be justied (i V).
D reads ro r u j i r while I read r0
u r or r. D seems unaware that her emenda-
tion, based on a Galenic gloss, was anticipated by Triller (for full
discussion, see commentary 151152).
(II.10 = Ds 6) D keeps V while I, following Foesius, emend
to (for reasons, which I think compelling, see commentary
150).
D fails to note that there are dierent manuscript readings of
adjectives and substantives beginning o- or o- (see commen-
tary 143, with n. 6).
Although there are some points of disagreement in interpretation (for
example, whether the word j refers to apples as D believes, or
to sheep as I prefer) there are points of agreement also (for example,
that the phrase i j refers to the aorta, and that the expres-
sion ri j i can stand).
INDEX OF AUTHORS AND TEXTS
Aetius 66
Alkaios 160
Alkmaion 18
DK 24 A 5 20, 83
Anaximander 133
Anonymus Londinensis
15, 160
XII 2226
(Dexippos) 20, 61
Aretaios 82, 98, 99, 130
Aristophanes
Eccles. 254, 398 25
Eq. 455 151
Nu. 327 61
1043 69
Pl. 665 25, 92
717725 25
Ra.
588 25
1067 144, n.
Aristotle
col. 796a 53
GA
5.1 20
6 20
HA
1.1 165, n.
1.16 131, 159
3.3 158
3.5 69
Metaph. 985b 132
PA
637b 141
647a 141
655b 160
664a 160
664b 160
667a 159
669b 131, 148, 149
670b 141
671b 143, 159
673b 140
Po. 1449a 152
Probl. 15, 21, 79
31.21 109
31.22 83
31.23 6061
31.25 5758
31.28 109
Rh. 1411a 61
Athenaios 262a 151, n.
Celsus 6, 11, 19, 2122,
23, 60,
6567, 69,
71, 79, 90,
9798, 104,
106107,
129, 155157
proem 8 164
proem 30 106
2.1.6 106
2.10.117 98
4.1.113 156
4.1.3 131, 136
4.1.7 151
4.1.11 144
6.6.1 106, 112
6.6.8 107
6.6.10 60, 79
6.6.26 79
6.6.31 60
6.6.35 52
6.6.38 99
7.7.3 60
7.7.4 67, 87
172 index of authors and texts
7.7.1314 51
7.7.15 65, 74, 79
7.7.31 76
8.3 103
Demokritos 19, 120, 132,
133, 136,
139, 150,
159, 164168
DK 68 A 37 142, 165
DK 68 A 61 165
DK 68 A 77 137
DK 68 A 125 165
DK 68 A 128 165
DK 68 A 132 142
DK 68 A 135 53, 165
DK 68 A 151 159
DK 68 A 152 139
DK 68 A 155 136
DK 68 B 5 147
DK 68 B 7 165
DK 68 B 8 164
DK 68 B 31 166
DK 68 B 33 165
DK 68 B 34 167
DK 68 B 37 139
DK 68 B 57 139
DK 68 B 135 142, n.
DK 68 B 139 164
DK 68 B 151 148
DK 68 B 155 133
DK 68 B 164 165
DK 68 B 165 165
DK 68 B 187 139
DK 68 B 197 165
DK 68 B 223 139
DK 68 B 270 139
DK 68 B 288 139
Demosthenes Philalethes
19
Diokles
fr. 137 20
Dioskorides 72, 79, 84, 92
Empedokles 18, 161, 163
DK 31 A 77 147
DK 31 A 83 149
DK 31 B 27 133
DK 31 B 61 147
DK 31 B 81 147
DK 31 B 84 83
DK 31 B 150 141
Erotian 7, 61, 156
18 63
38 131
35 147
2 91
25 80
56 143
15 75
34 63
13 92
Euripides
Alc. 261 53
Ba. 1339 137, n.
Cy. 683 65
El.
492 163
772 132
837 134, 163
Hel.
179 53
1502 53
HF 130 132
Ion 1011 163
IT
978 137, n.
1481 137
Supp. 94 132
Tro. 117 163
fr. 983 N. 160
Euryphon 18, 75
Galen 6, 7, 1922, 50,
66, 87, 98,
102, 106
107, 130, n.,
142, n., 147,
n., 156
de anatomicis administrationibus
2.349 K 104
2.719 K. 104
index of authors and texts 173
de compositione medicamentorum secundum
locos
12.701 K. 84
12.702 K. 92, 106
12.709711 K. 79, 93
12.711714 K. 106
12. 738 K. 93
12. 802 K. 98
de compositione medicamentorum
temperamentis et facultatibus
12.242 K. 84
Hippocratis de medici ocina liber et
Galeni in eum commentarius
18 (2).808 K. 102
Hippocratis de articulis liber et Galeni in
eum commentarii
18 (1).379 K. 150
in Hippocratis Prognosticon commentarii
106
18 (2).47 K. 82
introductio seu medicus
14.742 K. 21
14.767777 K. 20, 87, 93
14.768 K. 106
14.769 K. 90
14.782 K. 21, 66
linguarum Hippocratis explicatio
7, 144, n., 156,
170
19.74 K. 109
19.86 K. 81
19.91 K. 61
19.92 K. 152
19.97 K. 100
19.112 K. 91
19.118 K. 92
19.124 K. 93
19.125 K. 91, 146
19.128 K. 3, 158
19.148 K. 84, 111
de locis aectis
8.218 K. 2021
de methodo medendi
10.281K. 85
10.937942 K. 66
10.940 K. 92
10.1004 K. 88
de optimo medico cognoscendo
22
de placitis Hippocratis et Platonis
156
de remediis parabilibus
14.341 K. 22
14.342, 343, 344 K.
106, 107
14.410 K. 87
de simplicium medicamentorum
temperamentis et facultatibus
12.242 K. 84
de tumoribus praeter naturam
7.732 K. 88
Herakleitos 163
Herodotos
1.38 53
2.86 159
3.30 3
4.187 66
5.58 132
8.54 3
Herophilos 19, 98, 140, 159
Hesychios 7, 6162, 68,
81, 85, 91,
108, 130,
132, 136,
138, 142,
143, 144,
150, 151,
157
Hippocrates, HC
Acut. 17, 72, 92
5 [2.260 L.] 54
19 [2.264 L.] 150
30 [2.290 L.] 131
60 [2.356 L.] 77
Acut. Sp.
3 [2.398 L.] 108
5 [2.406 L.] 73
7 [2.424 L.] 73
910 [2.412 L.] 54, 96
15 [2.474 L.] 160
26 [2.486 L.] 77
174 index of authors and texts
61 [2.516 L.] 77
6566 [2.520 L.] 90, 91
Aer. 17, 55, 82
10 [2.42, 46 L.] 20, 105
A. 16, 17, 111, 147
2 [6.210 L.] 17, 79, 100
4 [6.212, 214 L.] 17, 96, 100
5 [6.214 L.] 17
9 [6.216 L.] 160
11, 12, 13 [6.218, 220 L.]
81
15 [6.224 L.] 17, 92, 145
18 [6.228 L.] 17
20 [6.230 L.] 54
22 [6.234 L.] 58
23 [6.234 L.] 17, 80
26 [6.238 L.] 110
27 [6.238 L.] 110
28 [6.240 L.] 17
29 [6.240, 242 L.]
17, 72
31 [6.244 L.] 72
33 [6.244 L.] 18, 81
37 [6.246 L.] 110
38 [6.248 L.] 111
40 [6.250 L.] 17
54 [6.264 L.] 98
58 [6.266 L.] 98
47 [6.258 L.] 108
Alim. 163
23 [9.106 L.] 150
25 [9.106 L.] 146
30 [9.110 L.] 140
31 [9.110 L.] 138
Aph. 17
Aph. 3
12 [4.490 L.] 20, 105
14 [4.492 L.] 105
31 [4.502 L.] 50
Aph. 4
77 [4.530 L.] 91
Aph. 6
19 [4.568 L.] 82
31 [4.570 L.] 22
de Arte
10 [6.16 L.] 134, 160, 161
11 [6.20 L.] 3
Artic. 7, 16, 18, 55,
57, 72, 89,
110, 112, 131,
137, 148,
157, 159,
162
7 [4.86, 92 L.] 12, 69, 110
8 [4.92, 94 L.] 159
2 9 [4.102 L.] 85
11 [4.106, 108 L.] 63, 70, 150
13 [4.116 L.] 146
16 [4.128 L.] 69
18 [4.132 L.] 163, n.
19 [4.132 L.] 55
22 [4.134 L.] 163, n.
31 [4.146 L.] 55
38 [4.166, 168 L.]
55, 71
40 [4.172176 L.] 82, 110
45 [4.190196 L.]
65, 130
46 [4.196 L.] 65
47 [4.202 L.] 55, 65
62 [4.264268 L.]
55, 62, 132
68 [4.282 L.] 73
78 [4.312 L.] 55
Carn. 157, 162
1 [8.584 L.] 137, 159
2 [8.584 L.] 161
3 [8.586 L.] 145, 147, 150,
152, 160
4 [8.588 L.] 151
59 [8.590596 L.]
145
5 [8.590 L.] 130, 138, 139,
n., 151, 155,
157
6 [8.594 L.] 150
13 [8.600 L.] 150
17 [8.604, 606 L.]
20, 83, 161
19 [8.614 L.] 152, 157
Coac. 18, 57, 82, 86,
94, 109, 112
2.209 [5.628 L.] 53
2.214 [5.630 L.] 5960
index of authors and texts 175
2.220 [5.632 L.] 22
2.357372 [5.660, 662 L.]
96
3.483 [5.692 L.] 89
5.502 [5.700 L.] 17
7.593 [5.722 L.] 83
7.611 [5.726 L.] 83
Cord. 83, 157
1 [9.80 L.] 137, 149
2 [9.80 L.] 146, 159, 160
5 [9.84 L.] 149
7 [9.84 L.] 139, 146
8 [9.84, 86 L.] 146, 150
10 [9.86 L.] 149
Epid. 17, 56, 71, 112
Epid. 1
1.2.4 [2.216 L.] 60, 105
Epid. 2 94, 120,
158, 161,
162163,
168
2.2.24 [5.94, 96 L.]
96, 137
2.3.1 [5.102 L.] 77
2.3.2 [5.104 L.] 111
2.3.14 [5.116 L.] 68
2.4.1 [5.120, 122 L.]
129, 141, 148,
158
2.4.2 [5.126 L.] 20
2.6.12 [5.134 L.] 95, 105
2.6.28 [5.138 L.] 93
Epid. 3
3.3.7 [3.84 L.] 78
Epid. 4 72, 168
4.7 [5.146 L.] 142
4.19 [5.156 L.] 163, n.
4.30 [5.174 L.] 3, 50
4.44 [5.184 L.] 77
4.52 [5.192 L.] 95
Epid. 5 62, 86, 91
5.7, 8 [5.208 L.] 56
5.25 [5.224 L.] 81
5.26 [5.226 L.] 56
5.68 [5.244 L.] 109
Epid. 6 25, 86, 94,
112, 120,
158, 161,
162163, 168
6.1.3 [5.266 L.] 163, n.
6.3.18 [5.302 L.] 158
6.4.6 [5.308 L.] 150, 159
6.4.21 [5.312 L.] 149
6.7.1 [5.332 L.] 95
Epid. 7 4, 86
7.3 [5.368, 370 L.]
73, 82
7.11 [5.384 L.] 57
7.12 [5.388 L.] 129
7.25 [5.394 L.] 129
7.43 [5.410 L.] 71
7.45 [5.412 L.] 105
7.59 [5.424 L.] 108
7.65 [5.430 L.] 109
7.78 [5.434 L.] 83
7.80 [5.436 L.] 83
7.124 [5.468 L.] 65
Epp.
1017, 1821, 2224
165, 166
Ep. 11 [9.326 L.] 152
Ep. 17 [9.354378 L.]
108, 159, 164,
n., 165
Ep. 18 [9.382 L.] 139, 150,
165166
Ep. 19 [9.382 L.] 165166
Epp. 20, 21, 22 164, n., 166
Ep. 23 [9.394, 396 L.]
120, 134, 137,
145, 148,
149, 151,
152, 164, n.,
166168
Ep. 24 166
Fist. 72, 92, 104, 112
1 [6.448 L.] 152
9 [6.456 L.] 78
Fract. 7, 18, 57, 82,
89, 104, 112,
137, 157
3 [3.422 L.] 70, 158
4 [3.430, 432 L.] 109, 163, n.
5 [3.434 L.] 70, 163, n.
176 index of authors and texts
9 [3.448 L.] 131
10 [3.450 L.] 55
12 [3.460 L.] 130
15 [3.470, 472 L.] 68
21 [3.486 L.] 101
30 [3.520 L.] 131
Gland. 16, 17, 18
1 [8.556 L.] 150
3 [8.558 L.] 74
4 [8.558 L.] 130
7 [8.560 L.] 130, 150
11 [8.564 L.] 17, 65
12 [8.564 L.] 61
13 [8.568 L.] 105
14 [8.568, 570 L.]
17, 65, 76, 131
Haem. 92, 152
2 [6.436, 438 L.] 63, 69
4 [6.440 L.] 103
5 [6.440 L.] 73
Hebd.
5 [8.636 L.] 146
35 [8.657 L.] 109
52 [8.673 L.] 139
Int. 1617, 55,
7576, 81,
92, 108
1 [7.166, 172 L.] 76, 129, 131, n.
2 [7.174 L.] 76
4 [7.178 L.] 87
6 [7.180 L.] 55
7 [7.184 L.] 110
8 [7.186 L.] 76
9 [7.188 L.] 81
12 [7.192, 194 L.] 17, 73
13 [7.200 L.] 17, 76
15 [7.204 L.] 54
18 [7.210, 212 L.] 54, 70, 74, 75
21 [7.220 L.] 98, 100
24 [7.228 L.] 89
26 [7.234 L.] 73
27 [7.238 L.] 55
28 [7.242 L.] 70, 81
35 [7.252 L.] 57
36 [7.256 L.] 73
37 [7.258 L.] 100
51 [7.292 L.] 57
Iudic. 51 [9.292 L.] 149
Loc. Hom. 9, 16, 18, 21,
6465, 72,
78, 86, 91,
94, 112, 156,
157
1 [6.276, 278 L.] 20, 64, 163, n.
2 [6.278, 280 L.] 20, 103, 119
3 [6.280, 282 L.] 82, 83, 129, 131,
134, 135,
139, 146, 161
6 [6.284 L.] 157
10 [6.294 L.] 129, 134
12 [6.298 L.] 101
13 [6.298, 300, 302 L.]
3, 16, 56, 61,
64, 74, 75,
78, 81, 103,
111, 112
14 [6.302308 L.]
91, 129, 131, n.,
134
15 [6.308 L.] 76
20 [6.312 L.] 146
2123 [6.312, 314 L.]
76
21 [6.312 L.] 17, 65
22 [6.314 L.] 101
26 [6.316 L.] 160
27 [6.318 L.] 101
30 [6.322 L.] 96, 101
32 [6.324 L.] 102
38 [6.328 L.] 85
40 [6.330 L.] 16, 64, 70, 73
42 [6.334 L.] 53
47 [6.346 L.] 93, 112
Medic.
2 [9.206, 208 L.] 69, 80
5 [9.212 L.] 17
8 [9.214 L.] 68
Mochl. 72, 82, 148,
158, 162, 163
1 [4.340, 342 L.] 65, 130, 157
8 [4.354 L.] 163, n.
12 [4.356 L.] 163, n.
34 [4.376 L.] 73
35 [4.378 L.] 81
index of authors and texts 177
39 [4.386 L.] 130
41 [4.392 L.] 131
42 [4.392 L.] 77
Morb. 1 147
3 [6.144 L.] 54, 105
56 [6.146150 L.]
70
26 [6.194 L.] 54
28 [6.196 L.] 54, 101, 160
Morb. 2 16, 21, 86, 94,
96, 112, 148
1 [7.8 L.] 65, 83, 102
111 [7.818 L.] 102
2 [7.8, 10 L.] 6465
4 [7.10 L.] 73
8 [7.16 L.] 73
9 [7.16 L.] 96
12 [7.18 L.] 57, 65, 71, 73
13 [7.22, 24 L.] 78, 84, 86, 101
15 [7.26, 28, 30 L.]
73, 78, 81, 101,
103, 104
18 [7.32 L.] 78, 86, 101
19 [7.32, 34 L.] 56, 87, 111
22 [7.38 L.] 56
24 [7.38 L.] 80
25 [7.38, 40 L.] 56, 73, 86, 101
26 [7.38, 40, 42 L.]
81, 97, 101
27 [7.42, 44 L.] 97, 101
28 [7.46 L.] 97, 98
29 [7.46 L.] 97
32 [7.50 L.] 71, 102, 103
33 [7.50 L.] 80
35 [7.52 L.] 80
36 [7.52 L.] 101
43 [7.60 L.] 98, 197
47 [7.66, 68, 70 L.]
69, 72, 81, 111
50 [7.78 L.] 81
51 [7.80 L.] 81
53 [7.82 L.] 76
56 [7.88 L.] 76
58 [7.90 L.] 91
59 [7.92 L.] 136
62 [7.96 L.] 76
69 [7.106 L.] 144
72 [7.108, 110 L.] 108
73 [7.112 L.] 70, 108
Morb. 3 84, 94
1 [7.118 L.] 57
2 [7.120 L.] 81, 109
3 [7.120 L.] 73, 86
6 [7.124 L.] 110
10 [7.128, 130 L.] 85, 96
11 [7.130 L.] 80
15 [7.140 L.] 74
16 [7.142148 L.] 74, 76, 109, 110,
160
17 [7.156 L.] 85
Morb. 4 56, 151
38 [7.556 L.] 160
40 [7.560 L.] 151
54 [7.596 L.] 150
56 [7.604608 L.]
134, 146, 160
Morb. Sacr.
3 [6.366 L.] 159
7 [6.374 L.] 20
17 [6.392 L.] 151
gynaecological works
5455, 56, 69,
71, 72, 80,
91
Mul. 1 17, 82, 86, 101,
112, 148
34 [8.80, 82 L.] 98, 160
70 [8.148 L.] 81
74 [8.156, 158 L.] 98, 111
75 [8.164, 168 L.]
81, 98
90 [8.214 L.] 98
97 [8.224 L.] 98
102105 [8.224228 L.]
90
102 [8.224 L.] 98
105 [8.228 L.] 61, 98
109 [8.232 L.] 85
Mul. 2 86, 101, 112, 151
110 [8.236, 238 L.]
89, 99
111 [8.240 L.] 111
112 [8.242 L.] 56
116 [8.250 L. 61, 83
178 index of authors and texts
119 [8.228 L.] 61
144 [8.316, 318 L.]
68
165 [8.344 L.] 111
185 [8.366 L.] 85
Nat. Hom.
3 [6.38 L.] 165, n.
11 [6.58 L.] 158
14 [6.66 L.] 91
Nat. Mul. 112
1 [7.312 L.] 146
13 [7.330 L.] 56
24 [7.342 L.] 111
32 [7.358, 362, 366 L.]
55, 98, 143
33 [7.370 L.] 55
40 [7.384 L.] 71
100 [7.416 L.] 98
Nat. Pue. 151
31 [7.540 L.] 159
O. 82
17 [7.322 L.] 84
23 [7.328 L.] 84
24 [7.332 L.] 84
Oss. 3, 73, 112,
120, 130,
148, 149,
157163,
168
1 [9.168 L.] 130, 141, 144,
150, 157,
159, 160,
163, n.
3 [9.170 L.] 152
47 [9.170172 L.]
158
4 [9.170 L.] 131, 143, 158,
160
5 [9.170 L.] 129, 163, n.
7 [9.172 L.] 141, 161
8 [9.174 L.] 158
9 [9.176 L.] 152, 158
10 [9.178, 180 L.] 141, 145, 148,
158
12 [9.182, 184 L.] 20, 133, 141,
145, 159
13 [9.184, 186 L.] 136, 160
14 [9.186, 188 L.]
76, 149, 152
16 [9.190 L.] 139, 145
17 [9.192 L.] 145, 152
18 [9.194 L.] 131, 135, 141,
151
19 [9.196 L.] 137
Prog. 82, 94, 111
2 [2.114, 116 L.] 21, 60, 106
23 [2.174, 178 L.] 96, 101
24 [2.184 L.] 136
Prorrh. 1 58, 86, 112
Prorrh. 2 17, 21, 25, 82,
94, 112
1820 [9.4448 L.]
17
18 [9.44, 46 L.] 5859, 107,
112
20 [9.48 L.] 50, 51, 87
21 [9.48 L.] 105
30 [9.60 L.] 91
33 [9.64 L.] 95
34 [9.66 L.] 95
43 [9.74 L.] 56
Septim. 132
1 [7.436 L.] 139
Steril. 82
221 [8.426 L.] 80
222 [8.430 L.] 63
248 [8. 460 L.] 68
Ulc. 16, 83, 85, 92
1 [6.400 L.] 110
6 [6.404 L.] 85
8 [6.406 L.] 85
10 [6.408 L.] 111
12 [6.412 L.] 85, 90, 93, 98
13 [6.416 L.] 92, 98
14 [6.418 L.] 89
17 [6.420 L.] 90, 93
22 [6.426 L.] 101
24 [6.428 L.] 74, 100, 101,
110
25 [6.430 L.] 101
26 [6.430 L.] 68
Vict. 1 72
6 [6.478 L.] 165, n.
11 [6.486 L.] 146
index of authors and texts 179
Vict. 2
54 [6.556 L.] 98
Vict. 3 56, 147
Vict. 4
90 [6.656 L.] 81
VC 7, 9, 82, 86, 89,
102, 112
2 [3.188192 L.] 65, 86
3 [3.194 L.] 65
9 [3.210 L.] 102
13 [3.228, 230 L.]
86, 101, 110
14 [3.236242 L.]
80, 89, 111
15 [3.244 L.] 85
18 [3.250 L.] 58, 81
19 [3.252, 254 L.] 80, 109
21 [3.256, 258 L.]
81, 102
VM 61
1819 [1.612616 L.]
6061
19 [1.616, 618 L.] 74, 161
22 [1.626632 L.]
136, 141, 146
Homer 53, 83, 148, 155
Il. 3.292 146
4.528 131
11.579 148
17.47 146
19.266 146
Lysias 25, 62
Oreibasios 21, 50, 130, n.
Parmenides 143, 163
Paul of Aigina 12, 21, 23, 50,
98, 103
Philolaus 133
Plato 133, n., 142, n.,
164, n.
Phd. 96b 147
R. 405c 107
517a 53
Sph. 258c 57
Ti.
33b, c 137
45b46a, 58c 82
71c 141
and Ti. Locr. 139, n.
Pliny 9899
Plutarch 61
Pollux 6162, 82, 106,
130, 131, 134,
151, n., 157
Poseidonios 155
Praxagoras 129
Protagoras 164
Pythagoras, Pythagoreans
57, 133, 139, n.,
145, 150
Rufus 23, 50, 129130,
133, 141,
143, 144,
146, 148,
149150,
152, 155157,
169
Scribonius Largus 78
Strabo 80
Theophrastos 81
Xenophon 56
GENERAL INDEX
Abdera, 19, 132, 164, n., 165, 168
acupuncture, 26
anatomy
comparative, 120, 129166
foetal, 140, n., 143
Homeric, 155
regional, 120, 155
arteries, see vessels
belly, 119120, 149150
bladder, 119, 144145, 156, 167
body uids, 129
bile, 17, 57, 61, 134, n.
blood, 10, 83, 96, 99, 129130
ichor, 10, 61, 8384
mualos, 65, 76
muxa, 6162
phlegm, 10, 17, 21, 52, 57, 61, 65,
83, 96, 102, 105, 107, 108, 134,
n.
pus, empyema, 27, 69, 76, 97,
102, 147, 160
sweat, 61
tears, 5961, 106
urine, 83
water, moisture, 10, 103
Calvus, 6, 56, 69, 84, 86
Cornarius, note also critical apparatus,
5, 67, 56, 64, 86, 89, 101, 108,
109, 134, 143
Demosthenes Philalethes, 19
diaphragm, 119, 147148, 156
diseases, see also eye
choker, 9598, 105
dropsy, 73, 76
jaundice, 73, 108
joint diseases, 105
malaria, 93
phthisis, 73, 76
pleurisy, 76
pneumonia, 93, 95, 160
stroke, 73, 86
tuberculosis, 93
dissection, 120, 159
drugs, see medicaments
Egypt, 22, 24, 77, 80, 159
Erasistratos, 19
eye
anatomy, note also glossary and
diagrams,
cornea, 8, 19, 51, 82
fundus, 25
iris, 3, 8, 51
lash, 9, 88
lid, 9, 7679, 8789
limbus, 82
membranes, 89, 19, 60
opsis, 34, 49
optic nerves, 19, 26; cf. ducts,
20, 21
pupil, 3, 8, 51
retina, 19, 50
tarsal plates, 82, 88
diseases, note also glossary,
amaurosis, 910, 101
amblyopia, 910
blepharitis, 59, 90, 91
cataract, 8, 22, 23, 24, 4951,
53
chalazion, 8, 22, 88
conjunctivitis, 8, 10, 22, 25, 59,
105
ectropion, 8, 59
entropion, 10, 59
glaucoma, 22, 23, 4951, 53
iritis, 50
keratitis, 50, 51
182 general index
night blindness, 8, 9, 22, 23,
25, 27, 93101
ophthalmia, 9, 13, 78, 94,
9596, 104112
papilloma, 8, 88
pterygion, 22, 8788
ptilosis, 87
rheum, 25, 5863
trachoma, 8, 10, 12, 19, 22, 23,
24, 27, 7679, 85, 8789
ux, 10, 16, 20, 52, 61, 6465, 74, 110
ocular ux, 16, 19, 2021, 61,
6466, 78, 102, 107, 111
Foesius, note also critical apparatus,
7, 37, 49, 58, 69, 71, 72, 75, 83, 84,
86, 87, 89, 92, 100, 101, 108,
110, 136, 143, 151, 170
grammar, see style
head, note also diagram 2,
bregma, 9, 17, 19, 78, 8586, 102
crown, vertex, 9, 71
inion, occiput, 9, 65, 67, 71
heart, 119, 135, 136138, 145, 156,
161, 167
Herophilos, 19, 98, 140
kidneys, 119, 142144, 145, 156, 157,
160
Knidos, Knidian, 18
Kos, 61
Kyrene, 19
language, see style, terminology
Libya, 19, 66
liver, 119120, 135, 140142, 145, 148,
154, 156, 167
lung, 20, 72, 76, 91, 96, 119120, 129,
131, 133140, 145, 156, 160, 161,
168
medicaments, see also therapy, 8, 11,
17
arum, 12, 72
bile (animal), 98
choice, dosage, 12, 56, 72, 84, 111
copper, 12, 22, 24, 56, 79, 84, 89,
90, 9193, 106
cypress, 78, 86
elaterion, 12, 96, 100
g (juice, leaves), 79, 92
fungus, 71
garlic, 11, 92, 95, 9798
grape (juice), 79, 90, 91, 92
honey, 11, 22, 72, 94, 98, 106
industry, 90
liver, 22, 27, 95, 9899
myssotos, 93
olive oil, 11, 71, 78
saron, 91
salt, 72, 86
vinegar, 92, 111
wine, 12, 22, 78, 91, 97, 98, 107
Miletos, Milesian, 80
moxibustion, 26, 70
number, numerology, 57, 145, 150
oesophagus, 119, 146147
ophthalmoscope, 2526
pain, 11, 13, 22, 53, 57, 5960, 78, 95,
103, 104, 106, 107, 111
papyri (ophthalmological), 66
Ebers, 22
Kahun, 22
pathology, see also diseases, 910
prognosis, 10, 17, 49, 59
pulse, 73, 74
Pythagoras, Pythagoreans, 57, 133,
145, 150
Sicily, 22
signs, 13, 21, 53, 60, 73, 82, 83, 96,
106
spleen, 54, 119, 132, 141, 145, 147,
148149, 152, 156, 157, 167
sponge, 11, 22, 68, 72, 79, 80, 97
style, 8, 1315
adverbial clauses
(conditional), 52, 61, 108
(temporal), 52, 61, 79, 106
general index 183
alliteration, 52, 108
antithetitical style, 52
aphoristic style, 67, 104, 108, 163
article, omitted, 120, 138, 145, 163
asyndeton, 14, 52, 67, 88, 120, 163
compendious comparison, 120,
137, 143, 150, 160
compound verbs, 1415, 61, 70,
72, 89, 101, 103, 131, 134, 137,
141, n., 142, 151, 164
compression, ellipse, 6, 14, 15, 65,
67, 84, 85, 88, 90, 94, 120, 142,
148, 150, 161, 163
connective particles, 18, n., 57
dialect, Doric, 75
dialect, Ionic, 132, 144
didactic tone, 13, 15, 61, 67, 135
diminutives, 72
dual number, 62
epic expression, 144, 162
genitive absolute, 111, 133
jussive (imperatival) innitive,
1314, 61, 67, 68, 79, 88, 91,
99, 103
jussive subjunctive, 14, 91
metaphor, 69, 131, 134, 136, 156
oral discourse, 63
parataxis (compound sentences),
14, 52, 67, 163
participles, 13, 68, 81, 9091, 99
poetic tone, 143, 164
prepositions, 14, 131
pronouns, demonstrative, 14, 52,
56, 58, 79, 84
rhythm, metrical elements, 162
simile, 15, 149, 162
sux
(adjectival), 54, 5556
(substantival), 112
triadic expression, 67
variatio, 67, 143
surgery
cautery, 10, 11, 12, 16, 17, 18, 22,
26, 27, 49, 52, 63, 6467, 79,
89
cupping, 8, 11, 12, 16, 27, 96, 98,
100
cutting, 8, 11, 16, 21, 26, 66,
7879, 85, 88, 102
instruments, 12, 63, 70, 79, 8081,
89
phlebotomy, venesection, 16, 22,
52, 58, 70, 94, 95, 96, 97, 105,
108
scarication, 22, 24, 27
scraping, 12, 24, 63, 76, 7980
trephining, trepanation, 8, 9, 12,
16, 22, 27, 78, 81, 101104
Susruta, 22
syntax, see style
terminology, nomenclature, 120, 132,
135, 148, 151, 161
anatomical, 89
technical, 8, 12, 54, 112, 132
vocabulary, choice, 5455, 120,
162163
therapy, see also surgery
diet, 13, 79
environment, weather, 13, 22, 81
exercise, 79
fumigation, vapour bath, 81
ointments, salves, 8, 11, 12, 16, 22,
24, 52, 84, 98, 106, 107, 111, 112
poultices, 8, 12, 13, 107, 110
purging of head (errhines)
and body (emetics, enemas,
laxatives), 8, 10, 11, 12, 16, 22,
49, 52, 56, 76, 77, 78, 86, 95,
98, 100, 108, 109
Thrace, 120, 159, 168
throat, 130, 132
trachea, 119120, 129130, 145, 156,
160, 168
veins, see vessels
vessels, 10, 11, 6366, 69, 7374, 86,
95, 96, 129130, 135, 137140, 155
aorta, 136, 137138, 155
portal vein, 140141
splenic artery, 140
vena cava, 136, 137138, 139, 141
wool, 11, 78, 80
STUDIES IN
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