mluz@research.haifa.ac.il
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Menahem Luz
The Philosophical Background of Hippocrates'
On Nutriment
INCLUDED in the Hippocratic collection is a short text entitled On Nutriment (peri Trophes) - known under its Latin titles of de Alimento and de Nutrimento.1 This work discusses the meaning of nutriment and nutrition in an individualistic manner and raises a considerable number of problems regarding its philosophical and medical milieu. As other works in the Hippocratic collection, On Nutriment was ascribed in ancient times not only to Hippocrates, but also to his son, Thessalus; a second ancient guess assigned it to the Alexandrian physician, Herophilus.2 Modern scholars once gave it a late 5th century date and as such, several extracts from it are included in Diels-Krantz' section on Heraclitus under the heading of 'Imitation'.3 However, in 1936, Hans Diller published a revolutionary paper totally rejecting its early dating and consigning this work to a late post-Posidonian period.4 In his opinion, its Heracliteanisms were siphoned through the late Stoa. This conclusion has been continued among more recent scholars, who explained its style, vocabulary and Heraclitean thought as 'self conscious anachronisms'..5 More recently, Karl Deichgräber has compared its content to that of the pneumatic school of medicine,6 that was founded by Athenaeus of Attaleia in the 1st century B.C..7 Athenaeus himself was allegedly an immediate pupil of Posidonius, from whose theory of pneuma he is said to have developed his medical theories..8 However, I.G. Kidd felt there is much to be still corrected in our account of the relationship between Posidonius and the pneumatic school..9 Any clarification of the latter would of course have important implications for the background of On Nutriment. However, what I propose to do in this paper, is to re-examine the philosophical and logical background of this work without actually opening the issue of Posidonius and the pneumatic school. While the belief that On Nutriment is a purely 5th century work, can no longer be substantiated, I will attempt to show that its Heracliteanism and Sophist references are not late indirect Stoicisms and penumaticisms. Rather, many of the anachronisms in the author's style and vocabulary can be put down to later glosses on an earlier strata of this work. After a preliminary examination of the criticisms leveled against it, I will finally examine the ideas that this work raises in relation to 5th century thought. In this way, I hope to reestablish its value as a text for elucidating later fourth century writers.
Those seeking a pneumatist origin for On Nutriment make much of its statement that "pneuma too is a nutriment" (sect. 48). However, it also mentions heat, moisture and dryness as important for conveying trophe in addition to pneuma.10 Furthermore, while pneuma is indeed considered an arche trophes, or principle of nutrition, this same passage also speaks of the moist and the dry nutriment as principles as well:
xxx )Arxh\ trofh=ç pneu/matoç, r(i=neç, sto/ma, bro/gxoç, pleu/mwn, kai\ h( a)/llh diapnoh/: a)rxh\ trofh=ç kai\ u(grh=ç kai\ chrh=ç, sto/ma, sto/maxoç, koili/h: h( de\ a)rxaiote/rh trofh\, dia\ tou= e)pigastri/ou, h(=| o)mfalo/ç.
"Principle of nutriment of breath - nostrils, mouth, throat, lungs and the remainder for exhalation. Principle of moist and dry nutriment - mouth, stomach, intestines. The earliest principle of nutriment - is through the epigastrium where is the navel"..11
I would then suggest that we do not consider the role of the pneuma in this work as exclusively unique to the detriment of the other elements, but that all four elements play a part in the nutrition of specific organs.
Secondly, Diels was correct to regard On Nutriment as an imitation for it copies not only the Ionic language of Heraclitus, but also his more famous epigrammatic, enigmatic style. This is true whether one is of the opinion that On Nutriment belongs to a Stoic milieu, or a much earlier one. The author expresses his thoughts in a list of largely independent clauses, in which he describes the sense and effect of nourishment by means of parallelism and antithesis in a typically succinct Heraclitean manner. For example, one immediately thinks of a resemblance between On Nutriment (sect. 8-9):
viii: Trofh\ de\ to\ tre/fon, trofh\ de\ to\ oi(=on, trofh\ de\ to\ me/llon
ix: a)rxh\ de\ pa/ntwn mi/a kai\ teleuth\ pa/ntwn mi/a, kai\ h( au)th\ teleuth\ kai\ a)rxh/."
"(8) Nutrition is that which nourishes, nutrition is that which is the sort to nourish, nutrition is that which is about to nourish (9) The beginning of all is one and the end of all is one - and the same is the end and the beginning"
and the style and ideas behind Heraclitus' famous line (Vorsokr. 22B10):
e)k pa/ntwn e(\n kai\ e)c e(no\ç pa/nta
("From all things one and from one all things")
Here we find the same cyclical antithesis: the beginning and end is identical and one. However, in the case of On Nutriment the author wishes to state that trophe has a present potential (hoion) as well as a still non-actualised future which in reality end at the same point. If we leave the discussion of the ideological milieu of this work, we should note that a more sophisticated explanation of this Heraclitean line is immediately appended to section 9:
x "kai\ o(/sa kata\ me/roç e)n trofh|= kalw=ç kai\ kakw=ç dioike/etai, kalw=ç me\n o(/sa proei/rhtai, kakw=ç de\ o(/sa tou/toisi th\n e)nanti/hn e)/xei ta/cin.
" (10) - that is: of all that by item are arranged well or badly in nutrition, the aforementioned are done well, - and those that have a contrary arrangement to these are done badly"
As we see from the phrase the aforementioned' (hosa proeiretai), this clause is intended to explain the two previous sentences. Thus its opening kai should be understood as explanatory rather than supplementary. These lines thus are intended to explain how trophe is both initial nutriment with a potential for being digested and absorbed as long as it is arranged properly - but trophe can also turn out to be the opposite of that which is absorbed.
The opening words of On Nutriment in fact present us with a very similar problem:
(1) Trofh\ kai\ trofh=ç ei)=doç, mi/a kai\ pollai/: mi/a me\n h(=| ge/noç e(\n, ei)=doç de\ u(gro/thti kai\ chro/thti: kai\ e)n toute/oisin i)de/ai kai\ po/son e)sti\ kai\ e)ç ti/na kai\ e)ç tosau=ta.
"(1) Nutriment and type of nutriment: one and many. One in as much as it is one class, type in its moistness and dryness. That is in things of this sourt there are forms, quantity, purpose and quantitive results."
Hans Diller of course suggested a post-Aristotelian milieu for this section.12 Undoubtedly, there is a discussion of the category of quantity and perhaps even the concept of telos (final cause) hides behind the word es tina (to what purpose). However, this explanatory clause is meant to interpret the totally different style of the first sentence with its Heraclitan antitheses of one and many and its enigmatic expressions of 'nutriment and type of nutriment'. I would thus suggest that once again kai separating both clauses be considered explanatory and preceding a type of gloss, whether written by the author himself - or as I will suggest, by a later post-Aristotelian interpretor.
Finally, let us then take some briefer examples of a different type. A number of disconnected sections contain only one, short independent clause. This time, each clause is not antithetical but nonetheless burgeoning Heraclitean enigma:
xiii: Duna/mioç de\ poiki/lai fu/sieç ("Of potency, varied natures")
xv: Fu/siç e)carke/ei pa/nta pa=sin ("Nature is sufficient for all in all")
xviii Farmakei/h a)/nw kai\ ka/tw, kai\ ou)/te a)/nw ou)/te ka/tw ("Purging upward and downward, and neither upward nor downward")
Although its philosophy is different, the last line especially may remind us of Heraclitus' enigma: "there is one way that is the same both upwards and downwards" (Vorsokr. 22B 60). However, what I wish to stress at this point, is that here too these independent enigmas are each supplemented by a prosaic explanatory line. In section 18, for instance, we find that it is followed by an independent sentence in a totally different style:
(19) )En trofh=| farmakei/h a)/riston, e)n trofh=| farmakei/h flau=ron, flau=ron kai\ a)/riston pro\ç ti/. ("In nutrition, purging is best, in nutrition purging is bad - both bad and best are relative")
We may immediately note that these line are meant to explain line 18 giving it a relativistic meaning. In fact, Diller says that the author's use of the term pros ti - 'in relation to' - is a sign of its post-Aristotelian origins. However, if section 19 is an explanatory gloss on section (18), then we may understand that while it may be post-Aristotelian, it is by no means obvious that section 18 belongs to the same date. Similarly, section (14) discusses the various potencies of humours and is thus an supplementary explanation of section (13) on the various natures of potency. Section (16) similarly supplements how nature is sufficient for all, defining the clinical means to assist nature.
What I would like to suggest is that these sudden changes of style from Heraclitean enigma to more prosaic hermeneutics and back to enigma, should be explained as the result of later explanatory insertions. It remains then for us to see whether this change of style belongs to the original author, or to a different period.
Both Diller and Deichgräber have given us a detailed analysis of the vocabulary of de Nutrimento with particular emphasis on its late Hellenistic terminology. Their conclusions are that the work shows the influence of post-Aristotelian, if not Stoic philosophical theory - as well as of (pneumatic) medical theory from the Roman. Some of their examples are undoubtedly late including words like: eu)ana/sfaltoi and dusana/sfaltoi - "those who recover easily/with difficulty" (sec. 28) 13 but here again they occur in the second explanatory clause of the section rather than in the prior Heraclitean section. The same may be said for the term Flebw=n diasfu/cieç ("pulsations of veins"; sec. 48) - but here the term and the following discussion of breath is in reality an entire explanatory clause relating to the preceding Heraclitean styled clause (47): )Afaire/ei kai\ prosti/qhsin ou) twu)to\, tw=| me\n a)faire/ei, tw=| de\ prosti/qhsi twu)to/. "(Nutriment) takes away and add not the same thing - from one it takes, from another it adds the same thing").
A closer examination of the text will reveal that many of the late terms may be relegated to the additional explanatory glosses on the preceding clause written in an entirely different Heraclitean style. I would then like to suggest that On Nutriment be divided into strata: an earlier stratum influenced by Heraclitus and perhaps belonging to the late 5th century; and a later hermeneutic section that was influenced by Aristotelian terminology and Stoic theory.
We can now ask ourselves in what way the earlier strata of this work imitated earlier philosophical theory. His work attempts to explain physiological phenomena in a consistent and coherent fashion, with no reference to supernatural causes. In this it follows the fine tradition of other early works in the Hippocratic corpus.
There is good reason to suppose that the primary philosophical tradition, on which the author of On Nutriment drew, was a late development of the physiological side of Heraclitus' theories. We certainly know of philosophers like Cratylus who revived Heraclitus' doctrine at the very the period when 'On Nutriment ' was being composed. It is possible that the author simply adapted aspects of this Heraclitean revival in order to construct his medical theory. As we have seen, both he and Heraclitus use the same philosophical principle of cyclical flux, expressed in the same epigrammatic, non-sequential style. Certainly, Heraclitus' original 'flux' hypothesis - that reality is in a constant state of changing flow (rhein). 14 - clarifies much of the author's explanation for the constant flow (syrrhoia) of Nutriment throughout the body (cap. 23). It is true that Diller finds fault with this term as late, but it is difficult to believe that it emerged only in the Hellenistic period. Furthermore, according to Heraclitus, even individual physical objects are in a state of constant change between opposite qualities, passing from hot to cold and cold to hot, from disease to health and health to disease (22B 61). There is no absolute or determined natural characteristics, for the flux changes in accordance with time and in relation to the subject:
"Sea: pure and impure waters - drinkable and healthy for fish, but undrinkable and noxious to man" (22B 61).
In this way, Heraclitus propounded the theory that "there is one way that is the same both upwards and downwards" (22B 60). Following this, the author of 'On Nutriment ' speaks of the 'road up and down' (45) and describes purging as "upward and downward, neither upward nor downward" (18). He also describes Nutriment as like a stream reaching all parts of the body (7, 21, 24). Its flux turns solid to moist for "Moisture is the vehicle (ochema) of Nutriment " (cap. 55). Furthermore, this flux is a constant cycle: "The great principle (arche) will reach the final part (of the body), and from the final part it will reach the great principle, for one nature is to be and not to be" (24). In this way, Nutriment is like a stream that is born to every body part along with the blood, the phlegm and air (cap. 48). Like Heraclitus, the author bases his arguments on relativistic principles, here applied to clotting blood and thin blood:
"Blood is moist, blood is solid. Moist blood is good, moist blood is bad. Solid blood is good, solid blood is bad. Everything is good and everything is bad by relation" (44).
Hence he draws the conclusion that "Nature is sufficient in everything for all" (15).
The tradition that he follows was not only influenced by philosophy, it also influenced it in its turn. The author based his medical theory on the principle of corporeal 'powers' (dynameis), or potencies:
"(Nutrition) resemble a power (dynamis) when it enters (the body) and takes control - and the (nutriment) found there previously is controlled (by it)" (3).
W.H.S. Jones was of the opinion that its theory of dynamis is entirely consistent with On Ancient Medicine.. 15 The author in fact understands nutrition as a holistic power, on which all the body parts are dependent:
"The power of nutrition reaches the bone and all its parts, as well as to the sinew, the artery, muscle, membrane, flesh, fat, blood, phlegm, marrow, brain, spinal marrow, the intestines and all their parts - as well as to the heat, breath and moisture (7).
We may then assume that the power of nutrition is prior even to the four elements of heat, cold, moisture and solid that are fed by it. This hypothesis is totally different from that of On Ancient Medicine, where it is assumed that the four elements are corporeal powers in themselves. As is well known, Hippocratic dynamis is mentioned in Plato's Phaedrus (270d), where Socrates attempts to adapt medical methodology for the dialectic in hand. A loose comparison may be made between the hypothesis of dynamis in On Nutriment and Aristotle's theory of 'potentiality' (dynamis). The latter is inherent in every substance whose potential (en dynamei) characteristics have the power to change to actuality (energeia). Aristotle's standard example is that of a seed that has the potentiality to grow into a tree. Moreover, as the author of On Nutriment, Aristotle also holds that potentiality is prior to the four basic elements (De Generatione et Corruptione 329a25-30). Finally, On Nutriment also employs three terms that became basic concepts in Platonic and Aristotelian philosophy: genos and eidos (caps. 1, 7). However, in this case, it can be argued that the medical use of these terms followed that of earlier fifth century philosophical discussion.
This short work then raises a number of interesting parallels with 5th century and mid-4th century philosophy. It is difficult to reconcile this with the late date of the glosses, which would surely have affected the historically earlier sections. It would be nice if scholarship were to return this little gem of ancient medicine to its original fifth century milieu, recognising its value as an imitation of the classical period.
Notes
1 Text in: R. Joly, Hippocrate VI (Budé; Paris, 1972). Earlier editions (as the Teubner and the Loeb) are marred by 'supplements' incorporated into the text that are derived from the fragments of four commentaries on this work ascribed to Galen (XV. 224-417 Kuehn), but which are now widely believed to be Rensaissance forgeries (Hans Diller, 'Eine stoisch-peneumatische Schrift im Corpus Hippocraticum' in: G. Baader - H. Grensemann, Kleine Schriften zur antiken Medizin (= Ars Medica II; Berlin-N.Y., 1973), 17; Karl Deichgräber, Pseudhippokrates ueber die Nahrung (Akademie der Wissenschaften und der Literatur Mainz;1973, Wiesbaden), 11).
2 Its ascription to Hippocrates is implied in many sources (e.g., Aul. Gell. III. xvi.7-8). On questions of surmised ascriptions to Thesallus, see: Ernst Diehl, 'Thessalos' (5) in: PW XI.2 s, 168. On Herophilus, see: Heinrich von Staden, Herophilus: The Art of Medicine in Early Alexandria (Cambridge, 1989), p. 84 fr. T36a-b.
3 Cf. Diels-Kranz, Fragmente der Vorsokratiker I (Dublin-Zurich, 1968), 22C2 quoting the opening chapters as 'imitation' of Heraclitus. W.H.S. Jones accepted this early date in his edition of the work: Hippocrates vol. 1 (Loeb; Harvard, 1923) pp. 342-361
4 Republished as: Diller (1973), 17-30.
5 Some ascribe it a 1st century B.C. origin (Deichgräber (1973, 82). Consequently, both the ascriptions to Thesallus and Herophilus have been dismissed (von Staden (1989), 76-77).
6 Deichgräber (1973), 80-81.
7 See: Der Neue Pauly 2, s.v. 'Athenaios (6)'. The school was later represented by 1st century A.D. eclectic Agathinus of Sparta and the 2nd century 'Archigenes' (ibid., 1, s,v, 'Agathinos', 'Archigenes').
8 I.G. Kidd has expressed doubts, although not concerning Posidonius' influence on members of the pneumatic school (Posidonius II. The Commentary (Cambridge, 1988), pp. 42-43).
9 Kidd (1988), II. 43, noting the case of the fragment's confusion with a much later medical writer, by name of Posidonius (p. 94).
10 Sects. 7, 23, 31 (pneuma is one of the four elements), 30, 48 (along with the elements it is a nutriment), 49 (digestion of moist and dry nutriment).
11 Unless otherwise stated, all translations are my own.
12 Diller (1973), 18.
13 Diller (1973), 19.
14 Diels-Kranz, Fragmente der Vorsokratiker I (Dublin-Zurich, 1968), 22B12.
15 Jones (1923), 338-339.