Medicine Between Natural Philosophy and Physician's Practice: A Debate Around 400 BC

  • Oliver Primavesi
Part of the International Library of Ethics, Law, and the New Medicine book series (LIME, volume 44)

“Sanguine, phlegmatic, choleric, melancholic types”: in this classification of the four temperaments survives a doctrine that influenced Western medicine into the nineteenth century, the doctrine of the four homours, blood (haima, lat. sanguis), phlegm (phlegma), yellow bile (chole) and black bile (melaina chole), the ratio of which was thought to cause health and sickness. This chapter tries to reconstruct the debate that resulted in this doctrine. This was a medical discussion of methods that occurred at the turn of the fourth century BC concerning the epistemologicalfoundations of medicine, namely its relation to the natural sciences. The battle lines in this debate were drawn up differently than we might expect today: on one side were sober practitioners who were equally averse to religious fantasies and the construction of scientific theories, and on the other a philosophical poet, who had many traits of a world-redeeming guru, and yet at the same time laid the basic foundations for the physical theories of the ancient world.


Living Thing Essential Form Ancient Medicine Black Bile Yellow Bile 
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  1. 1.
    Epicrates, frag. 10 Kassel/Austin, lines 27–29.Google Scholar
  2. 2.
    Wellmann (1901: 68–69) presumes that Philistion was actually not the physician of Dionysius II, but Dionysius I. That would bring him one generation closer to Empedocles.Google Scholar
  3. 3.
    Empedocles is cited according to the collection of fragments by Diels and Kranz 1951; fragments preceded by B contain original texts, those by A ancient testimonies about Empedocles.Google Scholar
  4. 4.
    Wellmann (1901: 29–31), note 1 to p. 29; Burnet (1892: 201–202); Jouanna (1961).Google Scholar
  5. 5.
    Here and in the following, Empedocles is cited according to the numbers in the Diels-Kranz collection 1951, with A (for testimonies) or B (for original fragments).Google Scholar
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    B 17, 7–8; B 20, 2–5; B 21, 7–8; B 26, 5–6.Google Scholar
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    A 49 (ii) (Aetius); B 50 (ascent of the fire); B 55 (the sea sweated out by the earth).Google Scholar
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    Aristotle, Nicomachean Ethics 8, 2; 1155 b 6–8. Cp. Aristotle, Eudemian Ethics 8, 1, 1235a 9–12.Google Scholar
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    For a long time this text was read in an expanded version which, if it were original, would lead to the conclusion of Jouanna (1961: 453) that the author also accepted Empedocles' theory of the four elements. But Diller (1936: 372 = 148 with n. 18) already showed that this expansion is not authentic, but was introduced into a late Greek manuscript (Paris. gr. 2255 = E) from the Latin translation of Calvus (Rome 1525) via the Greek text of Cornarius (Basel 1538).Google Scholar
  10. 10.
    Jouanna (1992 : 552).Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Oliver Primavesi
    • 1
  1. 1.Professor, Institute for Classical Philology Ludwig Maximilians University MunichGermany

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