Chapter 3 - Moral Medicine

Summary

This Chapter explains in detail how Galen endows medical science with moral probity. In broad outline, he extrapolates moral principles from his ethical programme to feed into his medical accounts and thus reveal his personal responses to what he represents as the immorality of other doctors. Assigning praise and blame or stressing social shame and fear are central moral-didactic devices here, as is reproach with a view to moral amendment or Galen’s attempts at self-deprecation in order to affect his readers’ moral activity.

Galen’s most penetrating engagement with ethics in works not clearly designated as ethical surfaces in accounts that explore his perception of a contemporary decline in medicine. This recurrent complaint in his oeuvre intersects with that of medical practitioners’ lack of suitable training and the related issue of the difficulty of demonstrating medical methodology to be grounded on robust logical foundations. Interestingly, in Galen’s opinion, at the root of this sad state of affairs were defective passions, either by being destructive of the proper function of the medical art tout court, or, on a more complex level, as symptomatic of an intense antagonism between Galen and others, which would eventually highlight the moral depravity of the science and society of his day. The ‘others’ are Galen’s medical opponents, but most frequently they are sophists, either in the literal, operative sense (as per the title of Philostratus’s Lives of the Sophists) or metaphorically as cunning doctors, following the Platonic interpretation of sophists as practitioners of devious, over-elaborate and dishonest arguments, as we will see in more detail in Chapter 7.

But what issues does this ‘otherness’ entail for Galen? What exactly is his problem with the members of this group that he has placed in the artificial category of people who get everything morally and intellectually wrong? For one thing, he says they are ignorant, lazy and liars. Furthermore, they nitpick and prattle excessively, waste their time in unproductive quarrelling over words and their meanings, make misjudgments, yield to self-contradictions and mislead inexperienced people through invalid arguments.¹ In a nutshell, they fail to obey the rules of Galen’s authentic science, characterised by a firm commitment to truth, accuracy, clarity, economy and hard work. It is from this critical dichotomy that Galen’s ethical concerns flow, when he aspires to see scientific research uncontaminated by love of discord, spite and other corresponding vices that instigate the degraded version of science described above. For Galen medicine should be above all a moral art, just as he claims to have professed and practised it himself. This is at odds with the Stoic mindset represented, for example, by Diogenes of Babylon in Cicero’s On Duties 3.51-64 in the context of a celebrated discussion about the morality of the merchant. Here a technē and its practitioners are said to be immune to moral uprightness, provided that their ministrations produce an end that is beneficial to life. Galen’s own view is radically different, contending as he does that the usefulness of a craft or a profession should always be enmeshed with the honourable, and especially so for medicine. This moral viewpoint is captured in Galen’s idealised perception of himself as a cleanser or purifier of other people’s souls, always allowing truth to prevail (καθαρὸν ἤδη τῇ ψυχῇ τὸν ἀκροατὴν ἔχων, SMT 1.40, XI.457.17-458.2 K.), in imitation of his idol Hippocrates (καθαρὰν ἐργασαμένῳ τὴν ψυχήν, Hipp. Art. 1.6, XVIIIB.340.16-19 K.).

Galen’s subjective description of the lamentable failure of medicine is not just a rhetorical technique for publicising his superiority in relation to his colleagues. Rather, it has a strong philosophical basis, which leads me to argue here and in what follows in favour of it being part of his programme that advocates for a moralising kind of medicine. In The Capacities of the Soul Galen (taking his cue from Posidonius) is realistic enough to accept that vice is endemic within us and thus cannot be wholly eliminated.² For that reason, rather than trying to avoid associating with wicked people, he suggests going down the more pragmatic route of connecting with individuals who can purge and prevent the spread of vice (QAM 11, 86.11-87.2 Ba. = IV.820.9-13 K.). This advice evokes Galen’s self-identified role as a cleanser of wicked souls in the SMT passage cited above, something that makes more sense if we bear in mind Galen’s heavily didactic persona throughout QAM as a whole (Chapter 2).

Another factor that, according to Galen, can mitigate vice (besides the mediation of a cleanser) is reproach (elenchos), namely criticism that exposes aberrations (often in displeasing ways) with a view to bringing about moral progress.³ In developing a kind of history of societal vice in the introduction to The Capacity of Cleansing Drugs, our author opines that in the past the problem of vice was far less acute than in the Imperial period, when it had proliferated,⁴ because in earlier times reproach had obliged people to check their wicked thoughts, dishonourable actions and injustice (Purg. Med. Fac. 1, 1.2-2.1 Ehlert = XI.323.1-324.5 K.). We will see with reference to the Affections and Errors of the Soul in Chapter 6 that reproach is one of the main obligations of the critical supervisor, another role that Galen attaches to his set of ethical activities targeted at the healing of vice, whether communal or individual. As has become clear, in order to shield medical science from degradation, Galen fits it with safety valves, unwritten rules, as it were, which he draws from the moral programme expounded in his ethically-oriented tracts.

We will now go on to investigate some examples in which Galen comments on the improper manners of doctors and/or sophists. The crucial element here is that he consistently expresses his moral responses to such manners, ranging from blame and hatred to revulsion and indignation. The first example comes from Good Humour and Bad Humour and explains the circumstances under which one can justly attract moral disapprobation. As far as Galen is concerned, we should generously forgive (πολλὴν συγγνώμην νέμειν) and indeed sympathise with (συναλγοῦντας) people who could not exercise their capacity of discernment because they had not had good teachers. He regards their condition as a misfortune (δυστυχίᾳ), which should not incur blame, since it did not involve reasoned choice on the part of the agent (οὐ τὴν προαίρεσιν μεμφομένους, Bon. Mal. Suc. 1.11, 68 Ieraci Bio = VI.753.17-754.3 K.). Conversely, those who established schools of erroneous thought, driven by love of distinction (διὰ φιλοτιμίαν), did deserve to be hated (ἄξιοι δὲ μίσους εἰσίν, Bon. Mal. Suc. 1.11, 68 Ieraci Bio = VI.754.3-4 K.), and in this instance their errors and subsequent deception of other people are presented as the result of a calculated decision (ἑκόντες ἐξαπατᾶν … οὐκ ἄκοντες σφαλῆναι, Bon. Mal. Suc. 1.11, 68 Ieraci Bio = VI.754.3-6 K.). Likewise, Galen often proposes unrelenting censure, especially when contentiousness and imprudence are displayed by medical practitioners (ἀσύγγνωστος ἡ φιλονεικία, τάχα δ’ ἀληθέστερόν ἐστιν εἰπεῖν, ἀναισχυντία, Loc. Aff. 3.7, VIII.167.1-11 K.). These instructions on when to show forgiveness and when to blame are in line with Galen’s frequent references to praiseworthy or blameworthy attitudes in Character Traits; and they are used throughout his medical texts too to inform his audience’s responses to problematic behaviour. He also achieves this by labelling detestable agents or predilections with derogatory denotations, such as ‘accursed’ sophists⁵ or a ‘scurrilous’ desire for reputation.⁶

On other occasions, Galen is keen to raise awareness of the potential risks or serious corollaries arising from certain moral positions in the context of medicine. In criticising the doctors Herodotus and Dioscorides for their contempt for sense-perception and attributing it to their contentiousness (διὰ φιλονεικίαν, SMT 1.35, XI.445.2-3 K.), Galen cautions that it is difficult to avoid their garrulity (ἔργον εἶναι φυλάξασθαι τὴν αδολεσχίαν αὐτῶν) and useless silly talk (ματαίας φλυαρίας). He goes on to stress that, once people have been perverted by these last two passions (τοὺς διεστραμμένους ὑπ᾽αὐτῶν), it takes a lot of effort to teach them anew (μεταδιδάξαι) and reform them (μεταλλάξαι). The gravity of such a quandary is further highlighted when the author lingers on the feeling of fear that this group of afflicted people must have felt, if they had been aware of the fraudulent theories on the capacity of simple drugs (SMT 1.36, XI.449.1-11 K.). Following his typical moralising pattern, Galen presents moral passions as disordering the proper workings of reason and increasing the emotional perplexity of those suffering from them. Indeed, even though his emphasis seems, strictly speaking, to be on the intellectual corruption of the victims, it is the moral vice of the victimisers that comes out most clearly in the passage, so that they will be disdained by Galen’s audience. To draw attention to the extent to which garrulity and nonsense can be irretrievably destructive, Galen aptly underlines the difficulty, if not impossibility, of intellectual and moral reversal.

The above examples promote a structured hostility to moral failing in the reader through the author’s narrative voice. In other cases, Galen’s recommended reaction to vice is communicated through the addressee, who is described as sharing Galen’s disapproval of dissolute conduct. The preface to Antecedent Causes showcases how some contemporary doctors and philosophers, seeking to establish their reputations but despairing of ever succeeding in the venture, resorted to showmanship and devised sophisms, or captious arguments. Galen focuses on the abundance of such sophisms in his world only to dismiss them with the ironical remark that ‘these wonderful sophisms’ ultimately made the medical art even longer than Hippocrates had originally assumed in his famous aphorism ‘The art is long, life is short’ (CP 1.2-6, 70.7-72.3 Hankinson). Nevertheless, the most patently moral response within the text is that of Gorgias, Galen’s addressee, who, according to Galen, laughs contemptuously at those doctors. Laughter (provoked by scorn and derision) at ethical deportment foreign to Galen’s personal morality is a commonplace in Galen, as we will observe in other Chapters. So, the addressee mirrors the author, who functions as his moral paragon, as indeed elsewhere, such as in The Composition of the Art of Medicine, where Patrophilus, following Galen’s example, is a lover of truth and eager to study medicine (CAM 135.1-6 Boulonge-Delattre = I.224.1-8 K.).⁷ The same Galenic technique may involve intratextual characters on other occasions, as we will see with Eudemus in Prognosis in Chapter 8.

Another method with a profoundly moralising intent in the medical texts is the personal opposition that Galen sets up, in order not only to show his rejection of ethical weaknesses in others but also to emphasise his moral self by contrast. This technique betokens how significant the autobiographical component is in Galen’s practical ethics, an observation that underlies the thesis argued for in the light of Avoiding Distress in Chapter 4. Galen’s aversion to specific vices is frequently articulated through a stated wish that his peers had acted differently: ‘I wish they would stop their vain love of strife’ (ἂν εὐξαίμην παύσασθαι ματαίου φιλονεικίας, SMT 1.39, XI.455.6-7 K.; transl. mine). In Fullness the device of a stated wish takes on the subtler form of an entreaty that reveals Galen’s own solution to the grievance and anger (ἄχθονται … ὀργίζονται) occasioned by love of strife, which is simply to feel drawn to like-mindedness (homonoia) (ἡμεῖς οὖν ἀμφοτέρους τε εὐξάμενοι παύσασθαι τῆς φιλονεικίας εἰς ὁμόνοιαν παρεκαλέσαμεν …, Plen. 2, 30.17-18 Otte = VII.520.4-8 K.).

In a context stressing the conceptual ambiguity of Galen’s era due to the competition among sophists and the prevalence of fallacies, the ‘wish’ technique is again deployed (Diff. Puls. 1.1, VIII.493.1 K.), this time to dismiss the way the doctors succumb to meddlesomeness (πολυπραγμονοῦντα), rashness (τολμῶντα) and disparaging (καταμεμφόμενον) (Diff. Puls. 1.1, VIII.497.3-5 K.). All the above vices Galen attributes to the sophists’ special area of activity (οἷα δὴ δρῶσιν οἱ σοφισταί) and makes them superfluous to and outside the remit of medicine (περιττὰ γὰρ ταῦτα ἅπαντα καὶ ἔξω τῆς ἡμετέρας τέχνης, Diff. Puls. 1.1, VIII.497.5-6 K.), which Galen conceptualised as being concerned with the correctness of things, not of names (Diff. Puls. 1.1, VIII.487.7-8 K.).⁸ At another juncture in the same work, the otiose use of definitions, which Galen tendentiously blunders as a sophistic practice under the Empire, is contrasted to the Greek custom of employing clear language, which Galen so wholeheartedly endorses as to call it the moderate and philanthropic choice (ἡ μὲν ἡμετέρα προαίρεσις τοιαύτη, μέτριος, ὡς νομίζω, καὶ φιλάνθρωπος, Diff. Puls. 2.2, VIII.1-16 K.). Once more, Galen parades his moral self by means of opposition and identifies it with philosophical uprightness and benevolence, so that when he informs us that his choices attracted the insolent reactions from the sophists, readers would have already been inclined to favour his preeminent character while condemning those he presents as his moral inferiors.

It is on this distinction between his philanthropy in displaying sensible use of definitions and other physicians’ over-the-top talkativeness (ἀδολεσχία) that Galen bases himself when he invents the negative passion of fondness of definition (φιλοριστία) – a hapax legomenon in antiquity – as a feature of the world in which he lived. Driven by the express opinion that obscurity is so prevalent in his day that even three lifetimes would not be enough for the acquisition of knowledge (Diff. Puls. 3.1, VIII.637.9-12 K.), Galen attributes φιλοριστία not just to doctors, most notably Archigenes (τὸ τῆς φιλοριστίας ἐπενείματο νόσημα, Diff. Puls. 4.1, VIII.698.3-6 K.), but also philosophers, orators, musicians and grammarians (Diff. Puls. 4.17, VIII.764.1-12 K.).

The inference to be drawn from these passages is that Galen differs radically from those suffering from the vice of φιλοριστία. Even though he seems to abstain from this and other deplorable qualities, however, Galen sometimes adopts the very practices that he censures in others, including the periodic adoption of an insolently polemical tone. This feature of Galen’s personality has been addressed in scholarly publications, but the extent to which it has been deemed an idiosyncratic aspect of his character has been overstated, given that the epideictic culture of the period would have experienced many other examples of similar acerbic polemic. If seen from the point of view of practical ethics, with which I am concerned here, Galen’s harsh criticism of morally despicable actions is consistent with the curative effects attributed to reprimand in other moralists. Plutarch, for example, argues that any gibe targeted at the improvement of character (πρὸς ἐπανόρθωσιν ἤθους) should be accepted mildly and treated as constructive criticism by an educated and liberal man (On Listening to Lectures 46C-47B). Likewise, the rebuke designed to elicit pangs of conscience and repentance is considered both kindly and healing (θεραπευτικός) (Political Precepts 810C; cf. 803C).⁹ Dio of Prusa’s Oration 8.5 is in the same spirit. This explanation might therefore offer a new reading of Galen’s adoption of polemics. Rather than understanding it as a self-contradiction (by assailing others Galen is not practising what he is preaching),¹⁰ this analysis marks out the moralising potential of Galen’s deployment of censure, which has a philosophical origin and practical orientation. As such it could be deemed part of the ‘co-operative ideals’, an umbrella phrase coined by Jason König to amend the one-sided scholarly focus on the competitive value-system of Greek medicine, of Galen’s character and work.¹¹

It is, then, within the tradition of a morally beneficial polemic that Galen’s attack against Thessalus, the founder of the Methodists, may also be construed, despite its agonistic implications. As we will observe in more detail in Chapter 8, Galen’s main issue with Thessalus is his brashness, attested in the disgraceful views he held regarding the attainment of medical qualifications (a science he thought could be taught within a mere six months) and the role of bygone authorities in medical theory and practice (he notoriously despised Hippocrates, considering himself distinctly superior to the father of medicine). By the same token, it is Thessalus’s infuriating shamelessness that motivates Galen to arm himself with weapons familiar to Thessalus himself:

Nevertheless, such a man feels no shame when he awards himself the crown. Accordingly, I think it falls to me to say something to him regarding his insolence toward the ancients, although it is certainly not my custom to refute harshly those who are foolish.¹²

MM 1.2, X.8.10-13 K.; transl. Johnston and Horsley

We have already noted that transformative reproach is part and parcel of Galen’s tool kit as a moral supervisor, and that he exonerates it from blame, so as to make it a fundamental medium of his moralism. Yet why Galen denies that it is his custom to reproach the guilty in the passage above remains a mystery. Why does he feel the need to apologise for his reprimand, given that he could have easily vindicated it, as argued above?

Another polemical intertext might illuminate the issue. In Against Julian Galen indicts the Methodist Julian for unabashed over-talking, insolence and recklessness, comparing him with Thessalus. Galen states that it is for the purposes of reproaching (ἐλέγξειν) a stupid, ignorant man who pretends to wisdom and prattles all the time that he will use harsher words than he normally would (Αdv. Jul. 2, 39.4-8 Wenkebach = XVIIIA.254.7-12 K.). So, again, he pleads for the audience’s forgiveness, requesting that they do not blame him for his chastisement (ὅπως μὴ καταγνωσθῶ πρὸς τῶν ἀναγνωσομένων αὐτά, Αdv. Jul. 2, 39.3-4 Wenkebach = XVIIIA.254.6-7 K.). Just before this section of the work, Galen had also likened Julian to Thersites, an epic character commonly known for his garrulity (ἀμετροεπίαν) and interminable argument (ἀπεραντολογίαν), stressing that he needs an Odysseus to chastise him with corporal punishment (Αdv. Jul. 2, 38.8-15 Wenkebach = XVIIIA.253.11-254.11 K.). As the text makes clear, this Odysseus is not Galen, for in the light of the previous passage, Galen opts for moral correctives, elenchus (ἐλέγξειν), rather than physical violence. This source shows that Galen expands the semantic range of elenchus beyond its conventional meaning of argumentative refutation of the Socratic model, to promote its usefulness as moral criticism, as in the other instances we have seen. A possible answer, then, to the question of why Galen was inclined to apologise for deploying elenchus is that in this way he created the impression of a non-vitriolic and therefore moderate (by contemporary mores) man, who was forced to engage in practices he did not normally indulge in, owing to the extreme failings of others. Indeed, Galen very often admits in frustration that he has been pushed over the edge to respond in unwanted ways to the vices of his foes (SMT 3.10, XI.560.15-17 K.; Diff. Puls. 4.1, VIII.696.5-13 K.).¹³ I shall return to this later.

In Julian’s case, Galen declares it dreadful (δεινόν) that Julian is allowed to abuse the most well-educated scholars of antiquity, whilst he himself is unable to reproach the Methodist’s enormous lack of culture (ἀπαιδευσίαν) (Αdv. Jul. 2, 39.7-10 Wenkebach = XVIIIA.253.11-254.12-16 K.). ‘Desperate times’ indeed ‘called for desperate measures’,¹⁴ to use Hankinson’s phrase, though, unlike Hankinson, the emphasis of my argument is on the fact that Galen’s rhetorical extravagance often serves serious moralising ends.¹⁵ For this rhetorical ploy of apologising demonstrates the urgency and social utility of Galen’s moralism. Through his self-deprecating attitude, Galen both gains his audience’s benevolence as an ethical exemplar and directly leads them to assimilate it as they distance themselves from other people’s cardinal sins. At the very core of this technique lies a strong comparative element that fuels Galen’s apology, reminiscent, for example, of the Plutarchan synkriseis appended to the paired biographies of prominent Greek and Roman men. These are prototypical examples of how comparison in works of the Imperial era could have an ethical payoff. Galen’s audience are meant actively to internalise recommended lifestyles after examining conflicting manners. That is what we have seen happening in Chapter 1, in cases where readers would have responded actively to the text by weighing opposing groups of moral agents against each other before judiciously espousing one of them.

Interestingly, the critical abilities expected of Galen’s readers were the result of a proper education, which entailed the additional advantage of emotional stability. This idea is explored by Galen in passages that associate lack of culture with ineffectual management of passions. For example, in the Commentary on Hippocrates’s ‘Nature of Man’, we learn that Galen’s exegetical work remains unappreciated by uneducated readers who are driven by envy and slander (HNH 1. proem. 9.15-18 Mewaldt = XV.13.8-12 K.);¹⁶ and, along similar lines, in Affected Places lack of education (ἀπαιδευσία) produces powerful psychic emotions (Loc. Aff. 5.1, 288.26-27 Brunschön = VIII.301.17-18 K.). Galen, then, conforms to the trend in the Imperial period for considering moral and intellectual shortcomings to result from a deficient philosophical learning, and he aligns himself squarely with what is advocated in contemporary moral works, namely that true education (paideia) engenders happiness (eudaimonia).

The tactics of self-humbling for moralising effect becomes more sophisticated in other works. In the passage from Semen below, Galen exposes an alleged personal weakness to engage his audience’s sympathies, and then to raise it to the status of a virtue:

Then I decided, as a second course, to go to women, inquiring of those who seemed the more self-observant whether what happened in their case appeared similar to what happened in irrational animals; I would censure myself in this—why shouldn’t I tell the truth?—if I supposed that conception differed at all in an irrational and a rational animal; and yet I wanted to know whether they followed what was taking place. I discovered more than I had hoped, so that I did not regret my curiosity.¹⁷

Sem. 1.2, 66.1-7 De Lacy = IV.514.7-15 K.; transl. De Lacy

Polypragmosynē, meddlesomeness or indiscreet curiosity, is a common conceit in the ethical literature of the Second Sophistic.¹⁸ Far from being a mere foible, it constitutes a reprehensible moral trait, a malady, as Plutarch’s eponymous treatise makes clear:

Curiosity is a desire to learn other people’s ills, a disease which seems to be free from neither envy nor malice:

‘Why do you look so sharply on others’ ills, malignant man,

yet overlook your own?’¹⁹

Plutarch, On Curiosity 515D²⁰

In Galen’s scientific discussions, the same trait signifies a positive attribute for a doctor, that is to inquire closely (πολυπραγμονήσας) into the patient’s environment (e.g. Hipp. Epid. VI, 4, 8, 200.4-6 Wenkebach = XVIIB.139.3-5 K.).²¹ However, as a moral characteristic, Galen considers it to be negative, judging by his admission in the passage quoted above that he did not regret his curiosity, and the generally remorseful tone with which he describes that quality. In particular the shrewd aside ‘Why shouldn’t I tell the truth?’ engages the audience’s goodwill, so that even before Galen stresses the fruitful outcome of his moral curiosity, readers have sided with him, because he has been depicted as a man endowed with self-knowledge and the stamina to disclose his failings. Intriguingly, the way in which he solicits the reader’s endorsement in this passage seems to build on similar sentiments expressed in the opening of Semen, where Galen makes another personal confession:

Someone may censure me for this, but I confess to my own passion, a passion that I have had all my life: I have not trusted any of those who report such things until I have tested for myself what it was possible for me to test. So in this matter too I was not going to put my trust solely in those who claim to have been eye-witnesses … and by exercising my customary disbelief, I conducted a double test …²²

Sem. 1.2, 64.20-26 De Lacy = IV.513.15-514.4 K.; transl. De Lacy, revised

Just as being a busybody may arouse social blame, so too may being a disbeliever, and so Galen humbly acknowledges his putative moral flaw only to progressively authorise it through self-deprecation.

Galen admits to other, more grave mistakes. In the Elements According to Hippocrates he narrates, in a lively exchange of the Platonic type, how as a youth he succumbed to fallacies. Even if Galen comes across as a sophist in this episode, it does not detract from his overall loathing of sophistic practices, already discussed above. Conversely, his moral lapse is amply revealed only to be ultimately rejected. The passage in question comes from a setting in which an instructor converses with Galen on Athenaeus of Attalia’s (in Galen’s opinion) paradoxical view that the elements of the medical art are hot, cold, dry and wet, while according to Galen they were fire, water, air and earth. Through the use of sophisms, Galen the protagonist of the episode increasingly infuriates the instructor, making him upset and angry at first and eventually wary of continuing the conversation due to his exasperation. At this point, the readers rightly favour the instructor, who has to suffer Galen’s vain sophistry and thus exclaims:

‘This fellow, who was reared in dialectic and was infected by the itch—that was the word he used—that it causes, turns everything around and twists and muddles everything, playing the sophist with us, in order to display his logical skill. … But we’, he said, ‘have not been taught to resolve sophisms. As he devised it, let him resolve it himself’.²³

Hipp. Elem. 1.6, 108.19-110.7 De Lacy = I.464.5-465.1 K.; transl. De Lacy

Galen detracts from his moral character by highlighting the repulsion provoked by his behaviour. Central to this repulsion is the teacher’s referring to Galen’s sophistic practice as an ‘itch’, accentuated by means of the Galenic aside ‘that was the word he used’. The term ‘itch’ is deployed by Galen in Affected Places to encourage readers of the work to act prudently and abandon the irritation they have developed in relation to medical sects, referred to as an itch (Loc. Aff. 3.5, VIII.148.7-10 K.). Likewise, in Natural Faculties sectarian partisanship is said to be harder to heal than any itch (Nat. Fac. 1.8, III.125.15-18 Helmreich = II.34.4-6 K.). Itch therefore is a key term in Galen’s moralising apparatus, being a signifier either of a debased habit or a moral passion of which one cannot easily be cured.²⁴

To return to Galen’s impugned moral profile, that is soon restored, once Galen the narrator of the story states that from then on he decided to keep quiet to avoid appearing to quibble (ἐσιώπων ὑπὲρ τοῦ μὴ δοκεῖν ἐρίζειν, Hipp. Elem. 1.6, 110.8-9 De Lacy = 465.1-3 K.). We will see in more detail the philosophical implications of Galen’s tendency to maintain silence in the episodes in Prognosis in Chapter 8. Here too his silence points to an informed resolution to exercise self-control, a repudiation of his earlier tendency to yield to sophistic loquacity and argumentative acrobatics, in favour of calibrated articulation of sound philosophical arguments. Galen teaches moral virtue through narrating formidable incidents of personal moral failing.²⁵

The passage just discussed also raises a central issue explored in this book, namely the moral implications of constructing deceitful arguments, which is one of the most pervasive and pointed ethical indictments we find in the whole of Galen’s oeuvre. In one of the most illuminating descriptions of it, in Natural Faculties, Galen likens scheming physicians who cobble together shamelessly fallacious arguments (ἀναίσχυντα σοφίσματα) with the Daoi and the Getae, the stock slaves in Menander’s comedies who excel in cheating their masters.²⁶ More exactly, by framing sophisms as no better than the devious antics of an illiterate, socially inferior and morally corrupt group, Galen separates it from loftier endeavours such as medicine and makes it an unacceptable form of conduct for his culturally and socially superior readers.

It has been argued above that, in order to uncover the extremity of vice in other people, and by extension invite readers to abstain from it, Galen strategically declares that he is compelled to resort to forms of conduct uncharacteristic of his true self.²⁷ An extended instance of this features in the Doctrines of Hippocrates and Plato, in a setting in which Galen takes umbrage at Chrysippus (ca. 280–207 BC) for making use of invalid proofs in his psychological theories:

Interrupting the present discussion, I shall not hesitate to describe my predicament. It was said by the ancient philosophers that when you converse with babblers you cannot entirely avoid all babbling. So being led on by Chrysippus’s chatter, I was compelled to give an account of the words of ordinary men and of Euripides, a thing that I would never have ventured to do voluntarily while writing the proofs of such an important doctrine. For not merely is Euripides or Tyrtaeus or any other poet, or any non-expert at all, insufficient authority for a doctrine in the absence of all proof, but even Hippocrates himself, admittedly the best of all physicians, or Plato, the first of all philosophers, is not sufficient authority on his own. And Plato’s successors, even if they all burst with envy or contentiously contrive shameless sophisms, as Chrysippus and his school did, will never be able to surpass his reputation or match the beauty of his proofs.²⁸

PHP 3.4, 198.17-30 DL = V.318.10-319.8 K.; transl. De Lacy, slightly revised

A number of points emerge from this passage. First, in terms of narrative technique, the section is thoughtfully heralded as a digression, so that it immediately alerts the reader to the shift from scientific discourse to moral report. This shift is also evinced in the topic under discussion, viz. what Galen here stigmatises as ‘babbling’, an issue conventionally treated by moral philosophers, which substantiates the impression that we are now in the sphere of ethics. Of course, what Galen dismisses as an act of babbling could be a meticulous argument for a loyal Stoic for example; or what Galen has earlier on attacked as pedantry might constitute a crucial piece of conceptual clarification for another intellectual in this period. So his diagnosis of failure here and elsewhere does not represent objective historical reality, but is rather a personal filter through which Galen sketches the modern state of affairs in medicine and society. This filter helps us make sense of the kind of virtues he wishes to parade and the type of moral path he wants to recommend to his readers. That said, his reportage of the modern world might not be a wholly factual one, but it must contain some truth about what was going on around him in some circles or on some occasions. It is not reasonable to accept that Galen was referring to individuals, things or situations to which his readers could not relate either as eye-witnesses or through first-hand experience. These issues are considered in Chapter 7.

Secondly, Galen in the passage quoted above stresses the contaminating effect of associating with babblers to justify how he has been affected by this vice, so that he now babbles himself, contrary to his declared wish elsewhere to remain free from this fault (Hipp. Epid. III, 2.5, 81.23-24 Wenkebach = XVIIA.610.14-15 K.).²⁹ His babbling consists in discussing testimonies written by non-experts, especially poets, whom he generally considers most unfitting doctrinal authorities.³⁰ This is stated elsewhere too, as, for instance, when Galen discourages his audience from reading Pindar (UP 3.1, 124.7-125.5 Helmreich = III.169.15-171.2 K.) or even Herodotus (AA 3.9, 185.13-15 Garofalo = II.393.7-10 K.) for the purposes of gaining knowledge, relegating the two authors to merely providing enjoyment.

Thirdly, Galen considers Chrysippus’s ‘chattering’ owing to his use of poetic sources a proper subject for criticism, and this is shown by his bold statement that not even Hippocrates or Plato could be deemed adequate authorities unless backed up by proper proof. Chrysippus has overstepped the mark. He has been acting like a feeble-minded old woman,³¹ not a true philosopher, and so Galen associates his prattling with other defects, notably envy and contentiousness, but also shamelessness and lack of loftiness of spirit,³² in order to dismiss him on moral grounds. Other Chapters in this book will look in more detail into the niceties of such character assassination. But in Doctrines of Hippocrates and Plato Galen often incites his audience to adopt only those philosophical tenets that were advocated by an ethically irreproachable exponent. Philosophical ‘orthodoxy’ is accompanied by moral righteousness. This method seems in a way akin to the Empirics’ belief, as addressed by Galen in The Best Sect, that the comportment (tropos) of the author determines the validity of the observational information (historia) he transmits in his writings.³³ The less the author subscribes to love of fame and love of strife, the more probable it is that he is telling the truth. Remarkably, in the same context Galen declares that it falls to the philosopher and not the doctor to judge characters (κρίνειν τὰ ἤθη, Opt. Sect. 14, I.146.10-148.4 K.), which is consistent with his self-projection as a moralist in the passage from Doctrines of Hippocrates and Plato cited above.

We have discussed the kaleidoscope of moral themes and the varying levels of moralism that Galen puts at the disposal of his readers for their ethical edification. We have noted that Galen is adroit at promoting a general sort of moralism (Chapter 1) while at other times he discusses the social aspects of his practical ethics in his physicalist accounts (Chapter 2) or the moral burden of the medical art (Chapter 3). And we have also seen that he deploys a wealth of strategies to that end, such as moralising assault or self-effacement. With this background in mind, we now turn to more detailed analysis of what I consider Galen’s most intriguing moral(ising) texts, which will be explored in self-contained discussions in Part II.