Chapter 5 - Exhortation to the Study of Medicine

Summary

Chapter 5 turns the spotlight on the rather overlooked treatise Exhortation to the Study of Medicine. It argues that in this work Galen constructs or conjures up images of young readers, intending it to act as an educational manual in moral intensification for prospective medical students. It hence demonstrates how Galen’s concern for his reader’s acculturation might explain the appropriation of advice and the selection of relevant material from a long-established protreptic tradition. In discussing Galen’s moralising methods and the pedagogical elements of the essay, this Chapter also draws links between Galenic and Plutarchan moralism, dealt with in detail for the first time, and thereby arguing that Galen’s moral writings need to be construed in the light of Imperial-period practical ethics. That proposition receives further support from the special features of Galen’s protreptic discourse discussed in this Chapter, especially practicability and effectiveness resulting from the author’s philosophical leanings (e.g. his Platonic-Aristotelian background) and medical expertise (the mechanics of the body and his emulation of Hippocrates in the second part of the essay).

In his history of ancient Rome, Cassius Dio records the story of Gellius Maximus, a legionary commander in Syria, who in 219 AD raised a revolt against the Roman emperor in order to assume supreme power. Cassius considers this incident a most fitting revelation of the degeneracy of the Imperial world, in that the son of a physician had aspired to become emperor (Roman History 80.7.1-2). Whatever the historical accuracy as to the social status of the person involved,¹ the story reflects long-standing prejudices against medicine, which had not always been a well-respected profession.² One of Galen’s most structured attempts to respond to such biases in a single work is perhaps his Exhortation to the Study of Medicine (henceforth in its abbreviated form Exhortation), which aimed to elevate the status of the art he was so passionately serving.

The Exhortation, classified among Galen’s works related to the empiricist medical school,³ is an unusual treatise both in the topics it tackles and in its style and form of argumentation more generally. In the first part (chapters 1–14), the author discusses the importance of engaging with the liberal arts, preparing the ground for a more specialised exaltation of the greatest of them, medicine. That was explored in the second part, which does not survive.

The dual subject of the work might partly explain its controversial title, which continues to perplex scholars to this day. Should it be called Exhortation to the Study of Medicine, as Galen himself appears to have called it in My Own Books?⁴ It is given this same title by St Jerome in the fourth century⁵ and by Ḥunayn ibn ʾIsḥāq (d. 873) in his Arabic translation of the title.⁶ Or should it be called Exhortation to the Study of the Arts in accordance with the quite reliable Aldine version (dated to 1525), our earliest surviving testimony of the work in the absence of any Greek manuscript?⁷ Whatever the answer to that might be, the existence of two alternative titles found in the various stages of the transmission of the text shows with some degree of certainty that, when the treatise was rediscovered in later times, its two sections must have been received as distinct thematic units,⁸ presumably serving the purposes of different readerships. There is no evidence, however, to suggest that the work circulated in two different parts in Galen’s own time. Therefore it would be fair to say that it was originally published as a single entity and intended for a specific audience, as will be discussed below.⁹ Furthermore, although we are not in a position to reconstruct the lost part on medicine, scholars have been right to suggest that it must have contained traditional material about the importance of the medical art, which Galen would have employed in other instances within his corpus, for instance in The Best Doctor is Also a Philosopher.¹⁰ Conversely, Galen’s encouragement of participation in the arts, which reflects his interest in philosophical education per se, points to a less familiar aspect of his thinking and one that can help us penetrate below the surface appearance of an allegedly technical treatise.¹¹

In this Chapter, I wish to focus on the moralising techniques that permeate Galen’s Exhortation and explore how these inform the construction of his moral authority. I want to look, in addition, at the ways in which he tailors his ethical advice to respond to the needs of his intended audience, comprising, I would suggest, adolescents who are about to start their intermediate education and are being urged to engage with professional studies, beginning with philosophy and progressing on to medicine. I aim to throw some interpretative light on this relatively neglected work by also discussing its rhetorical force vis-à-vis its literary peers (both earlier and later)¹² and especially by arguing that Galen is influenced by Plutarch, as a key moralist of the early Roman Imperial period, in his writing.

The surviving essay can be divided into two sections; chapters 1–8 juxtapose the permanent benefits of acquiring skills in the arts with unpredictable changes of fate, while chapters 9–14 describe at some length the risks associated with intense physical exercise.

Arts vs Fate

We have seen in the previous Chapter that Galen employs the philosophical subgenre of therapy to instruct his anonymous friend as well as a wider audience on how to manage the destructive emotion of distress. In the Exhortation Galen engages with another ethical subgenre, that of the protreptic, which conventionally aims to encourage (προτρέπειν) the study of philosophy and the attainment of virtue.¹³ That is the approach employed, for instance, in Plato’s Phaedo and Euthydemus,¹⁴ in Aristotle’s fragmentary Protreptic,¹⁵ Isocrates’s Antidosis¹⁶ or the much later Protreptic by Iamblichus (ca. 245–ca. 325 AD),¹⁷ although the origins of the genre may go back as far as the writings of the fifth-century sophists.¹⁸ Also associated with the exhortative performances of professional orators in law courts (e.g. those of Gorgias or Lysias), the protreptic continued to be used to persuade an audience not so much through rational arguments as through emotional appeals. As such it became a philosophical genre with rhetorical force, or more broadly a combination of rhetoric and popular philosophy.¹⁹ In many instances, I will explicitly show the function of what I call Galen’s ‘moralising rhetoric’, which makes use of epideictic elements to bring about his readers’ self-reform.²⁰

The Exhortation starts with Galen expressing some scepticism as to whether the so-called irrational animals are indeed entirely devoid of reason.²¹ Such agnostic statements often have a rhetorical purpose rather than being intended as a philosophical stimulus for further reflection, because they are often immediately countered by a remark reflecting Galen’s certain knowledge so as to win the reader over.²² Thus, in this instance, he goes on to assert that, although some animals possess at least some degree of reason, they certainly do not have the capacity to learn whichever art they choose in the way man does (Protr. 1, 84.8-13 B. = I.2-3 K.).²³

The sharp distinction between rational humans and irrational animals was posited in orthodox Stoicism by Chrysippus,²⁴ who surmised that animals could not be endowed with any reason. But Galen seems to take a more flexible stance here by accepting the existence of at least some sort of animal intelligence. This aligns him with the Stoic Posidonius of Apamea (ca. 135–ca. 51 BC), who, as Galen himself tells us in the Doctrines of Hippocrates and Plato, attributed emotions to animals such as pleasure (ἡδονή) and anger (θυμός).²⁵ Moreover, Galen’s eagerness to acknowledge the limited existence of animal rationality rather than dismiss it altogether shows how close he is to Plutarch’s influential thesis that all animals, to a greater or lesser extent, are endowed with reason. Plutarch was central to the debate over the mental capacities of animals in that he devoted three separate treatises to exploring the issue systematically, viz. On the Cleverness of Animals, Whether Beasts are Rational (also known as Gryllus) and On the Eating of Flesh, as well as independent discussions in other essays in his Moralia, for example in On the Love of Offspring and Table Talk, all of which, as Stephen Newmyer has persuasively contended, attest to his substantial contribution to this philosophical question.²⁶ Above all Galen’s reference to the intellectual abilities of land animals²⁷ (rather than of marine creatures) and, in the same context, the employment of illustrative examples that entail specifically spiders and bees,²⁸ are elements found in Plutarch’s animal-related accounts,²⁹ which make a strong case for Galen’s dependence on him.³⁰ This is part of a broader proposal I will be making throughout, which is primarily supported by the fact that Galen was well aware of the work of Plutarch, quoting from it several times throughout his writings either explicitly or in less direct ways.³¹ In the Exhortation Galen’s emphasis on man’s ability to learn and perform any art, a skill that as a rule all other animals lack, seems an intentional reversal of Plutarch’s On the Cleverness of Animals 966E-F, which refers to spiders’ webs being admired and imitated by man in weaving. Galen focuses more on man’s limitless ability to imitate and learn, which transcends animals’ inborn and very limited set of skills.³² This twist serves as the springboard for the ensuing narrative, in which Galen establishes the uniqueness of man by explaining his potential for practising the arts as the result of deliberative choice (prohairesis)³³ rather than of inherited nature (physis).³⁴

The reference to prohairesis (‘volition’ or ‘reasoned/moral choice’) is important on account of its association with the Platonic and Aristotelian educational model, where it constitutes a decisive aspect of virtue and character.³⁵ In fact, the distinction made between humans and animals in this prefatory context is predicated on the assumption that education (paideia), as a product of exercise and habituation, is an exclusively human asset. That explains why Galen goes on to stress the significance of training for human education³⁶ and to praise the continuous effort that helps man acquire the most outstanding of divine gifts, philosophy.³⁷ Galen therefore provides justification for the necessity of studying the arts, assuring his readers that his literary text is appropriate to their intellectual status.

The elements of irrationality, nature and hard work bring to mind Seneca’s Letter 90, which is also taken to be an exhortation.³⁸ This describes in nostalgic terms the golden age of mankind, in order to stress that the business of philosophy has always been the pursuit of moral virtue by living in harmony with nature, rather than achieving technological progress and material sufficiency. It thus seeks to refute Posidonius’s claim that humans had discovered the arts through philosophical training.³⁹ The emphasis that Galen puts on the notion of training therefore further attests to his affiliation to Posidonius, which in turn makes it highly probable that he might have been influenced by the latter’s lost Protreptic.⁴⁰ On the other hand, by defining the notion of physis as inherited traits rather than a mode of living in harmony with nature (as the orthodox Stoics did), and by associating it with the idea of philosophical practice, Galen situates himself in the Platonic-Aristotelian tradition and shows how experimental he is in his philosophical allegiances. Thus far our author appears as an intellectually diverse thinker, who favours doctrinal interpenetration rather than sectarian devotion, as was also noted in the previous Chapter.

Although some of the notions that Galen expresses up to this point are commonplace in the genre of the protreptic, especially the animal imagery and the role of physis, it is remarkable that he transposes them from theoretical or technical frameworks into a setting of practical ethics, giving them an intimate role in his reader’s moral progress. In Galen’s text the protreptic elements open up direct channels of communication between the experienced advisor (i.e. the author/narrator) and the less experienced recipient, whom Galen expects to learn to become alert and discriminating. For example, he frequently employs the distancing and assimilation strategies we have observed in the previous Chapter, i.e. clever techniques which depict groups of people whom the reader is advised either to despise or emulate so as to acquire virtue. In this way Galen prompts his audience to make the proper moral choices that are characteristic of their philosophical background and which differentiate them from animals, as we shall soon see in more detail. Thus the employment of animal imagery in the context of the Exhortation clearly serves a hortatory purpose,⁴¹ in contrast to its function in three ethical/psychological texts by Galen, Character Traits,⁴² Affections and Errors of the Soul⁴³ and Doctrines of Hippocrates and Plato,⁴⁴ in which animals are treated as representations of the uncontrollable impulses of the irrational faculty of the soul that need to be managed by the rational part and exhorted to obedience and habitual discipline. As such, they bear witness to their Platonic counterparts in the Republic 588c-d or Phaedrus 253c-254a and are inserted into Galen’s argumentation in order to gloss the doctrine of the division and function of the soul, rather than to instruct ethically in an intimate, hands-on and reader-friendly manner. These three texts are surely targeted at readers who were more advanced in terms of philosophical study than the readers of the Exhortation, and who were more in need of help to make sense of philosophical terms and theories on the soul than of helpful advice on how to embark upon a good life.

We have already started encountering cases in which the same elements (in this instance the animal imagery) recur in both technical passages relating to moral psychology and in popular philosophical texts, but which at the same time seem to serve rather different purposes depending on the context and intended meaning of each passage, as well as the intellectual and/or moral level of its recipient. Such retexturing of similar material appears not just throughout Galen’s own ethical and psychological essays, but also in relation to his technical works on how to maintain good health (as we shall see later on), and, interestingly, in relation to other ancient protreptics. For instance, Iamblichus’s Protreptic also suggests that reason renders humans divine and distinguishes them from all other creatures,⁴⁵ but the author does this in order to preach through systematic exposition the value of philosophy in general, and not as a rhetorical device to challenge the reader to immediate moral reflection, as happens in Galen’s Exhortation.

Galen’s text goes on, in chapter 2, to further stress the divide between irrationality and rationality, an issue which is introduced by a set of powerful rhetorical questions expressed in the sociative ‘we’:

Is it not vile, then, to neglect the one part of us which we share with the gods, while busying ourselves⁴⁶ with some other matter? To disregard the acquisition of Art, and entrust ourselves to Fate?⁴⁷

Protr. 2, 85.16-19 B. = I.3.5-8 K.

The above passage, apart from suggesting that humans are capable of union with the divine, thus building on the assimilation strategy, also conveys the two categories of ethical evaluation, praise and blame, in terms of the moral decisions we make as rational agents. The accumulation of terms denoting condemnation and public contempt awakens the reader’s sense of social honour, and Galen’s persuasion technique becomes more forceful once he inserts a word picture of Tychē and of Hermes together with their devotees. The literary ekphrasis of Tychē situates Galen within a long philosophical tradition, which dealt with the mutability of fate in an effort to prove the necessity of emotional resilience achieved through philosophical training. Similar descriptions occur in the Tabula of Cebes,⁴⁸ in Plutarch’s On the Fortune of the Romans (317C-318D) which presents a similar opposition between Fortune and Virtue,⁴⁹ in Dio of Prusa’s Orations 63-65 (three self-contained discussions on fate) and in Favorinus’s treatise On Fortune, with which Galen enters into dialogue, presumably as a result of the ad hominem attack he had made on Favorinus.⁵⁰

Unlike his predecessors, however, Galen dwells on the issue of fate by developing singular twists in his narrative. A striking example of this is the way he incorporates in his Avoiding Distress the destructive fate that incinerated a significant part of his library and medical instruments in the conflagration of 192 AD. We have seen how in that context evoking the vagaries of human affairs was expected to have a direct impact on the psychological state of the reader in that it retrospectively revived the feeling of distress as a way of eventually healing it (Chapter 4). In the Exhortation, however, the dangers of fate do not seem to have any psychotherapeutic function. They are meant rather to guide readers by means of delightful imagery, which in turn might hint at Galen’s concern to make his narrative attractive to people who had yet to become acquainted with the ups and downs of life, without unduly upsetting them.

The assumption of a young readership is reinforced by the similes we find in the description of Tychē in particular, which are intended to help readers visualise its form and associated qualities. The ancients, Galen tells us, depicted Tychē as a woman with a rudder in her hands, a spherical support for her feet and with no eyes.⁵¹ Not only, according to Galen, is her gender a sufficient index of inanity, but trusting her is like committing the same sort of mistake as handing the rudder of a ship in danger of capsizing to a blind helmsman.⁵² The image of the helmsman, which Galen adduces twice more in this text,⁵³ is of Platonic origin with important Presocratic antecedents, and was often employed in ethical tracts of popular philosophy, especially those of Plutarch.⁵⁴

The two groups of followers, those who trust to luck and those who rely on rationality, are illustrated by historical and mythical examples as well as more general allegorical figures each time, making the text even more accessible. So the adherents of Fate are idle and ignorant and comprise a whole band of demagogues, courtesans, betrayers of friends, desecrators of graves and even murderers.⁵⁵ Conversely, Hermes’s followers consist of noble and knowledgeable men of mild conduct, including geometers, mathematicians, philosophers, doctors and scholars alongside architects, grammarians and ultimately such great men as Socrates, Homer, Hippocrates and Plato.⁵⁶ Once he has set up this duality, Galen exploits his protreptic moralism and makes brief encouraging or discouraging remarks to direct the reader more explicitly. In both cases he uses the second-person-singular form of address⁵⁷ and claims that careful examination of the band of Fortune will lead to loathing (μισήσεις ὅλως τὸν χορόν, Protr. 4, 88.13-14 B. = I.6.10 K.), whereas moralising contemplation of Hermes’s chorus will excite both emulation and adoration (Τοῦτον … τὸν χορὸν … οὐ μόνον ζηλώσεις, ἀλλὰ καὶ προσκυνήσεις, Protr. 5, 89.16-18 B. = I.8.1-3 K.).

The reader is subtly prompted to identify with the followers of Hermes by the author’s explanation that this god does not judge people on the basis of political reputation, nobility or wealth, but on whether they lead a good life (τοὺς καλῶς μὲν βιοῦντας, Protr. 5, 89.12-13 B. = I.7.15-16 K.).⁵⁸ Good living (εὖ ζῆν) is the very essence of ethical philosophy and interestingly the association of Hermes with a whole branch of philosophy is entirely consistent with the way Galen uses Hermes in his Character Traits as a figure who leads human beings to assimilation with the divine after teaching them how above all else to despise worldly pleasures.⁵⁹ The affinities between the two works are symptomatic of a network of cross-references suitably adjusted to the twists and turns in the argument of each text. In addition to Hermes, the insertion of the anecdote about Aristippus, a proverbial model of self-sufficiency in ethical literature (especially in moral diatribes), lends legitimacy to Galen’s ethical production. Aristippus is deployed both in Avoiding Distress, as we have seen, and in Plutarch’s Tranquillity of the Soul, although in the Exhortation Galen provides us with three interrelated stories about him and seems to be drawing on Posidonius’s Protrepticus.⁶⁰

Despite the fact that the paradigm of Aristippus was intended to show that material wealth was something trivial and unimportant to human life,⁶¹ Galen emphasises that many people who found themselves destitute committed suicide (Protr. 6, 91.1-5 B. = I.9.6-10 K.). Presenting opposing attitudes to the loss of possessions points up the extent to which Galen differed from Philides the grammarian, whom he cites in Avoiding Distress as having died of depression caused by the loss of his property, whereas Galen cheerfully continued his normal activities regardless of his own losses in that same disaster.⁶² Galen disapproves of people who neglect their spiritual condition and who are more preoccupied with worldly blessings. He considers them equal to the most worthless slave,⁶³ once again challenging his reader’s sense of honour.⁶⁴

In addition to this, Galen’s moralism starts to take on the acerbic features of Cynic philosophy not only in that it appropriates the opinions of Antisthenes and Diogenes, but above all in that Galen himself is walking in their footsteps when he bitterly attacks rich and uneducated people for falling victim to the self-interest of flatterers:

So perhaps the comparison of such men (i.e. flatterers) to wells is not unreasonable. When a well, which once provided them with water, dries up, people lift up their clothes and urinate in it.⁶⁵

Protr. 6, 92.14-17 B. = I.11.3-7 K.

In similar vein, Galen castigates people who boast of their noble descent, unaware of the fact that their nobility is like the coinage of a state, which has currency with the local inhabitants but is worthless to everyone else.⁶⁶ By making a link to Antisthenes, who is credited with being the originator of the philosophical protreptic,⁶⁷ Galen might be staking a claim to being his emulator and perhaps a reformer of the genre he introduced.

Indeed, besides traits of the Stoic-Cynic diatribe combined with those of the protreptic, Galen’s account features characteristics of mainstream educational works and echoes in particular Plutarch’s On Listening to Poetry.⁶⁸ It is striking, for instance, that Galen quotes both from Euripides’s Phoenician Women (404-405) and Homer’s Iliad (4.405), the most important school texts in that period,⁶⁹ which are also present in Plutarch’s essay, and that he amends poetical lines to make them suit the moral message of his exposition. This is a key pedagogical technique, which Plutarch applies in instructing young readers how they should interpret poetry in a morally upright way and benefit from it as a preliminary stage to philosophy. The recurring use of imperative forms of akouein, a didactic directive that is interpreted to mean not simply ‘hearing’ but also ‘critically considering what is being heard’, is a typical trope in didactic communications, also present in Plutarch’s essay (more on this below).⁷⁰ In discussing the importance of eugenics, Galen argues that noble ancestors instigate a desire to emulate their example,⁷¹ intersecting both verbally and conceptually, for example, with the near-contemporary On the Education of Children, an essay now considered pseudo-Plutarchan, though thought to be authentic in antiquity.⁷² Furthermore, Galen’s emphasis on the emulation of noble exemplars and the severe criticism that he applies to any moral misconduct contribute to his self-depiction as a supervisor of morals, whose role in overseeing and correcting the ethical failings of less experienced agents is crucial, especially in his Affections and Errors of the Soul.⁷³ Finally, Galen’s protreptic on engagement with the arts resembles the introduction to Quintilian’s Institutes of Oratory (1.9-10), a basic educational manual of the Roman Imperial period, which also begins with a protreptic concerning the study of the liberal arts. In the light of the above, we can see that Galen’s Exhortation has a pedagogical character and was intended to have an appeal as an educational text in the transitional stage between secondary education and advanced studies.

In encouraging sensible people to practise the arts, Galen refers specifically to Themistocles as an example of a man who became a significant figure despite his lowly birth on his mother’s side.⁷⁴ The dictum usually attributed to Themistocles survives in Plutarch’s Sayings of Kings and Commanders (187B) and in Stobaeus’s Anthology (4.29.15) where it is attributed to Iphicrates instead. This misattribution may suggest Plutarch’s influence on Galen (see Life of Themistocles, 1.1-4), given that Galen seems to have consulted two other moral works by the same author in this context, as noted above, and presumably also the Life of Solon 22.1 for his Exhortation ch. 8.⁷⁵ Stobaeus (4.29.21-22) informs us that there was a work by Plutarch entitled Against Nobility (Κατὰ εὐγενείας) in which the dictum of Themistocles may have been mentioned, although this remains pure speculation and it is safer to assume that Galen might have drawn on the Life of Themistocles instead.

Be that as it may, the dictum of Themistocles, in addition to discounting the role of noble birth as a factor in ethical propriety, also reinforces the antithesis pride vs. shame that is omnipresent in Galen’s text from the beginning. Galen goes on to link this concept with a key topic in the cultural discourse of the period, namely ethnic identity.⁷⁶ By referring to the case of the Scythian Anacharsis, who was admired for his wisdom despite his barbarian birth, Galen teaches that moral behaviour, an acquired state, raises men above nobility and ethnicity, inherited qualities that are totally beyond their control. That seems to be a persistent issue in his Exhortation, also present in the anecdotes of Aristippus previously discussed.⁷⁷ The Stoics believed that anything that is not ‘up to us’ should not impinge on our happiness (this is their doctrine of the moral ‘indifferents’, as noted above),⁷⁸ but Galen here revises the idea, claiming that what is not up to us should not play a role in any moral evaluation of us:

Once mocked as a barbarian and Scythian, Anacharsis said: ‘my fatherland disgraces me, but you disgrace your fatherland’, a very fine response to a worthless person who gave himself airs solely on the strength of his homeland.⁷⁹

Protr. 7, 95.1-5 B. = I.14.1-5 K.

Galen’s position aligns with the story of the slaves of Perennis used in Character Traits to show that moral integrity is unrelated to social class or education.⁸⁰ Before ending the first part of the essay, Galen raises the issue of beauty and how this can hinder young people from caring for their psychic condition. He employs moral exempla from Solon, Euripides and Sappho, who all agreed that physical beauty did not guarantee happiness but rather threatened it. Additionally, Galen stresses that youth offers only temporary pleasures, and therefore he urges his young readers to develop special regard for the end of their life and appreciate old age.⁸¹ Once more Galen assesses the impact of pre-philosophical/worldly externals, depending on whether they contribute to one’s inner well-being or social adulation: e.g. acquiring money (χρηματισμός) through bodily charm is disgusting (αἰσχρός) and universally despised (διὰ παντὸς ἐπονείδιστος), but the money that comes from art is free (ἐλευθέριος), respectable (ἔνδοξος) and reliable (βέβαιος) (Protr. 8, 98.2-5 B. = I.17.14-17 K.). That helps Galen exhort young men to look in the mirror and try to make their inner morality as beautiful as their outward appearance.⁸² Here Galen is assuming the Socratic persona, as the same counsel is pronounced by Socrates himself notably in 141D of Plutarch’s Precepts of Marriage.⁸³ By neglecting their souls, human agents are only worthy of being spat upon, as the exemplum of the Cynic Diogenes suggests.⁸⁴ Galen filters this through his own protreptic voice:

So, young man, do not allow yourself to become worthy of being spat at, even if you think that everything else about you is splendid.⁸⁵

Protr. 8, 99.16-18 B. = I.19.13-15 K.

It is important to discuss Galen’s authority in the context of his exhortation. His address to young men is informed by a provocatively extravagant, almost paternal, tone: ‘Come then, my children, you who having heard my words have launched yourselves on an education in the arts’ (Ἄγετε οὖν, ὦ παῖδες, ὁπόσοι τῶν ἐμῶν ἀκηκοότες λόγων ἐπὶ τέχνης μάθησιν ὥρμησθε, Protr. 9, 100.1-2 B. = I.20.4-5 K.), which eventually becomes so insistent as to allow little freedom of choice to the young men. This address provides the audience with a sense of security that Galen’s advice will not only protect them against charlatans but to a large extent direct them towards the practice of those arts that are beneficial to life.⁸⁶ Both the appellations Galen uses above (μειράκια and παῖδες)⁸⁷ and the insistent urging to progress to the liberal arts point to the fact that this work is addressed to adolescents around 14 years old, who are about to finish or have just finished their primary education and will now move into general, secondary education (enkyklios paideia)⁸⁸ – a preliminary to any activity in life – with a view to taking up higher studies that will help them secure a noble profession in life, such as medicine.⁸⁹

Finally, Galen also works on the intellectual state of his young readers by subtly putting across the idea to them that the various forms of athletic activity differ from the arts. This he achieves by assuring them that he himself believes in their capacity for discernment⁹⁰ and also by warning them that they need some additional instruction on the crucial issue of athletics.⁹¹ The first section is rounded off in the form of a ring composition with a recapitulatory passage on man’s relationship to gods and animals respectively. However repetitive this might seem to modern tastes, it illustrates the authoritative voice of the author, who communicates his ethical teachings assertively and in plain language, with blunt analogies and conditional clauses, meant to ensure universal applicability to his collective readership of young men:

The human race, my children, has something in common with the gods and the irrational beasts; with the former to the extent that it is possessed by reason, with the latter to the extent that it is mortal. It is better then to realise our kinship with the greater of these and to take care of education, by which we may attain the greatest of goods, if we apply it successfully, and, if unsuccessfully, at least we will not suffer the shame of being inferior to the most idle beasts.⁹²

Protr. 9, 101.2-9 B. = I.21.4-10 K.

The exhortatory register in Galen differs from the mild didactic spirit of Plutarch, especially by comparison with the latter’s two main educational essays, On Listening to Poetry and On Listening to Lectures. Although on the whole all three works address the same concerns about the character development of young people about to embark on their philosophical studies, Plutarch is more philosophical than rhetorical and does not fail to theorise inter alia about the philosophical significance of silence, the role of envy or the power of self-exploration.⁹³ Galen’s rhetorical exuberance, by contrast, directs the reader in a more robust manner, presumably in order to signal more compellingly the need for philosophical engagement. The difference in tone may also tell us something about the authors’ public profiles as perceived by their respective contemporaries or even about the way they wished to be seen by them. Unlike Plutarch, who was well known for having taught philosophy all his life both in Greece and in Rome, Galen was primarily respected as a physician or at best – according to him – as a physician-cum-philosopher. Could Galen’s exuberant rhetoric (partly) hint at his ambitions to become a philosophical luminary in the area of practical ethics?

The dangers of athletics

I now turn to the second part of the essay (chapters 9–14) to show that here Galen inserts even more manipulative material than the merely protreptic sort we have seen in the previous section, and consequently that his tone becomes polemical rather than demonstrative. The author appears to follow the typical division of the protreptic into one section that demonstrates the value of philosophy, education and the arts (ἐνδεικτικόν) and another that refutes inimical arguments against them (ἀπελεγκτικόν).⁹⁴ Nevertheless, in this second part of the Exhortation, instead of testing the validity of the accusations against the arts, Galen demolishes the claims of alternative ideas of success and distinction. More specifically, he levels an attack against hypermasculinity and athletics and rebukes the reader for succumbing to any such wrong choices.⁹⁵ These new topics of discussion have important repercussions for his overarching argument on the practicability and value of ethical philosophy, especially in that they help clarify his view on the attention that should be paid to the care of the soul as opposed to giving excessive attention to the body.

On another level, Galen’s discussion of extreme physical exercise reflects and indeed critically responds to the important part athletics played as a cultural and philosophical field by the second century AD.⁹⁶ Some Imperial-period philosophers tended to advocate the inclusion of gymnastics in the liberal curriculum,⁹⁷ emphasising its benefits for the soul, but in the Exhortation Galen favours medicine at the expense of gymnastics, considering the former an ideal guarantor of physical and mental health, a view that fitted his conceptualisation of medicine as a philosophising area of study and practice. Galen’s attack on athletics has been rightly interpreted as an effective way for him to valorise medicine as an educational discipline in the contemporary health marketplace and consolidate its place in the intellectual setting of the High Roman Empire, thus demarcating his profession from that of athletic trainers, who were men of low educational and social status.⁹⁸ That may well be right, but, as I hope to show, his promotion of medicine must surely be linked to its potential as a social, moralising vocation too.

Abandoning the sociative ‘we’ and assuming the second person indicative or imperative form of address, Galen commences a rejection of athletics in so far as it interferes not so much with the care of the body as with care of the soul. He holds that the most excellent men attract divine praise not for their physical competence but their artistic accomplishments (Protr. 9, 101.12-17 B. = I.21.13-22.3 K.), providing the examples of Socrates, Lycurgus and Archilochus who were all praised by Apollo. In corroboration of this statement Galen interjects a direct aside which is designed to eliminate any hesitation on the reader’s part: ‘If you do not wish to listen to me, at least have some respect for the Pythian Apollo’ (εἰ δ᾽οὐκ ἐθέλεις ἐμοὶ πείθεσθαι, τὸν γε θεὸν αἰδέσθητι τὸν Πύθιον, Protr. 9, 101.21-22 B. = I.22.6-7 K.). Galen’s imposing voice taps into his reader’s religious sensibilities, and a bit further on he accuses the reader of succumbing to popular opinion and going along with the praise of the crowd (Protr. 10, 102.14-17 B. = I.23.3-5 K.), an accusation that seems to be a topos in protreptics.⁹⁹

In continuing his criticism, Galen asks how the reader can arrogantly set himself up as an arbiter of important matters, going against the judgment of men wiser than himself,¹⁰⁰ all of whom have condemned physical training. He elects to quote their opinions, accompanying them with various grammatical forms of the verb akouein.¹⁰¹ This serves Galen’s philosophical aims, because, as we have seen, it can be used in the sense of rationally processing what is being heard after dismissing superficial impressions. It is used in this way in educational contexts, where it can be translated as ‘to consider’, as in this case.

Plutarch’s On Listening to Poetry is again a good comparandum not just in respect of stressing the importance of akouein in the training of young men, but also in that it tackles issues relating to literary criticism, specifically referring to the correlation between poetry and philosophy. In contrast to Plato’s celebrated rejection of poetry on the grounds that it inculcated immorality in young readers, Plutarch adopted its study in his educational agenda, regarding it as a preparatory stage leading into the realm of philosophy.¹⁰² Galen not only seems aware of the tension between poetry and philosophy but also somehow revises this tradition, comparing the two fields on the basis of their opposition to athletics (though of course still prioritising philosophy over poetry). In fact, Galen’s treatment is all the more anchored, given that he is conveying the opinion of medicine too, which also condemns athletics, as the quotations from Hippocrates attest.¹⁰³

Galen’s use of accumulated testimonies from various authorities (especially poetic ones) to argue against athletics, although permissible in morally didactic settings in antiquity, is cast in the text as being at variance with Galen’s authorial principles, since he is anxious to state that he was compelled to resort to such ‘mean activities’ (φαῦλον … ἐπιτήδευμα) so as to benefit those yielding to the vacuities of popular reputation.¹⁰⁴ We have already remarked that Galen employs the argument of ‘compulsion’ when he wants to excuse his denunciation of the moral debasement of others, which often provokes him to respond in self-contradictory ways (Chapter 3). So here too, Galen justifies his use of authorities that distract him from his philosophical role, rendering him a rhetor,¹⁰⁵ by stressing his commitment to the moral incitement of his audience.¹⁰⁶ Such self-apologetics also probably reveal a concern that he may appear more rhetorical than necessary, a common preoccupation of many moral philosophers and a fear Galen also expresses in other works.

In claiming that athletes are totally ignorant of the existence of their souls, busying themselves with flesh and blood matters, Galen depicts them as extinguishing their capacity for contemplation and descending to the level of irrational animals.¹⁰⁷ Identifying athletes with pigs in particular¹⁰⁸ is a technique which helps Galen to relate what he had previously described as the non-rational nature of athletes’ souls to animal behaviour.¹⁰⁹ This brings to mind the similar passage in Character Traits (Chapter 1),¹¹⁰ which equates physical preoccupations with the life of a pig and spiritual concerns with a divine existence. Interestingly, abstaining from immoderate vices, such as over-eating or over-drinking and overindulgence in sexual intercourse, also becomes a crucial part of the profile of the philosophically minded physician in The Best Doctor is Also a Philosopher (e.g. Opt. Med. 290.2-7 Boudon-Millot = I.59.11-15 K.). Galen’s moral narratives clearly compartmentalise virtuous lifestyles, separating them from immoral ones.

Another important aspect in Galen’s exposition in respect of his construction of authority is the relationship he builds between himself and Hippocrates. The abundant Hippocratic quotations in the second section of the essay are not just back-up from an ancient thinker, reinforcing Galen’s medical arguments. Rather they lend persuasiveness to his personal views. That is reflected in the fact that Galen is careful not just to cite but above all to comment on and challenge some of the Hippocratic aphorisms, which ultimately makes a very strong impression.¹¹¹ This is apparent in his use of pertinent vocabulary describing the physical symptoms of an athletic regime¹¹² and in the exposition of the mechanics of the body. That said, this part of the treatise does not get bogged down with any medical trifles, not even deploying any technical terms from physiology, which might confound the inexperienced reader. In chapter 11 for example, Galen provides the reader with a straightforward clarification to explicate a Hippocratic aphorism that involves the distinction between the state and the condition of the body.¹¹³ This indicates that the audience do not yet have any medical background or familiarity with the Hippocratic corpus; otherwise such explanations would have been redundant. That also ties in with Galen’s working method in the Exhortation and elsewhere of carefully adjusting his material to the level of his readers. As he makes clear in a passage in My Own Books, introductory texts cannot be thorough or comprehensive in character, given that beginners fail to comprehend the niceties of the disquisition before first acquainting themselves with the basics (Lib. Prop. Prol. 10-11, 136.9-16 Boudon-Millot = XIX.10.18-11.6 K.).¹¹⁴ This rationale is applied in the Exhortation too, where Galen’s protreptic discourse purposefully omits any hard-core stuff on moral analysis and stays with the simpler hortatory material, as has been observed in the course of this Chapter.

By referring to the athletes’ physical deformities, Galen subverts the notion of their beauty, arguing that their bodily strength is of no significant value other than helping them to perform agricultural activities.¹¹⁵ The sarcastic tone progresses into a compelling assertion that the athletes’ resistance to extreme weather makes them like newborn babies,¹¹⁶ and he mocks them for lying all day long in dust and washing in muck.¹¹⁷ Such polemical comments are meant to undermine the self-esteem of athletes and, in order to conclude that athletics are of no use in any practical context in human life, Galen deploys a didactic myth in verse which preaches that athletic distinction is, in fact, not an accomplishment for humans but for animals.¹¹⁸ This polemical framework reinforces Galen’s concluding thesis that athletics should not even be a way of earning a living¹¹⁹ and so he classifies it in the category of the less-respected banausic arts, unlike medicine which is one of the higher arts, i.e. the ones that can mitigate the bestiality of the soul.¹²⁰ This final remark in the surviving part of the essay shows the ethical dimensions that Galen credits to medicine so as to demonstrate its right to be considered an elevated art. Thus, by urging the reader to adopt a well-defined cluster of habits in relation to the care of body and soul, he corroborates his role as physician but also as a moral mentor for his contemporaries.

Ethics in the Exhortation and in texts focusing on the mechanics of the body

The best constitution of the human body and its hygiene and physical exercise are vital issues in Galen’s naturalistic thought, which he discusses in a group of technical works.¹²¹ In this section, I would like to explore briefly some cases of material common both to these works and the Exhortation in an attempt to illuminate Galen’s moralising twists in the latter and further stress how his ethical pronouncements require subtle transformations in order to resonate with his young audience and the requirements of his philosophical exposition.

The first example comes from the short essay Good Condition. Here Galen examines the definition of ‘good condition’ in cases where reference is made to an individual’s nature, suggesting that one should always add the name of the person, for instance ‘Dion’s good condition’ or ‘Milo’s good condition’.¹²² Milo of Croton was a well-known wrestler of the sixth century BC (considered a follower of Pythagoras), whom Galen compares in this context to Hercules and Achilles, both representing positive cases of good condition in the unqualified sense. However, subsequently he twice adduces the authority of Hippocrates to warn against extreme bodily states: ‘Among people who take gymnastic exercise, the extremes of good condition are dangerous’ and ‘The athletic state is not natural; better the healthy condition’.¹²³ Both of these Hippocratic statements each occur twice in the Exhortation,¹²⁴ and Hercules too is used here as a positive model of physical resilience (Protr. 13, 112.3-7 B. = I.33.9-13 K.). In the Exhortation, however, the figure of Milo is treated in the most negative fashion, as Galen devotes a remarkable amount of space to showing that Milo’s physical achievements were a manifestation of incredible stupidity (ὦ τῆς ὑπερβαλλούσης ἀνοίας, Protr. 13, 112.17-18 B. = I.34.5 K.), linked to the hero’s servile sacrifice of his soul (Protr. 13, 112.15-114.4 B. = I.34.3-35.11 K.), which Galen calls ‘worthless’ (οὐδενὸς ἦν ἀξία, at Protr. 13, 113.4 B. = I.34.9-10 K.). Moreover, Galen depicts Milo as devoid of rationality, making his approach to life appear useless by comparison with Themistocles’s wisdom.¹²⁵ Those reconfigurings evince Galen’s moralising input in his Exhortation, a text concerned with distancing its young readers from an excessive preoccupation with the body.

Galen’s interest in depicting physical exercise through an ethical lens is also seen in The Exercise with the Small Ball, where again the degree of moralising is restrained by comparison with the Exhortation. This essay is addressed to Epigenes, a man of superlative physical condition, to whom our author proposes the most superior kind of physical activity, i.e. exercise with the small ball. The precise nature of this sport is unclear,¹²⁶ but it is telling that Galen embraces it because it does not just exercise the body, but above all delights the soul.¹²⁷ Elsewhere, he stresses that this form of exercise assists both body and soul to achieve their respective best state,¹²⁸ a recurrent motif in the essay, which eventually confirms the soul’s superiority over the body.¹²⁹ By contrast, Galen condemns wrestling on the grounds that it renders the intellect idle and sleepy, promoting body-building rather than the cultivation of virtue.¹³⁰ In this connection, Galen claims that if one engages with wrestling, one’s chances of a brilliant generalship or political power are minimal and that it would be better to assign such public duties to pigs than to wrestlers.¹³¹ The material here echoes a certain passage from the second part of the Exhortation where, as we have seen, Galen remonstrates with athletes for their body-building on the grounds that it extinguishes their rational capacities and renders them pigs.¹³²

Thus Galen reworks very similar material in the moral context of the Exhortation but in a manner that makes his argumentation more powerful, especially through the use of more direct condemnation devices. The retexturing patterns also show that Galen’s value of philosophical moderation in relation to the care of the body is a principal feature of his moralising medicine, which controls all other types of bodily knowledge. That is quite clear, for instance, in his Matters of Health, a work dedicated to hygiene but not free from moral overtones (Chapter 3). In a series of recommendations on physical health for adolescents, Galen again strikes a balance between lack of exercise and extreme gymnastics and emphasises how this balance impacts on a young man’s character formation, ensuring both orderly behaviour (εὐκοσμία) and ready obedience (εὐπείθεια).¹³³

Comparable retexturing patterns occur in another work concerned with the care of the body, namely Thrasybulus: Is Healthiness a Part of Medicine or of Gymnastics? As the work’s title suggests, the topic under examination is very close to that addressed in the second part of the Exhortation, yet Thrasybulus is more of a technical work undermining the value of gymnastics via logical demonstration.¹³⁴ Galen’s main thesis is that gymnastics is a perverted art, which has nothing to do with healthiness, concluding that it has justly attracted the contempt not only of Plato and Hippocrates but all other doctors and philosophers. Through vigorous interrogation, Galen eventually triumphs over his addressee, Thrasybulus, despite the latter’s philosophical propensities and inquisitive spirit. The assertive imposition of authorial intent also provides the framework for the Exhortation, although to a completely different end, as we are dealing with Galen’s moral didacticism towards a lay young audience here, not his promotion of logical practice for a group of intellectually advanced and demanding addressees.

The work’s contextual framework: Commodus attacked?

Before concluding, I would also like to discuss the contextual setting that may have inspired the composition of the Exhortation and provide a possible explanation for the polemic Galen launches against athletics in the second half of the tract. From the early years of his professional career, right back when he was appointed physician to the gladiators in Pergamum in ca. 157 AD, Galen appears to have been an ardent supporter of physical well-being and recovery.¹³⁵ Autobiographical descriptions show how upon moving to Rome he continued his own bodily care and devoted himself to wrestling until a severe injury in 164 AD obliged him to turn to less extreme forms of exercise.¹³⁶ The event in his career that may have made him reconsider the role of athletics might have been his personal supervision of the training of the young Commodus,¹³⁷ who, overwhelmed by Imperial wealth, his own beauty and bodily strength, resorted to the savagery of the Roman gladiatorial combats and despised the philosophical legacy of his high-minded father, Marcus Aurelius. The three factors that Galen castigates in his Exhortation as promoting the debased spirit of athletics, namely wealth, origin and beauty, are interestingly those that led to Commodus’s eccentric participation in the arena, according to the contemporary historian Cassius Dio (Roman History 72.7.4).

Cassius’s narration offers a lucid prosopography of Commodus that has striking similarities with Galen’s portrait of the athletic man. As Cassius repeatedly states (Hist. Rom. 72.7.1, Hist. Rom. 72.18.3-4), his report was the result of what he had seen for himself, which makes us wonder whether Galen was an eyewitness to the same events, especially in light of the affinities we notice between the two accounts. The Roman historian explains that Commodus became a slave to lustful and cruel habits due to his ignorance, which prevented him from living the good life (Hist. Rom. 72.1.1). Galen similarly condemns athletes for surrendering to bodily pleasures and ignoring the existence of their souls and the importance of moral virtues (Protr. 11, 106.1-7 B. = I.26.17-27.6 K., cf. Protr. 6, 91.16-22 B. = I.10.2-8 K.).¹³⁸ In describing Commodus’s public combats with wild beasts and gladiators (Hist. Rom. 72.102-3), Cassius mentions that the emperor wished to be called a Roman Hercules, and statues were erected representing him as such (Hist. Rom. 72.15).¹³⁹ Drawing on the Commodus–Hercules propaganda that was pervasive in the late second century AD, in the Exhortation Galen refers derogatorily to the ‘emulators of Hercules’ (Protr. 13, 112.4 B. = I.33.9-10 K.), mocking specifically their physical feebleness (Protr. 13, 112.5-7 B. = I.33.1-13 K.). Driven by his eccentricity, Commodus used to enter the amphitheatre in the garb of Hermes, carrying the god’s staff (Hist. Rom. 72.17.3-4, Hist. Rom. 72.19.4), and demanded that his reign be called the ‘Golden Age’ (Hist. Rom. 72.16.1). These details align with Hermes’s role in the proem to the Exhortation and, if I am right in my suggestion that Galen is alluding to Commodus, then he is hinting at the emperor’s deluded state of mind, given that his crimes set him apart from Hermes, who is the personification of virtue in Galen’s account (Protr. 3, 87.7-9 B. = I.5.2-4 K.). Commodus’s vice and depravity also dissociate him from the Golden Age, conventionally seen as a period of primitive wisdom and ethical righteousness.

Galen’s criticism of athletes might therefore be seen as an allusive commentary on the misbehaviour of the young emperor, probably reflecting similar public responses,¹⁴⁰ and more generally on the elevated position that athletes enjoyed at his Imperial court. Galen’s tacit approach is probably because he feared for his life amidst the ongoing turmoil and instability, since the Exhortation must have been written during the three-month reign of Pertinax (1 January 193 – 28 March 193 AD) that followed the assassination of Commodus, as Joseph Walsh suggests.¹⁴¹

On another level, Galen’s acquaintance with Imperial athletics must have made him oppose the unnatural ways in which athletic coaches attempted to create strong bodies. It was often the case that trainers entered the territory of medicine without having the necessary medical skills or background. This might explain why Galen so strongly adduces the authority of Hippocrates in his polemic against athletics: it reflects his attempt to demarcate his genuine medical status from that of charlatans. It is also important how Galen’s stance reflects contemporary cultural trends that associated the intense practice of athletics with a lowering of ethical standards. In the third century AD, Philostratus composed a manual for athletic coaches, which highlighted the pressing need for them to be knowledgeable about medicine, especially anatomy and eugenics, and at the same time to despise corruption, in line with the old system of gymnastics that produced praiseworthy men such as Milo and Hercules. Galen’s Exhortation makes, as I have shown, a markedly moralising appeal to readers both in terms of direct admonition and of social critique. The latter is employed most prominently in Recognising the Best Physician and Prognosis, which I shall discuss in forthcoming Chapters.

Conclusions

In one of his Discourses (‘On rhetorical display’, 3.23.33-38) Epictetus holds that the philosophical protreptic differs from epideictic oratory in that it does not set out to give the audience pleasure but to expose their moral weaknesses, often in crude ways. The protreptic, he goes on, is the most suitable form of exhortation the philosopher can use to induce self-realisation. In this Chapter, I hope to have shown that Galen’s Exhortation is not a conventional epideictic piece as Epictetus understood it,¹⁴² but one in which rhetoric to a large extent facilitates philosophical instruction. As I have tried to show, the work abounds in educational elements, which are consistent with its more developed moralising by comparison with what we get in other works treating the mechanics of the body. We have also seen how Galen’s authority imposes itself on what he expects to be an inexperienced, young audience in an attempt to initiate them into some of the tenets of philosophical training with a view to leading them to study medicine. This accounts for Galen’s avoidance of theoretical and technical material, which is replaced by practical counsel instead. Here readers are not active agents as they are in Avoiding Distress, they are not informed of the personal testimonies of the Galenic narrator, nor do they enjoy any interpersonal relationship with their instructor as yet. The function of Galen’s protreptic is less to develop independent thought than to arouse desire for imitation, eliminate erroneous impressions and provide safe choices to young people moving from literary and rhetorical studies to a philosophical education, ideally with a view to becoming physicians later.¹⁴³

The Socratic protreptic entails elenctic admonition, Aristotle’s (fragmentary) protreptic elaborates arguments and has a concluding peroration, Seneca’s protreptic is an epistolary refutation of Posidonius, while that of Iamblichus is an anthology of protreptics in the form of exegesis. Galen’s protreptic is of a different sort, not only in that it is an authoritative monologue verging on a traditional diatribe, but mostly because of its peculiar moralising rhetoric, which seems to cast a wide net, thus making it a public rather than an intimate piece. Its scope is also significant because of its close interplay with a large number of philosophical sources, not just the later Stoic tradition, represented by Posidonius and Seneca, but also with the Platonic and Aristotelian legacy, and most notably Plutarch. It is this richness and the diversity of Galen’s treatment of moral issues that makes him stand out in ancient philosophical culture. The Lamprias catalogue, an ancient list of Plutarch’s works, informs us that Plutarch himself produced two protreptics, An Exhortation to Philosophy, Addressed to a Rich Young Man (no. 207) and An Exhortation to Philosophy, Addressed to Asclepiades of Pergamum (no. 214), both of them lost. Attempting to prove that Galen’s Exhortation drew on these two works must surely remain a matter of speculation, but, on the basis of the other close parallels shared between the two authors, I hope at least to have made attractive the possibility of Galen trying to enter the moral tradition that Plutarch inherited and enriched, and to enjoy (some of) the latter’s popularity as a star moralist of the Graeco-Roman period. Even if Galen’s closeness to Plutarch is not conscious or direct (which I think it is), it does have something to tell us about the former’s sustained work in the area of moral philosophy and its envisaged impact on the contemporary philosophical and intellectual landscape.