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Art of Medicine in Early Alexandria

Edition and translation Heinrich von Staden

Fragments ascribed to Herophilus’ On Anatomy II-IV

60a Galenus, De anatomicis adminstrationibus 6.8 (II, pp. 570-2 K)

60b Oribasius, Collectiones medicae 24.25.1-6 (CMG VI.2.1 =vol. III, pp. 36-7 Raeder)

60a-b Not even in human beings is the liver similar in all with respect to its size and the number of its lobes. Herophilus writes very accurately about it, saying the following in so many words: “The liver of humans is of a good size, larger than in certain animals which match humans [sc. in size]. And where it touches against the diaphragm, it is convex and smooth, but where it touches against the abdominal cavity and against its lump, it is concave and uneven. Here it may be likened to a certain fissure by which in embryos, too the vein from the navel naturally extends into it.

“The liver is not similar in all, but different in different creatures, in breadth, length, thickness, height, number of lobes, and in the irregularity both at the front – where it is thickest – and at the circular parts at the top, where it is thin. In some, it does not even have lobes, but is completely round and unarticulated, whereas in others it has two lobes, in still others more, and in many also four lobes.”

The Herophilus said correctly. Furthermore, in the same Book II of his Anatomica he wrote correctly that in the case of [only] a few human beings but not a few other animals, the liver occupies some of the left parts. But he mentioned only the hare, and left it to us to examine the other animals as well, the details about which I have determined to go through as my treatise proceeds …I am compelled to make mention of not a few differences [between various animals], as, to be sure, now too the case of the liver: its largest part is on the right in all animals, but in addition it occupies some of the left, though not equally in all creatures but as Herophilus wrote, most of all the case of a hare.

61 Galenus De Semine (IV, pp. 596-8K)

Herophilus, however, says that the seed of females is somehow discharged to the outside, even though he wrote with accuracy about the ‘testicles’ [ovaries] in females in Book III of his Anatomy, saying this at the outset:

“Two ‘testicles’ (didymoi [ovaries]) are also attached to the uterus on the sides, one on either part, and they differ only a little from the testicles of the male.” Then what follows, not much later, these are his words:

“In females the two “testicles” [ovaries] are attached to the two shoulders of the uterus, one on the right, the other on the left, not both in a single scrotum but each of the two separate, enclosed in a thin, membranous skin. They are small and rather flat, like glands, sinewy at their surrounding covering but easily damageable in their flesh, just like the testicles of males. IN mares there are also quite sizeable. And they are attached to the uterus with no small number of membranes and wit ha vein and an artery implanted from the uterus into these “testicles”. You see, the attachment is from the vein and the artery that go to each of the two “testicles”, a vein from the vein and the artery from the artery.

“The spermatic duct from each “testical” is not very apparent but it is attached to the uterus from the outside, one duct from the right, the other from the left. Like the seminal duct of the male, its anterior part is also convoluted, and almost all the rest up to its end looks varicose. And the spermatic duct from each testicle grows into the fleshy part of the neck of the bladder, just like the male duct, being thin and winding in its anterior part where it touches the hip bones. Here [sc. at the neck of the bladder] it also terminates, like the pudendum penetrating to the interior from either side. But the “varix-like assistant” (parastates kirsoeides) is not observed in the female.”

This is Herophilus’ statement. I will mention what especially causes me astonishment: he described position, size, and nature of the “testicles” in female creatures accurately, not omitting anything, not even about the vein and artery which are attached to them on either side, but rather providing an accurate account of them. But afterwards, although he did mention correctly that the seminal duct is attached to the uterus externally, one on either side, he was mistaken to say that it is not very apparent. It is after all, quite a considerable size. Subsequently, he was much more mistaken in this matter, when he said that the seminal duct of the female is implanted into the neck of the bladder in a manner similar to the seminal passage of the male.

62 Galenus In Hippocratis Epidemiarum 2.4.1 Commentarius 4 (From Hunain’s Arabic translation of the lost original; CMG v. 10.1, p. 318 Pfaff)

. . .The veins turn towards the vertebrae and the ribs, the one on the left close to the collar-bone, the one on the right a bit lower, since it is bent toward the back…What Hippocrates says about this vein which is a bit lower on the right than on the left, Herophilus, too, already said in Book IV of his treatise On Anatomy. Herophilus, you see, first explained that two veins branch off from the thick vein where it reaches the collar-bone, and that one then proceed to the left side, the other to the right, and that each of these two then is divided again, branching out after four of the ribs of the chest. In this book he then says: “The vein which proceeds to the right side lies a bit lower than the vein which proceeds to the left.”

What Herophilus says here is in agreement with what appears in dissection and with what Hippocrates said.

63a A. Cornelius Celsus, Medicina (Artes 6) prohoem. 23-6 (CMI, I, p. 21 Marx)

[According to the ‘rationalist’ physicians] it is therefore necessary to dissect the bodies of the dead and to examine their viscera and intestines. Herophilus and Erasistratus, they say, did this in the best way by far when they cut open men who were alive, criminals out of prison, received from kings. And while breath still remained in these criminals, they inspected those parts which nature previously had concealed, also their position, color, shape, size, arrangement, hardness, softness, smoothness, connection, and the projections and the depressions of each, and whether anything is inserted into another thing, or whether anything receives a part of another into itself

…Nor is it cruel, as most people maintain that remedies for innocent people of all times should be sought in the sacrifice of people guilty of crimes, and of only a few such people at that.

63b Johannes Alexandrinus, Commentaria in librum De sectis Galeni (ad cap. 5; I, pp. 78-9K), 5ra35-42 (pp. 57-8 Pritchet)

The Empricists press on again, saying that the Dogmatists are distinguished by committing murder, since they perform dissection on human beings who are alive, although medicine is an art that effects health in human bodies. ‘But you Dogmatists, on the contrary, kill living human beings by cutting them open. We do not act in that way, rather; we perform dissection on the ape and the bear, since they have some features entirely similar to human beings.’ The Dogmatists, however, [respond]: ‘We kill those who deserve death and who have been condemned to die by the judges; and indeed, Herophilus and other ancients used to do the same.

63c Agnellus Ravennas (?) In Galeni De sectis (cap. 5) comm.. 23 (p. 92, Arethusa Monogr. 8)

The Empiricists stand firm again and say that ‘you perform your dissections poorly because you do them on living beings. You say that medicine is an art concerned with human bodies, effecting health. But you, on the contrary, take human beings to kill them by cutting them open.’ To this we [sc. the Dogmatists] say that ‘we cut open those who deserve death, because they have been condemned to die by the judges. Herophilus and the other ancients used to do this, in order that an account may be given.’ We to be sure, do not perform dissections in this manner but on apes or on the bear, who have some features similar to human beings.

64a Vindicianus, Gynaecia, praef. (vel. 2) cod. L (K. Sudhoff AGM 8 (1915) pp. 417-18

Our ancestors who practiced medicine in Alexandria, Rufus, of course, and Philip, Lycus, Erasistratus, Pelops, Herophilus, Hippocrates, Apollonius – found it proper to examine the bodies of the dead in order to know for what reason and in what manner they died. Humanity itself prohibits doing this, since all things would be manifest and fully open to those conducting the examination.