One such ‘non-Hippocratic’ medical author was Diocles of Carystus, whose importance in antiquity was rated so highly that he was given the [24] title of ‘younger Hippocrates’ or deemed ‘second in age and fame to Hippocrates’. He practised in the fourth century bce, and although we know very little of his life, we can safely assume that he was one of the most prominent medical thinkers of antiquity.1 His interests ranged widely, and he is reported to have written at least twenty works (some of them in at least four books) on a great variety of areas such as anatomy, physiology, digestion, fevers, prognostics, pathology, therapeutics, bandages, gynaecology, embryology, surgery, dietetics, hygiene and regimen in health, foods, wines, herbs, vegetables, olive oil, drugs, poisons, sexuality, and possibly also mineralogy and meteorology. He clearly had a keen interest in ‘the phenomena’ and in the practical aspects of medical care, and he rated the results of long-term medical experience very highly. Yet at the same time Diocles was known for his theoretical and philosophical outlook and for his tendency to build his medical views on a general theory of nature. There are good reasons to believe that he was well in touch with the medical and philosophical thinkers of his time, that he knew a number of the Hippocratic writings and that he was familiar with, and to, Aristotle and Theophrastus. Furthermore, he appears to have positioned himself prominently in the intellectual debates of the fourth century, and to have played a major role in the communication of medical views and precepts to wider audiences in Greek society by means of highly civilised literary writings in the Attic dialect. The basis for his fame may lie partly in the impressive range of subjects he dealt with, the almost encyclopaedic coverage of the subject of medicine and allied sciences such as botany, biology, and possibly mineralogy and meteorology, the considerable size of his literary production and the stylistic elegance his work displayed. But a further possible reason may have been Diocles’ philosophical and theoretical orientation and his tendency to relate his medical views to more general theoretical views on nature (see frs. 61, 63, 64),2 just like the ‘Hippocrates’ referred to by Socrates in the well-known passage in Plato’s Phaedrus (270 c-d). For from the remains of his work Diocles emerges as a very self-conscious scientist with a keen awareness of questions of methodology, a fundamental belief that treatment of a particular part of the body cannot be effective without taking account of the body as a whole (fr. 61) and of the essence of disease (fr. 63), and a strong desire for systematisation of medical knowledge. Diocles’ use of notions such as pneuma, humours and elementary qualities, his use of inference from signs [25] (cf. fr. 56), his references to obscure causes (fr. 177), his interest in cognition, sense-perception and locomotion, and even in the field ofdietetics his endeavours to develop and systematise dietetics into a detailed regimen for health and hygiene aimed at disease prevention — all this confirms the ‘theoretical’, ‘philosophical’ nature of Diocles’ medical outlook. It must have been these characteristics which prompted later Greek medical writers to reckon Diocles among the so-called Dogmatist or Rationalist physicians, who preferred to base medicine on a proper, theoretical and philosophical foundation, and who wanted to raise medicine from a craft to a systematic and explanatory intellectual discipline that obeyed the strict rules oflogical coherence.
Nevertheless, as we have seen, there was also a tradition in antiquity that represented Hippocrates as being hostile to philosophy, indeed as the one who liberated medicine as an empirical, practical art aimed at treatment of diseases from the bondage of theoretical philosophical speculation (cf. fr. 2). And there is that side to Diocles as well; for […] several fragments testify to Diocles’ awareness that the use of theoretical concepts and explanatory principles constantly has to be checked against the empirical evidence, and that their appropriateness to individual circumstances has to be considered time and time again in each individual case. Diocles’ reputation as the first to write a handbook on anatomy, in which he provided detailed descriptions of all the parts of the human body including the female reproductive organs, and his status as one of the leading authorities in the area of gynaecology, as well as the fame of some of his surgical instruments and bandages all suggest that we are dealing not only with a writer, communicator and thinker, but also with an experienced practitioner.
Yet whatever the title of ‘younger Hippocrates’ means, it certainly does not imply, and perhaps was not meant to suggest, that Diocles faithfully followed in the footsteps of the Father of medicine in all respects. For […] several fragments of his works bear out that, whatever the authority of Hippocrates may have been in Diocles’ time, it did not prevent Diocles from taking issue with some ideas and practices that are similar to what is to be found in texts which we call Hippocratic. Diocles can therefore be regarded as an independent key figure in the interaction between medicine and natural philosophy (at least in its epistemological results) in one of the founding periods of Greek science who long exercised a powerful influence on later Greek medicine. Diocles provides an important connection between Hippocratic medicine and Aristotelian science, and he is a major contributor to the development of early Hellenistic medicine, [26] especially because of his anatomical research and discoveries, his views on physiology, embryology and the role of pneuma, his views on gynaecology, and his development of a theory of regimen in health, food, and lifestyle, thus contributing to the increasing influence of doctors and medical writers on areas such as hygiene, cookery, gymnastics and sports.
Apart from Diocles’ more specifically medical views, his relationship to the Hippocratic writers is also manifest in two issues that reflect the ‘metamedical’ or philosophical nature of his approach to medicine. First, there are the principles of Dioclean therapeutics, which are at the heart of the question about the purposes of medical activity, and especially therapeutic intervention, in the light of more general considerations regarding the ethical aspects of medical practice and the question of the limits of doctors’ competence with regard to areas not strictly concerned with the treatment of disease. The Hippocratic writings, and especially the famous Oath, first of all reflect on the duties and responsibilities the doctor has in relation to the patient, for example in articulating such famous principles as ‘to do no harm’, not to cause death, or in advocating confidentiality, self-restraint, discretion, gentleness, acting without fear or favour. Yet, interestingly, they also emphasise the need for moral and religious integrity of the practitioner and for correspondence between theory and practice. Furthermore, in the field of dietetics, the Hippocratics’ development of the notions of moderation, ‘the mean’, and the right balance between opposites provided concepts and ways of thinking that found their way into ethical discussions as we find them in Plato and Aristotle; and, paradoxically, their tendency to ‘naturalise’ aspects of human lifestyle such as sexual behaviour, physical exercise, eating and drinking patterns by presenting these in terms of healthy or harmful provided useful arguments to those participants in ethical debates stressing the naturalness or unnaturalness of certain forms of human behaviour. (p. 23-26)