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Causes and Empiricism: A Problem in the Interpretation of Later Greek Medical Method

Author(s): R. J. HankinsonSource: Phronesis, Vol. 32, No. 3 (1987), pp. 329-348Published by: BRILL

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Causes and

Empiricism:

A

Problem n

the

Interpretationf

LaterGreek

Medical

Method

R.J. HANKINSON

Of the three schools of medicine in later antiquity,the Dogmatists, the

Methodists, and the Empiricists', he Empiricistshave

perhaps

been the

most badly

served by the capriciousness

f

the tradition.Complete

texts

survive

of

the

representatives

f the other

schools2;

ut

Empiricism

urvives

only infragments nd testimonia.However,

thingsare not quite asgloomy

as

they might

appear at first glance: for Galen, the great second

century

A.D.

physician, philosopher, philologist, polemicist, polymath,

and

workaholic,records a great deal of

Empiricistdoctrine, both

casually

throughouthas

vast oeuvre, and moresystematicallyn three treatises:

De

Sectis ad

IngredientibusSI), On MedicalExperience Med. Exp.3),

and

SubfiguratioEmpirica (Subf.Emp.4).

Galen was himself powerfully in-

I

These divisions

are conventional and to an extent

arbitrary;

but

they

are serviceable

enough.

See

Galen, De Sectisad Ingredientibus

SI)

I

65,

79

(unlessotherwise

mentioned

all

referencesto

Galen

are

keyed

to the

edition

of

C.G. Kuehn,

Galeni

Opera,

(1821-33),

22 vols., Leipzig);

[Gal.] Introductio (Int.) XIV 683-4;

[Gal.] Definitiones Medicales

(Def.Med.)

XIX

353; Celsus, De

Medicina(Med.) Pr. 13, 27, 57, etc.;

[Soranus]Quaes-

tiones Medicales

(Qu.Med.) 49; for

the rough and ready nature

of

these

divisions, see

Galen, De Libris

Propriis (Lib. Prop.) XIX 12.

2

Although

in

view

of the fact that Dogmatism in

particular s a genus

with

a widely

differingvariety of species, not all of

which are properlyrepresented by

surviving exts,

this is at best only

selectively true. As

for the Methodists, we have Soranus's

Gynaeco-

logy (Gyn.

=

CMG IV), and Caelius Aurelianus On

Acute

Diseases and

On Chronic

Diseases (MA, MT; ed. and trans.

Drabkin, 1954).

3

Which survives

only in

a

mediaeval

Arabic version done

by

the

great

Galenist Hunain

Ibn'

Ishaq; it is

edited and translated

n Walzer, Galen on Medical

Experience,

Oxford

(1944).

The

translationhas

been

recently re-issued in Frede, Galen:

Three Treatises

on

the Nature of

Science, Indiana (1985).

4

Subf.Emp. survives only in a

fourteenth century Latin version done by

Niccolo

da

Reggio

for

Robert

the Wise of

Naples; it is edited, with a back-translation

nto Greek

(which is a great

aid to understandingNiccolo's tortured

Latin), in Deichgraeber,Die

Griechische

Empirikerschule,Berlin(1930), as Fr.

10b.

It is also translated

n

Frede, op.

cit.,

as is

SI.

Phronesis 1987. Vol.

XXXII13

(Accepted

March

1987)

329







fluenced

by Empiricism,and stresses

throughout

his work the need

to

arrangea happymarriagebetweenlogic and theoryon the one hand, and

experienceand observation

on the other5. ndeed,

in his very earlyyouth,

he mightactuallyhave

been sufficiently lose

to the Empiricists

o enroll

himselfamongtheir

number6.Thus

with the evidenceto be

garnered rom

Galen, plus

the testimonyof other

useful, if less

valuable,sourcessuch

as

Celsus,

we can buildup a reasonably

learpictureof the nature

andscopeof

GreekmedicalEmpiricism7.

1.

Outlinesof Empiricism

The

Empiricists

hemselves,we

are told at Subf.Emp.

1, 42.22-43.6

D8,

variously

traced their

origins back to Acro,

a fifth centuryB.C.

near

contemporary

f Hippocrates;

Timon

of

Phlius,

the

Pyrrhonian

oet;

and

Serapion

of Alexandria,

he

pupil

of

Herophilus.

These

genealogical

laims

to distantaristocratic

ancestryare

no

more

convincing

n the realm

of

medicalscience

than

they are

in

more

quotidian ontexts9;

ut it is

perhaps

not

implausible

hatmedicalEmpiricism,

f the

typefamiliar

rom he texts

of

Galen,began o

take

shape

n the later

part

of

the

third

century

B.C.

And

if the attemptof later

doctors to discerna systematic

Empiricism

n their

distant

predecessors

s unconvincing,

tby

no means

ollows,

of

course,

that

they

could

not

point

to

genuineprecursors

f at

least

some

of

their

deasand

presuppositions.

Essentially,Empiricism

s

a

medical

doctrine

s hostile

to

grand

heory.

The

Empiricists

will

not attempt

o

produce

a

comprehensive

nd

general

I

See e.g. In

Hippocratisde

Natura

Hominum

(HNH)

XV 159-61.

6

Med.Exp.

is an extremely

early

work,

written

perhaps

when Galen

was

twentyyears

old, and

before

he made

his first

visit to Rome. In it,

he

is

concerned

to

defend

various

aspectsof Empiricistmethodologyagainst attacks

mounted

on them

by

the

Dogmatists.

By contrast,

Subf.

Emp.

seems to

be fairly

late, at least

if

the reference

to De

Methodo

Medendi (MM)

at 12, 89.2-3

Deichgraeber

is an

indication

of the temporal priority

of

MM to

Subf.Emp.:

but such

methods

of dating

by

internal

evidence in Galen

are

notoriously

suspect.

I

The work

of

MichaelFrede,

unfortunately

argely

still

unpublished,

is

of particular

importance

n this

regard.

See usefully,

if

briefly,

his introduction

n Frede,

1985.

8

And by

[Gal.]

Int.

XIV

683.

9

Although

the fact that

the

laterGreeks

continually

stressed

the supposed

antecedents

to

their views

is

interesting

from

a

psychological

point

of

view:

it

was

important

even

when innovating

to stress

one's

debts

to one's great

predecessors.

Galen,

in his lionisa-

tion of Hippocrates, is an outstandingexample of this strikingdoctrinal

conservatism

(although

t

shouldbe

noted that

Galen is

not uniformly

and unreflectively onstant

n

his

praise

of the

Master).

330







account

of

the

physics

and

chemistry

of the

human

body,

or of the

causal

mechanisms hat underliehealthand disease. They reject the theoretical

constructions

of

the Dogmatists,

with their

theories of

qualities and

humours,

of

basic

irreducible

elements,

of various

types

of

physicaland

psychical

nvEu'iaTa,

of

internalconstrictions

and

relaxations,

or

of

the

catastrophic transference of blood

from

the veins

to

the

arteries;

or

whatever.They restrict

hemselves o

observation,

and to

inference'0

rom

observation. And for

this part of their

doctrine, they

have

a

famous

Hippocratic ntecedent:

he text On Ancient

Medicine

VM).

The

writerof

VM

counselshis readers o forget

about

the

Hot, the

Cold, the

Wet and

the

Dry, and

to concentrate nstead on

inferring

herapies

rom

evident

con-

catenationsof

repeatableevents I.

However,

thereis no real evidence

that

the

Empiricistswere influenced

by

this

text,

ben

trovato

hough

it would

undoubtedly

have

been

for them.

The

actualhistoryof thedevelopment

of medical

Empiricism,

f how

and

when

it becamean

organisedbody of doctrine

of

sufficient

comprehensive-

ness and complexity to

warrant the description of

it as a

medical

aLQSOLg

s

obscure,and not in any

case

relevant

to

ourimmediatepurposes.What is

clear is that by the

time Galen is writing

about the subject, medical

Empiricism

s more than just a

vague set of

injunctionsto rely on the

obvious

and to steer

clear of the Charybdis f

grand heory; t has become

an

epistemological

heory of considerable

subtlety

and

complexity. The

Empiricists, faced with Dogmatic

objections to their

account of the

epistemologicalbasis

of medical

knowledge,wereforcedto

counter-attack

by

developing and deepening the

theoreticalresourcesat

their disposal.

Medical

Empiricismbecame, in

spite of itself,

theoretical n tone.

I

shalldo no more

thanoutline the

structure f that

development.At the

outset,

the Empiricistsdeny the

possibilityof discovering

anythingabout

the

hiddenthings,

xa a&nka n the technical

sense of the

word'2; nd

what

10

Inference of a type to

be

discussed later.

11

VM 1,

13-15: he author

stresses the

importanceof history,

and

the slow

accumulation

of

empiricaldata:

2-3;

and the

continuing progress of

the subject:4.

12

Technical

sense

perhaps overstates

the case slightly:

but

ui'a 6xka

figure

import-

antly n

debates on

epistemology,

particularly n

the

Hellenistic period: and

Sextus

(PH 2

97-8;

M

8 141-4)

distinguishes

between

different types of

non-evident

things (see

n.

32

below).

The notion of

the distinction

between

things that are

evident,

tvaQytg,

and

those which are

hidden,

&6rIAov,

s an

old one: it is

apparent n

the Hippocratic

reatise

On the

Art (Art),

where the

authordistinguishes

between

diseases

on the

surface

of

the

body,

which are easy to

diagnoseand

cure, andthose in

the

hollows of the

body ,

which

are

not so easy,

but can be

dealt with

provided that the

eye of the mind

learns

to

grasp

what ordinary

vision cannot: Art

9-11.

331







goeson

in

thebody

s

hidden

n

theappropriate

ense 3.

On

the other

hand,

we can

know

thingswhich

are

evident,

which

do

not rest

on

inference;

and

among

the

things

that

are

evident

is

that

certainsigns arecorrelatedwith

certaindiseases,

or

symptoms'4.

t

is on

this

basis

hat

the

Empiricist uilds

up his collectionof 6EwQi,uaa,

or

generaltruths'5,which

taken together

constitute the art

of

medicine (Subf.Emp. 2-4, 44.4-51.9D). The crucial

notion

here

is

that

of

an

experience , JrELQLa.

An

experience is

a

collection of instances sufficient to ground a theorem.

Quite

what

the

conditionson

something'sbeing an experienceare

is

obscure,

and

was

the

subject

of a soritical

attack

on the

coherence

of

the

notionitself'6;but

it

is

clear

that

repetition

s at

the

very least

a

part

of the

procedure.

But it is

not

the whole story: the Empiricistdoes not start from squareone. On the

contrary,

he

has a large body of previousexperienceand

medical

ore

to

relyon. However,the Empiricistswere aliveto the difficulties

f evaluating

historical material

for

its

veracity, and it seems that

they developed

a

method of

testing sources

for

reliability'7.

?oQela,

the reportsof pre-

decessors, s one of the methodsthe Empiricistwill use to

generatecandi-

dates

for

theorems: and

Galen says that

naToQla

an

provide

a

basis for

confidence

even

without

further

testing,

if

the

reports

are

sufficiently

trustworthy Subf.Emp. 9, 71.17-22D). But in general

they

should

be

tested, andconfirmedor disconfirmed,by observationor acl'oTpLa.

The

final

weapon

in

the

Empiricist's rmoury

s that of transition o

the

similar,

i

Tofv

6Ro(oU

,eTdaIp3laLg.

epending

on

how

broadly

the

similarities

re

construed,

and

just

what

ypes

of

things

imilarities

an

hold

between,

this

can,

as

we

shall

see,

become

a

weapon

of

considerable

epistemologicalpower.

In

general, however,

t

is

simply

a

heuristic or the

discovery

of

testable

candidatesfor

proper therapies

n

cases

which

lie

outside

the

doctor's

experience,

or

that

of

other

doctorswhose

experience

is known to

him

through i?oQta. Supposingyou

find

someone

in

your

surgerywitha sore fingerof a type youhaven'tseen before;butyouhave

13

See Celsus,

Med. Pr. 27-39.

14

I

leave out

of account

here the

question

of whether

the relation

that

holds for the

Empiricist

between

collection

of observed

instances

and general theorem is

one

of

inference

(presumably

nductive

n form)

atall: suffice it to say that

it doesn't

need

to

be.

15

Such

as Pomegranates

cure

diarrhoea ;

wounds

to the heart

cause

death :cf.

M 5

104.

16

See

Med.Exp.

chs. 16-7,

pp. 114-19

Walzer; cf.

Barnes,

Medicine,

Experience

and

Logic , in Barnes

et al. (edd.)

Science

and

Speculation,

Cambridge

1982).

17

Has this doctor'swordbeen reliablein the past? Does his testimonycohere of other,

already

tested parts

of the theory?

See Subf.Emp.

8, 65.28-69.28

D.

332







treated

similar onditions

n the toes. You

might

reason

as follows:

fingers

are liketoes;remedyx worked ortoes;so let'stryx onfingers ;hatwould

be

a case of transition

o the similar.

It

is

crucial

hat,

unlike

the case

of

LOToQLa,

A

toi3

6Roto

I?ETar3aoL;

annot

generate

knowledge;

t

merely

provides

a usefulheuristic

n the

discovery

of testable

hypotheses.

But

surely,

it

might

be

argued,

transition

o the similar

does

more

than

that:forit

suggests

hypotheses

hat

are

likely

to

be

true,

have

a

reasonable

probability

of succes?

Not

necessarily.

The

Empiricist

need

have no

story

aboutsuch

probabilities t

all;

the

connection,

f

there

s a

connection

at

all,

may

be

only

a

psychological

one

-

I

am caused

to

think

about

toes in

the

context of

finger

ailments

because of

their

morphological

imilarity.

But

there is

evidence of

a

considerable

divergence

among

the

Empiricists

on

this

matter18, s is

only to be

expected

if

my

account

of

Empiricism

as a

developing

viewpoint is

even

remotely

accurate,

and

Galen's

principal

discussion

of

the matter,

at

Subf.Emp. 9,

69.33-74.22

D,

stressesthat,

in

the

developed

version

of

the

theory at

least, the

Empiricistshad a

method

for

evaluating

differentcases of

transition n

orderto

determine

he

degree

of

hope one

might

legitimately

entertainthat

the result

of the

transition

wouldbe

successful:

Incases in whichthere is no history, or inwhich there is none of sufficientsimilarity,

there is

not

muchhope.

And

the same

thing is true in

the case of

transference

of

one

remedy

from

one

ailment to

another

similar o it:

one has a

greater

or

smaller

basis

for

expectation of

success in

proportion

to the

increase or

decrease in

similarity

of

the

ailment,

whether or not

history

is involved.

And the same

goes for the

trans-

ference from

one part of

the body

to

another part:

expectation

of success

varies in

direct

proportionto the

similarity

(Subf.Emp. 9,

74.9-23 D).

The

greaterthe

number

of

pointsof

similarity

between

the

testedand

the

proposed

cases,

andthe

greater he

degreeof

similarity

vinced,the

greater

one's

legitimate

expectations

of a

successful

outcome. It is

important,

however, that even in this sophisticatedanddevelopedaccount,the Em-

piricist

needmake

no

damaging

ssumptions

bout he

regular

natureof

the

universe;his

confidence

n the

power

of

transitional

rocedures o

deliver

likely

candidates or

successful

reatments s at

best

provisional,and

must

await

confirmation

t the

tribunalof

experience.It

rests, infact,

on a

meta-

18

Note

particularly

hat

Cassius

the

Pyrrhonian

attempted to

dispose

of the

idea

of

transition

altogether,

presumably

aware

that

its

increasing

theoretical

importance

in

Empirical

medicine

was

threatening

o

submerge

he

austerityof its

sceptical

origins:see

Galen's

confusing remarks

on

the

status of transition

as a

part

of

medicine at

Subf.

Emp.

4,

49.29-50.2 D.

333







theoremof transitional uccess:cases of transition o the similarare

them-

selves similar ust in thatthey are suchcases;I have the right o beconfident

about his particular pplication f transition,because,beinga transition,t

is itself relevantlysimilar o previouscases which have yielded

successful

outcomes:

So

Logical

transference

based

on

the

nature

of

things lays hold of knowledge by

means

of

indication. But

the

Empirical variety

relies

on

what

is

discovered

by

experience'9, not because

it

is persuasive or plausible that the similar should

be

productive of something similar,

or

require similar things, or undergo

similar

things; it is not because

of

this,

or

anything

else

of this sort, that they think it

justifiable

to make the

transference,

but on

the

basis

of

the

fact

that

they

have

discovered by experience that similarthings behave in this way (Subf.Emp. 9,

70.

10-20

D).

The

important hing

s

that

this s

not

a

logical

or

indicative nference,based

on

some

axiom

of

similarity;

t is

simply

an item

of

observed act20:

And

similarly

whenever

a

similar affliction

strikes

the

same

part,

it

requires

the

same

remedies .

.

.

and if

a similar

affliction has

already

established

itself,

it

requires

similar

remedies.

.

. For

experience teaches us

these

things (Subf.Emp.

9,

70.25-71.1

D).

Finally in this regard it is worth noting that transition forms part

of the

method employed for judgingthe reliability

of

orroQta: ubf.Emp.

8,

69.13-28;9,

71.11-13.This further

upports

he

claim

that,

in

the courseof

the

development

of

Empiricism,

he

role

of transition

diversified,

and

the

idea became of

paramount mportance

n the theoretical

underpinning

f

all

aspectsof Empirical cience.

Now,

in

all of these cases, the Empiricist nsists

that he makes

no

reference, mplicitor explicit,to the conditions

hatobtain nside

the

body.

He

simplyobserves

a

collectionof

symptoms,

an

60QoLogicSubf.Emp.6,

57.5

D),

that

is

regularly

onnectedwith

some

equally

evident

condition

or

setof conditions pains,fevers,orwhatever);andequally,onthetherapeu-

tic

side of matters,he simplynotes what ypes

of

remedy

have

a

tendency

o

alleviate these evident sources

of

discomfort.

19

Accepting

Deichgraeber's

eminently

plausible

suggestion

experientia

or Niccolo's

natura .

20

It is worth

pointing to the

formal

analogiesbetween

what

I

have

perhaps endentiously

and grandiosely

described

as the meta-theorem

of transitionand the attemptsof

some

to

produce self-supporting

arguments

for induction

as a valid procedure

in science; but

these are only analogies,

and it is

important o stress

that

the Empiricists

by no means

need

to

be committed

to induction,

much less to

some

philosophicalaccount

of it.

334







2.

Causesand

Signs

It mightbe thought, then, that Empiricistswouldhave no use for causal

analysis, for

the

attempt

to discern

a hidden

pattern

of

operationthat

underliesthe

phenomena

of

the world. And

that,

as we shall

discover,

is

substantially

he case.

However,

the

picture

s

obscured,

and to an

extent

confused,by

the

fact

that

t is

stated

withsome

regularity

n oursources

hat

the Empiricists did

allow

one

type

of

cause, namely

antecedent2l

or

evident22 auses into their

conception

of the collectionof

symptoms,or

OUuvbp?o

f

Furthermore,

t

is precisely this willingness

o allow the

significance

of

antecedent causes that differentiates he Empiricist romthe Methodical

Doctors. The

Methodists,

n

a

move which Sextus

Empiricusapprovingly

describes as

paradigmatically yrrhonian

PH

1

236-41), refuseto either

affirm or deny the

existence of hidden

states of the body, and hold

that

causes,

if

indeed

there are

such things,are of no

therapeutic mportance

whatsoever23.Galen illustrates he

difference n a passageof SI (I

88-89):

someone

sufferingfrom a

dog-bite visits

an

Empiricistand a

Methodist.

The Empiricist

will question

himcarefullyabout he

circumstancesnwhich

the

bite was

incurred,and will be

interested n the fact

that the dog was

foaming at the mouth; by contrast, the Methodistwill be completely

unconcernedabout how

the condition

arose, and will simply treat

the

wound by

sewing it up again. Galen's

point, of course,

is that bitesdiffer

from dog to

dog, according o whether

the dog in question is

reasonably

sane, or seriously rabid.

The Methodistcompletely

gnores what he con-

siders to be such peripheral

andunimportantssues.

21

CQoxatcaQx?lxdL:

ee SI

1

74,

88; MM

X

244.

22

Celsus, Med.

Pr.

27; on the

connections between

the

concepts

of

antecedence

and

evidence,

see my

Evidence,

Externality and

Antecedence , Phronesis

32, 1987.

23

Sf1

84-5;

[?Gal.]

Ther. XIV

278; and

[?Gal.]

De

OptimaSecta(Opt.

Sect.)

1

170. This

evidence

is

supported by

Celsus, Med. Pr. 54,

57;

these sources

must

be used

with

care,

however;

medical

Methodism

proper began in

the first century

with

Thessalus

(although

it

owed

much to the

previous work

of Themison:

on the

relation

of

Themison to

Methodism, see

Edelstein,

Medical

Methodism in

Ancient

Medicine, Baltimore

(1967)),

and Galen

regularlyuses the

term

Thessalian as a

synonymfor

Methodist

(e.g. at MM X

390,

909ff.); however, it

is clear that

Methodism

developed

and became

more complex in

the years after

Thessalus:the

survivingworks of

Soranus

demonstratea

tolerance, if a

limited

tolerance, of causal

theorising(Gyn.

3 6, 3 7,

3 40

=

CMG

IV

97.7ff., 97.21ff.,

119.2ff.): on these

issues, see Frede,

On the

Method

of

the

So-called

Methodical School of

Medicine , in

Barnes et al.,

op. cit.

(1982); and

G.E.R. Lloyd,

Science, Folkloreand Ideology,

Cambridge

1983)

192-6.

Celsus

refers more

cautiously,

and

perhaps

more accurately,

to the

followers of

Themison .

335







Now,

Galen explicitlysaysthat the Empiricisthere

accepts

acnca

aLio-

xataQXtLXa:

hat he

rejectsare hidden

causesand

hypotheses

bout the

internal

tatesof the

body24:his s confirmed

by the following

passage

rom

Celsus:

On

the

other

hand,

those

who style themselves

Empiricists on the

grounds

of

their adherence

to experience,

embrace evident

causes on

the one hand as

being

necessary,

but they claim that

the search for obscure

causes and natural

actions

is

utterlysuperfluous,

as their nature is

not graspable(Med.,

Pr. 27)

and

further

by some remarks

n Med.Exp.

(24, 133 Walzer;

cf. 3,

88

Walzer)

o

the effect

that the

Empiricist

eeds to knowthe salient

auses

of things25.

But

here

a difficulty

arises.

In anotherpassage,

De Causis

Procatarcticis

(CP)

XIII

16226,

Galen

writes:

For

some

people say

that

nothing s

the

cause

of

anything

else, others indeed

doubt

whether thereare or

not, like the Empiricists,

yet

others acceptthem

on the basisof

a

hypothesis,

such

as

Herophilus,

and still

others,

of

whom

he

[sc.

Erasistratus]

was

the leader,

did

away

with antecedent

causes

as

being

falselybelieved

in.

The

position attributed

by

Galen to the

Empiricists here

seems to

be

straightforwardly

yrrhonian:

hey

refuse

o

commit

hemselves

one

way

or

anotheras to whether here are causes.There s no indication hattheyare

prepared

o

accept

some andreject

others:

the

brXo'i

eems to

cover

any

and

every type

of

cause.

And

this

is

made

all

the more

strikingby

the

fact

that

CP

is

a text

explicitly

devoted

to

defending

he

concept

of

antecedent

causation

againstthe

attacks

mounted

upon

it

by

Erasistratus

and

the

Sceptics27.

nd in some

ways

this

is

perhaps

unsurprising, iven

the

close

24

Thisunderlies

the general

Empiricistrejection of anatomy:

see Galen's On

Anatomi-

cal Procedures

AA) 11288-9;

but as one might expect there

was

no

uniform

Empiricist

line on

the issue.

25

The

examples

suggest beyond

doubt that Hunain's salient causes

are

atta

7rQoxataQxTLxt.

26

CP

survives only in

a mediaeval

Latin translationdone by Niccolo

da

Reggio;

it is

edited by

Kurt Bardong

as

CMG Supp.

II; I have prepared a new critical

edition

with

English

translation

and commentary,

which

will be published by Van Gorcum

in

1988.

n For

Erasistratus's

attack,

see

CP

I

10, 3.18-22

Bardong,and

VI 46, 13.8-12

Bardong;

the argument

that if anything

s genuinely

a cause

it must never

fail

to exercise

its causal

powers)

is directly

attributed

to Erasistratus

by Celsus,

Med. Pr.

54; for its

use

by

the

Sceptics,

see

M

9 242-3.

336







I want to

leave those issueson one side for

the moment,and turn nstead

to

the

relatedarea of sign

theory, in which

again it is possibleto discern

doctrinal imilarities

betweenPyrrhonian

nd Empiricist.The Pyrrhonists

reject one

class of sign-inference, he so-called

indicativesigns

(arIitaa

bELXtLXa), and marshall

a range

of

argumentsagainst

he possibility

of

indicative

igns at PH

2

97-133and

M

8 141-299:

igns, that

is, in which he

antecedent

is

'revelatory

of

', bxxaXv'tLxOv

(PH

2

104, 117, 118),

the

consequent.

The

arguments re,

as usual

or

the Sceptics,

of

widelyvarying

scope, power

and plausibility, anging

rom the interestingand suggestive

to

the downright

atuous.

But for our purposes,what is

important s the

actualnatureof the sign-inferences

he Pyrrhonists

eject3l.In an indicative

sign-inference,

he

antecedent

s something

vident

( this

woman s lactat-

ing ), whereas

the conclusion

s

non-evident,d66&kov

thiswoman

has

conceived 32);he sign therefore

serves

as

a

means

of

derivingknowledge

about

non-evident hings.Clearly, then,

if

the

claims for

it can be

made

good,

indicative

igns

are

a

powerfulweapon

n the

Dogmaticarmoury.

t

is

not surprisinghat both Pyrrhonist

nd

Empiricist hould

be

found

attack-

ing them.

Whereas

he Pyrrhoniansast doubtupon

the

indicative

ign,

the

Empiri-

cists train their

guns

on what

they

call

&vaXoyLopY6g,

r inference to the

&&rkXaM,nd

the

MFt1t,

or indication, of the Dogmatist doctors

(Subf.Emp.

2 44.4-9 D). And where

the Pyrrhonian

s

happy

to

accept

31

One needs

to be careful

here: the Pyrrhonists

do notof course

say firmly hat

there are

no such thingsas

indicative sign-inferences:

hat

would be illegitimate negative

dogma-

tism. But Sextus

at least

spendsmore time

reviewing

the case for the

prosecution

than

that

of the defence.

32

The Stoics carefully distinguished different classes of

6u5i1ka:

ome things are

altogether

(x6O6t~)

d&bXlka

such

as

whether

the numbersof

stars s odd or

even);

some

are temporarily

ae6g

xacDov)

&6bqka

as

the

city of Athens is to me now );

and

some

are naturally

OoaEL)

&6v-ka the

skincontains

ntelligiblepores ):

PH

2

97-8;

M 8

145-

47;

at

ib.

316-7,

Sextus

produces a different

classification,

in which

the number

of

the

stars

is said to be

naturally

non-evident.

It is not clear

what if anything

turns

on this

Sextan indeterminacy. In

the medical

texts,

similar distinctions

are

drawn at

[Gal.]

Def.Med.

XIX 394;

and especially

[Gal.] Hipp.Alim.

XV

303,

where the writer

dis-

tinguishes

atcrLaL 7Qo,6'kot

and

atiuLaL

ov'

7Qo64XoL (on

which see further

below),

and draws a distinction

between

ra

nQ6;

xaiQov &6&ika

nd natei

&bXlka.

n

general,

on sign theory see

Sedley,

On Signs ,

in Barnes et al.

(edd.) Science

and Speculation,

Cambridge(1982); Glidden, ScepticalSemiotics , Phronesis27, 1982.

33

See Subf.Emp.

7

62.18-63.1;

S

I

77-8.

338







commemorative igns, sign-inferences rom one evident

thing

o another34,

the Empiricists rely on tnLXoyLoa6;, n entirely congruent form of

inference35.

he

epistemological mport

of all this

is clear:both

Pyrrhonian

andEmpiricistare happywith generalisations

hat relate items that are at

least

in

principleobservable36;

ut neitherwill allowthat

anything

can

be

inferredabout matters

hat

ie,

for

them,

irredeemably eyond

the

scope

of

human ken.

3.

The Terminology f Causes

The evidence, then, is confusing.On the

one

hand,

we

have a clear

picture

of

both Empiricist and Pyrrhonianaccepting

a

certain

type

of

sign-in-

ference; and there is a general connection,

albeit a

controversialone,

between Empiricalmedicine and Pyrrhonian

philosophy,

which Galen's

testimonyat CP XIII 41.29-42.2servesto

underline.Yet on the otherhand,

we are told that the Empiricistsaccepted antecedent causes, in sharp

contrastwith the orthodox Pyrrhonianine of PH

3

13-30.

What then did the Empiricistsbelieve?

How much causal theory would

they

be

inclined to accept? The therapeutic evidence of SP7 strongly

suggests there is at least some sense in which the Empiricistsaccepted

antecedent causes. Is Galen then merely

being careless n CP? Should he

have

restricted he scopeof the

Empiricists' oubt to hiddencauses, to the

arcane internalworkingsof the body?There is, I think, a better solution,

and one which throws ight not just on

the natureof Empiricist pistemo-

logy, but on the practicalaspectsof

Pyrrhonian cepticismas well38.

On

their own account, the

Empiricists will not waste time on

34The

consequent of the

commemorative

sign-inference

need not be evident

at the

time

the inference

is drawn:

indeed they

are standardly

&Q6;

a(Qov

dbiika.

Smoke is

a

commemorative

sign

of fire: you

may see the smoke

without

seeingthe

fire,

but of

course

you

can

always check to see

whether there

really is a fire

responsible; fires

are

not

naturally or

completely

non-evident: cf. PH 2

102.

35

Subf.

Emp. 7

62.8-65.21 D: nothing

hangs

on

my

use of the

term inference

here. I

do

not mean to

suggest

that the

Empiricists necessarily

(or even

plausibly) performed

anything

much like a

developed inference from

premisses

to

a

conclusion;

the

question,

which is an

important one,

of what exactly

the

epistemological basis for

Empiricist

rLXkOyLOaL6;

s supposed to

be, and what account

they should

give

of

the

cognitive

processes

involved in their

formation,is left

entirely

open.

36

Not

necessarilypublicly

observable:

patients' reportsof their own

symptoms

meet the

Empiricists'evidential

requirements.

37

and elsewhere: cf.

e.g. MM X 244.

3 See

the sources

cited in n. 30 above.

339







terminological

disputes39;

his is

somethingthat

Sextus

too

abhors40,

and

that

Galen himself

spends

much

time complaining

about4l. Most

il-

luminatingly,

t Subf.

Emp.

7 63.4-14,

Galen hashis Empiricist

argue

that

there

is nothing

to stop

the

Dogmatist

from using his

own

definition

of

definition ,

while the

Empiricist

uses another:

These

things

are

disagreements

about

terminology:

n cases

where

it is

possible

to

use language

either

proudly

(superbe

uti)

or humbly,

as it is in many cases,

the

Empiricists

are happy

to use

language

oosely

(abutentes)

Subf.Emp.

7 63.12-16).

abutentes

enders

xaTaxQwEvoL:

nd

theacceptability

f catachresis

o

thePyrrhonists

s

exemplified

by

PH 1

207

andM 11 18-1942. Superbe

uti

I think mplies mportinga theoretical oading ntoordinaryanguage-use,

which the

Empiricist

rejects43.

Galen's

Empiricist

continues:

In practical

matters, then,

the Empiricists

and the

Dogmatists

differ,

as was said

at

the

outset,

in that the

Empiricists

put

their

trust

only

in

what

is evident

to

the

senses

.

.

.

,

whereasthe

Dogmatists

rely

not only

on

these,

but

alsoon

those

things

discovered

through

reason

without observation

from the

natural

consequence

(assecutione

naturali)

of

things.

For

the Empiricist

makes use

not only

of

definitions

and distinctions

drawn

rom

evident

things,

but

also of causal

accounts

(redditiones

causarum4)

and

of demonstration

from things

clearly

known

to the

senses

(ib.

7

63.17-30).

So

the Empiricist

differs

greatly

rom

the

person

qui

irrationalem

rudi-

tionem

pertractat

Subf.Emp.

7 64.12-14

D);

but he also

has

no time

for

the Dogmatists'

alk of

natural

connections

n things.

He will, though,

on

this

account

use

redditiones

ausarum ,

nd

a certain ype

of

demonstra-

tion. The

sort

of thing

Galen

has in

mind

s

indicated

n the

next few lines:

f

a

patient

visitsa

doctor

with

a

dislocation

accompanied

by

a

wound,

and

asks

for

the limb

to

be reset,

the

Empiricist

doctor

will

refuse,

on

the

grounds

hat

it

has beenregularly

bserved

hat such

attempts

under

hese

circumstances

esult

in spasm.

In

asserting

his,

Galen's

Empiricist

can

avoid making

any

claims

about

assecutio

ogica ,

or

naturalis ;

e

relies

solely

and simply

on evidens

observatio

and

memoria .

Of

course,

the

story

is complicated

when

transition

o the

similar

puts

in an

appearance;

39

See Subf.Emp.

5

53.22-25; 6 55.27-56.3,

56.15-19:

utimur

autem

nominibus

maxime

quidem

si

possibile

fuerit secundumgrecorum

consuetudinem .

40

PH

1 195, 207;

cf.

M 11

18-19.

41

Cf. CP

VI 37,

13.12ff;

MM X 43-44,

61,

62, 139;

Diff. Puls.

VIII

493-7,

567-74,

641-43;

Plen.

VII

521; Tum.Pr.Nat.

VII

705ff.; Diff.Resp.

VII 758-60; Soph.

XIV

587.

42

Cf.

also

?ps.-Gal.

Syn.Puls.

IX 458.

43

Cf. Sextuson the aetiologisingof the Dogmatists:PH 1 180.

44

Plausibly

back-translated

by Deichgraeber

as

&no66oEtS

tr(wv.

340







but

for all

that,

the

Empiricist

can

still claim

that

he's

simply

going

by

regularities:he has no need of the type of theoretical sub-structure

favoured

by

the

Dogmatists.

All

thisseems

to

suggest

the

followingpicture.

The

Empiricists,

among

other

things,

hold

these

principles:

(1)There is no

need to

search

for naturalconnections

n

things;

(2)Observation

of

regular

conjunctions

of

event-types

(suitably

sup-

plemented

by

^otoQia

and TO

o

6,otou

RLET66aoLc)

upply

all

we

need in

the

way

of

epistemological

ustification;

(3)Consequently

t is

possible

to

infer45

rom the

occurrenceof

one

evidentevent to the occurrenceof some furtherevent;

(4)There s no

pointin

making

an

unnecessary

uss

about

terminology;

(5)It is

in order

to

offer

accountsof

causes;

(6)The

Empiricist

makes use of

antecedent

causes;

(7)It is

appropriate

to

adopt

a

Pyrrhonian

attitude

to

antecedent

causes.

Before

we go

any

further,

t

should

be

noted that

the

phrase

redditiones

causarum

might

meannot

that

the

Empiricist an

supply

causal

accounts,

but

rather

that he

can

give

reasons

for

why

he

behaves

the

way he

does

(refusingto reset the dislocated imb);andthat interpretations perhaps

lent

support

by

the

subsequent

contrast

with

the

random

procedureof

a

completely

irrational

physician.

But

even

if that

is

the

proper

way

to

read

Galen's

text

here,

there

is

ample

evidence

elsewhere

(collected

above) to

support

he

claimthat

in

some

sense the

Empiricists

were

prepared

o

talk

of

causes,

or

ratherof

antecedent

causes.

That

set of

principles

ooks

to be

fairly

straightforwardly

nconsistent.

How

can

you

adopt a

Pyrrhonian

attitude

to

antecedent

causes,

yet be

prepared o

offer

causal

accounts, f

the

only

type

of

cause

you're

prepared

to

allow is

the

antecedent

variety?

Before

attempting

to

dissolve

that

apparent

inconsistency,

and

show

how

and

why

the

Empiricists

could

consistently

and

interestingly

hold

that

set of

principles,

want to

consider

briefly a

different

possible

accountof

the

matter,

if only

to

dispose

of

it.

I

have

suggested

above

that

Empiricism,

particularly

n

regard

to

such

theoretical

mattersas

the

status

and

extension

of

transition

o

the

similar,

underwent

a

development

during

he

five

hundred

yearsor

so of

its

active

life.

Indeed, it

would

be

most

implausiblef

some

such

development

did

not

take

place:

the

Empiricists

re,

afterall,

committed

o

the

ideaof

progress,

and

the

steady

accumulation

f

knowledge

and

revisionof

previous

views;

4s

Again,

nothing

tums

on

infer

here:

see n.

35

above.

341







andwhile

a willingness

o accept

an evolution n the substance

f the

science

does notin itselfentailanyconcomitantwillingness

ocountenance

evision

of the theoretical

precepts

hatunderpin

he whole enterprise, here

seems

no good

reasonwhy

the

Empiricists

houldnot apply heir

own precepts

of

revisability

and

improvement

n the

light

of experience

to the

meta-prin-

ciples

of the

science as

well.

That would

square

with the account

of

transition

hat

I triedto

discern

earlier,an

account n

which

the notion

of

transition

can

applied

to itself

as a

means of

supplying

for it

an

epistemological

basis.

If that is

the case, if

medical

Empiricism,

s regards

itstheoretical

presuppositions,

was not an ossified

orthodoxy,but a

living,

developing

organism,

what

would there

be to

preventEmpiricists

at

one

time embracingantecedent

causes

and at another

rejecting

them?

And

further,

f there could be synchronic

s

well

as

diachronic

isputesas to

the

proper

form

of Empiricism,

as the case

of Cassius

he

Pyrrhonian

ndhis

tough attitude

to transition

indicate,

why might they

not concern

the

admissibility

r

otherwise

of causes?

No

doubttheremight

well have

been suchdisputes;

perhaps

here

were.

But if

that

is

whatthe divergence

n our sourcesreflects,

t is

extraordinary

that more

is

not made

of

it. We have no

names

of

protagonists

n

any

causal

dispute;no

indication,

apart

romthe

divergencetself,

of

the

existence

of

any

such

dispute.

And yet surely,

if

such

disputes

existed they

would

have

been

of enormous

theoretical

mportance.

After

all,

one

of

the defining

characteristics

f

Empirical

medicine

is its attitudetowards causes.

We

wouldsurely

expect

to

find

it

at the very

least alluded

o

in

Subf.

Emp.

or

Med.Exp.;

and it would be surprising

f

it

werenottreated n detail.

These

considerations,

plus

the

fact that

the

divergence

s

reported

within

the

works

of one

and

the

same

author,

Galen,

with

no

acknowledgement

f

any

inconsistency

of

doctrine,

and no

indication hat

any

other contemporary

Empiricists

are

being

discussed,

render such

a

hypothesis

highly

improbable.

But might

not Galen

simply

be

making

an

error

n CP?

The

weight

of

the

evidence

elsewhere

tells

against

his

contention

n thistext that the

Empiri-

cists

adopted

a

Pyrrhonian

attitude

towardscauses.

PerhapsGalen,

like

Homer,nodded.

But

it

would be

anextraordinary

mistake

o

make, given

that

it

occurs

n the context

of a discussion

ntirelygiven

over

to

the status

of

antecedent

causes.

Furthermore,

he claim

is

repeated

at

CP XIII

170:

As I

have frequently

said,

it is not possible for anyone unversed

n logical theory

to

remain

completely

undeceived;

whence even those

doctors from

the Empirical

school,

who above

all others

proclaim

things in accordance with

common-sense,

342







4.

The Natureof CausalConnections

Let us return o principles 1)-(7) in order o see how, properlynterpreted,

they

do

not forman inconsistent et. Firstof all, consider 2) and

(3). These

outline what one might not entirely untendentiously but I

think fairly

innocuously)describeas

a

proto-Humean ccountof causation.All there s

to say about the causal relation s that it's a matterof constantor regular

conjunctionof event-types48; e know nothing about any

arcane, occult

relation,and have no need to posit any assecutio ogica .In fact,

so far as I

can see,

the

Empiricists o further han Hume. They do not hold that our

view of the world'sworkings s solely basedon constantorregular onjunc-

tions: ratherthey have a classificationof connections and disjunctions,

regularities

and

irregularities, hat

is

more

catholic

than

that.

Essentially,

they divideevent-relations49nto the followingcategories:

we

can observe

events

that

go together (a) invariably; b)

for the most

part;(c)

half the

time; (d) rarely,and (e) never .

Now,

as

far

as

one

can see,

these

categories

are

all

equally mportant: a)

and

(b)

do not have a

privileged

tatus

(as

one

would expect them to have if one were interested

n

elucidating

he causal

structure

f

the world

on

the

basis

of

constant

or

regular

onjunction).

The

Empiricist simply

directs

his

therapeutic

and

diagnostic practice

by

referenceto these typesof generalstatement;andthat, I think,is to go a

step further han Hume.

Now

consider 1). There

is no

point

in

searching

or natural

onnections

in

things (Subf.Emp.

7

63.15-25, quoted above),

where

natural

onnect-

ions is plausibly nterpretedas being

to

do with

causal

connections.

Thus

the difference between

the

Empiricist

and

Dogmatist

accounts

goes

like

49

It makes no difference

for our

purposes how

one

dealswith Hume's

apparent

confu-

sion of a necessity with a sufficiency

thesis:

nor whether

one prefers his

psychological

criterion (although

the latter is

fairly obviously

at least

consonant

with the picture

of

Empiricism

I

have been

tryingto develop

here).

49

It may

be

objected

that

my talk of event-causationfails to

do

justice

to the

range

of

items the

Empiricistsare

prepared

to draw under

their epistemological

umbrella

(facts,

states

of affairs, objects,

or whatever);

and that

is a fair objection.

However,

I

adopt

it

purely

as

a

matter of convenience

-

nothing

hangs on it

whatever.

Everything

hatI

say

forevents

can go just as

happily or any

other

candidate or gap-filler

n a

causalsentence.

50 Subf.Emp. 6

58.13-18;

these categories

are exclusive (that is, e.g. alwaysp

is not

compatible

with for the

most part

p ); but will preserve

mutual

entailments

of

the

following kind:

alwaysp

ff never not-p ;

for the

most partp

iff

rarelynot-p ;

and

half the time p iff half the time not-p ; the Empiricists

do

mention

these latter

facts,

but don't

make much of them;

which, given

their general indifference

to

logic,

is not

altogether

surprising.

344







this.

The

Dogmatist,

on the basisof

physical

and

physiological

heory,will

assert

causal

connections between

events,

causation

n the

objects

in

Hume's

sense,

mediated

by

some

causal

power

which

is itself

unseen,

d&bvjov51.he

Empiricist

will havenone

of that kind

of

vapidtalk,

and

will

confine himself

to

asserting

simply

that certain

events

are

(or

are

not)

regularly een to

go

in

pairs;

he

will

stickto what s

evident,

and

confine

his

inferences

to

&tLXoyLoUio(.

Let us look

briefly

at another

relevant

text,

from

the

possibly

spurious

Galenic treatise De

Optima

Secta:

Since

they (i.e. the

Logical

or

Dogmatic

doctors)

think

that indications

(MVEL-

ctg)

ome from

causes,

and the

causes,

insofar as

they

are

causes,

are

dbilka

it

is

clear that

the indications do not

come

directly

to them

from the

phenomena

(Opt.Sect.

I

120

Kuehn).

The

author

goes

on to

generalise

the point to

cover

relations

between

objects:

if A and

B

stand in some

relation to each

other

R,

then

we can

perceive

A and B,

but not

R. In

the case of

causes, the

Logical doctor

argues,

against he

Empiricist

who

claims hat

pre-evident auses52

nly

are

advantageous

o the

doctor,

that t is not

enough

merely o

perceive

heitem

responsible

for the

causing,

such as the

thorn or

the

splinter:one

has to

know naddition hat t isthe

cause

of theeffect in

question.That

s

the

force

of

the

rider-clause

insofar as

they are

causes .

And

this

additional

knowledge

cannot, for

the Logical

doctor, be

evident, a

(paqcLvovov.

We

do

not

perceivecausal

connections

of

thistype: we

infer

them.

But

the

Empiricistwill

be quite

unmovedby

this.He

will

counter hat

he

is

quite

happyto

use the

word cause

o

refer to the

thorn,or the

bite

of

the

rabid

dog, or

whatever:

hat is just

sticking o

generalusage.

But he

does

so

humbly,

not

proudly.He

does not

import

mplicitly

or

otherwise

anystory

whatsoever

aboutthe

nature

of the

connection if

indeedthere

is

anyrealconnectionat all) betweenthe maddog'sbite and the subsequent

onset of

hydrophobia.

Calling the

bite a

cause of

the illness is

just

a

matter

of

being

unwillingto

abandon

ordinary

anguage. If

there is

any

metaphysical

baggage

hat the

Empiricist asto

shoulder, t is

onlythat

the

51

That is, it

is

66,nov

in the

third of

the

three

senses

distinguished

by

Barnes,

Ancient

Skepticism and

Causation ,in

M.F.

Burnyeat

(ed.)

The

Skeptical

Tradition

California,

1983),

P.

193;

cf.

also p.

202.

S2

aLTLw

ne(66Ta:

the

terminology is

clearly

connected with

that of

sign-theory;

and

there

is

some

evidence

(principally

o be

drawn rom

Clement

of

Alexandria,

Stromateis,

8 (9) 27) to suggestthat the classificationof causesas

nr.66YjXa

r d&r1kas owed to

the

Empiricists;but

that

need

not

concern

us

here.

345







futurewill, in the relevantrespects,continue o resemble he past;andeven

that is not forced upon him

in

any strongsense, provided hat transition o

the similarcan functionas a meta-principle

or its

own

application.So, by

applyingprinciple 4), the Empiricist

will talk of

causes: but thatwill not

force

him

to deny (1). In this sense, (5) turns

out true

allright,because he

Empiricistwill make use of those itemsthat other people call, with some

theoretical oading,

acLTLa

L3oxataixxtLXa;

ut he is

not in

any way com-

mittedto takingon that oadinghimself.

Thus(6) also turnsout true:but, if

antecedent

ause s readas

having ts

full theoretical

mport,

hat s

to say

if the termdoes not simply unctionas a

theoretically alue-neutral esigna-

tion

of a type of phenomenon,

but

rather

carriesalong with it Dogmatic

theoreticalbaggage53,

t turnsout true

de re but not de

dicto54.

And all

that, I

suggest, shows

how

the Empiricist an hold(7) consistently

with the

other

principles.The sense

in whichhe is a

Pyrrhonian

boutantecedent

auses

s

capturedby the

notion of assecutio

ogica ,

or

natural

connectionsbe-

tween things.

He

has

no views

whatsoever

boutsuch

arcana.But the

things

picked out by the Dogmatists n theirtalk

of

antecedentcauseswill

surely

play a role for the Empiricists: semiotic

role.

Thus,

from a

Dogmatist's

perspective,

f A is

an antecedentcause

of

B,

then a

good Empiricist

will

note

and make use of the regularconnectionbetween

A's and B's: but

the

Empiricistwill not assert

thatA is the

antecedent

causeof B. On the

other

hand, the Empiricist

will

refuse

to

countenance

any

other kinds

of

cause

in

any

sense

whatsoever: f A is

(still

from the

Dogmatist'spoint

of

view)

a

non-antecedent ause

of

B ,

then the

Empiricist

will

pay

no attention

o

A

and

its alleged connection

with B at

all-'6. Antecedent

causes ,

then

(to

53

That is, that they really are causes of

the

events in question, rather han simply

being

regularlycorrelated with them in some way.

54

This formulation

has

excited some comment:

I do not mean anything technically

sophisticatedby it. Rather

the point is simplythat Empiricists nd Dogmatists

refer o

the

same events

as

antecedent

causes :but the

term

antecedentcause in the mouth of an

Empiricist has a different

sense than the one it would have

for a Dogmatist: this is the

point of invoking the Fregean

distinction below.

ss E.g. a containing cause (a[TLov

ouVEXUx6v),

or

a preceding cause (a-rLov

n(oiyot5AEvov):

or this Stoic (or at least Stoic-influenced)

erminology n medicine, see

Galen's On Containing Causes

(another text which survives only in Latin and Arabic

versions), ch. 2, CMG Supp. Or. II, p. 134;and see Michael

Frede'sarticle The Original

Notion of Cause ,

in

Barnes et al. (edd.) Doubt

and

Dogmatism,

Oxford (1980),

and

my

own

Evidence, Externality

and Antecedence , Phronesis32, 1987.

1%

I am grateful o JonathanBames

for

suggesting

clarifications

o my account,

both here

and

elsewhere

in

the

text.

346







draw on

Frege),

have the same

(or

generally

the

same)

reference

for

Empiricists

and

Dogmatists57;

ut

they

havea

radically

different

sense.

5. Empiricism nd

Scepticism

If this account is

correct,

then the medical

Empiricist

turns out

to

be

remarkably

ike the sober

Sceptic

discerned

by

Jonathan

Barnes58:

e

has

beliefsof a

sort,

if

relativelymodest

ones,

about

phenomenal

matters;

he

is

happy

to use

ordinaryterminology

for

them;

and

he

sides with

P(og,

common-sense.His

sign-theory

s

impeccablyPyrrhonian

n

its

credentials;

and

the sense in which

he

embraces

antecedent causes turns

out to be

completely

compatible

with the

Pyrrhonian

osition

of

suspending

udge-

ment about

all the non-evident

objects

of scientific

enquiry

PH

1

13).

This is not

of course

enough to

show that medical

Empiricists

were

thoroughgoing

Pyrrhonians,

ven supposing

agreementcould be reached

on

what it wasto be a

thoroughgoing

Pyrrhoniann the firstplace.

Sextus's

critiqueof the

Empiricists's

egativedogmatismat

PH 1

136-41

might

still

go through:

there might well

have

been Empiricists

who

did

positively

affirm

the

inapprehensibility

f the

non-evident (ib.

236), and to

that

extent

abandonedthe

genuine

Pyrrhonian

ath of doubt in

favour of the

harder ine of the Academics59.

hat

impression s

strengthenedby the

use

the

Empiricistsapparently

make of the

Academic

criterialnotion

of

T'o

nLOav6v: I

I

756. But for

all that, it makes

sense

to thinkof

them as

Pyrrhonians

n this regardat

least.

As regards he

supposed

existence of

esoteric causal

connections n objects,

they

will replythat their

sciencehas

no

use

for

that sort of thing;

andwhetheror

not they

exist is in any

case

undeterminable.

If

these conclusions

are

right, then, the

Empiricistsurn

out afterall to

5V

At least

for the

good ones,

whose

therapies

and

diagnostics

are,

according

o

Galen,

indistinguishable:SI

I

72ff., 76-7.

58

Barnes,

op.

cit., pp.

154-60:cf. J.

Barnes,

The

Beliefs of a

Pyrrhonist ,

Proceedings

of

the

Cambridge

Philological

Society, 1982; for other contributions o the

debate as

to

the

scope of

ancient

Scepticism,

see M.

Frede,

Des

Skeptikers

Meinungen ,

Neue

Hefte

Pfir

Geschichte

der

Philosophie,

1979;

and

M.F.

Burnyeat,

Can

the

Skeptic

Live

his

Skepticism? n

Burnyeat

(ed.) op.

cit.

1983.

5

At

least,

the

line

attributed

o

themby

the

Pyrrhonistsof

&xa-citaXrna:ee

e.g.

PH 1

226-235; but

cf. the

attitude

of

Cicero:

Academica2

98-111.

60

For

Carneades'

epistemology,

see M

7

165ff: it

is still

worth

pointing

out that

T6

7cOav6v

does not mean the probable , but the

plausible ,

as

people are

still

to be

found

repeating

the old

orthodoxy

that

Carneades was

a

probabilist.

347







adoptone versionat leastof the Pyrrhonists' pistemology; ike the urbane

Sceptic, the Empinrcist

ides with life and common-sense

against

the

theoreticalextravagances f the Dogmatists.But thescope of theirdoubt s

similarly imited:

t leaves

ordinary ife

and

ordinary anguageuntouched

(or so

at

least they

would

claim);

thereis no

place

in their

picture

or such

luxuriesas global scepticism: hey have no

doubts

at

all

about the external

world. It is the internalworld that

is the

targetfor their Pyrrhonism.

McGill University

348

hankinson - causes and empiricism a problem in the interpretation of later greek medical method

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