Galen: On Diagnosis in Dreams

The vision-in-sleep [enhypnion], in my opinion, indicates a disposition of the body. Someone dreaming a conflagration is troubled by yellow bile, but if he dreams of smoke, or mist, or deep darkness, by black bile. Rainstorm indicates that cold moisture abounds; snow, ice, and hail, cold phlegm.

It is necessary also to pay attention to the stage [kairos] of the disease and to the nourishment that has been taken. If, for example, someone who thinks that he is being covered with snow has this impression at the onset of an attack accompanied by trambling, shivering, or chills, one must assign this for the most part to the stage of the disease, not to the disposition of the body. But someone who has such a dream when the disease is past its crisis will provide us with a firmer indication of the coldness of his prevailing humors, all the more so if he has not eaten any of the phlegmatic foods, which, when they are encompassed in the stomach, make possible the coming-into-being of such an impression, even though the disposition in the whole body is not similar.

But since in sleep the soul does not produce impressions based on dispositions of the body only, but also from the things habitually done by us day by day, and some from what we have thought – and indeed some things are revealed by it in fashion of prophesy (for even this is witnessed by experience) – the diagnosis of the body from the visions-in-sleep that arise from the body becomes difficult.

Now if it were necessary only to distinguish this cause from the things done or thought by day, it would not be at all difficult to conclude that whatever has not been done or thought is arising from the body. But since we concede that there are also prophetic dreams, it is not easy to say how these might be distinguished from the ones arising from the body.

At all events, a man dreamed that one of his legs had turned to stone, and many of those clever about such matters judged that the dream pertained to his slaves, but the man was paralyzed in that leg, although none of us expected that. We established, for example, that the wrestler who seemed to be standing in a receptacle of blood and to keep above it with difficulty had an abundance of blood and was in need of purging. And some who were about to sweat critically seemed to be bathing and swimming in receptacles of hot water. So also the impression of drinking without being filled befalls those who thirst exceedingly, just as also that of eating without fulfillment befalls the famished, and that of making love, those who are full of semen.

For it is likely that in sleep the soul, having gone into the depths of the body and retreated from the external perceptions, perceives the dispositions throughout the body and forms an impression of all that it reaches out to, as though these things were already present. And if this is the case, it would in no way be marvelous, whenever the psychic faculty, weighed down by an excess of humors, is troubled, that those moving themselves with difficulty have that impression in a dream and bear some vexations; or on the other hand, whenever the disposition of the body is light and unsuperfluous, that those who are so disposed have a dream that they are flying or running swiftly, the impressions of the soul always agreeing with the dispositions of the body, even to the point of seeming to smell bad or good odors. For those who have this impression that they are passing time in dung and mire either have their internal humors in bad condition, foul-smelling, and putrid, or they have an excess of dung encompassed in their bowels. One must conclude that those who are disposed in the reverse of this way and seem to be passing time in fragrant places have the opposite disposition in their body.

So what our patients see in their visions-in-sleep and seem to do often indicates to us both the shortage or abundance and the quality of their humors.

Galen: Exhortation to the Study of the Arts Especially Medicine: to Menodotus

I. Quest of Riches

Do animals ordinarily called irrational possess no species of reason whatsoever? This has never been decided. Failure of the ability to express thought in speech does not preclude the possibility of more of less reasoning which is unexpressed.

That man’s endowment is of a much higher order is demonstrated by the number of arts he cultivates and his aptitude in acquiring others. With special exceptions lower animals exercise no art. When they do, it is easily attributable to instinct rather than reflection. And man is no stranger to their arts. He imitates the web of the spider, models like the bee, and swims although structurally formed for walking.

He is even acquainted with the divine arts, emulating Aesculapius in the cure of the sick, rivaling Apollo in medicine, architecture, music and divination, and cultivating the studies of the muses, like astronomy and geometry. In the words of Pindar his attainments extend from the depths of the earth to the heights of the heavens. And here by his love for learning he has acquired the greatest of even celestial accomplishments, a knowledge of philosophy. In spite of the participation then of other animals in intelligence, man is the only one deservedly to be called rational.

Thus elevated above the rest of creation, is it not discreditable to neglect precisely what we have in common with the gods to occupy ourselves with lower pursuits, and spurning intellectuality chase only after riches? To demonstrate the perversity of Fortune the ancients not content with representing it both in painting and sculpture under the guise of a woman, surely a sufficiently significant symbol of unreason, have placed a rudder in her hand, a wobbly wheel under the feet and have covered the eyes with a bandage.

In the midst of a tempest about to be swallowed up by the waves, grave will be the blunder if we confide the helm to a blind man, yet no more grave than if on the sea of life, where the shipwrecks are even more to be feared, we trust our happiness to this unstable divinity.

Fortune is so stupid and bungling that passing over the worthy she enriches the least deserving – and even then only later to despoil them. In spite of this crowds rush after her rolling pedestal, and in their chase fail to perceive the precipices ahead. Escaping their grasp she scorns their supplications while ridiculing their laments.

Look, however, at the attributes painters and sculptors bestow on Mercury, the patron of logic and the arts: Healthy, young, with beauty neither borrowed not artificially enhanced, and reflecting the virtues of his soul; countenance smiling, eyes observing, pedestal a stable cube. Behold his worshippers, always happy and smiling like himself. Never abandoned, never separated, and accompanying him always, they rejoice in the benefits of his providence.

Look again at the followers of Fortune. Carried away by hope and easily misguided on account of their lack of learning they rush after the fleeing goddess, some nearer, some further away. In the forefront you distinguish Croesus of Lydia and Polycrates of Samos. Astonishing spectacle! For the first the Pactolus runs with gold – the fish of the sea purvey to the second! After them are found Cyrus, Priam and Dionysius. Look another time and you perceive Polycrates fixed to a cross, Croesus vanquished by Cyrus, Cyrus bent under the yoke of other kings, Priam thrown into Prison and Dionysius dying in obscurity at Corinth.

Taking cognizance of the crowd further back you will be disgusted, composed as it is of demagogues, prostitutes and traitors. You see there homicides, ghouls and bandits. You see atheists, who not content with insulting the gods, pillage even their temples.

The other cortege, that of Mercury, is composed of honorable men, cultivators of the arts. They are not rushing, nor vociferating, nor disputing. The god is in their midst. Ranged in order about him, each preserves the place assigned. Those nearest are the geometricians, mathematicians, philosophers, physicians, astronomers and philologists. Next are the painters, sculptors, teachers of grammar, carvers in wood, architects and lapidaries. In the third rank are the other artists. With eyes fixed on the god they are anxious only to obey without question.

They resemble in no way the crowd following Fortune. For not by the accident of birth, or riches, or official dignity, does he judge of superiority. He honors and attaches to his person the dignified and upright leaders in their art. Observing them you are seized by the desire of veneration and emulation. We see there Homer, Socrates, Hippocrates, Plato – men whose writings place them on a plane with the gods as the lieutenants and ministers of Mercury. Among them there in none not an object of his care. He concerns himself not only with the present but the absent, and watches over them in metaphorical and literal shipwreck.

On a sea voyage Aristippus’ vessel was shattered by a tempest. Thrown on an unknown and possibly hostile shore he was reassured when he observed traced on the sand geometrical figures. He thought he must have landed in Greece among the sages, yet knew at least he was not among barbarians. It proved to be Syracuse. He directed his steps to the university and had scarcely pronounced Sophocles’ verse: “Who will receive the wandering Oedipus and day by day his scanty needs supply?” when he was surrounded. Later some Syracusans about to sail for Cyrene, his native land, inquired if he had anything to say to his compatriots. “Instruct them,” he responded, “to acquire only the goods which pay for the continuance of the passage when the vessel is wrecked.”

Many with no thought but riches, landing in these straits weigh themselves down with their gold or silver only to lose their lives. They forget that they admire even among the lower animals the proficient. They choose horses bred for the race, and dogs trained to the chase. They make their slaves learn professions, even at considerable expense. Yet they fail to educate themselves. Is it not humiliating that a slave be estimated at two thousand dollars while the master is not worth one? One, did I say? Why we would not take him for nothing.

When we see them educating slaves, training animals and fertilizing fields, so as to increase their usefulness, while neglecting their own most precious possession – the mind, we are sensible of no depth of human degradation with which to compare them. With justice we say, “Your houses, slaves, horses, dogs and fields show the results of culture, you only have been neglected!”

Demosthenes and Diogenes were right, the former in calling the ignorant rich “sheep burdened with golden fleece;” the latter in comparing them to fig trees growing on precipitous mountain sides where humanity is unable to benefit by their fruit necessarily given over to crows and jays. For the treasures of the rich of no service to the worthy are the prey of flatterers who prevent them from realizing that Fortune may at any time despoil them.

He was no stranger to the Muses who compared the rich man to a well: As long as the water lasts we come to it to drink, but run dry we are just as ready to use it as a privy. It is perfectly rational that a man whose only recommendation is riches should find himself when despoiled, despoiled too of all the advantages they procured. What can he expect who with no personal qualifications plumes himself on extraneous circumstances dependent on Fortune?

II. Profession of Gentleman by Birth

Not unlike the rich are the gentlemen by birth. Possessing no qualifications of their own, they live their lives in the shadow of their ancestors. They are ignorant that titles of nobility resemble pieces of silver, passing current in the city where coined, but in others no better than counterfeit.

Apropos in Euripides:

Jocasta: “Are you not proud of your illustrious birth and the accompanying rank?”

Polynices: “My nobility fails to prevent me from starving, as far as it is concerned I possess nothing.”

The renown of ancestors, says Plato, is a precious treasure, but more pregnant with significance and idealism is the statement put by Homer into the mouth of Stheneos: “We honor our name by becoming greater than our fathers.”

If distinction of rank means anything, it ought to make us anxious to follow its lead. With every departure, our ancestors should grieve, if the dead can experience sentiment. The higher the standing the greater the dishonor in failing to uphold it.

Ignorant men of obscure extraction have at least this advantage – that people do not know what they ought to be. When the origin is illustrious it cannot be concealed. If we live not up to it what can we expect but dishonorable notoriety?

They who prove unworthy of their ancestors deserve less indulgence than others. A vicious man boasting of his birth, makes his conduct all the more reprehensible. To judge common people we have not the same criteria. If they prove mediocre, we willingly pardon them, finding an excuse in the baseness of origin. For the noble born we have no such plea, since they insist on their differentiation from the multitude.

The sensible man then will learn an art. If he is of good family, it will prove no disadvantage. If he is lowly born he has to opportunity of responding with Themistocles when reproached with his birth: “I am the beginner of a race, yours ends with you.” We refuse to Anacharsis neither our admiration nor the name of sage although of Scythian origin. When he was affronted with his barbarian birthplace he responded: “My country may be a shame to me; you are a shame to yours;” thus reducing to silence a man whose only recommendation was the culture of his native land.

On consideration we perceive it is not the cities which make the citizens illustrious, but he reverse. Whence comes the renown of Stagira, if not from Aristotle; of Soli, if not from Aratus and Chrysippus? Why is the name of Athens so widely known? Surely not on account of the meager fertility of her soil, but rather the number of superior men who have extended to her the éclat of their renown. This truth stands out when we recall that their being Athenians served only to make the misconduct of the demagogues Cleon and Hyperbole more notorious. As a reproach for their ignorance the Boeotians were called swine, but the poetical talent of Pindar alone was almost sufficient to efface this national disgrace.

II. Profession of Male Prostitute

Praiseworthy is Solon, the legislator of Athens, for excusing the son from caring for a father in his old age, who had taken no pains to educate him. Beauty should not be used as a means of livelihood, whatever the vicious may say. The traffic of the body is infamous, while the profit from the exercise of a profession is honest, glorious and sure.

Capable of learning an art only by beginning early, beautiful boys seduced from the path of culture find themselves later repeating with the poet: “Would that the beauty had never existed which has cost so dear!”

They recall then the recommendation of Solon that the last years of life be not forgotten. Hurling at old age a malediction which they deserve themselves, they come to agree with Euripides: “When beauty surpasses the ordinary it is a misfortune, not a good fortune.”

The truth in the verses of Sappho stands out:

The beautiful are so only as long as looked at;
The good will always be beautiful.

To receive old age, who comes on us unexpectedly like a tempest at sea, it is necessary to be prepared with clothing, a comfortable home and a thousand things, imitating in this the experienced mariner, who takes precautions far in advance of the storm.

Conforming then to the ancient precept, the young man should examine himself in the mirror. If endowed with a beautiful face, he should strive to put his soul in harmony, ashamed to possess an ignorant mind within a handsome body. If he finds his figure deformed, he should seek all the more to increase his intelligence, recognizing with Homer: “No matter how homely the man, if endowed with the gift of eloquence we look at and listen to him with pleasure. If when pleading in the assembly he speaks with confidence combined with the proper modesty, he carries us away, and when passing through the city is looked on with admiration almost as a god.”

From what has been said it must be evident to all not devoid of reason that dependence is not to be placed on birth, riches or beauty to the neglect of the arts, yet an excellent and final confirmation in a story of Diogenes may not be amiss: Dining one day at the house of a rich man, whose surroundings were in perfect taste, but who had neglected his own culture, he coughed and throwing his eyes around finally spit on the host himself. When the host reproached him with indignation for his rudeness and demanded the reason, Diogenes responded: “On looking about I found the walls adorned with exquisite paintings, the floor of mosaic of great value representing the images of the gods, the furniture polished and useful, the carpet and bed marvelous in their beauty, the only thing not in harmony was yourself, and since the general custom is to spit where it will do the least harm, I had no other recourse.”

II.A Profession of Athlete

Take care, however, not to be seduced by an imposter or charlatan, who will teach you a useless or contemptible profession. Learn that an occupation which has no serviceable end in life is not an art. You should know that it is not an art to be a tumbler, to walk a tight rope, to twirl around in a circle without vertigo, to imitate Myrmecides of Athens or Callicrates of Lacedaemon.

I trust, too, that the profession of athlete, though it boasts of giving strength to the body, is wildly acclaimed by the mob, was honored by the ancients with state compensation, and has often been put on a plane with the most illustrious professions, will not seduce you. I wish, however, to put you on your guard because without reflection it is easy to be led astray.

Man stands between the gods and the animals, near the first on account of his intellectuality; with the second, because he is mortal. His pursuits should be such as to bring him nearer the former. If he succeeds, he accomplishes everlasting good; if he fails, he has at least the satisfaction of still being above the lower animals. When athletes miss their end they are disgraced; when they attain it, they are not yet above the brutes. Who is stronger than a lion, or an elephant? Who more rapid than a hare? Who even knows that the gods are pleased by these accomplishments?

Divine honors have never been bestowed for running in the stadium, throwing the discus or wrestling, but only for excellence in the arts. Aesculapius and Dionysus, no matter whether they were originally men or were born gods, have been judged worthy of these honors; the first because he discovered medicine, the second because he taught cultivation of the soil.

If you doubt me, believe at least the Pythian Apollo, who addressed Lycurgus: “You come to my temple, Lycurgus. Whether god or man I know not, but I believe you are a god.”

The same oracle rendered no less honor to the memory of the poet Archilochus when his assassin, wishing to enter the precinct, was driven away with the words: “Begone from my temple, you have killed the nurse of the muses!”

Can you tell me of similar honors to athletes? You answer not. Is it because you have nothing to say, or because you consider my witnesses insufficient? You allow me to suspect such intentions when you call in the mob and put forward the applause it accords to athletes.

When you are sick do you place yourself in the hands of the crowd, or of men of education, and even among these the most skillful of physicians? When you are on the sea do you give the wheel to the passengers, or to a specially trained pilot? In the same way for things of less importance we have recourse to the carpenter when we build, and to the shoemaker when we want a pair of shoes. How then in an affair of so much more importance do you claim for yourself the right to judge instead of leaving it to those who are wiser?

Not wishing to speak again of the gods, I present you with some sentiments of Euripides:

A thousand evils afflict Greece, and not one greater than athletics.

What man trained for running or throwing the discus, or for breaking a jawbone has merited a civic crown while serving in the army?

Do we go to war with the discus in hand? Do we repel invaders by running along the defenses? The enemy at hand, we recognize the foolishness of this preparation.


Passing from the testimony of Euripides and other poets, let us turn to the judgment of scientific writers. All philosophers condemn the profession of athlete. Among even physicians, not a single one approves it. Listen, for instance, to Hippocrates: “The athletic development is not natural; much better the ordinary healthy condition of the body.”

I do not wish, however, to draw conclusions from opinions only, because this is rather a procedure of rhetoric than the course of a man endeavoring to arrive at truth. It is only that some, directing attention to the applause of the populace and refusing to consider the profession of athlete apart from this prestige, have forced me to bring forward these witnesses in order to show that the plaudits are merely of the mob and not of intellectual men.

The story of Phryne appears apropos. At a banquet the game of “follow-the-leader” was inaugurated, consisting in each commanding in turn whatever he or she wished. Seeing the women’s faces painted with orcanette, white lead, and rouge, Phryne ordered “hands in finger bowl, touch cheek and wipe immediately with napkin.” She began by doing it herself. The faces of the others, smeared with streaks, were made repellent, Phryne alone became more radiant – she alone possessing a natural beauty without need of detestable artifice.

As true beauty exists only apart from ornamentation, we will examine the profession of athlete to see if it possesses in itself some utility for the state, or for the individual.

There are in nature goods of the mind and goods of the body. Athletes enjoy none of the former, since they are too ignorant to appreciate even that they have a mind. In the amassing of their great quantity of flesh and blood their mind is lost in the vast mire. Receiving no stimulation to develop, it remains as stupid as that of brutes.

II.B Health of Athletes

Athletes think perhaps they participate in some of the goods of the body. Do their exercises create health, the greatest bodily good? If we listen to Hippocrates, in no one do we find a more unstable diathesis:

The extreme development which athletes acquire is deceiving.

The maintenance of health depends on the avoidance of satiety in eating and fatigue in exercise.

Fatigue, nourishment, drink, sleep, sex, all in moderation.

Athletes do exactly the opposite. They fatigue themselves to the limit and then gourmandize to excess, prolonging their repast often into the middle of the night. Analogous rules to those guiding their exercise and eating regulate also their sleep. At the hour when people who live according to the laws of nature quit work to take their lunch, the athletes are rising. They appear to take pleasure in forcing themselves with the madness of the Corybantes to act contrary to the precepts of the divine old man.

Leading a life contrary to the principles of hygiene makes them much more favorable to disease than to health. Hippocrates, I believe, had the same feeling when he stated: “The athletic development is not natural, the healthy condition is better;” thus declaring their manner of life to be against nature. He never even uses the word “condition” in connection with the adjective athletic, not wishing to employ an expression by which the ancients described the state of individuals in perfect health. Condition is a permanent state which changes with difficulty, while the athletic development, carried as it is to an extreme, is subject to change. Brought to the highest degree, it cannot increase, and unable to remain stationary it can only deteriorate.

While athletes pursue their profession their body remains in this dangerous state. When they quit it, they fall into a state even more dangerous. Some die shortly after, others live a little longer, but never reach old age, or if they do they resemble exactly the priests of Homer: “Limping, deformed, and squint-eyed.”

In the same way as walls shaken to their foundations by machines of war fall easily on the next attack, athletes, their bodies enfeebled by the jolts they have received, are predisposed to become sick on the least provocation. Their eyes ordinarily sunken, readily become the seat of fluxions; their teeth, so readily injured, fall out. With muscles and tendons frequently torn, their articulations become incapable of resisting strain and readily dislocate.

From the standpoint of health no condition is more wretched. With reason can it be said that they have been perfectly named, since the word athletai (athletes) is derived from athlioi meaning the unfortunate, or the latter from the former, or both come from the common source athliotes signifying miserable.

II.C Beauty of Athletes

After this discussion of one of the bodily goods, namely, health, let us pass to the other, how athletes fare on the side of beauty. Not only do they derive none from their profession, but many who have been perfectly proportioned fall into the hands of trainers who develop them beyond measure, overloaded them with flesh and blood, and make them just the opposite.

Pancratiasts and pugilists develop a disfigured countenance hideous to look upon. Limbs broken or dislocated and eyes gouged out of sockets show the kind of beauty produced. These are the fruits they gather. When they no longer exercise their profession, they lose sensation, their limbs become dislocated, and, as I have said, they become completely deformed.

Despite these disadvantages athletes assert that they wish to be strong, and that strength is the one thing worth the while. Ye gods! How are they strong? And of what use is their strength? Is it of use on the farm? Can the athlete dig, harvest, or accomplish more in agriculture? Is he more apt in war? Recall anew the verses of Euripides who thus glorifies the athlete: “Do we combat with the discus in hand? The enemy approaching, we recognize the foolishness of this preparation.”

Without doubt then these rivals of Hercules will show special resistance to cold and heat. Without shoes and covered with only a single skin in winter as well as summer, they sleep on the earth under the open heaven! You deceive yourself – in this respect they are more susceptible than a newborn babe.

Under what circumstances then do they show this strength, of which they are so proud? Is it in being able to overcome shoemakers, carpenters, or masons in the palaestra or in the stadium?

Milo, the famous athlete of Croton, by Jupiter, once carried on his shoulder through the stadium a bull destined for sacrifice. O extreme of foolishness! Is it not evident that a few moments before, the bull carried its own body more easily than Milo, since it could even run while carrying it?

His end proves how silly he was. Seeing a young man splitting a tree by the aid of wedges, he ridiculed his weakness and undertook to split it with his hands. Gathering his whole strength, in the first effort he separated the two sides, the wedges tumbled out, and his strength becoming exhausted, the tree gradually shut on his fingers. There he remained fast until he starved. Such was his miserable end.

Would the strength of Milo be capable of saving the Grecian republic against the barbarians? Was it not rather the wisdom of Themistocles who, having properly interpreted the oracle, made the war a success? Euripides gives us the answer:

Wise counsel means more than many men, armed ignorance is the worst of all evils.

Having demonstrated that the regime of athletes is useless as regards practical life, I am going to recount a fable in epic verse by a friend of the Muses to show that there is nothing in athletics as such: If by the will of Jupiter all living beings were brought together in harmony, and if the herald of Olympus called both men and animals to a contest in the same arena, no man would receive a crown. The horse would take it on the long course called the dolichos; the hare in the stadium; the antelope in the dialus. No mortal could enter into competition with the animals in quickness of foot. O light-footed athlete! What a miserable showing you make!

A descendant of Hercules himself would not prove strong as an elephant or a lion. The bull would triumph over the pugilist, and if the ass, adds the poet, was allowed to combat with his heels, he would be a victor. In the learned annals of history, then, would have to be written that man had been conquered in the pancration by the ass, and it would probably be recorded in these words:

Twenty-first Olympiad, Mr. John Ass – the laurel crown.

This fable shows that strength is not what ought to be cultivated, for if the athlete cannot even surpass the animals, of what advantage is it?

Nor do athletes even attain pleasure, if this can be called a corporeal good, neither while exercising their profession nor when they quit it. During the former they are subjected to great fatigue and misery – fatigue by their practice, and misery by their overeating. After quitting it they are crippled in all their members.

They boast perhaps of their emolument. Yet it is easy to discover that they are always in debt. Both while exercising their profession and afterwards they are never found richer than the high-class servants of an opulent man.

If you wish to possess a sure and honest means of making a good living, choose a profession which will remain with you during your whole life. The professions are divided into two categories. The first comprises those in the domain of intelligence, called the honorable or the liberal arts; the second, those demanding manual labor, called the illiberal or mechanical arts. It is assuredly better to choose one in the first category, because those of the second cannot ordinarily be continued during old age.

In the first are found medicine, rhetoric, music, geometry, arithmetic, philosophy, astronomy, literature, and jurisprudence, to which sculpture and painting may be added, for although they are associated with manual labor, they do not demand great strength. A young man whose mind does not resemble that of a brute should choose and exercise one of them, especially medicine, which in my opinion is the best of all.

This translation of Galen’s Exhortatio ad Artes Addiscendas or “Exhortation to Study the Arts” by Joseph Walsh, M.D. was first published in the periodical Medical Life, vol. 37 (1930), 507-529. The present edition was lightly edited and HTML coded for Ancient Medicine/Medicina Antiqua by Lee Pearcy in April, 1996 and subsequently reformatted by Jason Davies in early 2004.