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

Author(s): R. J. Hankinson
Source: Phronesis, Vol. 32, No. 3 (1987), pp. 329-348
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Causes and Empiricism:

A Problemin theInterpretation
of LaterGreekMedicalMethod
R.J. HANKINSON

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

Methodists,and the Empiricists',the Empiricistshave perhapsbeen the
most badly served by the capriciousnessof the tradition.Complete texts
surviveof the representativesof the otherschools2;butEmpiricismsurvives
only in fragmentsand testimonia.However,thingsare not quite as gloomy
as they might appearat 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 more systematicallyin three treatises:De
Sectis ad Ingredientibus(SI), On MedicalExperience(Med. Exp.3), and
SubfiguratioEmpirica (Subf.Emp.4).Galen was himself powerfully inI These divisions are conventional and to an extent arbitrary;but they are serviceable
enough. See Galen, De Sectisad Ingredientibus(SI) I 65, 79 (unless otherwise 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]Quaestiones 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 particularis a genus with a widely
differingvariety of species, not all of which are properlyrepresentedby survivingtexts,
this is at best only selectively true. As for the Methodists, we have Soranus's Gynaecology (Gyn. = CMG IV), and Caelius Aurelianus On Acute Diseases and On Chronic
Diseases (MA, MT; ed. and trans. Drabkin, 1954).
3 Which survivesonly in a mediaeval Arabic version done by the great Galenist Hunain
Ibn' Ishaq; it is edited and translatedin Walzer, Galen on Medical Experience,Oxford
(1944). The translationhas been recently re-issued in Frede, Galen: Three Treatiseson
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-translationinto Greek
(which is a great aid to understandingNiccolo's tortured Latin), in Deichgraeber, Die
GriechischeEmpirikerschule,Berlin (1930), as Fr. 10b. It is also translatedin Frede, op.
cit., as is SI.

Phronesis 1987. Vol. XXXII13(AcceptedMarch1987)

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329

fluenced by Empiricism,and stresses throughouthis work the need to

arrangea happymarriagebetween logic and theoryon the one hand, and
experienceand observationon the other5.Indeed, in his very earlyyouth,
he might actuallyhave been sufficientlyclose to the Empiriciststo enroll
himselfamongtheir number6.Thuswith the evidenceto be garneredfrom
Galen, plus the testimonyof other useful, if less valuable,sourcessuch as
Celsus,we canbuildup a reasonablyclearpictureof the natureandscopeof
Greek medicalEmpiricism7.
1. Outlinesof Empiricism
The Empiriciststhemselves, we are told at Subf.Emp. 1, 42.22-43.6 D8,
variously traced their origins back to Acro, a fifth century B.C. near
contemporaryof Hippocrates;Timonof Phlius,the Pyrrhonianpoet; and
Serapionof Alexandria,the pupilof Herophilus.Thesegenealogicalclaims
to distant aristocraticancestry are no more convincingin the realm of
medicalsciencethanthey are in more quotidiancontexts9;but it is perhaps
not implausiblethatmedicalEmpiricism,of the typefamiliarfromthe texts
of Galen, beganto takeshapein the laterpartof the thirdcenturyB.C. And
if the attemptof later doctorsto discerna systematicEmpiricismin their
distantpredecessorsis unconvincing,it by no meansfollows,of course,that
theycouldnot pointto genuineprecursorsof at leastsomeof theirideasand
presuppositions.
Essentially,Empiricismas a medicaldoctrineis hostile to grandtheory.
The Empiricistswill not attemptto producea comprehensiveand general
I

See e.g. In Hippocratisde Natura Hominum (HNH) XV 159-61.

Med.Exp. is an extremely early work, written perhapswhen Galen was twenty years
old, and before he made his first visit to Rome. In it, he is concerned to defend various
aspects of Empiricistmethodology againstattacksmounted 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 priorityof
MM to Subf.Emp.: but such methods of dating by internal evidence in Galen are
notoriously suspect.
I The work of Michael Frede, unfortunatelylargely still unpublished, is of particular
importancein this regard. See usefully, if briefly, his introductionin Frede, 1985.
8 And by [Gal.] Int. XIV 683.
9 Although the fact that the later Greeks continuallystressedthe supposed antecedents
to their views is interesting from a psychologicalpoint of view: it was importanteven
when innovatingto stress one's debts to one's great predecessors. Galen, in his lionisation of Hippocrates, is an outstanding example of this strikingdoctrinal conservatism
(althoughit should be noted that Galen is not uniformlyand unreflectivelyconstantin his
praise of the Master).
6

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accountof the physicsand chemistryof the humanbody, or of the causal

mechanismsthat underliehealth and disease. They reject the theoretical
constructions of the Dogmatists, with their theories of qualities and
humours,of basic irreducibleelements, of varioustypes of physicaland
psychicalnvEu'iaTa,of internal constrictionsand relaxations,or of the
catastrophictransference of blood from the veins to the arteries; or
whatever.They restrictthemselvesto observation,and to inference'0from
observation. And for this part of their doctrine, they have a famous
Hippocraticantecedent:the text OnAncientMedicine(VM). The writerof
VMcounselshis readersto forgetaboutthe Hot, the Cold, the Wet andthe
Dry, and to concentrateinstead on inferringtherapiesfrom evident concatenationsof repeatableevents"I.However,there is no real evidencethat
the Empiricistswere influencedby this text, ben trovatothough it would
undoubtedlyhave been for them.
The actualhistoryof the developmentof medicalEmpiricism,of how and
when it becamean organisedbody of doctrineof sufficientcomprehensiveness and complexity to warrant the description of it as a medical aLQSOLgis

obscure, and not in any case relevantto our immediatepurposes.Whatis

clear is that by the time Galen is writing about the subject, medical
Empiricismis more than just a vague set of injunctionsto rely on the
obviousand to steer clearof the Charybdisof grandtheory;it has become
an epistemologicaltheory of considerablesubtlety and complexity. The
Empiricists, faced with Dogmatic objections to their account of the
epistemologicalbasisof medicalknowledge,were forcedto counter-attack
by developing and deepening the theoreticalresourcesat their disposal.
MedicalEmpiricismbecame, in spite of itself, theoreticalin tone.
I shalldo no morethanoutlinethe structureof that development.At the
outset, the Empiricistsdeny the possibilityof discoveringanythingabout
the hiddenthings,xa a&nkain the technicalsense of the word'2;and what
10 Inference of

a type to be discussed later.

VM 1, 13-15:the authorstresses the importanceof history, and the slow accumulation
of empiricaldata: 2-3; and the continuing progressof the subject: 4.
12 "Technical sense" perhaps overstates the case slightly: but ui'a66xka figure importantlyin debates on epistemology, particularlyin the Hellenisticperiod: and Sextus (PH 2
97-8; M 8 141-4) distinguishesbetween 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,
is an old one: it is apparentin the Hippocratictreatise
On the Art (Art), where the author distinguishesbetween diseases on the surface of the
body, which are easy to diagnose and cure, and those "in the hollows of the body", which
are not so easy, but can be dealt with providedthat "the eye of the mind" learnsto grasp
what ordinaryvision cannot: Art 9-11.
11

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goes on in the bodyis hiddenin the appropriatesense"3.On the otherhand,

we can knowthingswhichare evident, whichdo not reston inference;and
among the thingsthat are evident is that certainsigns are correlatedwith
certaindiseases,or symptoms'4.It is on this basisthatthe Empiricistbuilds
up his collectionof 6EwQi,uaa, or generaltruths'5,whichtaken together
constitutethe art of medicine (Subf.Emp. 2-4, 44.4-51.9 D). 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
subjectof a soriticalattackon the coherenceof the notion itself'6;but it is
clearthat repetitionis at the very least a partof the procedure.But it is not
the whole story: the Empiricistdoes not start from square one. On the
contrary,he has a large body of previousexperienceand medicallore to
relyon. However,the Empiricistswere aliveto the difficultiesof evaluating
historicalmaterial for its veracity, and it seems that they developed a
method of testing sources for reliability'7.i?oQela, the reports of predecessors,is one of the methodsthe Empiricistwill use to generatecandidates for theorems:and Galen says that naToQla
can providea basis for
confidence even without further testing, if the reports are sufficiently
trustworthy(Subf.Emp. 9, 71.17-22 D). But in general they should be
tested, and confirmedor disconfirmed,by observationor acl'oTpLa.
The final weapon in the Empiricist'sarmouryis that of transitionto the
similar, i Tofv 6Ro(oU ,eTdaIp3laLg.
Depending on how broadly the
similaritiesare construed,andjust whattypesof thingssimilaritiescanhold
between, this can, as we shall see, become a weapon of considerable
epistemologicalpower. In general,however,it is simplya heuristicfor the
discoveryof testable candidatesfor proper therapiesin cases which lie
outsidethe doctor'sexperience,or that of other doctorswhose experience
is known to him through i?oQta. Supposingyou find someone in your
surgerywith a sore fingerof a type you haven'tseen before;but you have
See Celsus, Med. Pr. 27-39.
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 (presumablyinductivein form) at all: suffice it to say that it doesn't need to be.
15 Such as "Pomegranatescure diarrhoea";"woundsto the heart cause death": cf. M 5
13

14

104.

See Med.Exp. chs. 16-7, pp. 114-19Walzer; cf. Barnes, "Medicine, Experience and
Logic", in Barnes et al. (edd.) Science and Speculation,Cambridge(1982).
17 Has this doctor's word been reliable in the past? Does his testimony cohere of other,
already tested parts of the theory? See Subf.Emp. 8, 65.28-69.28 D.
16

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treatedsimilarconditionsin the toes. You mightreasonas follows:"fingers

are like toes; remedyx workedfor toes; so let's tryx on fingers";thatwould
be a case of transitionto the similar. It is crucialthat, unlike the case of
cannot generate knowledge;it merely
LOToQLa,A toi3 6Roto I?ETar3aoL;
providesa useful heuristicin the discoveryof testable hypotheses.
But surely, it might be argued,transitionto the similardoes more than
that:for it suggestshypothesesthat are likelyto be true, have a reasonable
probabilityof succes?Not necessarily.The Empiricistneed have no story
aboutsuchprobabilitiesat all;the connection,if thereis a connectionat all,
may be only a psychologicalone - I am caused to think about toes in the
context of finger ailments because of their morphologicalsimilarity.But
there is evidence of a considerabledivergenceamong the Empiricistson
this matter18,as is only to be expected if my accountof Empiricismas a
developing viewpoint is even remotely accurate, and Galen's principal
discussionof the matter, at Subf.Emp. 9, 69.33-74.22D, stressesthat, in
the developed versionof the theoryat least, the Empiricistshad a method
for evaluatingdifferentcases of transitionin orderto determinethe degree
of hope one might legitimatelyentertainthat the result of the transition
would be successful:
In cases in which there is no history, or in whichthere is none of sufficientsimilarity,
there is not much hope. And the same thing is true in the case of transferenceof one
remedy from one ailment to another similarto it: one has a greateror smallerbasis
for expectation of success in proportionto the increase or decrease in similarityof
the ailment, whether or not history is involved. And the same goes for the transference from one part of the body to another part: expectation of success varies in
direct proportion to the similarity(Subf.Emp. 9, 74.9-23 D).

The greaterthe numberof points of similaritybetween the tested and the

proposedcases, andthe greaterthe degreeof similarityevinced,the greater
one's legitimate expectations of a successful outcome. It is important,
however, that even in this sophisticatedand developed account, the Empiricistneed makeno damagingassumptionsaboutthe regularnatureof the
universe;his confidencein the power of transitionalproceduresto deliver
likely candidatesfor successfultreatmentsis at best provisional,and must
awaitconfirmationat the tribunalof experience.It rests,in fact, on a meta18 Note particularlythat Cassius "the Pyrrhonian"attempted to dispose of the idea of
transition altogether, presumably aware that its increasing theoretical importance in
Empiricalmedicine was threateningto submergethe austerityof its scepticalorigins:see
Galen's confusing remarkson the status of transitionas a partof medicine at Subf.Emp.
4, 49.29-50.2 D.

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theoremof transitionalsuccess:cases of transitionto the similarare themselves similarjust in thatthey aresuchcases;I havethe rightto be confident
aboutthisparticularapplicationof transition,because,beinga transition,it
is itself relevantlysimilarto previouscases which have yielded successful
outcomes:
So Logical transferencebased 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 similar things behave in this way (Subf.Emp. 9,
70. 10-20 D).

The importantthingis thatthisis not a logicalor indicativeinference,based

on some axiom of similarity;it is simplyan item of observedfact20:
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
requiressimilarremedies. . . 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 judging the reliabilityof orroQta:Subf.Emp. 8,

69.13-28;9, 71.11-13.This furthersupportsthe claimthat, in the courseof
the developmentof Empiricism,the role of transitiondiversified,and the
idea became of paramountimportancein the theoreticalunderpinningof
all aspectsof Empiricalscience.
Now, in all of these cases, the Empiricistinsists that he makes no
reference,implicitor explicit,to the conditionsthatobtaininsidethe body.
He simplyobservesa collectionof symptoms,an 60QoLogic
(Subf.Emp. 6,
57.5 D), that is regularlyconnectedwithsome equallyevidentconditionor
set of conditions(pains,fevers,or whatever);andequally,on the therapeutic side of matters,he simplynoteswhattypesof remedyhavea tendencyto
alleviatethese evident sourcesof discomfort.

19 Accepting Deichgraeber'seminently plausiblesuggestion "experientia"for Niccolo's

"natura".
20 It is worth pointingto the formalanalogiesbetween what I have perhapstendentiously
and grandioselydescribedas the meta-theoremof 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 importantto stress that the Empiricistsby no means
need to be committed to induction, much less to some philosophicalaccount of it.

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2. Causesand Signs
It might be thought, then, that Empiricistswould have no use for causal
analysis, for the attempt to discern a hidden pattern of operation that
underliesthe phenomenaof the world. And that, as we shall discover, is
substantiallythe case. However, the pictureis obscured,and to an extent
confused,by the factthatit is statedwithsome regularityin oursourcesthat
the Empiricistsdid allow one type of cause, namely antecedent2lor
evident22causes into their conception of the collection of symptoms,or
if
OUuvbp?o
Furthermore,it is preciselythis willingnessto allow the significanceof
antecedentcauses that differentiatesthe Empiricistfrom the Methodical
Doctors. The Methodists,in a move which Sextus Empiricusapprovingly
describes as paradigmaticallyPyrrhonian(PH 1 236-41), refuse to either
affirmor deny the existence of hidden states of the body, and hold that
causes, if indeed there are such things, are of no therapeuticimportance
whatsoever23.Galen illustratesthe differencein a passageof SI (I 88-89):
someone sufferingfrom a dog-bite visits an Empiricistand a Methodist.
The Empiricistwillquestionhimcarefullyaboutthe circumstancesin which
the bite was incurred,and will be interestedin the fact that the dog was
foaming at the mouth; by contrast, the Methodist will be completely
unconcerned about how the condition arose, and will simply treat the
wound by sewing it up again. Galen's point, of course, is that bites differ
from dog to dog, accordingto whetherthe dog in question is reasonably
sane, or seriouslyrabid. The Methodistcompletelyignoreswhat he considers to be such peripheraland unimportantissues.
CQoxatcaQx?lxdL:
see SI 1 74, 88; MM X 244.
22Celsus, Med. Pr. 27; on the connections between the concepts of antecedence and
evidence, see my "Evidence, Externalityand 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 Methodismproperbegan in the firstcenturywith 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 synonym for "Methodist"
(e.g. at MM X 390, 909ff.); however, it is clear that Methodismdeveloped and became
more complex in the years after Thessalus:the survivingworksof Soranusdemonstratea
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".

21

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Now, Galen explicitlysays that the Empiricisthere acceptsacncaaLiowhat he rejects are hiddencauses and hypotheses'bout the
xataQXtLXa:
internalstatesof the body24:thisis confirmedby the followingpassagefrom
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 naturalactions is
utterly superfluous, as their nature is not graspable(Med., Pr. 27)

and further by some remarksin Med.Exp. (24, 133 Walzer; cf. 3, 88

Walzer)to the effect thatthe Empiricistneedsto knowthe "salientcauses"
of things25.
But here a difficultyarises.In anotherpassage,De CausisProcatarcticis
(CP) XIII 16226,Galen writes:
For some people say that nothingis the cause of anythingelse, others indeed doubt
whether there are or not, like the Empiricists,yet others acceptthem on the basis of
a hypothesis, such as Herophilus,and still others, of whom he [sc. Erasistratus]was
the leader, did away with antecedent causes as being falsely believed in.

The position attributed by Galen to the Empiricists here seems to be

Pyrrhonian:they refuseto committhemselvesone wayor

straightforwardly
anotheras to whetherthere are causes.Thereis no indicationthatthey are
preparedto acceptsome and reject others:the brXo'iseems to cover any
and every type of cause. And this is made all the more strikingby the fact
that CP is a text explicitlydevoted to defendingthe conceptof antecedent
causation against the attacks mounted upon it by Erasistratusand the
Sceptics27.And in some ways this is perhapsunsurprising,given the close

24This underlies the general Empiricistrejection of anatomy:see Galen's On Anatomical 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 translationand commentary,which will be publishedby Van Gorcum in 1988.
n For Erasistratus'sattack, see CP I 10, 3.18-22 Bardong, and VI 46, 13.8-12 Bardong;
the argument(that if anythingis genuinelya cause it must never fail to exercise its causal
powers) is directly attributedto Erasistratusby Celsus, Med. Pr. 54; for its use by the
Sceptics, see M 9 242-3.

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connectionbetween Empiricalmedicineand Pyrrhonianscepticism'-8.

Not
only are many of the protagoniststhe same; similarterminologyis to be
found in Pyrrhonianand Empiricist texts. Perhaps the most striking
instance of this is the use of the notion of btacpwvWa,dispute, in order to
ground sceptical argumentsthat conclude to non-apprehensibility.The
word is paradigmaticallyPyrrhonist29;
it describes what the Pyrrhonian
considers to be the inevitable result of dogmaticinquiriesinto the nonevident. The Empiricistuse the same word to exactly the same purpose:
inquiries into the hidden natures and processes of things only result in
disagreement;and that disagreementis undecidable,&VMLXQwIog0.
If it is
true that the Empiricistspositively affirmedthe non-apprehensibilityof
hiddenconditions,as Sextusalleges in the problematicPH 1 236-41,there
was no compellingtheoreticalreason why they had to do so in order to
groundtheirpractice;no theoreticalreasons,thatis to say, why they could
not have been Pyrrhonists.Sextus'sdisavowalof the connectionsbetween
EmpiricistandPyrrhonianis in anycase of no realhelpto anyonewishingto
claim that the account of SI and Celsus presentsthe genuine Empiricist
picture, that of non-Pyrrhonianacceptanceof certaintypes of causes, and
that Galen's evidence in CP is simplymisguided;the reasonfor this is that
whereas Sextus stigmatisesthe Empiricistsfor being negativedogmatists,
the pictureof EmpiricismemergingfromSI and Celsus is one of a certain
(albeit limited) positive dogmatism.
28 Sextus was himself, if his sobriquetis accurate, an Empiricaldoctor; and in spite of PH

1 236-41, it seems improbable that the surname is completely misleading. In fact, the
resolution of this problem seems to me to have importantimplicationsfor the current
debate on the general scope of PyrrhonianScepticism:as to whether, in Barnes' terms,
Pyrrhonianswere sober or drunk, rusticor urbane (3. Barnes, "Ancient Scepticismand
Causation", in M.F. Burnyeat, (ed.) The Skeptical Tradition,Berkeley (1983): for the
debate, see M. Frede, "Des Skeptikers Meinungen", Neue Hefte fiir Geschichte der
Philosophie 15/6, 1979; M.F. Bumyeat "Can the Skeptic Live his Skepticism?" in
Burnyeat, (ed.) op. cit., (1983); and J. Barnes, "The Beliefs of a Pyrrhonist",Proceedings of the CambridgePhilological Society, 28, 1982. Furthermore,Diogenes Laertius's
list of Pyrrhoniansat 9 115-6 contains several Empiricists;and see also Subf.Emp. 4
49.27; 7 65.8; 8 67.2; 9 69.33; 11 82.3; 84.1, 84.1113, 84.31; 1287.23 D, all on Menodotus.
Cassius is described at Subf. Emp. as

ruVQQWVELO;(see

n. 18 above; and cf. Celsus, Med.

Pr. 69); and general connections of style, if not perhaps of substance, between the
Sceptics and the Empiricistsare assertedat the very outset of Subf Emp. (1 42.12-17 D).
" PH 1 59, 112, 114, 164-5; 2 32-3.
30SI I 75; cf. Nat.Fac. II 52; MM X 142; Subf.Emp. 12, 90.5 D employs the term in a
slightly different context. See also Celsus, Med. Pr. 28:
Non posse vero conprehendipatere ex eorum, qui de his disputarunt,discordia,cum
de ista re neque inter sapientiae professores, neque inter ipsos medicos conveniat.

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I wantto leave those issueson one side for the moment,andturninstead

to the related area of sign theory, in which again it is possible to discern
doctrinalsimilaritiesbetweenPyrrhonianand Empiricist.The Pyrrhonists
reject one class of sign-inference,the so-called indicativesigns (arIitaa
bELXtLXa), and marshalla range of argumentsagainstthe possibilityof
indicativesignsat PH 2 97-133andM 8 141-299:signs, thatis, in whichthe
antecedent is 'revelatoryof ', bxxaXv'tLxOv (PH 2 104, 117, 118), the
consequent.The argumentsare, as usualfor the Sceptics,of widelyvarying
scope, power and plausibility,rangingfrom the interestingand suggestive
to the downrightfatuous. But for our purposes,what is importantis the
actualnatureof the sign-inferencesthe Pyrrhonistsreject3l. In an indicative
sign-inference,the antecedentis somethingevident ("thiswomanis lactat("this woman has
ing"), whereas the conclusionis non-evident,d66&kov
a
of
as
means
deriving
knowledge
serves
the sign therefore
conceived"32);
about non-evidentthings. Clearly, then, if the claims for it can be made
good, indicativesignsare a powerfulweaponin the Dogmaticarmoury.It is
not surprisingthat both Pyrrhonistand Empiricistshouldbe found attacking them.
Whereasthe Pyrrhonianscastdoubtuponthe indicativesign,the Empirior inferenceto the
cists train their guns on what they call &vaXoyLopY6g,
&&rkXaM,
and the MFt1t, or indication, of the Dogmatist doctors
(Subf.Emp. 2 44.4-9 D). And where the Pyrrhonianis happy to accept

One needs to be carefulhere: the Pyrrhonistsdo not of course say firmlythat there are
no such things as indicative sign-inferences:that would be illegitimate negative dogmatism. But Sextus at least spends more time reviewingthe case for the prosecutionthan
that of the defence.
32 The Stoics carefully distinguished different classes of 6u5i1ka:some things are
(such as whetherthe numbersof starsis odd or even); some
altogether (x6O6t~) d&bXlka
("as the city of Athens is to me now"); and some
are temporarily(ae6g xacDov)&6bqka
are naturally(OoaEL)&6v-ka("the skin containsintelligiblepores"): PH 2 97-8; M 8 14547; at ib. 316-7, Sextus produces a different classification, in which the numberof the
stars is said to be naturallynon-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 dis31

tinguishes atcrLaLn7Qo,6'kot and atiuLaL ov' 7Qo64XoL (on which see further below),

and natei &bXlka.In general,

and draws a distinction between ra nQ6; xaiQov &6&ika
on sign theory see Sedley, "On Signs", in Barnes et al. (edd.) Science and Speculation,
Cambridge(1982); Glidden, "ScepticalSemiotics", Phronesis 27, 1982.
33 See Subf.Emp. 7 62.18-63.1; S I 77-8.

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commemorativesigns, sign-inferencesfromone evidentthingto another34,

the Empiricists rely on tnLXoyLoa6;,an entirely congruent form of
inference35.The epistemologicalimportof all this is clear:both Pyrrhonian
and Empiricistare happywith generalisationsthat relate items that are at
but neitherwill allow that anythingcan be
least in principleobservable36;
inferredaboutmattersthatlie, for them, irredeemablybeyondthe scope of
human ken.
3. The Terminologyof Causes
The evidence, then, is confusing.On the one hand, we have a clearpicture
of both Empiricistand Pyrrhonianaccepting a certain type of sign-inference; and there is a general connection, albeit a controversialone,
between Empiricalmedicine and Pyrrhonianphilosophy,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 orthodoxPyrrhonianline of PH 3 13-30.
What then did the Empiricistsbelieve? How muchcausaltheorywould
they be inclined to accept? The therapeuticevidence of SP7 strongly
suggests there is at least some sense in which the Empiricistsaccepted
antecedentcauses. Is Galen then merely being carelessin CP? Shouldhe
have restrictedthe scope of the Empiricists'doubtto hiddencauses, to the
arcane internalworkingsof the body? There is, I think, a better solution,
and one which throwslight not just on the natureof Empiricistepistemology, but on the practicalaspectsof Pyrrhonianscepticismas well38.
On their own account, the Empiricists will not waste time on
34The consequent of the commemorativesign-inferenceneed not be evident at the time
the inference is drawn: indeed they are standardly &Q6;
xa(Qov dbiika. Smoke is a
commemorativesign of fire: you may see the smoke without seeing the fire, but of course
you can always check to see whether there really is a fire responsible; fires are not
naturallyor completely non-evident: cf. PH 2 102.
35 Subf.Emp. 7 62.8-65.21 D: nothing hangson 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 premissesto a conclusion; the question,
which is an important one, of what exactly the epistemological basis for Empiricist
is supposed to be, and what account they should give of the cognitive
rLXkOyLOaL6;
processes involved in their formation, is left entirely open.
36 Not necessarilypubliclyobservable: patients'reportsof their own symptomsmeet the
Empiricists'evidential requirements.
37 and elsewhere: cf. e.g. MM X 244.
3 See the sources cited in n. 30 above.

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terminologicaldisputes39;this is somethingthat Sextus too abhors40,and

that Galen himself spends much time complaining about4l. Most illuminatingly,at Subf.Emp. 7 63.4-14, Galen has his Empiricistarguethat
there is nothing to stop the Dogmatist from using his own definitionof
"definition",while the Empiricistuses another:
These things are disagreementsabout terminology:in cases where it is possible to
use language either proudly (superbe uti) or humbly, as it is in many cases, the
Empiricistsare happy to use languageloosely (abutentes)(Subf.Emp. 7 63.12-16).

and the acceptabilityof catachresisto

"abutentes"rendersxaTaxQwEvoL:
the Pyrrhonistsis exemplifiedby PH 1 207 andM 11 18-1942."Superbeuti"
I thinkimpliesimportinga theoreticalloadinginto ordinarylanguage-use,
which the Empiricist rejects43.Galen's Empiricist continues:
In practicalmatters, then, the Empiricistsand 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 Dogmatistsrely not only on these, but also on those things
discovered through reason without observation from the natural consequence
(assecutionenaturali)of things. For the Empiricistmakes use not only of definitions
and distinctionsdrawnfrom 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 Empiricistdiffersgreatlyfrom the person "qui irrationalemeruditionem pertractat"(Subf.Emp.7 64.12-14D); but he also has no time for
the Dogmatists'talk of naturalconnectionsin things. He will, though, on
this accountuse "redditionescausarum",and a certaintype of demonstration. The sortof thingGalenhas in mindis indicatedin the next few lines:if
a patient visits a doctor with a dislocationaccompaniedby a wound, and
asks for the limb to be reset, the Empiricistdoctor will refuse, on the
groundsthat it has been regularlyobservedthatsuch attemptsunderthese
circumstancesresult in spasm. In assertingthis, Galen's Empiricistcan
avoidmakinganyclaimsabout"assecutiologica",or "naturalis";he relies
solely and simplyon "evidensobservatio"and "memoria".Of course, the
story is complicatedwhen transitionto the similarputs in an appearance;
See Subf.Emp. 5 53.22-25; 6 55.27-56.3, 56.15-19: "utimurautem nominibusmaxime
quidem si possibile fuerit secundumgrecorumconsuetudinem".
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. Sextus on the aetiologising of the Dogmatists: PH 1 180.
44 Plausibly back-translatedby Deichgraeber as &no66oEtSatr(wv.
39

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but for all that, the Empiricistcan still claim that he's simply going by
regularities: he has no need of the type of theoretical sub-structure
favouredby the Dogmatists.
All this seems to suggestthe followingpicture.The Empiricists,among
other things, hold these principles:
(1)There is no need to searchfor naturalconnectionsin things;
(2)Observationof regularconjunctionsof event-types (suitablysupplemented by ^otoQia and TO
to 6,otou RLET66aoLc)supplyall we
need in the way of epistemologicaljustification;
(3)Consequentlyit is possible to infer45from the occurrenceof one
evident event to the occurrenceof some furtherevent;
(4)Thereis no point in makingan unnecessaryfussaboutterminology;
(5)It is in order to offer accountsof causes;
(6)The Empiricistmakes use of antecedentcauses;
(7)It is appropriateto adopt a Pyrrhonianattitude to antecedent
causes.
Before we go any further,it shouldbe noted that the phrase"redditiones
causarum"mightmean not that the Empiricistcan supplycausalaccounts,
but ratherthat he can give reasons for why he behaves the way he does
(refusingto reset the dislocatedlimb); and that interpretationis perhaps
lent support by the subsequentcontrastwith the randomprocedureof a
completely irrationalphysician.But even if that is the properway to read
Galen's text here, there is ample evidence elsewhere (collected above) to
supportthe claim that in some sense the Empiricistswere preparedto talk
of causes, or ratherof antecedentcauses.
That set of principleslooks to be fairlystraightforwardly
inconsistent.
How can you adopt a Pyrrhonianattitude to antecedent causes, yet be
preparedto offer causalaccounts,if the only type of causeyou'reprepared
to allow is the antecedent variety? Before attemptingto dissolve that
apparent inconsistency, and show how and why the Empiricistscould
consistentlyand interestinglyhold that set of principles,I wantto consider
brieflya differentpossible accountof the matter, if only to dispose of it.
I have suggested above that Empiricism,particularlyin regardto such
theoreticalmattersas the statusand extensionof transitionto the similar,
underwenta developmentduringthe five hundredyearsor so of its active
life. Indeed, it wouldbe most implausibleif some suchdevelopmentdid not
take place: the Empiricistsare, afterall, committedto the idea of progress,
and the steady accumulationof knowledgeand revisionof previousviews;
4s

Again, nothing tums on "infer" here: see n. 35 above.

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andwhile a willingnessto acceptanevolutionin the substanceof the science

does not in itselfentailanyconcomitantwillingnessto countenancerevision
of the theoreticalpreceptsthatunderpinthe whole enterprise,thereseems
no good reasonwhy the Empiricistsshouldnot applytheirown preceptsof
revisabilityand improvementin the light of experienceto the meta-principles of the science as well. That would square with the account of
transitionthat I tried to discernearlier,an accountin whichthe notion of
transition can applied to itself as a means of supplying for it an
epistemologicalbasis. If that is the case, if medicalEmpiricism,as regards
its theoreticalpresuppositions,was not an ossifiedorthodoxy,but a living,
developingorganism,what would there be to prevent Empiricistsat one
time embracingantecedent causes and at another rejectingthem? And
further,if therecould be synchronicas well as diachronicdisputesas to the
properform of Empiricism,as the case of Cassiusthe Pyrrhonianand his
tough attitude to transition indicate, why might they not concern the
admissibilityor otherwiseof causes?
No doubtthere mightwell have been suchdisputes;perhapstherewere.
But if that is whatthe divergencein our sourcesreflects,it is extraordinary
thatmore is not madeof it. We haveno namesof protagonistsin anycausal
dispute;no indication,apartfromthe divergenceitself, of the existenceof
any such dispute.And yet surely, if such disputesexisted they would have
been of enormoustheoreticalimportance.After all, one of the defining
characteristicsof Empiricalmedicine is its attitude towardscauses. We
would surelyexpect to find it at the very least alludedto in Subf.Emp. or
Med.Exp.; and it wouldbe surprisingif it were not treatedin detail. These
considerations,plus the fact that the divergenceis reported within the
worksof one andthe sameauthor,Galen, withno acknowledgementof any
inconsistencyof doctrine, and no indicationthat any other contemporary
Empiricists are being discussed, render such a hypothesis highly
improbable.
But mightnot Galensimplybe makingan errorin CP?The weightof the
evidenceelsewheretells againsthis contentionin this text that the Empiricists adopted a Pyrrhonianattitudetowardscauses. PerhapsGalen, like
Homer, nodded. But it would be an extraordinarymistaketo make, given
that it occursin the contextof a discussionentirelygivenover to the status
of antecedentcauses. Furthermore,the claimis repeatedat CP XIII 170:
As I have frequentlysaid, it is not possible for anyone unversedin logical theory to
remain completely undeceived; whence even those doctors from the Empirical
school, who above all others proclaim things in accordancewith common-sense,

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were so overcome by the sophism as to be moved to doubt concerning antecedent

causes, and to dare to make no pronouncementsabout them.

And that repetitionrulesout anotherpossibility,thatthe text is corruptand

that Galen was originally ascribingto the Empiricistsscepticism about
other sorts of causes, hidden or obscure: for the sophism Galen is concerned with is explicitly that directed against the notion of antecedent
causationby Erasistratusandhis sectators46.
But at firstglancethere is also
somethingelse peculiaraboutthe passagein question,andthat is the claim
that even the Empiricists,so commonsensicalin most matters,were persuaded by the sophismto reject antecedentcauses. Now, at firstsight you
wouldn'texpect the Empiriciststo be readilypersuadableof anythingby
argument, at least if the argumentwas of any level of theoreticalcomplexity; they simplydon't botherthemselveswith that sort of thing. They have
no time for logic47. But it is one of Galen's primaryand oft-repeated
concernsin CP that ignoranceof or indifferenceto logic is responsiblefor
the most calamitoustheoreticaland practicalerrors. It is because people
don't do enoughdialecticthatthey can be takenin by sophistry.It is to this
dialecticaldeficiencyon the partof the commonherdthat Galen attributes
the success of Erasistratusand co. in seducingordinarypeople awayfrom
the path of common-sensebelief in evident, antecedent causes. So it is
clearlyin his polemicalinteresthere to painteven the Empiricists,a species
known for their imperviousnessto argumentand their consequent immunityto sophistry,as swept along on the captiouscurrent.And Galen is
not above distorting,or at the very least colouring,the evidencein support
of his polemicalpurposes.
But he would stop short, I think, of outrightinvention. So what is the
truth of this particularmatter? I shall argue that Galen, deliberatelyor
otherwise, presents a misleadingpicture of the Empiricists'attitude to
antecedentcauses;but that behindthat deceptivefacadewe can discernan
interestingsense in whichthe Empiricistswere, afterall, Pyrrhonistsabout
antecedent causes: not for the reasons suggestedby Galen in CP - their
Pyrrhonism was not of the type to be induced by consideration of
Erasistratus'ssophism;but for subtleand interestingreasonsof theirown.

46 For further information on the sophism, or rather sophisms, in question, see my

forthcomingstudy Galen on AntecedentCauses.

In this context, cf. particularlytheir attitude to the sorites at Med.Exp. 20, 123-6
Walzer; and see Jonathan Barnes' treatment of the issue in his "Medicine, Experience
and Logic", in Barnes, et al., (edd.) Science and Speculation(Cambridge, 1982).

47

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4. The Natureof CausalConnections

Let us returnto principles(1)-(7) in orderto see how, properlyinterpreted,
they do not forman inconsistentset. Firstof all, consider(2) and(3). These
outline what one might not entirely untendentiously(but I think fairly
innocuously)describeas a proto-Humeanaccountof causation.All thereis
to say about the causalrelationis that it's a matterof constantor regular
conjunctionof event-types48;we know nothing about any arcane, occult
relation,andhaveno need to positany"assecutiologica".In fact, so faras I
can see, the Empiricistsgo furtherthan Hume. They do not hold that our
view of the world'sworkingsis solely basedon constantor regularconjunctions: rather they have a classificationof connections and disjunctions,
regularitiesand irregularities,that is more catholicthan that. Essentially,
into the followingcategories:we can observe
they divide event-relations49
events that go together (a) invariably;(b) for the most part; (c) half the
time;(d) rarely,and(e) never".Now, as faras one cansee, these categories
are all equallyimportant:(a) and(b) do not havea privilegedstatus(as one
would expect them to have if one were interestedin elucidatingthe causal
structureof the worldon the basisof constantor regularconjunction).The
Empiricist simply directs his therapeutic and diagnostic practice by
referenceto these types of generalstatement;and that, I think, is to go a
step furtherthan Hume.
Now consider(1). Thereis no point in searchingfor naturalconnections
in things (Subf.Emp.7 63.15-25,quoted above), where "naturalconnections" is plausiblyinterpretedas being to do with causalconnections.Thus
the difference between the Empiricistand Dogmatistaccountsgoes like
49 It makes no difference for our purposes how one deals with Hume's apparentconfusion 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
EmpiricismI 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 preparedto draw under their epistemologicalumbrella(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. Everythingthat I say
for events can go just as happilyfor any other candidatefor gap-fillerin 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"iff "nevernot-p"; "for the most partp" iff "rarelynot-p";and
"half the time p" iff "half the time not-p"; the Empiricistsdo mention these latter facts,
but don't make much of them; which, given their general indifference to logic, is not
altogether surprising.

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this. The Dogmatist,on the basisof physicaland physiologicaltheory, will

assert causal connections between events, "causationin the objects" in
Hume's sense, mediated by some causal power which is itself unseen,
d&bvjov51.
The Empiricistwill have none of that kindof vapidtalk, andwill
confine himself to assertingsimply that certain events are (or are not)
regularlyseen to go in pairs;he will stickto whatis evident, andconfinehis
inferences to &tLXoyLoUio(.
Let us look briefly at anotherrelevanttext, from the possiblyspurious
Galenic treatise De OptimaSecta:
Since they (i.e. the Logical or Dogmatic doctors) think that indications (MVELctg) 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 relationto each other R, then we can
perceive A and B, but not R. In the case of causes, the Logical doctor
argues,againstthe Empiricistwho claimsthatpre-evidentcauses52only are
advantageousto the doctor,thatit is not enoughmerelyto perceivethe item
responsiblefor the causing, such as the thorn or the splinter:one has to
knowin additionthatit is thecauseof the effectin question.Thatis the force
of the rider-clause "insofar as they are causes". And this additional
knowledgecannot, for the Logicaldoctor, be evident, a (paqcLvovov.
We
do not perceive causal connectionsof this type: we infer them.
But the Empiricistwill be quite unmovedby this. He will counterthathe
is quite happyto use the word "cause"to referto the thorn, or the bite of
the rabid dog, or whatever:that is just stickingto general usage. But he
does so humbly, not proudly. He does not importimplicitlyor otherwise
any storywhatsoeveraboutthe natureof the connection(if indeedthere is
any real connectionat all) between the mad dog's bite and the subsequent
onset of hydrophobia.Calling the bite a "cause" of the illness is just a
matter of being unwillingto abandonordinarylanguage. If there is any
metaphysicalbaggagethat the Empiricisthas to shoulder,it is only thatthe
That is, it is 66,nov in the thirdof the three senses distinguishedby Barnes, "Ancient
Skepticismand Causation", in M.F. Burnyeat(ed.) The SkepticalTradition(California,
1983), P. 193; cf. also p. 202.

51

S2 aLTLw ne(66Ta:

the terminology is clearly connected with that of sign-theory; and

there is some evidence (principallyto be drawnfromClement of Alexandria, Stromateis,

8 (9) 27) to suggest that the classificationof causes as nr.66YjXa
or d&r1kais owed to the
Empiricists;but that need not concern us here.

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futurewill, in the relevantrespects,continueto resemblethe past;andeven

that is not forcedupon him in any strongsense, providedthat transitionto
the similarcan functionas a meta-principlefor its own application.So, by
applyingprinciple(4), the Empiricistwill talk of causes:but that will not
force him to deny (1). In this sense, (5) turnsout true all right,becausethe
Empiricistwill make use of those items that other people call, with some
but he is not in any way comtheoreticalloading, acLTLa
nL3oxataixxtLXa;
mittedto takingon thatloadinghimself.Thus(6) also turnsout true:but, if
"antecedentcause"is readas havingits full theoreticalimport,thatis to say
if the termdoes not simplyfunctionas a theoreticallyvalue-neutraldesignation of a type of phenomenon,but rathercarriesalong with it Dogmatic
it turnsout truede rebutnot de dicto54. And all that, I
theoreticalbaggage53,
suggest, shows how the Empiricistcan hold (7) consistentlywith the other
principles.The sense in whichhe is a Pyrrhonianaboutantecedentcausesis
capturedby the notion of "assecutiologica", or naturalconnectionsbetweenthings.He has no viewswhatsoeveraboutsucharcana.But the things
pickedout by the Dogmatistsin their talk of antecedentcauseswill surely
play a role for the Empiricists:a semioticrole. Thus, from a Dogmatist's
perspective,if A is an antecedentcause of B, then a good Empiricistwill
note and make use of the regularconnectionbetweenA's and B's: but the
Empiricistwill not assertthatA is the antecedentcauseof B. On the other
hand, the Empiricistwill refuseto countenanceany other kindsof causein
any sense whatsoever:if A is (still from the Dogmatist'spoint of view) a
non-antecedentcauseof B", then the Empiricistwill pay no attentionto A
and its alleged connectionwith B at all-'6."Antecedentcauses", then (to

53 That is, that they really are causes of the events in question, ratherthan simply being
regularlycorrelated with them in some way.
54 This formulation has excited some comment: I do not mean anything technically
sophisticatedby it. Ratherthe point is simplythat Empiricistsand Dogmatistsreferto the
same events as "antecedentcauses":but the term "antecedentcause" in the mouthof 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):for this Stoic (or at least Stoic-influenced)terminologyin 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 MichaelFrede'sarticle"The Original
Notion of Cause", in Barneset al. (edd.) Doubt and Dogmatism, Oxford (1980), and my
own "Evidence, Externalityand Antecedence", Phronesis32, 1987.
1%I am gratefulto JonathanBames for suggestingclarificationsto my account, both here
and elsewhere in the text.

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draw on Frege), have the same (or generally the same) reference for
but they have a radicallydifferentsense.
Empiricistsand Dogmatists57;
5. Empiricismand Scepticism
If this account is correct, then the medical Empiricistturns out to be
he has
remarkablylike the "soberSceptic"discernedbyJonathanBarnes58:
beliefsof a sort, if relativelymodestones, aboutphenomenalmatters;he is
happy to use ordinary terminology for them; and he sides with P(og,
common-sense.His sign-theoryis impeccablyPyrrhonianin its credentials;
and the sense in which he embraces antecedent causes turns out to be
completelycompatiblewith the Pyrrhonianpositionof suspendingjudgement about "all the non-evidentobjects of scientificenquiry"(PH 1 13).
This is not of course enough to show that medical Empiricistswere
thoroughgoingPyrrhonians,even supposingagreementcould be reached
on what it was to be a thoroughgoingPyrrhonianin the firstplace. Sextus's
critiqueof the Empiricists'snegativedogmatismat PH 1 136-41mightstill
go through:there might well have been Empiricistswho did "positively
affirm the inapprehensibilityof the non-evident"(ib. 236), and to that
extent abandonedthe genuine Pyrrhonianpath of doubt in favourof the
harderline of the Academics59.That impressionis strengthenedby the use
the Empiricistsapparentlymake of the Academic criterialnotion of T'o
nLOav6v:SI I 756. But for all that, it makes sense to think of them as
Pyrrhoniansin this regardat least. As regardsthe supposedexistence of
esotericcausalconnectionsin objects, they will replythattheirsciencehas
no use for that sort of thing; and whetheror not they exist is in any case
undeterminable.
If these conclusionsare right, then, the Empiriciststurnout after all to
5VAt least for the good ones, whose therapies and diagnosticsare, accordingto Galen,

indistinguishable:SI I 72ff., 76-7.

58Barnes, op. cit., pp. 154-60:cf. J. Barnes, "The Beliefs of a Pyrrhonist",Proceedings
of the CambridgePhilological Society, 1982; for other contributionsto the debate as to
the scope of ancient Scepticism,see M. Frede, "Des SkeptikersMeinungen",Neue Hefte
Pfir Geschichte der Philosophie, 1979; and M.F. Burnyeat, "Can the Skeptic Live his
Skepticism?"in Burnyeat (ed.) op. cit. 1983.
5 At least, the line attributedto them by the
Pyrrhonistsof &xa-citaXrna:
see e.g. PH 1
226-235; but cf. the attitude of Cicero: Academica 2 98-111.
60For 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 Carneadeswas a probabilist.

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adoptone versionat leastof the Pyrrhonists'epistemology;like the urbane

Sceptic, the Empinrcistsides with life and common-sense against the
theoreticalextravagancesof the Dogmatists.But the scope of theirdoubtis
similarlylimited:it leaves ordinarylife and ordinarylanguageuntouched
(or so at least they would claim);there is no place in theirpicturefor such
luxuriesas globalscepticism:they have no doubtsat all aboutthe external
world. It is the internalworld that is the targetfor their Pyrrhonism.
McGill University

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