Diocles of Carystus

Diocles of Carystus

(b. Carystus, Euboea; fl. Athens, late fourth century b.c.)

medicine.

Diocles, the son of Archidamus, also a physician, was still alive shortly after 300 b.c. The Athenians called him a “second Hippocrates” and Pliny the Elder (Natural History, XXVI, 10) wrote that Diocles came “next after Hippocrates in time and reputation.” Galen and Celsus place him as an equal with Hippocrates, Praxagoras, Herophilus, and Erasistratus. The last three of these physicians were contemporaries of Diocles, and these four raised Greek medicine to a high point in its history. Diocles was a pupil of Aristotle, and he was also a contemporary of such Peripatetics as Theophrastus and Strato. By some, Diocles is considered the leading representative of the dogmatic school, which introduced philosophical speculations into the Hippocratic materials and formalized the medical systems. Diocles saw, however, that philosophical theory could not explain everything, and he is best considered as independent of any school.

Diocles’ writings were considerable. The titles of seventeen works are known and more than 190 fragments have been preserved. Unlike the physicians of his time, he wrote in Attic Greek. His writings show a well-polished if simple style, and his language and terminology show the influence of the literary style of Aristotle in scientific writing. The subjects covered in his books range widely.

Diocles’ medical writings show the influence of the Aristotelian teleological view of nature. They also indicate that he was the first physician to use a collection of Hippocratic writings, which he may have assembled himself. According to Galen, he was the first to write a book on anatomy and to use that term in the title. While he did not distinguish the nerves from the veins, he did recognize more of the latter than his predecessors. The heart was the source of the blood, which was carried through the aorta and the vena cava. He also described the lungs, ureters, ovaries, fallopian tubes, ileocecal valve, cecum, and the gall bladder with the tube leading to it from the liver. He distinguished between pleurisy and pneumonia and described hepatic and splenic ascites.

In his views on embryology Diocles followed Empedocles. In generation both the man and the woman furnished seed, which contributed to the development of the embryo. The seed, originating in the brain and spinal marrow, was a product of nourishment. Excessive coition was detrimental to the eyes and spinal marrow. In agreement with Empedocles, he felt that the full development of the embryo occurred in forty days, and as the male child grew in the right (i.e., warmer) side of the uterus, it developed quicker than the female. He described human embryos of twentyseven and forty days. In his studies of sterility, he was especially interested in the mule, and according to Galen, he dissected such animals. Again following Empedocles, he asserted that menstruation occurred during the same period of life for all women, beginning at age fourteen and lasting until sixty. He felt that broad hips, freckles, auburn hair, and manly appearance were certain indicators of fertility. Sterility in the female was attributed to displacement of the uterus.

Diocles’ physiology was similar to that of Philistion and was based on the four basic elements of Empedocles—fire, water, air, and earth. The human body also had the four qualities of heat, moisture, cold, and dryness. Health was dependent upon the proper equilibrium of the four elements in the body. Warmth was especially important in the formation of the four humors of blood, phlegm, yellow bile, and black bile. The proper movement of the pneuma, seated in the heart and spreading through the body by means of the veins, had a most important place in health and illness, the latter being independent of outside causes. Fever, disease, or death occurred if the pneuma was hindered by phlegm or bile. Respiration took place through the pores of the skin as well as through the nose and mouth. The Pythagorean number seven was evident in Diocles’ view that the seventh, fourteenth, twenty-first, and twenty-eighth days were most critical during illness. Fever was not a disease itself but symptomatic of some morbid condition. He distinguished between continuous and intermittent fevers and also quotidian, tertian, and quartan forms. Like Hippocrates, he stressed practical experience, observation, and the importance of diagnosis and prognosis.

Some indication of Diocles’ prominence is seen in the fact that he was known to the rulers of his time. A work on hygiene, written after 300 b.c., was dedicated to the Macedonian prince Pleistarchus, the son of the famous general Antipater. Diocles’ letter on hygiene, written between 305 and 301 b.c. and addressed to King Antigone, one of the generals of Alexander the Great, was fortunately preserved by Paul of Aegina, a Greek physician of the late seventh century a.d. Many editions of this work were printed in the sixteenth century in Latin, French, and English.

One of Diocles’ works is entitled Archidamos in dedication to his dead father. His father had condemned the then current practice of massaging the body with oil, because to do so heated the body too much and made it too dry by rubbing. While refuting his father’s arguments, Diocles proposed a compromise: he suggested that in summer a mixture of oil and water be used and in winter pure oil. In the use of oil and water, he is apparently following the idea of a slightly earlier and anonymous work on diet.

Lengthy fragments of Diocles’ own work on diet were preserved by Oribasius, physician to Emperor Julian. In this work the Greek physician looked at human life as a whole and by describing the routine of one summer’s day prescribed what is suitable and beneficial for men. He made allowances for various ages and changes of seasons. His descriptions are given as ideal standards, dictated by suitable and tasteful behavior—the Aristotelian ethic. He does not describe the various physical exercises, but his whole plan for the day is based on exercise in the morning and the afternoon, revolving around the gymnastics of Greek civilization. His exposition of diet described well the Greek ideals of health, harmony, and balance.

In the history of medical botany or pharmacy, Diocles also deserves recognition. Here, like his colleague Theophrastus, he was probably stimulated to the study of botany by his teacher Aristotle. Diocles was the first scientist to write a herbal on the origin, recognition, nutritional value, and medical use of plants; thus he can be considered the founder of pharmacy. His work was used as a source for all later works until Dioscorides. Two other botanical works, dealing with vegetables and with healing, are practical in nature, but apparently they also advanced the study of plants. Theophrastus, the founder of scientific botany, seems to have made extensive use of the botanical works of Diocles; although he does not name his colleague in his botanical works, in his work On Stones he does refer to Diocles as an authority on a certain mineral.

Diocles is credited with two inventions—a bandage for the head and a spoonlike device for the extraction of arrows.

BIBLIOGRAPHY

1. Original Works. Fragments of Diocles’ works are in C. G. Kühn, Diocles Carystius fragmenta collegit (Leipzig, 1827); Mauritz Fraenkel, Dioclis Carystius fragmenta quae supersunt (Berlin, 1840); Werner Jaeger, “Vergessene Fragmente des Peripatetikers Diokles von Karystos,” in Abhandlungen der Deutschen Akademie der Wissenschaften zu Berlin, Phil-hist. Kl., no. 2 (1938); and Max Wellman, “Die Fragmente des sikelischen Aerzte, Akron, Philistion, und des Diokles von Karystos,” in Fragmentsammlung der griechischen Aerzte, I (Berlin, 1901), 117–207.

II. Secondary Literature. On Diocles and his work, see Gustav A. Gerhard, “Ein dogmatischer Arzt des vierten Jahrhunderts vor Christ,” in Sitzungsberichte der Heidelberger Akademie der Wissenschaften, Phil.-hist. Kl. (1913); W. Haberling, “Die Entdeckung einer kriegschirurgischen Instrumentes des Altertums,” in Deutsche militärärztliche Zeitschrift, 40 (1912), 658–660; Werner Jaeger, Paideia, Die Formung des griechischen Menschen, 3 vols. (Berlin-Leipzig, 1934–1947), trans, into English by G. Highet as Paideia: The Ideals of Greek Culture, 3 vols. (New York, 1960), III, 41–44, passim; Werner Jaeger, Diokles von Karystos. Die griechische Medizin und die Schule des Aristoteles (Berlin, 1938, 1963); George Sarton. Introduction to the History of Science, I (Baltimore, 1927), 121; and Max Wellman, Die pneumatische Schule bis auf Archigenes, in ihrer Entwicklung (Berlin, 1895); “Das ältesie Kräuterbuch der Griechen,” in Festgabe für Franz Susemihl. Zur Geschichte griechischer Wissenschaft und Dichtung (Leipzig, 1898); and “Diokles von Karystos,” in Pauly-Wissowa, Real Encyclopädie.

Karl H. Danwinfeldt