SAPERE Scripta Antiquitatis Posterioris ad Ethicam REligionemque pertinentia Schriften der späteren Antike zu ethischen und religiösen Fragen Herausgegeben von Reinhard Feldmeier, Rainer Hirsch-Luipold und Heinz-Günther Nesselrath Band XII Rufus of Ephesus On Melancholy edited by Peter E Pormann ISBN 978-3-16-149760-5 (cloth) ISBN 978-3-16-149759-9 (paperback) Die Deutsche Nationalbibliothek lists this publication in the Deutsche Natio- nalbibliographie; detailed bibliographic data is available on the Internet at http://dnb.d-nb.de. © 2008 by Mohr Siebeck Tübingen. This book may not be reproduced, in whole or in part, in any form (beyond that permitted by copyright law) without the publisher’s written permission. This applies particularly to reproductions, translations, microfilms and storage and processing in electronic systems. The book was printed by Gulde-Druck in Tübingen on non-aging paper and bound by Buchbinderei Held in Rottenburg. Printed in Germany. e-ISBN PDF 978-3-16-156442-0 SAPERE Greek and Latin texts of Late Antiquity (1st–4th centuries AD ) have for a long time been overshadowed by those dating back to so-called ‘classi- cal’ times. The fi rst four centuries of our era, however, produced a cornu- copia of works in Greek and Latin dealing with questions of philosophy, ethics, and religion that continue to be relevant even today. The series SAPERE (Scripta Antiquitatis Posterioris ad Ethicam REligionemque pertinentia, ‘Writings of Late Antiquity on Ethics and Religion’) under- takes the task of making these texts accessible through an innovative combination of edition, translation, and commentary in the form of inter- pretative essays. The title ‘SAPERE’ deliberately evokes the various connotations of the Latin verb. In addition to the intellectual dimension – which Kant made the motto of the enlightenment by translating ‘sapere aude’ as ‘dare to use thy reason’ – the notion of ‘tasting’ should come into play as well. On the one hand, SAPERE makes important source texts available for discussion within various disciplines such as theology and religious studies, philology, philosophy, history, archaeology, etc.; on the other, it also seeks to whet the reader’s appetite to ‘taste’ these texts. Con- sequently, a thorough scholarly analysis of the texts, which are investi- gated from the vantage points of different disciplines, complements the presentation of the sources both in the original and in translation. In this way, the importance of these ancient authors for the history of ideas and their relevance to modern debates come clearly into focus, thereby foster- ing an active engagement with the classical past. To the Warburg Institute, its Founder, Directors, Staff and Students Preface Among the recent physicians, Rufus of Ephesus has composed the best work on melancholy. Galen (d. c AD 216/17) Melancholy. Twofold melancholy. Madness and depression, innate and acquired, somatic disease and mental disorder. Since the dawn of time, man has suffered from this saddening sickness and maddening malady. The Greeks gave it the name by which we know it today: melancholy, melancholia , the condition caused by black bile, mélaina chol . An ail- ment which has occupied the minds of innumerable intellectuals, count- less quacks, and scores of artists and authors of prose and poetry. Hippocrates ( fl . 430 BC ) saw it as a disease characterised by despond- ency. Aristotle (d. 322 BC ) proclaimed it a precondition of great achieve- ment and genius. Galen codi fi ed it as a tripartite condition—hypochon- driac, encephalic, general. The three authors in fl uenced the coming generations of physicians and philosophers. This, in a nutshell, is the standard narrative of melancholy’s pre-history and history, with little ref- erence to the man who ‘composed the best work’ on the subject, Rufus of Ephesus ( fl c AD 100). He wrote a monograph On Melancholy which by common acclaim constituted an unsurpassed masterpiece, a model for many in Antiquity, the Middle Ages, and the Renaissance. Yet, although it enjoyed great popularity not only in the Latin West and the Greek East, but also in the Arabic-speaking world, it was lost: neither the Greek ori- ginal nor its Arabic translation have come down to us. The present book attempts for the fi rst time to collect all the known fragments in Arabic, Greek, and Latin. Through the efforts of painstaking philology, much of Rufus’ On Melancholy can be recovered and presented in a fashion easily accessible to the general reader. Yet Rufus’ masterwork deserves more than a mere snatching from the jaws of oblivion. Here, distinguished scholars interpret Rufus’ work from various vantage points, and invite readers to come on an intellectual jour- ney of gigantic dimensions. The readers will enter Roman high society, and meet of fi cials succumbing to social stress due to public engagements. They will stroll through the medical marketplaces of Asia Minor, where physicians competed in medical ‘Olympics’ for prizes, patronage, and power. They will learn how Rufus, unlike most of his successors, combined the Aristotelian and the Hippocratic traditions: desires for sex and wine characterise melancholics; and yet, intercourse and inebriation can also cure their raving madness and craving for solitude and suicide. In the hospitals of Baghdad, the courts of Cairo, and the palaces of Kair- ouan, Muslim, Jewish, and Christian clinicians relied on Rufus when treating cantankerous courtiers and quarrelling kings – sometimes at the cost of their own life. An absolute highlight on this virtual voyage through time and space is Dürer’s Melencolia I (1514). Two pre-eminent art historians offer a new interpretation of this compendious copperplate, and explain how Rufus’ ideas in fl uenced the great German engraver. The two last stations of the journey will lead through literature and bring us back to modern medicine. In his Anatomy of Melancholy , Robert Burton (d. 1640) further developed the type of the scholarly melancholic, fa- mously associated with Rufus. George Eliot (d. 1880) and Orhan Pamuk (b. 1952) both continued this tradition of scholarly melancholy, which, in transmuted form, also appears in the latest American manuals on mental disease. Finally, Rufus’ impact can be traced through the psychiatric lit- erature of eighteenth-century France and twentieth-century Germany in fascinating ways. The idea to write this book goes back to my undergraduate days in Tübingen. My esteemed teacher Manfred Ullmann gave me an off-print of his in fl uential article on the Arabic transmission of Rufus’ work (U LL- MANN 1994). I perused it during a fi eld trip with the Classics department in the hot summer of 1995 to the Roman town of Trier ( Augusta Tre- verorum ). Then, in 1997, I gave a talk on Rufus’ On Melancholy for a course on ‘Emotions in Graeco-Roman Antiquity ( Emoties in de Grieks- Romeinse Oudheid )’, jointly organised by Manfred Horstmanshoff and Piet Schrijvers at Leiden University. I continued to collect fragments over the years, and always wanted to heed Ullmann’s injunction to pro- duce an edition which would take all the available evidence into consid- eration. In January 2004, Lesley Dean-Jones circulated a call from the editors of SAPERE, who were keen to include a medical text in their series. In an extremely productive dialogue, the editors and I developed the concept for the present volume, and I was fortunate enough to be able to secure the collaboration of some of the greatest experts on this topic. I organised a small workshop at the Warburg Institute in September 2006, where the contributors and editors came together to present and listen to fi rst versions of the essays. An atmosphere of constructive criticism and great collegiality was instrumental in giving the volume its present shape. My thanks go fi rst and foremost to the authors who contributed such stimulating essays, as well as the series editors who helped in many ways. Peter Bachmann, Pauline Koetschet, and Manfred Ullmann read an earlier version of the fragments, commented on the text and translation, and saved me from many an error. Numerous other colleagues lent their x Peter E Pormann assistance; they include: Peter Adamson, Charles Burnett, A med Et- m n, Stefania Fortuna, Charles Hope, Andrew Laird, Elizabeth McGrath, James Montgomery, Caroline Petit, Mariana Saad, Emilie Savage-Smith, Nikolai Serikoff, Maude Vanhaelen, Elvira Wakelnig, and Fritz Zimmer- mann. Last, not least, the staff at Mohr Siebeck, and especially Matthias Spitzner of the desk-editing department, greatly helped in the process of producing this book. Many institutions have offered their support as this volume took shape. I owe my thanks to Merton College, Oxford, where I was a Junior Research Fellow (2001–4); to the Warburg Institute, which elected me to a Frances Yates long-term fellowship partly to work on this book (2004– 6); and to the Wellcome Trust for a University Award (no. 077558, held at Warwick, 2006–11). Furthermore, Corpus Christi College, Oxford, gave me membership in their Senior Common Room in 2004–5, and the American University in Cairo made me a Visiting Researcher in 2007–8. During my time in Cairo, I also bene fi ted tremendously from the re- sources of the Institut Dominicain d’Études Orientales. Finally, the lib- raries whose manuscripts are quoted and reproduced here made it pos- sible, through their sources and resources, to produce the present book. I am tremendously grateful to all of the above individuals and institu- tions without whose support I could never have undertaken this project, let alone bring it to a felicitous end. Aby Warburg (d. 1929) had an acute interest in melancholy, as did his pupils Fritz Saxl (d. 1948) and Erwin Panofsky (d. 1968). They discussed this topic at the Kulturwissenschaft- liche Bibliothek Warburg in Hamburg, fi rst a private library which opened its doors to the public in 1918. The library was saved from the claws of the Nazis and moved to London to become the Warburg Insti- tute in 1933. One can say without exaggeration that melancholy was at the origin of this great institution. Its founder, Aby Warburg, and its fi rst director, Fritz Saxl, studied the art historical aspects of melancholy in their larger context of cultural and intellectual history, focusing on Dürer’s Melencolia I . It is hoped that the present collection and interpret- ative essays contribute to the continuing study of this mysterious condi- tion, and that past, present, and future Warburgians will accept this book as a modest token of our appreciation for their efforts and achievements. Cairo – Hamburg – Oxford, 2008 Peter E Pormann Preface xi List of Contents SAPERE .........................................................................................................................v Preface ...........................................................................................................................ix Rufus of Ephesus’ On Melancholy Introduction ( Peter E Pormann ) ............................................................................. 3 Rufus of Ephesus .............................................................................................................. 4 Interpretations and Impact ................................................................................................ 8 Demise and Discontinuities .............................................................................................. 9 From Ephesus to Istanbul ............................................................................................... 22 Text and Translation ( Peter E Pormann ) .......................................................... 25 Commentary ( Peter E Pormann ) ......................................................................... 81 Essays Social Stress and Political Pressure On Melancholy in Context ( Simon Swain ) ...................................................... 113 Introduction ..................................................................................................................113 Melancholy and Moral Conduct................................................................................... 117 Rufus’ Case Histories................................................................................................... 123 Rufus and Plutarch ....................................................................................................... 128 Concluding Thoughts: Melancholy and Society ..........................................................135 The Medical World of Rufus of Ephesus ( Vivian Nutton ) .........................139 Rufus – His Work and His Life.................................................................................... 139 Ephesus and Its Medical Milieu ................................................................................... 141 Alexandria .................................................................................................................... 143 Anatomy at Alexandria ................................................................................................ 144 Hippocratism and Humoral Pathology.........................................................................146 The Three Sects ............................................................................................................ 149 The Medical Marketplace............................................................................................. 153 The ‘Pneumatists’ – a Fourth Sect?.............................................................................. 156 Conclusion....................................................................................................................157 Rufus’ On Melancholy and Its Philosophical Background ( Philip J van der Eijk ) .................................................................. 159 Introduction ..................................................................................................................159 Melancholy, Mind and Body........................................................................................ 161 Typologies of Melancholy ........................................................................................... 170 Psychosomatic Interaction............................................................................................ 174 Diagnosis and Understanding of the Disease ............................................................... 175 Melancholy in the Medieval World The Christian, Jewish, and Muslim Traditions ( Peter E Pormann ) ........179 Melancholy and Monasticism ...................................................................................... 181 Melancholy and the Fall of Man .................................................................................. 183 Maimonides and the Melancholic Sultan ..................................................................... 185 Rufus’ On Melancholy in Medieval Baghdad.............................................................. 188 From Hospital to Asylum............................................................................................. 193 Miskawaih and the Refutation of Atheism................................................................... 194 Conclusions .................................................................................................................. 196 Dürer and Rufus: Melencolia I in the Medical Tradition ( Peter-Klaus Schuster, Jörg Völlnagel ) ...........197 Dürer’s Depiction of Melancholy: His Denkbild ......................................................... 199 Dürer and Rufus ........................................................................................................... 211 Rufus of Ephesus and the Tradition of the Melancholy Thinker’ ( Peter Toohey ) ............................................................... 221 Introduction ..................................................................................................................221 Rufus’ On Melancholy and the Aristotelian Tradition................................................. 222 Geometers, Architect, and Melancholic Thinkers........................................................ 224 Melancholic Thinkers in Literature.............................................................................. 228 A Reinvention of the Melancholic Thinker? The DSM-IV-TR on Obsessive Compulsive Personality Disorder ............................. 240 Conclusion....................................................................................................................242 Rufus’ Legacy in the Psychopathological Literature of the (Early) Modern Period ( Thomas Rütten ) ......................................................... 245 Hubertus Tellenbach (1914–94)...................................................................................248 Anne Charles Lorry (1726–83) ....................................................................................252 Robert Burton (1577–1640) .........................................................................................257 xiv List of Contents Appendices 1. Greek Text, and Arabic and English Translations of Galen’s On the Affected Parts iii. 9–10 ( Philip J van der Eijk , Peter E Pormann ) .........265 The melancholic humour: variations in its composition ..............................................267 Diseases in the head caused by the melancholic humour............................................. 269 Melancholic conditions arising from co-affection ....................................................... 269 The melancholic humour segregated in one part of the body ...................................... 271 Consequences for treatment ......................................................................................... 273 Melancholy arising from the stomach: Diocles’ account............................................. 277 Different manifestations of melancholy ....................................................................... 285 2. Is q ibn Imr n on ‘Scholarly Melancholy’ ( Peter E Pormann ) .......289 3. Melancholy in ar-R z ’s Book of Experiences ( Peter E Pormann ) ....295 Bibliography ( Peter E Pormann ) ....................................................................... 297 Abbreviated Literature ................................................................................................. 297 Articles and Monographs ............................................................................................. 297 List of Contributors ................................................................................................ 311 Indices ( Peter E Pormann ) .................................................................................. 313 General Index ............................................................................................................... 313 Source Index.................................................................................................................325 List of Illustrations ................................................................................................. 333 List of Contents xv Rufus of Ephesus On Melancholy Introduction * P ETER E P ORMANN The shape and the detail of depression have gone through a thousand cartwheels, and the treatment of depression has alternated between the ridiculous and the sub- lime, but the excessive sleeping, inadequate eating, suicidality, withdrawal from so- cial interaction, and relentless despair are all as old as the hill tribes, if not as old as the hills. Andrew Solomon, Noonday Demon: An Anatomy of Depression 1 Melancholy, madness and other mental disorders have always disturbed and troubled man; but they also exercise a singular fascination on the imagination of countless generations of artists, writers, and thinkers, be they philosophers or physicians, poets or prose authors. Madness, after all, beckons the question of what is normal behaviour; what is acceptable within a social group; and how one deals with those who transgress the boundaries of rationality. In myth, great heros such as Hercules were consumed by a maddening fury, and frenzy drove others such as Medea to kill her own children. Yet, madness and melancholy are also portrayed as being characteristic of genius and exceptional achievement. Both the mystery and the fascination of this subject are singularly illustrated in Dürer’s Melencolia I (see fi g. 1 on p. 198 below). In many fi elds, ranging from literary criticism to psychiatry, not a year passes without studies be- ing published on one aspect of this topic or another. 2 Like no other physician from Antiquity, Rufus of Ephesus combines the two major strands in the concept of melancholy: melancholy as a mental disease having physiological origins, and melancholy as a dispos- ition leading both to despair and great creativity. And Rufus set the tone for many later developments of this concept. Yet who was this man who shaped ideas about melancholy for centuries to come? How did he con- ceive of black bile and melancholy? What place does he occupy in the evolution of the idea of melancholy? And why does he not fi gure more prominently in modern discourses on the history of this notion? In the present introduction, I shall offer answers to these questions. * In the present introduction, I obviously draw on the fragments themselves and the analysis contained in the commentary, as well as the essays of the contributors. The pur- pose here is merely to whet the reader’s appetite for what this volume has to offer. 1 S OLOMON 2002, 286. 2 For a survey of recent literature, see G OODWIN , J AMISON 2007; the authors talk elo- quently about the explosion of medical literature in this area (p. xxv). Rufus of Ephesus Rufus remains an elusive fi gure. He probably lived during the age of the Roman emperor Trajan (r. 98–117), although scholars have proposed earlier and later dates. 3 He hailed from the prosperous city of Ephesus, and stemmed from a rich family. Because of this background, he re- ceived an excellent education, and grew up to become a member of the intellectual elite. He probably studied in Alexandria, the most prominent centre for science and medicine which could easily rival the imperial capital, Rome. In his theoretical views, he followed the teachings of Hip- pocrates, which he interpreted to suit his own ideas. Rufus became fam- ous for his acute observations and clinical work. In his many mono- graphs, he appears as a thoroughly pragmatic practitioner. One of these monographs is On Melancholy , in which he analyses the mental condi- tion caused by an excess of black bile. Rufus’ On Melancholy Rufus’s On Melancholy is lost in the original Greek and its medieval Ar- abic translation. We do have, however, a signi fi cant number of frag- ments, mostly quotations in Greek, Arabic and Latin medical works. We shall return to the vagaries of transmission, loss, and rediscovery shortly. Suf fi ce it for now to say that any attempt at reconstructing the arguments and ideas contained in On Melancholy remains conjectural to a certain extent. 4 Rufus’ treatise was divided into two books ( FF 1–2 ). The fi rst dealt with ‘symptoms and incidents’ ( F 5 § 1), whereas the second con- tained advice about drugs and therapies. In general, Rufus focussed on the hypochondriac type of melancholy, but thought that the reader could easily infer from this one type what to do in other cases of melancholy. Rufus shared an important characteristic with the later Galen (d. c 216/17), in whose shadow he nearly disappeared: he adhered to the doc- trine of the four humours, or humoral pathology, as it is now known. This medical philosophy provided the theoretical framework for Rufus to for- mulate his ideas about black bile and melancholy. The Four Humours Already in the Hippocratic treatise On the Nature of Man , we fi nd the idea that health consists in the balance of the four humours, blood, 3 See Swain, below, pp. 115–38; and Nutton, below, pp. 139–58. 4 The following references to the fragments should be understood as both to the text and translation, and the commentary. The latter develops the points made here in greater detail. 4 Peter E Pormann