1 On the year of Galen’s death: Nutton (1995a); Strohmeier (2007); and see further discussion in chapter 8. On the authenticity of Ther. Pis., Swain (1996, Appendix D); Nutton (1997). Strohmeier (2007) doubts the authenticity of the treatise but considers the abundant evidence of Arab commentators decisive for a late date of Galen’s death.

2 On Galen’s case histories, see Mattern (2008a). On visiting patients, ibid. 140–41. Middle of the night: Meth. Med. 9.4 (10.611K); Praecog. 7 (14.636K). Before dawn: Meth. Med. 11.16 (10.792K). Donkey: Meth. Med. 7.6 (10.474K). Steward: Cur. Ven. Sect. 17 (11.299–302K).

3 Comp. Med. Gen. 3.2 (13.574–75K). On treating patients at his own house, see Mattern (2008a, 56–57) with notes 31–32 for further references and discussion of physicians’ houses in Pompeii. Knee injury: Comp. Med. Gen. 3.2 (13.574–75K). On the vocabulary of mixing drugs, see Gourevitch (2003).

4 On Galen’s diagnostic techniques, see Mattern (2008a, 149–52) for discussion and further references. Trained since childhood: Dign. Puls. 1.1 (8.770–71K). Extant pulse treatises are On the Pulse for Beginners; On the Differences in Pulses (four books); On Diagnosis of Pulses (four books); On the Causes of Pulses (four books); On Prognosis from Pulses (four books); and Synopsis of the Books on Pulses (8.453–9.549K). Notable ancient contributors to pulse lore include Herophilus; see von Staden (1989, 267–88 and testimonia 144–88b) for full discussion. Galen wrote a lost treatise specifically discussing Herophilus’s pulse lore (von Staden 1989, 287 and testimonium 162 = Dign. Puls. 4.3, 8.161K). On the vocabulary of touch in ancient medicine, including a discussion of Galen on the pulse (p. 235), see Boehm (2003). On Galen’s pulse lore, including social and cultural aspects, see Kuriyama (1998, 23–37, 63–70); Tamsyn S. Barton (1994, 152–163).

5 Trained sensitivity to differences in heat: Temp. 2.2 (1.594–99K). Familiarity with pulse: e.g., Syn. Puls. 7 (9.451K); Praecog. 11 (14.659K); Cris. 2.4 (9.638K). Bodily fluids: Diamandopoulos and Goudas (2003, 2005); Mattern (2008a, 150).

6 Loc. Affect. 4.11 (8.293–96K). Modern diagnosis: I am grateful for the opinions of Drs. Joseph M. Garland and Philip G. Haines in private correspondence.

7 See Mattern (2008a, 138–145) for further discussion.

8 Talking to women about conception: see Sem. 1.2 (4.514K) (and cf. Nat. Fac. 3.3, 2.149K). On hysterical conditions: Loc. Affect. 6.5 (8.417–19K, 426–34K); Uter. Dissect. 4 (2.893K); Comp. Med. Loc. 9.10 (13.319–20K); Hipp. 1 Prorrhet. 3.121 (16.773K); Hipp. Aph. 5.35 (17B.823–24K). Fumigation: Meth. Med. Glauc. 1.15 (11.54K). On the wandering womb in the Hippocratic Corpus and fumigation, see Dean-Jones (1994, 69–77). For a recent collection and analysis of the evidence for hysterical conditions in antiquity, see Faraone (2011). Interrogation: Hipp. 6 Epid. 3.29 (17B.95K); Sem. 1.2 (4.514K). Modesty (of both men and women, regarding different parts): Hipp. Off. 1.13 (18B.687–88K). Observing women’s conditions and illnesses: e.g., Hipp. 6 Epid. 1.2 (17A.811K, prolapsed uterus?); Meth. Med. Glauc. 2.12 (11.140–41K, breast cancer). Galen on menstruation: see especially Ven. Sect. Eras. 5 (11.164–66K); on women’s diseases in Galen, see Flemming (2000, 331–42); on fumigation, see ibid. 347.

9 Fevers: see especially Diff. Febr., book 2 (7.333–405K). Brain: Anim. Mor. Corp. 3 (4.776–77K); Loc. Affect. 3.9 (8.173–79K). Diet: see Galen’s Aliment. Fac. and the discussion of Powell (2003, 10–13). Drugs: see especially On Mixtures (English translation available in Singer 1997), book 3 (1.646–94K) and On the Mixtures and Powers of Simple Drugs, books 1–5, with the discussion of Vogt (2008). On bloodletting generally and for what follows, see Galen’s treatises On Venesection Against Erasistratus, On Treatment by Venesection, and On Venesection Against the Erasistrateans at Rome, with translation and discussion by Brain (1986). See also Galen’s treatise On Plenitude, available with German translation in Otte (2001).

10 Dead patients: Meth. Med. 9.10 (10.637K); Cur. Ven. Sect. 12 (11.288–89K). Debility: Meth. Med. 9.10 (10.367–68K).

11 On the history of bloodletting and for a modern evaluation of the practice, see Schneeberg (2002, 157–85). On bloodletting in western and Chinese culture (where its role is much more circumscribed), see Kuriyama (1999, chapter 5; 1995). On bloodletting in medieval Islamic medicine, see Pormann and Savage-Smith (2007, 121).

12 Anorexic patient: Hipp. 6 Epid. 3.29 (17B.81–82). Anorexia nervosa: Keel and Klump (2003). Contraindications: Brain (1986, 131–33).

13 Galen on specialization: see especially On the Parts of Medicine, which survives in Arabic; and To Thrasybulus on Whether Health belongs to Medicine or Gymnastics (5.806–98K). English translations are available of both: Lyons (1969); Singer (1997, 53–99). Galen’s longest discussion of surgery appears in his Hipp. Off. 1.17–25 (18B.694–718K).

14 Plac. Hipp. Plat. 1.6 (5.186K); Loc. Affect. 2.10 (8.128K). Quotation: Meth. Med. 6.6 (10.452–53K); see also the case that follows (10.453–54K). On trepanation, see further Rocca (2003, 181–84). On the skeletal evidence for trepanation in Roman Italy, see Mariani-Costatini et al. (2000, 305–7). Only three skeletons are known; one is that of a five-year-old child treated as a last resort for an “intracranial expanding lesion” that probably was the cause of death. The skeleton comes from Fidenae, near Rome, and dates to the first or second century C.E. It is conceivable that the patient, who was well-fed and otherwise healthy despite modest means, and whose parents clearly sought out the most expert care, was one of Galen’s, though it seems more likely that the child saw one of the specialists in trepanation that Galen mentions.

15 On the role of friends in the sickroom, see Mattern (2008a, 84–87).

16 Libr. Propr. 1 (19.14K) and Ven. Sect. Eras. 1 (11.190–94K), two similar but not entirely harmonious accounts of the same events.

17 Incurable: Diff. Febr. 1.10 (7.314K); Meth. Med. 10.10 (10.720K).

18 On astonishment etc., see Mattern (2008a, 80–83) and cf. the case of Glaucon’s friend, chapter 4.

19 On agonistic themes in Galen’s stories, see Mattern (2008a, chapter 3).

20 See Meth. Med. 2.7 (10.126–27K) with the commentary of Hankinson (1991a, 202–5).

21 On the role of case histories in Galen’s work, see Mattern (2008a, 40–43); on words for patient, also 101–2. On “among the arrhostoi,” see ibid. 42 n. 142 for references.

22 Regarding cranial nerves, Galen distinguishes between hard nerves of motion and soft nerves of sensation arising from harder and softer parts of the brain and brainstem in Usu Part. 9.11 (3.274–75K); but as the limbs had only hard nerves originating in the spinal column, his theory becomes more complicated in this context (Sympt. Caus. 1.5, 7.111–115K). On Galenic neurology, see Rocca (2003).

23 Pearson (2009).

24 Breast cancer most common: Meth. Med. Glauc. 2.12 (11.139K). I translate Galen’s terms karkinoma and karkinodes onkos as “cancer.” For a brief review of the medical references to breast cancer in antiquity, see Retief and Cilliers (2011, 513–15).

25 Hipp. Aph. 6.47 (18A.80K); the same patient also mentioned in Purg. Med. Fac. 1 (11.344–45K).

26 Hipp. Aph. 4.24 (17B.688K), 6.38 (18A.60K).

27 Philostratus, Vitae Sophistarum 13.

28 Coincidentally, I have suffered from almost exactly the same condition as Pausanias myself and am well familiar with the causes and symptoms.

29 The Pausanias story: Anat. Admin. 3.1 (2.343–45K); Loc. Affect. 1.6 (8.56–59K), 3.14 (8.213–14K; this is the version that names the patient); Opt. Med. Cogn. 9 (106–8 Iskandar). The versions in Anat. Admin. and Opt. Med. Cogn. were composed earliest and are roughly contemporary.

30 On epilepsy in ancient medicine, see Temkin (1971, part 1). Galen’s primary discussion of the etiology of epilepsy and other brain disorders is in Loc. Affect. 3.8–4.5 (8.168–237K).

31 Treatise on epilepsy: Puer. Epil. (11.357–78K); cf. Libr. Propr. 7 (19.31K). On the date of the treatise, see Ilberg (1896, 183, 195); for possible identifications of Caecilianus, see Prosopographia Imperii Romani (1933–66), C13.

32 Loc. Affect. 5.6 (8.340–41K); also San. Tuend. 6.14 (6.448–49K) and Ven. Sect. Eras. Rom. 9 (11.241–42K).

33 References to the story: Praecog. 5–6, 7, 13 (14.625–26, 630–33, 634, 640, 669K); Hipp. 2 Epid. (207–8 Wenkebach and Pfaff); Hipp. Prog. 1.8 (18B.40K). Concubine: Praecog. 6 (14.630–31K).

34 For the argument, see Mattern (2008a, 38–39 with n. 128). That the event was well-known is implied in Praecog. 5 (14.625–26K), where he places it in the context of other predictions and cures that enhanced his reputation.

35 Praes. Puls. 1.1 (9.218K), 1.4 (9.250K).

36 Sympt. Caus. 2.5 (7.191–93K); Puls. Tir. 12 (8.472–74K); Caus. Puls. 4.2–6 (9.157–62K). Fatal: Symp. Caus. 2.5 (7.193–94K); Loc. Affect. 5.2 (8.302K).

37 Galen’s most substantial discussion of melancholy is in Loc. Affect. 3.10 (8.190–93K), which appears to be heavily indebted to Rufus of Ephesus; see also Sympt. Caus. 2.7 (7.202–3K). On mental illness in Galen and in ancient medicine generally the most important author is Jackie Pigeaud, especially (1988) and (1981, chapter 1). On melancholy, which in antiquity was a psychotic illness in some ways similar to the modern diagnosis of schizophrenia, a new edition of the fragments of Rufus of Ephesus’s lost treatise on the subject is especially important (see Pormann 2008).

38 I was startled to learn that the passage containing Galen’s nonspecific reference to a hypothetical patient worried about Atlas in Loc. Affect. 3.10 is attributed to Rufus of Ephesus in an obscure ninth-century Latin commentary by Agnellus of Ravenna on Galen’s Sect. Intro. and in another commentary on the same text, apparently derivative from this one, attributed pseudepigraphically to John of Alexandria (Fischer 2010). If the passage is indeed from Rufus’s lost treatise on melancholy (it was overlooked by Pormann 2008 in his edition of the fragments of this text), and if Galen invented his own stories about the Atlas patient based on the reference in Rufus, it is the only example known to me of Galen inventing a patient (see Mattern 2008a, 38–40). Another possibility is that Galen met a patient with this delusion and that he diagnosed melancholy based on the reference in Rufus; this may seem unlikely but it is suggested by Galen’s wording in the passage from Hipp. 1 Epid. cited below (“and when he said this, we deduced that it was the beginning of a melancholic episode”). Full consideration of this complication must await a future project. I am grateful to Pauline Koetschet and Klaus-Dietrich Fischer for drawing my attention to the problem.

39 Hipp. 1 Epid. 3.1 (17A.213–14K); relying on the emendation of Wenkebach and Pfaff. Galen also perhaps refers this patient in Loc. Affect. 3.10 (8.190K).

40 Sympt. Caus. 2.7 (7.200–4K); Loc. Affect. 2.10 (8.126–35K), 3.6 (8.160–62K).

41 Galen’s terminology: Sympt. Caus. 2.7 (7.202K); Loc. Affect. 2.10 (8.127K), 3.7 (8.166K); Hipp. 1 Prorrh. 1.4 (16.517–18K); Hipp. 3 Epid. 3.45 (17A.698–99K). See further Pigeaud (1988, especially 161–162 on phrenitis).

42 Loc. Affect. 2.10 (8.127–28K), 3.9 (8.177–78K), 4.2 (8.225–26K); Sympt. Caus. 2.7, 7.202–3K.

43 Loc. Affect. 4.2 (8.226, 229, 331–32K); Sympt. Caus. 3 (7.61K).