227Elizabeth M. CraikBackgroundThis paper is the product of my experience as a classical philologistworking on Hippocratic texts exposed, through living in Kyoto, to east-ernmedicaltraditions.ThematerialpresentedherehasastrongHippocratic base and the attempt at comparative study is at this stagetentative. The Hippocratic treatises- attributed to, but not all, indeedperhapsnotany,writtenbyHippocratesofKos-datetoaroundthefifth century BC, the classical period of Greek civilization. Hippocrateswas revered by Galen, and Hippocratic medicine, as mediated throughGalen,becamethefoundationofmodernwesternmedicine.Butsincethe nineteenth and twentieth centuries modern medicine, in becominghightech,hasdeviatedfromitsHippocraticroots.Insomerespects,the medicine of the Hippocratic Corpus (HC) is more similar to tradi-tional Chinese medicine (TCM) than to modern western medicine.1)IamverygratefultothestudentsatKyodaiwhoinitiatedmeinthesesimilarities.IthinkofthoseinmyfirstlecturecourseonHippocrates,especiallyGonoji-kunwhoshowedmewheretofindmyfirstKANPOshop,andSawada-sanwhoinstructedmeonJapanesegourds-andtothoseinmylastsuchcourse,especiallyOkada-senseiwho introduced me to colleagues at the Meiji University, experts in thetheoryandpracticeofacupunctureandmoxibustion.However,whenin Japan my first obligation was to SEIYOKOTEN and I did not ven-turefarintothefascinatingfieldofcomparativestudy.Sinceretire-mentIamfree.AndIhavebeenstimulatedtothinkfurtheraboutsuch comparisons by two scholars, whose help and influence I warmly228acknowledge.ThefirstisProfessorShigehisaKuriyama,whosebril-liantlyoriginalbookilluminatesthefundamentallydifferentwaysinwhich the same thing can be perceived in different cultures that is,human anatomy in ancient Greece (primarily of the time of Galen) andin China (of around the same date, in the early centuries of our era);2)butIarguehereforsimilarityratherthandifference,convergencerather than divergence, in the earlier Hippocratic period. The second isDr Vivienne Lo, who has patiently instructed me in early Chinese his-tory and generously shared with me her work on the earliest evidencefor ideas about the channels of the body. (See Section V below.)Thereareobviouslimitationsanddifficultiesinessayinganapproach neither clearly synchronic nor firmly diachronic: present-dayJapancannot(ofcourse)bedirectlyormeaningfullycomparedwiththe Greek world of 500 BC. And Chinese evidence from the Han periodfallsseveralcenturiesaftertheHippocraticmaterial.Ishallreturnlater to these fundamental methodological problems. Hippocratic Physiology: Nature of the BodyIntheHC,thebodyisviewedasimportantbits(~organs,viscerasuchaslungs,liver,kidneys)andorifices(includingeyes,ears,geni-tals)linkedbyhollowtubes,ductsorchannelsofwhichthemostimportantarethephlebes (~veinsandarteries,notdistinguished),andsolidthreadsforwhichthegeneraltermisneura (~ligaments,nerves etc.). The Hippocratics were aware that their explanations didnot meet the complexity of the body and allowed for channels interme-diatebetweenphlebes andneura (variouslydescribed,e.g.ashollowneura); also, in addition to the regular channels, for irregular channelswhich might open up to convey an excess of fluids. These refinementsdo not concern us here. What does concern us is the way in which themain vascular system was envisaged, and especially views held on thelocation of vessels in the head and neck (route to the lower body); andviews of the contents of the vessels in a healthy and unhealthy state. ItmustbestressedthattheseviewsaspresentedintheHCarenot229abstractanatomicalsurveys;butratherpracticaladjunctstophysio-logical understanding, as in Places in Man or aids in therapeutic inter-vention, as in Nature of Man. The general treatise On Anatomy dealsonly incidentally with the vessels.3)Accounts of the course of the vessels are found in several Hippocratictreatisesaswellasinthefragmentaryremainsofthepre-SocraticphilosopherDiogenesofApolloniaandinPlatosTimaeus.ThemostdetailedaccountsareinBones andin PlacesinMan (asIstubbornlycall it: some would prefer the politically correct title Places in People orPlacesinHumans).Theformerisacompositeworkwhichbringstogethervariousviewsofthevascularsystemwithsimilaritiesandinconsistenciesalikeapparent.Thatdifferentvocabularyisemployedindifferentsectionstoexpresstheroutesofphlebes (twowordsforneckandtwoforback)revealsthediversesourcesforthesebeliefs.Different parts of Bones can be traced to different sources: 1-7 (proba-bly) and 11-19 (certainly) to a work described by Galen as Appendix toMochlicon(Galen19.128K.);8toSyennesisofCyprus(soAristotleHA 511b24-30);9replicatesNatureofMan 1,while10replicatesEpidemics 2. 4. 1.4)Although these accounts are confused and fancifulin details, a salient common supposition is that the vessels originate inthehead.ThereissomeHippocraticevidence-exaggeratedbythosewhobelievethatthecirculationofthebloodwasknowntotheHippocratics-forarivalsuppositionthattheheartplayedacentralpart in the system; but treatises presenting this picture are late. It isa common supposition too that the vessels go in pairs; and the notionofinterconnectionsisrecurrent.Supposedpairingmaybebasedonobservationofvisibleconjunctionsofveinsandarteries,aidedbytheGreek tendency to favour duality and contrast in modes of thought.5)My main concern today is with a common, but little noted, patternwhich is regularly implicit and occasionally explicit in these accounts:the pattern of a single vessel going from head to lower body, associatedwithmyelos,Ionicmyalos marrow,thatisspinal(orcerebral)fluid.The supposed existence of this route from upper to lower body can be230clearlyseenintheaccountoffluxtheorypresentedinPlacesinMan(see commentary, especially 170-1) and in Glands; also in the accountsofdiseasesfoundinsuchworksasInternalAffections.ThecourseofsuchavesselisdescribedinBones 13-18:itisrootedinthegenitalsand intertwined like ivy with the marrow; it passes through the bodybehind the midriff (diaphragm), and through the neck and throat. Thisvesselwhichiswhiteandsinewyisdescribedbytheunexpectedadjective archaie the ancient vessel, a term occurring only here in theHC.Commentatorshavemistranslatedmainvessel;oremendedarchaie ancient to pacheie thick, but neither expedient is helpful. Wemay note that the extended description of the ancient vessel is preced-ed by a brief account of a vessel running around the entire head, withacomplexnetworkofchannelsleadingtothebrain(Bones 12);alsothat in Places in Man, a single vessel is believed to run from crown ofhead via forehead to bridge of nose.None of these postulated vesselscorresponds with the realities of observation or of anatomy.TheancientvesselofBones maybecomparedwiththevascularanatomytacitlypostulatedbyHomerintheIliad,ouroldestextantGreek text. Homer uses the word phleps vessel only once, with refer-encetoavesselrunninguptheneck,betweenheadandtrunk.Twopassages are relevant: in one, a hero dies when the single phleps saidtotravelrightupthebackandthroughtheneckissevered;intheother,aheroisbeheadedandmyelos marrowissaidtospurtout(Homer Il. 13. 546-8; 20. 481-3). Commentators, surprised to find thisrarelapseinHomersanatomicalknowledgeandprecision,rightlypoint out the anatomical impossibility. Like phleps, associated anatom-ical terminology is known to Homer, though rare in the epics. In addi-tion to the sole occurrence of phleps Il. 13. 546 the term sphondylion orsphondylos vertebraoccursonlyIl. 20.483.Thediminutivespho-ndylion issaidbyLSJtobeadiminutiveinformonlyandbyEdwards, commentary ad loc., to be introduced metri causa to avoid acretic; however, the diminutive fits the sense, as the cervical vertebraeare relatively small. A related hapax is brechmos the equivalent of the231laterbregma (anteriorfontanelles)atIl. 5.586,whereaherofallsheadlong on bregma and shoulders. The root sense brecho surely con-veysanareawheremoisturewasbelievedtocollectratherthanbecause this part of the bone is longest in hardening, pace LSJ.Tosummarise:HomersbeliefthatasinglevesselcarryingmyelostravelledthroughtheneckhasHippocraticanaloguesnotonlyintheancient vessel of Bones, but also in aspects of the flux theory expound-ed in Places in Man and Glands (flux believed to travel via the myelosfrom head to back and to hips) and in aspects of the nosology presentedin such works as Internal Affections. Hippocratic Pathology: Nature of DiseaseAsapreliminary,wecannotethateyetroubleswerepeculiarlyprevalent in the ancient Greek world. Literary imagery abounds asso-ciated with eyes and vision. In Airs, Waters and Places there is muchstressonophthalmiasregularlyarisingwiththechangeofthesea-sons.Itwasrealizedthattheeyesareagooddiagnosticindicatorofhealthordisease;alsothattheeyesareaffectedinmanyapparentlyunrelated conditions (as is indeed the case with systemic diseases suchasdiabetes).Cataractwasrecognizedasadegenerativedisease;tra-choma was endemic and other scrofular infections were prevalent.6)Diseaseis,inHippocraticterms,regularlyassociatedwithpeccantmatter, noxious stuff, often described simply as moisture. Whereas inhealththevesselscarrygoodfluidsnourishingthebody(primarily,butnotonly,blood),inillnessthesefluidsareadulteratedorunbal-anced. Phlegm (especially) and bile are the fluids most regularly impli-cated in this process, but the formal schema of the four humours devel-opsonlylater.Typically,itissupposedthatunwantedorexcessivemoisturegathersinthehead,thendispersesinfluxtosomebodilypart which becomes affected by disease - eyes, ears, chest etc. Moisturestuck or fixed in the wrong place causes particular problems.7)A distinction can be seen between noxious stuff localized in and flow-232ing from the scalp above the skull (hereafter, flux A) and noxious stufflocalized in and flowing from the brain below the skull (hereafter, fluxB): whereas the former was viewed as common and readily treated, thelatterwasthoughtseriousandintractable.Indiscussionofeyetrou-bles,noxiousstufffromthescalpabovetheskull(fluxA)wasaddressed by treating the flesh of the bregma or the vessels of the tem-ples,whilenoxiousstufffromthebrainbelowtheskull(fluxB)wasdangerously inaccessible in its course from brain to eye (Places in Man13, On the Eye 3). There was a particular danger if matter should dryupandbecomestuckintheseducts(PlacesinMan2.2;cf.3.3).CelsusandGalen,despitehugepracticaladvancesnotonlyinocularanatomyandphysiologybutalsoinsurgicaltechniques,continuedtosubscribe to such theoretical notions (Celsus 7. 7. 15; Galen de metho-domedendi 10.937-42K.).Theyexemplifythegeneralmedicaltruththat theory tends to be conservative, while therapy is more innovative.Moregenerally,diseasespresentingatvariouspointsinthelowerbody were thought to be particularly difficult to treat when the causalflux was associated with the conduit of the marrow, rather than withotherroutesfromtheheadviaphlebes,tracheaoroesophagus.Diseases where the marrow was implicated were commonly associatedwithexcessofsexualactivity:semenandspinalfluidwerealliedinearly Greek thought.Tosummarise:Adeeppathwayfromheadtolowerbody,viathemyelos,wasinvokedtoexplainvariousintractableconditions.Conditions asssociated with deep flux from the brain, involving myelos,weremoreseriousthanconditionsassociatedwithshallowfluxfromthe top of the head, involving other fluids such as phlegma. Hippocratic surgery, especially cauterization (burning)Thosediseasesthatdrugsdonotcure,theknifecures;thosethatthe knife does not cure, fire cures; those that fire does not cure must beconsideredincurable(Aphorisms 7.87).ThedrugsmostcommonlyutilisedbyHippocraticphysicianswerepurgatives:emetics,laxatives233and nasal insertions. The common aim was to eliminate noxious mat-ter,bydivertingittoabodilyorifice(or,ifnecessary,toanopeningcreated for the purpose). Cautery and cutting fulfilled broadly similarfunctions (to reduce unwanted bodily moisture or eliminate fleshy tis-sue)anditseemsthatintheclassicalperiodindividualpractitionersor corporate groups favoured the use of one or the other method. Later,cutting prevailed: Galen made extensive use of phlebotomy but rarelymentions cautery (though he does prescribe it for streaming eyes (14.782K.).Cauterymightbepractisedalmostanywhereinthebody(back,chest,neck,head),andappliedtofleshyaswellastovenousareas, but cautery of the vessels was especially common. The dangersoftheprocedurewererecognizedandprecautionswerecommonlyadvised.Thetranslationcauterise,andtheGreekverbkaiein,literallyburn, may be somewhat misleading. The sense may be simply applyheat, using a cauterising instrument and the action merely the appli-cation of a gentle soothing warmth: the inherent sense burn does notnecessarily or always involve extreme heat, far less branding and scar-ring.Cauterymightbedry(alessinvasivetreatment)orwet.Indrycautery, the instrument is used simply to apply gentle warmth over oralongside the blood vessels, with a view to changing the consistency orthemovementoftheircontents.Inwetcautery,theinstrumentisplacedacrossthem,apparentlywiththeintentofactuallybreakingthe wall of the vessel (hopefully vein, not artery) or even severing it. Inboth wet and dry procedures, sponges were used to mitigate the pain,to control the severity of the heat, or to mop up blood. (Similarly, in drycupping,thecuppinginstrumentisappliedtothesurfaceoftheskinandleftthere,withtheaimofdrawingoutnoxiousstufffromtheunbrokenskinbysuction;inwetcuppingtheskinisbrokenorscari-fiedinordertoremovebloodornoxiousmatterfromavesselorelse-where.)Theinstrumentsusedincauteryvaried:themostcommonwere rods of metal directly heated by fire (hence the injunction not toallowtheinstrumenttobecomewhite-hot)orofwoodheatedbydip-234pinginhotoil(boxwood,InternalAffections 28).However,theuseofvegetable matter is attested also (mykes fungus, Internal Affections: itis not clear which plant was used). (Thereis a secondary meaning ofmykes suppurationandthecognateverbmykaomai suppurate,per-haps allied with myxa mucus and the adjective myxodes mucus-like:the lexicographer Erotian and Galen Glosses recognize that only.) Foreyetroubles(fluxA)cauteryofthevesselsofthetempleswasthe first recourse: in Places in Man (13. 7) the vessels which press onthe eye, those which constantly beat and are situated between ear andbrow; and in Diseases 2 (12. 6; cf. 2. 1) these vessels comprehensivelywith six other vessels of the head two alongside the ears, two at theinnercornersoftheeyes,andtwobehindtheheadoneithersideattheocciput.Anothersurgicalexpedientintendedtoarrestthedown-ward course of disease-inducing flux is scarification of the scalp at thebregma.Trephinationoftheskullwaspractisedalso.Theseproce-dureswereprevalentthroughouttheknownworld,withconsiderablelocalvariationaccordingtoCelsus,writinginthefirstcenturyAD(Celsus 7. 7. 15).In a section dealing with general principles of cautery, the author ofOntheEye (3)indicatescauteryofvesselsofthebackandbehind.ThesevesselsmaybethesamepairasaredesignatedinDiseases 2and cf. Bones 9 = Nature of Man 11 (flux A). However, as the adjectiveusedisthatcommonlyappliedtothespinalfluid,thevesselslooselydesignatedofthebackmaybemorepreciselydesignatedastheves-sels which run from head to neck to back, that is those through whichthemarrow,cerebralorspinalfluidwasbelievedtocoursefromthebraintotheeyeorlowerbody(fluxB).Cauteryofthevesselsintheneckwaspractisedinordertostoptheprogressofnoxiousmatterbehind and to divert it to the nose for expulsion (Places in Man 21. 1).In Glands as well as in Places in Man, the marrow carries noxious fluxto lower parts of the body (Gland. 11, 14). In Koan Prognoses, a list ofdiseasesnotfoundbeforepuberty(significantly:sexualmaturityisinvolved)includesfluxintheback(Coac.5.502).InInternal235Affections, two types of phthisis are related to abnormal functioning ofthe marrow: in one, the marrow becomes filled with blood (or the hol-lowvesselsfilledwithbileandphlegm);intheother,themarrowbecomesdry,withblockageinthesmallvesselsfromthebrainandhere, cautery of the neck is prescribed (12, 13; cf. Places in Man 21 dis-cussed above).To summarise: Cautery and cutting were used to address many con-ditions, including eye troubles. The sites of surgery were chosen on thebasis of supposed routes through the body, the aim being to change theconstitution or the consistency of body fluids coursing through the ves-sels.Onesuchroutecarriedthemarroworspinalfluid,believedtooriginate in the brain and allied also with semen.GlobalisationItiseasytooutlinebroadsimilaritiesbetweentheancientGreekviewsofanatomy,physiology,pathologyandtherapyoutlinedabove,andviewsheldbymodernpractitionersoftraditionalChinesemedi-cine.8)Both in the HC and in TCM, anatomical structures and orificesare seen in terms of the channels which link them to one another andto other areas of the body. Greek phlebes and Chinese mo are signifi-cant in physiology (normal carrying blood and pneuma analogous toqi)andpathology(abnormalcarryingnoxiousmatter,inducingdis-ease).Theirsupposedpathsdonotexactlycoincide,butseveralarebroadlysimilar(andmoresimilartoeachotherthaneitheristotheobservedpathsofarteriesandveins).Treatmentbyphlebotomyandcautery have broad similarities to treatment by acupuncture and moxi-bustion.Kuriyamahassuggestedthatphlebotomyandacupunctureareconnected;aparallelconnectionmaybepostulatedbetweencau-terisation and moxibustion or acumoxa. More specifically, the route of the Chinese du channel (governor ves-sel) from spine to back of head carrying life force is similar to that ofthe Greek vessel carrying vital myelos. And the vessel centrally placedin the forehead in some accounts is similar to the anterior continuation236of the du channel. Further, the points selected for cutting and cauterybyHippocraticeyedoctorscorrespondrathercloselywiththepointsaddressedbymodernphysicianstreatingeyecomplaintsbyacupunc-tureandmoxibustion.Inadditiontopointsonthebackofthehead,both at crown and occiput, in the forehead, and in the eye area on thedu channel,thesearetwoofthethreeyang channelsofthefoot(uri-narybladderchanneloffoottaiyang andgallbladderchanneloffoottaiyang); a trio of parallel channels are addressed.Of course, there is a ready explanation for these similarities in treat-ment: as human physiology is constant, it is intrinsically probable thatdoctorsofdifferentsocietiesatdifferenttimesshouldtreatsimilarafflictionsinasimilarwaysimplybecausetheyseparatelyhavedis-coveredaneffectivetreatmentonanempiricalpragmaticbasis.(Thecommontheorymustthenberegardedasalatercommondevelop-ment.) After all, doctors do not cut and burn for fun, but in the hope ofacure;andtheydonotadvocatetreatmentswhichneverwork,oratleast seem to work. Even today, the reason for the undoubted effective-ness of the practice of acumoxa is not understood: the treatment seemsto stimulate the body to resist disease and to become stronger; but itsworkings, especially in relation to particular diseases, where it acts notmerely as a palliative but actually as a remedy, are mysterious. It hasbeensuggestedthatacupunctureraisestheredcorpusclecountandenhances blood circulation; that it stimulates the nervous system (per-haps through specific neurological reactions between parts treated andparts affected); that it provokes responses in the cerebral cortex whichinturnreactontheorgans.Itseemstomethataprofitablelineofapproachwouldbethroughonespecifictypeofailment,suchaseyeconditions,andwithinthatthroughaconditionwhichishighlylocal-ized and relatively well understood, such as cataract affecting the lens.PerhapsaneyesurgeonoraneurologistmighthavetheoriesaboutwhyparticulartreatmentsadvocatedintheHC,andpractisedinTCM, are effective?Thereisasecondpossiblewaytoaccountforsimilaritiesbetween237medicalsystems:contactsandinteractionsbetweenpeoples.Ireturnnowtothemethodologicalproblemsmentionedattheoutset.Itisalways difficult to decide whether apparent similarities are real: thisappliesevenwhencomparingtwowritersofthesamegenreandera(such as the Greek tragedians Sophocles and Euripides in the fifth cen-tury) or two roughly contemporaneous belief systems (such as the reli-gious cults of Athens and Thebes in the archaic age). How much maybe put down to coincidence? How close must similarities be to becomesignificant? In which direction does the influence go? For most critics,the answers will depend in part on the existence of contacts and oppor-tunities. Problems arise in comparing material from different eras; andin comparing evidence from texts with evidence of archaeology.Unquestionable similarities present themselves in the medicamentsusedinvariouscountries.Hereagaineyediseasesmaybetakenasparadeigmatic.9)Doctors of Egypt, India and China as well as of GreeceandRomeusedlivertherapytotreatnightblindness(butperhapsbecausealldiscoveredindependentlythatliver,whichisrichinvita-minA,wasactuallybeneficialinthisdeficiencydisease);allappliedderivativesofcopperasanastringentorhaemostatic,anddriedlilyrootasananalgesic(but,again,perhapsbecauseindependenttrialand error proved their effectiveness).Apersistentrecurrenttheoreticalbelief,seeninGreece,IndiaandChinaalike,isthatfireispresentintheeye.Thisnotion,however,probablyarisesfromuniversalperceptionoflightsensationsarisingfromdeformationoftheeyeballindarknessor,popularly,seeingstars on receiving a blow to the closed eye. The idea that light is actu-ally generated in the eye, and, with it, the idea that the eye sends outrather than receives signals in vision, was slow to disappear and per-sisted in Europe even after Kepler (1571-1630) argued against it, to befinally disproved by Morgagni (1682-1771).10)ThereisgoodevidenceforextensivecontactsbetweenGreeceandEgyptthroughouttheclassicalperiodandlongbeforeit.Althoughtherearechronologicaldifficultiesrestingprimarilyonthelackof238documentaryevidencefromsimilareras-itcanbearguedthatHippocraticophthalmologyinparticularhasanEgyptianorLibyan(NorthAfrican)connection,withinputfromtheGreekcityKyrene.11)Connections with Babylonia are similarly easy to substantiate.12)Persia, which conquered both Egypt and Babylonia, occupied in theclassicalperiodapivotalpositionbetweenGreeceandthelargenon-Greek world loosely designated Asia. Though there was sporadic war-farebetweenGreeceandPersia,manyGreekcolonies,foundationswheretheoriginalGreekpopulationwasadulteratedbynon-Greeksettlers,suchasMiletosonthecoastofAsiaMinor(modernTurkey)and Kyrene in Kyrenaika (North Africa), contrived to maintain friend-ly relations with Persia for at least part of the time. Many Greeks wereinthepayofthePersiancourt.Prisonersofwarmusthavepassedbetweentheregions.Itisevenpossibletonameindividualswhomovedfreelybetweenthecontinents,amongthemthemedicalmenPythagoras(admittedlyanebulousfigure)andDemokedes(whosecareercanbeplausiblyreconstructed).Ineveryage,topdoctorshavegravitatedorhavebeenattractedtoroyalcourtswherepatronageguaranteed prestige.Itisknownfromthecase-historiesdetailedintheEpidemics thatthe Hippocratic physicians practised on the fringes of the Greek penin-sula: in regions to the north such as Thessaly, Thrace and the island ofThasos; and in regions to the east, including cities such as Kyzikos onthe Asiatic side of the Propontis (Sea of Marmara). The most far-flungcase recorded is at Odessa on the western shore of the Black Sea (mod-ernBulgaria).ThisiscontiguoustotheregionsinhabitedbytheScythians, a nomadic people with a wide-ranging habitat (Aer. 18; Hdt.4.46sqq.).Contactsbetweenthecontinentsandthecultures,withsuchnomadicpeoplesasintermediaries,areatantalisingpossibility.Anotherregionwhichmayhavebeenanintermediarybetweentheeast and the Greek world is Bactria (modern Afghanistan); but the evi-dence for early Greek travel to this region is less reliable (Hdt. 4. 204).ManyofthecitiesmentionedintheEpidemics hadaflourishing239trade,exportingtimber,grain,driedfishandvariousluxurygoodstothe Greek mainland. It is reasonable to suppose that ideas came alongthesetraderouteswithmerchantsandtheirgoods.Buthowfareastcan we venture? It is certain that the Hippocratic doctors had access tomedicalspecificsunavailableinEurope.Cinnamonandotherspicesarementioned,quitecasually.ItisgenerallybelievedthatGreekknowledge of India began with Alexanders expeditions; but it is possi-blethathemerelyopeneduproutesalreadypartiallyknown.Certainly,theGreekshadcontactswithIndiaindirectlythroughPersia; India had contact with China.Chinese trade is almost synonymous with the silk-route. Now hereis a coincidence. Kos was a centre not only of medicine but of sericul-ture. Where did Kos get the knowledge and the materials to producesilk? The earliest authority for silk spinning at Kos is Aristotle (HA 5.19. 551b13), but he is quoting a well-known story (it is said that )andheimpliesantiquityinthenamesattributedtothefirstwomansaidtoberesponsible,andtoherfatherPamphile,daughterofPlateus.Theseareheroicnames,suchaswefindinHomer.IthasbeenarguedthatthesilkofclassicalKoswasnotChinesesilkfromsilkwormsbutaninferiorvariety,suchasthatfromoneofthelargeSaturniae which furnished the tussore silk of India.13 )It has been sug-gestedtoothatthesilkofKoswasrawsilk,combedoutlikeflaxrather than reeled as a thread off the cocoon. But even if such sugges-tionsarecorrect,sericultureimpliescontactwiththeneareast.Itissurely possible that with it there was indirect access to oriental med-icalideas.ThedebtofHomertotheneareastisnowgenerallyacknowledged.We return to medicine, especially ophthalmology. A persuasive casehas been made for connections between Indian and Greek medicine.14)ButitmustbeconcededthatsimilaritiestracedbetweenGreekandIndian medicine do not coincide with those similarities which seem toexistbetweenGreekmedicineoftheHCandTCM.Hereisanothermethodological problem: by being sufficiently selective, one can make a240caseforsimilarities(orindeeddifferences)betweenvarioussystems;but these must always be viewed with caution.IntreatingIndianandChinesemedicine,werunintoseriouschronologicaldisjunctions.ThereisearlytextualevidenceforIndianmedicine(c.1000BCorearlier,writteninclassicalSanskrit).Inthiscopious and highly sophisticated material, ophthalmology is well rep-resented:conditionsareclassifiedonananatomicalbasisandthenaccordingtomethodsofsurgicaltreatment.AsintheophthalmologyoftheHC,thereisextensiverecoursetovenesectionandtovariousformsofpurgatives(enemas,emetics,errhines);and,againasintheHC, scarification is practised to treat diseases of the eyelids. However,a much deeper knowledge of the anatomy of the eye is apparent, andsurgeryiscorrespondinglyambitious.Notably,cataractsaretreatedbycouching.15 )ForChinesemedicineontheotherhandthereisnodocumentaryevidence,andverylittleevidenceofanykind,beforeearlysecondcenturyBC.Thatisnottosaythatmedicinebeginsinthisperiod;merelythatmedicinebeforetheHanperiodcannotbereconstructed.Inviewofthedisturbedpoliticalconditions,thisisunsurprising. IntheearliestextantChinesemedicaltexts,fromtombsdatedto168BC(theMa-wang-duitombs),cauteryisrecommendedforeyetroubles.16 )Thesetextscontainrecordsalsoofelevenchannelstra-versingthebody:therearedifferentversionswithinterrelationsascomplex as those in Hippocratic accounts of the course of the phlebes.From around the same period comes the silent yet eloquent testimonyofablacklacqueredfigurineonwhichsixlinesorchannelsaremapped out in red.17)Whether the figurine presents an early model forthepracticeofacumoxa,oranearlypresentationofself-cultivationidealscanbedebated.Thepurposeofthefigurineandthenatureofthechannelsisopaque,andtherelationofthechannelstothosedescribed in contemporary and later texts (themselves not fully consis-tent) is imprecise and indeterminate: there is a broad overall similari-tybutalsosomevariationindetail.Thevariationindetailprompts241comparisonwiththevariationindetailintheversionsofthephlebespresented in the Hippocratic treatise Bones. On the figurine, the linesrun more or less parallel along the length of the body. One line beginsbetweenthebuttocksandfollowsthespinetothehead(analogoustothe archaie phleps of Bones); there are roughly parallel lines on eitherside(analogoustothesystempresentedinBones 9=NatureofMan11). These correspond with the du channel and with the yang channelsof the foot, discussed above.Wheredowegofromhere?Somegeneralpointscanbemade.Moxibustion preceded acupuncture in China just as cautery was moreprevalent than cutting in early Greek medicine. In China, stones wereoriginallyused.ThereisnoevidencethatstoneswereusedinGreekmedicine, but texts often fail to specify materials. Early Chinese textsindicatethatcauterywasusedforeyetroublesandalsoforhaemor-rhoidsasinGreece.Originallytherewasnoelaboratesystemofpoints with measurements, any more than in Hippocratic practice. Weseesimilarchannelswithsimilarpathsandsimilaruseofknifeandfireinmedicaltreatment.Butisthissignificant?Intheend,broadideashavetodependonprecisestudyforsubstantiation.AncientGreek ideas about the routes of the phlebes have been much discussed,but always mapped against the system of veins and arteries; the devel-opment of Chinese channels is now being systematically studied, butprimarilyinrelationtolateracumoxapractice.Acomparativedia-grammaticrepresentationofdifferentGreekanddifferentChinesetheories would be interesting. The archaie phleps ancient vessel tendstobedisregardedbecauseitdoesnotcorrespondwithvascularreali-ties. It does however correspond with a channel in the earliest Chineseevidence,laterhighlysignificantinDaoistself-cultivationtheory.DaoistideasaboutthedesirabilityofsexualabstinenceandHippocratic theories about the consequences of over-indulgence in sexare centred on a similarly located bodily duct and that duct is authen-ticated in the earliest evidence for both traditions. As to ophthalmologymystartingpointforthisstudyprecisecomparisonsmightbe242made between the points targeted by physicians in east and west; andtheadviceofaneurologistmightassistindeterminingtherationalefor these treatments.NotesFor approach, see E. M. Craik edition with introduction, translation andcommentaryoftheHippocratictreatisePlacesinMan (Oxford,1998).For similarities, see E. M. Craik The Lasting Significance of HippocraticMedicineinReconstitutionofClassicalStudies No.13,Kyoto,March2003.The Expressiveness of the Body and the Divergence of Greek and ChineseMedicine, Zone Books, NY 2002.SeeE.M.Craik,TheHippocraticTreatiseOnAnatomy,ClassicalQuarterly 48 (1998), 135-167.On Places in Man, see E. M. Craik commentary 106-114; on Bones, seeC.R.S.Harris,TheHeartandtheVascularSysteminAncientGreekMedicine (Oxford,1973),50-73;M-P.DuminilLaDescriptiondesvais-seaux dans les chapitres 11-19 du trait de la Nature des Os, in CIH III(Paris,1980),135-48,LeSang,lesvaisseaux,lecoeurdanslacollectionhippocratique:anatomieetphysiologie (Paris,1983),Hippocratet.8Plaies, nature des os, coeur, anatomie (Paris, 1998).Cf. G. E. R. Lloyd, Polarity and Analogy (Cambridge, 1996).These will be discussed in my forthcoming edition, translation and com-mentary of the short Hippocratic treatise On the Eye.Forthistheoryexpressedbyanon-medicalwriter,seeE.M.Craik,ThucydidesonthePlague:PhysiologyofFluxandFixation,ClassicalQuarterly 51 (2001), 102-108.SeeE.M.CraikTheLastingSignificanceofHippocraticMedicineinReconstitution of Classical Studies No. 13, Kyoto, March 2003.SeeH.Nielsen,MedicamentsusedinthetreatmentofEyeDiseasesinEgypt,thecountriesoftheNearEast,IndiaandChinainantiquity(Odense, 1987).SeeO.-J.GrsserandM.Hagner,Onthehistoryofdeformationphosphenes and the idea of light generated in the eye for the purpose ofvision, Documenta Ophthalmologica 74 (1990), 57-85.SeeM.-H.MarganneLinksbetweenEgyptianandGreekMedicine,243Forum 3,5(1993),35-43forgeneralnegativeconclusionsandE.M.Craik,TheHippocratictreatiseontheOrganofSight,ProceedingsofHippocratic Congress at Newcastle, forthcoming, for positive conclusionsin the case of ophthalmology.SeeD.Goltz,StudienzuraltorientalischenundgriechischeHeilkunde.Therapie,Arzneibereitung,Rezeptstruktur,SudhoffsArchivSuppl. 16(1974); also Krankheit und Sprache, Sudhoffs Archiv 53 (1969), 225-69.SeeDArcyWentworthThompson,tr.andcomm.Aristotle,1910;Frazer, tr. andcomm. Pausanias, vol. 4, 1898.J. Filliozat, La doctrine classique de la mdecine indienne. Ses origineset ses parallles grecs (Paris, 1949); see also R. Bernier, tude compara-tive de lembryologie hippocratique et de lembryologie indienne antique,CIH 7 (Madrid, 1992), 37-53. See N. K. Bidyadhar, Susruta and his ophthalmic operations, Archivesof Ophthalmology 22 (1939), 550-74; Principles of Susrutian ocular ther-apyinterpretedinthelightofmodernophthalmicscience,25(1947),582-628.See introduction, J. Kovacs and P. U. Unschuld, Essential Subtleties onthe Silver Sea (Berkeley, Los Angeles, London, 1998).See H. Zhiguo and V. Lo, The channels: a preliminary examination of alacquered figurine from the Western Han period, Early China 21 (1996),81-123. I am indebted to Vivienne Lo for a most helpful discussion of thisartefact. See also V. Lo, Spirits of Stone: technical considerations in thetreatment of the Jade Body, Bulletin of SOAS 65 (2002), 99-128.