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This paper argues that significant changes in the medical role of the sense of touch occurred between the classical and later periods. It examines the nature of these changes and, in particular, whether, and to what extent, the changes reflect shifting conceptions of the human body and entail new forms of interaction between the physician’s hand and the patient’s body. While acknowledging significant continuities in medical views of the tactile sense from the fifth and fourth centuries BCE (for instance Hp., Flat., Mul. I-II, Nat. Mul., Epid. IV, VI and VII, Off. Med., VC, and Prorrh. II) to Late Antiquity (for example, Caelius Aurelianus and Philaretus), the paper argues that the corporeal territory traditionally governed by the sense of touch in interactions between physician and patient expanded and was radically redefined over time. The principal focus is on one such change, entailed by the momentous discovery of the pulse, which repositioned the physician’s tactile approach to the patient’s body.

The historical background to this discovery is sketched only briefly in the paper. The late fourth-century BCE discovery of the systematic distinction between arteries (arteriai) and veins (phlebes) throughout the body was a breakthrough that led to the discovery of the pulse. With rare exceptions, Hippocratic writings of the classical period, like Aristotle’s writings on animals, had used phlebes as a generic term for ‘blood-vessels’, even when they described vessels later known as arteries (Arist. HA 1.17.496a4-35, 3.3-4.513a16-515a26; PA 3.4-5665b5-668b32; but cf. Hp. Artic. 45 and 69, Epid. 2.4.1, Carn. 5). Although some Hippocratics had identified ‘throbbing’ in the blood-vessels as a pathological sign, feeling the pulse did not belong to their therapeutic arsenal. Apparently beginning with Praxagoras of Cos, however, the arterial/venous distinction became sharply defined (Praxag. med., fr. 26-31, 7-8 Steckerl). This in turn led to the recognition of the pulse as an arterial phenomenon, and by the third century BCE physicians were developing elaborate, competing pulse theories and pulse taxonomies.

I argue that several closely related consequences of this development can be traced. The first is a reconceptualization of the body as an organism that is, in crucial respects, finely measurable and quantifiable by means of a well trained tactile sense. Nature’s music in the arteries – its invisible and inaudible rhythms, speeds, volume, intensity – now could be read by the physician’s expert, highly differentiating touch of the patient’s wrist. Defining normal pulses by age, gender, and ‘body type’ allowed the fingers of the iatros to measure deviations from the norms (in part aided by an innovative technology; Marcellin. Puls. 11 = Herophil. fr. 182 vS). Touching the pulse rapidly became established as an indispensable diagnostic act, and this not only gave rise to a large, contentious literature on methods of touching but also to a popular fascination – reflected in fiction and historiography – with ‘miraculous’ diagnoses by means of touch. Though some ancients saw pulse theory as having problematic epistemological foundations, the pulse nevertheless transformed the socio-medical relation between iatros and patient. In the physical transactions between physician and patient, perhaps no sense was more fraught with social and aesthetic difficulty than touch, and this prompted some early medical writings at times to recommend self-touching by the patient for diagnostic or therapeutic purposes. Furthermore, a Hippocratic author famously included ‘touching repugnant things’ in the ‘harvest of sorrows’ that belong to the physician (Hp. Flat. 1.2). The discovery of the pulse did not entail abolishing this bitter harvest or other earlier forms of medical touching, such as palpation, feeling for hot, cold, hard and soft in the body, touching to test for pain, and so on. Yet feeling the pulse allowed the physician to do a differentiating tactile reading of the invisible bodily interior of male and female alike, without risking social, aesthetic or moral offense.