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Do something daily that gets your heart rate up (aerobics) generic aygestin 5 mg overnight delivery, challenges your muscles (strength training) buy aygestin in india, and causes you to extend and contract ligaments buy aygestin once a day, muscles discount aygestin 5mg visa, and tendons (flexibility). Thinking about how we evolved and the amount of movement done by healthy aging cultures, we need to expect movement ev- ery day—not three days per week, but every day, for a minimum of a half-hour per day. If you shoot for one hour and fall short a day or two, two things usually happen: 1. Daily structured movement has to be as important and expected as brushing your teeth, taking a shower, combing your hair, and other normal and expected activities of daily living. When you get to the point where not exercising feels “not right,” the way you’d feel if you didn’t brush your teeth for the day, then you have built the exercise habit. When you don’t go home from work until you exercise, you have built the exercise habit. When you are looking for ways to exercise when you are away from home on business or vacation, you have built the exercise habit. When you don’t try to make an excuse for not exer- cising, you have built the exercise habit. If you say, “Some exercise is better than no exercise” when you can’t do your regular exercise routine, and you do something else involving movement, you have developed the exercise habit. It’s about Time and Consistency More than Intensity and Technique If you are new to the exercise game, it is going to take three to nine months before you build the exercise habit and it becomes “part of you. It doesn’t matter at first what type of exercise, as long as it is some type of aerobic, big muscle-moving exercise and is safe. Success with exercise is more about consistency and time than it is about technique and intensity. If you build in the time to exercise as part of your normal day and are consistent with your exercise program, you will see results and will naturally start to pick up the intensity and duration of the - 161 - staying healthy in the fast lane exercise after a few weeks. For the average person it is far more important to have lots of victories to keep your exer- cise program alive than to push through pain and injure yourself or be so sore you quit. Nagging injuries, persistent soreness, and pain are “killers” to building the exercise habit. Down the road, af- ter exercising three months to a year, if you really want to push yourself, give it a try. The most common excuse I get in the clinic is “I can’t exercise because I am too busy (and/ or too tired). I am very efficient with my exercise from strength training to aerobics and my flexibility work. You want to have a good cardiovascular system, be strong, and be flexible—and you want to do the exercises fast, efficiently, and safely. When you have that exerciser’s mentality—when that exercise habit is part of you—you will see the opportunities within your daily life to exercise efficiently and safely. How to Increase “Non-Exercise” Exercise More traditional cultures get their exercise from “non-exer- cise” exercise. Just the work they have to do to feed themselves, their daily jobs, and taking care of their dwellings provide some vigorous physical activity. If you are older and all you have is canned products around, use the cans as dumb bells. We are talking about a few extra minutes, not hours, be- cause you choose to walk. I have heard some very successful weight-loss specialists talk about how important it is to get obese people to add this “non- exercise” exercise to a structured exercise program. He committed himself to using the stairs during his hospital rounds versus the elevator and was amazed at how much exercise he got while seeing patients in his very busy medical practice. Just think: These basic examples only cover the simple things we can do as a part of our daily routines. They don’t even begin to account for all the exercise opportunities just waiting to be incor- porated into our “fun” time! Exercising when Traveling for Business or Pleasure When staying at a hotel, always ask if there is a fitness room. Trips can be stressful enough (whether for business or plea- sure), so it’s critical to have a space to exercise, take a little edge off, and do something good for your body. Just because the setup is dif- ferent or less optimal than your home or personal gym, be creative. By not skipping a day when travel- ing, even if you do less than you normally do, you are more likely - 164 - the triad exercise program to stay with your overall program and ultimately be successful in your fitness goals. If the hotel does not have an exercise room, look for a space in your room to stretch and do push-ups, chair-dips, etc. Also, ask the concierge or front-desk staff if there is a safe place to walk around the hotel. On a cruise or at an all-inclusive resort, check out the gym and see if there are any classes you might like to sign up for (yoga, aero- bics, dance, etc. If there is something physically active you like to do (dancing, swimming, snorkeling, boogie boarding, hiking, aerobics, yoga, etc. I’m a dancer, so I always check out salsa and lindy hop dance venues near where I am going on vacation or business. If your vacation is outdoors and near nature, hiking and swim- ming are enjoyable and productive ways to exercise. You won’t lose that much from your regular fitness routine if you do some- thing while away from home. If you haven’t been exercising in a while and/or are overweight or have cardiac issues, you should see your doctor first. Think about it: How much of your normal daily activity can you make into movement? I can’t think of anything more important than exercising and spending quality time with your family; it is a “win-win. The combination isn’t important; keeping - 166 - the triad exercise program yourself from getting bored and moving for at least thirty minutes is important! You could exercise for fifteen min- utes on the stair-stepper at your business gym and then walk with your family/spouse for a half-hour when you get home. Or maybe go to a martial arts class in the eve- ning or dance for an hour (keep a vision in the back of your mind of a total goal of one hour per day). For exam- ple, play tennis two days per week, walk two days, take an aerobics class two days, and hike one day. First and foremost, you don’t have to spend hours in the gym to get a really cut body and be strong. With a focused, - 167 - staying healthy in the fast lane fifteen-minute circuit training program three to four days per week, you can have a great physique and be strong. It may sound egotistical, but I know it because I do it, and I get compliments on my fifty-plus-year-old body frequently. You also have to eat right and get lean if you want your physique to show definition. You don’t need to be downing protein-rich sports drinks, or eating tons of meat and eggs daily or immediately after exercising. If you choose to have animal foods, which are not necessary for muscles or for good health, then eat lean meat, poultry (grass-fed, free-ranged, hormone- and antibiotic-free), and fish in the context of your three daily meals surrounded by lots of unrefined plant foods. You meat-eating and dairy-supplementing gym rats have been duped into thinking you have to consume lots of protein and animal foods to be strong and athletic. He was telling me about his weight issues and medical problems with diabetes, hypertension, and kidney issues. He was a classic “dairy-aholic” and was stunned when I told him to elimi- nate the dairy, cut back on the meat, and eat more vegetables, and that he’d still be fine in the gym. I also told him he’d drop some weight and probably improve his diabetes and kidney function. He was fearful of not being strong and muscular if he cut back on those foods (meat and dairy, to which he was addicted). Americans have been brainwashed by the propaganda that you have to consume meat, poultry, fish, and dairy products to be healthy and strong. He or she doesn’t have hours and hours to train in the gym, is not an elite athlete train- ing for some type of competition, and is not a movie star trying to tweak a particular area of his or her body. That said, building lean body mass is not only healthy for our metabolism (blood sugar control and immune function), but also helps us function in our daily lives, especially as we get older.
Then order aygestin with a visa, by knowing someone’s X score and using the relationship discount aygestin online amex, we can predict his or her Y score purchase aygestin 5mg. Thus purchase aygestin without a prescription, from our previous data, if I know the number of hours you have studied, I can predict the errors you’ll make on the test, and I’ll be reasonably accurate. Inferential Statistics After answering the above questions for our sample, we want to answer the same ques- tions for the population being represented by the sample. Thus, although technically descriptive statistics are used to describe samples, their logic is also applied to popula- tions. Because we usually cannot measure the scores in the population, however, we must estimate the description of the population, based on the sample data. But remember, we cannot automatically assume that a sample is representative of the population. Therefore, before we draw any conclusions about the relationship in the population, we must first perform inferential statistics. Inferential statistics are proce- dures for deciding whether sample data accurately represent a particular relationship in the population. Essentially, inferential procedures are for deciding whether to believe what the sample data seem to indicate about the scores and relationship that would be found in the population. Thus, as the name implies, inferential procedures are for mak- ing inferences about the scores and relationship found in the population. If the sample is deemed representative, then we use the descriptive statistics com- puted from the sample as the basis for estimating the scores that would be found in the population. Thus, if our study-time data pass the inferential “test,” we will infer that a relationship similar to that in our sample would be found if we tested everyone after they had studied 1 hour, then tested everyone after studying 2 hours, and so on. Like- wise, we would predict that when people study for 1 hour, they will make around 12 errors and so on. Statistics versus Parameters Researchers use the following system so that we know when we are describing a sam- ple and when we are describing a population. A number that is the answer from a de- scriptive procedure (describing a sample of scores) is called a statistic. On the other hand, a number that describes a charac- teristic of a population of scores is called a parameter. Thus, for example, the average in your statistics class is a sample average, a descrip- tive statistic that is symbolized by a letter from the English alphabet. If we then esti- mate the average in the population, we are estimating a parameter, and the symbol for a population average is a letter from the Greek alphabet. Inferential proce- dures are for estimating parameters, which describe a population of scores and are symbolized using the Greek alphabet. Although we discuss a number of descriptive and inferential procedures, only a few of them are appropriate for a particular study. First, your choice depends on what it is you want to know—what question about the scores do you want to answer? A study’s design is the way the study is laid out: how many samples there are, how the partici- pants are tested, and the other specifics of how a researcher goes about demonstrating a relationship. Therefore, part of learning when to use different statistical procedures is to learn with what type of de- sign a procedure is applied. To begin, research can be broken into two major types of designs because, essentially, there are two ways of demonstrating a relationship: exper- iments and correlational studies. Experiments In an experiment the researcher actively changes or manipulates one variable and then measures participants’ scores on another variable to see if a relationship is produced. For example, say that we examine the amount of study time and test errors in an exper- iment. We decide to compare 1, 2, 3, and 4 hours of study time, so we randomly select four samples of students. We ask one sample to study for 1 hour, administer the test, and count the number of errors that each participant makes. We have another sample study for 2 hours, administer the test, and count their errors, and so on. Then we look to see if we have produced the relationship where, as we increase study time, error scores tend to decrease. To select the statistical procedures you’ll use in a particular experiment, you must understand the components of an experiment. The Independent Variable An independent variable is the variable that is changed or manipulated by the experimenter. Implicitly, it is the variable that we think causes a change in the other variable. In our studying experiment, we manipulate study time because we think that longer studying causes fewer errors. Or, in an experiment to determine whether eating more chocolate causes people to blink more, the experimenter would manipulate the Understanding Experiments and Correlational Studies 23 independent variable of the amount of chocolate a person eats. You can remember the independent variable as the variable that occurs independently of the participants’ wishes (we’ll have some participants study for 4 hours whether they want to or not). Technically, a true independent variable is manipulated by doing something to par- ticipants. However, there are many variables that an experimenter cannot manipulate in this way. For example, we might hypothesize that growing older causes a change in some behavior. Instead, we would manipulate the variable by selecting one sample of 20-year-olds and one sample of 40-year-olds. Similarly, if we want to examine whether gender is related to some behavior, we would select a sample of females and a sample of males. In our discussions, we will call such variables independent variables because the experimenter controls them by controlling a characteristic of the samples. In essence, a participant’s “score” on the independent variable is assigned by the experimenter. In our examples, we, the researchers, decided that one group of students will have a score of 1 hour on the variable of study time or that one group of people will have a score of 20 on the variable of age. Conditions of the Independent Variable An independent variable is the overall variable that a researcher examines; it is potentially composed of many different amounts or categories. A condition is a specific amount or category of the independent vari- able that creates the specific situation under which participants are examined. Thus, although our independent variable is amount of study time—which could be any amount—our conditions involve only 1, 2, 3, or 4 hours. Likewise, 20 and 40 are two conditions of the independent variable of age, and male and female are each a condi- tion of the independent variable of gender. A condition is also known as a level or a treatment: By having participants study for 1 hour, we determine the specific “level” of studying that is present, and this is one way we “treat” the participants. The Dependent Variable The dependent variable is used to measure a partici- pant’s behavior under each condition. A participant’s high or low score is supposedly caused or influenced by—depends on—the condition that is present. Thus, in our studying experiment, the number of test errors is the dependent variable because we believe that errors depend on the amount of study. If we manipulate the amount of chocolate people consume and measure their eye blinking, eye blinking is our depend- ent variable. Or, if we studied whether 20- or 40-year-olds are more physically active, then activity level is our dependent variable. The behavior that is to be influenced is measured by the dependent variable, and the amounts of the variable that are present are indicated by the scores. Drawing Conclusions from Experiments The purpose of an experiment is to produce a relationship in which, as we change the conditions of the independent vari- able, participants’ scores on the dependent variable tend to change in a consistent fash- ion. To see the relationship and organize your data, always diagram your study as shown in Table 2. Each column in the table is a condition of the independent variable (here, amount of study time) under which we tested some participants.
For a gamma camera with a parallel-hole collimator aygestin 5 mg fast delivery, (a) The spatial resolution increases with decreasing detector thickness discount aygestin 5 mg. What are the effects of the following factors on the spatial resolution and sensitivity of a gamma camera? Single-photon emission computed tomography in the year 2001: Instrumentation and quality control buy 5mg aygestin with amex. In imaging modalities order aygestin 5 mg on-line, the computers are used to quantitate the distribution of radiopharmaceuticals in an object both spatially and temporally. Both data acquisition and image processing in scintigraphy are accomplished by digital computers. In nonimaging appli- cations, patient scheduling, archiving, inventory of supplies, management of budget, record keeping, and health physics are just a few examples of what is accomplished with the help of digital computers. Computational capabil- ities have advanced tremendously over the years and are still evolving, and the utility of a computer is limited only by the limitations of hardware and software. I/O devices include peripherals such as keyboards, mouse, video monitors, and printers, whose functions are to communicate with the computer for input of the acquired data and output of the processed data. Digital computers operate with binary numbers using only two digits, 0 and 1, as opposed to 10 digits 0 to 9 in the decimal system. The basic unit of the binary system is a bit (binary digit) that is either 0 or 1. Thus, the binary number 10101 is equal to the decimal number (1 × 24 + 3 2 1 0 1 0 0 × 2 + 1 × 2 + 0 × 2 + 1 × 2 ) = 21, which is given as 2 × 10 + 1 × 10 in the decimal system. The bits, 1 and 0, are represented by the “on” or “off” states of many tran- sistor components present in the computer memory. A two-bit number can be expressed in 22, or four, ways (00, 01, 10, 11) corresponding to decimal numbers, 0, 1, 2, 3; a three-bit number can be expressed in 23, or eight, ways (000, 001, 010, 011, 100, 101, 110, 111) corresponding to decimal numbers 0, 1,2,... In computer nomenclature, a byte of 8 memory is equal to eight bits that can store up to 2 , i. Similarly, a word of memory consists of 16 bits or two bytes and can store up to 216, i. In newer com- puters, a word can consist of 32 or 64 bits, allowing more counts to be stored in memory. A computer program is a set of sequential instructions for the computer to perform with essential data inserted whenever appropriate. The efﬁciency of the computer operation is further increased by using parallel transfer of data (where many transfers are performed simultane- ously) rather than serial transfer (where only one transfer is carried out at a time). Computer Memory The memory of a computer is a section assigned for temporary storage of data during the operation of a program. Hard drives are installed virtually in all computers for internal storage of the programs and data. Floppy disks are commonly used for storing data externally as backup copies, although in some applications programs and data can be stored for input into the computer for execution. While hard drives have the storage capacity of hundreds of gigabytes, ﬂoppy disks can only store up to a few megabytes and are getting out of use. Magnetic tapes and laser optical disks have large storage space in compact form and can be utilized primarily for archiving of patient data that can be retrieved for future reference. Input/Output Devices Input/output (I/O) devices are essential for input of the initial data and for output of the processed data. Digital Computers in Nuclear Medicine the use of acquisition and video interfaces via serial or parallel buses. The keyboard and the mouse are the most common input devices used in com- puters, although joysticks, light pens, and trackballs are occasionally used as input devices. While the keyboard is essential for the input of alpha- numeric data such as patient identiﬁcation, date, time, and operator’s name, the mouse and trackballs are used to select items from the menu. Common output devices include display screens (video monitor) for texts, images or graphics, and printers for printing. Display screens normally have a capability of a gray scale or a color scale for comparison between the intensities or amplitudes of different regions of the image. Operation of a Computer A computer operates according to instructions provided by an operator. A col- lection of programs is called the software, which is developed by specialists according to the speciﬁc need for a project. The utility of this program is to facilitate communication between the computer and opera- tor’s instructions. Other utili- ties of this system include ﬁle transfer from one location to another, storing data in the external storage device, and display of the data. Data must be provided as input to the computer for processing, and in nuclear medicine they are available in the form of counts or voltage pulses obtained from scintigraphic studies. Data are processed according to instructions in the software program, and the processed data are then stored in computer memory or external storage spaces or displayed on video mon- itors. Digitization of Analog Data In nuclear medicine, signals from a gamma camera are acquired in analog form, which are digitized before storing and further processing by the com- puter. While the analog signals can be distorted by the electronic noise, there is some inherent loss of signal information as a result of digitization, i. This arises from the fact that there is a likeli- hood of a small fraction of the signal being lost during the conversion of a continuous analog signal to discrete digital values. Digital-to-Analog Conversion For video displays, data must be in the analog form, and therefore digitized data must be converted back to analog data. Digital Images Digital images are characterized by two quantities: matrix size and pixel depth. The computer memory approximates the area of the detector in a gamma camera as a square matrix of a deﬁnite size that can range from 32 × 32 to 1024 × 1024 with 1024 (1K) to 1,048,576 (1M) picture elements, called pixels, respectively. How many counts can be stored in a pixel depends on the depth of the pixel, which is represented by a byte or a word. Thus, a 1-byte pixel could record up to 28, or 256, events, whereas a 1-word pixel could store up to 216,or 65,536, events. The pixel size, which depends on the choice of the matrix size for a study, is an important factor that affects the spatial resolution of a digital image. Often, a zoom factor is applied during data acquisition to improve spatial resolution because it reduces the pixel size. The use of a zoom factor of, say, 2, reduces the pixel size by half, improving the spatial resolution, but counts per pixel are reduced thus increasing the noise on the image (see later). The choice of pixel size and zoom factor is limited by the spatial resolu- tion of the imaging device, particularly in tomographic systems. If the expected system resolution is 18mm, then the pixel size in the matrix should be less than 6mm. However, as mentioned before, the counts in each pixel would be reduced by 1/4, as the total counts are distributed over four times the pixels, compared to a 64 × 64 matrix. Thus the noise increases in the image and so the signal-to-noise ratio decreases causing degradation in image contrast. In both modes, a technique of magniﬁcation or zooming can be applied, whereby the pixel size is decreased by a zoom factor. Data acquisition in the frame mode is the most common practice in nuclear medicine and widely used in static, gated, dynamic, and single Application of Computers in Nuclear Medicine 145 A B Fig. In this mode, a matrix is chosen that approximates the entire area of the detector so that a position (X, Y) in the detector corresponds to a pixel position in the matrix. Digitized signals (X, Y) are stored in the corresponding (X, Y) posi- tions (pixel) of the matrix of choice in the computer. In this mode, one must specify the size and depth of the matrix, the number of frames per study, and the time of collection of data per frame or total counts to be collected. In the list mode, digitized X- and Y-signals are coded with “time marks” as they are received in sequence in time, and are stored as individual events in the order they occur (Fig. After the data acquisition is completed, the data can be sorted to form images in a variety of ways to suit a speciﬁc need. Data can be manipulated by changing the matrix size and the time of acquisition per frame. Since the data are listed sequentially without overlapping each other, the bad signals from an arrhythmic cardiac cycle can be discarded, as found appropriate, in the 146 11. Although the list mode acquisition provides wide ﬂexibility, its major disadvantages are larger memory space and longer processing time required and unavailability of images during or immedi- ately after the completion of the study.
The use of words indicating causal links such as ‘because’ buy aygestin from india, ‘since’ aygestin 5mg on line, ‘as a result of’ (di»ti buy 5mg aygestin with visa, te order aygestin overnight, Âti, di) in these sections is very frequent indeed. But it is especially the nature of these explanations which calls for consideration, for the fact is that many of them suffer from defects that might be interpreted as provoking the kind of criticism Diocles is expressing, such as circularity – no clear distinction being made between the level of qualities and that of powers – shifting the problem, and tautology – explanandum and explanation being stated in the same terms. It warms, because it is vinous, moistens because it is nutritious, and sends to stool because it is sweet and moreover boiled-down’); 2. The most prominent instances where the importance of causal explanation is stated are: 20. Considering these examples, we may be inclined to say that Diocles’ warnings against too automatic an application of causal explanation, as well as his prescription (in section 11 of fr. It rather seems to me that Diocles is arguing against what he believes to be – in the context of dietetics – some undesirable consequences of the search for causes or principles, or to put it in other words, against too strict an application of what in itself – and in Diocles’ opinion too – remains a sound scientiﬁc procedure. These consequences seem to have pervaded Greek scientiﬁc thought in the fourth century to such an extent that opposition to it was also expressed by Aristotle and Theophrastus (in their case, the opposition is probably directed against certain tendencies in the early Academy). There are a number of passages which reﬂect a similar awareness in Aristotle and Theophrastus of the limits of causal explanation. Theophrastus, Metaphysics 9 b 1–13: ‘Wherefore this too is problematical or at any rate not easy to say, up to which point and of which entities one should seek the cause, in the objects of sense and in the objects of thought alike: for the inﬁnite regress is foreign to their nature in both cases and destroys our understanding. Both of them are starting-points in some way: and perhaps the one for us, the other absolutely, or, on the one hand, the end and the other a starting-point of ours. Up to some point, then, we are capable of studying things causally, taking our starting-point from sense-perceptions in each case; but when we proceed to the extreme and primary entities, we are no longer capable of doing so, either owing to the fact that they do not have a cause, or through our lack of strength to look, one would say, at the brightest things’ (¨ kaª toÓtì poron £ oÉ çdi»n ge e«pe±n, mcri p»sou kaª t©nwn zhthton a«t©av ¾mo©wv n te to±v a«sqhto±v kaª nohto±vá ¡ gr e«v peiron ¾d¼v n mfo±n llotr©a kaª nairoÓsa t¼ frone±n. For example, Diocles’ way of expressing himself in section 8 certainly reminds us of Aristotle, who also often uses the combination of ‘in a certain way’ (tr»pon tin) and ‘look like’ (oike) in order to qualify the similarities he sees between different entities or phenomena; the combination rca±v oike (‘look like starting-points’) is also attested several times in Aristotle’s works. Similar searches for combinations of tr»pon tina and a form of oika yielded the following results: Aristotle, Gen. For pretty much all animals in some way seem to produce grubs to start with; 94 Hippocratic Corpus and Diocles of Carystus against claims one and two sounds very Aristotelian (although he does not use the typically Aristotelian terminology of kaqì aËt», kat sumbebhk»v, or the qualiﬁer ¨). The advice not to take unknown, disputed or implausible items as starting-points is perfectly in keeping with the principles and the practice of Aristotelian dialectic. For once the ﬁg is closed neither dew nor drizzle can make it miscarry, and it is dew and drizzle that get warmed and cause the drop, as with the pomegranate blossom. That these are responsible (and they are cited by some people) is indicated by what happens: there is more dropping of the fruit when light rain follows its ﬁrst appearance’ ( ïEoike dì eper ¡ noixiv poie± tn pimonn eÎpnoin te kaª prasin poioÓsa paraplsion tr»pon tin [t¼] sumba±non kaª pª tän n A«gÅptw sukam©nwná ll toÓto diamfisbhtoÓs© tinev Þv rì oÉk no©gousin o¬ y¦nev ll summÅein poioÓsin Âtan e«sdÅwsin Âqen kaª tn a«t©an stªn k toÓ nant©ou frein Þv toÅtou crin rinazomnwná n gr summÅwsin oÎqì ¡ dr»sov oÎte t yakdia dÅnatai diafqe©rein Ëfì æn pop©ptousi diugrain»menoi ãsper kaª o¬ kÅtinoi tän çoäná Âti d taÓta atia mhnÅei t¼ sumba±non Á d kaª lgous© tinevá pobllousi gr mllon Ëdat©wn piginomnwn;tr. It seems that of the two opposites, namely sweet and bitter, the sweet is the origin (as it were) of good ﬂavour, whereas the bitter is the origin of fragrance and in some way the bitter is to a greater extent the origin of fragrance. For it is hard to ﬁnd any fragrant thing that is not bitter, but many non-sweet things have excellent ﬂavour’ ( v pª pn d t gì eÎosma pnta pikrá toÅtou mn oÔn tn a«t©an Ìsteron lekton. I am aware that linguistic resemblances do not prove intellectual exchange or even similarity of doctrine (for the abuse of linguistic ‘evidence’ by Jaeger see von Staden (1992) 234–7) and that the Aristotelian corpus is so much larger than the Hippocratic that the signiﬁcance of the fact that only occurrences in Aristotle and Theophrastus are found may be doubted (the computer also found Plato, Phaedo 100 e 6–a 1: swv mn oÔn æ e«kzw tr»pon tin oÉk oiken, but this passage is not quite comparable with the Diocles fragment). Diocles of Carystus on the method of dietetics 95 Connections of Diocles’ views with Aristotle’s have, of course, been made by earlier scholars, especially by Werner Jaeger, in whose picture of Diocles as a pupil of Aristotle fragment 176 played a central part. He argued that the fragment could not have been written without the inﬂuence of the great Stagirite on the Carystian physician, and from this and other considerations drew far-reaching conclusions concerning Diocles’ date. Yet this should not make us a priori hostile to any attempt to associate Diocles with the Lyceum. The resemblance is not so much between Diocles’ ar- gument that knowledge of the cause is often not necessary for practical purposes and similar statements found in Aristotle’s Nicomachean Ethics (which Jaeger emphasised) – it has been shown that what is at issue in those passages is rather different from what Diocles is concerned with. While, to my knowledge, no parallels of this idea can be found in the Hippocratic Corpus, it clearly re- sembles statements in Aristotle and Theophrastus (see note 41) to the effect that the search for causes should stop somewhere and that further analy- sis even ‘destroys’ our understanding. It will probably remain a matter of dispute whether this resemblance is actually to be interpreted as evidence of intellectual exchange between Diocles, Aristotle and Theophrastus. It should be noted, however, that Jaeger’s views have been setting the agenda for Dioclean studies for quite a long time and are sometimes still determining the kind of questions asked by scholars who are at the same time in doubt concerning the validity of his conclusions (see, e. For a plea for a study of Diocles in his own right (with the question of his date and his being ‘inﬂuenced’ by this or that particular ‘school’ being kept away from the study of the individual fragments as long as possible) see van der Eijk (1993b) and (2001a) xxi–xxxviii. Gottschalk (private correspondence) points out to me that the doctrine of the limits of causal explanation, which is a very sophisticated piece of philosophy, is presented by Aristotle as his invention, whereas Diocles alludes to it very brieﬂy: ‘his sentence presupposes a knowledge of Aristotle or something very like it’. The latter are either – in the case of real undemonstrable principles such as deﬁnitions or logical postulates – concerned with the avoidance of an inﬁnite regress or with the consideration that within the limits of a particular branch of study some things should be accepted as starting-points, the demonstra- tion of which belongs to another discipline: the ignorance of this is seen by them as a sign of ‘being uneducated’ (paideus©a). While Aristotle’s warnings against pursuing causal analysis too far in these latter contexts look like methodological prescriptions based on considerations of fruit- fulness and economy (one should not ask for a cause here because it is useless – although it may be possible to state one), Diocles’ point is that in the ﬁeld of dietetics many things simply do not allow of explanation, because when pursuing the search for causes too far, one passes the level of the ‘whole nature’ of a foodstuff and loses the connection with the actual explanandum. On the other hand, it is not unlikely that some sort of contact between Diocles and the Lyceum took place. Diocles enjoyed a good reputation in Athens – although our source for this does not specify in what times he did. It has been doubted whether this should be taken as applying to the Carystian physician, seeing that the name Diocles was very common in Greek and that several persons named Diocles in fourth- century Athens are known from literary and epigraphical sources. The fact that he is credited by Theophrastus with an opinion on a mineralogical topic is a weak argument, which is based on doubtful presuppositions concerning a ‘division of labour’ between the sciences. Diocles may have had various interests, just as Theophrastus himself, or Aristotle, or the authors of such 48 (Pseudo-)Vindicianus, On the Seed 2: ‘Diocles, a follower of Hippocrates, whom the Athenians gave the name of younger Hippocrates’ (Diocles, sectator Hippocratis, quem Athenienses iuniorem Hippocratem vocaverunt). The use of the Attic dialect may be an indication that Diocles lived or practised in Athens (although several fragments preserved in Oribasius also – in some manuscripts – show Ionic forms [see van der Eijk 2001a, xxiv n. The fact that Theophras- tus refers to Diocles without further speciﬁcation is regarded by Eichholz as evidence that the Carys- tian is meant (1965) 107–8; but this argument will not do, for two different people named Diocles are also mentioned in the will of the Peripatetic Strato (Diogenes Laertius 5. We can only say that it must have been evident to Theophrastus and his audience which Diocles was meant [see van der Eijk (2001a) 416–19]. Diocles of Carystus on the method of dietetics 97 Hippocratic writings as On Fleshes or On Regimen for that matter. Of course we cannot prove that the Diocles mentioned by Theophrastus is the Carystian physician; but then there are a great number of other testimonies about a Diocles where this proof cannot be given. What we can say, I think, is that Diocles marks a methodological aware- ness of the limits of causal explanation that was not anticipated in the Hippocratic Corpus and that showed several signiﬁcant resemblances to remarks found in Aristotle and Theophrastus. These resemblances may have been the result of intellectual exchange and discussion between them (the existence of which is likely), but this cannot be proved, and we are in no position to decide who was ‘inﬂuenced’ by whom. Finally, it seems that any association of Diocles with Empiricism or Scepticism should be abandoned once and for all. Those who have read the fragment in this way not only seem to have extrapolated Diocles’ re- marks about dietetics to all other branches of medicine (on the question whether this is justiﬁed, see above), but also, as far as dietetics itself is con- cerned, to have been guided by Galen’s presentation of it, that is, as propa- ganda for an exclusively empirical approach to the search for the powers of 50 It has been argued by von Staden (1992, 253) that there is no independent evidence of mineralogist interest by Diocles. The fragment is quoted by Galen in the context of embryology, but there is no evidence that in its original context it just served the purpose of analogy (as it does for Galen). Moreover, as von Staden concedes, in the immediate context of the Diocles fragment in On Stones, Theophrastus mentions dietetic and physiological factors affecting the magnetic force of the lyngourion – although I agree that this does not prove that the Diocles mentioned was Diocles of Carystus. In fact, when reading Galen’s own discussion of the right method of dietetics in the pages following on the fragment, it turns out that Diocles’ position as reﬂected in the fragment (especially in his crit- icism of claims one and two) perfectly meets the requirements of what Galen himself calls ‘qualiﬁed experience’ (diwrismnh pe±ra; see chapter 10 below). By this concept, which Galen presents as his own innovation, he means an empirical approach which takes into account the conditions un- der which a dietetic statement like ‘rock ﬁsh are difﬁcult to digest’ is true. All these should be considered, Galen points out, before any generalising statement about the power of a particular foodstuff is allowed. Galen represents Diocles as being completely unaware of these factors and as being more one-sided than he actually was – and it would seem that Galen is doing so not for lack of understanding but in order to articulate his own reﬁned position as against Diocles’ unqualiﬁed acceptance of experience as the only way to get to know the powers of foodstuffs. But here too there is a highly useful qualiﬁcation, itself, too, not mentioned by Diocles, just as also none of the others we have discussed until now [was mentioned by him]’ (t to©nun msa ta±v krsesin oÉdem©an pikratoÓsan conta poi»thta Diocles of Carystus on the method of dietetics 99 the ‘highly useful distinction’ (diorism»v) between ‘foodstuffs’ (trofa©) and ‘drugs’ (frmaka) – that is to say, for not having pointed out under what circumstances a particular substance acts like a foodstuff (which only preserves the state of the body) or as a drug (which changes the state of the body) – just as he failed to deal, Galen adds maliciously, with the other distinctions discussed by him in the previous paragraphs. In fact, in the context of another treatise, namely On Medical Experience (De experientia medica, De exp. For if everything which is ascertained is ascertained only by reasoning, and nothing is ascertained by experience, how is it possible that the generality, who do not use reason, can know anything of what is known? And how was it that this was unanimously asserted among the elder doctors, not only by Hippocrates, but also by all those who came after him, Diogenes, Diocles, Praxagoras, Philotimus, and Erasistratus? For all of these acknowledge that what they know concerning medical practice they know by means of reasoning in conjunction with experience. In particular, Diogenes and Diocles argue at length that it is not possible in the case of food and drink to ascertain their ultimate effects but by way of experience. In this testimony, the view of Diocles and the other ancient authorities is obviously referred to in order to support Galen’s argument against an exclusively theoretical approach to medicine. And although we should not assign much independent value to this testimony – which, apart from its vagueness, is a typical example of Galen’s blufﬁng with the aid of one of his lists of Dogmatic physicians – it is compatible both with the picture of Diocles’ general medical outlook that emerges from the collection of fragments as a whole and with his approach to dietetics as reﬂected in our fragment 176. Diogenes and Diocles are mentioned by Galen in particular trofaª m»non e«s©n, oÉ frmaka, mqì Ëpgonta gastra... This reference to the ‘ultimate effects’58 is in accordance with the in- terpretation of section 8 given above: this ultimate effect does not admit of further causal explanation; we can only make sure what it is by experience, by applying the foodstuff in a given case and seeing how it works out.