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Acknowledgment

Elizabeth Domholdt was the sole author of the first three editions of Rehabilitation
Research and author emerita of the fourth edition. We wish to express our gratitude to her
as this edition could not have been completed without her pioneering authorship. Her vision
in previous editions, her knowledge coupled with outstanding writing and organization, and
her ­commitment to bringing research principles and applications into the clinical milieu
were invaluable stepping stones as we fashioned the new edition. We sincerely hope that we
have enhanced her vision and labors.

Russell E. Carter, PT, EdD

Jay Lubinsky, PhD, CCC-A/SLP, ASHA Fellow

vii
 Contents

SECTION ONE SECTION SIX

Research Fundamentals Measurement
1 Rehabilitation Research, 1 18 Measurement Theory, 231
2 Theory in Rehabilitation Research, 11 19 Methodological Research, 249
3 Evidence-Based Practice, 23
SECTION SEVEN
4 Finding Research Literature, 33
Data Analysis
5 Research Ethics, 42
20 Statistical Reasoning, 259
SECTION TWO 21 Statistical Analysis of Differences:
Research Design The Basics, 281
6 Research Paradigms, 55 22 Statistical Analysis of Differences:
Advanced, 298
7 Variables, 68
23 Statistical Analysis of Relationships:
8 Research Validity, 76
The Basics, 318
9 Selection and Assignment of
24 Statistical Analysis of Relationships:
Participants, 92
Advanced, 329

SECTION THREE
SECTION EIGHT
Experimental Designs Being a Consumer of Research
10 Group Designs, 107
25 Evaluating Evidence One Article at a
11 Single-Subject Designs, 120 Time, 345
26 Synthesizing Bodies of Evidence, 363
SECTION FOUR
Nonexperimental Research for SECTION NINE
Rehabilitation
Implementing Research
12 Overview of Nonexperimental
27 Implementing a Research Project, 377
Research, 143
28 Publishing and Presenting
13 Clinical Case Reports, 153
Research, 399
SECTION FIVE Appendices
Research Beyond the Everyday
Appendix A: Random Numbers Table, 409
14 Qualitative Research, 159
Appendix B: Areas in One Tail of the Standard
15 Epidemiology, 176 Normal Curve, 414
16 Outcomes Research, 194 Appendix C: Questions for Narrative Evaluation of a
17 Survey Research, 215 Research Article, 415

viii
 Contents ix

Appendix D: Basic Guidelines for Preparing a Journal Appendix G: Sample Platform Presentation Script
Article Manuscript, 418 with Slides, 463
Appendix E: American Medical Association Style:
Sample Manuscript for a Hypothetical Index, 471
Study, 423
Appendix F: American Psychological Association
Style: Sample Manuscript for a
Hypothetical Study, 443
This page intentionally left blank
REHABILITATION
RESEARCH
Principles and Applications
This page intentionally left blank
 SECTION
ONE Research Fundamentals

CHAPTER
1
Rehabilitation Research

CHAPTER OUTLINE

Definitions of Research Barriers to Rehabilitation Research The Clinician-Researcher Dichotomy

Research Challenges the Status Quo Lack of Funds Overcoming Barriers
Research Is Creative Lack of Research Mentors The Scientist-Practitioner
Research Is Systematic Lack of Time Status of Rehabilitation Research
Reasons for Developing Lack of Familiarity with the Research Professional Association Goals
Rehabilitation Research Process Research Publication Vehicles
Develop Body of Knowledge Lack of Statistical Support Educational Standards
Determine Whether Interventions Ethical Concerns About Use of Research Funding
Work Human Participants and Summary
Improve Patient and Client Care Animal Subjects

Rehabilitation professionals believe that the work we do material while challenging previously held beliefs can
makes a difference in the lives of the people we serve. engender frustration with the new material and doubt
Rehabilitation research is the means by which we test about previous learning. Some clinicians, unable to cope
that belief. In the rapidly changing and increasingly with such uncertainty, retreat to anecdotes and intu-
accountable world of health care, it is no longer enough ition as the basis for their work in rehabilitation. Others
to say that we do good work or to note that patients delight in the intellectual stimulation of research and
or clients feel better after we’ve intervened. Rather, we commit themselves to developing an ­ evidence-based
must be willing to search for, or even create, evidence practice. Such clinicians balance the use of existing
about the value of our practices and then modify those but unsubstantiated practices with critical evaluation
practices in response to the evidence. Rehabilitation of those same practices through regular review of the
professionals who embrace evidence-based practice also ­professional literature and thoughtful discussion with
embrace the challenge of learning about rehabilitation colleagues. Furthermore, these professionals may par-
research. ticipate in clinical research to test the assumptions
Learning about rehabilitation research involves under which they practice.
developing a diverse set of knowledge and skills in This introductory chapter defines research, examines
research methodologies, research design, statistical and reasons for and barriers to implementing rehabilitation
qualitative analysis, presentation, and writing. At the research, and considers the current status of rehabili-
same time a practitioner or student is acquiring these tation research. Based on this foundation, the rest of
new skills, he or she is forced to reexamine the status the book presents the principles needed to understand
quo, the conventional wisdom of the rehabilitation research and suggests guidelines for the application of
professions. This combination of trying to learn new those principles to rehabilitation research.

1
2 Section One n
Research Fundamentals

outcomes research (see Chapter 16). Emphasis and lit-

DEFINITIONS OF RESEARCH erature on evidence-based practice (see Chapter 3) con-
Research has been defined by almost every person who tinue to grow. The increasing number of meta-analyses
has written about it. Kettering, an engineer and philan- and critical reviews validates some of our clinical prac-
thropist, had this to say: tices and challenges others (see Chapter 4). These recent
developments suggest a powerful research agenda for
“Research” is a high-hat word that scares a lot of peo-
rehabilitation providers.
ple. It needn’t; … it is nothing but a state of mind—a
Despite recent efforts, we continue many rehabilita-
friendly, welcoming attitude toward change.… It is
tion practices about which few, if any, data exist. A sec-
the problem-solving mind as contrasted with the let-
ond approach to challenging the status quo, therefore,
well-enough-alone mind. It is the composer mind
is to systematically test the effects of these practices.
instead of the fiddler mind. It is the “tomorrow”
A third way of challenging the status quo is to test
mind instead of the “yesterday” mind.1(p. 91)
novel or traditionally avoided treatments. Some exam-
We think his words, published in 1961, still ring true. ples of such treatments are (1) use of human magnetic
Payton, a physical therapist who has written widely fields to manage pain8 and (2) application of sensory
about research, indicates that “research should begin integration training to a very wide variety of clinical
with an intellectual itch that needs scratching.”2(p. 8) conditions.9–11
Kazdin, a psychologist, speaks about various research These examples of challenges to the status quo iden-
methods, noting that “they have in common careful tified gaps in knowledge about rehabilitation practice,
observation and systematic evaluation of the subject may provide support for one set of clinical practices,
matter.”3(p. 2) Portney and Watkins,4 Polit and Beck,5 and suggest a need for review of another set of clinical
Stein and colleagues,6 and Nelson,7 who have written beliefs. Research is about embracing these kinds of chal-
texts on clinical, nursing, occupational therapy, and lenges. It is about the willingness to test our assump-
communication disorders research, respectively, all tions, to use what works, and to change our practices in
emphasize the organized, systematic nature of research. light of new evidence.
Three important characteristics about research emerge
from these different authors: (1) research challenges the
status quo, (2) it is creative, and (3) it is systematic.
Research Is Creative
The second characteristic of research is that it is cre-
ative. Rothstein, in an editorial, chastised physical ther-
Research Challenges the Status Quo apists for their willingness to accept authoritarian views
Definers of research all indicate it as a way of answering of their profession: “Our teachers and our texts tell us
questions. Thus, the first characteristic is that research how it should be, and we accept this in our eagerness
challenges the status quo. Sometimes the results of to proceed with patient care.”12(p. 895) Researchers are
research may support current clinical practices; other creative individuals who move past the authoritarian
times the results point to treatment techniques that teachings of others and look at rehabilitation in a differ-
are not effective. But whether research does or does not ent way. And, in at least a partial answer to Rothstein,
lead to a revision of currently accepted principles, the we note the increasing emphasis on evidence-based
guiding philosophy of research is one of challenge. Does practice and the emergence of the scientist-practitioner.
this treatment work? Is it more effective than another Virtually every piece of research is the product of a cre-
treatment? Would this person recover as quickly with- ative question.13 In any science, “the dualism between
out intervention? The status quo can be challenged in science and creativity is unfounded.”14 “Why?” and
several ways, as illustrated in the three examples that “Why not?” are core questions, as is, “What if …?”
follow. Creative aspects of rehabilitation research are
One way of challenging the status quo is to iden- emphasized in Chapter 2, which presents information
tify gaps in our knowledge—for example, to identify about the use of theory in practice and research, and
common practices about which we know very little. Chapter 4, which provides a framework for the devel-
Because much of our practice as clinicians is based on opment of research problems.
the collective wisdom of past professionals, we forget
that much of this practice has not been verified in a sys-
tematic way. However, we are increasingly in the pro-
Research Is Systematic
cess of validating our clinical practices. Many clinicians, The third characteristic of research is that it is system-
professional associations, and scientists are engaged in atic. In contrast, much of our clinical knowledge is
 Chapter 1 n
Rehabilitation Research 3

anecdotal, or is passed on by prominent practitioners

Box 1-1
who teach a particular treatment to eager colleagues
or students. As Hicks noted,… “after all, many of the Characteristics of a Profession
therapeutic techniques currently in practice have been
developed over the years and consequently are tried Conceptual Characteristic
and tested.”15(p. 3) Anecdotal claims for the effectiveness Establishment of a central mission
of treatments are colored by the relationship between
the clinician and patient and typically do not control Performance Characteristics
for factors, other than the treatment, that may account Mastery of theoretical knowledge
for changes in the condition of the patient or client. Capacity to solve problems
The systematic nature of some research methodologies Use of practical knowledge
attempts to isolate treatment effects from other influ- Self-enhancement
ences not ordinarily controlled in the clinic setting.
Other methodologies focus on systematic description Collective Identity Characteristics
of the phenomenon of interest, rather than control Formal training
of the research setting. Much of this text presents the Credentialing
systematic principles that underlie research methods: Creation of a subculture
Sections 2 through 5 (Chapters 6 through 17) cover Legal reinforcement
research design, Section 6 (Chapters 18 and 19) dis- Public acceptance
cusses measurement tools, and Section 7 (Chapters 20 Ethical practice
through 24) introduces data analysis. Penalties
Relations to other vocations
Relations to users of service
REASONS FOR DEVELOPING
REHABILITATION RESEARCH List developed from Houle CO. Continuing Learning in the
There are at least three reasons for conducting rehabili- Professions. San Francisco, Calif: Jossey-Bass; 1981.
tation research: (1) to develop a body of knowledge for
the rehabilitation professions, (2) to determine whether “evidence-based practice,” a concept that has achieved
interventions work, and (3) to improve patient and cli- widespread recognition. Kenyon and Blackinton applied
ent care. Each of these reasons is examined in the sec- aspects of motor-control theory to a clinical case, further
tions that follow. integrating theory and the development of the knowl-
edge base for physical therapy.18 The search for defini-
tion and understanding of what may seem like basic
Develop Body of Knowledge concepts is far from complete.
The “body of knowledge” rationale for rehabilitation
research is related to the concept of a profession. The
characteristics of a profession have been described by
Determine Whether Interventions Work
many authors but include several common elements. The second major rationale we offer for performing
Houle16 divided the characteristics of a profession into rehabilitation research relates to determining whether
three broad groups: conceptual, performance, and collec- interventions work.
tive identity characteristics (Box 1-1). One of the critical The need for research on the effectiveness of
performance characteristics is mastery of the theoretical ­rehabilitation interventions was highlighted by Brummel-
knowledge that forms the basis for the profession. Smith19 when he summarized the research recommen-
The theoretical foundations of the rehabilitation dations of a National Institutes of Health Task Force
professions, discussed further in Chapter 2, include on Medical Rehabilitation Research and applied them
concepts such as occupation, disablement, and move- to rehabilitation of older adults. He noted four major
ment science. areas in need of study: the natural history of disabil-
Although the knowledge base for our professions ity, functional assessment and ­performance evaluation,
has grown and continues to grow, rehabilitation pro- intervention issues, and rehabilitation service delivery.
fessionals and students still work to develop ways of In discussing intervention issues, he identified a need
identifying important theoretical constructs as well as both to “evaluate effectiveness of existing interventions
ways of understanding them. Kinsella and Whiteford17 and to develop novel approaches to care,”19(p. 895) noting
offer, as an example, a way of structuring the concept of that “current interventions have not received the type
4 Section One n
Research Fundamentals

of careful scrutiny that is now expected of medical inter- safety, does not require handheld assistive devices, uses
ventions.”19(p. 895) More recently, the ­sentiment is sum- relatively normal gait patterns, and has reduced energy
marized by Hicks, who notes, “healthcare professionals demands when compared with unsupported walking.
have an imperative to ensure that their clinical decisions A recent innovation included the use of robots to assist
can be justified on empirical grounds …” and further with body-weight support.20 Clinicians with a good
laments, “good quality research studies that address fun- knowledge base in research will be able to critically
damental issues in care provision have not been as plen- evaluate this article to determine whether they can
tiful as is either desirable or necessary.”15(p. vii) apply the results to the clinical situations in which they
work. Chapters 25 and 26 present guidelines for evalu-
ating research literature.
Improve Patient and Client Care
The third reason for rehabilitation research is perhaps
BARRIERS TO REHABILITATION
the most important one: improving patient and cli-
ent care. This, of course, is not completely separate
RESEARCH
from the reason of finding out whether our treatments In 1975, Hislop, a physical therapist, articulated one
work. However, once we find out what works and what major philosophical barrier to research in the profession:
does not, and under what circumstances, research can
A great difficulty in developing the clinical science of
improve care by helping clinicians make good decisions
physical therapy is that we treat individual persons,
about the use of existing practices or by providing sys-
each of whom is made up of situations which are
tematic evaluation of the effectiveness of new practices.
unique and, therefore, appear incompatible with the
When we know what has or has not been supported
generalizations demanded by science.21(p. 1076)
by research, we can make intelligent, evidence-based
decisions about which clinical procedures to use with Although this conceptual barrier may still loom large
our clients. Clinical research about these procedures for some practitioners, many more concrete obstacles
could provide additional evidence that would help to rehabilitation research have been documented.22–24
practitioners make informed decisions about recom- These obstacles include lack of familiarity with research
mending the procedures. methodology, lack of statistical support, lack of fund-
Although there are many areas of rehabilitation prac- ing, lack of a mentor, and lack of time. An additional
tice for which evidence is thin, there are other areas in obstacle is concern for ethical use of humans or ani-
which clinicians who are committed to ­evidence-based mals in research activities. Although the cited authors’
practice can find a rich body of evidence on which comments go back several years, we think they are still
to base their work. Chapter 4 gives a hint about the valid; given the economy and demand for productiv-
large and growing amount of literature available (and ity at the writing of this book, they may be even more
how to find it) to rehabilitation scientist-­practitioners. problematic than previously thought. However, this
The increase in meta-analyses and critical reviews (see book should help to overcome several of the obstacles,
Chapters 4 and 26) points to not only how much is avail- particularly those pertaining to research methodology.
able but also how useful it is. A search for meta-analyses
and critical reviews in the period 2009 through 2012 for
all journals related to physical therapy or occupational
Lack of Funds
therapy indexed in the CINAHL search engine (see The scope of this text will not directly help in over-
Chapter 4) yielded more than 16,000 results. Results of coming lack of funding, although information in
the same search for speech-language pathology in the Chapter 27 will help you gain access to funds that are
same period yielded more than 11,000 results. available. Funding, especially from public sources, is
In addition to helping clinicians make judgments largely a political process; we urge readers to take part
about the use of existing treatments, research can be in that arena to advocate for research budgets.
used to test new procedures so that clinicians can make
evidence-based decisions about whether to add them
to their clinical repertoire. For example, body-weight–
Lack of Research Mentors
supported treadmill ambulation, although established, Another example is lack of research mentors.
continues to undergo modifications in need of such Contemporary research is often done in teams. Ideally,
testing. In theory, body-weight–supported treadmill novice researchers would be invited by experienced
ambulation should enable patients to improve their researchers to become members of working research
ambulation function by training in a way that ensures teams with ongoing projects, external funding, and
 Chapter 1 n
Rehabilitation Research 5

access to a network of colleagues engaged in similar everyday practice. Although this characterization is a
work. The importance of research mentors—and the caricature, and evidence exists of ways to implement
difficulty in finding them in the rehabilitation profes- a research culture in a clinical environment,36 even the
sions—has been discussed for several rehabilitation pro- most clinically grounded research uses the specialized
fessions.25–27 The picture is possibly made bleaker by the language of research design and data analysis, and those
documented shortage of research-prepared doctoral fac- who have not acquired the vocabulary are understand-
ulty in academic programs,28–30 and, at least at this writ- ably intimidated when it is spoken. One goal of this text
ing, it is difficult to predict how the advent of required is to demystify the research process by clearly articulat-
entry-level professional (i.e., clinical) doctorates will ing the knowledge base needed to understand it.
affect the situation. There may be at least one bright
light in the situation, however. Although the traditional
model of mentoring is that the mentor and protégé are
Lack of Statistical Support
in the same institution, professional associations have Another barrier we think can be overcome is lack of sta-
recently developed research-mentoring programs in tistical support. Section 7 (Chapters 20 through 24) of
which the mentor and protégé are not necessarily in the this book provides the conceptual background needed to
same institution, giving more flexibility to establishing understand most of the statistics reported in the rehabil-
possible mentor-protégé relationships.31–33 itation research literature.37,38 A conceptual background
does not, however, provide an adequate theoretical and
mathematical basis for selection and computation of a
Lack of Time given statistic on a particular occasion, particularly for
A third barrier difficult to overcome is lack of time. complex research designs. Thus, many researchers will
Testa34 outlined six major factors that influence the require the services of a statistician at some point in the
completion of research. Two of the six factors referred research process. Guidelines for working with statisti-
to “time” directly, and two more (complexity and cians are provided in Chapter 27.
funding) are indirectly related to the time that a
researcher has available to devote to the task. Hegde
Ethical Concerns About Use of Human
noted, “Clinicians do not have the needed extra time
for research.”35(p. 10)
Participants and Animal Subjects
Indeed, it is difficult to separate the “time” issue from Often, rehabilitation research is halted by ethical con-
the “funding” issue because a lack of external funding cerns related to the use of either human participants
generally limits the time available for research. In the or animal subjects. Those who choose to study ani-
absence of external funding, tasks with firm deadlines mal models should follow appropriate guidelines for
are given higher priority than research, and the imme- the use, care, and humane destruction of animal sub-
diate time pressures of the clinic and classroom may jects. Clinicians who use human participants in their
lead clinicians and academicians alike to postpone or research must pay close attention to balancing the risks
abandon research ideas. One solution is to design stud- of the research with potential benefits from the results.
ies that are relatively easy to integrate into the daily Chapter 5 examines ethical considerations in detail;
routine of a practice. Chapters 11, 13, and 16 present Chapter 27 provides guidelines for working with the
a variety of research designs particularly suitable for committees that oversee researchers to ensure that they
implementation in a clinical setting. protect the rights of research participants.
Despite these difficulties, there are barriers to
research that can be overcome, which are addressed
in this text. They include lack of familiarity with the
The Clinician-Researcher Dichotomy
research process, lack of statistical support, ethical con- Yet another barrier to research implementation is the
cerns, and the clinician-researcher dichotomy. apparent and widely held belief that clinicians and
researchers have little in common. We refer to this as
the “clinician-researcher” dichotomy. The history of
Lack of Familiarity with the Research
this situation is a long one, especially in clinical psy-
Process chology, and accounts of its development are offered
Clinicians sometimes view rehabilitation research as a by Hayes and associates39 and Merlo and colleagues.40
mysterious process that occupies the time of an elite Hayes and associates offer two primary reasons for the
group of professionals, far removed from patient or dichotomy: “(a) the almost universally acknowledged
client care, who develop projects of little relevance to inadequacies of traditional research methodology to
6 Section One n
Research Fundamentals

address issues important to practice and (b) the lack of a Thorough histories of the effort are offered by Hayes
clear link between empiricism and professional success and associates39 and Merlo and colleagues.40 Essentially,
in the practice context.”39(p. 15) By “traditional research the model seeks to provide education so that clinicians
methodologies,” the authors are referring to large- have good research training and researchers have good
scale group-data experiments, especially clinical trials. clinical training at least to the extent of good under-
Hegde also offers the doubt “regarding the extent to standing of both roles.
which research affects day-to-day practice.”35(p. 10) Fago The history of attempts at developing scientist-­
confirms a “widening division between psychology’s practitioners is far from over, but we see hopeful trends.
clinical investigators and clinical practitioners.”41(p. 15) In an abridged meta-analysis of 10 articles, Chang
Bishop notes the “general consensus … that the transla- and colleagues47 concluded that current education of
tion of sport-science research to practice is poor.”42(p. 253) scientist-practitioners is based on a flawed version of
Clearly, if clinicians do not think that they have much the model and needs to be more flexible and ­versatile.
in common with researchers (including time available, That is, with changed attitudes, attainment of the
research training, etc.) and that the research that is scientist-practitioner is a reasonable goal. Proposing
­
completed has little applicability to their practice, the an educational model based on dialectics, Fago41 offers
production and even consumption of research is going several suggestions for overcoming the clinician-­
to be significantly curtailed. researcher dichotomy and fostering development of the
scientist-practitioner. In a survey of students from 163
Council of University Directors of Clinical Psychology
Overcoming Barriers (CUDCP) programs, the returns from 611 students,
Overcoming these barriers depends on leaders who are representing 55 programs, showed that students over-
willing to commit time and money to research efforts, whelmingly “indicated that science training was very
individuals who are willing to devote time and effort important to them. Overall, students reported expe-
to improving their research knowledge and skills, and riencing a fairly balanced emphasis on science and
improved systems for training researchers and fund- clinical work, and endorsed receiving a good amount
ing research. Cusick’s qualitative study of clinician-­ of high-quality training in science.”40(p. 58) Pettigrew48
researchers underscores the importance of making and Brobeck and Lubinsky49 offer examples of how stu-
an individual commitment to becoming a researcher, dents in training are actually immersed in the scientist-­
accepting responsibility for driving the research process, practitioner model during the clinical rotations of their
and learning to negotiate the administrative and social graduate programs in occupational therapy and/or
systems that make clinical research possible.43 Research speech-language pathology.
is, however, rarely an individual effort. Therefore, one Although the past certainly has supported the notion
key to overcoming barriers to research is to develop pro- of a clinician-researcher dichotomy, we are encouraged
ductive research teams composed of individuals who, by the growth of and attention to “evidence-based
together, have all the diverse skills needed to plan, practice” in academic programs and in the rehabilita-
implement, analyze, and report research. The different tion professions. Examination of academic curricula
rehabilitation professions are working to develop such by one of the authors, an accreditation site visitor in
teams in different ways: the Foundation for Physical communication sciences and disorders, reveals univer-
Therapy in 2002 funded its first Clinical Research sal attention to ways in which students can incorpo-
Network, designed to increase research capacity in rate an evidence base into their clinical practice. The
physical therapy through collaborative arrangements Web site of the American Speech-Language-Hearing
between academic and clinical sites44; and building Association devotes considerable space to the subject,50
research capacity in the allied health professions has as do the Web sites of the American Physical Therapy
been of interest to policy-making bodies in the United Association51 and American Occupational Therapy
States45 and the United Kingdom.46 Association.52 Only time will tell if, and to what extent,
the emphasis on evidence-based practice has influenced
the everyday lives of rehabilitation clinicians.
The Scientist-Practitioner We do not expect that all clinicians will be prolific
We wish to make special note of the possible solution (or even occasional) researchers, but we do ascribe
to the barrier of the clinician-researcher dichotomy. in this text to the notion that the clinician who is a
That is the development of the scientist-practitioner ­scientist-­practitioner will be able to fulfill at least two
model of education first developed in clinical psychol- of the three roles suggested by Hayes and associates39:
ogy and later applied to other rehabilitative professions. (1) a knowledgeable consumer of new research, using
 Chapter 1 n
Rehabilitation Research 7

s­ cientifically based clinical procedures; (2) an evaluator participate in scholarly activity.”59 Their recently
of his or her own clinical practices; and (3) a producer introduced “core requirements” include the abil-
of new data. ity to “appraise and assimilate scientific evidence.”60
Furthermore, these associations do not simply make
empty statements about their roles in research—they
STATUS OF REHABILITATION follow through with actions to promote research in
RESEARCH their respective professions. For example, the American
The rehabilitation professions are relative newcomers to Speech-Language-Hearing Association’s commitment to
the health care arena, as the “conflagrations of World research is shown by its development of a national out-
War I and II provided the impetus for the development comes measurement system.61
and growth of the field of rehabilitation.”53(p. 1) Mindful
of the way in which new professions grow, in 1952 Du
Vall, an occupational therapist, wrote about the devel-
Research Publication Vehicles
opment of the health care professions into research: Dissemination of rehabilitation research findings in
peer-reviewed journals is an important indicator of the
A study of the growth and development of any
status of rehabilitation research. Over the past several
well established profession will show that, as it
decades, the number of journals with a primary mis-
emerged from the swaddling clothes of infancy and
sion to publish research related to rehabilitation has
approached maturity, research appeared.54(p. 97)
increased dramatically, as a journey through any rele-
Research has indeed appeared across the rehabilita- vant database (see Chapter 4) will attest. As of February
tion professions. A great deal can be learned about the 2015, searching the CINAHL database (see Chapter 4)
current status of rehabilitation research by examining for journal titles added just since 2000 reveals that 40
the role of research in the professional associations new titles have been added relevant to physical therapy,
of the various rehabilitation disciplines, by reviewing 16 for occupational therapy and 32 for speech-­language
the development of research publication vehicles, by pathology and audiology. The increased importance
examining the educational standards for the different of rehabilitation research across time is apparent both
rehabilitation professions, and by reviewing research in the ability of the professions to sustain these new
funding opportunities for rehabilitation and related journals and in the emergence of new types of publica-
research. tions: specialty journals (e.g., Journal of Pediatric Physical
Therapy), interdisciplinary journals (e.g., Journal of
Occupational Rehabilitation), and international journals
Professional Association Goals (e.g., International Journal of Language and Communication
All of the major professional associations that pro- Disorders).
mote the rehabilitation professions take a leading role
in advancing rehabilitation research. The American
Occupational Therapy Association works “through
Educational Standards
standard-setting, advocacy, education, and research on As research becomes more important to a profession,
behalf of its members and the public.”55 As part of its mis- the standards against which education programs
sion statement, the International Society for Prosthetics that prepare new practitioners are evaluated can be
and Orthotics includes, “Promoting research and evi- expected to reflect this emphasis. A review of educa-
dence based practice.”56 The American Physical Therapy tional program requirements for the various rehabili-
Association developed a clinical research agenda in tation professions shows that this is indeed the case,
2000 designed to “support, explain, and enhance phys- with requirements for research content, research activ-
ical therapy clinical practice by facilitating research that ities, or both. The American Speech-Language-Hearing
is useful primarily to clinicians.”57(p. 499) That association Association,62 in its standards for educational program
has recently revised and broadened the agenda to include accreditation, requires that “the scientific and research
all research, eliminating the limiting word “clinical.”58 foundations of the profession are evident in the cur-
Common Program Requirements of the Accreditation riculum” to prepare speech-language pathologists
Council for Graduate Medical Education require that and audiologists. The Commission on Accreditation
“the curriculum must advance residents’ knowledge of in Physical Therapy Education notes that “physical
the basic principles of research, including how research therapy upholds and draws on a tradition of scientific
is conducted, evaluated, explained to patients, and inquiry while contributing to the profession’s body
applied to patient care” and also that “­residents should of knowledge,” requires a “scholarly agenda,” and
8 Section One n
Research Fundamentals

requires “activities that s­ystematically advance the Although the refrains to increase and improve reha-
teaching, research, and practice of physical therapy bilitation research do not seem to change from one
through rigorous inquiry.”63 The American Council generation of providers to the next, this review of the
on Occupational Therapy Education lists “researcher” status of rehabilitation research shows that, in the sec-
among the roles to be mastered by occupational ther- ond decade of this century, professional associations for
apists in training and requires that graduates be pre- the rehabilitation disciplines include the development
pared as an effective consumer of the latest research.64 of research among their stated goals, that there is a wide
Finally, the Accreditation Council for Graduate Medical variety of established and emerging journals in which
Education has enhanced its physical medicine and to publish rehabilitation research, that educational
rehabilitation residency requirements to include for- standards for rehabilitation providers include criteria
mal curricular elements related to research design and related to research, and that external funds for rehabili-
methodology as well as opportunities to participate in tation research are available from several sources. These
research projects and conferences.59,60 signs of the recent strength of rehabilitation research
must be tempered by the often chaotic economic and
political influences that can limit research funding for
Research Funding government granting agencies and philanthropic dona-
The creation of a vast government-funded medical tions to private ones. Yes, the barriers to research are sig-
research enterprise began in earnest in the United States nificant. Yes, identifying and using available resources
in the 1940s after World War II. One symbol of this takes initiative and energy. Yes, making research a pri-
expansion of the research enterprise was the transfor- ority in a cost-containment environment is difficult.
mation in 1948 of the National Institute for Health, for- However, the incentives to overcome these barriers are
merly a “tiny public health laboratory,”65(p. 141) into the substantial in that the future of rehabilitation within
plural National Institutes for Health (NIH) that conduct the health care system and society requires that we
and support research through many specialized institutes establish a firm base of evidence on which to build our
focusing on particular branches of medicine and health practice.
care. It was not until the 1980s, however, that NIH, as
well as the Centers for Disease Control (in 1992 becom-
ing the Centers for Disease Control and Prevention),
SUMMARY
became important sources of funding for rehabilitation Research is the creative process by which profession-
research.66 Today, the NIH’s National Institute of Child als systematically challenge their everyday practices.
Health and Human Development, National Institute on Developing a body of rehabilitation knowledge, deter-
Aging, National Institute of Arthritis and Musculoskeletal mining whether rehabilitation interventions work, and
and Skin Diseases, National Cancer Institute, National improving patient and client care are reasons for con-
Institute of Mental Health, National Institute of ducting rehabilitation research. Barriers to research are
Neurological Disorders and Stroke, and National Institute lack of familiarity with the research process, lack of sta-
of Deafness and Other Communication Disorders tistical support, lack of funds, lack of mentors, lack of
are important sources of funding for rehabilitation time, and concern for the ethics of using humans and
researchers.67,68 The National Institute for Disability and animals in research. The importance of research to the
Rehabilitation Research, an arm of the U.S. Department rehabilitation professions is illustrated by professional
of Education, is another important source of funding association goals, publication vehicles for rehabilitation
for rehabilitation research.66 In addition, private foun- research, educational standards, and funding for reha-
dations associated with the various rehabilitation pro- bilitation research.
fessions, such as the American Occupational Therapy
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Another Random Scribd Document
with Unrelated Content
ὕδωρ) περιφερόμενον καὶ καταμεμιγμένον ἐς τὸν ἠέρα, τὸ μὲν
θολερὸν αὐτοῦ καὶ νυκτοειδὲς ἐκκρίνεται καὶ ἐξίσταται καὶ γίνεται
ἠὴρ καὶ ὁμίχλη, τὸ δὲ λαμπρότατον καὶ κουφότατον αὐτοῦ λείπεται
καὶ γλυκαίνεται ὑπὸ τοῦ ἡλίου καιόμενόν τε καὶ ἑψόμενον. In the
first instance, τὸν ἠέρα means, of course, ‘the air,” but the second
ἠήρ is “mist.” 1 To the ἀπόκρισις of the opposites from one another
(Anaxag. B 12, Β 4: πρὶν dmoxpiOjvar.. .5 cf. B 8) corresponds the
separating-out of αἰθήρ and ἀήρ (B 2, B 12). The actual process is
described in B 15. The four opposing couples clearly define the ἀήρ
and the αἰθήρ for Anaxagoras, just as the two “‘forms’”’ of
Parmenides (B 8.53) are distinguished by their respective δυνάμεις
(B 9).
 ELEMENTS AND OPPOSITES 163 Returning now to our
point of departure, we see what historical reality must lie behind the
statements of Simplicius and Aristotle that Anaximander ‘‘observed
the change of the four elements into one another,” and so ‘‘did not
think fit to make any one of these the materia] substratum,” but
chose instead “δὴ infinite body . . . beside the elements,” out of
which he could “generate the latter.”! In such a report the four
elements are an anachronism, just as it is unhistorical to project the
Aristotelian ὑποκείμενον back into the sixth century. The point of
view described may nevertheless be recognized as that of a Milesian.
The cyclical interchange of elemental forms was familiar to
Anaximander and Anaximenes, and naturally led them to seek a
more permanent source of cosmic evolution. Like the ἄπειρον itself,
the boundless ἀήρ of Anaximenes is also really “‘different from the
elements,” since it is defined as imperceptible in its own form,
distinguishable as wind or cloud only under the action of the hot,
cold, or other active powers. Aristotle’s statement that the elements
were “‘generated out of the dzecpov’’ corresponds to their
designation as ‘‘offspring of the Air” in the case of Anaximenes.
What little we know of Anaximander’s cosmogony suggests that Hot
and Cold, the basic constituents of the heavens, appeared as the
eldest progeny of the Boundless. We cannot pretend to say just how
many primary powers or portions were generated by Anaximander
out of the ἄπειρον. Not only hot and cold, but the other major pairs
of opposites must also have figured among them, incorporated in (or
acting upon) the visible bodies of the natural world. Here, in addition
to the sun, moon, and stars, Anaximander probably recognized the
αἰθήρ as well as the ἀήρ and the six forms mentioned by
Anaximenes: fire, wind, cloud, water, earth, and stones.
Supplementary Note: On the Chronological Relationship Between
Anaxagoras and Empedocles The priority of Anaxagoras is asserted
by Aristotle, Met. 984711: ᾿Εμπεδοκλῆς δὲ τὰ τέτταρα (sc. ἀρχὰς
τίθησι)... Ἀναξαγόρας δὲ ὁ Κλαζομένιος τῇ μὲν ἡλικίᾳ πρότερος ὧν
τούτου τοῖς δ᾽ ἔργοις ὕστερος ἀπείρους εἶναί φησι τὰς ἀρχάς. The
statement concerning their relative age is confirmed by
Theophrastus, who, with his usual precision, adds that Empedocles
was ‘“‘born not much later than Anaxagoras” (Phys. Opin. fr. 3; Dox.
477.17). According to the Hellenistic chronology, τ See the passages
cited at the beginning of this chapter, p. 119.
 164 THE COSMOLOGY OF ANAXIMANDER Anaxagoras was
the senior by about seventeen years: his birth was placed in 500/499
B.c., that of Empedocles in 483/2 (see “‘Fasti Apollodorei,” in F.
Jacoby, Apollodors Chronik (Berlin, 1902], p. 407). Of course, such
dates must be taken with a grain of salt. But it would be futile to
pretend to any greater accuracy by arbitrarily raising or lowering one
of the figures, and a difference of seventeen years is compatible
with the οὐ πολὺ κατόπιν γεγονώς of Theophrastus— Empedocles
was younger by less than a generation. In view of all this, it seems
somewhat perverse of Zeller (15, 1024-26) to argue that the points
of contact between the two philosophers must be due to the
influence of the younger man. One would naturally suppose the
contrary to be true. We need not, like Alcidamas, make Empedocles
a “hearer” of Anaxagoras (D.L. vui1.56), but we may reasonably
assume that he had read the latter’s book. On the other hand, Ross
(probabiy with Zeller’s view in mind) renders as follows the text of
the Metaphysics quoted above: “‘Anaxagoras of Clazomenae, who,
though older than Empedocles, was later in his philosophical
activity.”’ Zeller’s theory has thus succeeded in implanting itself in
our sources. But in fact this cannot be what Aristotle means by τοῖς
δ᾽ ἔργοις ὕστερος, for in the same chapter he clearly assumes that
not only the birth but also the doctrine of Anaxagoras was prior in
time. The motive cause made its first real appearance with
Anaxagoras’ concept of Nous (984°15-22), while Empedocles was
the first to conceive this cause as double, in Love and Strife (985*2-
10, 2931; similarly 985718-23: Ἀναξαγόρας τε yap μηχανῇ χρῆται TO
νῷ. καὶ ᾿Εμπεδοκλῆς ἐπὶ πλέον μὲν τούτου χρῆται τοῖς αἰτίοις, od μὴν
οὔθ᾽ ἱκανῶς). The same order is presupposed by Theophrastus:
Avagayopas... πρῶτος μετέστησε τὰς περὶ τῶν ἀρχῶν δόξας καὶ τὴν
ἐλλείπουσαν αἰτίαν ἀνεπλήρωσε (fr. 4; Dox. 478.18). The temporal
priority of Empedocles’ doctrine is therefore excluded. What then can
Aristotle mean by saying that Anaxagoras is τοῖς δ᾽ ἔργοις ὕστερος"
The obvious answer is given by Alexander (in Met. 28.1-10):
ὕστερος here means “‘inferior, second-rate.” Aristotle often
expresses his preference for the few principles of Empedocles over
the infinite number introduced by Anaxagoras (Phys. 188717,
189715). As Alexander remarks, just such a contrast between the
number of principles is suggested here by the context. The meaning
of the phrase in question is thus simply: ““Anaxagoras comes before
Empedocles in time, but after him in his philosophical
 ELEMENTS AND OPPOSITES 165 achievements.” The
remark is offered as a kind of apology for having mentioned
Empedocles before Anaxagoras. Such a stylistic contrast or parallel
between priority in time and superiority in rank or quality is a
standard device in Greek, answering to the double sense of πρῶτος:
“first”? and “‘best.’? Compare D.L. 111.48: [who first wrote dialogues
is a matter for dispute] δοκεῖ δέ μοι []Adtwv ἀκρίβωσας τὸ εἶδος καὶ
τὰ πρωτεῖα δικαίως ἂν ὥσπερ τοῦ κάλλους οὕτω καὶ τῆς εὑρέσεως
ἀποφέρεσθαι. And Theophrastus probably had our passage from the
Metaphysics in mind when he contrasted Plato with the earlier
philosophers ; τούτοις ἐπιγενόμενος I]Adtwv τῇ μὲν δόξῃ καὶ TH
δυνάμει πρότερος τοῖς δὲ χρόνοις ὕστερος (fr. 9; Dox. 484.19).
 III ANAXIMANDER’S FRAGMENT: THE UNIVERSE
GOVERNED BY LAW AVING done what we can to reconstruct the
historical context of Milesian thought, we must see what sense can
be made of the only original document surviving from this period. It
will be well to recall once more the doxographical framework within
which Anaximander’s fragment has been preserved. Ἀναξίμανδρος...
ἀρχήν τε Kal στοιχεῖον εἴρηκε τῶν ὄντων TO ἄπειρον, πρῶτος τοῦτο
τοὔνομα κομίσας τῆς ἀρχῆς" λέγει δ᾽ αὐτὴν μήτε ὕδωρ μήτε ἄλλο τι
τῶν καλουμένων εἶναι στοιχείων, ἀλλ᾽ ἑτέραν τινὰ φύσιν ἄπειρον, ἐξ
ἧς ἅπαντας γίνεσθαι τοὺς οὐρανοὺς καὶ τοὺς ἐν αὐτοῖς κόσμους" ἐξ
ὧν δὲ ἡ γένεσίς ἐστι τοῖς οὖσι, καὶ τὴν φθορὰν εἰς ταῦτα γίνεσθαι
κατὰ τὸ χρεών, διδόναι γὰρ αὐτὰ δίκην καὶ τίσιν ἀλλήλοις τῆς ἀδικίας
κατὰ τὴν τοῦ χρόνου τάξιν, ποιητικωτέροις οὕτως ὀνόμασιν αὐτὰ
λέγων. δῆλον δὲ ὅτι τὴν εἰς ἄλληλα μεταβολὴν τῶν τεττάρων
στοιχείων οὗτος θεασάμενος οὐκ ἠξίωσεν ἕν τι τούτων ὑποκείμενον
ποιῆσαι, ἀλλά τι ἄλλο παρὰ ταῦτα. Anaximander . . . declared the
Boundless to be principle and element of existing things, having
been the first to introduce this very term of “‘principle’’; he says that
“‘it is neither water nor any other of the so-called elements, but
some different, boundless nature, from which all the heavens arise
and the κόσμοι within them; out of those things whence is the
generation for existing things, into these again does their destruction
take place, according to what must needs be; for they make amends
and give reparation to one another for their offense, according to
the ordinance of time,”’ speaking of them thus in rather poetical
terms. It is clear that, having observed the change of the four
elements into one another, he did not think fit to make any one of
these the material substratum, but something else besides these.
(Phys. Opin. fr. 2, Dox. 476, cited above, 1-6. S) It is the mention of
Anaximander’s use of poetical terms which proves that we have
here, at least in part, a verbatim citation. From the grammatical
point of view, the more obviously “poetic”? expressions cannot be
isolated from the long sentence in indirect discourse, which is
introduced by the word λέγει and concluded by its repetition λέγων.
The continuity of the thought as well as of the form is underlined for
us by the following remark: it is precisely because the elements
change
 THE UNIVERSE GOVERNED BY LAW 167 into one another,
that the ἀρχή was not identified with any one of them. These words
direct us back to the very beginning of the indirect citation (μήτε
ὕδωρ μήτε ἄλλο τι... .). For Simplicius, then, the fragment illustrates
one idea and one alone: why the source from which ‘‘all the
heavens” arise cannot be one of the so-called elements. That the
“‘poetical terms,” in particular, are taken to refer directly to the
elements, is evident from the phrase ποιητικωτέροις οὕτως ὀνόμασιν
αὐτὰ λέγων. The neuter plural pronoun can only refer back to the
στοιχεῖα, which are immediately mentioned again in the next
sentence. This phrase tells us that Simplicius understood the
preceding αὐτά (subject of the poetic διδόναι δίκην ἀλλήλοις) in the
same way. For him, it is the elements which are picturesquely
described as “‘making reparation to one another for their offense.’
But this first use of the pronoun, in the phrase διδόναι yap αὐτὰ
δίκην, implies that they have been mentioned in what immediately
precedes. Did Simplicius intend the antecedent of αὐτά to be τοῖς
οὖσι or the neuter pronouns ἐξ ὧν and εἰς ταῦτα ἢ The second
alternative seems the more likely when we recall the Aristotelian
definition of an element as “that out of which a thing is composed
and into which it can be resolved” (cf. οἷον φωνῆς στοιχεῖα ἐξ ὧν
σύγκειται ἡ φωνὴ Kal εἰς ἃ διαιρεῖται ἔσχατα, Met. 10147 27). A
close reading of the passage shows that Simplicius’ whole attention
is focused on the notion of elements, and that the poetic phrase
which he quotes from Anaximander explains the generation of ra
ὄντα out of, and their dissolution into, the elements as a reparation
which the latter make to one another for their offense. There is, I
submit, no other interpretation of this passage which is suggested
by the immediate context, and therefore no reason to suppose that
either Simplicius or Theophrastus (who are in this instance
indistinguishable from one another) understood the words of
Anaximander in any other way. The whole meaning of the passage—
and, in particular, the identify of τὰ dévra—is still by no means clear.
What does seem evident is that there is no place, either in the
wording of the fragment or in the immediate context, for any penalty
or wrongdoing which could involve the Boundless. The ‘‘poetic
expressions” clearly point to a relationship of the elements among
themselves (ἀλλήλοις). Merely on grammatical grounds, there is no
term in the fragment which could refer to the ἄπειρον." 1 The
inaccurate translation of ἐξ ὧν... εἰς ...” (as if we had ἐξ od . . . εἰς
τοῦτο... .) was ταῦτα... by “into that from which things arise
universally prevalent until twenty years ago, when
 168 THE COSMOLOGY OF ANAXIMANDER Such a view
should occur to anyone who examines the text of Simplicius without
knowing in advance what it is supposed to say. If a very different
interpretation has been adopted by most commentators, including
Nietzsche and Diels, itis perhaps because they were so fascinated by
the concept of das Unendliche as the source of all that exists that
they never seriously considered the possibility that τὸ ἄπειρον might
not even be mentioned in the only sentence surviving from
Anaximander’s book. Furthermore, they probably had in mind the
parallel version of Aétius : φησὶ τῶν ὄντων ἀρχὴν εἶναι TO ἄπειρον"
ἐκ yap τούτου πάντα γίγνεσθαι Kal εἰς τοῦτο πάντα φθείρεσθαι. But
this formula represents nothing more than a banal and inaccurate
rendering of the same text which is much more faithfully preserved
by Simplicius.! Once this fact is recognized, no motive remains for
finding any reference to the Boundless in Anaximander’s words.?
Before pressing any further into the problems of an explication de
texte, we must first see just how much of a text we have. Where
does the literal quotation begin and where does it end? The only
methodical approach to this question is necessarily a long one. It
leads us to a minute analysis of certain points of style. The
Language of the Fragment The language in which Anaximander
wrote was not the artificially archaic dialect of the epic tradition, but
the spoken tongue of sixthcentury Ionia. This inference may be
drawn directly from his use of prose, but it is confirmed for us by the
very expressions which the H. Cherniss drew attention to the plural
forms them, will be found in the Supplementary Note on in
Aristotle's Criticism of Presocratic Philosophy (Baltimore, 1935), p.
377- The error is now being corrected, but slowly. The latest editions
of Diels— Kranz still translate “‘Woraus aber . . . in das ὈΠΟΙΠῚ Στ ἢ
At the same time, Cherniss understood the plurals as referring to the
ἄπειρον, and thus maintained the interpretation which stood behind
the faulty translations in the first place. On this point he has been
followed by G. Vlastos, CP, XLII, 170 ff., and by H. Frankel, Dichtung
und Philosophie des friihen Griechentums (New York, 1951), Ρ. 3475
n. 19. But any explanation of a plural form—even a neuter plural—as
if it were a singular must inevitably arouse some misgiving, and such
devices become unnecessary if, as I suggest, the plurals offer a
natural and satisfactory sense. 1 See the commentary on 4.A. 2 A
brief review of the older interpretations of the fragment, and of my
reasons for rejecting P- 193The phrase which immediately precedes
the fragment (ἐξ ἧς ἅπαντας γίνεσθαι τοὺς οὐρανοὺς καὶ τοὺς ἐν
αὐτοῖς κόσμους) refers indeed to generation out of the Boundless.
There is furthermore a certain resemblance between the two
formulas: ἐξ ἧς γίνεσθαι, and ἐξ ὧν δὲ ἡ γένεσίς ἐστι. These facts
may serve to explain—but not to justify— the insistence on
understanding ἐξ dv .. . εἰς ταῦτα in the same way. But the relative
clause ἐξ ἧς ἅπαντας γίνεσθαι τοὺς οὐρανούς is a parenthetical
expression, specifying the role of the φύσις ἄπειρος, while the
particle in ἐξ ὧν δὲ ἡ γένεσίς ἐστι τοῖς οὖσι introduces a new
development, continued by yap in the following clause. That
Simplicius here turns his attention back to τὰ καλούμενα στοιχεῖα is
proved by αὐτὰ λέγων at the end of the sentence. It is to these
again that he refers with δῆλον δέ in the next sentence.
 THE UNIVERSE GOVERNED BY LAW 169 doxographer
describes as “poetic.” This remark must apply above all to the phrase
διδόναι δίκην καὶ τίσιν ἀλλήλοις τῆς ἀδικίας. Now the words δίκη and
τίσις are both known to the old epic language, but neither appears
there with the verb διδόναι in the sense required here. When, for
example, Hesiod says δίκας διδοῦσιν, he means, not “they pay the
penalty,” but “they render judgments” (Op. 225). His expression for
“making amends” is δίκην παρασχεῖν. On the other hand, this
construction of δίκην (or τίσιν) διδόναι, with the genitive of the
offense committed and the dative of the person to whom retribution
is due, is a regular feature of Attic and Ionic poetry and prose in the
fifth century : ~ ,» ὔ τοιᾶσδέ τοί ἁμαρτίας σφε δεῖ θεοῖς δοῦναι
δίκην. (Aesch. P.V. 8) οὐδὲ ἐκεῖνοι lots τῆς Apyeins ἔδοσάν σφι δίκας
τῆς ἁρπαγῆς" οὐδὲ ὧν αὐτοὶ δώσειν ἐκείνοισι. (Hdt. 1.2.3) iva...
ἀπολαμφθέντες ἐν τῇ Σαλαμῖνι δοῖεν τίσιν (sc. τοῖσι ΠΙ|έρσησι) τῶν
ἐπ᾽ Ἀρτεμισίῳ ἀγωνισμάτων. (Hdt. vi.76.2) Thus the fragment of
Anaximander represents the earliest example of what must have
been a very common phrase in the law courts. The case of ἀδικία is
similar. This word is frequent in early Attic and Ionic for the
“wrongdoing” or “‘offense”’ of one who inflicts harm upon another
(ἀδικεῖν twa), and in particular for an offense which lies within the
scope of legal action and compensation (δίκη). Later, of course, it
comes to mean injustice or unrighteousness in general, the contrary
of δικαιοσύνη. But it is unattested in any sense before the time of
Anaximander.? In its most unmistakably genuine portions, the
fragment is thus the oldest known specimen of the classical tongue
of Athens and Ionia, apart from the inscriptions. It has a much more
direct kinship with the dialect of Herodotus and of the Hippocratic
Corpus than with the old poetry based stylistically upon the epic. If
we could read the treatises of sixth-century Miletus, the syntax
would no doubt strike us as archaic (as does that of most Ionic
compositions) ; the vocabulary, however, would be largely that of the
fifth century. This relatively modern linguistic character of the
fragment appears 1 Op. 712. Homer’s phrase is πάντ᾽ ἀποδοῦναι ποῖ
to the defendant, and means “‘submit the case (2 499; cf. B 78),
πάντ᾽ ἀπέτισε (a 43), or simply ἰἴο judgment.”’ τίσις ἔσσεται (a 40, β
76). At hymn. ad Merc. 312, 2 See LSJ s.v. ἀδικία. δὸς δὲ δίκην καὶ
δέξο is addressed to the plaintiff,
 170 THE COSMOLOGY OF ANAXIMANDER in another
expression which can hardly be due to the pen of a doxographer:
κατὰ τὸ χρεών. The form χρεών is used impersonally by Solon
(23.18, Diehl) and by Theognis (564), but the phrase with the article
is not attested before Anaximander.! (We are not surprised to find
the article employed by an author who spoke of τὸ ἄπειρον, and
probably also of τὸ θερμόν, τὸ ὑγρόν, and the rest.) This
construction is of course current in the fifth century: κάνες τὸν οὐ
χρῆν, καὶ τὸ μὴ χρεὼν πάθε. (Aesch. Cho. 930) οὐ yap ποιῆσαί μιν
TO χρεὸν ἦν ποιέειν. (Hdt. 11.133.3) οὔτε... καταπροΐξεαι
ἀποτρέπων τὸ χρεὸν γενέσθαι. (Hdt. νιι.17.9) Thus far, the literal
citation from Anaximander is beyond dispute. The authenticity of the
concluding phrase, κατὰ τὴν τοῦ χρόνου τάξιν, should be equally
clear. The word τάξις is not attested before Anaximander, but fifth-
century examples of the legal or military usage of the term are too
numerous and too well known to require citation.? The full sense of
the word is ‘‘an arrangement prescribed with authority ; an order
which is morally binding’; hence λιπεῖν τάξιν is an act of shame. In
the present case such authority is exercised by Time.3 The judicial
color of διδόναι δίκην is maintained in the “ordinance” or
“‘ordainment”’ by which the penalty is fixed, and Time appears as
the magistrate who determines what the retribution shall be. Now
the personification of Chronos as a mighty power in human and
cosmic affairs is a constant theme of archaic and early classical
literature. Time is already a judge in one of Solon’s poems, and he is
regularly personified by the Attic tragedians as well as by Pindar.4+
His 1 χρεών is a (late) variant for χρεώ at a 225 and o 201. See the
discussion of G. Redard, Recherches sur χρή, χρῆσθαι (Paris, 1953),
pp. 70 ff. It is only the infinitival construction of χρεών (like χρή)
which occurs in Aristotelian prose, as was pointed out by G. S. Kirk,
CQ, XLIX, 33; see Bonitz, Index, 85335. 2 It may be recalled that
τάξις designates the ordering of the seven cosmic regions in De
Hebd. 1-2; and compare De Victu 8 (Jones, IV, 242): χρόνον δὲ
τοσοῦτον ἕκαστον τὴν αὐτὴν τάξιν ἔχει, ἄχρι μηκέτι δέχηται ἡ χώρη
μηδὲ τροφὴν ἱκανὴν ἔχῃ ἐς τὸ μήκιστον τῶν δυνατῶν (according to
the text of Diels, Vors. 22 c 1). 3 The genitive of κατὰ τὴν τοῦ
χρόνου τάξιν is obviously ‘‘subjective’’: that is, it does not represent
the accusative which receives the action of the verb (as if we had
κατὰ τὸν χρόνον τὸν τεταγμένον), but the nominative which exerts
this action: κατὰ τὴν τάξιν ἣν ὁ χρόνος τάττει. Kirk compares κατὰ
τὴν Ἀριστεί[δου τάξιν], “the assessment of Aristides’? (Meritt, Wade-
Gery, and McGregor, The Athenian Tribute Lists, ΤΙ [Princeton,
1949], p. 61, no. D 13). Jaeger had already cited Plato, Politicus
305c.1: παρὰ τὴν τοῦ νομοθέτου τάξιν. # Solon 24.3 (Diehl) : ἐν
δίκῃ χρόνου compared by Jaeger, Theology, p. 207, n. 60, with
references back to his earlier discussions. Cf. Aesch. P.V. 981: ἀλλ᾽
ἐκδιδάσκει πάνθ᾽ ὁ γηράσκων χρόνος; Soph. 0.7. 614, Ajax 645; Eur.
fr. 303, etc. One of the most striking Pindaric examples is fr. 14
(Bowra): ἄνακτα τὸν πάντων ὑπερβάλλοντα Χρόνον μακάρων.
 THE UNIVERSE GOVERNED BY LAW 171 importance as a
primary figure in cosmogony is echoed with emphasis by
Anaximander’s younger contemporary, Pherecydes, whose
philosophical fable begins with these words: Zas μὲν καὶ Χρόνος
ἦσαν ἀεὶ καὶ XOovin.! It is therefore surprising that the phrase in
question has recently been ascribed not to Anaximander but to his
excerptor.? Τάξις, some critics argue, is a term frequently employed
by Aristotle in reference to a temporal sequence. We have, for
example: πάντων yap ἐστι τάξις Kal πᾶς χρόνος καὶ Bios μετρεῖται
περιόδῳ. (Gen. Corr. 336°12) κατὰ μέντοι τινὰ τάξιν νομίζειν χρὴ
ταῦτα γίγνεσθαι καὶ περίοδον. (Meteor. 351°25) Μ nn ee. \ ω /, » /
hal / ἄρχειν... ἢ κατ᾽ ἐνιαυτὸν ἢ κατά τινα ἄλλην τάξιν ἢ χρόνον.
(Pol. 1261°34) Indeed, the thought of the fragment is rendered by
Simplicius elsewhere in nearly the same words: ἡ γένεσις διὰ τὸν
χρόνον ev τάξει διακέκριται. (in Cat. 356.26) When, therefore, we
find a similar phrase in the doxography for Heraclitus, it is
reasonable to suppose that we are dealing not with the original
words of the philosopher, but with a Peripatetic paraphrase: ποιεῖ δὲ
Kal τάξιν τινὰ Kal χρόνον ὡρισμένον τῆς τοῦ κόσμου μεταβολῆς κατά
τινα εἱμαρμένην ἀνάγκην. (Heracl. a 5 = Phys. Opin. fr. 1) The final
phrase of Anaximander’s fragment, κατὰ τὴν τοῦ χρόνου τάξιν, must
(it is argued) be a similar paraphrase, of which the original has been
lost. 1 Pherecydes Β 1. In his discussion of ‘‘Die Zeitauffassung in
der friihgriechischen Literatur” (Friihgriechisches Denken, p. 19), H.
Frankel suggested that the reading Χρόνος in D.L. does not
represent the text of Pherecydes, but a later interpretation of the
original Κρόνος such as is given in the summary of Hermias (Vors. 7
A 9): Κρόνον δὲ τὸν χρόνον. Pherecydes himself may of course have
written both forms, just as he sets X@ovin next to Γῆ. But, in such
matters, D.L. is after all a better source than Hermias. Even if
Pherecydes had written Kpovos, he obviously meant it to be
understood allegorically by “‘those who know.”? What else could be
the sense of Father Cronus next to the ungenerated Zas? This
enigmatic use of Cronus for Time is (as Cornford pointed out) also
familiar to Pindar; cf. O. 1: Χρόνος 6 πάντων πατήρ (Vv. 17), παρὰ
Κρόνου τύρσιν (v. 70), πόσις ὁ πάντων ‘Péas (ν. 77). 2 F. Dirlmeier,
‘‘Der Satz des Anaximandros von Milet,’”? RM, LXXXVII (1938), 376,
and the same author in Hermes, LXXV (1940), 329; followed by O.
Gigon, Der Ursprung der griechischen Philosophie (Basel, 1945), p.
81, n. 16; and also by Martin Heidegger in Holzwege (Frankfurt,
1950), pp. 296 ff. Dirlmeier’s conclusions were rejected by K.
Deichgraber in “Anaximander von Milet,”’ Hermes, LX XV, (1940), 10,
and recently by Kirk, CQ, XLIX, 35.
 172 THE COSMOLOGY OF ANAXIMANDER Despite its
apparent rigor, this argument is rather like a will-o’-thewisp which
vanishes when one comes up for a closer look. In the first place, can
such a striking parallel between the statement of Anaximander and
the doctrine of Heraclitus be explained merely by the fact that in
both cases Theophrastus is our source? Surely the possibility exists
that Heraclitus was influenced by the thought of his predecessor and
fellow Ionian. In regard to style, on the other hand, the parallels
cited prove the exact opposite of what they are intended to show. In
the texts of Aristotle and Simplicius, as in the doxography for
Heraclitus, τάξις and χρόνος are pale abstractions, set on an equal
footing side by side, in order to designate a fixed temporal
sequence. Here indeed we have the colorless prose of the schools.!
The concrete sense of τάξις in the fragment, like the personification
of χρόνος, only emerges more vividly from such a comparison. We
may therefore regard the following words with confidence, as
Anaximander’s minimum text: κατὰ τὸ χρεών, διδόναι yap αὐτὰ
δίκην καὶ τίσιν ἀλλήλοις κατὰ τὴν τοῦ χρόνου τάξιν. But the text so
established is clearly incomplete. The phrase κατὰ τὸ χρεών and the
conjunctive yap are both meaningless without what precedes. From
the point of view of grammar as well as logic, we require the first
clause: ἐξ ὧν δὲ ἡ γένεσίς ἐστι τοῖς οὖσι, Kal τὴν φθορὰν εἰς ταῦτα
γίνεσθαι. At this point the question of authenticity becomes very
delicate. There is nothing sufficiently unusual in the words under
consideration to guarantee their complete stylistic faithfulness. And
we must bear in mind that the difference between free paraphrase
and indirect quotation is only a matter of degree. The instinct of
every epitomist is not only to abbreviate, but occasionally to vary his
original, if only as a means of relieving the boredom of copying what
someone else has written. Hence, until that unlikely day when the
text of Anaximander is rediscovered, no method exists for
determining with certainty which words did or did not stand in the
original text. Once this has been said, we must also point out how
inconclusive are most of the objections which have been raised
against the clause ἐξ ὧν... εἰς ταῦτα... .2 Although γένεσις, φθορά,
and τὰ ὄντα are frequently 1 Compare the paraphrase of the
fragment “the Greek practice of blending quotations with given by
Hippolytus: λέγει δὲ χρόνον ὡς ὡρισμένης the text,’ and adds: “‘It is
safer not to ascribe the τῆς γενέσεως καὶ τῆς οὐσίας Kal τῆς φθορᾶς
(5.H.). terms γένεσις and φθορά in their technical Platonic Some of
Anaximander’s thought has been pre- sense to Anaximander; and it
is not likely that served, none of his style. Anaximander said
anything about τὰ ὄντα.᾽᾽ 2 Burnet (p. 52, n. 6), for instance, refers
to
 THE UNIVERSE GOVERNED BY LAW 173 used by Plato and
by later authors, these terms were not invented in the fourth
century. It is one thing to admit that Theophrastus might have
supplied them himself, and something else again to insist that he
did. When the balance is struck here between paraphrase and
faithful citation, the scales seem to me to dip on the side of fidelity.
The evidence for this view consists essentially in three points: 1) the
accuracy with which the preceding words have been paraphrased, 2)
the direct link to what follows (underlined by ydp), and 3) the
rhythmic balance of the clause, implying its organic unity with the
second member of the fragment. Before enlarging upon these
points, we must first demonstrate that Anaximander might in fact
have made use of such expressions as γένεσις, φθορά, and τὰ ὄντα.
Γένεσις appears in Homer: ᾽Ωκεανοῦ ὅς περ γένεσις πάντεσσι
τέτυκται. (F 246; cf. 201) It is noteworthy that the word is here
associated with the dative, as in the fragment, whereas the genitive
is more normal in Aristotle and later writers. (Alone, this would of
course prove nothing. Together with other considerations, it weights
the scales for authenticity.) Furthermore, in this epic passage γένεσις
means not merely ‘“‘birth,” but “causal origin,” the creative source of
coming-to-be. It is this same active sense which is implied by the
refutation of Parmenides : τὼς γένεσις μὲν ἀπέσβεσται Kal ἄπυστος
ὄλεθρος. (B 8.21) The generation of things is a raging fire, which
has been put out. An equally general reference to the coming-to-be
of all things occurs in the poem of Empedocles: Soin δὲ θνητῶν
γένεσις, δοιὴ δ᾽ ἀπόλειψις. (B 17.3) The list could be lengthened, in
particular from the Hippocratic Corpus. But these examples should
suffice to show that the philosophic use of the word did not originate
with Plato. Φθορά is not attested before Aeschylus and Herodotus.
(This is no argument against its possible use by Anaximander; the
case is the same for ἀδικία, τὸ χρεών, and τάξις, as has been seen.)
The verb φθείρω “‘to ruin, destroy, waste away,” is, of course,
current from the oldest period.
 174 THE COSMOLOGY OF ANAXIMANDER The first known
uses of φθορά are for civil and military calamities (Hdt. u.161.4;
vu.18.3; Democr. B 249; cf. Aesch. Ag. 814, where the text is
doubtful). When did the word become current in the general sense
of physical “wasting”? We do not know. The author of the De Victu
(c. 400 B.C.?) opposes this concept to that of “growth, waxing”
(αὐξάνεται or αὔξη) : φθορὴ dé πᾶσιν an’ ἀλλήλων, τῷ μέζονι ἀπὸ
τοῦ pelovos καὶ τῷ μείονι ἀπὸ τοῦ μέζονος. (ch. 5, Jones, ΓΝ, 238)
When Plato speaks of ‘‘undertaking a causal study οἵ γένεσις καὶ
φθορά, he refers immediately to ‘‘this wisdom which, as you know,
they call περὶ φύσεως ἱστορία᾽᾽ (Phaedo g5e-g6a). He seems to be
making an intentional use of expressions already familiar in Ionian
natural science. A similar phrase occurs again in the Laws, when the
doctrines of the physicists are quoted for refutation : 6 πρῶτον
γενέσεως καὶ φθορᾶς αἴτιον ἁπάντων... (891e.53 cf. 894b.11). It is
then conceivable that φθορά was also used by Anaximander in the
work which brought Ionian prose into being. The same idea, at any
rate, is expressed by ὄλεθρος in the verse just quoted from
Parmenides, and by ἀπόλειψις in that of Empedocles, while for
Heraclitus the pendant to γένεσις is θάνατος (B 36, B 76).
Anaximander may have used any one of these words, or another:
τελευτή, for example, or one of its verbal forms. (We find τελευτᾶν
in Xenoph. B 27 and Parm. B 19; θανάτοιο τελευτή in Emped. B 8;
τελευτᾶν and τελευτή in Melissus B 2; τελευτᾶν in Nat. Hom. 3,
Jones, tv, 10; etc.) Anaximander’s original word has perhaps been
replaced here by the canonical φθορά: but the idea has scarcely
been distorted. The use of τὰ ὄντα for “‘the things that are’ is again
of Homeric antiquity : ὃς ἤδη τά τ᾽ ἐόντα τά τ᾽ ἐσσόμενα πρό τ᾽
ἐόντα. (A 70) In the epic this expression refers to all events known
to an inspired seer, who, like Isaiah, can declare “former things that
are come to pass, and new things before they spring forth.”” The old
phrase is applied by Hesiod to the contents of the Theogony (32; cf.
38), and, as we have seen, it was apparently echoed by Anaximenes
in describing the cosmogonical procession out of the Air: ἐξ οὗ τὰ
γινόμενα καὶ τὰ γεγονότα Kal Ta ἐσόμενα... (A 7.1). This solemn
formula for past, present, and future is
 THE UNIVERSE GOVERNED BY LAW 175 employed again by
Anaxagoras for the totality of things set in order by Nous (B 12). The
neuter plural participle is found not only among the Eleatics? but
also in Empedocles : a ~ 4 “ pet’ ὅ γε τῶν ὄντων πάντων
λεύσσεσκεν ἕκαστον. (Β 129.5) in Protagoras : ‘ ~ A πάντων
χρημάτων μέτρον ἐστὶν ἄνθρωπος, τῶν μὲν ὄντων ὡς ἔστιν, τῶν δὲ
οὐκ ὄντων ὡς οὐκ ἔστιν. (Β 1) in Diogenes: ΄ ..»»ν 3 ‘ ~ ΩΣ a ¢ “- ‘ ‘
’ ‘ 5 > ‘ πάντα τὰ ὄντα ἀπὸ τοῦ αὐτοῦ ἑτεροιοῦσθαι Kal TO αὐτὸ
εἶναι... εἰ yap >? ~ ~ 7 ~ ~ Vie, Ne JAN ‘ ~ \ τὰ ἐν τῷδε τῷ κόσμῳ
ἐόντα νῦν, γῆ Kal ὕδωρ Kal ἀὴρ Kal πῦρ Kal , > ~ ~ IZ ore. τὰ ἄλλα
Goa φαίνεται ἐν τῷδε TH κόσμῳ EovTA.... (B 2) and in the
Hippocratic treatises : > / , ‘ « , / ᾽ \ Ἃ ” ~ ~ εἰ δέ ποτε κρατηθείη
καὶ ὁκότερον [πρότερον], οὐδὲν ἂν εἴη τῶν νῦν ἐόντων ὥσπερ ἔχει
νῦν. (De Victu 3; Jones, ΓΝ, 232) The ἐόν of Parmenides is itself no
technical expression, but means ‘what is in fact the case, what is
real and true,” just as in Herodotus: τὰς δίκας ἀποβαίνειν κατὰ τὸ
ἐόν (1.97.1). Parmenides’ attack on the plural ὄντα of the Ionians
gains in sharpness, if we suppose such expressions to have been
used by them in the sixth century.3 It is not only the individual terms
of Anaximander’s proposition which are familiar to early Greek
thought. The rhetorical balance of generation and corruption is itself
an ancient theme of poetry, as well as of religion. The idea finds its
natural symbol in the yearly cycle of vegetation: οἵη περ φύλλων
yeven, τοίη δὲ Kal ἀνδρῶν. φύλλα τὰ μέν τ᾽ ἄνεμος χαμάδις χέει,
ἄλλα δέ θ᾽ ὕλη τηλεθόωσα φύει, ἔαρος δ᾽ ἐπιγίγνεται ὥρη: ὡς
ἀνδρῶν γενεὴ ἡ μὲν φύει ἡ δ᾽ ἀπολήγει. (Z 146 ff.) 1 Anaxag. B 12:
πάντα ἔγνω νοῦς. καὶ ὁποῖα Kérpers (Leipzig, 1935). ἔμελλεν ἔσεσθαι
καὶ ὁποῖα ἦν, ἅσσα νῦν μὴ ἔστι, καὶ 3 Zeno B 3; Melissus Β 8.3. Even
here the sense . es Nf AUS , , - “ «p99 , ΘΚ ΕΣΤῚ ὅσα νῦν ἐστι καὶ
ὁποῖα ἔσται, πάντα διεκόσμησε is not “‘technical.’’ Cf. φοβούμενος δὲ
μὴ of πεμνοῦς. Compare the parallel in De Carn. 2: 6 πόμενοι. .. οὐ
τὰ ὄντα ἀπαγγέλλωσιν, used as καλέομεν θερμόν... εἰδέναι πάντα
ἐόντα τε καὶ equivalent to ἡ ἀλήθεια, Thuc. v1.8.2. ἐσόμενα, where
the reading πάντα καὶ τὰ ἐόντα καὶ 3 See ἀπεόντα, παρεόντα in
Parm. Β 4.1; μὴ τὰ μέλλοντα ἔσεσθαι 5 preferred by K. Deichgraber,
ἐόντα in B 7.1. Both passages are polemical. Hippokrates tiber
Enstehung und Aufbau des menschlichen
 176 THE COSMOLOGY OF ANAXIMANDER It is just such
seasonal change from which exemption is granted by the magical air
of Phaeacia: / » MA > , 299 95 , τάων ov ποτε καρπὸς ἀπόλλυται
οὐδ᾽ ἀπολείπει ,ὔ 20» / > /, > δ 4\> ΝΡ, χείματος οὐδὲ θέρευς,
ἐπετήσιος" ἀλλὰ μάλ᾽ αἰεί Ζεφυρίη πνείουσα τὰ μὲν φύει, ἄλλα δὲ
πέσσει. (η 117 ff.) The idea οἴ δἰϊεγπαίε growth and waning is applied
by the philosophers not only to human life, but to all natural
processes : ὕδατι δὲ θάνατος γῆν γενέσθαι, ἐκ γῆς δὲ ὕδωρ γίνεται
(Heracl. B 36) καὶ τὸς ἀνθρώπως: 6 μὲν yap av&eb’, ὁ δέ ya μὰν
φθίνει (Epicharmus Β 2.7) -“ A / μὲ / , ” οὕτω τοι κατὰ δόξαν ἔφυ
τάδε καί νυν ἔασι ‘ /, 99 \ ~ / , καὶ μετέπειτ᾽ ἀπὸ τοῦδε
τελευτήσουσι τραφέντα (Parm. Β 10) τῇ μὲν γίγνονταί τε καὶ οὔ
σφισιν ἔμπεδος αἰών (Emped. Β 17.11) τῶν δὲ τὰ μὲν γίνεται, τὰ δὲ
ἀπολείπει (Diog. Β 7) In all these passages there is an implicit or
express contrast with the imperishable life of divine beings.! At the
same time, the natural philosophers are concerned not merely to
emphasize the passing-away of mortal things, but also to define the
process in terms of its source and its destination : ἐκ γαίης yap
πάντα Kal εἰς γῆν πάντα τελευτᾷ. (Xenoph. B 27) συνεκρίθη καὶ
διεκρίθη κἀπῆλθεν ὅθεν ἦλθεν πάλιν γᾶ μὲν εἰς γᾶν, πνεῦμα δ᾽ ἄνω.
(Epicharmus Β 9) / ~ > ~ ἘΣ a ¢ , ” > A , A > παντα ταῦτα EK τοῦ
AUTOU ετεροιουμενα ἄλλοτε ἀλλοῖα γίνεται καὶ εἰς \ 3 ‘ > A O TO
QUTO αναχωρει. (Diog. B 2) The statement of Anaximander, which
describes the necessary dissolution of all generated things back into
their source of birth, forms a natural link between such expressions
and the Homeric antecedents quoted above. There is therefore no
cogent objection, either linguistic or historical, to the authenticity of
the first portion of the fragment. And these t Although the echo of
Plato has a distinctly γιγνόμενον οὔτε ἀπολλύμενον, οὔτε
αὐξανόμενον Parmenidean ring, we see that the tradition is οὔτε
φθίνον (Symp. 2114.1). both older and wider: τι καλὸν... dei ὃν Kai
οὔτε
 THE UNIVERSE GOVERNED BY LAW 177 general
considerations are reinforced by certain positive features of the text,
which we have mentioned : 1. The unusual phrase which
immediately precedes the fragment, ἅπαντας τοὺς οὐρανοὺς Kal
τοὺς ev αὐτοῖς κόσμους, also suggests a very faithful rendering of
Anaximander’s original.! 2. After this Anaximandrian phrase,
Theophrastus passes directly to ἐξ ὧν δὲ... εἰς tadra..., ending his
clause with the poetic κατὰ τὸ χρεών, and recalling the link with a
γάρ in the next (and clearly genuine) part of the citation. The
likelihood of any important reformulation of what lies in between
seems therefore slight. 3. The first clause of the fragment forms a
symmetrical balance to what follows: κατὰ τὸ χρεών is clearly
answered by κατὰ τὴν τοῦ χρόνου τάξιν ; and, to all appearances,
the γένεσις and φθορά of the first member must somehow
correspond to the δίκη and ἀδικία of the second. This careful period
does not suggest the work of an excerptor. On the contrary, we
know how a student of Aristotle would have formulated the same
idea: > fa A ” ν A » " > e , tA \ > a ἐξ οὗ yap ἔστιν ἅπαντα τὰ ὄντα
Kal ἐξ οὗ γίνεται πρώτου Kal εἰς ὃ φθείρεται τελευταῖον. (Met.
983°8) πάντα γὰρ φθείρεται εἰς ταῦτ᾽ ἐξ ὧν ἔστιν. (Met. τοοο 25) So
Simplicius, following Theophrastus : > ‘ ~ ‘ 7 ι καὶ ἐκ πυρὸς ποιοῦσι
τὰ ὄντα πυκνώσει καὶ μανώσει καὶ διαλύουσι πάλιν εἰς πῦρ. (Phys.
Opin. fr. 1; Vors. 22 a 5) As we have seen, the fragment itself has
been recast by Aétius in the same mold: ἐκ yap τούτου πάντα
γίγνεσθαι καὶ εἰς τοῦτο πάντα φθείρεσθαι. (4.A.) Set against such a
drab background, the style of Anaximander can speak for itself.2 ἐξ
ὧν δὲ ἡ γένεσίς ἐστι τοῖς οὖσι, Kal τὴν φθορὰν εἰς ταῦτα γίνεσθαι \
κατὰ TO χρεών. .... We have not proved that the fragment of
Anaximander is a verbatim citation from his book. It is in fact difficult
to believe that Theophrastus ¥ See above, pp. 49 f. and economical
writer, would not write ἡ γένεσίς 2 This stylistic contrast was rightly
character- ἐστι τοῖς οὖσι for γίγνεται τὰ ὄντα or τὴν φθορὰν ized by
Cornford: ‘“Theophrastus, a very terse γίγνεσθαι for φθείρεσθαι (CQ,
XXVIII, 11, n. 2). B 7155 N
 178 THE COSMOLOGY OF ANAXIMANDER can have cast
these sentences into indirect discourse without altering a jot or tittle
of the text. We have seen that the habitual φθορά might easily have
taken the place of an older term, such as τελευτή. But it is at most a
word that has been changed, not an idea. We have the fragment of
Anaximander in a form at least as faithful as that of the longer
excerpts from the Zimaeus, which Theophrastus has reproduced for
us almost word for word in the De Sensibus.! A Literal Interpretation
According to Simplicius, the entities which make reparation to one
another for their wrongdoing are the elements. Is there any good
reason to reject this view? We have seen in the previous chapter
how the “‘elements’” must be understood for Anaximander: they are
the opposite powers of cold and heat, moisture and dryness,
darkness and light, and also the main portions of the visible world,
regarded as embodiments of these universal factors. Now it was
long ago pointed out that only such opposing forces could
reasonably be said to inflict damage on one another, and to make
recompense ‘‘according to the ordinance of Time.”? The opposites
indeed are inevitably and continually at war with one another, and
the advantage of one is the disaster (φθορά) of its rival.3 Nothing
can be more in harmony with this vivid picture of cosmic strife than
to speak of the vanquished party as ‘‘offended,” and of his periodic
triumph as “revenge” or ‘“compensation.” Since the old cosmological
texts are lost, it is above all from the medical literature that we can
illustrate such expressions. The doctors regularly refer in this way to
the internal struggle of forces in the body, as well as to the action of
external factors upon the microcosm. Thus the verb ἀδικεῖν
describes the effect of a morbid agent: ‘“‘One should continue to
make use of the same modes of regimen, when they clearly do no
harm (οὐδὲν ἀδικέοντα) to the man’s body” (Nat. Hom. 9; Jones, IV,
28). The excessive strength of any power is considered a wrong
(ἁμάρτημα) for which punishment is due ;+ hence one factor is said
to 1 See, e.g., the epitome of Tim. 67b.2 ff. in De Sensibus 6 (Dox.
500.14 ff.): φωνὴν yap εἶναι πληγὴν bm’ ἀέρος ἐγκεφάλου καὶ
αἵματος δι᾽ ὥτων μέχρι ψυχῆς, τὴν δ᾽ ἀπὸ ταύτης κίνησιν ἀπὸ
κεφαλῆς μέχρι ἥπατος ἀκοήν, where the spaced words are identical
with Plato’s own text (although their order has been slightly
simplified). On this literal accuracy in Theophrastus’ excerpts, see
above, pp. 17-24. 2 Burnet, pp. 53 f.; W. A. Heidel, ‘‘On
Anaximander,” CP, VII (1912), 233 ff. Similarly Cornford, Principium
Sapientiae, p. 168; Kirk, CQ, XLIX, 33 ff. 3 See above, p. 130. + For
the ἁμάρτημα inflicted by hostile forces on the body, see De Hebd.
ch. 19.31.
 THE UNIVERSE GOVERNED BY LAW 179 chastise another
(κολάζειν), or to avenge its intemperance (τιμωρεῖν) ἷ The wronged
party is in this case not so much the weaker clement, as the healthy
state of the whole body. The aggressor may be conceived either as
the hot or moist within the body, or as its cosmic “‘ally.’’2 Hence it is
the spring which kills men in an epidemic, and the summer which
“benefits” them. Plato’s doctor in the Symposium is speaking the
language of the medical textbooks when he refers to ‘“‘the hot and
cold, and dry and wet,” which, when blended and harmonized with
one another, bring a season of health and prosperity to men,
animals, and plants, ‘‘and cause no offense” (οὐδὲν ἠδίκησεν). But
when ὕβρις reigns among the seasons of the year, these same
powers destroy many things and are cause of harm (διέφθειρέν τε
πολλὰ καὶ ἠδίκησεν). For plagues generally arise from such
circumstances, and many other irregular diseases for beasts and for
plants as well. And indeed frosts and hailstorms and plant blights
come from the excessive and unruly lust of such things for one
another. (Symp. 188a-b) The doctors are, of course, concerned with
the damage inflicted by these powers upon the human body. The
fragment of Anaximander speaks instead of the wrong (ἀδικία)
perpetrated by the cosmic powers upon one another. His words
suggest an exchange of crimes like that which Herodotus presents
as the antecedent for the Persian War, in which Greeks and Orientals
are alternative offenders against one another: τῶν ἀδικημάτων
πρῶτον τοῦτο ἄρξαι... μετὰ δὲ ταῦτα “EAAnvas αἰτίους τῆς δευτέρης
ἀδικίης γενέσθαι (Hdt. 1.2.1). In such a context, the balance is
restored when the wronged party retaliates in full (ταῦτα μὲν δὴ ἴσα
πρὸς ἴσα σφι γενέσθαι). The crime establishes a debt, which the
guilty party must “‘pay’’; hence the phrase for rendering
compensation: διδόναι δίκην καὶ tiow.* In the fragment, the
conditions of payment are fixed by the arbiter Time, and his law is a
periodic pendulum of give and take. ? Wind and water inhaled in
breathing cool the body, and thus serve as retaliation (τιμωρίη)
against congenital heat (De Cord. 3, Littré, IX, 82). Since the lung is
cold by nature, and further cooled by respiration, its presence
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