 This is, in fact, not a fragment but a testimonium and much of the language comes from the doxographical tradition rather than Alcmaeon. The report goes on to say that Alcmaeon thought that disease arose because of an excess of heat or cold, which in turn arose because of an excess or deficiency in nutrition. Disease is said to arise in the blood, the marrow, or the brain. It can also be caused by external factors such as the water, the locality, toil, or violence. The idea that health depends on a balance of opposed factors in the body is a commonplace in Greek medical writers. Although Alcmaeon is the earliest figure to whom such a conception of health is attributed, it may well be that he is not presenting an original thesis but rather drawing on the earlier medical tradition in Croton. Perhaps what is distinctive to Alcmaeon is the use of the specific political metaphor and most scholars (e.g., Sassi 2007, 198; Jouanna 1999, 327; Kouloumentas 2014, 871) agree that the political terminology (isonomia, monarchia) goes back to him. Indeed, these terms are not found elsewhere in the Greek medical tradition. Just as Anaximander explained the order of the cosmos in terms of justice in the city-state, so Alcmaeon used a political metaphor to explain the order of the human body. It is commonly recognized that isonomia (equality) is not a specific form of government but rather a concept of political equality in terms of which forms of government are evaluated (Ostwald 1969, 108; Meier 1990, 162 calls it a “yardstick”, Vlastos 1981, 173–74 a “banner”). Its primary application is to democracies (Herodotus III.80) but it is also applied to moderate oligarchies that have democratic features (Thucydides III. 62.3–4). Although a significant number of scholars argue that there is a purely aristocratic application for isonomia as the equality of aristocratic peers in opposition to a tyrant (e.g., Raaflaub 2004: 95; Zhmud 2012a: 358), one of the most noted early adherents of this view later abandoned it (Ehrenberg 1956: 67) and it appears more likely that the term  isonomia originated with the radical democracy which emerged in Athens in the late sixth century and was only applied in a secondary sense to moderate oligarchies (Vlastos 1973, 175–7; Ostwald 1969, 99–106). Is Alcmaeon’s use of the term simply descriptive of the equality of powers that is necessary for the healthy body, or does his use of the term to describe health suggest that he was in sympathy with radical democracy (Vlastos 1953, 363)? We simply have no direct evidence for Alcmaeon’s political views. However, Aristotle emphasizes that Alcmaeon posited an indefinite number of opposites as active in the human body in contrast to the Pythagoreans who specified ten pairs (see 4.2 below), which suggests that Alcmaeon’s “body” politic was not an oligarchy with a numerically defined group of peers but rather a democracy which gave equality to the full range of opposites. Mansfeld has recently argued that scholars are wrong to ascribe the key terms  isonomia and monarchia to Alcmaeon (Mansfeld 2014a). Such a metaphorical use of isonomia is unparalleled at this early date and is much more likely to have been introduced later in the doxographical tradition. Moreover, monarchia may have been introduced by a doxographer familiar with its use in the famous debate on constitutions in Herodotus (III 80–3), where isonomia also appears (III 80). Mansfeld concludes that this origin of the terms from the doxography is more likely than assuming influence on Alcmaeon from the reforms of Cleisthenes. The difficulty with Mansfeld’s approach is that the striking thing about the report on Alcmaeon is precisely the political metaphor and it seems more plausible that his views were introduced into the doxography because of that metaphor than that his views were typical Greek views on disease and the metaphor only arose as an artefact of the doxographical tradition. If he did introduce the political metaphor then it is as probable as not that he used the terms ascribed to him, especially since both appear only a little later in Herodotus, although not with a metaphorical sense. 