If the work of Hippocrates can be taken as representing the foundation of Greek medicine, then the work of Galen, who lived six centuries later, is the apex of that tradition. Galen crystallised all the best work of the Greek medical schools which had preceded his own time. It is essentially in the form of Galenism that Greek medicine was transmitted to the Renaissance scholars.

Woodcut illustration from a Venetian edition of Galen's works, 1550

Collection Bertarelli, Milan Medicatrina, Clinic Scene (above) This illustration accompanying Galen’s work shows the surgical procedures described by Galen--on the head, eye, leg, mouth, bladder and genitals--still practiced in the 16th century.
Galen hailed from Pergamon, an ancient center of civilization, containing, among other cultural institutions, a library second in importance only to Alexandria itself. Galen’s training was eclectic and although his chief work was in biology and medicine, he was also known as a philosopher and philologist. Training in philosophy is, in Galen’s view, not merely a pleasant addition to, but an essential part of the training of a doctor. His treatise entitled That the best Doctor is also a Philosopher gives to us a rather surprising ethical reason for the doctor to study philosophy. The profit motive, says Galen, is incompatible with a serious devotion to the art. The doctor must learn to despise money. Galen frequently accuses his colleagues of avarice and it is to defend the profession against this charge that he plays down the motive of financial gain in becoming a doctor. Galen’s first professional appointment was as surgeon to the gladiators in Pergamon. In his tenure as surgeon he undoubtedly gained much experience and practical knowledge in anatomy from the combat wounds he was compelled to treat. After four years he immigrated to Rome where he attained a brilliant reputation as a practitioner and a public demonstrator of anatomy. Among his patients were the emperors Marcus Aurelius, Lucius Verus, Commodus and Septimius Severus.

GALENISM

Galen, for all his mistakes, remained the unchallenged authority for over a thousand years. After he died in 203 CE, serious anatomical and physiological research ground to a halt, because everything there was to be said on the subject had been said by Galen, who, it is reported, kept at least 20 scribes on staff to write down his every dictum. Although he was not a Christian, Galen’s writings reflect a belief in only one god, and he declared that the body was an instrument of the soul. This made him most acceptable to the fathers of the church and to Arab and Hebrew scholars. Galen’s mistakes perpetuated fundamental errors for nearly fifteen hundred years until Vesalius, the sixteenth century anatomist, although he regarded his predecessor with esteem, began to dispel Galen’s authority.

Postage Stamp, 1977

People's Democratic Republic of Yemen. A testament to Galen's lasting influence.

GALEN ON THE SOUL

The fundamental principle of life, in Galenic physiology, was pneuma (air, breath), which took three forms and had three types of action: animal spirit (pneuma physicon) in the brain, center of sensory perceptions and movement; vital spirit (pneuma zoticon) centering on the heart regulated flow of blood and body temperature; natural spirit (pneuma physicon) residing in the liver, center of nutrition and metabolism. Galen studied the anatomy of the respiratory system, and of the heart, arteries and veins. But he did not discover the circulation of the blood throughout the body, and believed that blood passed from one side of the heart to the other through invisible pores in the dividing wall. Galen was convinced that the venous and arterial systems were each sealed and separate from each other. William Harvey, discoverer of the circulation of the blood, wondered how Galen, having got so close to the answer, did not himself arrive at the concept of the circulation.

Manuscript Illustration from an edition of the works of Galen, Lyons, 1528

National Library of Medicine, Bethesda Hippocrates, Galen and Avicenna As Galen looked back to Hippocrates as his authority, Avicenna looked to Galen.


GALEN’S PHYSIOLOGY

Galen’s genius was evident in experiments conducted on animals for physiological purposes. The work On the use of the parts of the human body comprised seventeen books concerned with this topic. To study the function of the kidneys in producing urine, he tied the ureters and observed the swelling of the kidneys. To study the function of the nerves he cut them, and thereby showed paralysis of the shoulder muscles after division of nerves in the neck and loss of voice after interruption of the recurrent laryngeal nerve. Because his knowledge was derived for the most part from animal (principally the Barbary ape) rather than human dissection, Galen made many mistakes, especially concerning the internal organs. For example, he incorrectly assumed that the rete mirabile, a plexus of blood vessels at the base of the brain of ungulate animals, was also present in humans. In spite of Galen’s mistakes and misconceptions, the wealth of accurate detail in his writings is astonishing.
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