Galen

Roman physician

• Born: 129
• Birthplace: Pergamum Mysia, Anatolia (now Bergama, Turkey)
• Died: c. 199
• Place of death: Possibly Rome or Pergamum (now in Italy)

Although not a first-rate philosopher, Galen was influential in formulating a powerful logical empiricism that took scientific axioms as self-evident rather than hypothetical. His greatest contribution was in medicine, where he made the best presentation of anatomical knowledge in the ancient world; his theories and practices remained dominant during the Middle Ages.

Early Life

Galen (GAH-luhn) was born on an estate in Pergamum (also known as Pergamon), a city situated on the mainland almost opposite the island of Lesbos in Asia Minor. Pergamum lay inland in a fertile valley, and its hilltops were crowned by temples and theaters. Pergamum’s library rivaled Alexandria’s. Another distinguishing feature was the Asclepieion, or medical temple dedicated to Asclepius, the god of healing. This was a combination religious sanctuary, sanatorium, and place of recreation. Pergamum was one of the great seats of Christianity and held one of the seven churches mentioned by John the Apostle in the Revelations (2:12-17). Because of these features, the city became one of the great pilgrimage and entertainment centers in the Roman world, and Galen grew up exposed not only to scholars but also to rhapsodists, musicians, tumblers, actors, and snake-charmers.

Galen’s father, Nicon, was an architect and geometer. He was also a prosperous landowner with a farm that cultivated peas, beans, lentils, almonds, figs, olives, and grapes. Nicon himself came from a highly educated family and was able to provide his son with an education partly in the country and partly in the city. Galen (whose name derives from galenos, Greek for “calm” or “serene”) was closer to his father than to his mother, who scolded the maids and quarreled almost incessantly with her husband. Galen compared her with Socrates’ difficult wife, Xanthippe, but was able to keep his distance from her by accompanying his father to lectures in the city. His father provided or supervised Galen’s education until the boy reached fourteen, then directed his son to philosophical studies.

There were four leading philosophical systems at the time—Platonism, Aristotelianism, Stoicism, and Epicureanism—and Galen was not prodded along any single path of knowledge. He had the benefit of a liberal education, although he found confusion in philosophy and had doubts about mathematics. His father wanted a state career for the boy, but after having a dream in which Asclepius directed attention to medicine, Nicon sent Galen, then seventeen, to study under the celebrated anatomist and Sophist Satyros.

Life’s Work

When Nicon died, probably in 151, Galen worked with Pelops in Smyrna and with Numisianos in Corinth and Alexandria, where he wrote a treatise in three parts on the movement of the lungs and thorax. He remained in Alexandria for roughly five years, traveling in various parts of Egypt. There were six main medical sects at the time, three ancient (the Hippocratic, Dogmatic, and Empirical) and three “modern” (the Methodist, Pneumatic, and Eclectic). Galen, like many of his colleagues, was free to try combinations of these sects, and he devoted two treatises to the discussion of them.

On his return to Pergamum, he was appointed physician to the school of gladiators by the head priest of the Asclepieion. Galen’s appointment lasted more than two years and was a useful experience. Because gladiators often received severe wounds, a physician was obliged to attend to the diet, exercise, and convalescence of these combatants in order to ensure that they were in good health and that they would recover in due course from certain injuries. Galen did not perform much surgery on the gladiators, and his knowledge of anatomy was derived exclusively from dissections on animals—particularly the Barbary ape (for which he was nicknamed the “ape doctor”). Slaves or students would prepare the cadavers of pigs, sheep, oxen, cats, dogs, horses, lions, wolves, birds, and fish by shaving and flaying them, and it is a wonder that Galen and other anatomists were not killed by infection.

Dissection led to insights about the general plan of the body, and Galen showed that this plan was essentially the same from creature to creature. He discovered that arteries contain blood and that a severed artery (even a small one) could drain all the body’s blood in one-half hour or less. He showed that the right auricle outlives the rest of the heart and that there is a link between the brain and the larynx.

When a new war between the Pergamumites and the neighboring Galatians began, Galen left for Rome. His life and career coincided with the noble rule of Antoninus Pius and that of his son, Marcus Aurelius. Galen rented a large house, practiced as a physician, attended medical meetings in the temple of peace, and continued his interest in philosophy.

He respected the ancients, particularly Aristotle, Plato, and Hippocrates. He argued that all scientific knowledge begins with the senses, or mind, and he was opposed to the Skeptics, who taught their disciples to argue on either side of any point. Galen found it absurd to argue so freely while doubting, as the Skeptics did, the starting points of knowledge. Although somewhat “magical” or irrational in medical practice (he believed in the therapeutic value of excrement and amulets), he was a rationalist in his philosophical method, recognizing a role for syllogistic reasoning and admiring the purposiveness of all nature. He believed, with Aristotle, that nature never makes anything superfluous; he tried in Peri chreias morion (169-175, commonly known as De usu partium corporis humani; On the Usefulness of the Parts of the Body, 1907-1909) to justify the form and function of each organ of the body. He interpreted other philosophers (especially Plato, Aristotle, Theophrastus, Chrysippus, and Epicurus), but his many ethical treatises were lost, as was a series of works on lexicographical and stylistic problems.

He held a Platonic view of the soul, recognizing the three parts (nutritive, animal, rational) distinguished in Plato’s Republic and opposing the Stoic doctrine of a single, indivisible soul. His treatise on the subject ascribes nutrition to the liver and veins, the pneuma or spirit to the lungs and heart, and sensation and muscular movement to the brain and nerves. It is easy to see how physiology and philosophy mixed in Galen’s theories, especially in his pneumatic theory, which, though derived from Hippocrates and Anaximenes of Miletus, was an interesting revision of those older beliefs. According to Galen, each of the three fundamental members (liver, heart, brain) was dominated by a special pneuma or spirit: the liver by natural or physical spirit—a vapor from blood, which controlled nutrition, growth, and reproduction; the heart by vital spirit, transmitted in the veins and conveying heat and life; the brain by animal or psychical spirit, which regulated the brain, nerves, and feeling.

Galen believed that the habits of the soul were influenced by bodily temperament (rather than by climate, as Hippocrates had insisted). Galen’s theory of the four humors (based on the four elements earth, air, fire, and water) went back to Empedocles but was a restatement of Hippocrates’ theory of four qualities (dry, wet, hot, cold) and of another version of the four humors (blood, yellow bile, black bile, phlegm). This attempted reconciliation of medicine and philosophy was consistent with his claim that the best physician was also a philosopher.

Galen became a friend of the Aristotelian philosopher Eudemos, and when the latter fell ill, Galen was consulted—much to the hostility of the patient’s other physicians. A contest of invective, suspicion, and tactlessness broke out between Galen and his rivals. Galen’s outspoken and contemptuous criticism of those he considered charlatans put his life in danger; he decided to return to Pergamum.

His recuperation from Rome-weariness was short. He received a letter from the two rulers, Marcus Aurelius and Lucius Verus, ordering him to join the Imperial camp in Aquileia (a commercial and military center and one of the great cities of the west), where legions were gathering to march against the barbarians. These military preparations were disrupted by plague, a form of typhus or smallpox probably brought in from Syria and stubbornly resistant to health measures. The emperors decided to leave the army, but when Verus died in 169, Marcus returned to the field after ordering Galen back to Rome to take medical charge of Marcus’s eight-year-old son, Commodus.

As court physician, Galen strengthened his position. He continued in office when Commodus succeeded his father as emperor in 180. Galen remained in Rome until 192, when a fire destroyed the Temple of Peace, as well as many libraries and bookshops. Many of his writings, especially some of his philosophical treatises, which existed only in a few copies, were annihilated.

Under Commodus, the climate for scholars and philosophers became intolerable. The emperor, a superior athlete who regarded himself as a reincarnation of Hercules, placed a premium on hunting and circus games rather than on intellectual pursuits. Galen returned to Pergamum in 192, where he had yet another encounter with the plague. He was saved by letting his own blood. Most of his time was devoted to meditation and writing, and he died about 199.

Significance

Galen’s writings were diverse and profuse. Although he did not have students of his own, nor did he found a school, his stature was large in his lifetime and larger after his death. His texts were translated into Syriac and Arabic as Greek culture spread throughout Syria and then into Persia and the Islamic world. From the eleventh century onward, Latin translations of Galen made their way into Europe, where the phenomenon of Galenism dominated the medicine of the Middle Ages, despite the plethora of other commentators and forgeries of Galen’s texts.

As a medical practitioner and theorist, Galen mixed fact and speculation. Although a brilliant diagnostician, he relied on observations of “critical days,” pulse, and urine for his prognoses. He had a deep distaste for surgery, except as a means to repair injuries or suppurations, and confined his operative surgery to nasal polyps, goiters, and tumors of fatty or fibrous tissues. His writing in the field, however, provides information on the use of caustics, unguents for healing wounds, and opium and other drugs for anesthesia. His anatomical knowledge suffered from the unavailability of human cadavers, so his errors were understandable. His physiology was strictly limited, but he was far ahead of his time in developing concepts of digestion, assimilation, blood formation, nerve function, and reproduction.

As a philosopher, he was hardly original, but he was useful for his commentaries on Plato and Hippocrates, and he wrote about logic, ethics, and rational psychology, arguing that “passions” were the result of unbridled energy opposed to reason, and “errors” of the soul were the result of false judgments or opinions. Galen believed that psychological troubles could be related more to the body’s predisposition to disease than to disease itself, and so he recommended a daily self-examination as a preventative.

Galen erred in thinking that inadequate medical knowledge could be compensated by general knowledge. Nevertheless, he was versatile, producing works of philology (including two dictionaries) and an autobiography in addition to his more than one hundred treatises on medicine. His language was often repetitive and difficult, but he never assumed literary affectations, and he continually revised his work.

Despite the fact that the Renaissance saw the overthrow of many of his theories of anatomy, physiology, and therapy, Galen can be credited for several things: setting a high ideal for the medical profession; insisting on contact with nature as a condition for treating disease; stressing the unity of an organism and the interdependence of its parts; and realizing that a living organism can be understood only in relation to its environment. His fame and theories lasted for nine centuries, before being rivaled by those of the Muslim philosopher-physician Avicenna.

Bibliography

Brock, Arthur John, trans. Greek Medicine, Being Extracts Illustrative of Medical Writers from Hippocrates to Galen. 1929. Reprint. New York: AMS Press, 1972. A good historical survey by one of the best English translators of Galen. Places Galen in historical context. Includes annotations.

Galen. Galen on Bloodletting. Translated by Peter Brain. New York: Cambridge University Press, 1986. Includes translations of Galen’s works against Erasistratus and the Erasistrateans, with extensive annotations.

Galen. On Respiration and the Arteries. Edited by David J. Furley and J. S. Wilkie. Princeton, N.J.: Princeton University Press, 1984. Pages 26 to 37 offer an excellent introduction to Erasistratus’s views on respiration, the heart, and the arteries. The volume also includes an annotated translation of three Galenic works that are important sources for Erasistratus’s physiology.

Galen. Three Treatises on the Nature of Science. Translated by Michael Frede and Richard Walzer. Indianapolis, Ind.: Hackett Publishing, 1985. A useful source for aspects of Erasistratus’s theory of scientific method and his epistemology.

Gilbert, N. W. Renaissance Concepts of Method. New York: Columbia University Press, 1963. Contains information on Galen’s scientific methodology.

Nutton, Vivian. “Logic, Learning, and Experimental Medicine.” Science 295, no. 5556 (February 1, 2002): 800-801. In this physician’s profile, Nutton notes that, based on logic and experimental methodology, Galen’s ideas dominated the field of medicine for centuries.

Porter, Dorothy. Health, Civilization, and the State: A History of Public Health from Ancient to Modern Times. New York: Routledge, 1999. Galen is covered as a Roman practitioner of medicine as well as an early figure in public health.

Sarton, George. Galen of Pergamon. Lawrence: University of Kansas Press, 1954. An accessible and readable biography. Contains interesting historical background, but the discussion of philosophy is brief and takes some knowledge for granted.

Temkin, Owsei. Galenism: Rise and Decline of a Medical Philosophy. Ithaca, N.Y.: Cornell University Press, 1973. An authoritative overview of the phenomenon that so influenced medieval medicine and philosophy. Also contains a description of the various forgeries of Galen’s texts.