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Galen

Galen

Overview


Aelius Galenus or Claudius Galenus (September AD 129 – 199/217; , Galēnos, from adjective "γαληνός", "calm"), better known as Galen of Pergamon (modern-day Bergama
Bergama
Bergama is a populous district, as well as the center city of the same district, in İzmir Province in western Turkey. By excluding İzmir's metropolitan area, it is one of the prominent districts of the province in terms of population and is largely urbanized at the rate of 53,6 per cent...

, Turkey
Turkey
Turkey , known officially as the Republic of Turkey , is a Eurasian country located in Western Asia and in East Thrace in Southeastern Europe...

), was a prominent Roman (of Greek ethnicity) physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

, surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...

 and philosopher
Philosophy
Philosophy is the study of general and fundamental problems, such as those connected with existence, knowledge, values, reason, mind, and language. Philosophy is distinguished from other ways of addressing such problems by its critical, generally systematic approach and its reliance on rational...

. Arguably the most accomplished of all medical researchers of antiquity
Ancient history
Ancient history is the study of the written past from the beginning of recorded human history to the Early Middle Ages. The span of recorded history is roughly 5,000 years, with Cuneiform script, the oldest discovered form of coherent writing, from the protoliterate period around the 30th century BC...

, Galen contributed greatly to the understanding of numerous scientific
Science
Science is a systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe...

 disciplines, including anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...

, physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...

, pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

, pharmacology
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

, and neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...

, as well as philosophy, and logic
Logic
In philosophy, Logic is the formal systematic study of the principles of valid inference and correct reasoning. Logic is used in most intellectual activities, but is studied primarily in the disciplines of philosophy, mathematics, semantics, and computer science...

.

The son of Aelius Nicon, a wealthy architect
Architect
An architect is a person trained in the planning, design and oversight of the construction of buildings. To practice architecture means to offer or render services in connection with the design and construction of a building, or group of buildings and the space within the site surrounding the...

 with scholarly interests, Galen received a comprehensive education that prepared him for a successful career as a physician and philosopher.
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Aelius Galenus or Claudius Galenus (September AD 129 – 199/217; , Galēnos, from adjective "γαληνός", "calm"), better known as Galen of Pergamon (modern-day Bergama
Bergama
Bergama is a populous district, as well as the center city of the same district, in İzmir Province in western Turkey. By excluding İzmir's metropolitan area, it is one of the prominent districts of the province in terms of population and is largely urbanized at the rate of 53,6 per cent...

, Turkey
Turkey
Turkey , known officially as the Republic of Turkey , is a Eurasian country located in Western Asia and in East Thrace in Southeastern Europe...

), was a prominent Roman (of Greek ethnicity) physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

, surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...

 and philosopher
Philosophy
Philosophy is the study of general and fundamental problems, such as those connected with existence, knowledge, values, reason, mind, and language. Philosophy is distinguished from other ways of addressing such problems by its critical, generally systematic approach and its reliance on rational...

. Arguably the most accomplished of all medical researchers of antiquity
Ancient history
Ancient history is the study of the written past from the beginning of recorded human history to the Early Middle Ages. The span of recorded history is roughly 5,000 years, with Cuneiform script, the oldest discovered form of coherent writing, from the protoliterate period around the 30th century BC...

, Galen contributed greatly to the understanding of numerous scientific
Science
Science is a systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe...

 disciplines, including anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...

, physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...

, pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

, pharmacology
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

, and neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...

, as well as philosophy, and logic
Logic
In philosophy, Logic is the formal systematic study of the principles of valid inference and correct reasoning. Logic is used in most intellectual activities, but is studied primarily in the disciplines of philosophy, mathematics, semantics, and computer science...

.

The son of Aelius Nicon, a wealthy architect
Architect
An architect is a person trained in the planning, design and oversight of the construction of buildings. To practice architecture means to offer or render services in connection with the design and construction of a building, or group of buildings and the space within the site surrounding the...

 with scholarly interests, Galen received a comprehensive education that prepared him for a successful career as a physician and philosopher. He traveled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome
Ancient Rome
Ancient Rome was a thriving civilization that grew on the Italian Peninsula as early as the 8th century BC. Located along the Mediterranean Sea and centered on the city of Rome, it expanded to one of the largest empires in the ancient world....

, where he served prominent members of Roman society and eventually was given the position of personal physician to several emperors
Roman Emperor
The Roman emperor was the ruler of the Roman State during the imperial period . The Romans had no single term for the office although at any given time, a given title was associated with the emperor...

.

Galen's understanding of anatomy and medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 was principally influenced by the then-current theory of humorism
Humorism
Humorism, or humoralism, is a now discredited theory of the makeup and workings of the human body, adopted by Greek and Roman physicians and philosophers, positing that an excess or deficiency of any of four distinct bodily fluids in a person directly influences their temperament and health...

, as advanced by many ancient Greek
Ancient Greece
Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...

 physicians such as Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...

. His theories dominated and influenced Western
Western culture
Western culture, sometimes equated with Western civilization or European civilization, refers to cultures of European origin and is used very broadly to refer to a heritage of social norms, ethical values, traditional customs, religious beliefs, political systems, and specific artifacts and...

 medical science for nearly two millennia. His anatomical reports, based mainly on dissection
Dissection
Dissection is usually the process of disassembling and observing something to determine its internal structure and as an aid to discerning the functions and relationships of its components....

 of monkeys
Old World monkey
The Old World monkeys or Cercopithecidae are a group of primates, falling in the superfamily Cercopithecoidea in the clade Catarrhini. The Old World monkeys are native to Africa and Asia today, inhabiting a range of environments from tropical rain forest to savanna, shrubland and mountainous...

 and pig
Pig
A pig is any of the animals in the genus Sus, within the Suidae family of even-toed ungulates. Pigs include the domestic pig, its ancestor the wild boar, and several other wild relatives...

s, remained uncontested until 1543, when printed descriptions and illustrations of human dissections were published in the seminal work De humani corporis fabrica
De humani corporis fabrica
De humani corporis fabrica libri septem is a textbook of human anatomy written by Andreas Vesalius in 1543....

by Andreas Vesalius where Galen's physiological theory was accommodated to these new observations. Galen's theory of the physiology
Human physiology
Human physiology is the science of the mechanical, physical, bioelectrical, and biochemical functions of humans in good health, their organs, and the cells of which they are composed. Physiology focuses principally at the level of organs and systems...

 of the circulatory system
Circulatory system
The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc...

 endured until 1628, when William Harvey
William Harvey
William Harvey was an English physician who was the first person to describe completely and in detail the systemic circulation and properties of blood being pumped to the body by the heart...

 published his treatise
Treatise
A treatise is a formal and systematic written discourse on some subject, generally longer and treating it in greater depth than an essay, and more concerned with investigating or exposing the principles of the subject.-Noteworthy treatises:...

 entitled De motu cordis
Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus
Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, is the best-known work of the physician William Harvey. The book was first published in 1628 and established the circulation of the blood. It is a landmark in the history of physiology. Just as important as its substance was its...

, in which he established that the blood circulates with the heart
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...

 acting as a pump. Medical students continued to study Galen's writings until well into the 19th century. Galen conducted many nerve ligation
Ligature (medicine)
In surgery or medical procedure, a ligature consists of a piece of thread tied around an anatomical structure, usually a blood vessel or another hollow structure to shut it off. With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat,...

 experiments that supported the theory, which is still believed today, that the brain
Human brain
The human brain has the same general structure as the brains of other mammals, but is over three times larger than the brain of a typical mammal with an equivalent body size. Estimates for the number of neurons in the human brain range from 80 to 120 billion...

 controls all the motions of the muscle
Muscle
Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...

s by means of the cranial
Cranial nerves
Cranial nerves are nerves that emerge directly from the brain, in contrast to spinal nerves, which emerge from segments of the spinal cord. In humans, there are traditionally twelve pairs of cranial nerves...

 and peripheral nervous system
Peripheral nervous system
The peripheral nervous system consists of the nerves and ganglia outside of the brain and spinal cord. The main function of the PNS is to connect the central nervous system to the limbs and organs. Unlike the CNS, the PNS is not protected by the bone of spine and skull, or by the blood–brain...

s.

Galen saw himself as being both a physician and a philosopher, as he wrote in his treatise entitled That the Best Physician is also a Philosopher. Galen was very interested in the debate between the rationalist and empiricist medical sects, and his use of direct observation, dissection and vivisection
Vivisection
Vivisection is defined as surgery conducted for experimental purposes on a living organism, typically animals with a central nervous system, to view living internal structure...

 represents a complex middle ground between the extremes of those two viewpoints. Many of his works have been preserved and/or translated from the original Greek, although many were destroyed and some credited to him are believed to be spurious. Although there is some debate over the date of his death, he was no younger than seventy when he died.

Early life: AD 129–161


Galen describes his early life in On the affections of the mind. He was born in September 129 AD; his father Aelius Nicon was a wealthy patrician, an architect and builder, with eclectic interests including philosophy, mathematics, logic, astronomy, agriculture and literature. Galen describes his father as a "highly amiable, just, good and benevolent man". At that time Pergamon
Pergamon
Pergamon , or Pergamum, was an ancient Greek city in modern-day Turkey, in Mysia, today located from the Aegean Sea on a promontory on the north side of the river Caicus , that became the capital of the Kingdom of Pergamon during the Hellenistic period, under the Attalid dynasty, 281–133 BC...

 was a major cultural and intellectual centre, noted for its library (Eumenes II
Eumenes II
Eumenes II of Pergamon was king of Pergamon and a member of the Attalid dynasty. The son of king Attalus I and queen Apollonis, he followed in his father's footsteps and collaborated with the Romans to oppose first Macedonian, then Seleucid expansion towards the Aegean, leading to the defeat of...

), second only to that in Alexandria
and attracted both Stoic
STOIC
STOIC was a variant of Forth.It started out at the MIT and Harvard Biomedical Engineering Centre in Boston, and was written in the mid 1970s by Jonathan Sachs...

 and Platonic
Platonism
Platonism is the philosophy of Plato or the name of other philosophical systems considered closely derived from it. In a narrower sense the term might indicate the doctrine of Platonic realism...

 philosophers, to whom Galen was exposed at age 14. His studies also took in each of the principal philosophical systems of the time, including Aristotelian
Aristotelianism
Aristotelianism is a tradition of philosophy that takes its defining inspiration from the work of Aristotle. The works of Aristotle were initially defended by the members of the Peripatetic school, and, later on, by the Neoplatonists, who produced many commentaries on Aristotle's writings...

 and Epicurean. His father had planned a traditional career for Galen in philosophy or politics and took care to expose him to literary and philosophical influences. However Galen states that in around 145 AD, his father had a dream in which the god Asclepius
Asclepius
Asclepius is the God of Medicine and Healing in ancient Greek religion. Asclepius represents the healing aspect of the medical arts; his daughters are Hygieia , Iaso , Aceso , Aglæa/Ægle , and Panacea...

 (Aesculapius) appeared and commanded Nicon to send his son to study medicine. Again, no expense was spared, and following his earlier liberal education, at 16 he began studies at the prestigious local sanctuary or Asclepieum dedicated to Asclepius, god of medicine, as a θεραπευτής (therapeutes, or attendant) for four years. There he came under the influence of men like Aeschrion of Pergamon
Aeschrion of Pergamon
Aeschrion of Pergamon was a physician in the 2nd century AD. He was one of Galen's tutors, who says that he belonged to the sect of the Empirici, and that he had a great knowledge of pharmacy and materia medica...

, Stratonicus and Satyrus. Asclepiea functioned as spas or sanitoria to which the sick would come to seek the ministrations of the priesthood. The temple at Pergamon was eagerly sought by Romans in search of a cure. It was also the haunt of notable people such as Claudius Charax the historian, Aelius Aristides
Aelius Aristides
Aelius Aristides was a popular Greek orator , who lived during the Roman Empire. He is considered to be a prime example of the Second Sophistic, a group of showpiece orators who flourished from the reign of Nero until ca. 230 AD. His surname was Theodorus...

 the orator, Polemo
Polemon
-Philosophers:*Polemon , the head of the Platonic Academy from 314-269 BC*Polemon of Athens, a 2nd century BC Stoic philosopher, also referred to as Polemon of Ilium*Polemon of Laodiceia, a 2nd century sophist-Kings:...

 the sophist, and Cuspius Rufinus the Consul.

In 148, when he was 19, his father died, leaving him independently wealthy. He then followed the advice he found in Hippocrates' teaching and travelled and studied widely including Smyrna
Smyrna
Smyrna was an ancient city located at a central and strategic point on the Aegean coast of Anatolia. Thanks to its advantageous port conditions, its ease of defence and its good inland connections, Smyrna rose to prominence. The ancient city is located at two sites within modern İzmir, Turkey...

 (now Izmir
Izmir
Izmir is a large metropolis in the western extremity of Anatolia. The metropolitan area in the entire Izmir Province had a population of 3.35 million as of 2010, making the city third most populous in Turkey...

), Corinth, Crete
Crete
Crete is the largest and most populous of the Greek islands, the fifth largest island in the Mediterranean Sea, and one of the thirteen administrative regions of Greece. It forms a significant part of the economy and cultural heritage of Greece while retaining its own local cultural traits...

, Cilicia
Cilicia
In antiquity, Cilicia was the south coastal region of Asia Minor, south of the central Anatolian plateau. It existed as a political entity from Hittite times into the Byzantine empire...

 (now Çukurova
Çukurova
Çukurova , historically known as Cilicia, is a geographic, economic and cultural region in south-central Turkey, covering the provinces of Mersin, Adana, Osmaniye and Hatay...

), Cyprus
Cyprus
Cyprus , officially the Republic of Cyprus , is a Eurasian island country, member of the European Union, in the Eastern Mediterranean, east of Greece, south of Turkey, west of Syria and north of Egypt. It is the third largest island in the Mediterranean Sea.The earliest known human activity on the...

 and finally the great medical school of Alexandria
Medicine in Ancient Greece
The first known Greek medical school opened in Cnidus in 700 BC. Alcmaeon, author of the first anatomical work, worked at this school, and it was here that the practice of observing patients was established. Ancient Greek medicine revolved around the theory of humours...

, exposing himself to the various schools of thought in medicine. In 157, aged 28, he returned to Pergamon as physician to the gladiators of the High Priest of Asia, one of the most influential and wealthiest men in Asia. The High Priest chose Galen over other physicians after Galen claims he eviscerated an ape and challenged other physicians to repair the damage. When they refused, Galen did the surgery himself and in doing so won himself the favor of the High Priest of Asia. Over the four years there he learnt the importance of diet, fitness, hygiene and preventive measures, as well as living anatomy, and the treatment of fractures and severe trauma, referring to their wounds as "windows into the body". Only five deaths occurred while he held the post, compared to sixty in his predecessor's time, generally ascribed to his attention to their wounds. At the same time he pursued studies in theoretical medicine and philosophy.

Later years: AD 162–217


Galen went to Rome
Rome
Rome is the capital of Italy and the country's largest and most populated city and comune, with over 2.7 million residents in . The city is located in the central-western portion of the Italian Peninsula, on the Tiber River within the Lazio region of Italy.Rome's history spans two and a half...

 in 162 AD and made his mark as a practicing physician. His impatience brought him into conflict with other doctors and he felt menaced by them. His demonstrations there antagonized the less able and original physicians in the city. They plotted against him and he feared he might be driven away or poisoned so he left the city.

Rome then engaged in the foreign wars in 161 AD. Marcus Aurelius and his colleague Lucius Verus
Lucius Verus
Lucius Verus , was Roman co-emperor with Marcus Aurelius, from 161 until his death.-Early life and career:Lucius Verus was the first born son to Avidia Plautia and Lucius Aelius Verus Caesar, the first adopted son and heir of Roman Emperor Hadrian . He was born and raised in Rome...

 were in the north fighting the Marcomanni
Marcomanni
The Marcomanni were a Germanic tribe, probably related to the Buri, Suebi or Suevi.-Origin:Scholars believe their name derives possibly from Proto-Germanic forms of "march" and "men"....

. During the autumn of 169 AD when Roman troops were returning to Aquileia
Aquileia
Aquileia is an ancient Roman city in what is now Italy, at the head of the Adriatic at the edge of the lagoons, about 10 km from the sea, on the river Natiso , the course of which has changed somewhat since Roman times...

, the great plague broke out and the emperor summoned Galen back to Rome. He was ordered to accompany Marcus and Verus to Germany as the court physician. In the following spring Marcus was persuaded to release Galen after receiving a report that Asclepius
Asclepius
Asclepius is the God of Medicine and Healing in ancient Greek religion. Asclepius represents the healing aspect of the medical arts; his daughters are Hygieia , Iaso , Aceso , Aglæa/Ægle , and Panacea...

 was against the project. He was left behind to act as physician to the imperial heir Commodus
Commodus
Commodus , was Roman Emperor from 180 to 192. He also ruled as co-emperor with his father Marcus Aurelius from 177 until his father's death in 180. His name changed throughout his reign; see changes of name for earlier and later forms. His accession as emperor was the first time a son had succeeded...

. It was here in court that Galen wrote extensively on medical subjects. Ironically, Lucius Verus died in 169, and Marcus Aurelius himself died in 180, both victims of the plague.

Galen was the physician to Commodus for much of the emperor’s life and treated his common illnesses. According to Dio Cassius 72.14.3–4, in about 189 AD, under Commodus’ reign, a pestilence occurred, the largest of which he had knowledge, in which 2,000 people died in Rome each day. It is most likely that this was the same plague that struck Rome during Marcus Aurelius’ reign.

Galen became physician to Septimius Severus
Septimius Severus
Septimius Severus , also known as Severus, was Roman Emperor from 193 to 211. Severus was born in Leptis Magna in the province of Africa. As a young man he advanced through the customary succession of offices under the reigns of Marcus Aurelius and Commodus. Severus seized power after the death of...

 during his reign in Rome. Galen compliments Septimius and Caracalla
Caracalla
Caracalla , was Roman emperor from 198 to 217. The eldest son of Septimius Severus, he ruled jointly with his younger brother Geta until he murdered the latter in 211...

 on keeping a supply of drugs for their friends and mentions three cases in which they had been of use in 198 AD.

The Antonine Plague



The Antonine Plague was named after Marcus Aurelius’ family name of Antoninus. It was also known as the Plague of Galen and holds an important place in medicinal history because of its association with Galen. Galen had first hand knowledge of the disease. He was in Rome when it struck in 166 AD, and was also present in the winter of 168–69 during an outbreak among troops stationed at Aquileia
Aquileia
Aquileia is an ancient Roman city in what is now Italy, at the head of the Adriatic at the edge of the lagoons, about 10 km from the sea, on the river Natiso , the course of which has changed somewhat since Roman times...

. He had experience with the epidemic, referring to it as very long lasting, and describes its symptoms and his treatment of it. Unfortunately, his references to the plague are scattered and brief. Galen was not trying to present a description of the disease so that it could be recognized in future generations; he was more interested in the treatment and physical effects of the disease. For example, in his writings about a young man afflicted with the plague, he concentrated on the treatment of internal and external ulcerations. According to Niebuhr "this pestilence must have raged with incredible fury; it carried off innumerable victims. The ancient world never recovered from the blow inflected upon it by the plague which visited it in the reign of M. Aurelius."
The mortality rate of the plague was 7–10 percent; the outbreak in 165–6–168 would have caused approximately 3.5 to 5 million deaths. Otto Seek believes that over half the population of the empire perished. J. F. Gilliam believes that the Antonine plague probably caused more deaths than any other epidemic during the empire before the mid-3rd century. It is believed that the Antonine Plague was smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

, because though his description is incomplete, Galen gave enough information to enable a firm identification of the disease.

Galen notes that the exanthema covered the victim’s entire body and was usually black. The exanthem became rough and scabby where there was no ulceration. He states that those who were going to survive developed a black exanthem. According to Galen, it was black because of a remnant of blood putrefied in a fever blister that was pustular. His writings state that raised blisters were present in the Antonine plague, usually in the form of a blistery rash. Galen states that the skin rash was close to the one Thucydides
Thucydides
Thucydides was a Greek historian and author from Alimos. His History of the Peloponnesian War recounts the 5th century BC war between Sparta and Athens to the year 411 BC...

 described. Galen describes symptoms of the alimentary tract via a patient’s diarrhea and stools. If the stool was very black, the patient died. He says that the amount of black stools varied. It depended on the severity of the intestinal lesions. He observes that in cases where the stool was not black, the black exanthum appeared. Galen describes the symptoms of fever, vomiting, fetid breath, catarrh, cough and ulceration of the larynx and trachea.

Eudemus


When Peripatetic philosopher Eudemus became ill with Quartan fever
Plasmodium malariae
Plasmodium malariae is a parasitic protozoa that causes malaria in humans. It is closely related to Plasmodium falciparum and Plasmodium vivax which are responsible for most malarial infection. While found worldwide, it is a so-called "benign malaria" and is not nearly as dangerous as that...

, Galen felt obliged to treat him "since he was my teacher and I happened to live nearby." Galen wrote: "I return to the case of Eudemus. He was thoroughly attacked by the three attacks of quartan ague, and the doctors had given him up, as it was now mid-winter." Some Roman physicians criticized Galen for his use of the prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...

 in his treatment of Eudemus. This practice conflicted with the then-current standard of care, which relied upon divination
Divination
Divination is the attempt to gain insight into a question or situation by way of an occultic standardized process or ritual...

 and mysticism
Mysticism
Mysticism is the knowledge of, and especially the personal experience of, states of consciousness, i.e. levels of being, beyond normal human perception, including experience and even communion with a supreme being.-Classical origins:...

. Galen retaliated against his detractors by defending his own methods. Garcia-Ballester quotes Galen as saying: "In order to diagnose, one must observe and reason. This was the basis of his criticism of the doctors who proceeded alogos and askeptos." However, Eudemus warned Galen that engaging in conflict with these physicians could lead to his assassination. "Eudemus said this, and more to the same effect; he added that if they were not able to harm me by unscrupulous conduct they would proceed to attempts at poisoning. Among other things he told me that, some ten years before, a young man had come to the city and had given, like me practical demonstrations of the resources of our art; this young man was put to death by poison, together with two servants who accompanied him."

Garcia-Ballester says the following of Galen’s use of prognosis: "In modern medicine, we are used to distinguishing between the diagnostic judgment (the scientific knowledge of what a patient has) and the prognostic judgment (the conjecture about what will happen to him.) Galen, like the Hippocratics, was not. For him, to understand a clinical case technically, ‘to diagnose’, was among other things, to know with greater or lesser certainty the outcome fore the patient, ‘to prognosticate’. Prognosis, then, is one of the essential problems and most important objectives of Galenic diagnosis. Galen was concerned to distinguish it from divination or prophecy, both to improve diagnosis technically and to enhance the physician’s reputation."

Death


The 11th-century Suda
Suda
The Suda or Souda is a massive 10th century Byzantine encyclopedia of the ancient Mediterranean world, formerly attributed to an author called Suidas. It is an encyclopedic lexicon, written in Greek, with 30,000 entries, many drawing from ancient sources that have since been lost, and often...

lexicon states that Galen died at the age of 70, therefore about the year 199. However, there is a reference in Galen's treatise "On Theriac to Piso" (which may however be spurious) to events of 204. There are also statements in Arabic sources that he died at 87, after 17 years studying medicine and 70 practicing it, therefore about 217. Nutton believes that "On Theriac to Piso" is genuine, the Arabic sources are correct and that the Suda has erroneously interpreted the 70 years of Galen's career in the Arabic tradition as referring to his whole lifespan. Boudon-Millot more or less concurs and favours a date of 216.

Contributions to medicine


Galen contributed a substantial amount to the Hippocratic understanding of pathology. Under Hippocrates’ bodily humors theory, differences in human moods come as a consequence of imbalances in one of the four bodily fluids: blood, yellow bile, black bile, and phlegm. Galen advanced this theory, creating a typology of human temperaments. An imbalance of each humor corresponded with a particular human temperament (blood-sanguine, black bile-melancholic, yellow bile-choleric, and phlegm-phlegmatic). Individuals with sanguine temperaments are extroverted and social. Choleric people have energy, passion and charisma. Melancholics are creative, kind and considerate. Phlegmatic temperaments are characterized by dependability, kindness, and affection.

Galen’s principal interest was in human anatomy, but Roman law had prohibited the dissection of human cadavers since about 150 BC. Because of this restriction, Galen performed anatomical dissections on living (vivisection
Vivisection
Vivisection is defined as surgery conducted for experimental purposes on a living organism, typically animals with a central nervous system, to view living internal structure...

) and dead animals, mostly focusing on pigs and primate
Primate
A primate is a mammal of the order Primates , which contains prosimians and simians. Primates arose from ancestors that lived in the trees of tropical forests; many primate characteristics represent adaptations to life in this challenging three-dimensional environment...

s. This work turned out to be particularly useful because in most cases, the anatomical structures of these animals closely mirror those of humans. Galen clarified the anatomy of the trachea and was the first to demonstrate that the larynx generates the voice. Galen may have understood the importance of artificial ventilation, because in one of his experiments he used bellows to inflate the lungs of a dead animal.

Among Galen’s major contributions to medicine was his work on the circulatory system
Circulatory system
The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc...

. He was the first to recognize that there were distinct differences between venous
Venous blood
Venous blood is deoxygenated blood in the circulatory system. It runs in the systemic veins from the organs to the heart. Deoxygenated blood is then pumped by the heart to lungs via the pulmonary arteries, one of the few arteries in the body that carries deoxygenated blood .Venous blood is...

 (dark) and arterial
Artery
Arteries are blood vessels that carry blood away from the heart. This blood is normally oxygenated, exceptions made for the pulmonary and umbilical arteries....

 (bright) blood. Although his many anatomical experiments on animal models led him to a more complete understanding of the circulatory system, nervous system
Nervous system
The nervous system is an organ system containing a network of specialized cells called neurons that coordinate the actions of an animal and transmit signals between different parts of its body. In most animals the nervous system consists of two parts, central and peripheral. The central nervous...

, respiratory system
Respiratory system
The respiratory system is the anatomical system of an organism that introduces respiratory gases to the interior and performs gas exchange. In humans and other mammals, the anatomical features of the respiratory system include airways, lungs, and the respiratory muscles...

 and other structures, his work was not without scientific inaccuracies. Galen believed that the circulatory system consisted of two separate one-way systems of distribution, rather than a single unified system of circulation. His understanding was that venous blood was generated in the liver, from where it was distributed and consumed by all organs of the body. He posited that arterial blood originated in the heart, from where it was distributed and consumed by all organs of the body. The blood was then regenerated in either the liver or the heart, completing the cycle. Galen also believed in the existence of a group of blood vessels he called the rete mirabile
Rete mirabile
A rete mirabile is a complex of arteries and veins lying very close to each other, found in some vertebrates. The rete mirabile utilizes countercurrent blood flow within the net...

, near the back of the human brain. Both of these theories of the circulation of blood were later shown to be incorrect.

In his work De motu musculorum, Galen explained the difference between motor and sensory nerve
Sensory nerve
Sensory nerves are nerves that receive sensory stimuli, such as how something feels and if it is painful, smooth, rough, etc.They are made up of nerve fibers, called sensory fibers .Sensory neurons are neurons that are activated by sensory input Sensory nerves are nerves that receive sensory...

s, discussed the concept of muscle tone
Muscle tone
In physiology, medicine, and anatomy, muscle tone is the continuous and passive partial contraction of the muscles, or the muscle’s resistance to passive stretch during resting state. It helps maintain posture, and it declines during REM sleep.-Purpose:Unconscious nerve impulses maintain the...

 and explained the difference between agonists
Agonist (muscle)
Agonist is a classification used to describe a muscle that causes specific movement or possibly several movements to occur through the process of its own contraction. This is typically a term designated for skeletal muscles...

 and antagonists
Antagonist (muscle)
Most muscles work in pairs, and when a muscle works it needs to have an agonist and an antagonist, unless the muscle's natural state is opposite to that which is produced by the muscle, example Sphincter ani externus muscle....

.

Galen was also a highly skilled surgeon, and he performed surgical operations on human patients. Many of the procedures and techniques that he utilized would not be used again for centuries. Of particular note are procedures that Galen performed on patients’ brains and eyes. In order to correct cataract
Cataract
A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light...

s in patients, Galen performed an operation that was similar to what is performed by contemporary ophthalmologists. Using a needle-shaped instrument, Galen attempted to remove the cataract from behind the lens of the eye.

At first reluctantly, but then with increasing vigour, Galen promoted Hippocratic teaching, including venesection
Venipuncture
In medicine, venepuncture, venopuncture or venipuncture is the process of obtaining intravenous access for the purpose of intravenous therapy or for blood sampling of venous blood. This procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics,...

 and bloodletting
Bloodletting
Bloodletting is the withdrawal of often little quantities of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be "humors" the proper balance of which maintained health...

, then unknown in Rome. This was sharply criticised by the Erasistrateans
Erasistratus
Erasistratus was a Greek anatomist and royal physician under Seleucus I Nicator of Syria. Along with fellow physician Herophilus, he founded a school of anatomy in Alexandria, where they carried out anatomical research...

, who predicted dire outcomes, believing that it was not blood but pneuma
Pneuma (Stoic)
In Stoic philosophy, pneuma is the concept of the "breath of life," a mixture of the elements air and fire . Originating among Greek medical writers who locate human vitality in the breath, pneuma for the Stoics is the active, generative principle that organizes both the individual and the cosmos...

 that flowed in the veins. Galen, however, staunchly defended venesection in his three books on the subject, and in his demonstrations and public disputations.

Contributions to philosophy


Although the main focus of his work was on medicine, anatomy, and physiology, Galen also wrote about logic and philosophy. His writings were influenced by earlier Greek and Roman thinkers, including Plato
Plato
Plato , was a Classical Greek philosopher, mathematician, student of Socrates, writer of philosophical dialogues, and founder of the Academy in Athens, the first institution of higher learning in the Western world. Along with his mentor, Socrates, and his student, Aristotle, Plato helped to lay the...

, Aristotle
Aristotle
Aristotle was a Greek philosopher and polymath, a student of Plato and teacher of Alexander the Great. His writings cover many subjects, including physics, metaphysics, poetry, theater, music, logic, rhetoric, linguistics, politics, government, ethics, biology, and zoology...

, and the Stoics
Stoicism
Stoicism is a school of Hellenistic philosophy founded in Athens by Zeno of Citium in the early . The Stoics taught that destructive emotions resulted from errors in judgment, and that a sage, or person of "moral and intellectual perfection," would not suffer such emotions.Stoics were concerned...

. Several schools of thought existed within the medical field during Galen’s lifetime, the main two being the Empiricists and Rationalists (also called Dogmatists or Philosophers), with the Methodists being a lesser, more moderate group. The Empiricists emphasized the importance of physical practice and experimentation, or "active learning" in the medical discipline. In direct opposition to the Empiricists were the Rationalists, who valued the study of established teachings in order to create new theories in the name of medical advancements. The Methodists formed somewhat of a middle ground, as they were not as experimental as the Empiricists, nor as theoretical as the Rationalists. The Methodists mainly utilized pure observation, showing greater interest in studying the natural course of ailments than making efforts to find remedies.

Galen was highly interested in the importance of combining philosophical thought with medical practice, an idea he expressed in his brief work "That the Best Physician is also a Philosopher." He refused to be placed into one particular school of thought, instead taking aspects from each group and combining them with his original thoughts to form his own unique approach to medicine. He was a proponent of medicine as a highly interdisciplinary field that was best practiced by utilizing theory, observation, and experimentation in conjunction to yield the most complete results. This attitude was largely a result of his pluralist education, which exposed him to the four major schools of thought (Platonists, Peripatetics, Stoics, Epicureans), and encouraged him to pick and choose aspects from each to adhere to. His early education also included instruction both from teachers who belonged to the Rationalist sect and from teachers who belonged to the Empiricist sect, allowing him to learn about the merits of both schools.

Published works



Galen may have produced more work than any author in antiquity, rivaling the quantity of work issued from Augustine of Hippo
Augustine of Hippo
Augustine of Hippo , also known as Augustine, St. Augustine, St. Austin, St. Augoustinos, Blessed Augustine, or St. Augustine the Blessed, was Bishop of Hippo Regius . He was a Latin-speaking philosopher and theologian who lived in the Roman Africa Province...

. So profuse was Galen's output that the surviving texts represent nearly half of all the extant literature
Extant literature
Extant literature refers to texts that have survived from the past to the present time. Extant literature can be divided into extant original manuscripts, copies of original manuscripts, quotations and paraphrases of passages of non-extant texts contained in other works, translations of non-extant...

 from ancient Greece. It has been reported that Galen employed twenty scribe
Scribe
A scribe is a person who writes books or documents by hand as a profession and helps the city keep track of its records. The profession, previously found in all literate cultures in some form, lost most of its importance and status with the advent of printing...

s to write down his words. Galen may have written as many as 600 treatises, amounting to some 10 million words. Although his surviving works amount to some 3 million words, this is thought to represent less than a third of his complete writings. In AD 191, a fire in the Temple of Peace destroyed many of his works, particularly treatises on philosophy.

Because Galen's works were not translated into Latin in the ancient period, and because of the collapse of the Roman Empire in the West, the study of Galen, along with the Greek medical tradition as a whole, went into decline in Western Europe during the Early Middle Ages
Early Middle Ages
The Early Middle Ages was the period of European history lasting from the 5th century to approximately 1000. The Early Middle Ages followed the decline of the Western Roman Empire and preceded the High Middle Ages...

, when very few Latin scholars could read Greek. However, Galen and the ancient Greek medical tradition generally continued to be studied and followed in the Eastern Roman Empire, commonly known as the Byzantine Empire. All of the extant Greek manuscripts of Galen were copied by Byzantine scholars. In the Abbasid period (after 750 AD) Arab Muslims
Arab Muslims
Arab Muslims are adherents of the religion of Islam who identify linguistically, culturally, or genealogically as Arabs. They greatly outnumber other ethnic groups in the Middle East. Muslims who are not Arabs are called mawali by Arab Muslims....

 began to be interested in Greek scientific and medical texts for the first time, and had some of Galen's texts translated into Arabic, often by Syrian Christian scholars (see below). As a result some texts of Galen exist only in Arabic translation, while others exist only in medieval Latin translations of the Arabic. In some cases scholars have even attempted to translate from the Latin or Arabic back into Greek where the original is lost. For some of the ancient sources, such as Herophilus, Galen's account of their work is all that survives.

Even in his own time, forgeries and unscrupulous editions of his work were a problem, prompting him to write On his Own Books. Forgeries in Latin, Arabic or Greek continued until the Renaissance
Renaissance
The Renaissance was a cultural movement that spanned roughly the 14th to the 17th century, beginning in Italy in the Late Middle Ages and later spreading to the rest of Europe. The term is also used more loosely to refer to the historical era, but since the changes of the Renaissance were not...

. Some of Galen's treatises have appeared under many different titles over the years. Sources are often in obscure and difficult to access journals or repositories. Although written in Greek, by convention the works are referred to by Latin titles, and often by merely abbreviations of those. No single authoritative collection of his work exists, and controversy remains as to the authenticity of a number of works attributed to Galen. Consequently research on Galen's work is fraught with hazard.

Various attempts have been made to classify Galen's vast output. For instance Coxe (1846) lists a Prolegomena, or introductory books, followed by 7 classes of treatise embracing Physiology (28 vols.), Hygiene (12), Aetiology (19), Semeiotics (14), Pharmacy (10), Blood letting (4) and Therapeutics (17), in addition to 4 of aphorisms, and spurious works. The most complete compendium
Compendium
A compendium is a concise, yet comprehensive compilation of a body of knowledge. A compendium may summarize a larger work. In most cases the body of knowledge will concern some delimited field of human interest or endeavour , while a "universal" encyclopedia can be referred to as a compendium of...

 of Galen's writings, surpassing even modern projects like the Corpus Medicorum Graecorum, is the one compiled and translated by Karl Gottlob Kühn of Leipzig
Leipzig
Leipzig Leipzig has always been a trade city, situated during the time of the Holy Roman Empire at the intersection of the Via Regia and Via Imperii, two important trade routes. At one time, Leipzig was one of the major European centres of learning and culture in fields such as music and publishing...

 between 1821 and 1833. This collection consists of 122 of Galen's treatises, translated from the original Greek into Latin (the text is presented in both languages). Over 20,000 pages in length, it is divided into 22 volumes, with 676 index pages. Many of Galen's works are included in the Thesaurus Linguae Graecae
Thesaurus Linguae Graecae
The Thesaurus Linguae Graecae is a research center at the University of California, Irvine. The TLG was founded in 1972 by Marianne McDonald with the goal to create a comprehensive digital collection of all surviving texts written in Greek from antiquity to...

, a digital library of Greek literature started in 1972. Another useful modern source is the French Bibliothèque interuniversitaire de médicine (BIUM).

Late antiquity


In his time, Galen's reputation as both physician and philosopher was legendary, the Emperor Marcus Aurelius describing him as "Primum sane medicorum esse, philosophorum autem solum" (first among doctors and unique among philosophers Praen 14: 660). Other contemporary authors in the Greek world confirm this including Theodotus the Shoemaker
Theodotus of Byzantium
Theodotus of Byzantium was an early Christian writer from Byzantium, one of several named Theodotus whose writings were condemned as heresy in the early church.Theodotus claimed that Jesus was born of the Virgin Mary and the Holy Spirit as a mortal man, and though later "adopted" by...

, Athenaeus
Athenaeus
Athenaeus , of Naucratis in Egypt, Greek rhetorician and grammarian, flourished about the end of the 2nd and beginning of the 3rd century AD...

 and Alexander of Aphrodisias
Alexander of Aphrodisias
Alexander of Aphrodisias was a Peripatetic philosopher and the most celebrated of the Ancient Greek commentators on the writings of Aristotle. He was a native of Aphrodisias in Caria, and lived and taught in Athens at the beginning of the 3rd century, where he held a position as head of the...

. The 7th-century poet George of Pisida
George Pisida
George Pisida was a Byzantine poet, born in Pisidia, flourished during the 7th century AD....

 went so far as to refer to Christ as a second and neglected Galen. Galen continued to exert an important influence over the theory and practice of medicine until the mid-17th century in the Byzantine and Arabic worlds and Europe. Hippocrates and Galen form important landmarks of 600 years of Greek medicine. AJ Brock describes them as representing the foundation and apex respectively. A few centuries after Galen Palladius Iatrosophista
Palladius (physician)
Palladius a Greek medical writer, some of whose works are still extant. Nothing is known of the events of his life, but, as he is commonly called Iatrosophistes, he is supposed to have gained that title by having been a professor of medicine at Alexandria. His date is uncertain; he may lived in...

 in his commentary on Hippocrates, stated that Hippocrates sowed and Galen reaped.

Thus Galen summarised and synthesised the work of his predecessors, and it is in Galen's words (Galenism) that Greek medicine was handed down to subsequent generations, such that Galenism became the means by which Greek medicine was known to the world. Frequently this was in the form of restating and reinterpreting, such as in Magnus of Nisibis' 4th-century work on urine, which was in turn translated into Arabic. Yet the full importance of his contributions was not appreciated till long after his death. Galen's rhetoric and prolificity were so powerful as to convey the impression that there was little left to learn. The term Galenism has subsequently taken on both a positive and pejorative meaning as one that transformed medicine in late antiquity yet so dominated subsequent thinking as to stifle further progress.

After the collapse of the Western Empire the study of Galen and other Greek works almost disappeared in the Latin West. In contrast, in the predominantly Greek-speaking eastern half of the Roman empire (Byzantium), many commentators of the subsequent centuries, such as Oribasius
Oribasius
Oribasius or Oreibasius was a Greek medical writer and the personal physician of the Roman emperor Julian the Apostate. He studied at Alexandria under physician Zeno of Cyprus before joining Julian's retinue. He was involved in Julian's coronation in 361, and remained with the emperor until...

, physician to the emperor Julian
Julian the Apostate
Julian "the Apostate" , commonly known as Julian, or also Julian the Philosopher, was Roman Emperor from 361 to 363 and a noted philosopher and Greek writer....

 who compiled a Synopsis in the 4th century, preserved and disseminated Galen's works, making Galenism more accessible. Nutton refers to these authors as the "medical refrigerators of antiquity". In late antiquity medical writing veered increasingly in the direction of the theoretical at the expense of the practical, with many authors merely debating Galenism. Magnus of Nisibis was a pure theorist, as were John of Alexandria and Agnellus of Ravenna with their lectures on Galen's De Sectis. So strong was Galenism that other authors such as Hippocrates began to be seen through a Galenic lens, while his opponents became marginalised and other medical sects such as Asclepiadism slowly disappeared. Greek medicine was part of Greek culture, and Syrian Eastern Christians came in contact with it while the Eastern Roman Empire (Byzantium) ruled Syria and Western Mesopotamia, regions that were conquered from Byzantium in the 7th century by Arab Muslims. After 750 AD, Muslims had these Syrian Christians make the first translations of Galen into Arabic. From then on Galen and the Greek medical tradition in general became assimilated into the medieval and early modern Islamic Middle East.

Influence on Islamic medicine


The first major translator of Galen into Arabic was the Syrian Christian Hunayn ibn Ishaq
Hunayn ibn Ishaq
Hunayn ibn Ishaq was a famous and influential Assyrian Nestorian Christian scholar, physician, and scientist, known for his work in translating Greek scientific and medical works into Arabic and Syriac during the heyday of the Islamic Abbasid Caliphate.Ḥunayn ibn Isḥaq was the most productive...

. Hunayn translated (c. 830–870) 129 works of "Jalinos" into Arabic
Arabic language
Arabic is a name applied to the descendants of the Classical Arabic language of the 6th century AD, used most prominently in the Quran, the Islamic Holy Book...

. One of the Arabic translations, ‘Kitab ila Aglooqan fi Shifa al Amraz’, which is extant in the Library of Ibn Sina Academy of Medieval Medicine & Sciences, is a master piece of all literary works of Galen. It is a part of the Alexandrian compendium of Galen’s work. This manuscript of the 10th century comprises two parts that include details regarding various types of fevers (Humyat) and different inflammatory conditions of the body. More importantly, it includes details of more than 150 single and compound formulations of both herbal and animal origin. The book provides an insight into understanding the traditions and methods of treatment in Greek (Unani) and Roman era. In addition, this book provides a direct source for the study of more than 150 single and compound drugs used during the Greco-Roman period.

Galen's insistence on a rational systematic approach to medicine set the template for Islamic medicine
Islamic medicine
In the history of medicine, Islamic medicine, Arabic medicine or Arabian medicine refers to medicine developed in the Islamic Golden Age, and written in Arabic, the lingua franca of Islamic civilization....

, which rapidly spread throughout the Arab Empire
Caliphate
The term caliphate, "dominion of a caliph " , refers to the first system of government established in Islam and represented the political unity of the Muslim Ummah...

. Arabic sources, such as Rhazes (Muhammad ibn Zakarīya Rāzi 865–925 AD), continue to be the source of discovery of new or relatively inaccessible Galenic writings. As the title, Doubts on Galen by Rhazes implies, as well as the writings of physicians such as Ibn Zuhr
Ibn Zuhr
Abū Merwān ’Abdal-Malik ibn Zuhr was a Muslim physician, surgeon and teacher in Al-Andalus.He was born at Seville...

 (Avenzoar) and Ibn al-Nafis, the works of Galen were not taken on unquestioningly, but as a challengeable basis for further inquiry
Scientific method
Scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering empirical and measurable evidence subject to specific principles of...

.

A strong emphasis on experiment
Experiment
An experiment is a methodical procedure carried out with the goal of verifying, falsifying, or establishing the validity of a hypothesis. Experiments vary greatly in their goal and scale, but always rely on repeatable procedure and logical analysis of the results...

ation and empiricism
Empiricism
Empiricism is a theory of knowledge that asserts that knowledge comes only or primarily via sensory experience. One of several views of epistemology, the study of human knowledge, along with rationalism, idealism and historicism, empiricism emphasizes the role of experience and evidence,...

 led to new results and new observations, which were contrasted and combined with those of Galen by writers such as Rhazes, Ali ibn Abbas al-Majusi
Ali ibn Abbas al-Majusi
Ali ibn al-'Abbas al-Majusi , also known as Masoudi, or Latinized as Haly Abbas, was a Persian physician and psychologist most famous for the Kitab al-Maliki or Complete Book of the Medical Art, his textbook on medicine and psychology.-Biography:He was born in Ahvaz, southwestern Persia, and...

 (Haly Abbas), Abu al-Qasim al-Zahrawi (Abulasis), Ibn Sina
Avicenna
Abū ʿAlī al-Ḥusayn ibn ʿAbd Allāh ibn Sīnā , commonly known as Ibn Sīnā or by his Latinized name Avicenna, was a Persian polymath, who wrote almost 450 treatises on a wide range of subjects, of which around 240 have survived...

 (Avicenna), Ibn Zuhr and Ibn al-Nafis. For example, the experiments carried out by Rāzi and Ibn Zuhr contradicted the Galenic theory of humorism, while Ibn al-Nafis' discovery of the pulmonary circulation
Pulmonary circulation
Pulmonary circulation is the half portion of the cardiovascular system which carries Oxygen-depleted Blood away from the heart, to the Lungs, and returns oxygenated blood back to the heart. Encyclopedic description and discovery of the pulmonary circulation is widely attributed to Doctor Ibn...

 contradicted the Galenic theory on the heart.

Reintroduction to the Latin West


From the 11th century onwards, Latin translations of Islamic medical texts began to appear in the West, alongside the Salerno
Schola Medica Salernitana
The Schola Medica Salernitana was the first medieval medical school in the cosmopolitan coastal south Italian city of Salerno, which provided the most important source of medical knowledge in Western Europe at the time...

 school of thought, and were soon incorporated into teaching at the universities of Naples and Montpellier. Galenism now took on a new unquestioned authority, Galen even being referred to as the "Medical Pope of the Middle Ages". Constantine the African
Constantine the African
Constantine the African was a Tunisian doctor of the eleventh century. The first part of his life was spent in Tunisia and the rest in Italy. In Salerno, Italy, he became a professor of medicine and his work attracted widespread attention...

 was amongst those who carried out translations of both Hippocrates and Galen from Arabic. In addition to the more numerous translations of Arabic texts in this period, there were a few translations of Galenic works directly from the Greek, such as Burgundio of Pisa's translation of De complexionibus. Galen's works on anatomy and medicine became the mainstay of the medieval physician's university curriculum, alongside Ibn Sina's The Canon of Medicine
The Canon of Medicine
The Canon of Medicine is an encyclopedia of Galenic medicine in five books compiled by Ibn Sīnā and completed in 1025. It presents a clear and organized summary of all the medical knowledge of the time...

which elaborated on Galen's works. Unlike pagan Rome, Christian Europe did not exercise a universal prohibition of the dissection and autopsy of the human body and such examinations were carried out regularly from at least the 13th century. However, Galen's influence, as in the Arab world, was so great that when dissections discovered anomalies in Galen's anatomy, the physicians often tried to fit these into the Galenic system. An example of this is Mondino de Liuzzi
Mondino de Liuzzi
Mondino de Luzzi, or de Liuzzi or de Lucci, , also known as Mundinus, was an Italian physician, anatomist, and professor of surgery who lived and worked in Bologna...

, who describes rudimentary blood circulation in his writings but still asserts that the left ventricle should contain air. Some cited these changes as proof that human anatomy had changed since the time of Galen.

Renaissance


The Renaissance and fall of the Byzantine Empire (1453) was accompanied by an influx of Greek scholars and manuscripts to the West, allowing direct comparison between the Arabic commentaries and the original Greek texts of Galen. This New Learning
New Learning
In the history of ideas the New Learning in Europe is a term for Renaissance humanism, developed in the later fifteenth century. Newly retrieved classical texts sparked philological study of a refined and classical Latin style in prose and poetry....

 and the Humanist
Renaissance humanism
Renaissance humanism was an activity of cultural and educational reform engaged by scholars, writers, and civic leaders who are today known as Renaissance humanists. It developed during the fourteenth and the beginning of the fifteenth centuries, and was a response to the challenge of Mediæval...

 movement, particularly the work of Thomas Linacre
Thomas Linacre
Thomas Linacre was a humanist scholar and physician, after whom Linacre College, Oxford and Linacre House The King's School, Canterbury are named....

, promoted literae humaniores
Literae Humaniores
Literae Humaniores is the name given to an undergraduate course focused on Classics at Oxford and some other universities.The Latin name means literally "more humane letters", but is perhaps better rendered as "Advanced Studies", since humaniores has the sense of "more refined" or "more learned",...

including Galen in the Latin scientific canon, De Naturalibus Facultatibus appearing in London in 1523. Debates on medical science now had two traditions, the more conservative Arabian and liberal Greek. The more extreme liberal movements began to challenge the role of authority in medicine, as exemplified by Paracelsus
Paracelsus
Paracelsus was a German-Swiss Renaissance physician, botanist, alchemist, astrologer, and general occultist....

 symbolically burning the works of Avicenna and Galen at his medical school in Basle
University of Basel
The University of Basel is located in Basel, Switzerland, and is considered to be one of leading universities in the country...

. Nevertheless Galen's pre-eminence amongst the great thinkers of the millennium is exemplified by a 16th-century mural in the refectory of the Great Lavra
Great Lavra
This is the monastery on Mount Athos. For the monastery associated with Saint Sabbas, see Mar Saba.The Monastery of Great Lavra is the first monastery built on Mount Athos. It is located on the southeastern foot of the Mount at an elevation of 160 metres...

 of Mt Athos. This depicts pagan sages at the foot of the Tree of Jesse
Tree of Jesse
The Tree of Jesse is a depiction in art of the Ancestors of Christ, shown in a tree which rises from Jesse of Bethlehem, the father of King David; the original use of the family tree as a schematic representation of a genealogy...

, with Galen between the Sibyl
Sibyl
The word Sibyl comes from the Greek word σίβυλλα sibylla, meaning prophetess. The earliest oracular seeresses known as the sibyls of antiquity, "who admittedly are known only through legend" prophesied at certain holy sites, under the divine influence of a deity, originally— at Delphi and...

 and Aristotle
Aristotle
Aristotle was a Greek philosopher and polymath, a student of Plato and teacher of Alexander the Great. His writings cover many subjects, including physics, metaphysics, poetry, theater, music, logic, rhetoric, linguistics, politics, government, ethics, biology, and zoology...

.

Galenism's final defeat came from a combination of the negativism of Paracelsus and the constructivism of the Italian Renaissance anatomists, such as Vesalius
Vesalius
Andreas Vesalius was a Flemish anatomist, physician, and author of one of the most influential books on human anatomy, De humani corporis fabrica . Vesalius is often referred to as the founder of modern human anatomy. Vesalius is the Latinized form of Andries van Wesel...

 in the 16th century. In the 1530s, Flemish anatomist and physician Andreas Vesalius took on a project to translate many of Galen's Greek texts into Latin. Vesalius' most famous work, De humani corporis fabrica, was greatly influenced by Galenic writing and form. Seeking to examine critically Galen's methods and outlook, Vesalius turned to human cadaver dissection as a means of verification. Galen's writings were shown to describe details present in monkeys but not in humans by Vesalius, who demonstrated Galen's limitations through books and hands-on demonstrations, despite fierce opposition from pro-Galenist orthodoxy, such as Jacobus Sylvius
Jacques Dubois
Jacques Dubois , also known as Jacobus Sylvius in Latin, was a French anatomist in Paris.-Early grammar of French:Dubois was the author of the first grammar of the French language to be published in France...

. Since Galen states that he is using observations of monkeys (human dissection was prohibited) to give an account of what the body looks like, Vesalius could portray himself as using Galen's approach of description of direct observation to create a record of the exact details of the human body, since he worked in a time when human dissection was allowed. Galen argued that monkey anatomy was close enough to humans for physicians to learn anatomy with monkey dissections and then make observations of similar structures in the wounds of their patients, rather than trying to learn anatomy only from wounds in human patients as students being trained by the Empiricist medical sect would. The examinations of Vesalius also disproved medical theories of Aristotle
Aristotle
Aristotle was a Greek philosopher and polymath, a student of Plato and teacher of Alexander the Great. His writings cover many subjects, including physics, metaphysics, poetry, theater, music, logic, rhetoric, linguistics, politics, government, ethics, biology, and zoology...

 and Mondino de Liuzzi
Mondino de Liuzzi
Mondino de Luzzi, or de Liuzzi or de Lucci, , also known as Mundinus, was an Italian physician, anatomist, and professor of surgery who lived and worked in Bologna...

. One of the best known examples of Vesalius' overturning of Galenism was his demonstration that the interventricular septum
Interventricular septum
Interventricular septum , abbreviated IVS, is the stout wall separating the lower chambers of the heart from one another....

 of the heart was not permeable, as Galen had taught (Nat Fac III xv).However, this had been revealed 2 years before by Michael De Villeneuve( Michael Servetus
Michael Servetus
Michael Servetus was a Spanish theologian, physician, cartographer, and humanist. He was the first European to correctly describe the function of pulmonary circulation...

) in his fatidique "Christianismi restitutio" (1553).

Michael De Villanueva (Michael Servetus
Michael Servetus
Michael Servetus was a Spanish theologian, physician, cartographer, and humanist. He was the first European to correctly describe the function of pulmonary circulation...

), Vesalius
Vesalius
Andreas Vesalius was a Flemish anatomist, physician, and author of one of the most influential books on human anatomy, De humani corporis fabrica . Vesalius is often referred to as the founder of modern human anatomy. Vesalius is the Latinized form of Andries van Wesel...

' fellow student, was the best Galenist at the University of Paris, according to Johann Winter von Andernach
Johann Winter von Andernach
Johann Winter von Andernach, also Johannes Winter von/aus Andernach, born Johann Winter, Latin Doctor Ioannes Guinterius Andernacus was a physician, university professor, humanist, translator of ancient, mostly medical works, and writer own medical, philological and humanities works.- Name...

, who taught both. In the Galenism of the Renaissance, editions of the Opera Omnia by Galen were very important. It was begun in Venice in 1541–1542 by the Guinta. There were fourteen editions of the book from that date until 1625. Just one edition was produced from Lyon, between 1548 and 1551. The Lyon edition has commentaries on breathing and blood streaming, that correct the work of earlier renowned authors such as Vesalius
Vesalius
Andreas Vesalius was a Flemish anatomist, physician, and author of one of the most influential books on human anatomy, De humani corporis fabrica . Vesalius is often referred to as the founder of modern human anatomy. Vesalius is the Latinized form of Andries van Wesel...

, Caius
Caius
-Persons:*Caius , bishop of Milan in the early 3rd-century, saint*Caius , Christian writer*Caius Gabriel Cibber, sculptor*Caius of Korea, Catholic missionary*Caius Welcker, footballer...

 or Janus Cornarius
Janus Cornarius
Janus Cornarius was a Saxon humanist and friend of Erasmus. A gifted philologist, Cornarius specialized in editing and translating Greek and Latin medical writers with "prodigious industry," taking a particular interest in botanical pharmacology and the effects of environment on illness and the body...

 . Michael De Villeneuve had contracts with Jean Frellon for that work, and the Servetus scholar-researcher Francisco Javier González Echeverría presented research that became an accepted communication in the International Society for the History of Medicine which concluded that Michael De Villeneuve(Michael Servetus
Michael Servetus
Michael Servetus was a Spanish theologian, physician, cartographer, and humanist. He was the first European to correctly describe the function of pulmonary circulation...

) is the author of the commentaries of this edition of Frellon, in Lyon
Lyon
Lyon , is a city in east-central France in the Rhône-Alpes region, situated between Paris and Marseille. Lyon is located at from Paris, from Marseille, from Geneva, from Turin, and from Barcelona. The residents of the city are called Lyonnais....

.

Another convincing case where understanding of the body was extended beyond where Galen had left it came from these demonstrations of the nature of the circulation and the subsequent work of Andrea Cesalpino
Andrea Cesalpino
Andrea Cesalpino was an Italian physician, philosopher and botanist....

, Fabricio of Acquapendente
Hieronymus Fabricius
Hieronymus Fabricius or Girolamo Fabrizio or by his Latin name Fabricus ab Aquapendende also Girolamo Fabrizi d'Acquapendente was a pioneering anatomist and surgeon known in medical science as "The Father of Embryology."...

 and William Harvey
William Harvey
William Harvey was an English physician who was the first person to describe completely and in detail the systemic circulation and properties of blood being pumped to the body by the heart...

. Some Galenic teaching, such as his emphasis on bloodletting
Bloodletting
Bloodletting is the withdrawal of often little quantities of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be "humors" the proper balance of which maintained health...

 as a remedy for many ailments, however remained influential until well into the 19th century.

Contemporary scholarship


Galenic scholarship remains an intense and vibrant field, following renewed interest in his work, dating from the Realencyclopädie der Classischen Altertumswissenschaft.

See also

  • Ancient Greek medicine
  • Galenic formulation
    Galenic formulation
    Galenic formulation deals with the principles of preparing and compounding medicines in order to optimize their absorption. Galenic formulation is named after Claudius Galen, a 2nd Century AD Greek physician, who codified the preparation of drugs using multiple ingredients...

  • Timeline of medicine and medical technology
    Timeline of medicine and medical technology
    - Antiquity :* 2600 BC – Imhotep wrote texts on ancient Egyptian medicine describing diagnosis and treatment of 200 diseases in 3rd dynasty Egypt.* 1500 BC – Saffron used as a medicine on the Aegean island of Thera in ancient Greece...

  • Abascantus
    Abascantus
    Abascantus was a physician of Lugdunum, who probably lived in the 2nd century. He is several times mentioned by Galen, who has also preserved an antidote invented by him against the bite of serpents...


Sources


Further reading

  • C. Gill, T. Whitmarsh, and J. Wilkins (eds), Galen and the World of Knowledge (New York and Cambridge, 2009) (Greek Cultures in the Roman World).

External links



(Commentary on Hippocrates' On the Nature of Man; On the Natural Faculties; Exhortation to Study the Arts: To Menodotus; On Diagnosis from Dreams)