English versions of Pliny’s Natural History and of Pliny the Younger’s Letters have been published in what is known as Bohn’s Libraries.
Pedanius Dioscorides, a native of Anazarba, a small Greek town near Tarsus in Cilicia, lived about the middle of the first century A. D. (during the reigns of Nero and Vespasian). From his earliest youth he took a great interest in botany, and, after reaching manhood, traveled extensively in the wake of different Roman armies, for the sole purpose of studying by direct observation the plants of different countries and of verifying the medicinal virtues which each one was reputed to possess. In this way he visited, in turn, Greece, Italy, Asia Minor and perhaps also the southern portion of France (the Narbonaise). He collected great quantities of specimens of every kind of drug—animal and mineral substances as well as objects belonging to the vegetable kingdom; and, wherever it was possible to do so, he wrote memoranda of the traditions of the natives with regard to the uses and medicinal effects of these different drugs. After he had completed all these researches and had gathered together all this vast mass of materials, he wrote his famous treatise on materia medica—“the most complete, the best considered, and the most useful work of its kind to be found anywhere to-day.” (Galen.) It is from this treatise, therefore, says Dezeimeris, that one can derive the most satisfactory idea of the early Greek materia medica; but at the same time, he adds, it is not a book in which will be found a detailed account of the manner in which the practitioners of that period employed the remedies which he describes. The same authority calls attention to the great difficulty which modern physicians often experience in their attempts to identify the drugs which Dioscorides describes. Le Clerc calls attention to the fact that the physicians who were contemporaries of Dioscorides were not in the habit of employing either iron or antimony (called by them stibium) internally. Apparently they had not yet learned that these substances possess properties which exert a curative action in certain diseases. On the other hand, he mentions the manner of extracting quicksilver, by chemical means, from cinnabar [red sulphide of mercury], the steps required for preparing acetate of lead, and the proper way of making lime water.
The work to which reference has been made above was published by Dioscorides about the year 77 A. D. It is the earliest pharmacological treatise that has come down to our time, and for many succeeding centuries it served as the authoritative guide in all questions relating to drugs. The first printed edition of the Greek original appeared in Venice in 1499, but a still earlier Latin version was issued in 1478. According to Pagel the best edition (in Latin and fully illustrated) is that of Pietro Andrea Mattioli, which was printed in Venice in 1554. Neuburger commends highly the German version by J. Berendes. (Stuttgart, 1902.)
Of Caelius Aurelianus we possess no biographical details beyond the facts that he was a native of Sicca in Numidia, Africa, and that he lived toward the end of the fourth or during the first part of the fifth century of the present era. He was the author of several works, all but one of which, however, have been lost. The single treatise which has come down to our time treats of acute and chronic diseases, and is spoken of by Daremberg as being virtually a translation of one of the lost writings of Soranus. This book, says Haeser in his History of Medicine, is the most important source from which our knowledge of Methodism is derived; and Neuburger not only agrees with this statement, but adds that the treatise of Caelius Aurelianus played a most important part, toward the end of the Middle Ages, in the evolution of medicine. Up to the present time no translation of this work into any modern language has been published, but Neuburger furnishes a very full analysis of its important parts. In two places, as appears from this analysis, Caelius Aurelianus mentions—among the signs and symptoms of certain affections of the respiratory apparatus—phenomena which show beyond a doubt that he (or Soranus) was familiar with auscultation of the chest. The words which he uses are these:—
“Stridor vel sonitus interius resonans aut sibilans in ea parte quae patitur,” and “sibilatus vehemens atque asper in ultimo etiam pectoris resonans stridor.”
CHAPTER XV
CLAUDIUS GALEN
During the centuries immediately preceding the Christian era, Greek medicine was represented by a collection of treatises which had been written by Hippocrates and his followers on anatomical, physiological, pathological, therapeutical and ethical subjects, and which constituted a fairly complete but not always easily intelligible system. As time went on, however, and especially as new and useful facts were constantly being added to the existing stock of medical knowledge, the more thoughtful physicians began to feel that the system, which up to that day had proved acceptable, needed to be perfected in a number of respects; and accordingly, as a result of this feeling of dissatisfaction, and also as an expression of the prevailing desire for a more perfect knowledge of the truth, there developed, as has been stated in the preceding chapters, a number of different medical sects. When Galen first appeared in the field as a physician of unusual promise, these various sects were all still in a thriving condition. The Methodists, in particular, were very popular. Galen did not favor any special sect, but in his writings he made it manifest that he attached more importance to the teachings of Hippocrates than to those of any other author. “It was Hippocrates,” he said, “who laid the real foundations of the science of medicine.” It is therefore not surprising that Galen should have devoted so much time to the writing of elaborate commentaries on the works of Hippocrates. The service which he thus rendered to medicine, says Daremberg, was of very great value. But Galen, notwithstanding his great admiration for Hippocrates, did not hesitate to criticise a number of his teachings, and especially those which, as he believed, were not stated with sufficient clearness. Valuable as was the service rendered to medicine by the writing of these commentaries, there still remained an urgent need for a service of a different and much more difficult kind, viz., that of welding together into a single clearly written and easily intelligible system of medicine, all that was good in the Hippocratic writings and in the disconnected and at times antagonistic teachings of the sects. To accomplish this successfully required the services of a man endowed with mental gifts of a most exceptional character—complete knowledge of medicine in all its departments, a mind thoroughly trained in philosophy, the power to express his thoughts in simple language, and an independence and fairness of judgment which would render him indifferent to the petty interests of the sects. Claudius Galen, as subsequent events showed, possessed these very gifts in a high degree, and he devoted the better part of his reasonably long lifetime to the accomplishment of this much-needed work. How greatly it was needed at that particular period of time, nobody then knew or could even suspect. It soon appeared, however, that all the vaunted civilization of the Graeco-Roman world—much of it of the purest gold and a great deal of the basest alloy—was to be swept so completely off the face of the earth that, for thirteen hundred or more years, almost no thought whatever could possibly be given to the science and art of medicine. Fortunate, most fortunate it was, therefore, that, before this wave of destruction reached Rome, all the best part of Greek medical literature—for such it was in truth—had been gathered together and carefully systematized by Galen and stowed away in the recesses and chambers of remotely situated monasteries and churches by clear-sighted monks for the benefit of later generations of physicians.
Brief Biographical Sketch.—Claudius Galen was born in Pergamum, an important Greek city of Asia Minor, about the year 131 A. D., under the reign of the Emperor Hadrian. His father, whose name was Nicon, was a man of ample means, well informed in philosophy, astronomy and geometry, and most liberal in providing for the thorough education of his son in every branch of useful knowledge. In two or three places in his writings Galen speaks of his father in terms of affection. On the other hand, he does not hesitate to state in the plainest language possible that his mother was a veritable Xanthippe. In her moments of bad temper she would not only shout and scream in a violent manner, but would sometimes go so far as to bite her serving-maids. Pergamum, at the time of which I am writing, offered unusually good opportunities for studying disease. Its Asclepieion, which was built during Galen’s boyhood, had already become one of the famous temples of Asia Minor, and the sick and maimed flocked to it in large numbers. Then, in addition, the city was well equipped with able physicians, who appear, according to Neuburger, to have been on very friendly terms with the priests of the temple. It was under the guidance of such men that Galen—at the early age of seventeen, and after a careful training in philosophy, mathematics, etc.—began the study of medicine. He speaks with special interest and respect of one of his instructors, a certain Quintus, who had the reputation of being an excellent anatomist and at the same time one of the most distinguished practitioners of that day. Another anatomist, Styrus, was also one of Galen’s teachers.
On the death of his father Galen left his home and devoted the succeeding nine years to visiting all the different cities in which he believed he might gain some additional knowledge in medicine and surgery. A large part of this long period was spent in Alexandria, which still retained much of its importance as a home of all the sciences. On attaining his twenty-eighth year he left that city and returned to Pergamum, evidently with the purpose of establishing himself there in the regular practice of his profession. Through the influence of the temple officials, and especially of the High Priest, Galen received the appointment of physician to the gladiators, a position which he held with credit for a period of four years, and which afforded him excellent opportunities for cultivating his knowledge of surgery. It was while he was serving in this capacity that he devised and put into practice a method of saturating the dressings (in cases of severe wounds) with red wine, for the purpose of preventing the development of inflammation in the parts affected; and the success which he thus obtained was so great that not one of the gladiators intrusted to his care died from his wounds. History does not state the precise manner in which Galen carried out his method of utilizing wine in the dressing of wounds, and we are therefore unable to determine just how much credit he was entitled to receive for this crude but apparently effective means of securing local antisepsis. It is clear, however, that Galen’s treatment could only have been a modification of a much older method, for Jesus, in his answer to a question put to him by a lawyer, said: “But a certain Samaritan, as he journeyed, came where he (the injured man) was: and when he saw him, he had compassion on him, and went to him, and bound up his wounds, pouring in oil and wine, and set him on his own beast, ...” (St. Luke x., 33, 34).
At the end of four years there broke out in Pergamum a riot which rendered residence there, at least for a certain length of time, undesirable. Accordingly Galen, who was now thirty-two years old, and who was probably glad of an excuse for leaving a place where a physician of his education and talents had so few opportunities for gaining distinction, decided to visit Rome, and—if circumstances appeared to favor the plan—to settle there. His first impressions after arriving in that metropolis were favorable to the plan of establishing himself there permanently, but at the end of a few years he became conscious of the growing hostility of those practitioners who had been for a longer time than he well established in that city. This hostility increased as he rose in favor and esteem with people of position and influence. He had treated skilfully and with success Eudemus, a peripatetic philosopher of great celebrity, for a quartan fever. He had also cured the wife of Boëthus (a patrician who belonged to the consular class) of a serious illness and had received as an expression of appreciation a gift of four hundred pieces of gold. He had won the friendship and esteem of such men as Sergius Paulus, the Praetor; of Barbaras, the uncle of the Emperor Lucius; and of Severus, who was at that time Consul, but who later became Emperor. These very influential men took an active interest in Galen’s scientific work, having been invited by him on more than one occasion to witness his dissections of apes,—dissections which he made for the particular purpose of demonstrating the organs of respiration and of the voice. All these facts soon became known to Galen’s rivals and probably helped to fan the spark of their envy into a flame; but it is very doubtful whether he was justified in saying that the ill feeling thus engendered threatened to end in some act of personal violence, for which reason he decided to leave Rome and return to Pergamum. His secret manner of departure, without taking leave of anybody, and the fact that the Plague was just at that time rapidly approaching Rome, justify the belief, says Neuburger, that it was not fear of personal violence at the hands of his jealous rivals that drove Galen away so mysteriously from the city in which, in the short space of four or five years, he had won so great professional success, but an unwillingness to face his duty, which was, to remain and aid in the approaching fight against the great destroyer—the Plague. If Galen had been a simple physician, one of the great body of medical practitioners in Rome, no one would be disposed to question the justice of the criticism which the distinguished Viennese historian makes of his decision to abandon that city at the moment of her distress and peril. But, as a matter of fact, Galen was not a practitioner of medicine in the full sense of that term. He treated cases of illness because in no other way would it be possible for him to acquire the necessary familiarity with disease; but, almost from the very beginning, he seems to have fully realized that he was destined to devote his time and his energies to a very different kind of professional work,—work which was urgently needed, which promised to be of very great value to medical science, and which probably no other physician then living was competent to do effectively. Furthermore, he was himself profoundly conscious that the work in question constituted the main object of his life. His own words (see his statement with reference to Archigenes, on page 174) show this plainly, and the huge mass of medical treatises which he wrote reveal in the most unmistakable manner with what untiring persistency he pursued the path which he believed it was his duty to follow. It being assumed, then, that such were the motives which actuated Galen, was it a mistake on his part to conclude that duty did not require him to remain in Rome? The question is a difficult one to answer, and I do not feel called upon to decide it. We do not, however, brand a general in the army a coward because he endeavors to protect himself as much as possible from danger during a battle, that he may be able, to the very end, to direct the soldiers under his command. Similarly, was not Galen justified in avoiding every risk which was likely to imperil the performance of duties which were of far greater value to medicine and to humanity at large than that of acting as a mere soldier in the ranks of medical men?