The growth of medicine from the earliest times to about 1800

by Albert H. Buck

He describes the optic nerve, the oculo-motorius and trochlearis, the different ramifications of the trigeminus, the acusticus and facialis, the vagus and glossopharyngeus, the nerves of the pharynx and larynx, the sympatheticus (with the accompanying ganglia), and the radial, ulnar, median, crural and ischiatic nerves. (Puschmann.)

Although it is true that certain important anatomical and physiological facts are found recorded for the first time in the works of Galen, this must not be accepted as evidence that Galen himself is the real discoverer of these facts. The most that can be claimed for him is that he is the first writer to bring the facts in question to the knowledge of us moderns. When the ancient books that have been lost are once more brought to light, as they very well may be at any time, we shall be able, perhaps, to give credit where credit is due. But there is one department in which Galen did experimental work of an entirely original character and for which he deserves unstinted praise. I refer to the experiments which he made concerning the physiology of the brain and spinal cord. They are related in the following extract, which has been translated from the account given by Neuburger (op. cit., Vol. I., p. 380):—

The brain itself is not sensitive; it expands and contracts synchronously with the respiratory movements, the purpose of which action is to drive the pneuma from the cavities of that organ into the nerves. The function of the meninges is to hold the parts firmly together and to unite the blood-vessels. Pressure upon the brain causes stupor. An injury of the tissues surrounding the fourth ventricle or of those which constitute the beginning of the spinal cord produces death. The seat of the soul is in the substance of the brain, and not in its membranes. The spinal cord serves as a conductor of sensation and of motor impulses, and it also plays the part of a brain for those structures of the body which lie below the head. It gives off nerves like streamlets. Division of the spinal cord longitudinally in its median axis does not give rise to paralysis. Transverse division, on the other hand, causes symmetrical paralyses. If the cord is divided between the third and fourth cervical vertebrae, respiration is arrested, and if the division is made between the cervical and the thoracic portions of the spinal column, the animal breathes with the aid only of its diaphragm and of the upper muscles of the trunk of the body. Division of the recurrent nerves produces aphonia; if the fifth cervical nerve is divided, the scapular muscles on the corresponding side will be paralyzed. Galen considers the ganglia to be organs for reinforcing the energy of the nerves. The fact that both cerebral and spinal-cord nerve-filaments enter into the composition of the sympathetic nerve explains the extraordinary sensitiveness of the abdominal organs.

When we consider that these experiments are the first of their kind of which history makes mention, that they were carried out nearly seventeen hundred years ago, and that—so far as we know—they sprang entirely from the brain of the experimenter, we may well express unlimited admiration for Claudius Galen.

Daniel Le Clerc says that Galen’s principal treatise on human physiology, entitled “Utility of the Different Parts of the Human Body,” constitutes a chef-d’oeuvre which has challenged the admiration of physicians and philosophers in all ages. Christians, however, he adds, are particularly gratified to learn from this work that “Galen, although classed as a Pagan, unhesitatingly recognizes that it was an all-wise, an all-powerful, an all-good God who created man and all the other animals.” Further on, Le Clerc refers to another statement which was made by Galen and which will be found on page 261 of Daremberg’s version. It reads as follows:—

If I were to spend any more time in talking about such brutes—by which term he designates men who cannot appreciate the wisdom of God in distributing the different parts of the body in the manner in which He has done this—I should justly incur the blame of sensible persons. They would accuse me of desecrating the account which I am writing, an account which is intended as a hymn of sincere praise of the Creator of man. I believe that true piety consists, not in sacrificing numberless hecatombs nor in burning unlimited quantities of incense and a thousand perfumes, but in first searching out and then making known to my fellow men how great are the wisdom, the power, and the goodness of the Creator.

Galen’s work on “The Utility of the Different Parts of the Human Body” is composed of seventeen books, all of which exist to-day in a complete state. Taken together they form, as may be seen by the following list of contents, a remarkably complete treatise on physiology. Books I. and II. are devoted to the hand, forearm and arm (105 pages); Book III. to the thigh, leg and foot (62 pages); Books IV. and V. to the alimentary organs and their accessories (101 pages); Book VI. to the respiratory organs (78 pages); Book VII. to the organs of the voice (67 pages); Book VIII. to the head, the encephalon and the organs of special sense (45 pages); Book IX. to the cranium, the encephalon and the cranial nerves (38 pages); Book X. to the eyes and their accessories (45 pages); Book XI. to the face and more particularly the jaws (55 pages); Book XII. to the neck and the rest of the spinal column (46 pages); Book XIII. to the shoulder and the structure of the spinal column in detail (40 pages); Books XIV. and XV. to the genital organs and the parts in which the foetus develops (70 pages); Book XVI. to the nerves, arteries and veins (43 pages); and Book XVII. Epilogue (11 pages).

There are very few modern text books in which the author treats the subject in as exhaustive a manner as Galen has done in these seventeen books. As may readily be imagined from the great number and length of his writings, he often wanders off into side issues and thus lays himself open to the charge of being a diffuse writer. At the same time he cannot be accused of dullness, for in reading Daremberg’s version one is seldom tempted to omit any of the text, and his style is interesting. The following brief extracts, to which should be added that given on a previous page, may be taken as fair samples of his manner of treating questions in the department of physiology:—

Reasons why the Alae Nasi are Cartilaginous and why they may be Moved by Voluntary Muscular Action.—We have already explained in some measure the reasons why the alae nasi should be composed of cartilage and why it should be possible for the animal to move them at will.[41] It is an established fact that the movements of these parts are competent to aid in no small degree the somewhat forcible inspirations and expirations. This is the reason why the alae are constructed in such a manner as to be easily movable. They are made of cartilage because this substance is hard to fracture or to tear apart. The placing of these alar movements under the control of the will, and not under that of some other bodily force (like the arterial impulse, for example), is certainly an excellent arrangement; and, if one does not appreciate this without any further explanation, it must be because my previous reasonings about such matters have fallen upon inattentive ears.

(Translated from Book XI., Chapter XVII., of Daremberg’s French version of Galen’s works.)