Outlines of Greek and Roman Medicine

by Sir James Elliott

Galen stayed several years in Rome, and wrote and practised as on his former visit. He again returned to Pergamos, and probably was in Rome again at the end of the second century. It is certain he was still alive in the year 199, and probably lived in the reign of the Emperor Caracalla.

He was not only a great physician, but a man of wide culture in every way. In matters of religion he was a Monotheist. There was persecution of the Christians in his day, and it is likely that he came little into contact with the disciples of the new religion, and heard distorted accounts of it, but in one of his lost books, quoted by his Arabian biographers, Galen praises highly the love of virtue of the Christians.

He no doubt found the practice of medicine lucrative when he had gained pre-eminence, and it is recorded that he received £350 for curing the wife of Boetius, the Consul.

Galen wrote no less than five hundred treatises, large and small, mostly on medical subjects, but also on ethics, logic, and grammar. His style is good but rather diffuse, and he delights in quoting the ancient Greek philosophers. Before his time, as we have seen, there were disputes between the various medical sects. The disciples of Dogmatism and of Empiricism had been opposed to each other for several centuries, and the Eclectics, Pneumatists, and Episynthetics had arisen shortly before his time. Galen wrote against slavish attachment to any sect, but "in his general principles he may be considered as belonging to the Dogmatic sect, for his method was to reduce all his knowledge, as acquired by the observation of facts, to general theoretical principles. These principles he, indeed, professed to deduce from experience and observation, and we have abundant proofs of his diligence in collecting experience, and his accuracy in making observations; but still in a certain sense at least, he regards individual facts and the details of experience as of little value, unconnected with the principles which he had laid down as the basis of all medical reasoning. In this fundamental point, therefore, the method pursued by Galen appears to have been directly the reverse of that which we now consider as the correct method of scientific investigation; and yet, such is the force of natural genius, that in most instances he attained the ultimate object in view, although by an indirect path. He was an admirer of Hippocrates, and always speaks of him with the most profound respect, professing to act upon his principles, and to do little more than expound his doctrines, and support them by new facts and observations. Yet, in reality, we have few writers whose works, both as to substance and manner, are more different from each other than those of Hippocrates and Galen, the simplicity of the former being strongly contrasted with the abstruseness and refinement of the latter."[1]

A list of the various editions of Galen's works is given in Dr. Smith's "Dictionary of Greek and Roman Biography and Mythology" (1890 edition, vol. ii, pp. 210-12), and also the titles of the treatises classified according to the branch of medical science with which they deal, and it is convenient to follow this classification.

I.—Works on Anatomy and Physiology.

Galen insisted upon the study of anatomy as essential, and in this respect was in conflict with the view held by the Methodists and the Empirics who believed that a physician could understand diseases without any knowledge of the exact structure of the body. His books on anatomy were originally fifteen in number. The last six of these are now extant only in an Arabic translation, two copies of which are preserved in the Bodleian Library at Oxford.

The directions he gives for dissection show that he was a master of the art. In dissecting out the portal vein and its ramifications, for instance, he advises that a probe should be inserted into the vein, and the point of the probe gradually advanced as the surrounding tissue is cut away, so that finally the minute branches are exposed; and he describes the use of the blowpipe, and other instruments used in dissection. He carried out the experiment of tying the iliac and axillary arteries in animals, and found that this procedure stopped the pulse in the leg and arm, but caused no serious symptoms, and he found that even the carotid arteries could be tied without causing death. He also pointed out that tying the carotid artery did not cause loss of voice, but that tying the artery carelessly so as to include the nerve had this effect. He was the first to describe the ductus arteriosus, and the three coats of the arteries.

It is highly improbable that Galen dissected human bodies in Rome, though he dissected a great variety of the lower animals. He writes that the doctors who attended Marcus Aurelius in the German wars dissected the dead bodies of the barbarians. The chief mistakes made by Galen as an anatomist were due to his assumption that what is true of the anatomy of a lower animal is true also when applied to man.

Galen greatly assisted the advance of physiology by recognizing that every part of the body exists for the purpose of performing a definite function. Aristotle, like Plato, had taught that "Nature makes nothing in vain," and Galen's philosophy was greatly influenced by the teaching of Aristotle. Galen regarded his work as "a religious hymn in honour of the Creator, who has given proof of His Omnipotence in creating everything perfectly conformable to its destination."