Fig. 11. Illustrating Galen’s physiological teaching.
The basic principle of life, in the Galenic physiology, is a spirit, anima or pneuma, drawn from the general world-soul in the act of respiration. It enters the body through the rough artery (τραχεια αρτηρια, arteria aspera of mediaeval notation), the organ known to our nomenclature as the trachea. From this trachea the pneuma passes to the lung and then, through the vein-like artery (αρτηρια φλεβωδης, arteria venalis of mediaeval writers, the pulmonary vein of our nomenclature), to the left ventricle. Here it will be best to leave it for a moment and trace the vascular system along a different route.
Ingested food, passing down the alimentary tract, was absorbed as chyle from the intestine, collected by the portal vessel, and conveyed by it to the liver. That organ, the site of the innate heat in Galen’s view, had the power of elaborating the chyle into venous blood and of imbuing it with a spirit or pneuma which is innate in all living substance, so long as it remains alive, the natural spirits (πνευμα φυσικον, spiritus naturalis of the mediaevals). Charged with this, and also with the nutritive material derived from the food, the venous blood is distributed by the liver through the veins which arise from it in the same way as the arteries from the heart. These veins carry nourishment and natural spirits to all parts of the body. Iecur fons venarum, the liver as the source of the veins, remained through the centuries the watchword of the Galenic physiology. The blood was held to ebb and flow continuously in the veins during life.
Now from the liver arose one great vessel, the hepatic vein, from division of which the others were held to come off as branches. Of these branches, one, our common vena cava, entered the right side of the heart. For the blood that it conveyed to the heart there were two fates possible. The greater part remained awhile in the ventricle, parting with its impurities and vapours, exhalations of the organs, which were carried off by the artery-like vein (φλεπς αρτηριωδης, the mediaeval vena arterialis, our pulmonary artery) to the lung and then exhaled to the outer air. These impurities and vapours gave its poisonous and suffocating character to the breath. Having parted thus with its impurities, the venous blood ebbed back again from the right ventricle into the venous system. But for a small fraction of the venous blood that entered the right ventricle another fate was reserved. This small fraction of venous blood, charged still with the natural spirits derived from the liver, passed through minute channels in the septum between the ventricles and entered the left chamber. Arrived there, it encountered the external pneuma and became thereby elaborated into a higher form of spirit, the vital spirits (πνευμα ζωτικον, spiritus vitalis), which is distributed together with blood by the arterial system to various parts of the body. In the arterial system it also ebbed and flowed, and might be seen and felt to pulsate there.
But among the great arterial vessels that sent forth arterial blood thus charged with vital spirits were certain vessels which ascended to the brain. Before reaching that organ they divided up into minute channels, the rete mirabile (πλεγμα μεγιστον θαυμα), and passing into the brain became converted by the action of that organ into a yet higher type of spirits, the animal spirits (πνευμα ψυχικον, spiritus animalis), an ethereal substance distributed to the various parts of the body by the structures known to-day as nerves, but believed then to be hollow channels. The three fundamental faculties δυναμεις), the natural, the vital, and the animal, which brought into action the corresponding functions of the body, thus originated as an expression of the primal force or pneuma.
This physiology, we may emphasize, is not derived from an investigation of human anatomy. In the human brain there is no rete mirabile, though such an organ is found in the calf. In the human liver there is no hepatic vein, though such an organ is found in the dog. Dogs, calves, pigs, bears, and, above all, Barbary apes were freely dissected by Galen and were the creatures from which he derived his physiological ideas. Many of Galen’s anatomical and physiological errors are due to his attributing to one creature the structures found in another, a fact that only very gradually dawned on the Renaissance anatomists.
The whole knowledge possessed by the world in the department of physiology from the third to the seventeenth century, nearly all the biological conceptions till the thirteenth, and most of the anatomy and much of the botany until the sixteenth century, all the ideas of the physical structure of living things throughout the Middle Ages, were contained in a small number of these works of Galen. The biological works of Aristotle and Theophrastus lingered precariously in a few rare manuscripts in the monasteries of the East; the total output of hundreds of years of Alexandrian and Pergamenian activities was utterly destroyed; the Ionian biological works, of which a sample has by a miracle survived, were forgotten; but these vast, windy, ill-arranged treatises of Galen lingered on. Translated into Latin, Syriac, Arabic, and Hebrew, they saturated the intellectual world of the Middle Ages. Commented on by later Greek writers, who were themselves in turn translated into the same list of languages, they were yet again served up under the names of such Greek writers as Oribasius, Paul of Aegina, or Alexander of Tralles.
What is the secret of the vitality of these Galenic biological conceptions? The answer can be given in four words. Galen is a teleologist; and a teleologist of a kind whose views happened to fit in with the prevailing theological attitude of the Middle Ages, whether Christian, Moslem, or Jewish. According to him everything which exists and displays activity in the human body originates in and is formed by an intelligent being and on an intelligent plan, so that the organ in structure and function is the result of that plan. ‘It was the Creator’s infinite wisdom which selected the best means to attain his beneficent ends, and it is a proof of His omnipotence that he created every good thing according to His design, and thereby fulfilled His will.’[43]
After Galen there is a thousand years of darkness, and biology ceases to have a history. The mind of the Dark Ages turned towards theology, and such remains of Neoplatonic philosophy as were absorbed into the religious system were little likely to be of aid to the scientific attitude. One department of positive knowledge must of course persist. Men still suffered from the infirmities of the flesh and still sought relief from them. But the books from which that advice was sought had nothing to do with general principles nor with knowledge as such. They were the most wretched of the treatises that still masqueraded under the names of Hippocrates and Galen, mostly mere formularies, antidotaries, or perhaps at best symptom lists. And, when the depression of the western intellect had passed its worst, there was still no biological material on which it could be nourished.