Litnet

The two greatest names in Western medicine are Hippocrates (born 460 BC) and Galen (born 130 AD) — critics were always about: "Galen perpetuated Hippocratic Medicine moving both forward and backward."

Claudius Galen was the son of Nicon a prosperous architect of Pergamum (about 85 km north of the present Izmir in Turkey). His mother had aggressive tendencies and was so bad tempered that she at times would bite her maids. He inherited this trait as a useful asset to draw upon in dealing with his adversaries.

Galen had a broad education ... The Pergamum library was second in size to the one at Alexandria.. He studied mathematics, grammar, logic and philosophy. When he was 17 years old his father had a dream about Asclepius (the god of medicine and healing) — and considered this to be an omen that his son should pursue medicine. Galen studied medicine at Smyrna, Côrinth and Alexandria (where he spent four years and was introduced to autopsy).

At the age of 27 he was appointed to the prestigious position of ‘Physician to the Gladiators’ at Pergamum. Here he gained vast experience in the management of trauma and further pursued his studies in anatomy and physiology. He is widely regarded as the ‘Father of Sport Medicine’.

With civil unrest in Pergamum he left for Rome in the year 161. He however returned to Pergamum in 169 ostensibly to avoid the professional jealousy of his peers but the truth was probably that he wanted to escape from the plague of Antonine (small pox) – which killed 2000 Romans a day at its peak and left a death toll of 5 million in the Roman Empire from 165 – 180.

The two Augusti, Lucius Verus and Marcus Aurelius, summoned Galen to Rome in 168 to attend to the outbreak of the plague among the troops at Aquileia. He reported in the brief treatise Methodus Medendi. Lucius Verus died of the plague in 169 (and Marcus Aurelius in 180).

When Marcus Aurelius marched against the Germanic tribes in 169 he summoned Galen to ride with him. Galen politely declined claiming higher allegiance to the god Asclepius. This was accepted with grace — and Galen became a successful conscientious objector. Marcus Aurelius, however, demanded in turn that Galen must attend to the health of his son Commodus. Galen did his job rather too well. By curing the deranged Commodus of an illness around 174 he allowed him to embark on a murderous spree some 10 years later.

Galen was vain, arrogant and intimidated everybody — the lay public, students, fellow physicians and elite public figures. He commonly exclaimed “Galen cannot be wrong”. He recognized that blood entered the kidney and urine left it, but refuted the idea of blood filtration in the kidney. He suggested that the kidneys ‘attract’ water and waste products from arterial blood. This concept was probably adopted from Erasistratus (310-250 BC) but it was not beyond Galen to label Erasistratus as’foolish’ in accordance with his custom towards predecessors and colleagues.

Galen brought together and reflected on all that he learnt from his teachers and discovered himself. He continued with research and wrote profusely about it. He trained himself in the solution of medical and philosophical problems. He had a thorough knowledge of the philosophers and developed a pluralistic sensibility in his study of their legacies. Galen was preoccupied by how doctors came to know what they do.

In his time there were 3 schools of thought :

Empiricists — who entirely relied on experience.

Rationalists — who depended on reason, from a prescribed theory of causation.

Methodists — who rejected both experience and causal theory. They put all illnesses down to a tension between the flow of bodily discharges and their constipation.

Galen considered opposing arguments, identified their flaws, erased erroneous logic and combined what remained into a practicable clinical method. He wanted to achieve his unique individuality — not to be a remote theorist nor merely a word doctor. He stated: “My practice of the art alone would suffice to indicate the level of my understanding.”

Galen’s treatise entitled The Best Doctor is also a Philosopher provides a rather surprising ethical reason for a doctor to study philosophy: “The profit motive is incompatible with the art of healing. The doctor must learn to despise money.” Galen frequently accused his colleagues of avarice — but — he is said to have collected a fee of 400 gold pieces, about fifteen times the going rate, for making a house call on the wife of the Roman consul Flavius Boethius. It is estimated that Galen accumulated 20 million sesterces — twice the amount collected by the poet Vergil.

The writings of Galen reflect his belief in only one God. He declared that the body is an instrument of the soul. He was not a Christian but his monotheism made him equally acceptable amongst the Abrahamic religions. Perhaps illustrated by a commemorative stamp issued by the People’s Republic of Yemen in 1977 to his memory. He also had a crater on the Moon (10 km in diameter) named after him — ‘joining’ amongst others Hippocrates (crater-diameter 60 km), Aristotle (87 km), Plato (109 km) — with Socrates the notable absentee.

Galen was physician to five Roman emporers.

He never married and had no known children. Galen advocated a longer healthful life by eating easily digested meats and taking moderate exercise. It is generally assumed that he died at 70 but he might have lived to be 87 to die around 216 during the reign of Caracalla. There is no evidence of any surviving statue, public benefaction or inscription commemorating his life.

Galen wrote profusely. Many of his works perished when the Temple of Peace, considered to be one of the three most beautiful buildings in Rome by Pliny, was gutted by fire in 191 — but a great many of Galen’s manuscripts have survived. His texts were primarily kept alive by the Arabs until they were retranslated in Europe in the Middle Ages.

The Galeni Opera Omnia of more than 20 000 pages in Greek and Latin gathered in 20 volumes was edited by Carl Gottlob Kühn and published in Leipzig between 1821 and 1833 It remains the definitive source of reference.

Ironically the analytical and probing curiosity of Galen transmuted into the rigid Galenism of the ensuing 1500 years — sicut asserit Galenus (thus does Galen declare).

When he was eventually challenged it was often with trepidation. When Andreas Vesalius (De Humani Corporis Fabrica – 1543) discovered an error in Galen’s description of the hip bone he reluctantly explained his departure from Galen by asserting that “man has changed shape by wearing tight pants”

Naas Viljoen