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hist2613.week03.galen_influence_1.ppt

The Great Classical Era Physician: Galen and His Legacy

The Roman World

Galen

Roman Medicine

Roman Surgery

Layout of Roman Bath

Respected the Greeks for their culture (philosophy, literature, art), but generally distrusted Greek doctors—instead placed emphasis on public health.
Other issues are important to note: 1) that the Romans did believe that they had a duty to bring civilization to the world; 2) need to safeguard the health of their army; 3) in therapeutics: diet over drugs, drugs over surgery; and 4) Galen’s legacy.
Anatomy: Galen did dissect some bodies in Alexandria, but most of his work was done on animals in Rome—led to errors.
Physiology: Galen showed that the body was controlled by nerves coming from the brain, and that the bladder produced urine.
Cause of illness: a) Supernatural causes (the gods); b) Ideas concerning ‘germs’ or ‘tiny creatures’ that lived in swamps, but no follow-up; c) Galen accepted and developed ideas of the four humours.
Cures: a) Supernatural (pray to gods, visit Asclepion temples); b) herbal remedies; c) Quacks in local markets and towns
Physicians: Galen the most famous, but generally mistrusted and most were market quacks or retired soldiers. No formal training required.
Surgery: Advanced by treatment of war and gladiatorial injuries. Hospitals built for soldiers.
Preventative medicine: Hygiene was key (baths, fountains, sewers) and tied to urban development.

Life of Claudius Galen

Galen was born in the Hellenistic city of Pergamon in Asia Minor (modern-day Turkey) in 129 AD. Tutored by his father Nicon, a wealthy architect, in Greek traditions of arithmetic, geometry, literature and philosophy, Galen began a decade of medical schooling at age 18 after his father had a dream involving Asclepius, went to Egypt in order to study anatomy, drugs (from India and Africa) and the dissection of animals. At the age of 28, Galen obtained post of physician for his city’s gladiators, and six years later left for Rome to become a court physician. Ultimately, he was appointed (due to skill and self-promotion) to be the personal physician to emperor’s son Commodus, and then the emperor himself, Caesar Marcus Aurelius.
He was devoted to his work (no wife or children), and spent his time lecturing, working in private practice, and writing around 350 papers on medical and scientific topics. More of his works survive than for any other ancient writer.

Early Modern Woodcut Illustration of Galen (16th Century Text)

Roman Era Bust of Galen (129-216 AD)

Galen’s Writings and Legacy

Galen in the Library of Hippocrates, 1550 Woodcut

Medieval Illumination of Galen’s Four Humours

Human body was governed by natural laws. Once he believed that he had identified the basic structure and functions of the body their was no need for further experimentation (by anyone).
Introduced physicians to the anatomical concept of disease—the basic principle being that disease can be properly treated by understanding both anatomy and physiology (hence his work with both dissection and experimentation). Most of his observations of how the body worked were correct, but many of his conclusions were false—led to stagnation and stasis in Western medicine for almost 1500 years!
Things that Galen got correct: much on the cranial nerves, distinguished between motor and sensory nerves; descriptions of diseases; and that tuberculosis was contagious, and that hydrophobia (rabies) could be linked to dog bites.
Writings on Fevers: fevers might result from an excess of yellow bile, black bile or phlegm, or from an excess of blood. Surplus humours accumulate in a bodily part where they would cause putrefaction and excessive heat or fever. To remove surplus and restore humoral balance, he advocated energetic blood-letting (not only when obviously ill), with amount of bleeding determined by age, season, weather and location.