No other ﬁgure in the history of medicine has inﬂuenced concepts of anatomy, physiology, therapeutics, and philosophy as much as Galen, the physician known as the Medical Pope of the Middle Ages and the mentor of Renaissance anatomists and physiologists. Galen left vo- luminous writings that touch on all the major medical, scientiﬁc, philo- sophical, and religious issues of his time. Contemporary admirers, including his patron the emperor Marcus Aurelius, called him the ‘‘First of Physicians and Philosophers.’’ His critics preferred titles like ‘‘mule head’’ and called him a vain, arrogant ‘‘windbag.’’ In attempting to sum up his work and thought, scholars have said that, as a physician, Galen was essentially a Hippocratic, but as a philosopher, he was generally an Aristotelian.
Galen was born in Pergamum, a city in Asia Minor that claimed to be the cultural equal of Alexandria. When describing himself, Galen asserted that he had emulated the excellent character of his father, Aelius Nikon, a wealthy architect, known for his amiable and benevo- lent nature. Although he tried to dissociate himself from the example set by his mother, a bad-tempered woman, perpetually shouting at his father, provoking quarrels, and biting the servants, these efforts may not have been completely successful. By the time he was 14, Galen had mastered mathematics and philosophy. About two years later, Asclepius came to Nikon in a dream and told him that his son was des- tined to become a physician. While still a student of medicine at the famous sanctuary of Asclepius in Pergamum, Galen composed at least three books. Later, in his advice to medical students and teachers, Galen emphasized the importance of fostering a love of truth in the young that would inspire them to work day and night to learn all that had been written by the Ancients and to ﬁnd ways of testing and proving such knowledge.
After the death of Nikon, Galen left Pergamum to continue his medical education in Smyrna, Corinth, and Alexandria. On returning to Pergamum after years of study and travel, Galen was appointed physician to the gladiators. Although he also worked at the Temple of Asclepius and established a ﬂourishing private practice, within a few years, he became restless again. In 161, he arrived in Rome where through good fortune, brilliant diagnoses, and miraculous cures he soon attracted many
Galen, contemplating a human skeleton.
inﬂuential patients, patrons, and admirers. During this period, Galen engaged in public anatomical lectures, demonstrations, and disputes, and composed some of his major anatomical and physiological texts. Five years later, Galen returned to Pergamum, claiming that the hostility of other physicians had driven him from Rome. His critics noted that his abrupt departure coincided with the outbreak of an epidemic that had entered the city along with soldiers returning from the Parthian War. Not long afterwards, honoring a request from Emperor Marcus Aurelius, Galen returned to Rome and settled there permanently. Although strictly speaking, Galen was not a ‘‘court physician,’’ he did enjoy the friendship
and protection of the emperors Marcus Aurelius, Commodus, Septimius
Severus, and other prominent ﬁgures.
Late in life, troubled by evidence that careless copyists, shameless impostors, and plagiarists were corrupting his writings, Galen com- posed a guide for the cautious reader called On His Own Books, which described the genuine works of Galen, as well as a reading program for physicians. Works for beginners were necessary, Galen complained, because many students lacked a good, classical education and most
‘‘physicians’’ were pretenders who could barely read. Galen’s medical, philosophical, and philological writings discussed almost every aspect of medical theory and practice of Greek and Roman times, as well as his own studies of anatomy, physiology, dietetics, and therapeutics. Unfortunately, a ﬁre in the Temple of Peace in 191 destroyed many of his manuscripts. Nevertheless, his surviving works ﬁll about twenty volumes in Greek. Some of his works survived in Arabic and medieval Latin editions.
Galen taught that the best physician was also a philosopher.
Therefore, the true physician must master the three branches of philo- sophy: logic, the science of how to think; physics, the science of nature; and ethics, the science of what to do. With such knowledge, the physi- cian could gain his patient’s obedience and the admiration due to a god. Ideally, the physician would practice medicine for the love of mankind, not for proﬁt, because the pursuit of science and money were mutually exclusive. In his writings, Galen portrayed himself as a scholar who re- alized that it was impossible to discover all that he passionately wished to know despite his persistent search for truth.
The essential features of Galen’s system are a view of nature as purposeful and craftsman-like and the principle of balance among the four qualities and the four humors. For Galen, anatomical research was the source of a ‘‘perfect theology’’ when approached as the study of form and function in terms of the ‘‘usefulness’’ of the parts. Instead of sacriﬁcing bulls and incense, the anatomist demonstrated reverence for the Creator by discovering his wisdom, power, and goodness through anatomical investigations. The dissection of any animal revealed a little universe fashioned by the wisdom and skill of the Creator. Assuming that nature acts with perfect wisdom and does nothing in vain, Galen argued that every structure was crafted for its proper function.