Galen 129–199

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Galen
129–199

Galen, the most prolific ancient writer on medicine, studied at Pergamum, Smyrna, Corinth, and Alexandria. He first practiced in Smyrna as a physician to gladiators and later went to Rome, where he gave public lectures on medicine. He left Rome after four years and returned to Pergamum but soon became physician to Commodus, the son of the emperor Marcus Aurelius, and traveled in imperial circles for much of the rest of his life.

GALEN'S WORKS

Galen was a prolific author who never quit writing or dictating. It is estimated that he wrote about four hundred works, although many of them have been lost. Remaining in Latin are eighty-three books that can be attributed to him, nineteen of doubtful attribution, and fifteen commentaries on Hippocratic texts. Many other texts have survived in Arabic translations. Nevertheless, much of Galen's work has been lost, though many of the treatises attributed to Galen were not written by him and some of those works appeared during his lifetime. He was a brilliant diagnostician but was not particularly good at prognosis. He wrote not only on medicine but also on philosophy and on philology and grammar.

The enormous range of Galen's works made him the dominant medical figure in late antiquity and in the medieval period. He wrote in Greek, but translations into Latin were made during his lifetime. His works were also was translated into Syriac and Arabic. An open challenge to many of his ideas took place in the fifteenth and sixteenth centuries, when his anatomy was shown to be erroneous, along with much of his physiology, which held that the liver is the starting point of blood.

THEORY OF DISEASE AND TREATMENT

Galen distinguished two fundamental kinds of diseases. The first category was diseases that are simple or elementary, such as inflammation and abnormal composition of the blood considered in relation to the tissues involved. The second type was organic disease, that is, conditions classified according to diseases of different organs and susceptible to changes in position, intensity, and duration. Some of the errors Galen made, such as his support of the theory that the right kind of pus is essential to healing, were accepted until the nineteenth century. He also believed in contraria contrariis, or the treatment of opposites; for example, heat should be applied to diseases caused by cold and vice versa. His medicine was founded on a localistic pathology rather than a general one, and his treatments were analytic and were systematized in rigid forms. His ideas on treatment are based more on a theory of structure and form (morphology) and biological syntheses than on detailed case studies. As a result his theory of medicine is filled with hypotheses. He had a somewhat inflated view of himself, claiming that he did as much for medicine as the emperor Trajan had done for the Roman Empire and that he alone had pointed out the true method of treating diseases.

GALEN ON SEX AND GENDER

In dealing with issues of sex and gender, Galen, following Hippocrates, believed in the bicornate uterus (with two hornlike projections), holding that male babies are formed on the right side and females on the left side. This meant that males are superior and females are inferior. He also subscribed to the two-seed doctrine, holding that although both the male and female seeds have coagulative power and receptive capacity for coagulation, one is stronger in the male and the other in the female. Like Aristotle, he thought that the semen supplies the form, whereas the female supplies the substance (i.e., menstrual blood) needed for the growth of the embryo. The male is the active force, whereas the female is passive, merely supplying material for the semen to work on.

Galen taught that the womb wishes to be pregnant and that problems will result if a woman is not regularly pregnant. This is the case because women have a secretion similar to male semen that is produced in the uterus, and retention of this substance leads to the spoiling and corruption of the blood, which in turn leads to a cooling of the body and eventually to an irritation of the nerves, producing hysteria. Galen felt the solution for women who were unable to conceive or have regular intercourse was masturbation. To do this, a woman was advised to apply warm substances to her pudenda and then use digital manipulation:

Following the warmth of the remedies and arising from the touch of the genital organs required by the treatment there followed twitching accompanied at the same time by pain and pleasure after which she emitted turbid and abundant sperm. Thus it seem to me that the retention of sperm impregnated with evil essences had—in causing damage throughout the body—a much greater power than that of the retention of the menses.
(Cresbron 1909, p. 44)

Galen also recognized that a similar danger existed in males and that the retention of sperm had a much more noxious influence on the male than did the retention of the menses on the female. However, he did not mention male masturbation as a solution, probably because he believed there was no need to do so as it was practiced so widely.

GALEN IN THE TWENTY-FIRST CENTURY

Many of the treatments Galen advocated have been abandoned. Still, he had great influence on the development of medicine. Currently the only complete edition of Galen's work is a Greek text with a Latin translation (Kühn 1964–1965). There is no complete translation of the works in a modern language, although some individual works have been translated into English and other languages (Nutton 1979). Despite his often erroneous assumptions, for many generations Galen was regarded as all-knowing. His position in medicine is similar to that of Aristotle in philosophy.