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proponent of the importance of anatomical study and of treating every patient as an individual


Claudius Galen was born about 129 in Pergamum, Asia Minor (present-day Turkey). His father, Nicon, was a prominent and wealthy architect, which gave Galen the ability to gain an excellent and varied education. Although his father expected Galen to focus on philosophy and/or politics, Galen found himself drawn to the study of medicine instead, quite possibly because Pergamum was then the site of a major temple to Asclepius, the Roman god of healing. A substantial inheritance from his father allowed him to study in Smyrna, Corinth, Alexandria, and other major centers of learning. In addition to medicine, he also studied philosophy from at least four different schools of thought.

About 157, Galen was appointed physician to gladiators in his hometown. His skill as a physician grew, and by 162 he was ready to make the move to Rome, where he knew better opportunities awaited. Around 168 he became personal physician to Emperor Marcus Aurelius, and to the emperor's son, Commodus. Except for occasional journeys undertaken for research purposes, Galen remained in Rome until his death, which came sometime around 216.

His Medical Philosophy and Teachings

Galen is believed to have authored more than 300 works on medicine, philosophy, and philology, but very few of those writings have survived. Fortunately, however, those that do survive give a very good picture of what Galen did, what he believed, and what he taught others.

Like Aristotle, Galen believed the body is composed of a balance of four elements -- fire, earth, water, and air -- and that each of those elements is manifested in the body as yellow bile, black bile, water, and phlegm, respectively. He further believed that all diseases are manifestations of an imbalance in those elements, and that all cures must be based on correcting that imbalance.

Galen "broke" the human body into three distinct systems -- brain and nerves, heart and arteries, and liver and veins. According to Galen, each system is represented by a form of pneuma, an air-like substance considered essential to all life -- the brain, the organ responsible for sensation and thought, is represented by pneuma physicon (animal spirit); pneuma zoticon (vital spirit) is present in the heart and represents life energy; and pneuma physicon (natural spirit) is in the liver and veins, which are involved with nutrition and growth.

Although neither of the above beliefs were unique to Galen, how he used those beliefs to treat his patients was indeed unique. Since, according to Galen, a disease-causing imbalance of the elements could be located within a specific organ or organ system, it was possible to treat that disease with much more accuracy, since the physician need only treat the affected organ rather than the entire body. Like many of his contemporaries, Galen generally followed the theory of treating with contraries -- that is, providing or removing opposing elements to correct the specific imbalance from which the patient was suffering.

What made Galen's work much more unique, however, was that he "preached" the importance of anatomical knowledge to any practice of medicine. Since diseases are manifestations of some kind of impaired anatomical functioning, no physician could diagnose or treat a disease without a fundamental understanding of human structure. Unfortunately, social and religious restrictions of his day prevented Galen from dissecting humans, so most of his anatomical experiments were conducted on animals. This means that while many of his basic assumptions have been proven correct, just as many of his specific conclusions have since been proven wrong. Nevertheless, his method of using anatomical study to further medical study remains a mainstay of today's medical science.

Galen made many important discoveries regarding the movement of blood in the body, including the differences between veins and arteries, as well as the anatomy of the heart and its associated vasculature. Although he correctly surmised that arteries carry blood from the heart to the rest of the body, while veins carry the blood back to the heart, he was never quite able to connect the movement of the blood with the pumping of the heart itself. He also incorrectly surmised that food from the stomach is digested and taken to the liver, where it is transformed into blood. He was, however, the first physician to use the pulse as an indicator of illness when compared to the normal pulse.

Galen also did extensive studies of the brain and spinal cord. In one series of experiments he demonstrated the functions of various nerves by tying off a specific nerve in order to observe which specific function was interrupted. Other areas of anatomical study included the eyes, tongue, reproductive organs (especially female), and kidneys.

Galen also did much to improve the science and use of drugs in the treatment of disease. He classified each drug according to its specific properties -- heating, cooling, drying, or moistening -- and also established different degrees of potency to each drug. This classification system meant that he could prescribe a specific drug to treat a specific condition, and in a specific dosage according to the severity of that condition.

Galen's beliefs and methods were gradually adopted by much of the "civilized world" during his lifetime. The details included in most of his writings made the study of medicine possible for almost anyone who could read and possessed a basic knowledge of anatomy. And, since Galen's writings apparently included everything necessary to prove his various theories, they would go unchallenged for over 1,000 years after his death. It wasn't until the Renaissance era that scientists began to conduct their own anatomical experiments, on humans rather than other animals, and only then did many of Galen's assumptions begin to be disproven.

While many of Galen's theories regarding human anatomy have long since been disproven, he remains an important figure in the history of medicine. His absolute devotion to the idea that a physician must first understand his patient before he can treat him and that each patient must be treated as an individual set him apart from most of his contemporaries, and are ideas that continue to be employed by physicians today.

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The Robinson Library >> Medicine >> History of Medicine

This page was last updated on 02/05/2019.