Galen : Part 3

Outlines of Greek and Roman Medicine
by James Sands Elliott

(Page 11 of 15)

V. - On Pharmacy, Materia Medica, and Therapeutics

In these subjects Galen was not as proficient as Dioscorides, whose teaching he adopted with that of other medical authors. In Galen's works there are lengthy lists of compound medicines, several medicines being recommended for the same disease, and never with very marked confidence. He paid high prices for various nostrums, and, sad to relate, placed great faith in amulets, belief in which was general in his time, and nowhere held more strongly than in superstitious Rome. Medicines were classified by him according to their qualities, by which he meant, not their therapeutic effects, but their inherent dryness or moistness, coldness or heat. A medicine might be cold in the first degree, and not in the second degree. Paulus Ægineta followed this strange and foolish doctrine of Galen very closely, as the following extracts from his book on Materia Medica will show: -

"Cistus (rock-rose). - It is an astringent shrub of gently cooling powers. Its leaves and shoots are so desiccative as to agglutinate wounds; but the flowers are of a more drying nature, being about the second degree; and hence, when drunk, they cure dysenteries and all kinds of fluxes."

"Ferrum (iron). - When frequently extinguished in water, it imparts a considerable desiccative power to it. When drunk, therefore, it agrees with affections of the spleen."

Many features, however, of Galen's teaching and practice of therapeutics are worthy of praise. He enunciated two fundamental principles: (1) That disease is something contrary to Nature, and is to be overcome by that which is contrary "to the disease itself"; and (2) that Nature is to be preserved by what has relation with Nature. He recognized that while the invading disease was to be repelled, the strength and constitution of the patient should be preserved, and that in all cases the cause of the disease was to be treated and not the symptoms. Strong remedies should not be used on weak patients.

VI. - Surgery

Galen conformed to the custom of the physicians in Rome, and did not practise surgery to any extent, although he used the lancet in phlebotomy, and defended this practice against the followers of Erasistratus in Rome. He is said to have resected a portion of the sternum for caries, and also to have ligatured the temporal artery.

VII. - Gynæcology

Galen had little more than a superficial knowledge of this subject, and was quite ignorant of the surgery of diseases of women. He was not so well informed as Soranus was as to the anatomy of the uterus and its appendages, but deserves credit for having been better acquainted with the anatomy of the Fallopian tubes than his predecessors. He had erroneous views on the causation of displacements of the uterus. Several of the books inaccurately attributed to the authorship of Galen deal with the medical treatment of various minor ailments of women.

Galen was a man of wide culture, and one of his essays is written for the purpose of urging physicians to become acquainted with other branches of knowledge besides medicine. As a philosopher he has been quoted in company with Plato and Aristotle, and his philosophical writings were greatly used by Arabic authors. In philosophy, as in medicine, he had studied the teachings of the various schools of thought, and did not bind himself to any sect in particular. He disagreed with the Sceptics in their belief that no such thing as certainty was attainable, and it was his custom in cases of extreme difficulty to suspend his judgment; for instance, in reference to the nature of the soul, he wrote that he had not been able to come to a definite opinion.

Galen mentions the discreditable conduct of physicians at consultations. Sometimes several doctors would hold a consultation, and, apparently forgetting the patient for the time, would hold violent disputations. Their main object was to display their dialectical skill, and their arguments sometimes led to blows. These discreditable exhibitions were rather frequent in Rome in his time.

With Galen, as with Hippocrates, it is sometimes impossible to tell what works are genuine, and what are spurious. He seemed to think that he was the successor of Hippocrates, and wrote: "No one before me has given the true method of treating disease: Hippocrates, I confess, has heretofore shown the path, but as he was the first to enter it, he was not able to go as far as he wished.... He has not made all the necessary distinctions, and is often obscure, as is usually the case with ancients when they attempt to be concise. He says very little of complicated diseases; in a word, he has only sketched what another was to complete; he has opened the path, but has left it for a successor to enlarge and make it plain." Galen strictly followed Hippocrates in the latter's humoral theory of pathology, and also in therapeutics to a great extent.

It is a speculation of much interest how it was that Galen's views on Medicine received universal acceptance, and made him the dictator in this realm of knowledge for ages after his death. He was not precisely a genius, though a very remarkable man, and he established no sect of his own. The reason of his power lay in the fact that his writings supplied an encyclopædic knowledge of the medical art down to his own time, with commentaries and additions of his own, written with great assurance and conveying an impression of finality, for he asserted that he had finished what Hippocrates had begun. The world was tired of political and philosophical strife, and waiting for authority. The wars of Rome had resulted in placing political power in the hands of one man, the Emperor; the disputations and bickerings of philosophers and physicians produced a similar result, and Galen, in the medical world was invested with the purple.

The effect, therefore, of Galen's writings was, at first, to add to and consolidate medical knowledge, but his influence soon became an obstacle to progress. Even in the sixteenth and seventeenth centuries, Galenism held almost undisputed sway.

The house of Galen stood opposite the Temple of Romulus in the Roman Forum. This temple, in A.D. 530, was consecrated by Pope Felix IV to the honour of the saints, Cosma and Damiano, two Arabian anargyri (unpaid physicians) who suffered martyrdom under Diocletian.

The date of Galen's death is not exactly known, but was probably A.D. 200.

Published in 1971 by Milford House Inc. Boston, MA.