Galen

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Galen
Galenus.jpg
A 17th-century engraving by Georg P. Busch
Background information
Birthdate: 129 AD
Birth place: Pergamon, [Asia Minor
Date of death: Circa 216 AD (Age 87)
Death place: Unknown
field: Anatomy
Medicine
Philosophy


Aelius Galenus or Claudius Galenus (Greek: Κλαύδιος Γαληνός; September 129 – c. 216 AD), often anglicized as Galen or Galen of Pergamon, was a Roman and Greek physician, surgeon, and philosopher. Considered one of the most accomplished medical researchers of antiquity, Galen influenced the development of various scientific disciplines, including anatomy, physiology, pathology, pharmacology, and neurology, as well as philosophy and logic.

The son of Aelius Nicon, a wealthy Greek architect with scholarly interests, Galen received a comprehensive education that prepared him for a successful career as a physician and philosopher. Born in the ancient city of Pergamon (present-day Bergama, Turkey), Galen traveled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome, where he served prominent members of Roman society and was eventually appointed as the personal physician to several emperors.

Galen's grasp of anatomy and medicine was shaped mainly by the prevailing theory of the four humors- black bile, yellow bile, blood, and phlegm- first proposed by the author of On the Nature of Man from the Hippocratic corpus. For over 1,300 years, his views reigned over and shaped Western medical science. His anatomical findings were primarily derived from the dissection of Barbary apes. However, upon realizing that their facial expressions resembled those of humans too closely, he shifted his focus to other animals, such as pigs. Although Herophilus and Erasistratus conducted dissections and vivisections on humans in Alexandria during the 3rd century BCE with Ptolemaic approval, such practices were strictly prohibited in the Roman Empire by the time of Galen. Thus, he had to rely on the dissection and vivisection of animals, notably Barbary apes and pigs, echoing Aristotle's approach centuries earlier in studying anatomy and physiology. Like many of his contemporaries, Galen believed that animal anatomy closely mirrored that of humans. He encouraged his students to observe deceased gladiators or corpses washed up on shore to better familiarize themselves with human anatomy.

Galen's circulatory physiology theory was widely accepted until around 1242, when Ibn al-Nafis released his book, Sharh tashrih al-qanun li' Ibn Sina (Commentary on Anatomy in Avicenna's Canon). In this work, he highlighted his discovery of pulmonary circulation. His findings went unchallenged until 1543, when Andreas Vesalius published De humani corporis fabrica, containing printed descriptions and illustrations of human dissections that incorporated new observations into Galen's physiological framework.

Galen saw himself as both a physician and a philosopher, as he wrote in his treatise titled " That the Best Physician Is Also a Philosopher. " Galen was very interested in the debate between the rationalist and empiricist medical sects, and his use of direct observation, dissection, and vivisection represents a complex middle ground between the extremes of those two viewpoints. Many of his works have been preserved or translated from the original Greek, although many were destroyed, and some credited to him are believed to be spurious. Although there is some debate over the date of his death, he was at least seventy when he died.

Biography

Galen's Greek name, Γαληνός (Galēnós), is derived from the adjective γαληνός (galēnós), meaning "calm". His Latin name (Aelius or Claudius) suggests he held Roman citizenship.

Galen describes his early life in On the Affections of the Mind. He was born in September 129 AD. His father, Aelius Nicon, was a wealthy patrician, an architect and builder, with eclectic interests including philosophy, mathematics, logic, astronomy, agriculture, and literature. Galen describes his father as a "highly amiable, just, good and benevolent man. " At that time, Pergamon (modern-day Bergama, Turkey) was a major cultural and intellectual center, noted for its library, second only to that in Alexandria, as well as being the site of a large temple to the healing god Asclepius. The city attracted both Stoic and Platonic philosophers, to whom Galen was exposed at age 14. His studies also encompassed each of the principal philosophical systems of the time, including Aristotelian and Epicurean. His father had planned a traditional career for Galen in philosophy or politics and took care to expose him to literary and philosophical influences. However, Galen states that around 145, his father had a dream in which the god Asclepius appeared and commanded Nicon to send his son to study medicine.

Medical education

Following his earlier liberal education, Galen, at age 16, began his studies at the prestigious local healing temple or asclepeion as a θεραπευτής (therapeutes, or attendant) for four years. There, he came under the influence of individuals such as Aeschrion of Pergamon, Stratonicus, and Satyrus. Asclepiea functioned as spas or sanitoria where the sick would come to seek the ministrations of the priesthood. Romans frequented the temple at Pergamon in search of medical relief from illnesses and diseases. It was also a gathering place for notable figures such as the historian Claudius Charax, the orator Aelius Aristides, the sophist Polemo, and the consul Cuspius Rufinus.

Galen's father died in 148, leaving Galen independently wealthy at the age of 19. He then followed the advice he found in Hippocrates' teachings and traveled and studied widely, including destinations such as Smyrna (now İzmir), Corinth, Crete, Cilicia (now Çukurova), Cyprus, and finally the great medical school of Alexandria, exposing himself to various schools of thought in medicine. In 157, at the age of 28, he returned to Pergamon as the physician to the gladiators of the High Priest of Asia, one of the most influential and wealthy men in Asia. Galen claims that the High Priest chose him over other physicians after he eviscerated an ape and challenged them to repair the damage. When they refused, Galen performed the surgery himself, thereby winning the favor of the High Priest of Asia. Over his four years there, he learned the importance of diet, fitness, hygiene, and preventive measures, as well as living anatomy and the treatment of fractures and severe trauma, referring to their wounds as "windows into the body. " Only five deaths among the gladiators occurred while he held the position, compared to sixty during his predecessor's time, a result generally ascribed to the attention he paid to their wounds. At the same time, he pursued studies in theoretical medicine and philosophy.

Rome

In 162, Galen arrived in Rome and established himself as a physician. His public demonstrations and refusal to accept alternative medical views led to disputes with other physicians in the city. When Eudemus, a Peripatetic philosopher and his teacher, fell ill with quartan fever, Galen felt it necessary to treat him because they lived close to each other. He wrote: "I return to the case of Eudemus. He was thoroughly attacked by the three attacks of quartan ague, and the doctors had given him up, as it was now mid-winter." Some Roman physicians criticized Galen for relying on prognosis in his treatment of Eudemus, as this approach clashed with the prevailing standard of care rooted in divination and mysticism. In response to his critics, Galen defended his methods, stating, "In order to diagnose, one must observe and reason." This assertion formed the foundation of his critique against those physicians who operated without reason or investigation.

Eudemus warned Galen that challenging these doctors could lead to his murder. He noted, "Eudemus said this, and more to the same effect; he added that if they were not able to harm me by unscrupulous conduct they would proceed to attempts at poisoning. Among other things he told me that, some ten years before, a young man had come to the city and had given, like me practical demonstrations of the resources of our art; this young man was put to death by poison, together with two servants who accompanied him." As Galen's animosity toward the Roman physicians grew, he began to fear exile or poisoning, which drove him to leave the city.

Rome was engaged in foreign wars in 161; Marcus Aurelius and his then co-emperor and adoptive brother, Lucius Verus, were in the north fighting the Marcomanni. During the autumn of 169, as Roman troops returned to Aquileia, a great plague, most likely the first appearance of smallpox (then referred to as the Antonine Plague) in the Mediterranean world, broke out, prompting the emperor to summon Galen back to Rome. He was ordered to accompany Marcus and Verus to Germany as the court physician. The following spring, Marcus was persuaded to release Galen after receiving a report that Asclepius opposed the project. Galen was left behind to serve as physician to the imperial heir, Commodus. It was in court that Galen wrote extensively on medical subjects. Ironically, Lucius Verus died in 169, and Marcus Aurelius himself died in 180, both victims of the plague.

Galen served as the physician to Commodus for a significant part of the emperor's life, treating his common ailments. As noted by Dio Cassius around the year 189, a pestilence struck during Commodus' rule, peaking at 2,000 deaths daily in Rome. This epidemic was likely the same as the so-called ' Antonine Plague,' probably smallpox, that afflicted Rome during the time of Marcus Aurelius. Additionally, Galen served as physician for Septimius Severus during his rule in Rome. He praised both Severus and Caracalla for maintaining a supply of medicines for their associates and cited three instances where these provisions were beneficial in 198.

The Antonine Plague

The Antonine Plague, named after Marcus Aurelius' family name, Antoninus, was also referred to as the Plague of Galen, marking its significance in medical history due to its connection with Galen. He had direct experience with the disease, having been in Rome when it first appeared in 166, and again during an outbreak among troops in Aquileia in the winter of 168- 69. Galen described the epidemic as enduring and provided accounts of its symptoms and his treatment methods. However, his references to the plague are mostly brief and not intended as a detailed description for future recognition; instead, he focused on treatments and the disease's physical impacts. For instance, when discussing a young man suffering from the plague, he emphasized the management of both internal and external ulcers. According to Niebuhr, "this pestilence must have raged with incredible fury; it carried off innumerable victims. The ancient world never recovered from the blow inflicted upon it by the plague that visited it in the reign of M. Aurelius." The plague had a mortality rate of 7–10 percent, leading to an estimated 3.5 to 5 million deaths during the outbreak from 165 to 168. Otto Seeck posits that more than half the empire's population died as a result. At the same time, J. F. Gilliam suggests that the Antonine plague likely caused more fatalities than any other epidemic in the empire before the mid-3rd century. Although Galen's accounts are not exhaustive, they allow for a clear identification of the disease as related to smallpox.

Galen notes that the exanthema covered the victim's entire body and was typically black. The exanthem became rough and scabby in areas without ulceration. He states that those who were likely to survive developed a black exanthem. According to Galen, it was black due to remnants of blood that had putrefied in a pustule from a fever blister. His writings indicate that raised blisters were present during the Antonine plague, usually appearing as a blistering rash. Galen mentions that the skin rash resembled the one described by Thucydides. He details symptoms of the alimentary tract through a patient's diarrhea and stools. If the stool was very dark, the patient died. He notes that the quantity of black stools varied, depending on the severity of the intestinal lesions. He observes that in cases where the stool was not black, the black exanthema appeared. Galen describes symptoms of fever, vomiting, fetid breath, catarrh, cough, and ulceration of the larynx and trachea.

Later years

In his later years, Galen continued his scholarly work, completing treatises on drugs and remedies, as well as a comprehensive compendium of diagnostics and therapeutics. This work would significantly impact medical practices in both the Latin Middle Ages and Medieval Islam.

The 11th-century Suda lexicon states that Galen died at the age of 70, which would place his death in about the year 199. However, there is a reference in Galen's treatise "On Theriac to Piso" (which may, however, be spurious) to events of 204. There are also statements in Arabic sources that he died in Sicily at age 87, after 17 years studying medicine and 70 practicing it, which would mean he died about 216. According to these sources, the tomb of Galen in Palermo was still well-preserved in the tenth century. Nutton believes that "On Theriac to Piso" is genuine, that the Arabic sources are correct, and that the Suda has erroneously interpreted the 70 years of Galen's career in the Arabic tradition as referring to his whole lifespan. Boudon-Millot] more or less concurs and favors a date of 216.

Legacy

Late antiquity

A group of physicians is depicted in an image from the Vienna Dioscurides, with Galen positioned at the top center. In his time, Galen's reputation as both a physician and a philosopher was legendary. The emperor Marcus Aurelius described him as "Primum sane medicorum esse, philosophorum autem solum" (first among doctors and unique among philosophers Praen 14: 660). Other contemporary authors in the Greek world, including Theodotus the Shoemaker, Athenaeus, and Alexander of Aphrodisias, confirm this. The 7th-century poet George of Pisida went so far as to refer to Christ as a second and neglected Galen. Galen continued to exert a significant influence over the theory and practice of medicine until the mid-17th century in the Byzantine, Arabic, and European worlds. A few centuries after Galen, Palladius Iatrosophista stated in his commentary on Hippocrates that Hippocrates sowed and Galen reaped.

Galen summarized and integrated the work of those before him, and it is through his writings (Galenism) that Greek medicine was passed down through the ages, making Galenism the way Greek medicine was introduced to the world. This often involved restating and reinterpreting, exemplified by Magnus of Nisibis' 4th-century treatise on urine, which was later translated into Arabic. However, the true significance of Galen's contributions was not fully recognized until long after his death. His persuasive writing and extensive output gave the impression that there was little more left to discover. Consequently, the term Galenism has acquired both positive and negative connotations, representing a pivotal transformation in late antiquity medicine, yet it became so dominant that it hindered further advancement in the field.

After the collapse of the Western Empire, the study of Galen and other Greek works almost disappeared in the Latin West. In contrast, in the predominantly Greek-speaking eastern half of the Roman Empire (Byzantium), many commentators in the subsequent centuries, such as Oribasius, physician to the emperor Julian who compiled a Synopsis in the 4th century, preserved and disseminated Galen's works, making them more accessible. Nutton refers to these authors as the "medical refrigerators of antiquity". In late antiquity, medical writing increasingly veered toward the theoretical at the expense of the practical, with many authors merely debating Galenism. Magnus of Nisibis was a pure theorist, as were John of Alexandria and Agnellus of Ravenna, with their lectures on Galen's De Sectis. So strong was Galenism that other authors such as Hippocrates began to be seen through Galen's eyes, while his opponents became marginalized and other medical sects, such as Asclepiadism, slowly disappeared.

Greek medicine was integral to Greek culture, and Syrian Christians encountered it while the Eastern Roman Empire (Byzantium) governed Syria and western Mesopotamia, areas that were conquered by the Arabs in the 7th century. After 750, these Syrian Christians produced the first translations of Galen into Syriac and Arabic. Consequently, Galen and the broader Greek medical tradition became integrated into the medieval and early modern Islamic Middle East. Job of Edessa is said to have translated 36 of Galen's works into Syriac, some of which were later translated into Arabic by Hunain ibn Ishaq.

Medieval Islam

Galen's approach to medicine became and remains influential in the Islamic world. The first major translator of Galen into Arabic was the Arab Christian Hunayn ibn Ishaq. He translated (c. 830–870) 129 works of "Jalinos" into Arabic. Arabic sources, such as Muhammad ibn Zakarīya al-Rāzi (AD 865–925), continue to serve as a source for the discovery of new or relatively inaccessible Galenic writings. One of Hunayn's Arabic translations, Kitab ila Aglooqan fi Shifa al Amrad, which is extant in the Library of Ibn Sina Academy of Medieval Medicine & Sciences, is regarded as a masterpiece of Galen's literary works. A part of the Alexandrian compendium of Galen's work, this 10th-century manuscript comprises two sections that include details regarding various types of fevers (Humyat) and different inflammatory conditions of the body. More importantly, it includes descriptions of more than 150 single and compound formulations of both herbal and animal origin. The book provides insight into the traditions and methods of treatment in the Greek and Roman eras. In addition, this book serves as a direct source for the study of more than 150 single and compound drugs used during the Greco-Roman period.

As the title of "Doubts on Galen" by al-Rāzi implies, as well as the writings of physicians such as Ibn Zuhr and Ibn al-Nafis, the works of Galen were not accepted unquestioningly but were seen as a challengeable basis for further inquiry. A strong emphasis on experimentation and empiricism led to new results and observations, which were contrasted and combined with those of Galen by writers such as al-Rāzi, Ali ibn Abbas al-Majusi, Abu al-Qasim al-Zahrawi, Ibn Sina (Avicenna), Ibn Zuhr, and Ibn al-Nafis. For example, Ibn al-Nafis' discovery of the pulmonary circulation contradicted the Galenic theory on the heart.

Galen's writings, particularly his humorism, significantly influence contemporary Unani medicine, which is closely linked to Islamic culture and practiced widely from India, where it enjoys official recognition, to Morocco. Maimonides found inspiration in Galen, frequently referencing him in his medical texts and regarding him as the greatest physician ever. In India, numerous Hindu physicians studied Persian and Urdu and adopted Galenic medicine. This educational trend among Hindu physicians started in the 17th century and continued until the early 20th century (Speziale 2018).

Middle Ages

Starting in the 11th century, Latin translations of Islamic medical texts emerged in the West, accompanied by the Salerno school of thought, and were quickly integrated into the curricula of the universities of Naples and Montpellier. During this time, Galenism gained an unprecedented level of authority, with Galen even being dubbed the "Medical Pope of the Middle Ages. " Constantine the African was among those who translated works of Hippocrates and Galen from Arabic. In addition to the numerous Arabic translations from this era, a handful of Galenic texts were translated directly from Greek, such as Burgundio of Pisa's rendition of De complexionibus. Galen's contributions to anatomy and medicine became central to the curricula of medieval physicians, alongside Ibn Sina's The Canon of Medicine, which expanded upon Galen's ideas. Unlike pagan Rome, Christian Europe did not impose a universal ban on the dissection and autopsy of human bodies, and such procedures were regularly conducted from at least the 13th century. However, Galen's overwhelming impact meant that when dissections revealed discrepancies with Galenic anatomy, physicians often sought to reconcile these findings with his theories. For instance, Mondino de Liuzzi discussed basic blood circulation in his writings but still maintained that the left ventricle should contain air. Some interpreted these discrepancies as evidence that human anatomy had evolved since Galen's time.

The key translator of Galen's works into Latin was Niccolò di Deoprepio da Reggio, who dedicated several years to this task. He worked at the Angevin Court during King Robert of Naples' reign. One of Niccolò's notable translations is from a medical treatise by Galen, the original text of which has been lost.

Renaissance

The first edition of Galen's complete works in Latin translation was edited by Diomede Bonardo of Brescia and printed at Venice by Filippo Pinzi in 1490.

The fall of the Byzantine Empire in 1453 coincided with a surge of Greek scholars and manuscripts moving to the West. This shift enabled a direct comparison between the Arabic commentaries and the original Greek texts of Galen. This New Learning, along with the Humanist movement- especially through Linacre's contributions- helped integrate literae humaniores, which included Galen, into the Latin scientific canon with works like De Naturalibus Facultatibus published in London in 1523. Consequently, debates in medical science were framed by two traditions: the more conservative Arabian and the innovative Greek. Extreme liberal factions began to contest authority in medicine, notably represented by Paracelsus who dramatically burned the works of Avicenna and Galen at his medical school in Basel. Nevertheless, Galen continued to be regarded as a leading thinker of the millennium, as illustrated by a 16th-century mural in the Great Lavra of Mt Athos' refectory. The mural shows pagan sages at the base of the Tree of Jesse, featuring Galen positioned between the Sibyl and Aristotle.

Galenism' s final defeat resulted from a combination of the negativism of Paracelsus and the constructivism of Italian Renaissance anatomists, such as Vesalius in the 16 th century. In the 1530 s, the Flemish anatomist and physician Andreas Vesalius undertook a project to translate many of Galen' s Greek texts into Latin. Vesalius' most famous work, De humani corporis fabrica, was greatly influenced by Galenic writing and form. Seeking to critically examine Galen' s methods and outlook, Vesalius turned to human cadaver dissection as a means of verification. Vesalius demonstrated that Galen' s writings described details found in monkeys but not in humans, illustrating Galen' s limitations through books and hands- on demonstrations despite fierce opposition from orthodox pro- Galenists like Jacobus Sylvius. Since Galen states that he is using observations of monkeys (human dissection was prohibited) to describe the body' s appearance, Vesalius could present himself as employing Galen' s method of direct observation to create a precise record of the human body' s details, as he worked during a time when human dissection was permitted. Galen argued that monkey anatomy was sufficiently similar to human anatomy for physicians to learn through monkey dissections and then observe analogous structures in their patients' wounds, rather than learning anatomy solely from wounds in human patients, as would be the case for students trained in the Empiricist model. The examinations of Vesalius also disproved the medical theories of Aristotle and Mondino de Liuzzi. One of the best- known examples of Vesalius overturning Galenism was his demonstration that the interventricular septum of the heart was not permeable, contrary to Galen' s teachings (Nat Fac III xv). However, this had been revealed two years earlier by Michael Servetus in his fateful "Christianismi restitutio" (1553), with only three surviving copies of the book, which remained hidden for decades; the others were burned shortly after its publication due to the persecution of Servetus by religious authorities.

During his time in France, Michael Servetus, known as "Michel de Villeneuve, " was a student of Vesalius and distinguished himself as the leading Galenist at the University of Paris, as noted by Johann Winter von Andernach, who was their instructor. In the Renaissance's Galenism, the Opera Omnia editions of Galen were crucial, with the Aldine Press' first edition published in Venice in 1525. This was succeeded by the Giunta edition in Venice from 1541 to 1542. Between this time and 1625, there were fourteen editions released. Only one edition came from Lyon between 1548 and 1551. This Lyon edition features commentaries on respiration and blood circulation that correct earlier works by esteemed authors like Vesalius, Caius, and Janus Cornarius. "Michel De Villeneuve" had contracts with Jean Frellon for this work. The researcher Francisco Javier González Echeverría established that Michael De Villeneuve (Michael Servetus) authored the commentaries in Frellon's Lyon edition, and this research was accepted by the International Society for the History of Medicine.

Another compelling instance of advancing knowledge beyond Galen's contributions is illustrated by the insights into human circulation and the pioneering work of Andrea Cesalpino, Fabricio of Acquapendente, and William Harvey. Nevertheless, certain aspects of Galenic teachings, particularly his advocacy for bloodletting as a cure for various diseases, continued to hold sway well into the 19th century.

Contemporary scholarship

Galenic scholarship is a dynamic and thriving discipline, with enthusiasm for Galen's writings enhanced by the German encyclopedia Realencyclopädie der Classischen Altertumswissenschaft.

The National Library of Medicine in Bethesda, Maryland, houses copies of his works translated by Robert M. Green.

In 2018, researchers at the University of Basel, Switzerland, found a Greek papyrus featuring mirror writing on both sides. This artifact, belonging to Basilius Amerbach, a 16th-century professor of jurisprudence, is believed to be an unidentified medical document by Galen or a commentary on his work. The text discusses the condition known as "hysterical apnea. "

External links

More information is available at [ Wikipedia:Galen ]


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