Chapter IV Galen
I. The Man and His Times
Recent ignorance of Galen—His voluminous works—The manuscript tradition of his works—His vivid personality—Birth and parentage—Education in philosophy and medicine—First visit to Rome—Relations with the emperors; later life—His unfavorable picture of the learned world—Corruption of the medical profession—Lack of real search for truth—Poor doctors and medical students—Medical discovery in his time—The drug trade—The imperial stores—Galen’s private supply of drugs—Mediterranean commerce—Frauds of dealers in wild beasts—Galen’s ideal of anonymity—The ancient book trade—Falsification and mistakes in manuscripts—Galen as a historical source—Ancient slavery—Social life; food and wine—Allusions to Judaism and Christianity—Galen’s monotheism—Christian readers of Galen.
II. His Medicine and Experimental Science
Four elements and four qualities—His criticism of atomism—Application of the theory of four qualities in medicine—His therapeutics obsolete—Some of his medical notions—Two of his cases—His power of rapid observation and inference—His happy guesses—Tendency toward scientific measurement—Psychological tests with the pulse—Galen’s anatomy and physiology—Experiments in dissection—Did he ever dissect human bodies?—Dissection of animals—Surgical operations—Galen’s argument from design—Queries concerning the soul—No supernatural force in medicine—Galen’s experimental instinct—His attitude toward authorities—Adverse criticism of past writers—His estimate of Dioscorides—Galen’s dogmatism; logic and experience—His account of the Empirics—How the Empirics might have criticized Galen—Galen’s standard of reason and experience—Simples knowable only through experience—Experience and food science—Experience and compounds—Suggestions of experimental method—Difficulty of medical experiment—Empirical remedies—Galen’s influence upon medieval experiment—His more general medieval influence.
III. His Attitude Toward Magic
Accusations of magic against Galen—His charges of magic against others—Charms and wonder-workers—Animal substances inadmissible in medicine—Nastiness of ancient medicine—Parts of animals—Some scepticism—Doctrine of occult virtue—Virtue of the flesh of vipers—Theriac—Magical compounds—Amulets—Incantations and characters—Belief in magic dies hard—On Easily Procurable Remedies—Specimens of its superstitious contents—External signs of the temperaments of internal organs—Marvelous statements repeated by Maimonides—Dreams—Absence of astrology in most of Galen’s medicine—The Prognostication of Disease by Astrology—Critical days—On the History of Philosophy—Divination and demons—Celestial bodies.
ἀλλ’ εἴ τις καταγνῷ μου τόδε, ὁμολογῶ τὸ πάθος τοὐμὸν ὃ παρ’ ὅλον ἐμαυτοῦ τὸν βίον ἔπαθον, οὐδενὶ πιστεύσας τῶν διηγουμένων τὰ τοιαῦτα, πρὶν πειραθῆναι καὶ αὐτὸς ὧν δυνατὸν ἦν εἰς πεῖραν ἐλθεῖν με.
Kühn, IV, 513.
διὸ κᾂν μετ’ ἐμέ τις ὁμοίως ἐμοὶ φιλόπονός τε καὶ ξηλωτικὸς ἀληθείας γένηται, μὴ προπετῶς ἐκ δυοῖν ἢ τριῶν χρήσεων ἀποφαινέσθω. πολλάκις γὰρ αὐτῷ φανεῖται διὰ τῆς μακρᾶς πείρας ὥσπερ ἐφάνη κᾀμοὶ...
Kühn, XIII, 96-1.
χρὴ γὰρ τὸν μέλλοντα γνώσεσθαί τι τῶν πολλῶν ἄμεινον εὐθὺς μὲν καὶ τῇ φύσει καὶ τῇ πρώτῃ διδασκαλίᾳ πολὺ τῶν ἄλλων διενεγκεῖν ἐπειδὰν δὲ γένηται μειράκιον ἀληθείας τινὸς ἔχειν ἐρωτικὴν μανίαν ὥσπερ ἐνθουσιῶντα, καὶ μήθ’ ἡμέρας μήτε νυκτὸς διαλείπειν σπεύδοντά τε καὶ συντεταμένον ἐκμαθεῖν, ὅσα τοῖς ἐνδοξοτάτοις εἴρηται τῶν παλαιῶν· ἐπειδὰν δ’ ἐκμάθη, κρίνειν αὐτὰ καὶ βασανίζειν χρόνῳ παμπόλλῳ καὶ σκοπεῖν πόσα μὲν ὁμολογεῖ τοῖς ἐναργῶς φαινομένοις πόσα δὲ διαφέρεται καὶ οὕτως τὰ μὲν αἱρεῖσθαι τὰ δ’ ἀποστρέφεσθαι.
Κϋhν, II, 179.
“But if anyone charges me therewith, I confess my disease from which I have suffered all my life long, to trust none of those who make such statements until I have tested them for myself in so far as it has been possible for me to put them to the test.”
“So if anyone after me becomes like me fond of work and zealous for truth, let him not conclude hastily from two or three cases. For often he will be enlightened through long experience, just as I have been.” (It is remarkable that Ptolemy spoke similarly of his predecessor, Hipparchus, as a “lover of toil and truth”—φιλόπονον καὶ φιλαλήθεα, quoted by Orr (1913), 122.)
“For one who is to understand any matter better than most men do must straightway differ much from other persons in his nature and earliest education. And when he becomes a lad he must be madly in love with the truth and carried away by enthusiasm for it, and not let up by day or by night but press on and stretch every nerve to learn whatever the ancients of most repute have said. But having learned it, he must judge the same and put it to the test for a long, long time and observe what agrees with visible phenomena and what disagrees, and so accept the one and reject the other.”
I. The Man and His Times
Recent ignorance of Galen.
At the close of the nineteenth century one English student of the history of medicine said, “Galen is so inaccessible to English readers that it is difficult to learn about him at first hand.”517 Another wrote, “There is, perhaps, no other instance of a man of equal intellectual rank who has been so persistently misunderstood and even misinterpreted.”518 A third obstacle to the ready comprehension of Galen has been that while more critical editions of some single works have been published by Helmreich and others in recent times,519 no complete edition of his works has appeared since that of Kühn a century ago,520 which is now regarded as very faulty.521 A fourth reason for neglect or misunderstanding of Galen is probably that there is so much by him to be read.
His voluminous works.
Athenaeus stated that Galen wrote more treatises than any other Greek, and although many are now lost, more particularly of his logical and philosophical writings, his collected extant works in Greek text and Latin translation fill some twenty volumes averaging a thousand pages each. When we add that often there are no chapter headings or other brief clues to the contents,522 which must be ploughed through slowly and thoroughly, since some of the most valuable bits of information come in quite incidentally or by way of unlooked-for digression; that errors in the printed text, and the technical vocabulary with numerous words not found in most classical dictionaries increase the reader’s difficulties;523 and that little if any of the text possesses any present medical value, while much of it is dreary enough reading even for one animated by historical interest, especially if one has no technical knowledge of medicine and surgery:—when we consider all these deterrents, we are not surprised that Galen is little known. “Few physicians or even scholars in the present day,” continues the English historian of medicine quoted above, “can claim to have read through this vast collection; I certainly least of all. I can only pretend to have touched the fringe, especially of the anatomical and physiological works.”524
The manuscript tradition of Galen’s works.
Although the works of Galen are so voluminous, they have reached us for the most part in comparatively late manuscripts,525 and to some extent perhaps only in their medieval form. The extant manuscripts of the Greek text are mostly of the fifteenth century and represent the enthusiasm of humanists who hoped by reviving the study of Galen in the original to get something new and better out of him than the schoolmen had. In this expectation they seem to have been for the most part disappointed; the middle ages had already absorbed Galen too thoroughly. If it be true, as Dr. Payne contends,526 that the chief original contributions to medical science of the Renaissance period were the work of men trained in Greek scholarship, this was because, when they failed to get any new ideas from the Greek texts, they turned to the more promising path of experimental research which both Galen and the middle ages had already advocated. The bulky medieval Latin translations527 of Galen are older than most of the extant Greek texts; there are also versions in Arabic and Syriac.528 For the last five books of the Anatomical Exercises the only extant text is an Arabic manuscript not yet published.529
Galen’s vivid personality.
If so comparatively little is generally known about Galen, it is not because he had an unattractive personality. Nor is it difficult to make out the main events of his life. His works supply an unusual amount of personal information, and throughout his writings, unless he is merely transcribing past prescriptions, he talks like a living man, detailing incidents of daily life and making upon the reader a vivid and unaffected impression of reality. Daremberg asserts530 that the exuberance of his imagination and his vanity frequently make us smile. It is true that his pharmacology and therapeutics often strike us as ridiculous, but he did not imagine them, they were the medicine of his age. It is true that he mentions cases which he has cured and those in which other physicians have been at fault, but official war despatches do the same with their own victories and the enemy’s defeats. Vae victis! In Galen’s case, at least, posterity long confirmed his own verdict. And dull or obsolete as his medicine now is, his scholarly and intellectual ideals and love of hard work at his art are still a living force, while the reader of his pages often feels himself carried back to the Roman world of the second century. Thus “the magic of literature,” to quote a fine sentence by Payne, “brings together thinkers widely separated in space and time.”531
Birth and parentage.
Galen—he does not seem to have been called Claudius until the time of the Renaissance—was born about 129 A.D.532 at Pergamum in Asia Minor. His father, Nikon, was an architect and mathematician, trained in arithmetic, geometry, and astronomy. Much of this education he transmitted to his son, but even more valuable, in Galen’s opinion, were his precepts to follow no one sect or party but to hear and judge them all, to despise honor and glory, and to magnify truth alone. To this teaching Galen attributes his own peaceful and painless passage through life. He has never grieved over losses of property but managed to get along somehow. He has not minded much when some have vituperated him, thinking instead of those who praise him. In later life Galen looked back with great affection upon his father and spoke of his own great good fortune in having as a parent that gentlest, justest, most honest and humane of men. On the other hand, the chief thing that he learned from his mother was to avoid her failings of a sharp temper and tongue, with which she made life miserable for their household slaves and scolded his father worse than Xanthippe ever did Socrates.533
Education in philosophy and medicine.
In one of his works Galen speaks of the passionate love and enthusiasm for truth which has possessed him since boyhood, so that he has not stopped either by day or by night from quest of it.534 He realized that to become a true scholar required both high natural qualifications and a superior type of education from the start. After his fourteenth year he heard the lectures of various philosophers, Platonist and Peripatetic, Stoic and Epicurean; but when about seventeen, warned by a dream of his father,535 he turned to the study of medicine. This incident of the dream shows that neither Galen nor his father, despite their education and intellectual standards, were free from the current belief in occult influences, of which we shall find many more instances in Galen’s works. Galen first studied medicine for four years under Satyrus in his native city of Pergamum, then under Pelops at Smyrna, later under Numisianus at Corinth and Alexandria.536 This was about the time that the great mathematician and astronomer, Ptolemy, was completing his observations537 in the neighborhood of Alexandria, but Galen does not mention him, despite his own belief that a first-rate physician should also know such subjects as geometry and astronomy, music and rhetoric.538 Galen’s interest in philosophy continued, however, and he wrote many logical and philosophical treatises, most of which are lost.539 His father died when he was twenty, and it was after this that he went to other cities to study.
First visit to Rome.
Galen returned to Pergamum to practice and was, when but twenty-nine, made the doctor for the gladiators by five successive pontiffs.540 During his thirties came his first residence at Rome.541 The article on Galen in Pauly-Wissowa states that he was driven away from Rome by the plague, and in De libris propriis he does say that, “when the great plague broke out there, I hurriedly departed from the city for my native land.”542 But in De prognosticatione ad Epigenem his explanation is that he became disgusted with the malice of the envious physicians of the capital, and determined to return home as soon as the sedition there was over.543 Meanwhile he stayed on and gained great fame by his cures but their jealousy and opposition multiplied, so that presently, when he learned that the sedition was over, he went back to Pergamum.
Relations with the emperors: later life.
His fame, however, had come to the imperial ears and he was soon summoned to Aquileia to meet the emperors on their way north against the invading Germans. An outbreak of the plague there prevented their proceeding with the campaign immediately,544 and Galen states that the emperors fled for Rome with a few troops, leaving the rest to suffer from the plague and cold winter. On the way Lucius Verus died, and when Marcus Aurelius finally returned to the front, he allowed Galen to go back to Rome as court physician to Commodus.545 The prevalence of the plague at this time is illustrated by a third encounter which Galen had with it in Asia, when he claims to have saved himself and others by thorough venesection.546 The war lasted much longer than had been anticipated and meanwhile Galen was occupied chiefly in literary labors, completing a number of works. In 192 some of his writings and other treasures were lost in a fire which destroyed the Temple of Peace on the Sacred Way. Of some of the works which thus perished he had no other copy himself. In one of his works on compound medicines he explains that some persons may possess the first two books which had already been published, but that these had perished with others in a shop on the Sacra Via when the whole shrine of peace and the great libraries on the Palatine hill were consumed, and that his friends, none of whom possessed copies, had besought him to begin the work all over again.547 Galen was still alive and writing during the early years of the dynasty of the Severi, and probably died about 200.
His unfavorable picture of the learned world.
Although the envy of other physicians at Rome and their accusing him of resort to magic arts and divination in his marvelous prognostications and cures were perhaps neither the sole nor the true reason for Galen’s temporary withdrawal from the capital, there probably is a great deal of truth in the picture he paints of the medical profession and learned world of his day. There are too many other ancient witnesses, from the encyclopedist Pliny and the satirist Juvenal to the fourth century lawyer and astrologer, Firmicus, who substantiate his charges to permit us to explain them away as the product of personal bitterness or pessimism. We feel that these men lived in an intellectual society where faction and villainy, superstition and petty-mindedness and personal enmity, were more manifest than in the quieter and, let us hope, more tolerant learned world of our time. Selfishness and pretense, personal likes and dislikes, undoubtedly still play their part, but there is not passionate animosity and open war to the knife on every hand. The status belli may still be characteristic of politics and the business world, but scholars seem able to live in substantial peace. Perhaps it is because there is less prospect of worldly gain for members of the learned professions than in Galen’s day. Perhaps it is due to the growth of the impartial scientific spirit, of unwritten codes of courtesy and ethics within the leading learned professions, and of state laws concerning such matters as patents, copyright, professional degrees, pure food, and pure drugs. Perhaps, in the unsatisfactory relations between those who should have been the best educated and most enlightened men of that time we may see an important symptom of the intellectual and ethical decline of the ancient world.
Corruption of the medical profession.
Galen states that many tire of the long struggle with crafty and wicked men which they have tried to carry on, relying upon their erudition and honest toil alone, and withdraw disgusted from the madding crowd to save themselves in dignified retirement. He especially marvels at the evil-mindedness of physicians of reputation at Rome. Though they live in the city, they are a band of robbers as truly as the brigands of the mountains. He is inclined to account for the roguery of Roman physicians compared to those of a smaller city by the facts that elsewhere men are not so tempted by the magnitude of possible gain and that in a smaller town everyone is known by everyone else and questionable practices cannot escape general notice. The rich men of Rome fall easy prey to these unscrupulous practitioners who are ready to flatter them and play up to their weaknesses. These rich men can see the use of arithmetic and geometry, which enable them to keep their books straight and to build houses for their domestic comfort, and of divination and astrology, from which they seek to learn whose heirs they will be, but they have no appreciation of pure philosophy apart from rhetorical sophistry.548
Lack of real search for truth.
Galen more than once complains that there are no real seekers after truth in his time, but that all are intent upon money, political power, or pleasure. You know very well, he says to one of his friends in the De methodo medendi, that not five men of all those whom we have met prefer to be rather than to seem wise.549 Many make a great outward display and pretense in medicine and other arts who have no real knowledge.550 Galen several times expresses his scorn for those who spend their mornings in going about saluting their friends, and their evenings in drinking bouts or in dining with the rich and powerful. Yet even his friends have reproached him for studying too much and not going out more. But while they have wasted their hours thus, he has spent his, first in learning all that the ancients have discovered that is of value, then in testing and practicing the same.551 Moreover, now-a-days many are trying to teach others what they have never accomplished themselves.552 Thessalus not only toadied to the rich but secured many pupils by offering to teach them medicine in six months.553 Hence it is that tailors and dyers and smiths are abandoning their arts to become physicians. Thessalus himself, Galen ungenerously taunts, was educated by a father who plucked wool badly in the women’s apartments.554 Indeed, Galen himself, by the violence of his invective and the occasional passionateness of his animosity in his controversies with other individuals or schools of medicine, illustrates that state of war in the intellectual world of his age to which we have adverted.
Poor doctors and medical students.
We suggested the possibility that learning compared to other occupations was more remunerative in Galen’s day than in our own, but there were poor physicians and medical students then, as well as those greedy for gain or who associated with the rich. Many doctors could not afford to use the rarer or stronger simples and limited themselves to easily procured, inexpensive, and homely medicaments.555 Many of his fellow-students regarded as a counsel of perfection unattainable by them Galen’s plan of hearing all the different medical sects and comparing their merits and testing their validity.556 They said tearfully that this course was all very well for him with his acute genius and his wealthy father behind him, but that they lacked the money to pursue an advanced education, perhaps had already lost valuable time under unsatisfactory teachers, or felt that they did not possess the discrimination to select for themselves what was profitable from several conflicting schools.
Medical discovery in Galen’s time.
Galen was, it has already been made apparent, an intellectual aristocrat, and possessed little patience with those stupid men who never learn anything for themselves, though they see a myriad cures worked before their eyes. But that, apart from his own work, the medical profession was not entirely stagnant in his time, he admits when he asserts that many things are known to-day which had not been discovered before, and when he mentions some curative methods recently invented at Rome.557
The drug trade.
Galen supplies considerable information concerning the drug trade in Rome itself and throughout the empire. He often complains of adulteration and fraud. The physician must know the medicinal simples and their properties himself and be able to detect adulterated medicines, or the merchants, perfumers, and herbarii will deceive him.558 Galen refuses to reveal the methods employed in adulterating opobalsam, which he had investigated personally, lest the evil practice spread further.559 At Rome at least there were dealers in unguents who corresponded roughly to our druggists. Galen says there is not an unguent-dealer in Rome who is unacquainted with herbs from Crete, but he asserts that there are equally good medicinal plants growing in the very suburbs of Rome of which they are totally ignorant, and he taxes even those who prepare drugs for the emperors with the same oversight. He tells how the herbs from Crete come wrapped in cartons with the name of the herb written on the outside and sometimes the further statement that it is campestris.560 These Roman drug stores seem not to have kept open at night, for Galen in describing a case speaks of the impossibility of procuring the medicines needed at once because “the lamps were already lighted.”561
The imperial stores.
The emperors kept a special store of drugs of their own and had botanists in Sicily, Crete, and Africa who supplied not only them with medicinal herbs, but also the city of Rome as well, Galen says. However, the emperors appear to have reserved a large supply of the finest and rarest simples for their own use. Galen mentions a large amount of Hymettus honey in the imperial stores—ἐν ταῖς αὐτοκρατορικαῖς ἀποθήκαις,562 whence our word “apothecary.”563 He proves that cinnamon564 loses its potency with time by his own experience as imperial physician. An assignment of the spice sent to Marcus Aurelius from the land of the barbarians (ἐκ τῆς βαρβάρου) was superior to what had stood stored in wooden jars from the reigns of Trajan, Hadrian, and Antoninus Pius. Commodus exhausted all the recent supply, and when Galen was forced to turn to what had been on hand in preparing an antidote for Severus, he found it much weaker than before, although not thirty years had elapsed. That cinnamon was a commodity little known to the populace is indicated by Galen’s mentioning his loss in the fire of 192 of a few precious bits of bark he had stored away in a chest with other treasures.565 He praises the Severi, however, for permitting others to use theriac, a noted medicine and antidote of which we shall have more to say presently. Thus, he says, not only have they as emperors received power from the gods, but in sharing their goods freely they are like the gods, who rejoice the more, the more people they save.566
Galen’s private supply of drugs: terra sigillata .
Galen himself, and apparently other physicians, were not content to rely for medicines either upon the unguent-sellers or the bounty of the imperial stores. Galen stored away oil and fat and left them to age until he had enough to last for a hundred years, including some from his father’s lifetime. He used some forty years old in one prescription.567 He also traveled to many parts of the Roman Empire and procured rare drugs in the places where they were produced. Very interesting is his account of going out of his way in journeying back and forth between Rome and Pergamum in order to stop at Lemnos and procure a supply of the famous terra sigillata, a reddish clay stamped into pellets with the sacred seal of Diana.568 On the way to Rome, instead of journeying on foot through Thrace and Macedonia, he took ship from the Troad to Thessalonica; but the vessel stopped in Lemnos at Myrine on the wrong side of the island, which Galen had not realized possessed more than one port, and the captain would not delay the voyage long enough to enable him to cross the island to the spot where the terra sigillata was to be found. Upon his return from Rome through Macedonia, however, he took pains to visit the right port, and for the benefit of future travelers gives careful instructions concerning the route to follow and the distances between stated points. He describes the solemn procedure by which the priestess from the neighboring city gathered the red earth from the hill where it was found, sacrificing no animals, but wheat and barley to the earth. He brought away with him some twenty thousand of the little discs or seals which were supposed to cure even lethal poisons and the bite of mad dogs. The inhabitants laughed, however, at the assertion which Galen had read in Dioscorides that the seals were made by mixing the blood of a goat with the earth. Berthelot, the historian of chemistry, believed that this earth was “an oxide of iron more or less hydrated and impure.”569 In another passage Galen advises his readers, if they are ever in Pamphylia, to lay in a good supply of the drug carpesium.570 In the ninth book of his work on medicinal simples he tells of three strata of sory, chalcite, and misy, which he had seen in a mine in Cyprus thirty years before and from which he had brought away a supply, and of the surprising chemical change which the misy underwent in the course of these years.571
Mediterranean commerce.
Galen speaks of receiving other drugs from Great Syria, Palestine, Egypt, Cappadocia, Pontus, Macedonia, Gaul, Spain, and Mauretania, from the Celts, and even from India.572 He names other places in Greece and Asia Minor than Mount Hymettus where good honey may be had, and states that much so-called Attic honey is really from the Cyclades, although it is brought to Athens and there sold or reshipped. Similarly, genuine Falernian wine is produced only in a small part of Italy, but other wines like it are prepared by those who are skilled in such knavery. As the best iris is that of Illyricum and the best asphalt is from Judea, so the best petroselinon is that of Macedonia, and merchants export it to almost the entire world just as they do Attic honey and Falernian wine. But the petroselinon crop of Epirus is sent to Thessalonica and there passed off for Macedonian. The best turpentine is that of Chios but a good variety may be obtained from Libya or Pontus. The manufacture of drugs has spread recently as well as the commerce in them. The best form of unguent was formerly made only in Laodicea, but now it is similarly compounded in many other cities of Asia Minor.573
Frauds of dealers in wild beasts.
We are reminded that parts of animals as well as herbs and minerals were important constituents in ancient pharmacy by Galen’s invective against the frauds of hunters and dealers in wild beasts as well as of unguent-sellers. They do not hunt them at the proper season for securing their medicinal virtues, but when they are no longer in their prime or just after their long period of hibernation, when they are emaciated. Then they fatten them upon improper food, feed them barley cakes to stuff up and dull their teeth, or force them to bite frequently so that virus will run out of their mouths.574
Galen’s ideal of anonymity.
Besides the ancient drug trade, Galen gives us some interesting glimpses of the publishing trade, if we may so term it, of his time. Writing in old age in the De methodo medendi,575 he says that he has never attached his name to one of his works, never written for the popular ear or for fame, but fired by zeal for science and truth, or at the urgent request of friends, or as a useful exercise for himself, or, as now, in order to forget his old age. Popular fame is only an impediment to those who desire to live tranquilly and enjoy the fruits of philosophy. He asks Eugenianus, whom he addresses in this passage, not to praise him immoderately before men, as he has been wont to do, and not to inscribe his name in his works. His friends nevertheless prevailed upon him to write two treatises listing his works,576 and he also is free enough in many of his books in mentioning others which are essential to read before perusing the present volume.577 Perhaps he felt differently at different times on the question of fame and anonymity. He also objected to those who read his works, not to learn anything from them, but only in order to calumniate them.578
The ancient book trade.
It was in a shop on the Sacra Via that most of the copies of some of Galen’s works were stored when they, together with the great libraries upon the Palatine, were consumed in the fire of 192. But in another passage Galen states that the street of the Sandal-makers is where most of the bookstores in Rome are located.579 There he saw some men disputing whether a certain treatise was his. It was duly inscribed Galenus medicus and one man, because the title was unfamiliar to him, bought it as a new work by Galen. But another man who was something of a philologer asked to see the introduction, and, after reading a few lines, declared that the book was not one of Galen’s works. When Galen was still young, he wrote three commentaries on the throat and lungs for a fellow student who wished to have something to pass off as his own work upon his return home. This friend died, however, and the books got into circulation.580 Galen also complains that notes of his lectures which he has not intended for publication have got abroad,581 that his servants have stolen and published some of his manuscripts, and that others have been altered, corrupted, and mutilated by those into whose possession they have come, or have been passed off by them in other lands as their own productions.582 On the other hand, some of his pupils keep his teachings to themselves and are unwilling to give others the benefit of them, so that if they should die suddenly, his doctrines would be lost.583 But his own ideal has always been to share his knowledge freely with those who sought it, and if possible with all mankind. At least one of Galen’s works was taken down from his dictation by short-hand writers, when, after his convincing demonstration by dissection concerning respiration and the voice, Boëthus asked him for commentaries on the subject and sent for stenographers.584 Although Galen in his travels often purchased and carried home with him large quantities of drugs, when he made his first trip to Rome he left all his books in Asia.585
Falsification and mistakes in manuscripts.
Galen dates the falsification of title pages and contents of books back to the time when kings Ptolemy of Egypt and Attalus of Pergamum were bidding against each other for volumes for their respective libraries.586 Works were often interpolated then in order to make them larger and so bring a better price. Galen speaks more than once of the deplorable ease with which numbers, signs, and other abbreviations are altered in manuscripts.587 A single stroke of the pen or slight erasure will completely change the meaning of a medical prescription. He thinks that such alterations are sometimes malicious and not mere mistakes. So common were they that Menecrates composed a medical work written out entirely in complete words and entitled Autocrator Hologrammatos because it was also dedicated to the emperor. Another writer, Damocrates, from whom Galen often quotes long passages, composed his book of medicaments in metrical form so that there might be no mistake made even in complete words.
Galen as a historical source.
Galen’s works contain occasional historical information concerning many other matters than books and drugs. Clinton in his Fasti Romani made much use of Galen for the chronology of the period in which he lived. His allusions to several of the emperors with whom he had personal relations are valuable bits of source-material. Trajan was, of course, before his time, but he testifies to the great improvement of the roads in Italy which that emperor had effected.588 Galen sheds a little light on the vexed question of the population of the empire, if Pergamum is the place he refers to in his estimate of forty thousand citizens or one hundred and twenty thousand inhabitants, including women and slaves but perhaps not children.589
Ancient slavery.
Galen illustrates for us the evils of ancient slavery in an incident which he relates to show the inadvisability of giving way to one’s passions, especially anger.590 Returning from Rome, Galen fell in with a traveler from Gortyna in Crete. When they reached Corinth, the Cretan sent his baggage and slaves from Cenchrea591 to Athens by boat, but himself with a hired vehicle and two slaves went by land with Galen through Megara, Eleusis, and Thriasa. On the way the Cretan became so angry at the two slaves that he hit them with his sheathed sword so hard that the sheath broke and they were badly wounded. Fearing that they would die, he then made off to escape the consequences of his act, leaving Galen to look after the wounded. But later he rejoined Galen in penitent mood and insisted that Galen administer a beating to him for his cruelty. Galen adds that he himself, like his father, had never struck a slave with his own hand and had reproved friends who had broken their slaves’ teeth with blows of their fists. Others go farther and kick their slaves or gouge their eyes out. The emperor Hadrian in a moment of anger is said to have blinded a slave with a stylus which he had in his hand. He, too, was sorry afterwards and offered the slave money, but the latter refused it, telling the emperor that nothing could compensate him for the loss of an eye. In another passage Galen discusses how many slaves and “clothes” one really needs.592
Social life: food and wine.
Galen also depicts the easy-going, sociable, and pleasure-loving society of his time. Not only physicians but men generally begin the day with salutations and calls, then separate again, some to the market-place and law courts, others to watch the dancers or charioteers.593 Others play at dice or pursue love affairs, or pass the hours at the baths or in eating and drinking or some other bodily pleasure. In the evening they all come together again at symposia which bear no resemblance to the intellectual feasts of Socrates and Plato but are mere drinking bouts. Galen had no objection, however, to the use of wine in moderation and mentions the varieties from different parts of the Mediterranean world which were especially noted for their medicinal properties.594 He believed that drinking wine discreetly relieved the mind from all worry and melancholy and refreshed it. “For we use it every day.”595 He affirmed that taken in moderation wine aided digestion and the blood.596 He classed wine with such boons to humanity as medicines, “a sober and decent mode of life,” and “the study of literature and liberal disciplines.”597 Galen’s treatise in three books on food values (De alimentorum facultatibus) supplies information concerning the ancient table and dietary science.
Allusions to Judaism and Christianity.
Galen’s allusions to Judaism and Christianity are of considerable interest. He scarcely seems to have distinguished between them. In two passages in his treatise on differences in the pulse he makes incidental allusion to the followers of Moses and Christ, in both cases speaking of them rather lightly, not to say contemptuously. In criticizing Archigenes for using vague and unintelligible language and not giving a sufficient explanation of the point in question, Galen says that it is “as if one had come to a school of Moses and Christ and had heard undemonstrated laws.”598 And in criticizing opposing sects for their obstinacy he remarks that it would be easier to win over the followers of Moses and Christ.599 Later we shall speak more fully of a third passage in De usu partium600 where Galen criticizes the Mosaic view of the relation of God to nature, representing it as the opposite extreme to the Epicurean doctrine of a purely mechanistic and materialistic universe. This suggests that Galen had read some of the Old Testament, but he might have learned from other sources of the Dead Sea and of salts of Sodom, of which he speaks in yet another context.601 According to a thirteenth century Arabian biographer of Galen, he spoke more favorably of Christians in a lost commentary upon Plato’s Republic, admiring their morals and admitting their miracles.602 This last, as we shall see, is unlikely, since Galen believed in a supreme Being who worked only through natural law. “A confection of Ioachos, the martyr or metropolitan,” and “A remedy for headache of the monk Barlama” occur in the third book of the De remediis parabilibus ascribed to Galen, but this third book is greatly interpolated or entirely spurious, citing Galen himself as well as Alexander of Tralles, the sixth century writer, and mentioning the Saracens. Wellmann regards it as composed between the seventh and eleventh centuries of our era.603
Galen’s monotheism.
Like most thoughtful men of his time, Galen tended to believe in one supreme deity, but he appears to have derived this conception from Greek rather than Hebraic sources. It was to philosophy and the Greek mysteries that he turned for revelation of the deity, as we shall see. Hopeless criminals were for him those whom neither the Muses nor Socrates could reform.604 It is Plato, not Christ, whom in another treatise he cites as describing the first and greatest God as ungenerated and good. “And we all naturally love Him, being such as He is from eternity.”605
Galen’s Christian readers.
But while Galen’s monotheism cannot be regarded as of Christian or Jewish origin, it is possible that his argument from design and supporting theology by anatomy made him more acceptable to both Mohammedan and Christian readers. At any rate he had Christian readers at Rome at the opening of the third century, when a hostile controversialist complains that some of them even worship Galen.606 These early Christian enthusiasts for natural science, who also devoted much time to Aristotle and Euclid, were finally excommunicated; but Aristotle, Euclid, and Galen were to return in triumph in medieval learning.
II. His Medicine and Experimental Science
Four elements and four qualities.
Galen held as his fundamental theory of nature the view which was to prevail through the middle ages, that all natural objects upon this globe are composed of four elements, earth, air, fire, and water,607 and the cognate view, which he says Hippocrates first introduced and Aristotle later demonstrated, that all natural objects are characterized by four qualities, hot, cold, dry, and moist. From the combinations of these four are produced various secondary qualities.608 Neither hypothesis was as yet universally accepted, however, and Galen felt it incumbent upon him to argue against those who contended that the human body and world of nature were made from but one element.609 There were others who ridiculed the four quality hypothesis, saying that hot and cold were words for bath-keepers, not for physicians to deal with.610 Galen explains that philosophers do not regard any particular variety of earth or any other mineral substance as representing the pure element earth, which in the philosophical sense is an extremely cold and dry substance to which adamant and rocks make perhaps the closest approach. But the earths that we see are all compound bodies.611
Criticism of atomism.
Galen rejected the atomism of Democritus and Epicurus, in which the atoms were indivisible particles differing in shape and size, but not differing in quality as chemical atoms are supposed to do. He credits Democritus with the view that such qualities as color and taste are sensed by us from the concourse of atoms, but do not reside in the atoms themselves.612 Galen also makes the criticism that the mere regrouping of “impassive and immutable” atoms is not enough to account for the new properties of the compound, which are often very different from those of the constituents, as when “we alter the qualities of medicines in artificial mixtures.”613 Thus he virtually says that the purely physical atomism of Democritus will not account for what to-day we call chemical change. He also, as we shall see, rejected Epicurus’ theory of a world of nature ruled by blind chance.
Application of the theory of four qualities in medicine.
Galen of course thought that a dry medicine was good for a moist disease, and that in a compound medicine, by mixing a very cold with a slightly cold drug in varying proportions a medicine of any desired degree of coldness might be obtained.614 In general he regarded solids like stones and metals as dry and cold, while he thought that hot and moist objects tended to evaporate rapidly into air.615 So he declared that dryness of solid bodies was incurable, while he believed that children’s bodies were more easily dissolved than adults’ because moister and warmer.616 The Stoics and many physicians believed that heat prolonged life, but Asclepiades pointed out that the Ethiopians are old at thirty because the hot sun dries up their bodies so, while the inhabitants of Britain sometimes live to be one hundred and twenty years old. This last, however, was regarded as probably due to the fact that their thicker skins conserved their innate heat longer.617
Galen’s therapeutics obsolete.
As an offset to the evidence which will be presented later of the traces of occult virtues, magic, and astrology in Galen’s therapeutics I should like to be able to indicate the good points in it. But his entire system, like the four quality theory upon which it is largely based, seems now obsolete, and what evidenced his superiority to other physicians in his own day would probably strike the modern reader only as a token of his distinct inferiority to present practice. Eighty odd years of modern medical progress since have added further emphasis to Daremberg’s declaration that we have had to throw overboard “much of his physiology, nearly all of his pathology and general therapeutics.”618
Some of his medical notions.
Nevertheless, we may note a few specimens which perhaps represent his ordinary theory and practice as distinguished from passages in which the influence of magic enters. He holds that bleeding and cold drink are the two chief remedies for fever.619 He notes that children occasionally resemble their grandparents rather than their parents.620 He disputes the assertion of Epicurus—one by which some of his followers failed to be guided—that there is no benefit to health in Aphrodite, and contends that at certain intervals and in certain individuals and circumstances sexual intercourse is beneficial.621 His discussion of anodynes and stupor or sleep-producing medicines shows that the ancients had anaesthetics of a sort.622 He recognized the importance of breathing plenty of fresh, invigorating, and unpolluted air, free from any intermixture of impurity from mines, pits, or ovens, or of putridity from decaying vegetable or animal matter, or of noxious vapors from stagnant water, swamps, and rivers.623 As was usual in ancient and medieval times, he attributes plagues to the corruption of the air, which poisons men breathing it, and tells how Hippocrates tried to allay a plague at Athens by purifying the air by fumigation with fires, odors, and unguents.624
Two of Galen’s cases.
Two specimens may be given of Galen’s accounts of his own cases. In the first, some cheese, which he had told his servants to take away as too sharp, when mixed with boiled salt pork and applied to the joints, proved very helpful to a gouty patient and to several others whom he induced to try it.625 In the second case Galen administered the following heroic treatment to a woman at Rome who was afflicted with catarrh to the point of throwing up blood.626 He did not deem it wise to bleed her, since for four days past she had gone almost without food. Instead he ordered a sharp clyster, rubbed and bound her hands and feet with a hot drug, shaved her head and put on it a medicament made of doves’ dung. After three hours she was bathed, care being taken that nothing oily touched her head, which was then covered up. At first he fed her only gruel, afterwards some bitter autumn fruit, and as she was about to go to sleep he administered a medicament made from vipers four months before. On the second day came more rubbing and binding except the head, and at evening a somewhat smaller dose of the viper remedy. Again she slept well and in the morning he gave her a large dose of cooked honey. Again her body was well rubbed and she was given barley water and a little bread to eat. On the fourth day an older and therefore stronger variety of viper-remedy was administered and her head was covered with the same medicament as before. Its properties, Galen explains, are vehemently drying and heating. Again she was given a bath and a little food. On the fifth day Galen ventured to purge her lungs, but he returned at intervals to the imposition upon her head. Meanwhile he continued the process of rubbing, bathing, and dieting, until finally the patient was well again,—a truly remarkable cure!
His power of rapid observation and inference.
These two cases, however, do not give us a just comprehension of Galen’s abilities at their best. In his medical practice he could be as quick and comprehensive an observer and as shrewd in drawing inferences from what he observed as the famous Sherlock Holmes, so that some of his slower-witted contemporaries accused him of possessing the gift of divination. His immediate diagnosis of the case of the Sicilian physician by noting as he entered the house the excrements in a vessel which a servant was carrying out to the dungheap, and as he entered the sick-room a medicine set on the window-sill which the patient-physician had been preparing for himself, amazed the patient and the philosopher Glaucon627 more than, let us hope in this case in view of his profession, they would have amazed the estimable Dr. Watson.
His happy guesses.
Puschmann has pointed out that Galen employs certain expressions which seem happy guesses at later discoveries. He writes: “Galen was supported in his researches by an extremely happy imaginative faculty which put the proper word in his mouth even in cases where he could not possibly arrive at a full understanding of the matter,—where he could only conjecture the truth. When, for instance, he declares that sound is carried ‘like a wave’ (Kühn, III, 644), or expresses the conjecture that the constituent of the atmosphere which is important for breathing also acts by burning (IV, 687), he expresses thoughts which startle us, for it was only possible nearly two thousand years later to understand their full significance.”628
Tendency towards scientific measurement.
Galen was keenly alive to the need of exactness in weights and measurements. He often criticizes past writers for not stating precisely what ailment the medicament recommended is good for, and in what proportions the ingredients are to be mixed. He also frequently complains because they do not specify whether they are using the Greek or Roman system of weights, or the Attic, Alexandrine, or Ephesian variety of a certain measure.629 Moreover, he saw the desirability of more accurate means of measuring the passage of time.630 When he states that even some illustrious physicians of his acquaintance mistake the speed of the pulse and are unable to tell whether it is slow, fast, or normal, we begin to realize something of the difficulties under which medical practice and any sort of experimentation labored before watches were invented, and how much depended upon the accuracy of human machinery and judgment. Yet Galen estimates that the chief progress made in medical prognostication since Hippocrates is the gradual development of the art of inferring from the pulse.631 Galen tried to improve the time-pieces in use in his age. He states that in any city the inhabitants want to know the time of day accurately, not merely conjecturally; and he gives directions how to divide the day into twelve hours by a combination of a sun-dial and a clepsydra, and how on the water clock to mark the duration of the longest, shortest, and equinoctial days of the year.632
Psychological tests with the pulse.
Delicate and difficult as was the task of measuring the pulse in Galen’s time, he was clever enough to anticipate by seventeen centuries some of the tests which modern psychologists have urged should be applied in criminal trials. He detected the fact that a female patient was not ill but in love by the quickening of her pulse when someone came in from the theater and announced that he had just seen Pylades dance. When she came again the next day, Galen had purposely arranged that someone should enter and say that he had seen Morphus dancing. This and a similar test on the third day produced no perceptible quickening in the woman’s pulse. But it bounded again when on the fourth day Pylades’ name was again spoken. After recounting another analogous incident where he had been able to read the patient’s mind, Galen asks why former physicians have never availed themselves of these methods. He thinks that they must have had no conception of how the bodily health in general and the pulse in particular can be affected by the “psyche’s” suffering.633 We might then call Galen the first experimental psychologist as well as the first to elaborate the physiology of the nervous system.
Galen’s anatomy and physiology.
It would scarcely be fair to discuss Galen’s science at all without saying something of his remarkable work in anatomy and physiology. Daremberg went so far as to hold that all there is good or bad in his writings comes from good or bad physiology, and regarded his discussion of the bones and muscles as especially good.634 He is generally considered the greatest anatomist of antiquity, but it is barely possible that he may have owed more to predecessors and contemporaries and less to personal research than is apparent from his own writings, which are the most complete anatomical treatises that have reached us from antiquity. Herophilus, for example, who was born at Chalcedon in the closing fourth century B. C. and flourished at Alexandria under the first Ptolemy, discovered the nerves and distinguished them from the sinews, and thought the brain the center of the nervous system, so that it is perhaps questionable whether Payne is justified in calling Galen “the founder of the physiology of the nervous system,” and in declaring that “in physiological diagnosis he stands alone among the ancients.”635 However, if Galen owed something to Herophilus, we owe much of our knowledge of the earlier physiologist to Galen.636
Experiments in dissection.
Aristotle had held that the heart was the seat of the sensitive soul637 and the source of nervous action, “while the brain was of secondary importance, being the coldest part of the body, devoid of blood, and having for its chief or only function to cool the heart.” Galen attacked this theory by showing experimentally that “all the nerves originated in the brain, either directly or by means of the spinal cord, which he thought to be a conducting organ merely, not a center.” “A thousand times,” he says, “I have demonstrated by dissection that the cords in the heart called nerves by Aristotle are not nerves and have no connection with nerves.” He found that sensation and movement were stopped and even the voice and breathing were affected by injuries to the brain, and that an injury to one side of the brain affected the opposite side of the body. His public demonstration by dissection, performed in the presence of various philosophers and medical men, of the connection between the brain and voice and respiration and the commentaries which he immediately afterwards dictated on this point were so convincing, he tells us fifteen years later, that no one has ventured openly to dispute them.638 His “experimental investigation of the spinal cord by sections at different levels and by half sections was still more remarkable.”639 Galen opposed these experimental proofs to such unscientific arguments on the part of the Stoic philosopher, Chrysippus, and others, as that the heart must be the chief organ because it is in the center of the body, or because one lays one’s hand on one’s heart to indicate oneself, or because the lips are moved in a certain way in saying “I” (ἐγώ).640 Another noteworthy experiment by Galen was that in which, by binding up a section of the femoral artery he proved that the arteries contain blood and not air or spiritus as had been generally supposed.641 He failed, however, to perform any experiments with the pulmonary veins, and so the notion persisted that these conveyed “spirit” and not blood from the lungs to the heart.642
Did Galen ever dissect human bodies?
It has usually been stated that Galen never dissected the human body and that his inferences by analogy from his dissection of animals involved him in serious error concerning human anatomy and physiology. Certainly he speaks as if opportunities to secure human cadavers or even skeletons were rare.643 He mentions, however, the possibility of obtaining the bodies of criminals condemned to death or cast to beasts in the arena, or the corpses of robbers which lie unburied in the mountains, or the bodies of infants exposed by their parents.644 It is not sufficient, he states in another passage,645 to read books about human bones; one should have them before one’s eyes. Alexandria is the best place for the student to go to see actual exhibitions of this sort made by the teachers.646 But even if one cannot go there, one may be able to procure human bones for oneself, as Galen did from a skeleton which had been washed out of a grave by a flooded stream and from the corpse of a robber slain in the mountains. If one cannot get to see a human skeleton by these means or some other, he should dissect monkeys and apes.
Dissection of animals.
Indeed Galen advises the student to dissect apes in any case, in order to prepare himself for intelligent dissection of the human body, should he ever have the opportunity. From lack of such previous experience the doctors with the army of Marcus Aurelius, who dissected the body of a dead German, learned nothing except the position of the entrails. Galen at any rate dissected a great many animals. Tiny animals and insects he let alone, for the microscope was not yet discovered, but besides apes and quadrupeds he cut up many reptiles, mice, weasels, birds, and fish.647 He also gives an amusing account of the medical men at Rome gathering to observe the dissection of an elephant in order to discover whether the heart had one or two vertices and two or three ventricles. Galen assured them beforehand that it would be found similar to the heart of any other breathing animal. This particular dissection was not, however, performed exclusively in the interests of science, since it was scarcely accomplished when the heart was carried off, not to a scientific museum, but by the imperial cooks to their master’s table.648 Galen sometimes dissected animals the moment he killed them. Thus he observed that the lungs always sensibly shrank from the diaphragm in a dying animal, whether he killed it by suffocation in water, or strangling with a noose, or severing the spinal medulla near the first vertebrae, or cutting the large arteries or veins.649
Surgical operations.
Surgical operations and medical practice were a third way of learning the human anatomy, and Galen complains of the carelessness of those physicians and surgeons who do not take pains to observe it before performing an operation or cure. He himself had had one case where the human heart was laid bare and yet the patient recovered.650 As a young practitioner before he came to Rome Galen worked out so successful a method of treating wounds of the sinews that the care of the health of the gladiators in his native city of Pergamum was entrusted to him by several successive pontifices651 and he hardly lost a life. In the same passage he again speaks contemptuously of the doctors in the war with the Germans who were allowed to cut open the bodies of the barbarians but learned no more thereby than a cook would. When Galen came from Pergamum to Rome he found the professions of physicians and surgeons distinct and left cases to the latter which he before had attended to himself.652 We may note finally that he invented a new form of surgical knife.653
Galen’s argument from design.
In Galen’s opinion the study of anatomy was important for the philosopher as well as for the physician. An understanding of the use of the parts of the body is helpful to the doctor, he says, but much more so to “the philosopher of medicine who strives to obtain knowledge of all nature.”654 In the De usu partium655 he came to the conclusion that in the structure of any animal we have the mark of a wise workman or demiurge, and of a celestial mind; and that “the investigation of the use of the parts of the body lays the foundation of a truly scientific theology which is much greater and more precious than all medicine,” and which reveals the divinity more clearly than even the Eleusinian mysteries or Samothracian orgies. Thus Galen adopts the argument from design for the existence of God. The modern doctrine of evolution is of course subversive of his premise that the parts of the body are so well constructed for and marvelously adapted to their functions that nothing better is possible, and consequently of his conclusion that this necessitates a divine maker and planner.
In the treatise De foetuum formatione Galen displays a similar inclination but more tentatively and timidly. He thinks that the human body attests the wisdom and power of its maker,656 whom he wishes the philosophers would reveal to him more clearly and tell him “whether he is some wise and powerful god.”657 The process of the formation of the child in the womb, the complex human muscular system, the human tongue alone, seem to him so wonderful that he will not subscribe to the Epicurean denial of any all-ruling providence.658 He thinks that nature alone cannot show such wisdom. He has, however, sought vainly from philosopher after philosopher for a satisfactory demonstration of the existence of God, and is by no means certain himself.659
Queries concerning the soul.
Galen is also at a loss concerning the existence and substance of the soul. He points out that puppies try to bite before their teeth come and that calves try to hook before their horns grow, as if the soul knew the use of these parts beforehand. It might be argued that the soul itself causes the parts to grow,660 but Galen questions this, nor is he ready to accept the Platonic world-soul theory of a divine force permeating all nature.661 It offends his instinctive piety and sense of fitness to think of the world-soul in such things as reptiles, vermin, and putrefying corpses. On the other hand, he disagrees with those who deny any innate knowledge or standards to the soul and attribute everything to sense perception and certain imaginations and memories based thereon. Some even deny the existence of the reasoning faculty, he says, and affirm that we are led by the affections of the senses like cattle. For these men courage, prudence, temperance, continence are mere names.662
No supernatural force in medicine.
In commenting upon the works of Hippocrates, Galen insists that in speaking of “something divine” in diseases Hippocrates could not have meant supernatural influence, which he never admits into medicine in other passages. Galen tries to explain away the expression as having reference to the effect of the surrounding air.663 Thus while Galen might look upon nature or certain things in nature as a divine work, he would not admit any supernatural force in science or medicine, or anything bordering upon special providence. In the De usu partium Galen states that he agrees with Moses that “the beginning of genesis in all things generated” was “from the demiurge,” but that he does not agree with him that anything is possible with God and that God can suddenly turn a stone into a man or make a horse or cow from ashes. “In this matter our opinion and that of Plato and of others among the Greeks who have written correctly concerning natural science differs from the view of Moses.” In Galen’s view God attempts nothing contrary to nature but of all possible natural courses invariably chooses the best. Thus Galen expresses his admiration at nature’s providence in keeping the eyebrows and eyelashes of the same length and not letting them grow long like the beard or hair, but this is because a harder cartilaginous flesh is provided for them to grow in, and the mere will of God would not keep hairs from growing in soft flesh. If God had not provided the cartilaginous substance for the eyelashes, “he would have been more careless, not merely than Moses but than a worthless general who builds a wall in a swamp.”664 As between the views on God of Moses and Epicurus, Galen prefers to steer a middle course.
Galen’s experimental instinct.
Already in describing Galen’s dissections and tests with the pulse we have seen evidence of the accurate observation and experimental instincts which accompanied his zest for hard work and zeal for truth. In one of his treatises he confesses that it was a passion of his always to test everything for himself. “And if anyone accuses me of this, I will confess my disease, from which I have suffered all my life long, that I have trusted no one of those who narrate such things until I have tested it myself, if it was possible for me to have experience of it.”665 Galen also recognized that general theories were not sufficient for exact knowledge and that specific examples seen with one’s own eyes were indispensable.666 He maintains that, if all teachers and writers would realize and observe this, they would make comparatively few false statements. He saw the danger of making absolute assertions and the need of noting the particular circumstances of each individual case.667 Galen more than once declared that things, not names, were important and refused to waste time in disputing about terminology and definitions which might be spent in “pursuing the knowledge of things themselves.”668 Thus we see in Galen a pragmatic scientist intent upon concrete facts and exact knowledge; but at the same time it must be recognized that he accepted some universal theorems and general views.
Attitude towards authorities.
Galen did not believe in merely repeating in new books the statements of previous authorities. Ever since boyhood, he writes in his Anatomical Administrations, it has seemed to him that one should record in writing only one’s new discoveries and not repeat what has been said already.669 Nevertheless in some of his writings he collects the prescriptions of past physicians at great length, and a previous treatise by Archigenes is practically embodied in one of Galen’s works on compound medicines. On another occasion, however, after stating that Crito had combined previous treatises upon cosmetics, including the work of Cleopatra, into four books of his own which constitute a well-nigh exhaustive treatment of the subject, Galen says that he sees no profit in copying Crito’s work again and merely reproduces its table of contents.670 On the other hand, as this passage shows, Galen thought that the ancients had stated many things admirably and he had little patience with contemporaries who would learn nothing from them but were always ambitiously weaving new and complicated dogmas, or misinterpreting and perverting the teachings of the ancients.671 His method was rather first to “make haste and stretch every nerve to learn what the most celebrated of the ancients have said;”672 then, having mastered this teaching, to judge it and put it to the test for a long time and determine by observation how much of it agrees and how much disagrees with actual phenomena, and then embrace the former portion and reject the latter.
Adverse criticism of past writers.
This critical employment of past authorities is frequently illustrated in Galen’s works. He mentions a great many names of past physicians and writers, thereby shedding some light upon the history of Greek medicine; but at times he criticizes his predecessors, not sparing even Empedocles and Aristotle. Although he cites Aristotle a great deal, he declares that it is not surprising that Aristotle made many errors in the anatomy of animals, since he thought that the heart in large animals had a third ventricle.673 As we have already seen in discussing the topic of weights and measurements, Galen especially objects to the vagueness and inaccuracy of many past medical writers,674 or praises individuals like Heras who give specific information.675 He also shows a preference for writers who give first-hand information, commending Heraclides of Tarentum as a trustworthy man, if there ever was one, who set down only those things proved by his own experience.676 Galen declares that one could spend a lifetime in reading the books that have already been written upon medicinal simples. He urges his readers, however, to abstain from Andreas and other liars of that stamp, and above all to eschew Pamphilus who never saw even in a dream the herbs which he describes.
Galen’s estimate of Dioscorides.
Of all previous writers upon materia medica Galen preferred Dioscorides. He writes, “But Anazarbensis Dioscorides in five books discussed all useful material not only of herbs but of trees and fruits and juices and liquors, treating besides both all metals and the parts of animals.”677 Yet he does not hesitate to criticize certain statements of Dioscorides, such as the story of mixing goat’s blood with the terra sigillata of Lemnos. Dioscorides had also attributed marvelous virtues to the stone Gagates which he said came from a river of that name in Lycia; Galen’s comment is that he has skirted the entire coast of Lycia in a small boat and found no such stream.678 He also wonders that Dioscorides described butter as made of the milk of sheep and goats, and correctly states that “this drug” is made from cows’ milk.679 Galen does not mention its use as a food in his work on medicinal simples, and in his treatise upon food values he alludes to butter rather incidentally in the chapter on milk, stating that it is a fatty substance and easily recognized by tasting it, that it has many of the properties of oil, and in cold countries is sometimes used in baths in place of oil.680 Galen further criticizes Dioscorides for his unfamiliarity with the Greek language and consequent failure to grasp the significance of many Greek names.
Galen’s dogmatism: logic and experience.
Daremberg said of Galen that he represented at the same time the most exaggerated dogmatism and the most advanced experimental school. There is some justification for the paradox, though the latter part seems to me the truer. But Galen was proud of his training in philosophy and logic and mathematics; he stood fast by many Hippocratic dogmas such as the four qualities theory, he thought681 that in medicine as in geometry there were a certain number of self-evident maxims upon which reason, conforming to the rules of logic, might build up a scientific structure. In the De methodo medendi682 he makes a distinction between the discovery of drugs and medicines, simple or compound, by experience and the methodical treatment of disease which he now sets forth and which should proceed logically and independently of mere empiricism, and he wishes that other medical writers would make it clear when they are relying merely on experience and when exclusively upon reason.683 At the same time he expresses his dislike for mere dogmatizers who shout their ipse dixits like tyrants without the support either of reason or experience.684 He also grants that the ordinary man, taught by nature alone, often instinctively pursues a better course of action for his health than “the sophists” are able to advise.685 Indeed, he is of the opinion that some doctors would do well to stick to experience alone and not try to mix in reasoning, since they are not trained in logic, and when they endeavor to divide or analyze a theme, perform like unskilled carvers who fail to find the joints and mutilate the roast.686 Later on in the same work687 he again affirms that persons who will not read and profit by the books of medical authorities and whose own reasoning is defective, should limit themselves to experience.
Galen’s account of the Empirics.
Normally, however, Galen upholds both reason and experience as criteria of truth against the opposing schools of Dogmatics and Empirics. The former attacked experience as uncertain and impossible to regulate, slow and unmethodical. The latter replied that experience was consistent, adaptable to art, and proof enough.688 Galen’s chief objection to the Empirics is that they reject reason as a criterion of truth and wish the medical art to be irrational.689 “The Empirics say that all things are discovered by experience, but we say that some are found by experience and some by reason.”690 Galen also objects to Herodotus’s explanation of the medical art as originating in the conversation of patients exposed at crossroads who told one another of their complaints and recoveries and thus evolved a fund of common experience.691 Galen criticizes such experience as irrational and not yet put into scientific form (οὔπω λογική). Of the Empirics he tells us further that they regard phenomena only and ignore causes and put no trust in reasoning. They hold that there is no system or necessary order in medical discovery or doctrine, and that some remedies have been discovered by dreams, others by chance. They also accepted written accounts of past experiences and thus to a certain extent trusted in tradition. Galen argues that they should test these statements of past authorities by reason.692 His further contention that, if they test them by experience, they might as well reject all writings and trust only to present experience from the start, is a sophistical quibble unworthy of him. He adds, however, that the Empirics themselves say that past tradition or “history” (ἱστορία) should not be judged by experience, but it is unlikely that he represents their view correctly in this particular. In another passage693 he says that they distinguish three kinds of experience, chance or accidental, offhand or impromptu, and imitative or the repetition of the same thing. In a third passage694 he repeats that they held that observation of one or two instances was not enough, but that oft-repeated observation was needed with all conditions the same each time. In yet another place695 he says that the Empirics observe coincidences in things joined by experience. He himself defines experience as the comprehending and remembering of something seen often and in the same condition,696 and makes the good point that one cannot observe satisfactorily without use of reason.697 He also admits in one place that some Empirics are ready to employ reason as well as experience.698
How the Empirics might have criticized Galen.
Having noted Galen’s criticism of the Empirics, we may imagine what their attitude would be towards his medicine. They would probably reject all his theories—which we, too, have finally discarded—of four elements and four qualities and the like, and would accept only his specific recommendations for the cure of disease based upon his medical experience; except that they would also be credulous concerning anything which he assured them was based upon his own or another’s experience, whether it truly was or not. They would, however, have probably questioned much of his anatomical inference from the dissection of the lower animals, since he tells us that they “have written whole books against anatomy.”699 Considering the state of knowledge in their time, their refusal to attempt any large generalizations or to hazard any scientific hypotheses or to build any risky medical system was in a way commendable, but their credulity as to particulars was a weakness.
Galen’s standard of reason and experience.
On the whole Galen’s attitude towards experience seems an improvement upon theirs. He was apparently more critical towards the “experiences” of past writers than the average Empiric, and in his combination of reason and experience he came a little nearer to modern experimental method. Reason alone, he says, discovers some things, experience alone discovers some, but to find others requires use of both experience and reason.700 In his treatise upon critical days he keeps reiterating that their existence is proved both by reason and experience. These two instruments in judging things given us by nature supplement each other.701 “Logical methods have force in finding what is sought, but in believing what has been well found there are two criteria for all men, reason and experience.”702 “What can you do with men who cannot be persuaded either by reason or by practice?”703 Galen also speaks of discovering a truth by logic and being thereby encouraged to try it in practice and of then verifying it by experience.704 This, however, is not quite the same thing as saying that the scientist should aim to discover new truth by purposive experiments, or that from a number of experiences reason may infer some general law of nature.
Simples knowable only from experience.
It is perhaps in his work on medicinal simples that Galen lays most stress upon the importance of experience. Indeed he sees no other way to learn the properties of natural objects than through the experience of the senses.705 “For by the gods,” he exclaims, “how is it that we know that fire is hot? Are we taught it by some syllogism or persuaded of it by some demonstration? And how do we learn that ice is cold except from the senses?”706 And Galen sees no advantage in spending further time in arguments and hair-splitting where one can learn the truth at once from the senses. This thought he keeps repeating through the treatise, saying, for example, “The surest judge of all will be experience alone, and those who abandon it and reason on any other basis not only are deceived but destroy the value of the treatise.”707 Moreover, he restricts his account of medicinal simples to those with which he is personally acquainted. In the three books treating of plants he does not mention all those found in all parts of the world, but only as many as it has been his privilege to know by experience.708 He proposes to follow the same rule in the ensuing discussion of animals and to say nothing of virtues which he has not tested or of substances mentioned in the writings of past physicians but unknown to him. He dares not trust their statements when he reflects how some have lied in such matters. In the middle ages Albertus Magnus talks in much the same strain in his works on animals, plants, and minerals, and perhaps he was stimulated to such ideals, consciously or unconsciously, directly by reading Galen or indirectly through Arabic works, by Galen’s earlier expression of them. Galen mentions some virtues ascribed to substances which he has tested by experience and found false, such as the medicinal properties attributed to the belly of a seagull709 and some of those claimed for the marine animal called torpedo.710 Anointing the place with frog’s blood or dog’s milk will not prevent eyebrows that have been plucked out from growing again, nor will bat’s blood and viper’s fat remove hair from the arm-pits.711 Also the brain of a hare is only fairly good for boys’ teeth.712
Experience and food science.
In beginning his work on food values713 Galen states that many have discussed the properties of aliments, some on the basis of reason alone, some on the basis of experience alone, but that their statements do not agree. On the whole, since reasoning is not easy for everyone, requiring natural sagacity and training from childhood, he thinks it better to start from experience, especially since not a few physicians are of the opinion that only thus can the properties of foods be learned.
Experience and compounds.
The Empirics contended that most compound medicines had been hit upon by chance, and Galen grants that the Dogmatics usually are unable to give reasons for the ingredients of their doses and find difficulty in reproducing a lost prescription.714 But he holds that reasons can be given for the constituents of the compound and that the logical discovery of such remedies differs from the empirical.715 His own method was to learn the nature of each disease and the varied properties of simples, and then prepare a compound suited to the disease and to the patient.716 On the other hand, we see how much depends upon experience from his confession that sometimes he has hastily prepared a compound from a few simples, sometimes from more, sometimes from a great variety. If the compound worked well, he would continue to use it, sometimes making it stronger and sometimes weaker.717 For as you cannot put together compounds without rational method, so you cannot tell their strength certainly and accurately without experience.718 He admits that no one can tell the exact quantity of each ingredient to employ without the aid of experience,719 and says, “The proper proportions in the mixture we shall find conjecturally before experience, scientifically after experience.”720 In these treatises upon compound medicines, unlike that on medicinal simples, Galen gives the prescriptions of former physicians as well as some tested by his own experience.721 Sometimes, however, he expresses a preference for the medicines of those writers who were “most experienced”; and once says that he will give some compounds of the more recent writers, who in their turn had selected the best from older writers of long experience and added later discoveries.722 We suspect, however, that some of these prescriptions had not been tested for centuries.
Suggestions of experimental method.
Galen gives a few directions how to regulate medical observation and experience, although they cannot be said to carry us very far on the road to modern laboratory research. He saw the value of “long experience,” a phrase which he often employs.723 He states that one experience is enough to learn how to prepare a drug, but to learn to know the best medicines in each kind and in different places many experiences are required.724 Medicinal simples should be frequently inspected, “since the knowledge of things perceived by the senses is strengthened by careful examination.”725 Galen advises the student of medicine to study herbs, trees, and fruit as they grow, to find out when it is best to pluck them, how to preserve them, and so on. But elsewhere he states that it is possible to estimate the general virtue of the simple from one or two experiences.726 However, he suggests that their effect be noted in the three cases of a perfectly healthy person, a slightly ailing patient, and a really sick man.727 In the last case one should further note their varying effects as the disease is marked by any excess of heat, cold, dryness, or moisture. Care should be taken that the simples themselves are pure and free from any admixture of a foreign substance.728 “It is also essential to test the relation to the nature of the patient of all those things of which great use is made in the medical art.”729 One condition to be observed in experimental investigation of critical days is to count no cases where any slip has been made by physician or patient or bystanders or where any other foreign factor has done harm.730 Galen was acquainted with physical experiments in siphoning, for he says that, if one withdraws the air from a vessel containing sand and water, the sand will follow before the water, which is the heavier (sic?).731
Difficulty of medical experiment.
Galen also points out some of the difficulties of medical experimentation. One is the extreme unlikelihood of ever being able to observe in even two cases the same combination of symptoms and circumstances.732 The other is the danger to the life of the patient from rash experimenting.733 Thus Galen more than once tells us of abstaining from testing some remedy because he had others of whose effects he was surer.
Empirical remedies.
In the treatise on easily procurable remedies ascribed to Galen,734 in which we have already seen evidence of later interpolation or authorship, some recipes are concluded by such expressions as, “This has been experienced; it works unceasingly,”735 or “Another remedy tested by us in many cases.”736 This became a custom in many subsequent medical works, including those of the middle ages. One recipe is introduced by the caution, “But don’t cure anybody unless you have been paid first, for this has been tested in many cases.”737 But we are left in some doubt whether we should infer that remedies tested by experience are so superior that they call for cash payment rather than credit, or so uncertain that it is advisable that the physician secure his fee before the outcome is known. In the middle ages the word experimentum was used a great deal as a synonym for any medical treatment, recipe, or prescription. Galen approaches this usage, which we have already noticed in Pliny’s Natural History, when he describes “a very important experiment” in bleeding performed by certain doctors at Rome.738
Galen’s influence upon medieval experiment.
Indeed Galen appears to have exerted a great influence in the middle ages by his passages concerning experience in particular as well as by his medicine in general. Medieval writers cite him as an authority for the recognition of experience and reason as criteria of truth.739 Gilbert of England cites “experiences from the book of experiments experienced by Galen,”740 and we shall find more than one such apocryphal work ascribed to Galen in the middle ages. John of St. Amand seems to have developed seven rules741 which he gives for discovering experimentally the properties of medicinal simples from what we have heard Galen say on the subject, and in another work, the Concordances, John collects a number of passages about experience from the works of Galen.742 Peter of Spain, who died as Pope John XXI in 1277, cites Galen in his discussion of “the way of experience” and “the way of reason” in his Commentaries on Isaac on Diets.743 We have already suggested Galen’s possible influence upon Albertus Magnus, and we might add Roger Bacon who wrote some treatises on medicine. But it is hardly possible to tell whether such ideas were in the air, or were due to Galen individually either in their origin or their transmission. But he made a rather close approach to the medieval attitude in his equal regard for logic and for experimentation.
His more general medieval influence.
The more general influence of Galen upon all sides of the medicine of the following fifteen centuries has often been stated in sweeping terms, but is difficult to exaggerate. His general theories, his particular cures, his occasional marvelous stories, were often repeated or paraphrased. Oribasius has been called “the ape of Galen,” and we shall see that the epithet might with equal reason be applied to Aëtius of Amida. Indeed, as in the case of Pliny, we shall find plenty of instances of Galen’s influence in our later chapters. Perhaps as good a single instance of medieval study of Galen as could be given is from the Concordances of John of St. Amand already mentioned, which bear the alternative title, “Recalled to Mind” (Revocativum memoriae), since they were written to “relieve from toil and worry scholars who often spend sleepless nights in searching for points in the books of Galen.”744 Or we may note how the associates of the twelfth century translator from the Arabic, Gerard of Cremona, added a list of his works at the close of his translation of Galen’s Tegni, “imitating Galen in the commemoration of his books at the end of the same treatise,” as they themselves state.745
Not that medieval men did not make additions of their own to Galen. For instance, the noted Jewish philosopher, Moses Maimonides, in adding his collection of medical Aphorisms to the many previous compilations of this sort by Hippocrates, Rasis (Muhammad ibn Zakariya), Mesuë (Yuhanna ibn Masawaih), and others, states that he has drawn them mainly from the works of Galen, but that he supplements these with some in his own name and some by other “moderns.”746 Not that Galen was not sometimes criticized or questioned. A later Greek writer, Symeon Seth, ventured to devote a special treatise to a refutation of some of Galen’s physiological views. In it, addressing himself to those “persons who regard you, O Galen, as a god,” he endeavored to make them realize that no human being is infallible.747 Among the medical treatises of Gentile da Foligno, who was papal physician and performed a public dissection at Padua in 1341,748 is found a brief argument against Galen’s fifth aphorism.749 But such criticism or opposition only shows how generally Galen was accepted as an authority.
III. His Attitude Towards Magic
From Galen’s habits of critical estimation rather than blind acceptation of authority, of scientific observation, careful measurement, and personal experiment, from his brilliant demonstrations by dissection, and his medical prognostication and therapeutics, sane and shrewd for his time,—from these we have now to turn to the other side of the picture, and examine what information his works afford us concerning the magic and astrology in ancient medicine, concerning the belief in occult virtues, suspensions, characters, incantations, and the like. We may first consider what he has to say concerning magic and divination as he understands those words, and then take up his attitude to those other matters which we look upon as almost equally deserving classification under those heads.
Accusations of magic against Galen.
Apollonius of Tyana and Apuleius of Madaura were not the only celebrated men of learning in the early Roman Empire to be accused of magic; we have already alluded to the charges of magic made against Galen by the envious physicians of Rome during his first residence in that city. It is hard to escape the conviction that at that time learned men were very liable to be suspected or accused of magic. Indeed, Galen makes the general assertion that when a physician prognosticates aright concerning the future course of a malady, this seems so marvelous to most men that they would receive him with great affection, if they did not often regard him as a wizard.750 Soon after saying this, Galen begins the story of the prognostications he made and the cure he wrought, when all the other doctors took an opposite view of the case.751 One of them then jealously suggested that Galen’s diagnosis was due to divination.752 When asked by what kind of divination, he gave different answers at different times and to different persons, sometimes saying by dreams, sometimes by sacrificing, again by symbols, or by astrology. Afterwards such charges against Galen kept multiplying.753 As a result, Galen says that since then he has not gone about advertising his prognostications like a herald, lest the physicians and philosophers hate him the more and slander him as a wizard and diviner, but that he now reveals his discoveries only to his friends.754 In another treatise he represents Hippocrates as saying that a proficient doctor should be able to prognosticate the course of diseases, but adds that contemporary physicians call such a doctor a sorcerer and wonder-worker (γόητά τε καὶ παραδοξολόγον).755 Again in his work on medicinal simples756 he states that he abstained from testing the supposed virtue of crocodile’s blood in sharpening the vision, and the blood of house mice in removing warts, partly because he had other reliable eye-medicines and cures for warts—such as myrmecia, a gem with wart-like lumps, partly because by employing such substances he feared to incur the reputation of a sorcerer, since jealous physicians were already slandering his medical prognostications as divination. This last passage affords a good illustration of the close connection with magic of certain natural substances supposed to possess marvelous virtues, while Galen’s wart stone also seems magical to the modern reader.
His charges of magic against others.
Galen himself sometimes calls other physicians magicians. Certain men with whom he does not agree are called by him “liars or wizards or I don’t know what to say,”757 and another man who used mouse dung to excess he calls superstitious and a sorcerer.758 In the same work on simples759 he says that he will list herbs in alphabetical order as Pamphilus did, but that he will not like him descend to old wives’ tales, Egyptian sorceries and incantations, amulets and other magical devices, which not only do not belong in the medical art but are utterly false. Pamphilus never saw most of the herbs he mentioned, much less tested their virtues, but copied anything he found, piling up names, incantations, and wizardry. Galen accuses Xenocrates Aphrodisiensis also of not having eschewed sorcery, and he notes that medical writers have either said nothing about sweat or what is superstitious and bordering upon magic.760
Charms and wonder-workers.
Philters, love-charms, dream-draughts, and imprecations Galen regards as impossible or injurious, and intends to have nothing to do with them. He thinks it ridiculous to believe that by such spells one can bewitch one’s adversaries so that they cannot plead in court, or conceive or bear children. He considers it worse to advertise and perpetuate such false or criminal notions in writings than to practice such a crime but once.761 In one passage,762 however, to illustrate his theory that the gods prepare the sperms of plants and animals, and set them going as it were, and afterwards leave them to themselves, Galen compares them to the wonder-workers—who were perhaps not magicians but men similar to our sidewalk fakirs who exhibit mechanical toys—who start things moving and then go away themselves while what they have prepared moves on artificially for a time.
Animal substance inadmissible in medicine.
Galen’s own works are not entirely free from the magical devices of which he accuses others. We may begin with animal substances, since he himself has testified that the use of sweat, crocodile’s blood, and mouse’s dung is suggestive of magic. Moreover, he attributes more bizarre virtues to the parts of animals than to herbs or stones. In a passage somewhat similar to that in which Pliny763 expressed his horror at the use of human blood, entrails, and skulls as medicines, Galen declares that he will not mention the abominable and detestable, as Xenocrates and some others have done. The Roman law has long forbidden eating human flesh, while Galen regards even the mention of certain secretions and excrements of the human body as offensive to modest ears.764 Nevertheless, before long he offends against his own standard and describes how he administered to patients the very substance which he had before characterized as most unmentionable.765 It may also be noted that he repeats unquestioningly such a tale as that the cubs of the bear are born unformed and licked into shape by their mother.766
Nastiness of ancient medicine.
Further milder illustrations of the fact that such nasty substances were then not merely recommended in books but freely employed in actual medical practice, are seen in the frequent use by one of Galen’s teachers of the dung of dogs who for two days before had eaten nothing but bones,767 in Galen’s own wonderfully successful treatment of a tumor on a rustic’s knee with goat dung—which is, however, too sharp for the skins of children or city ladies,768 and in his discovery by repeated experience that the dung of doves who take little exercise is less potent than that of those who take much,769 Galen also says that he has known of doctors who have cured many persons by giving them burnt human bones in drink without their knowledge.770
Parts of animals.
Galen’s medicinal simples include the bile of bulls, hyenas, cocks, partridges, and other animals.771 A digestive oil can be manufactured by cooking foxes and hyenas, some alive and some dead, whole in oil.772 Galen discusses with perfect seriousness the relative strength of various animal fats, those of the goose, hen, hyena, goat, pig, and so forth.773 He decides that lion’s fat is by far the most potent, with that of the pard next. Among his simples are also found the slough of a snake, a sheepskin, the lichens of horses, a spider’s web,774 and burnt young swallows, for whose introduction into medicine he gives Asclepiades credit.775 Of Archigenes’ prescriptions for toothache he repeats that which recommended holding for some time in the mouth a frog boiled in water and vinegar, or a dog’s tooth, burnt, pulverized, and boiled in vinegar.776 Cavities may be filled with toasted earthworms or spiders’ eggs diluted with unguent of nard. Teething infants are benefited, if their gums are moistened with dog’s milk or anointed with hare’s brains.777 For colic he recommends dried cicadas with three, five, or seven grains of pepper.778
Some scepticism.
Galen is less confident as to the efficacy for earache of the multipedes which roll themselves up into a ball, and which, cooked in oil, are employed especially by rural doctors.779 He is still more sceptical whether the liver of a mad dog will cure its bite.780 Many say so, and he knows of some who have tried it and survived, but they took other remedies too.781 Galen has heard that some who trusted to it alone died. In one treatise782 Galen discusses the strange virtues of the basilisk in much the usual way, but in his work on simples783 he remarks drily that it is obviously impossible to employ it in pharmacy, since, if the tales about it be true, men cannot see it and live or even approach it without danger. He therefore will not include it or elephants or Nile horses (hippopotamuses?) or any other animals of which he has had no personal experience.
Doctrine of occult virtue.
Galen tries to find some satisfactory explanation of the strange properties which he believes exist in so many things. The attractive power of the magnet and of drugs suggests to him that nature in us is divine, as Homer says, and leads like to like and thus shows its divine virtues.784 Galen rejects Epicurus’s explanation of the magnet’s attractive power.785 It was that the atoms flowing off from both the magnet and iron fit one another so closely that the two substances are drawn together. Galen objects that this does not explain how a whole series of rings can be suspended in a row from a magnet. Galen’s teacher Pelops, who claimed to be able to tell the cause of everything, explained why ashes of river crabs are used for the bite of a mad dog as follows.786 The crab is efficacious against hydrophobia because it is an aquatic animal. River crabs are better for this purpose than salt water crabs because salt dries up moisture. He also thought the ashes of crabs very potent in absorbing the venom. But this type of reasoning is unsatisfactory to Galen, who finds the best explanation of all such action in the peculiar property, or occult virtue, of the substance as a whole. Upon this subject787 he proposes to write a separate treatise, and in the fragment De substantia facultatum naturalium (περὶ οὐσίας τῶν φυσικῶν δυνάμεων) he again discusses the matter.788
Virtue of the flesh of vipers.
Among parts of animals Galen regarded the flesh of vipers as especially medicinal, particularly as an antidote to poisons. Of the following cures wrought by vipers’ flesh which Galen narrates789 two were repeated without giving him credit by Aëtius of Amida in the sixth, and Bartholomew of England in the thirteenth century, and doubtless by other writers. When Galen was a youth in Asia, some reapers found a dead viper in their jug of wine and so were afraid to drink any of it. Instead they gave it to a man near by who suffered from the terrible skin disease elephantiasis and whom they thought it would be a mercy to put quietly out of his misery. He drank the wine but instead of dying recovered from his disease. A similarly unexpected cure was effected when a slave wife in Mysia tried to kill her husband by offering him a like drink. A third case was that of a patient whom Galen told of these two previous cures. After resorting to augury to learn if he too should try it and receiving a favorable response, the patient drank wine infected by venom with the result that his elephantiasis changed into leprosy, which Galen cured a little later with the usual drugs. A fourth man, while hunting vipers, was stung by one. Galen bled him, extracted black bile with a drug, and then made him eat the vipers which he had caught and which were prepared in oil like eels. A fifth man, warned by a dream, came from Thrace to Pergamum. Another dream instructed him both to drink, and to anoint himself with, a concoction of vipers. This changed his disease into leprosy which in its turn was cured by drugs which the god prescribed.
Theriac.
The flesh of vipers was an important ingredient in the famous antidote and remedy called theriac, concerning which Galen wrote two special treatises790 besides discussing it in his works on simples and antidotes. Mithridates, like King Attalus in Galen’s native land, had tested the effects of various drugs upon condemned criminals, and had thus discovered antidotes against spiders, scorpions, sea-hares, aconite, and other poisons. He then combined the results of his research into one grand compound which should be an antidote against any and every poison. But he did not include the flesh of the viper, which was added with some other changes by Andromachus, chief physician to Nero.791 The divine Marcus Aurelius used to take a dose of theriac daily and it had since come into general use.792 Galen gives a long list of ills which it will cure, including the plague and hydrophobia,793 and adds that it is beneficial in keeping a man in good health.794 He advises its use when traveling or in wintry weather, and tells Piso that it will prolong his life.795 He explains more than once796 how to prepare the viper’s flesh, why the head and tail must be cut off, how it is cleaned and boiled until the flesh falls from the backbone, how it is mixed with pounded bread into pills, how the flesh of the viper is best in early summer. Galen also accepts the legend,797 quoting six lines of verse from Nicander to that effect, that the viper conceives in the mouth and then bites off the male’s head, and that the young viper avenges its father’s death by gnawing its way out of its mother’s vitals. The Marsi at Rome denied the existence of the dipsas or snake whose bite causes one to die of thirst, but Galen is not quite sure whether to agree with them.
Magical compounds.
Already we have had occasion to refer to Galen’s two works on compound medicines which occupy the better part of two bulky volumes in Kühn’s edition and contain a vast number of prescriptions. It is not uncommon for one of these to contain as many as twenty-five ingredients. It seems unlikely that such elaborate concoctions would have been discovered by chance, as the Empirics held, but the modern reader is ready to agree that it was chance, if anyone was ever cured of anything by one of them. Yet Galen, as we have seen, believes that reasons can be given for the ingredients and would not for a moment admit that they are no better than the messes of witches’ cauldrons. He argues that, if all diseases could be cured by simples, no one would use compounds, but that they are essential for some diseases, especially such as require the simultaneous application of contrary virtues.798 Also where a simple is too strong or weak, it can be toned up or down to just the right strength in a compound. Plasters and poultices seem always to be compounds. Of panaceas Galen is somewhat more chary, except in the case of theriac; he opines that a medicine which is good for a number of ills cannot be very good for any one of them.799
Amulets.
Procedure as well as substances suggestive of magic is found to some extent in Galen’s works. He instructs, for example, to pluck an herb with the left hand before sunrise.800 He also recommends the suspension of a peony to cure epilepsy.801 He saw a boy who wore this root remain free from that disease for eight months, when the root happened to drop off and the boy soon fell in a fit. When another peony root was hung about his neck, he remained in good health until Galen for the sake of experiment removed it a second time, whereupon another epileptic fit ensued as before. In this case Galen suggests that perhaps some particles from the root were drawn in by the patient’s breathing or altered the surrounding air. In another passage he holds that there is no medical reason to account for the virtues of amulets, but that those who have tested them by experience say that they act by some marvelous antipathy unknown to man.802 A ligature recommended by Galen is to bind about the neck of the patient a viper which has been suffocated by tying several strings, preferably of marine purple, about its neck.803 Galen marvels that stercus lupinum, even when simply suspended from the neck, “sometimes evidently is beneficial.”804 It should not have touched the ground but should have been taken from trees or bushes. It also works better, as Galen has found in his own practice, if suspended by the wool of a sheep who has been torn by a wolf.
Incantations and characters.
While Galen thus employs ligatures and suspensions and sanctions magic logic, he draws the line at use of images, characters, and incantations. In the passage just cited he goes on to say that he has found other suspended substances efficacious, but not the barbarous names such as wizards use. Some say that the gem jasper comforts the stomach if bound about the abdomen,805 and some wear it in a ring engraved with a dragon and rays,806 as King Nechepso directs in his fourteenth book. Galen has employed it suspended about the neck without any engraving upon it and found it equally beneficial. In illustrating the virtue of human saliva, especially that of a fasting man, Galen tells of a man who promised him to kill a scorpion by means of an incantation which he repeated thrice. But at each repetition he spat on the scorpion and Galen afterwards killed one by the same procedure without any incantation, and more quickly with the spittle of a fasting than of a full man.807
Belief in magic dies hard.
The preceding paragraph gives a good illustration of the slow progress of human thought away from magic and towards science. Men are discovering that marvels can be worked as well without characters and incantations. Similar passages may be found in Arabic and Latin medieval writers. But while Galen questions images and incantations, he still clings to the notions of marvelous virtue in a fasting man’s spittle or in a gem suspended about the neck. And these and other passages in which he clung to old superstitions were unfortunately equally influential upon succeeding writers, who sometimes, we fear, took them as an excuse for further indulgence in magic. Indeed, we shall find Alexander of Tralles in the sixth century arguing that Galen finally became a believer in the efficacy of incantations. Thus the old notions and practices die hard.
On easily procurable remedies.
In the treatise on easily procurable remedies, where popular and rustic remedies enter rather more largely than in Galen’s other writings, superstitious recipes are also met with more frequently, and, if that be possible, the doses become even more calculated to make one’s gorge rise, it being felt that the unfastidious tastes and crude constitutions of peasants and the poorer classes can stand more than daintier city patients. Another reason for separate consideration of the contents of this treatise is the possibility, already mentioned, that it is interpolated and misarranged, and the fact that it is in part of much later date than Galen.
Specimens of its superstitious contents.
We must limit ourselves to a hasty survey of a few specimens of its prescriptions. Following Archigenes, ligatures and crowns are employed for headaches.808 In contrast to Galen’s previous scepticism concerning depilatories for eyebrows we now find a number mentioned, including the blood of a bed-bug.809 To cure lumbago,810 if the pain is in the right foot, reduce to powder with your right hand the wings of a swallow. Then make an incision in the swallow’s leg and draw off all its blood. Skin it and roast it and eat it entire. Then anoint yourself all over with the oil for three days and you will marvel at the result. “This has been often proved by experience.” To prevent hair from falling out take many bees and burn them and mix with oil and use as an ointment.811 For a sty in the eye catch flies, cut off their heads, and rub the sty with the rest of their bodies.812 A cooked black chameleon performs the double duty of curing toothache and killing mice.813 To extract a tooth in the upper jaw surround it with the worms found in the tops of cabbages; for a lower tooth use the worms on the lower parts of the leaves.814 Pain in the intestines will vanish, if the patient drinks water in which his feet have been washed.815 A net transferred from a woman’s hair to the patient’s head acts as a laxative, especially if the net is first heated.816 Various superstitious devices are suggested to insure the birth of a child of the sex desired.817 Bituminous trefoil,818 boiled and applied hot, cures snake or spider bite, but let no one use it who is not so afflicted or it will make him feel as if he was.819 For cataract is recommended a mixture of equal parts of mouse’s blood, cock’s gall, and woman’s milk, dried.820 For pain on one side of the head or face smear with fifteen earthworms and fifteen grains of pepper powdered in vinegar.821 To stop a cough wear the tongue of an eagle as an amulet.822 Wearing a root of rhododendron makes one fearless of dogs and would cure a mad dog itself, if it could be tied on the animal.823 A “confection” covering three pages is said to prolong life, to have been used by the emperors, and to have enabled Pythagoras, its inventor, who began to make use of it at the age of fifty, to live to be one hundred and seventeen without disease. “And he was a philosopher and unable to lie about it.”824
External signs of the temperaments of internal organs.
It remains to note what there is in Galen’s works in the way of divination and astrology. We are not entirely surprised that contemporary doctors confused his medical prognostic with divination, when we read what he has to say concerning the outward signs of hot or cold internal organs. In the treatise, entitled The Healing Art (τέχνη ἰατρική),825 which Mewaldt says was the most studied of Galen’s works and spread in a vast number of medieval Latin manuscript translations,826 he devotes a number of chapters to such subjects as signs of a hot and dry heart, signs of a hot liver, and signs of a cold lung. Among the signs of a cold brain are excessive excrements from the head, stiff straight red hair, a late birth, mal-nutrition, susceptibility to injury from cold causes and to catarrh, and somnolence.827
Marvelous statements repeated by Maimonides.
In his commentary on the Aphorisms of Hippocrates Galen adds other signs by which it may be foretold whether the child will be a boy or girl to those signs already mentioned by Hippocrates.828 Some of these seem superstitious enough to us. And it was a case of the evil that men do living after them, for Moses Maimonides, the noted Jewish physician of Cordova in the twelfth century, in his collection of Aphorisms, drawn chiefly from the works of Galen, repeats the following method of prognostication: Puerum cum primo spermatizat perscrutare, quem si invenis habere testiculum dextrum maiorem sinistro, you will know that his first child will be a male, otherwise female. The same may be determined in the case of a girl by a comparison of the size of her breasts. Maimonides also repeats, from Galen’s work to Caesar on theriac,829 the story of the ugly man who secured a beautiful son by having a beautiful boy painted on the wall and making his wife keep her eyes fixed upon it. Maimonides also repeats from Galen830 the story of the bear’s licking its unformed cubs into shape.831
Dreams.
In another treatise on Diagnosis from Dreams Galen makes a closer approach to the arts of divination.832 He states that dreams are affected by our daily life and thought, and describes a few corresponding to bodily states or caused by them. He thinks that if you dream you see fire, you are troubled by yellow bile, and if you dream of vapor or darkness, by black bile. In diagnosing dreams one should note when they occurred and what had been eaten. But Galen also believes that to some extent the future can be predicted from dreams, as has been testified, he says, by experience.833 We have already mentioned the effect of his father’s dream upon Galen’s career. In the Hippocratic commentaries834 he says that some scorn dreams and omens and signs, but that he has often learned from dreams how to prognosticate or cure diseases. Once a dream instructed him to let blood between the index and great fingers of the right hand until the flow of blood stopped of its own accord. “It is necessary,” he concludes, “to observe dreams accurately both as to what is seen and what is done in sleep in order that you may prognosticate and heal satisfactorily.” Perhaps he had a dim idea along Freudian lines.
Lack of astrology in most of Galen’s medicine.
In the ordinary run of Galen’s pharmacy and therapeutics there is very little mention or observance of astrological conditions, although Hippocrates is cited as having said that a study of geometry and astronomy—which may well mean astrology—is essential in medicine.835 In the De methodo medendi he often urges the importance of the time of year, the region, and the state of the sky.836 But this expression seems to refer to the weather rather than to the position of the constellations. The dog-star is also occasionally mentioned,837 and one passage838 tells how “Aeschrion the Empiric,... an old man most experienced in drugs and our fellow citizen and teacher,” burned live river crabs on a plate of red bronze after the rise of the dog-star when the sun entered Leo and on the eighteenth day of the moon. We are also informed that many Romans are in the habit of taking theriac on the first or fourth day of the moon.839 But Galen ridicules Pamphilus for his thirty-six sacred herbs of the horoscope—or decans, taken from an Egyptian Hermes book.840 On the other hand, one of his objections to the atomists is that “they despise augury, dreams, portents, and all astrology,” as well as that they deny a divine artificer of the world and an innate moral law to the soul.841 Thus atheism and disbelief in astrology are put on much the same plane.
The Prognostication of Disease by Astrology.
Whereas there is so little to suggest a belief in astrology in most of Galen’s works, we find among them two devoted especially to astrological medicine, namely, a treatise on critical days in which the influence of the moon upon disease is assumed, and the Prognostication of Disease by Astrology. In the latter he states that the Stoics favored astrology, that Diodes Carystius represented the ancients as employing the course of the moon in prognostications, and that, if Hippocrates said that physicians should know physiognomy, they ought much more to learn astrology, of which physiognomy is but a part.842 There follows a statement of the influence of the moon in each sign of the zodiac and in its relations to the other planets.843 On this basis is foretold what diseases a man will have, what medical treatment to apply, whether the patient will die or not, and if so in how many days. This treatise is the same as that ascribed in many medieval manuscripts to Hippocrates and translated into Latin by both William of Moerbeke and Peter of Abano.
Critical days.
The treatise on critical days discusses them not by reason or dogma, lest sophists befog the plain facts, but solely, we are told, upon the basis of clear experience.844 Having premised that “we receive the force of all the stars above,”845 the author presents indications of the especially great influence of sun and moon. The latter he regards not as superior to the other planets in power, but as especially governing the earth because of its nearness.846 He then discusses the moon’s phases, holding that it causes great changes in the air, rules conceptions and birth, and “all beginnings of actions.”847 Its relations to the other planets and to the signs of the zodiac are also considered and much astrological technical detail is introduced.848 But the Pythagorean theory that the numbers of the critical days are themselves the cause of their significance in medicine is ridiculed, as is the doctrine that odd numbers are masculine and even numbers feminine.849 Later the author also ridicules those who talk of seven Pleiades and seven stars in either Bear and the seven gates of Thebes or seven mouths of the Nile.850 Thus he will not accept the doctrine of perfect or magic numbers along with his astrological theory. Much of this rather long treatise is devoted to a discussion of the duration of a moon, and it is shown that one of the moon’s quarters is not exactly seven days in length and that the fractions affect the incidence of the critical days.
On the history of philosophy.
A treatise on the history of philosophy, which is marked “spurious” in Kühn’s edition, I have also discovered among the essays of Plutarch where, too, it is classed as spurious.851 In some ways it is suggestive of the middle ages. After an account of the history of Greek philosophy somewhat in the style of the brief reviews of the same to be found in the church fathers, it adds a sketch of the universe and natural phenomena not dissimilar to some medieval treatises of like scope. There are chapters on the universe, God, the sky, the stars, the sun, the moon, the magnus annus, the earth, the sea, the Nile, the senses, vision and mirrors, hearing, smell and taste, the voice, the soul, breathing, the processes of generation, and so on.
Divination and demons.
In discussing divination852 the treatise states that Plato and the Stoics attributed it to God and to divinity of the spirit in ecstasy, or to interpretation of dreams or astrology or augury. Xenophanes and Epicurus denied it entirely. Pythagoras admitted only divination by haruspices or by sacrifice. Aristotle and Dicaearchus admit only divination by enthusiasm and by dreams. For although they deny that the human soul is immortal, they think that there is something divine about it. Herophilus said that dreams sent by God must come true. Other dreams are natural, when the mind forms images of things useful to it or about to happen to it. Still others are fortuitous or mere reflections of our desires. The treatise also takes up the subject of heroes and demons.853 Epicurus denied the existence of either, but Thales, Plato, Pythagoras, and the Stoics agree that demons are natural substances, while heroes are souls separate from bodies, and are good or bad according to the lives of the men who lived in those bodies.
Celestial bodies.
The treatise also gives the opinions of various Greek philosophers on the question whether the universe or its component spheres are either animals or animated. Fate is defined on the authority of Heracleitus as “the heavenly body, the seed of the genesis of all things.”854 The question is asked why babies born after seven months live, while those born after eight months die.855 On the other hand, a very brief discussion of how the stars prognosticate does not go into particulars beyond their indication of seasons and weather, and even this Anaximenes ascribed to the effect of the sun alone.856 Philolaus the Pythagorean is quoted concerning some lunar water about the stars857 which reminds one of the waters above the firmament in the first chapter of Genesis.