Galen in the Roman Empire
The Prince of Medicine
Galen in the Roman Empire
Susan P. Mattern
Oxford University Press 334pp £20
The physician Galen of Pergamum was the leading anatomist of antiquity. However his science was based on dissection of animals, since the dissection of humans was virtually taboo in the Roman Empire. He was, therefore, mistaken in many of his views of human anatomy, such as the structure of the heart (though he did disprove Aristotle’s notion that the heart was the seat of reason, noting that gladiators wounded in the heart remained lucid until death). Not until the Renaissance did Andreas Vesalius undertake human dissection in earnest and reveal the true cardiac anatomy. Indeed Vesalius acknowledged his debt to Galen, calling him the ‘prince of medicine’ in the second edition of his De Fabrica Corporis Humani (1555). However neither Galen nor Vesalius grasped the concept of circulation of the blood, pumped by the heart, which was discovered only in the 17th century.
This much is widely known. Less appreciated is Galen’s life in Alexandria, Pergamum, Rome and places in between, which was eventful and fascinating, as Susan Mattern vividly shows. For example, after gaining a stellar reputation in disease-ridden Rome, Galen was recalled from Pergamum by Emperor Marcus Aurelius in order to accompany his army against ‘barbarian’ German tribes. Galen, who apparently never learnt Latin and was ambivalent about joining the Roman elite, wriggled out of what he guessed would be a protracted and gruelling war. However he later regretted his evasion as the emperor had permitted dissection of one or more of the slain enemy. Mattern stresses that: ‘There can be no doubt that if he had known he would be allowed to dissect a human, he would have braved the perils and discomforts of the campaign and endured the importunities of the emperor.’ As for his colleagues fortunate to have dissected German corpses, Galen showed only scorn. They ‘did not learn more than butchers know’, he wrote.
Galen’s relationships with his contemporaries tended to be highly competitive, even cut-throat. With his intellect, skill and daring, Galen usually worsted his professional rivals, while saving his patients. Competition was very public in the sickroom, surrounded by the patient’s family, friends and other doctors. But Galen upped the ante by offering ‘anatomy-as-spectacle’: demonstrating animal vivisection surrounded by scrolls of anatomical works by his fellow physicians. He would ask his audience to name a part for dissection, then operate on the struggling creature and show how reality differed from the anatomy described in his rivals’ manuscripts.
According to Galen, he never charged a patient a fee and regularly treated the poor for no personal advantage. The only payment he mentioned – a huge gift of 400 gold coins – came from his old friend and patron, the senator and ex-consul Flavius Boethus, for curing his wife. Susan Mattern endorses these claims but criticises Galen’s support for therapeutic bloodletting. ‘He was a gentleman, a Greek, a leading citizen of Pergamum. His lifestyle came to him by birthright; but his skill and reputation, by hard work, exhaustive study, experiment, experience and proven superiority over his rivals.’ Having read this scholarly, gripping and often gory biography, one appreciates, exquisitely, the author’s conclusion that Galen, though ‘not necessarily a good man’, could still be ‘a good doctor’. Perhaps this has been true of all the greatest physicians.
Andrew Robinson is the editor of Exceptional Creativity in Science and Technology: Individuals, Institutions and Innovations (Templeton Foundation Press, 2013) and The Scientists: An Epic of Discovery (Thames and Hudson, 2012)