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For other uses, see Galen (disambiguation). Galen_sentence_0


BornGalen_header_cell_0_1_0 September 129 AD

Pergamon, Asia, Roman EmpireGalen_cell_0_1_1

DiedGalen_header_cell_0_2_0 c. 210 AD

Rome, Roman EmpireGalen_cell_0_2_1

NationalityGalen_header_cell_0_3_0 GreekGalen_cell_0_3_1
OccupationGalen_header_cell_0_4_0 PhysicianGalen_cell_0_4_1

Aelius Galenus or Claudius Galenus (Greek: Κλαύδιος Γαληνός; September 129 AD – c. 200/c. Galen_sentence_1

216), often Anglicized as Galen and sometimes known as Galen of Pergamon (/ˈɡeɪlən/), was a physician, surgeon and philosopher in the Roman Empire. Galen_sentence_2

He is considered one of the most accomplished of all medical researchers of antiquity, Galen influenced the development of various scientific disciplines, including anatomy, physiology, pathology, pharmacology, and neurology, as well as philosophy and logic. Galen_sentence_3

The son of Aelius Nicon, a wealthy Greek architect with scholarly interests, Galen received a comprehensive education that prepared him for a successful career as a physician and philosopher. Galen_sentence_4

Born in the ancient city of Pergamon (present-day Bergama, Turkey), Galen travelled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome, where he served prominent members of Roman society and eventually was given the position of personal physician to several emperors. Galen_sentence_5

Galen's understanding of anatomy and medicine was principally influenced by the then-current theory of humorism (also known as the theory of the four humors: black bile, yellow bile, blood, and phlegm), as advanced by ancient Greek physicians such as Hippocrates. Galen_sentence_6

Galen's views dominated and influenced Western medical science for more than 1,300 years. Galen_sentence_7

His anatomical reports were based mainly on the dissection of monkeys. Galen_sentence_8

However, while dissecting them he discovered that their facial expressions were too much like those of humans; thus, he switched to other animals, especially pigs. Galen_sentence_9

The reason for using animals to discover the human body was due to the fact that dissections and vivisections on humans were strictly prohibited at the time. Galen_sentence_10

Galen would encourage his students to go look at dead gladiators or bodies that washed up in order to get better acquainted with the human body. Galen_sentence_11

Galen’s most famous experiment that he recreated in public was the squealing pig. Galen_sentence_12

The squealing pig experiment was when Galen would cut open a pig, and while it was squealing he would cut the nerve, or vocal cords, showing they controlled the making of sound. Galen_sentence_13

His anatomical reports remained uncontested until 1543, when printed descriptions and illustrations of human dissections were published in the seminal work De humani corporis fabrica by Andreas Vesalius where Galen's physiological theory was accommodated to these new observations. Galen_sentence_14

Galen's theory of the physiology of the circulatory system remained unchallenged until ca. 1242, when Ibn al-Nafis published his book Sharh tashrih al-qanun li’ Ibn Sina (Commentary on Anatomy in Avicenna's Canon), in which he reported his discovery of the pulmonary circulation. Galen_sentence_15

Galen saw himself as both a physician and a philosopher, as he wrote in his treatise titled That the Best Physician Is Also a Philosopher. Galen_sentence_16

Galen was very interested in the debate between the rationalist and empiricist medical sects, and his use of direct observation, dissection and vivisection represents a complex middle ground between the extremes of those two viewpoints. Galen_sentence_17

Many of his works have been preserved and/or translated from the original Greek, although many were destroyed and some credited to him are believed to be spurious. Galen_sentence_18

Although there is some debate over the date of his death, he was no younger than seventy when he died. Galen_sentence_19

Early life: AD 129–161 Galen_section_0

Galen's name Γαληνός, Galēnos comes from the adjective "γαληνός", "calm". Galen_sentence_20

Galen describes his early life in On the affections of the mind. Galen_sentence_21

He was born in September AD 129. Galen_sentence_22

His father, Aelius Nicon, was a wealthy patrician, an architect and builder, with eclectic interests including philosophy, mathematics, logic, astronomy, agriculture and literature. Galen_sentence_23

Galen describes his father as a "highly amiable, just, good and benevolent man". Galen_sentence_24

At that time Pergamon (modern-day Bergama, Turkey) was a major cultural and intellectual centre, noted for its library, second only to that in Alexandria, and attracted both Stoic and Platonic philosophers, to whom Galen was exposed at age 14. Galen_sentence_25

His studies also took in each of the principal philosophical systems of the time, including Aristotelian and Epicurean. Galen_sentence_26

His father had planned a traditional career for Galen in philosophy or politics and took care to expose him to literary and philosophical influences. Galen_sentence_27

However, Galen states that in around AD 145 his father had a dream in which the god Asclepius (Aesculapius) appeared and commanded Nicon to send his son to study medicine. Galen_sentence_28

Again, no expense was spared, and following his earlier liberal education, at 16 he began studies at the prestigious local sanctuary or Asclepieum dedicated to Asclepius, god of medicine, as a θεραπευτής (therapeutes, or attendant) for four years. Galen_sentence_29

There he came under the influence of men like Aeschrion of Pergamon, Stratonicus and Satyrus. Galen_sentence_30

Asclepiea functioned as spas or sanitoria to which the sick would come to seek the ministrations of the priesthood. Galen_sentence_31

Romans frequented the temple at Pergamon in search of medical relief from illness and disease. Galen_sentence_32

It was also the haunt of notable people such as Claudius Charax the historian, Aelius Aristides the orator, Polemo the sophist, and Cuspius Rufinus the Consul. Galen_sentence_33

Galen's father died in 148, leaving Galen independently wealthy at the age of 19. Galen_sentence_34

He then followed the advice he found in Hippocrates' teaching and travelled and studied widely including such destinations as Smyrna (now Izmir), Corinth, Crete, Cilicia (now Çukurova), Cyprus, and finally the great medical school of Alexandria, exposing himself to the various schools of thought in medicine. Galen_sentence_35

In 157, aged 28, he returned to Pergamon as physician to the gladiators of the High Priest of Asia, one of the most influential and wealthy men in Asia. Galen_sentence_36

Galen claims that the High Priest chose him over other physicians after he eviscerated an ape and challenged other physicians to repair the damage. Galen_sentence_37

When they refused, Galen performed the surgery himself and in so doing won the favor of the High Priest of Asia. Galen_sentence_38

Over his four years there, he learned the importance of diet, fitness, hygiene and preventive measures, as well as living anatomy, and the treatment of fractures and severe trauma, referring to their wounds as "windows into the body". Galen_sentence_39

Only five deaths among the gladiators occurred while he held the post, compared to sixty in his predecessor's time, a result that is in general ascribed to the attention he paid to their wounds. Galen_sentence_40

At the same time he pursued studies in theoretical medicine and philosophy. Galen_sentence_41

Later years: AD 162–217 Galen_section_1

Galen went to Rome in 162 and made his mark as a practicing physician. Galen_sentence_42

His impatience brought him into conflict with other doctors and he felt menaced by them. Galen_sentence_43

His demonstrations there antagonized the less skilled and more conservative physicians in the city. Galen_sentence_44

When Galen's animosity with the Roman medical practitioners became serious, he feared he might be exiled or poisoned, so he left the city. Galen_sentence_45

Rome had engaged in foreign wars in 161; Marcus Aurelius and his colleague Lucius Verus were in the north fighting the Marcomanni. Galen_sentence_46

During the autumn of 169 when Roman troops were returning to Aquileia, a great plague broke out, and the emperor summoned Galen back to Rome. Galen_sentence_47

He was ordered to accompany Marcus and Verus to Germany as the court physician. Galen_sentence_48

The following spring Marcus was persuaded to release Galen after receiving a report that Asclepius was against the project. Galen_sentence_49

He was left behind to act as physician to the imperial heir Commodus. Galen_sentence_50

It was here in court that Galen wrote extensively on medical subjects. Galen_sentence_51

Ironically, Lucius Verus died in 169, and Marcus Aurelius himself died in 180, both victims of the plague. Galen_sentence_52

Galen was the physician to Commodus for much of the emperor’s life and treated his common illnesses. Galen_sentence_53

According to Dio Cassius 72.14.3–4, in about 189, under Commodus’ reign, a pestilence occurred which at its height killed 2,000 people a day in Rome. Galen_sentence_54

This was most likely the same plague that struck Rome during Marcus Aurelius’ reign. Galen_sentence_55

Galen became physician to Septimius Severus during his reign in Rome. Galen_sentence_56

Galen compliments Severus and Caracalla on keeping a supply of drugs for their friends and mentions three cases in which they had been of use in 198. Galen_sentence_57

The Antonine Plague Galen_section_2

Main article: Antonine Plague Galen_sentence_58

The Antonine Plague was named after Marcus Aurelius’ family name of Antoninus. Galen_sentence_59

It was also known as the Plague of Galen and held an important place in medicinal history because of its association with Galen. Galen_sentence_60

He had first-hand knowledge of the disease, and was present in Rome when it first struck in 166 AD, and was also present in the winter of 168–69 during an outbreak among troops stationed at Aquileia. Galen_sentence_61

He had experience with the epidemic, referring to it as very long lasting, and described its symptoms and his treatment of it. Galen_sentence_62

Unfortunately, his references to the plague are scattered and brief. Galen_sentence_63

Galen was not trying to present a description of the disease so that it could be recognized in future generations; he was more interested in the treatment and physical effects of the disease. Galen_sentence_64

For example, in his writings about a young man afflicted with the plague, he concentrated on the treatment of internal and external ulcerations. Galen_sentence_65

According to Niebuhr, "this pestilence must have raged with incredible fury; it carried off innumerable victims. Galen_sentence_66

The ancient world never recovered from the blow inflicted upon it by the plague that visited it in the reign of M. Galen_sentence_67

Aurelius." Galen_sentence_68

The mortality rate of the plague was 7–10 percent; the outbreak in 165–168 would have caused approximately 3.5 to 5 million deaths. Galen_sentence_69

Otto Seeck believes that over half the population of the empire perished. Galen_sentence_70

J. F. Gilliam believes that the Antonine plague probably caused more deaths than any other epidemic during the empire before the mid-3rd century. Galen_sentence_71

Although Galen's description is incomplete, it is sufficient to enable a firm identification of the disease as smallpox. Galen_sentence_72

Galen notes that the exanthema covered the victim's entire body and was usually black. Galen_sentence_73

The exanthem became rough and scabby where there was no ulceration. Galen_sentence_74

He states that those who were going to survive developed a black exanthem. Galen_sentence_75

According to Galen, it was black because of a remnant of blood putrefied in a fever blister that was pustular. Galen_sentence_76

His writings state that raised blisters were present in the Antonine plague, usually in the form of a blistery rash. Galen_sentence_77

Galen states that the skin rash was close to the one Thucydides described. Galen_sentence_78

Galen describes symptoms of the alimentary tract via a patient's diarrhea and stools. Galen_sentence_79

If the stool was very black, the patient died. Galen_sentence_80

He says that the amount of black stools varied. Galen_sentence_81

It depended on the severity of the intestinal lesions. Galen_sentence_82

He observes that in cases where the stool was not black, the black exanthema appeared. Galen_sentence_83

Galen describes the symptoms of fever, vomiting, fetid breath, catarrh, cough, and ulceration of the larynx and trachea. Galen_sentence_84

Eudemus Galen_section_3

When the Peripatetic philosopher Eudemus became ill with quartan fever, Galen felt obliged to treat him "since he was my teacher and I happened to live nearby." Galen_sentence_85

Galen wrote: "I return to the case of Eudemus. Galen_sentence_86

He was thoroughly attacked by the three attacks of quartan ague, and the doctors had given him up, as it was now mid-winter." Galen_sentence_87

Some Roman physicians criticized Galen for his use of the prognosis in his treatment of Eudemus. Galen_sentence_88

This practice conflicted with the then-current standard of care, which relied upon divination and mysticism. Galen_sentence_89

Galen retaliated against his detractors by defending his own methods. Galen_sentence_90

Garcia-Ballester quotes Galen as saying: "In order to diagnose, one must observe and reason. Galen_sentence_91

This was the basis of his criticism of the doctors who proceeded alogos and askeptos." Galen_sentence_92

However, Eudemus warned Galen that engaging in conflict with these physicians could lead to his assassination. Galen_sentence_93

"Eudemus said this, and more to the same effect; he added that if they were not able to harm me by unscrupulous conduct they would proceed to attempts at poisoning. Galen_sentence_94

Among other things he told me that, some ten years before, a young man had come to the city and had given, like me practical demonstrations of the resources of our art; this young man was put to death by poison, together with two servants who accompanied him." Galen_sentence_95

Garcia-Ballester says the following of Galen’s use of prognosis: "In modern medicine, we are used to distinguishing between the diagnostic judgment (the scientific knowledge of what a patient has) and the prognostic judgment (the conjecture about what will happen to him.) Galen_sentence_96

For Galen, to understand a clinical case technically, ‘to diagnose’, was, among other things, to know with greater or lesser certainty the outcome for the patient, ‘to prognosticate’. Galen_sentence_97

Prognosis, then, is one of the essential problems and most important objectives of Galenic diagnosis. Galen_sentence_98

Galen was concerned with distinguishing prognosis from divination or prophecy, both to improve diagnosis technically and to enhance the physician's reputation." Galen_sentence_99

Death Galen_section_4

The 11th-century Suda lexicon states that Galen died at the age of 70, which would place his death in about the year 199. Galen_sentence_100

However, there is a reference in Galen's treatise "On Theriac to Piso" (which may, however, be spurious) to events of 204. Galen_sentence_101

There are also statements in Arabic sources that he died in Sicily at age 87, after 17 years studying medicine and 70 practicing it, which would mean he died about 217. Galen_sentence_102

According to these sources, the tomb of Galenus in Palermo was still well preserved in the tenth century. Galen_sentence_103

Nutton believes that "On Theriac to Piso" is genuine, that the Arabic sources are correct, and that the Suda has erroneously interpreted the 70 years of Galen's career in the Arabic tradition as referring to his whole lifespan. Galen_sentence_104

Boudon-Millot more or less concurs and favours a date of 216. Galen_sentence_105

Contributions to medicine Galen_section_5

Further information: Humorism Galen_sentence_106

Galen contributed a substantial amount to the Hippocratic understanding of pathology. Galen_sentence_107

Under Hippocrates' bodily humors theory, differences in human moods come as a consequence of imbalances in one of the four bodily fluids: blood, yellow bile, black bile, and phlegm. Galen_sentence_108

Galen promoted this theory and the typology of human temperaments. Galen_sentence_109

In Galen's view, an imbalance of each humor corresponded with a particular human temperament (blood—sanguine, black bile—melancholic, yellow bile—choleric, and phlegm—phlegmatic). Galen_sentence_110

Thus, individuals with sanguine temperaments are extroverted and social; choleric people have energy, passion, and charisma; melancholics are creative, kind, and considerate; and phlegmatic temperaments are characterized by dependability, kindness, and affection. Galen_sentence_111

Galen's principal interest was in human anatomy, but Roman law had prohibited the dissection of human cadavers since about 150 BC. Galen_sentence_112

Because of this restriction, Galen performed anatomical dissections on living (vivisection) and dead animals, mostly focusing on primates. Galen_sentence_113

This work was useful because Galen believed that the anatomical structures of these animals closely mirrored those of humans. Galen_sentence_114

Galen clarified the anatomy of the trachea and was the first to demonstrate that the larynx generates the voice. Galen_sentence_115

In one experiment, Galen used bellows to inflate the lungs of a dead animal. Galen_sentence_116

Galen's work on the anatomy remained largely unsurpassed and unchallenged up until the 16th century in Europe. Galen_sentence_117

In the middle of the 16th century, the anatomist Andreas Vesalius challenged the anatomical knowledge of Galen by conducting dissections on human cadavers. Galen_sentence_118

These investigations allowed Vesalius to refute aspects of Galen's anatomy. Galen_sentence_119

Among Galen's major contributions to medicine was his work on the circulatory system. Galen_sentence_120

He was the first to recognize that there are distinct differences between venous (dark) and arterial (bright) blood. Galen_sentence_121

Although his anatomical experiments on animal models led him to a more complete understanding of the circulatory system, nervous system, respiratory system, and other structures, his work contained scientific errors. Galen_sentence_122

Galen believed the circulatory system to consist of two separate one-way systems of distribution, rather than a single unified system of circulation. Galen_sentence_123

He believed venous blood to be generated in the liver, from where it was distributed and consumed by all organs of the body. Galen_sentence_124

He posited that arterial blood originated in the heart, from where it was distributed and consumed by all organs of the body. Galen_sentence_125

The blood was then regenerated in either the liver or the heart, completing the cycle. Galen_sentence_126

Galen also believed in the existence of a group of blood vessels he called the rete mirabile in the carotid sinus. Galen_sentence_127

Both of these theories of the circulation of blood were later (beginning with works of Ibn al-Nafis published ca. 1242) shown to be incorrect. Galen_sentence_128

In his work De motu musculorum, Galen explained the difference between motor and sensory nerves, discussed the concept of muscle tone, and explained the difference between agonists and antagonists. Galen_sentence_129

Galen was a skilled surgeon, operating on human patients. Galen_sentence_130

Many of his procedures and techniques would not be used again for centuries, such as the procedures he performed on brains and eyes. Galen_sentence_131

To correct cataracts in patients, Galen performed an operation similar to a modern one. Galen_sentence_132

Using a needle-shaped instrument, Galen attempted to remove the cataract-affected lens of the eye. Galen_sentence_133

His surgical experiments included ligating the arteries of living animals. Galen_sentence_134

Although many 20th century historians have claimed that Galen believed the lens to be in the exact center of the eye, Galen actually understood that the crystalline lens is located in the anterior aspect of the human eye. Galen_sentence_135

At first reluctantly but then with increasing vigour, Galen promoted Hippocratic teaching, including venesection and bloodletting, then unknown in Rome. Galen_sentence_136

This was sharply criticised by the Erasistrateans, who predicted dire outcomes, believing that it was not blood but pneuma that flowed in the veins. Galen_sentence_137

Galen, however, staunchly defended venesection in his three books on the subject and in his demonstrations and public disputations. Galen_sentence_138

Contributions to philosophy Galen_section_6

See also: Philosophy of medicine Galen_sentence_139

Although the main focus of his work was on medicine, anatomy, and physiology, Galen also wrote about logic and philosophy. Galen_sentence_140

His writings were influenced by earlier Greek and Roman thinkers, including Plato, Aristotle, the Stoics, and the Pyrrhonists. Galen_sentence_141

Galen was concerned to combine philosophical thought with medical practice, as in his brief work That the Best Physician is also a Philosopher he took aspects from each group and combined them with his original thought. Galen_sentence_142

He regarded medicine as an interdisciplinary field that was best practiced by utilizing theory, observation, and experimentation in conjunction. Galen_sentence_143

Several schools of thought existed within the medical field during Galen's lifetime, the main two being the Empiricists and Rationalists (also called Dogmatists or Philosophers), with the Methodists being a smaller group. Galen_sentence_144

The Empiricists emphasized the importance of physical practice and experimentation, or "active learning" in the medical discipline. Galen_sentence_145

In direct opposition to the Empiricists were the Rationalists, who valued the study of established teachings in order to create new theories in the name of medical advancements. Galen_sentence_146

The Methodists formed somewhat of a middle ground, as they were not as experimental as the Empiricists, nor as theoretical as the Rationalists. Galen_sentence_147

The Methodists mainly utilized pure observation, showing greater interest in studying the natural course of ailments than making efforts to find remedies. Galen_sentence_148

Galen's education had exposed him to the five major schools of thought (Platonists, Peripatetics, Stoics, Epicureans, Pyrrhonists), with teachers from the Rationalist sect and from the Empiricist sect. Galen_sentence_149

Opposition to the Stoics Galen_section_7

Galen was well known for his advancements in medicine and the circulatory system, but he was also concerned with philosophy. Galen_sentence_150

He developed his own tripartite soul model following the examples of Plato; some scholars refer to him as a Platonist. Galen_sentence_151

Galen developed a theory of personality based on his understanding of fluid circulation in humans, and he believed that there was a physiological basis for mental disorders. Galen_sentence_152

Galen connected many of his theories to the pneuma and he opposed the Stoics' definition of and use of the pneuma. Galen_sentence_153

The Stoics, according to Galen, failed to give a credible answer for the localization of functions of the psyche, or the mind. Galen_sentence_154

Through his use of medicine, he was convinced that he came up with a better answer, the brain. Galen_sentence_155

The Stoics only recognized the soul as having one part, which was the rational soul and they claimed it would be found in the heart. Galen_sentence_156

Galen, following Plato's idea, came up with two more parts to the soul. Galen_sentence_157

Galen also rejected Stoic propositional logic and instead embraced a hypothetical syllogistic which was strongly influenced by the Peripatetics and based on elements of Aristotelian logic. Galen_sentence_158

Localization of function Galen_section_8

One of Galen's major works, On the Doctrines of Hippocrates and Plato, sought to demonstrate the unity of the two subjects and their views. Galen_sentence_159

Using their theories, combined with Aristotle's, Galen developed a tripartite soul consisting of similar aspects. Galen_sentence_160

He used the same terms as Plato, referring to the three parts as rational, spiritual, and appetitive. Galen_sentence_161

Each corresponded to a localized area of the body. Galen_sentence_162

The rational soul was in the brain, the spiritual soul was in the heart, and the appetitive soul was in the liver. Galen_sentence_163

Galen was the first scientist and philosopher to assign specific parts of the soul to locations in the body because of his extensive background in medicine. Galen_sentence_164

This idea is now referred to as localization of function. Galen_sentence_165

Galen's assignments were revolutionary for the time period, which set the precedent for future localization theories. Galen_sentence_166

Galen believed each part of this tripartite soul controlled specific functions within the body and that the soul, as a whole, contributed to the health of the body, strengthening the "natural functioning capacity of the organ or organs in question". Galen_sentence_167

The rational soul controlled higher level cognitive functioning in an organism, for example, making choices or perceiving the world and sending those signals to the brain. Galen_sentence_168

He also listed "imagination, memory, recollection, knowledge, thought, consideration, voluntary motion and sensation" as being found within the rational soul. Galen_sentence_169

The functions of "growing or being alive" resided in the spirited soul. Galen_sentence_170

The spirited soul also contained our passions, such as anger. Galen_sentence_171

These passions were considered to be even stronger than regular emotions, and, as a consequence, more dangerous. Galen_sentence_172

The third part of the soul, or the appetitive spirit, controlled the living forces in our body, most importantly blood. Galen_sentence_173

The appetitive spirit also regulated the pleasures of the body and was moved by feelings of enjoyment. Galen_sentence_174

This third part of the soul is the animalistic, or more natural, side of the soul; it deals with the natural urges of the body and survival instincts. Galen_sentence_175

Galen proposed that when the soul is moved by too much enjoyment, it reaches states of "incontinence" and "licentiousness", the inability to willfully cease enjoyment, which was a negative consequence of too much pleasure. Galen_sentence_176

In order to unite his theories about the soul and how it operated within the body, he adapted the theory of the pneuma, which he used to explain how the soul operated within its assigned organs, and how those organs, in turn, interacted together. Galen_sentence_177

Galen then distinguished the vital pneuma, in the arterial system, from the psychic pneuma, in the brain and nervous system. Galen_sentence_178

Galen placed the vital pneuma in the heart and the psychic pneuma within the brain. Galen_sentence_179

He conducted many anatomical studies on animals, most famously an ox, to study the transition from vital to psychic pneuma. Galen_sentence_180

Although highly criticized for comparing animal anatomy to human anatomy, Galen was convinced that his knowledge was abundant enough in both anatomies to base one on the other. Galen_sentence_181

In his treatise On the usefulness of the parts of the body, Galen argued the perfect conformation of each part of the body and its strict pertinence with its function founded the needy role of an intelligent creator. Galen_sentence_182

His creationist was anticipated by the anatomical examples of Socrates and Empedocles. Galen_sentence_183

Mind–body problem Galen_section_9

Further information: Mind–body problem Galen_sentence_184

Galen believed there to be no distinction between the mental and the physical. Galen_sentence_185

This was a controversial argument of the time, and Galen fell with the Greeks in believing that the mind and body were not separate faculties. Galen_sentence_186

He believed that this could be scientifically proven. Galen_sentence_187

This was where his opposition to the Stoics became most prevalent. Galen_sentence_188

Galen proposed organs within the body to be responsible for specific functions, rather than individual parts. Galen_sentence_189

According to Galen, the Stoics' lack of scientific justification discredited their claims of the separateness of mind and body, which is why he spoke so strongly against them. Galen_sentence_190

Psychotherapy Galen_section_10

Another one of Galen's major works, On the Diagnosis and Cure of the Soul's Passion, discussed how to approach and treat psychological problems. Galen_sentence_191

This was Galen's early attempt at what would later be called psychotherapy. Galen_sentence_192

His book contained directions on how to provide counsel to those with psychological issues to prompt them to reveal their deepest passions and secrets, and eventually cure them of their mental deficiency. Galen_sentence_193

The leading individual, or therapist, had to be a male, preferably of an older, wiser, age, as well as free from the control of the passions. Galen_sentence_194

These passions, according to Galen, caused the psychological problems that people experienced. Galen_sentence_195

Published works Galen_section_11

Main article: Galenic corpus Galen_sentence_196

Galen may have produced more work than any author in antiquity, rivaling the quantity of work issued from Augustine of Hippo. Galen_sentence_197

So profuse was Galen's output that the surviving texts represent nearly half of all the extant literature from ancient Greece. Galen_sentence_198

It has been reported that Galen employed twenty scribes to write down his words. Galen_sentence_199

Galen may have written as many as 500 treatises, amounting to some 10 million words. Galen_sentence_200

Although his surviving works amount to some 3 million words, this is thought to represent less than a third of his complete writings. Galen_sentence_201

In AD 191, a fire in the Temple of Peace destroyed many of his works, in particular treatises on philosophy. Galen_sentence_202

Because Galen's works were not translated into Latin in the ancient period, and because of the collapse of the Roman Empire in the West, the study of Galen, along with the Greek medical tradition as a whole, went into decline in Western Europe during the Early Middle Ages, when very few Latin scholars could read Greek. Galen_sentence_203

However, in general, Galen and the ancient Greek medical tradition continued to be studied and followed in the Eastern Roman Empire, commonly known as the Byzantine Empire. Galen_sentence_204

All of the extant Greek manuscripts of Galen were copied by Byzantine scholars. Galen_sentence_205

In the Abbasid period (after AD 750) Arab Muslims began to be interested in Greek scientific and medical texts for the first time, and had some of Galen's texts translated into Arabic, often by Syrian Christian scholars (see below). Galen_sentence_206

As a result, some texts of Galen exist only in Arabic translation, while others exist only in medieval Latin translations of the Arabic. Galen_sentence_207

In some cases scholars have even attempted to translate from the Latin or Arabic back into Greek where the original is lost. Galen_sentence_208

For some of the ancient sources, such as Herophilus, Galen's account of their work is all that survives. Galen_sentence_209

Even in his own time, forgeries and unscrupulous editions of his work were a problem, prompting him to write On his Own Books. Galen_sentence_210

Forgeries in Latin, Arabic or Greek continued until the Renaissance. Galen_sentence_211

Some of Galen's treatises have appeared under many different titles over the years. Galen_sentence_212

Sources are often in obscure and difficult-to-access journals or repositories. Galen_sentence_213

Although written in Greek, by convention the works are referred to by Latin titles, and often by merely abbreviations of those. Galen_sentence_214

No single authoritative collection of his work exists, and controversy remains as to the authenticity of a number of works attributed to Galen. Galen_sentence_215

As a consequence, research on Galen's work is fraught with hazard. Galen_sentence_216

Various attempts have been made to classify Galen's vast output. Galen_sentence_217

For instance Coxe (1846) lists a Prolegomena, or introductory books, followed by 7 classes of treatise embracing Physiology (28 vols.), Hygiene (12), Aetiology (19), Semeiotics (14), Pharmacy (10), Blood letting (4) and Therapeutics (17), in addition to 4 of aphorisms, and spurious works. Galen_sentence_218

The most complete compendium of Galen's writings, surpassing even modern projects like the Corpus Medicorum Graecorum, is the one compiled and translated by Karl Gottlob Kühn of Leipzig between 1821 and 1833. Galen_sentence_219

This collection consists of 122 of Galen's treatises, translated from the original Greek into Latin (the text is presented in both languages). Galen_sentence_220

Over 20,000 pages in length, it is divided into 22 volumes, with 676 index pages. Galen_sentence_221

Many of Galen's works are included in the Thesaurus Linguae Graecae, a digital library of Greek literature started in 1972. Galen_sentence_222

Another useful modern source is the French (BIUM). Galen_sentence_223

Legacy Galen_section_12

Late antiquity Galen_section_13

In his time, Galen's reputation as both physician and philosopher was legendary, the Emperor Marcus Aurelius describing him as "Primum sane medicorum esse, philosophorum autem solum" (first among doctors and unique among philosophers Praen 14: 660). Galen_sentence_224

Other contemporary authors in the Greek world confirm this including Theodotus the Shoemaker, Athenaeus and Alexander of Aphrodisias. Galen_sentence_225

The 7th-century poet George of Pisida went so far as to refer to Christ as a second and neglected Galen. Galen_sentence_226

Galen continued to exert an important influence over the theory and practice of medicine until the mid-17th century in the Byzantine and Arabic worlds and Europe. Galen_sentence_227

Hippocrates and Galen form important landmarks of 600 years of Greek medicine. Galen_sentence_228

A. J. Brock describes them as representing the foundation and apex respectively. Galen_sentence_229

A few centuries after Galen, Palladius Iatrosophista stated, in his commentary on Hippocrates, that Hippocrates sowed and Galen reaped. Galen_sentence_230

Thus Galen summarised and synthesised the work of his predecessors, and it is in Galen's words (Galenism) that Greek medicine was handed down to subsequent generations, such that Galenism became the means by which Greek medicine was known to the world. Galen_sentence_231

Often, this was in the form of restating and reinterpreting, such as in Magnus of Nisibis' 4th-century work on urine, which was in turn translated into Arabic. Galen_sentence_232

Yet the full importance of his contributions was not appreciated till long after his death. Galen_sentence_233

Galen's rhetoric and prolificity were so powerful as to convey the impression that there was little left to learn. Galen_sentence_234

The term Galenism has subsequently taken on both a positive and pejorative meaning as one that transformed medicine in late antiquity yet so dominated subsequent thinking as to stifle further progress. Galen_sentence_235

After the collapse of the Western Empire the study of Galen and other Greek works almost disappeared in the Latin West. Galen_sentence_236

In contrast, in the predominantly Greek-speaking eastern half of the Roman empire (Byzantium), many commentators of the subsequent centuries, such as Oribasius, physician to the emperor Julian who compiled a Synopsis in the 4th century, preserved and disseminated Galen's works, making Galenism more accessible. Galen_sentence_237

Nutton refers to these authors as the "medical refrigerators of antiquity". Galen_sentence_238

In late antiquity, medical writing veered increasingly in the direction of the theoretical at the expense of the practical, with many authors merely debating Galenism. Galen_sentence_239

Magnus of Nisibis was a pure theorist, as were John of Alexandria and Agnellus of Ravenna with their lectures on Galen's De Sectis. Galen_sentence_240

So strong was Galenism that other authors such as Hippocrates began to be seen through a Galenic lens, while his opponents became marginalised and other medical sects such as Asclepiadism slowly disappeared. Galen_sentence_241

Greek medicine was part of Greek culture, and Syrian Eastern Christians came in contact with it while the Eastern Roman Empire (Byzantium) ruled Syria and Western Mesopotamia, regions that were conquered from Byzantium in the 7th century by Arab Muslims. Galen_sentence_242

After AD 750, Muslims had these Syrian Christians make the first translations of Galen into Arabic. Galen_sentence_243

From then on, Galen and the Greek medical tradition in general became assimilated into the medieval and early modern Islamic Middle East. Galen_sentence_244

Influence on medicine in the Islamic world Galen_section_14

Further information: Medicine in the medieval Islamic world Galen_sentence_245

Galen's approach to medicine became and remains influential in the Islamic world. Galen_sentence_246

The first major translator of Galen into Arabic was the Arab Christian Hunayn ibn Ishaq. Galen_sentence_247

He translated (c. 830–870) 129 works of "Jalinos" into Arabic. Galen_sentence_248

Arabic sources, such as Muhammad ibn Zakarīya al-Rāzi (AD 865–925), continue to be the source of discovery of new or relatively inaccessible Galenic writings. Galen_sentence_249

One of Hunayn's Arabic translations, Kitab ila Aglooqan fi Shifa al Amrad, which is extant in the Library of Ibn Sina Academy of Medieval Medicine & Sciences, is regarded as a masterpiece of Galen's literary works. Galen_sentence_250

A part of the Alexandrian compendium of Galen's work, this 10th-century manuscript comprises two parts that include details regarding various types of fevers (Humyat) and different inflammatory conditions of the body. Galen_sentence_251

More important is that it includes details of more than 150 single and compound formulations of both herbal and animal origin. Galen_sentence_252

The book provides an insight into understanding the traditions and methods of treatment in the Greek and Roman eras. Galen_sentence_253

In addition, this book provides a direct source for the study of more than 150 single and compound drugs used during the Greco-Roman period. Galen_sentence_254

As the title of Doubts on Galen by al-Rāzi implies, as well as the writings of physicians such as Ibn Zuhr and Ibn al-Nafis, the works of Galen were not accepted unquestioningly, but as a challengeable basis for further inquiry. Galen_sentence_255

A strong emphasis on experimentation and empiricism led to new results and new observations, which were contrasted and combined with those of Galen by writers such as al-Rāzi, Ali ibn Abbas al-Majusi, Abu al-Qasim al-Zahrawi, Ibn Sina (Avicenna), Ibn Zuhr and Ibn al-Nafis. Galen_sentence_256

For example, Ibn al-Nafis' discovery of the pulmonary circulation contradicted the Galenic theory on the heart. Galen_sentence_257

The influence of Galen's writings, including humorism, remains strong in modern Unani medicine, now closely identified with Islamic culture, and widely practiced from India (where it is officially recognized) to Morocco. Galen_sentence_258

Reintroduction to the Latin West Galen_section_15

From the 11th century onwards, Latin translations of Islamic medical texts began to appear in the West, alongside the Salerno school of thought, and were soon incorporated into the curriculum at the universities of Naples and Montpellier. Galen_sentence_259

From that time, Galenism took on a new, unquestioned authority, Galen even being referred to as the "Medical Pope of the Middle Ages". Galen_sentence_260

Constantine the African was amongst those who translated both Hippocrates and Galen from Arabic. Galen_sentence_261

In addition to the more numerous translations of Arabic texts in this period, there were a few translations of Galenic works directly from the Greek, such as Burgundio of Pisa's translation of De complexionibus. Galen_sentence_262

Galen's works on anatomy and medicine became the mainstay of the medieval physician's university curriculum, alongside Ibn Sina's The Canon of Medicine, which elaborated on Galen's works. Galen_sentence_263

Unlike pagan Rome, Christian Europe did not exercise a universal prohibition of the dissection and autopsy of the human body and such examinations were carried out regularly from at least the 13th century. Galen_sentence_264

However, Galen's influence was so great that when dissections discovered anomalies compared with Galen's anatomy, the physicians often tried to fit these into the Galenic system. Galen_sentence_265

An example of this is Mondino de Liuzzi, who describes rudimentary blood circulation in his writings but still asserts that the left ventricle should contain air. Galen_sentence_266

Some cited these changes as proof that human anatomy had changed since the time of Galen. Galen_sentence_267

The most important translator of Galen's works into Latin was Niccolò di Deoprepio da Reggio, who spent several years working on Galen. Galen_sentence_268

Niccolò worked at the Angevin Court during the reign of king Robert of Naples. Galen_sentence_269

Among Niccolò's translations is a piece from a medical treatise by Galen, of which the original text is lost. Galen_sentence_270

Renaissance Galen_section_16

The first edition of Galen's complete works in Latin translation was edited by Diomede Bonardo of Brescia and printed at Venice by Filippo Pinzi in 1490. Galen_sentence_271

The Renaissance, and the fall of the Byzantine Empire (1453), were accompanied by an influx of Greek scholars and manuscripts to the West, allowing direct comparison between the Arabic commentaries and the original Greek texts of Galen. Galen_sentence_272

This New Learning and the Humanist movement, particularly the work of Linacre, promoted literae humaniores including Galen in the Latin scientific canon, De Naturalibus Facultatibus appearing in London in 1523. Galen_sentence_273

Debates on medical science now had two traditions, the more conservative Arabian and the liberal Greek. Galen_sentence_274

The more extreme liberal movements began to challenge the role of authority in medicine, as exemplified by Paracelsus' symbolically burning the works of Avicenna and Galen at his medical school in Basle. Galen_sentence_275

Nevertheless, Galen's pre-eminence amongst the great thinkers of the millennium is exemplified by a 16th-century mural in the refectory of the Great Lavra of Mt Athos. Galen_sentence_276

It depicts pagan sages at the foot of the Tree of Jesse, with Galen between the Sibyl and Aristotle. Galen_sentence_277

Galenism's final defeat came from a combination of the negativism of Paracelsus and the constructivism of the Italian Renaissance anatomists, such as Vesalius in the 16th century. Galen_sentence_278

In the 1530s, the Flemish anatomist and physician Andreas Vesalius took on a project to translate many of Galen's Greek texts into Latin. Galen_sentence_279

Vesalius' most famous work, De humani corporis fabrica, was greatly influenced by Galenic writing and form. Galen_sentence_280

Seeking to examine critically Galen's methods and outlook, Vesalius turned to human cadaver dissection as a means of verification. Galen_sentence_281

Galen's writings were shown by Vesalius to describe details present in monkeys but not in humans, and he demonstrated Galen's limitations through books and hands-on demonstrations despite fierce opposition from orthodox pro-Galenists such as Jacobus Sylvius. Galen_sentence_282

Since Galen states that he is using observations of monkeys (human dissection was prohibited) to give an account of what the body looks like, Vesalius could portray himself as using Galen's approach of description of direct observation to create a record of the exact details of the human body, since he worked in a time when human dissection was allowed. Galen_sentence_283

Galen argued that monkey anatomy was close enough to humans for physicians to learn anatomy with monkey dissections and then make observations of similar structures in the wounds of their patients, rather than trying to learn anatomy only from wounds in human patients, as would be done by students trained in the Empiricist model. Galen_sentence_284

The examinations of Vesalius also disproved medical theories of Aristotle and Mondino de Liuzzi. Galen_sentence_285

One of the best known examples of Vesalius' overturning of Galenism was his demonstration that the interventricular septum of the heart was not permeable, as Galen had taught (Nat Fac III xv). Galen_sentence_286

However, this had been revealed two years before by Michael Servetus in his fateful "Christianismi restitutio" (1553) with only three copies of the book surviving, but these remaining hidden for decades; the rest were burned shortly after its publication because of persecution of Servetus by religious authorities. Galen_sentence_287

Michael Servetus, using the name "Michel de Villeneuve" during his stay in France, was Vesalius' fellow student and the best Galenist at the University of Paris, according to Johann Winter von Andernach, who taught both. Galen_sentence_288

In the Galenism of the Renaissance, editions of the Opera Omnia by Galen were very important. Galen_sentence_289

It was begun in Venice in 1541–1542 by the Guinta. Galen_sentence_290

There were fourteen editions of the book from that date until 1625. Galen_sentence_291

Just one edition was produced from Lyon between 1548 and 1551. Galen_sentence_292

The Lyon edition has commentaries on breathing and blood streaming that correct the work of earlier renowned authors such as Vesalius, Caius or Janus Cornarius. Galen_sentence_293

"Michel De Villeneuve" had contracts with Jean Frellon for that work, and the Servetus scholar-researcher Francisco Javier González Echeverría presented research that became an accepted communication in the International Society for the History of Medicine, which concluded that Michael De Villeneuve (Michael Servetus) is the author of the commentaries of this edition of Frellon, in Lyon. Galen_sentence_294

Another convincing case where understanding of the body was extended beyond where Galen had left it came from these demonstrations of the nature of human circulation and the subsequent work of Andrea Cesalpino, Fabricio of Acquapendente and William Harvey. Galen_sentence_295

Some Galenic teaching, such as his emphasis on bloodletting as a remedy for many ailments, however, remained influential until well into the 19th century. Galen_sentence_296

Contemporary scholarship Galen_section_17

Galenic scholarship remains an intense and vibrant field, following renewed interest in his work, dating from the German encyclopedia Realencyclopädie der Classischen Altertumswissenschaft. Galen_sentence_297

Copies of his works translated by Robert M. Green are held at the National Library of Medicine in Bethesda, Maryland. Galen_sentence_298

In 2018, the University of Basel discovered that a mysterious Greek papyrus with mirror writing on both sides, which was at the collection of Basilius Amerbach, a professor of jurisprudence at the University of Basel in the 16th century, is an unknown medical document of Galen or an unknown commentary on his work. Galen_sentence_299

The medical text describes the phenomenon of ‘hysterical apnea’. Galen_sentence_300

See also Galen_section_18


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