Galen 2

Claudius  Galenus

The Origins of Pharmacy

In the autumn of Roman imperial power and culture, scholars began recording all the medical knowledge acquired over centuries of study and conquest. The famous book "De Materia Medica" by the military doctor Dioscorides, describing more than six hundred vegetable, animal and mineral remedies, laid the basis for pharmacology. Dioscorides also produced a discourse on poisons and antidotes. A little earlier, the physician Cornelius Celsus had completed a huge encyclopaedia of Greek and Alexandrian medicine.

However, it was not until the second century of the Christian era that the tone was really set by Galen (Claudius Galenus in Latin, Klaudios Galenos in Greek), who was born on 22 September 131 in Pergamum, Asia Minor, and died in Rome in 201.

This Greco-Roman doctor, pharmacist and philosopher produced around five hundred books and treatises and was unquestionably the leading scientist of his day. Galen wrote on all aspects of medical science, his books on medicine and anatomy shaping medical thinking throughout the Middle Ages and beyond. The word "galenic" is still used to describe drugs and medicaments made directly from vegetable or animal ingredients (known as "simplicia") using prescribed methods.

The Gladiators' Doctor

After initially studying philosophy, particularly Aristotle, Galen began to specialize in medicine at the age of seventeen. Having gained experience on travels through Greece, Asia Minor and Palestine, when he further developed his skills, Galen established himself as a doctor in Alexandria (Egypt), the leading medical centre of the day.

In about 159, at the age of 28, Galen returned to Pergamum, the city of his birth, where he was appointed doctor to the gymnasium attached to the local sanctuary of Asklepios. (In the Greek pantheon, Asklepios was son to the sun god Apollo, traditionally depicted carrying a staff with a serpent coiled around it.) Five years later, however, Galen moved to the capital of the Empire to teach medicine. He quickly gained great fame and was made personal physician to Emperor Marcus Aurelius and his son Commodus. He also had the job of looking after the gladiators; by treating their wounds, Galen was able to expand his anatomical knowledge still further. Now he was also able to carry out surgery and study plastic anatomy.

The Galenic Pharmacy

Galen also helped to shape pharmacological science. In addition to running a thriving medical practice, he had his own pharmacy which stocked hundreds of medicines made from vegetable and animal ingredients. Galen catalogued countless remedies, recording how each was made. One striking feature of his work was the attention he paid to the precise quantities of the various ingredients used in the preparation of each remedy, and to the doses which had to be given. He believed that, depending on the dose taken, every medicine was capable of having a slight, strong, harmful or even fatal effect on the patient.

Humoral Pathology

Galen firmly believed in what is known as humoral pathology: the science of the bodily fluids pioneered by the Greek physician Hippocrates (460 to 377 BC). Humoral pathology is based on the notion that the human body contains four humours or bodily fluids (blood, phlegm, choler and melancholy) and that good health depends upon these humours being kept in balance. Hippocratic theory suggested that if any one humour became predominant, ill health would result; however, Galen argued that sickness could also be caused by an insufficiency of one of the four humours. This belief was the guiding principle of Galenic medicine.

So, to restore the patient's physiological balance, doctors needed to bleed their patients or to prescribe laxative, emetic or sudorific medication. Vegetable-based medicines were also used.

Human Temperaments

Drawing upon Hippocrates' theory regarding the four humours, Galen suggested the existence of four basic human temperaments, each of which was caused by a predominance of one of the four humours. First, there was the sanguinicus, whose cheerful and lively temperament resulted from the dominance of the blood. The temperament of the calm and tough flegmaticus was influenced by excess phlegm, while the worry and gloominess of the melancholicus were due to a surfeit of melancholy. Finally, the energetic cholericus had too much choler in his or her system. Thus Galen believed that one's personality was closely related to one's physical make-up.

Physiology

The development of human physiological science owes much to Galen's theories and discoveries. For the ancients, the functions of the heart and blood vessels were a great mystery. Five hundred years before Christ, the Greek Alcmaeon of Croton suggested that sleep was caused by blood draining from the brain via the veins, and that death was the result of the brain becoming completely drained. Two hundred years later, Aristotle ascribed the power of thought to the heart, which he contended also contained the soul. Erasistratus argued that intaken breath entered the arteries, which thus carried nothing but air. Galen demonstrated the error of many of these theories.

Anatomy

Dissection was forbidden in Greece, so Galen's work in this field must have been carried out in Egypt. Be that as it may, he certainiy contributed a great deal to the development of anatomy as a science. He wrote long anatomical treatises on the skeleton, the muscles and the central nervous system. In Rome, he gave lectures in anatomy and performed animal dissections, demonstrating that the arteries carried blood, rather than air. (Galen did, however, subscribe to the contemporary theory that blood flowed back and forth within the arteries. It was not until 1628 that the Englishman William Harvey showed that the blood circulated round a closed system.)

Philosophy

On the basis of his philosophical studies, Galen came to the conclusion that the various bodily functions were induced by the Pneuma or universal spirit. He believed the pneuma to be a fine, spirit-like material which drifted through the universe and which controlled and organized physical bodies. Galen distinguished between three types of spirit: the spiritus vitalis or life spirit, originating in the heart and flowing through the arteries; the spiritus animalis or animal spirit to be found in the brain and nerves; and the spiritus naturalis, or natural spirit, formed in the liver.

However, Galen also believed that the life process was sustained by food, which was convened into blood in the liver. Blood from the liver nourished the heart, lungs and other organs, including the brain. Waste materials were also thought to be removed by the blood. Thus, blood circulation and metabolism are critical elements of galenic physiological theory, and Galen was the first person to suggest a relationship between food, blood and air.

Interestingly, later medical and church authorities considered Galen's work to be based upon divine inspiration and therefore infallible, dubbing him Divinus Galenus (Galen the Divine). Those who dared call Galen's theories into question often ended their lives burnt at the stake.

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