<h2><i>GALEN.</i></h2>
<p><span class="smcap">Under</span> the Ptolemies a powerful stimulus was given to
biological studies at Alexandria. Scientific knowledge
was carried a step or two beyond the limit reached by
Aristotle. Thus Erasistratus and Herophilus thoroughly
investigated the structure and functions of the valves of
the heart, and were the first to recognize the nerves as
organs of sensation. But, unfortunately, no complete
record of the interesting work carried on by these men
has come down to our times. The first writer after
Aristotle whose works arrest attention is Caius Plinius
Secundus, whose so-called "Natural History," in thirty-seven
volumes, remains to the present day as a monument
of industrious compilation. But, as a biologist properly
so called, Pliny is absolutely without rank, for he lacked
that practical acquaintance with the subject which alone
could enable him to speak with authority. Of information
he had an almost inexhaustible store; of actual
knowledge, the result of observation and experience, so
far as biological studies were concerned, he had but<span class='pagenum'><SPAN name="Page_48" id="Page_48"></SPAN></span>
little. This was largely due to the encyclopædic
character of the work he undertook; his mental powers
were weighed down by an enormous mass of unarranged
and ill-digested materials. But it was due also to the
peculiar bent of Pliny's mind. He was not, like Aristotle,
an original thinker; he was essentially a student of
books, an immensely industrious but not always judicious
compiler. Often his selections from other works prove
that he failed to appreciate the relative importance of the
different subjects to which he made reference. His
knowledge of the Greek language appears, too, to have
been defective, for he gives at times the wrong Latin
names to objects described by his Greek authorities.
To these defects must be added his marvellous readiness
to believe any statement, provided only that it was
uncommon; while, on the other hand, he showed an
indefensible scepticism in regard to what was really
deserving of attention. The chief value of his work
consists in the historical and chronological notes of the
progress of some of the subjects of which he treats—fragments
of writings which would otherwise be lost to
us. Pliny was killed in the destruction of Pompeii,
<span class="smcapl">A.D.</span> 79.</p>
<p>Claudius Galenus was born at Pergamus, in Asia Minor,
in the hundred and thirty-first year of the Christian era.
Few writers ever exercised for so long a time such an
undisputed sway over the opinions of mankind as did<span class='pagenum'><SPAN name="Page_49" id="Page_49"></SPAN></span>
this wonderful man. His authority was estimated at a
much higher rate than that of all the biological writers
combined who flourished during a period of more than
twelve centuries, and it was often considered a sufficient
argument against a hypothesis, or even an alleged matter
of fact, that it was contrary to Galen.</p>
<p>Endowed by nature with a penetrating genius and a
mind of restless energy, he was eminently qualified to
profit by a comprehensive and liberal education. And
such he received. His father, Nicon, an architect, was
a man of learning and ability—a distinguished mathematician
and an astronomer—and seems to have devoted
much time and care to the education of his son.
The youth appears to have studied philosophy successively
in the schools of the Stoics, Academics,
Peripatetics, and Epicureans, without attaching himself
exclusively to any one of these, and to have taken from
each what he thought to be the most essential parts
of their system, rejecting, however, altogether the tenets
of the Epicureans. At the age of twenty-one, on the
death of his father, he went to Smyrna to continue the
study of medicine, to which he had now devoted himself.
After leaving this place and having travelled extensively,
he took up his residence at Alexandria, which was then
the most favourable spot for the pursuit of medical
studies. Here he is said to have remained until he was
twenty-eight years of age, when his reputation secured<span class='pagenum'><SPAN name="Page_50" id="Page_50"></SPAN></span>
his appointment, in his native city of Pergamus, to the
office of physician in charge of the athletes in the
gymnasia situated within the precincts of the temple of
Æsculapius. For five or six years he lived in Pergamus,
and then a revolt compelled him to leave his native
town. The advantages offered by Rome led him to
remove thither and take up his residence in the capital
of the world. Here his skill, sagacity, and knowledge
soon brought him into notice, and excited the jealousy
of the Roman doctors, which was still further increased
by some wonderful cures the young Greek physician
succeeded in effecting. Possibly it was owing to the
ill feeling shown to Galen that, on the outbreak of
an epidemic a year afterwards, he left the imperial city
and proceeded to Brindisi, and embarked for Greece.
It was his intention to devote his time to the study
of natural history, and for this purpose he visited
Cyprus, Palestine, and Lemnos. While at the last-named
place, however, he was suddenly summoned to Aquileia
to meet the Emperors Marcus Aurelius and Lucius
Verus. He travelled through Thrace and Macedonia on
foot, met the imperial personages, and prepared for them
a medicine, for which he seems to have been famous,
and which is spoken of as the <i>theriac</i>. It was probably
some combination of opium with various aromatics and
stimulants, for antidotes of many different kinds were
habitually taken by the Romans to preserve them from<span class='pagenum'><SPAN name="Page_51" id="Page_51"></SPAN></span>
the ill effects of poison and of the bites of venomous
animals.<SPAN name="FNanchor_16_16" id="FNanchor_16_16"></SPAN><SPAN href="#Footnote_16_16" class="fnanchor">[16]</SPAN></p>
<p>With the Emperor M. Aurelius he returned to Rome,
and became afterwards doctor to the young Emperor
Commodus. He did not, however, remain for a long
period at Rome, and probably passed the greater part
of the rest of his life in his native country.</p>
<p>Although the date of his death is not positively known,
yet it appears from a passage<SPAN name="FNanchor_17_17" id="FNanchor_17_17"></SPAN><SPAN href="#Footnote_17_17" class="fnanchor">[17]</SPAN> in his writings that he
was living in the reign of Septimius Severus; and Suidas
seems to have reason for asserting that he reached his
seventieth year.</p>
<p>Galen's writings represent the common depository of
the anatomical knowledge of the day; what he had
learnt from many teachers, rather than the results of
his own personal research. Roughly speaking, they
deal with the following subjects: Anatomy and Physiology,
Dietetics and Hygiene, Pathology, Diagnosis and
Semeiology, Pharmacy and Materia Medica, Therapeutics.</p>
<p>The only works of this voluminous writer at which
we can here glance are those dealing with Anatomy
and Physiology. These exhibit numerous illustrations
of Galen's familiarity with practical anatomy, although
it was most likely comparative rather than human<span class='pagenum'><SPAN name="Page_52" id="Page_52"></SPAN></span>
anatomy at which he especially worked. Indeed, he
seems to have had but few opportunities of carrying
on human dissections, for he thinks himself happy in
having been able to examine at Alexandria two human
skeletons; and he recommends the dissection of monkeys
because of their exact resemblance to man. To this disadvantage
may, perhaps, be attributed the readiness, which
sometimes appears, to assume identity of organization
between man and the brutes. Thus, because in certain
animals he found a double biliary duct, he concluded
the same to be the case in man, and in one instance he
proceeded to deduce the cause of disease from this
erroneous assumption.</p>
<p>He supposed that there were three modes of existence
in man, namely—</p>
<div class="block1"><p>(<i>a</i>) The nutritive, which was common to all animals
and plants, of which the liver was the source.</p>
<p>(<i>b</i>) The vital, of which the heart was the source.</p>
<p>(<i>c</i>) The rational, of which the brain was the source.</p>
</div>
<p>Again, he considered that the animal economy possessed
four natural powers—</p>
<div class="block1"><p>(1) The attractive.</p>
<p>(2) The alterative or assimilative.</p>
<p>(3) The retentive or digestive.</p>
<p>(4) The expulsive.</p>
</div>
<p>Like his predecessors, he asserted that there were
four humours, namely, blood, yellow bile, black bile, and<span class='pagenum'><SPAN name="Page_53" id="Page_53"></SPAN></span>
aqueous serum. He held that it was the office of the
liver to complete the process of sanguification commenced
in the stomach, and that during this process the yellow
bile was attracted by the branches of the hepatic duct
and gall-bladder; the black bile being attracted by the
spleen, and the aqueous humour by the two kidneys;
while the liver itself retained the pure blood, which was
afterwards attracted by the heart through the vena cava,
by whose ramifications it was distributed to the various
parts of the body.</p>
<p>Following Aristotle especially, he regarded hair, nails,
arteries, veins, cartilage, bone, ligament, membranes,
glands, fat, and muscle as the simplest constituents of
the body, formed immediately from the blood, and perfectly
homogeneous in character. The organic members,
<i>e.g.</i> lungs, liver, etc., he looked upon as formed of several
of the foregoing simple parts.</p>
<p>The osteology contained in Galen's works is nearly
as perfect as that of the present day. He correctly
names and describes the bones and sutures of the
cranium; notices the quadrilateral shape of the parietals,
the peculiar situation and shape of the sphenoid, and
the form and character of the ethmoid, malar, maxillary,
and nasal bones. He divides the vertebral columns
into cervical, dorsal, and lumbar portions.</p>
<p>With regard to the nervous system, he taught that
the nerves of the senses are distinct from those which<span class='pagenum'><SPAN name="Page_54" id="Page_54"></SPAN></span>
impart the power of motion to muscles—that the former
are derived from the anterior parts of the brain, while
the latter arise from the posterior portion, or from the
spinal cord. He maintained that the nerves of the finer
senses are formed of matter too soft to be the vehicles
of muscular motion; whereas, on the other hand, the
nerves of motion are too hard to be susceptible of fine
sensibility. His description of the method of demonstrating
the different parts of the brain by dissection is
very interesting, and, like his references to various instruments
and contrivances, proves him to have been
a practical and experienced anatomist.</p>
<p>In his description of the organs and process of nutrition,
absorption by the veins of the stomach is correctly
noticed, and the union of the mesenteric veins into one
common <i>vena portæ</i> is pointed out. The communications
between the ramifications of the vena portæ and
of the proper veins of the liver are supposed by Galen
to be effected by means of anastomosing pores or
channels. Although it is evident that Galen was ignorant
of the true absorbent system, yet he appears to have
been aware of the <i>lacteals</i>; for he says that in addition
to those mesenteric veins which by their union form
the vena portæ, there are visible in every part of the
mesentery other veins, proceeding also from the intestines,
which terminate in glands; and he supposes that
these veins are intended for the nourishment of the<span class='pagenum'><SPAN name="Page_55" id="Page_55"></SPAN></span>
intestines themselves. Some of Galen's contemporaries
asserted that upon exposing the mesentery of a sucking
animal several small vessels were seen filled <i>first</i> with
air, and <i>afterwards</i> with milk. They had, doubtless,
mistaken colourless lymph for air; but Galen ridicules
both assertions, and thereby shows that he had not
examined the contents of the lacteals. This is somewhat
remarkable, because as a rule he omitted no opportunity
of determining with certainty, by vivisection and
experiments on living animals, the uses of the various
parts of the body. As an illustration of this, we have
his correct statement, established by experiment, that
the pylorus acts as a valve <i>only</i> during the process of
digestion, and that it is relaxed when digestion is completed.</p>
<p>He recognizes that the flesh of the heart is somewhat
different to that of the muscles of voluntary motion. Its
fibres are described as being arranged in longitudinal
and transverse bundles; the former by their contractions
shortening the organ, the latter compressing and narrowing
it. Such statements show that he regarded the heart
as essentially muscular. He thought, however, that it
was entirely destitute of nerves. Although he admitted
that possibly it had one small branch derived from the
<i>nervus vagus</i> sent to it, yet he entirely overlooked the
great nervous plexus surrounding the roots of the blood-vessels,
from which branches proceed in company with<span class='pagenum'><SPAN name="Page_56" id="Page_56"></SPAN></span>
the branches of the coronary arteries and veins, and
penetrate the muscular substance of the ventricles. He
endeavoured to prove, by experiment, observation, and
reasoning, that the arteries as well as the veins contained
blood, and in this connection he tells an amusing story.
A certain teacher of anatomy, who had declared that the
aorta contained no blood, was earnestly desired by his
pupils, who were ardent disciples of Galen, to exhibit
the requisite demonstration, they themselves offering
animals for the experiment. He, however, after various
subterfuges, declined, until they promised to give him a
suitable remuneration, which they raised by subscription
among themselves to the amount of a thousand drachmæ
(perhaps £30). The professor, being thus compelled
to commence the experiment, totally failed in his attempt
to cut down upon the aorta, to the no small amusement
of his pupils, who, thereupon taking up the experiment
themselves, made an opening into the thorax in the way
in which they had been instructed by Galen, passed one
ligature round the aorta at the part where it attaches
itself to the spine, and another at its origin, and then, by
opening the intervening portion of the artery, showed
that blood was contained in it.</p>
<p>The arteries, Galen thought, possessed a pulsative and
attractive power of their own, independently of the heart,
the moment of their dilatation being the moment of their
activity. They, in fact, <i>drew</i> their charge from the heart,<span class='pagenum'><SPAN name="Page_57" id="Page_57"></SPAN></span>
as the heart by its diastole <i>drew</i> its charge from the vena
cava and the pulmonary vein. The pulse of the arteries,
he also thought, was propagated by their coats, not by
the wave of blood thrown into them by the heart. He
taught that at every systole of the arteries a certain
portion of their contents was discharged at their extremities,
namely, by the exhalents and secretory vessels.
Though he demonstrated the anastomosis of arteries and
veins, he nowhere hints his belief that the contents of the
former pass into the latter, to be conveyed back to the
heart, and from it to be again diffused over the body.
He made a near approach to the Harveian theory of
the circulation, as Harvey himself admits in his "De
Motu Cordis;"<SPAN name="FNanchor_18_18" id="FNanchor_18_18"></SPAN><SPAN href="#Footnote_18_18" class="fnanchor">[18]</SPAN> but the grand point of difference between
Galen and Harvey is the question whether or not, at
every systole of the left ventricle, more blood is thrown
out than is expended on exhalation, secretion, and
nutrition. Upon this point Galen held the negative,
and Harvey, as we all know, the affirmative.</p>
<p>The famous Asclepiads held that respiration was for
the generation of the soul itself, breath and life being
thus considered to be identical. Hippocrates thought
it was for the nutrition and refrigeration of the innate<span class='pagenum'><SPAN name="Page_58" id="Page_58"></SPAN></span>
heat, Aristotle for its ventilation, Erasistratus for the
filling of the arteries with spirits. All these opinions are
discussed and commented upon by Galen, who determines
the purposes of respiration to be (1) to preserve
the animal heat; (2) to evacuate from the blood the
products of combustion.</p>
<p>He conjectured that there was in atmospheric air not
only a quality friendly to the vital spirit, but also a
quality inimical to it, which conjecture he drew from
observation of the various phenomena accompanying
the support and the extinction of flame; and he says that
if we could find out why flame is extinguished by absence
of the air, we might then know the nature of that substance
which imparts warmth to the blood during the
process of respiration.</p>
<p>On another occasion he says that it is evidently the
<i>quality</i> and not the <i>quantity</i> of the air which is necessary
to life. He further shows that he recognized the analogy
between respiration and combustion, by comparing the
lungs to a lamp, the heart to its wick, the blood to the
oil, and the animal heat to the flame.</p>
<p>From certain observations in various parts of his
works, it appears that, although ignorant of the doctrine
of atmospheric pressure, he was acquainted with some
of its practical effects. Thus, he says, if you put one
end of an open tube under water and suck out the air
with the other end, you will draw up water into the<span class='pagenum'><SPAN name="Page_59" id="Page_59"></SPAN></span>
mouth, and that it is in this way that infants extract the
milk from the mother's breast.</p>
<p>Again, Erasistratus supposed that the vapour of charcoal
and of certain pits and wells was fatal to life because
<i>lighter</i> than common air, but Galen maintained it to be
<i>heavier</i>.</p>
<p>He describes two kinds of respiration, one by the
mouths of the arteries of the lungs, and one by the
mouths of the arteries of the skin. In each case, he
says, the surrounding air is drawn into the vessels during
their diastole, for the purpose of cooling the blood, and
during their systole the fuliginous particles derived from
the blood and other fluids of the body are forced out.</p>
<p>He considers the diaphragm to be the principal muscle
of respiration, but he makes a clear distinction between
ordinary respiration, which he calls a natural and involuntary
effort, and that deliberate and forced respiration
which is obedient to the will; and he says that there are
different muscles for the two purposes. Elsewhere he
particularly points out the two sets of intercostal muscles
and their mode of action, of which, before his time, he
asserts that anatomists were ignorant.</p>
<p>He describes various effects produced on respiration
and on the voice by the division of those nerves which
are connected with the thorax; and shows particularly
the effect of dividing the recurrent branch of his sixth
pair of cerebral nerves (the pneumogastric of modern<span class='pagenum'><SPAN name="Page_60" id="Page_60"></SPAN></span>
anatomy). He explains how it happens that after division
of the spinal cord, provided that division be <i>beneath</i>
the lower termination of the neck, the diaphragm will
still continue to act—in consequence, namely, of the
origin of the phrenic nerve being <i>above</i> the lower termination
of the neck.</p>
<p>Before the time of Galen the medical profession was
divided into several sects, <i>e.g.</i> Dogmatici, Empirici,
Eclectici, Pneumatici, and Episynthetici, who were
always disputing with one another. After his time all
sects seem to have merged in his followers. The subsequent
Greek and Roman biological writers were mere
compilers from his works, and as soon as his writings
were translated into Arabic they were at once adopted
throughout the East to the exclusion of all others. He
remained paramount throughout the civilized world until
within the last three hundred years. In the records of
the College of Physicians of England we read that Dr.
Geynes was cited before the college in 1559 for impugning
the infallibility of Galen, and was only admitted
again into the privileges of his fellowship on acknowledgment
of his error, and humble recantation signed with
his own hand. Kurt Sprengel has well said that "if
the physicians who remained so faithfully attached to
Galen's system had inherited his penetrating mind, his
observing glance, and his depth, the art of healing would
have approached the limit of perfection before all the<span class='pagenum'><SPAN name="Page_61" id="Page_61"></SPAN></span>
other sciences; but it was written in the book of destiny
that mind and reason were to bend under the yoke of
superstition and barbarism, and were only to emerge
after centuries of lethargic sleep."</p>
<div class="footnotes"><h3>FOOTNOTES:</h3>
<div class="footnote"><p><SPAN name="Footnote_16_16" id="Footnote_16_16"></SPAN><SPAN href="#FNanchor_16_16"><span class="label">[16]</span></SPAN> Hence the name <span title="thêriakai">θηρίακαι</span>.</p>
</div>
<div class="footnote"><p><SPAN name="Footnote_17_17" id="Footnote_17_17"></SPAN><SPAN href="#FNanchor_17_17"><span class="label">[17]</span></SPAN> "De Antidotis," i. 13, vol. xiv. p. 65, Kuhn.</p>
</div>
<div class="footnote"><p><SPAN name="Footnote_18_18" id="Footnote_18_18"></SPAN><SPAN href="#FNanchor_18_18"><span class="label">[18]</span></SPAN> "Ex ipsius etiam Galeni verbis hanc veritatem confirmari posse,
scilicet: non solum posse sanguinem e vena arteriosa in arteriam
venosam et inde in sinistrum ventriculum cordis, et postea in
arterias transmitti."—"De Motu Cordis," cap. vii.</p>
</div>
</div>
<hr /><p><span class='pagenum'><SPAN name="Page_65" id="Page_65"></SPAN></span></p>
<div style="break-after:column;"></div><br />