choosing him as surgeon to the wounded gladiators shortly after his return to his native city. In these duties his knowledge of anatomy aided him greatly, and he is said to have healed certain kinds of wounds that had previously baffled the surgeons.
In the time of Galen dissections of the human body were forbidden by law, and he was obliged to confine himself to dissections of the lower animals. He had the advantage, however, of the anatomical works of Herophilus and Erasistratus, and he must have depended upon them in perfecting his comparison between the anatomy of men and the lower animals. It is possible that he did make human dissections surreptitiously, but of this we have no proof.
He was familiar with the complicated structure of the bones of the cranium. He described the vertebrae clearly, divided them into groups, and named them after the manner of anatomists of to-day. He was less accurate in his description of the muscles, although a large number of these were described by him. Like all anatomists before the time of Harvey, he had a very erroneous conception of the circulation, although he understood that the heart was an organ for the propulsion of blood, and he showed that the arteries of the living animals did not contain air alone, as was taught by many anatomists. He knew, also, that the heart was made up of layers of fibres that ran in certain fixed directions—that is, longitudinal, transverse, and oblique; but he did not recognize the heart as a muscular organ. In proof of this he pointed out that all muscles require rest, and as the heart did not rest it could not be composed of muscular tissue.
Many of his physiological experiments were conducted upon scientific principles. Thus he proved that certain muscles were under the control of definite sets of nerves by cutting these nerves in living animals, and observing that the muscles supplied by them were rendered useless. He pointed out also that nerves have no power in themselves, but merely conduct impulses to and from the brain and spinal-cord. He turned this peculiar knowledge to account in the case of a celebrated sophist, Pausanias, who had been under the treatment of various physicians for a numbness in the fourth and fifth fingers of his left hand. These physicians had been treating this condition by applications of poultices to the hand itself. Galen, being called in consultation, pointed out that the injury was probably not in the hand itself, but in the ulner nerve, which controls sensation in the fourth and fifth fingers. Surmising that the nerve must have been injured in some way, he made careful inquiries of the patient, who recalled that he had been thrown from his chariot some time before, striking and injuring his back. Acting upon this information, Galen applied stimulating remedies to the source of the nerve itself—that is, to the bundle of nerve-trunks known as the brachial plexus, in the shoulder. To the surprise and confusion of his fellow-physicians, this method of treatment proved effective and the patient recovered completely in a short time.
Although the functions of the organs in the chest were not well understood by Galen, he was well acquainted with their anatomy. He knew that the lungs were covered by thin membrane, and that the heart was surrounded by a sac of very similar tissue. He made constant comparisons also between these organs in different animals, as his dissections were performed upon beasts ranging in size from a mouse to an elephant. The minuteness of his observations is shown by the fact that he had noted and described the ring of bone found in the hearts of certain animals, such as the horse, although not found in the human heart or in most animals.
His description of the abdominal organs was in general accurate. He had noted that the abdominal cavity was lined with a peculiar saclike membrane, the peritoneum, which also surrounded most of the organs contained in the cavity, and he made special note that this membrane also enveloped the liver in a peculiar manner. The exactness of the last observation seems the more wonderful when we reflect that even to-day the medical, student finds a correct understanding of the position of the folds of the peritoneum one of the most difficult subjects in anatomy.
As a practical physician he was held in the highest esteem by the Romans. The Emperor Marcus Aurelius called him to Rome and appointed him physician-inordinary to his son Commodus, and on special occasions Marcus Aurelius himself called in Galen as his medical adviser. On one occasion, the three army surgeons in attendance upon the emperor declared that he was about to be attacked by a fever. Galen relates how "on special command I felt his pulse, and finding it quite normal, considering his age and the time of day, I declared it was no fever but a digestive disorder, due to the food he had eaten, which must be converted into phlegm before being excreted. Then the emperor repeated three times, 'That's the very thing,' and asked what was to be done. I answered that I usually gave a glass of wine with pepper sprinkled on it, but for you kings we only use the safest remedies, and it will suffice to apply wool soaked in hot nard ointment locally. The emperor ordered the wool, wine, etc., to be brought, and I left the room. His feet were warmed by rubbing with hot hands, and after drinking the peppered wine, he said to Pitholaus (his son's tutor), 'We have only one doctor, and that an honest one,' and went on to describe me as the first of physicians and the only philosopher, for he had tried many before who were not only lovers of money, but also contentious, ambitious, envious, and malignant."(7)
It will be seen from this that Galen had a full appreciation of his own abilities as a physician, but inasmuch as succeeding generations for a thousand years concurred in the alleged statement made by Marcus Aurelius as to his ability, he is perhaps excusable for his open avowal of his belief in his powers. His faith in his accuracy in diagnosis and prognosis was shown when a colleague once said to him, "I have used the prognostics of Hippocrates as well as you. Why can I not prognosticate as well as you?" To this Galen replied, "By God's help I have never been deceived in my prognosis."(8) It is probable that this statement was made in the heat of argument, and it is hardly to be supposed that he meant it literally.
His systems of treatment were far in advance of his theories regarding the functions of organs, causes of disease, etc., and some of them are still first principles with physicians. Like Hippocrates, he laid great stress on correct diet, exercise, and reliance upon nature. "Nature is the overseer by whom health is supplied to the sick," he says. "Nature lends her aid on all sides, she decides and cures diseases. No one can be saved unless nature conquers the disease, and no one dies unless nature succumbs."
From the picture thus drawn of Galen as an anatomist and physician, one might infer that he should rank very high as a scientific exponent of medicine, even in comparison with modern physicians. There is, however, another side to the picture. His knowledge of anatomy was certainly very considerable, but many of his deductions and theories as to the functions of organs, the cause of diseases, and his methods of treating them, would be recognized as absurd by a modern school-boy of average intelligence. His greatness must be judged in comparison with ancient, not with modern, scientists. He maintained, for example, that respiration and the pulse-beat were for one and the same purpose—that of the reception of air into the arteries of the body. To him the act of breathing was for the purpose of admitting air into the lungs, whence it found its way into the heart, and from there was distributed throughout the body by means of the arteries. The skin also played an important part in supplying the body with air, the pores absorbing the air and distributing it through the arteries. But, as we know that he was aware of the fact that the arteries also contained blood, he must have believed that these vessels contained a mixture of the two.
Modern anatomists know that the heart is divided into two approximately equal parts by an impermeable septum of tough fibres. Yet, Galen, who dissected the hearts of a vast number of the lower animals according to his own account, maintained that this septum was permeable, and that the air, entering one side of the heart from the lungs, passed through it into the opposite side and was then transferred to the arteries.
He was equally at fault, although perhaps more excusably so, in his explanation of the action of the nerves. He had rightly pointed out that nerves were merely connections between the brain and spinal-cord and distant muscles and organs, and had recognized that there were two kinds of nerves, but his explanation of the action of these nerves was that "nervous spirits" were carried to the cavities of the brain by blood-vessels, and from there transmitted through the body along the nerve-trunks.
In the human
