Galen and Galenic Medicine

Who was Galen?

The National Library of Medicine (NLM) says Galen was born in Pergamos in Asia Minor in 129 CE. [1] He trained in Smyrna and Alexandria and gained fame as a surgeon to the gladiators of Pergamos. [1] He was later summoned to Rome to be physician to Emperor Marcus Aurelius and spent the rest of his life at court writing an enormous body of medical works. [1] The NLM gives his death as 201 CE. [1] Other scholarly papers give a death date of around 200 or around 216, so treat the exact years as approximate. [2][3]

What he built on

Galen took the Hippocratic notions of the humors and pathology and added the anatomical knowledge of Alexandrian scholars such as Herophilus. [1] For the humors themselves, see Hippocratic medicine and the four humors. The NLM describes Galen as a supporter of observation and reasoning and as one of the first experimental physiologists, who studied the function of the kidneys and the spinal cord in controlled experiments. [1]

A review of ancient head-injury care credits Galen with substantial contributions to neuroanatomy and physiology, with his own classification of skull fractures, and with refining the surgical technique of trephination (opening the skull). [4] Those are historical descriptions of what he wrote. They are not instructions, and nothing on this page should be used to treat an injury.

How Galen's authority spread

The NLM says Galen's works came to symbolize Greek medicine for the medical scholars of Europe and the Middle East for the next fifteen centuries. [1] Galen's observation-and-experiment message was largely lost, and his theories became dogma in the West. [1] Galen's ideas were also taken up and revised in the Islamic world. For example, a review of Avicenna's work on the heart says Avicenna refined Galen's theory of the pulse. [5] See Avicenna and the Canon of Medicine.

Galen was also a source for the plant-drug tradition. In the oldest surviving copy of Dioscorides' work, produced in Constantinople about 512 CE, the plant descriptions were expanded with observations from Galen. [6] See Dioscorides and the materia medica tradition.

Where Galenic medicine went wrong

Anatomy. One paper notes that Galen dissected lower animals and carried his findings over to human anatomy. [7] A Finnish history paper adds that Vesalius, working in the sixteenth century, concluded that Galen had relied too much on animal dissection. [2] By then Galen was regarded as almost infallible, and Vesalius had to reconcile what he saw in human bodies with that authority. [2] A paper on the Renaissance anatomist notes that Vesalius' 1543 book "De humani corporis fabrica" challenged Galen's teachings as no one had before. [8] Another paper says that this book was based on dissection of the human body. [8]

Circulation. The NLM's catalogue of Islamic medical manuscripts says that Ibn al-Nafis, in a commentary on Avicenna's Canon, stated that blood in the right ventricle of the heart must reach the left by way of the lungs, not through a passage between the ventricles as Galen had maintained. [9] The NLM notes this was three centuries before Servetus and Colombo, the first Europeans to describe the pulmonary circulation. [9]

Humoral treatment. Galenic medicine inherited humoral ideas and the practice of bloodletting. A haematology review says phlebotomy was practiced for thousands of years first for unproven indications, with evidence-based use arriving mainly since the nineteenth century. [10]

What can be said responsibly

Galen is a case where both parts of the story are true. He was an energetic observer and experimenter for his time, and a body of teaching built on his work became rigid dogma that blocked correction for centuries. [1] The NLM says the message that observation and investigation are required began to re-emerge in the mid-sixteenth century, and modern research methods followed. [1]

This is also a useful rule for reading any tradition, including today's: an idea's age or the fame of its author is not evidence. For how to weigh old claims, see historical use vs clinical evidence.

If you are unwell

Do not use Galenic or humoral categories to judge your own health. For new or worsening symptoms, see a licensed clinician; in a US emergency call 911.

Related pages

Hippocratic medicine and the four humors, Western herbal traditions and ancient Greek medicine, Unani medicine.