Galen: The Father of Experimental Physiology
Claudius Galen was he was born 130 AD in the city of Pergamon (modern-day Bergama, Turkey) and died 200 AD. Galen was “a very prominent physician [that] greatly influenced the development of various scientific disciplines like anatomy*, physiology*, pathology* and neurology, and was considered an authority on medical theory and practice in Europe up until the mid-17th century.”3 He was a Greek doctor in the Roman Empire. He received medical education in his youth (age 16-19), traveled extensively (starting at age 19) and then later attended another school of medicine in Alexandria. He was an expert of his time.1,3,4,9
- Anatomy: “the science dealing with the structure of animals and plants.”2
- Physiology: “the branch of biology dealing with the functions and activities of living organisms and their parts, including all physical and chemical processes.”2
- Pathology: “the science or the study of the origin, nature, and course of diseases.”2
- Neurology: “the science of the nerves and the nervous system, especially of the diseases affecting them.”2
Discussion Topic: Hippocrates was a major influence on Galen’s work. The ideas of Diagnosis and Prognosis came up in our discussion of Hippocrates. How is anatomy, physiology and pathology related to diagnosis and prognosis?
When he was 28 years old, he became the doctor for the gladiators; which is an important position. At at 32 he established himself in Rome as a prominent doctor. But he had to flee Rome because he had made many enemies there by being hateful and scornful to the other doctors working there that he felt were less skilled them he was. But he was later called back when a plague struck. He then became the doctor for Emperor Marcus Aurelius and Aurelius’ son, Commodus. He remained emperor’s physician into Commodus’s reign. It was from this position that he was afforded the ability to do most of his research.1,3,4,9
Religion* and philosophy* were major influences on the culture and social structure of the Roman empire. This created hurdles for Galen, but it also paved the way for major medical advancements.
- Religion: “a set of beliefs concerning the cause, nature, and purpose of the universe, especially when considered as the creation of a superhuman agency or agencies, usually involving devotional and ritual observances, and often containing a moral code governing the conduct of human affairs.”2
Galen began his medical training in a temple dedicated to Asclepius, God of healing. There were 14 deities that included some sort of healing, health or well being in their domain. Of these, were Asclepius’s 2 daughters, Hygeia and Panacea. Also of note was Paean, physician to the gods. These gods and goddesses influenced Galen’s medical career. He was devote. The more he researched human anatomy, the more he believed that a divine hand must have created it. The gods and goddesses also reflect the values of the society of the time. It was an era when medicine was highly valued.
The Asclepions, the temples dedicated to Asclepius, were important figures in the medical world. Despite the new natural approach to medicine, supernatural causes continued to be important and for many continued to be more important. Asclepions served the same role as hospitals. People went there for healing. They engaged in a ritual which included: bathing in the sea, making an offering, sleeping in n abaton (sacred building with a ceiling but no walls) and being anointed by the priests. They believed that Asclepius would visit and heal them while they slept.5,6,9 It is important to note that there are still religions today that do not accept scientific based medicine. There are also religious that will only accept portions of it.
Galen believed that Religion was an important aspect of medicine even though his medical research had a scientific approach. He used astrology charts as part of his diagnostic work up. He also believed that analysis of dreams could reveal the cause for someone’s illness. He believed that science had a divine connection.11 This is an idea that has been recently renewed in American culture. It is the idea that religion and science are not mutually exclusive ideas; that one can live by both at the same time.
In current medical practice, there is a standard that it is important to treat the entire person: “Mind, Body and Soul.” Current medical practice also continues with a philosophical connection in its evaluation of ethics and the development of medical theory. Much of Galen’s approach is still in use today.
Discussion Topic:Why are religious considerations important in medicine? In what ways can religions considerations affect medical practice and research?
- Philosophy: “the rational investigation of the truths and principles of being,knowledge, or conduct” and “the critical study of the basic principles and concepts of a particular branch of knowledge, especially with a view to improving or reconstituting them”2
Philosophy played a major role in Galen’s approach to medicine. He structured many of his medical ideas in the same format of the philosophical texts of the time. He believes that the best physicians mixed philosophy with medicine.4,9 Through philosophy, he took a close look at the manner in which science was conducted.9The way in which we conduct medical research is important and is still something that is frequently brought into question today. But for Galen’s part, he was more focused on the scientific method itself.
Discussion Topic: Why is the method of research important?
Greek philosophy stressed the importance of observation. This was something that Hippocrates also stressed. This importance put upon observing the natural world laid solid groundwork for advancements medicine. Going back to the concepts of Hippocrates: observation is important for knowing the symptoms the patient is having, comparing cases for possible treatment options and noting the patient’s status for the purpose of judging prognosis.4 Aristotle and Plato also considered observation a key to understanding the world. They both advocated for dissection of cadavers.*5,9
- Cadaver: “a dead body, especially a human body to be dissected; corpse.”2
Discussion Topic: How is observation important in medical research?
- Science*: “a branch of knowledge or study dealing with a body of facts or truths systematically arranged and showing the operation of general laws” and “systematic knowledge of the physical or material world gained through observation and experimentation.”2
Discussion Topic: How are Science, Religion and Philosophy the same? How are they different? Why were these 3 domains of thought important in the Roman Empire and to Galen?
Galen considered anatomy to be the foundation of medicine. Because of this, he felt that studying human anatomy was the center of all medical research. But it was illegal to dissect cadavers in his time. Because of this, he dissected animals.1,3,4,9 He believed that animals would have anatomy like humans. Upon examination of several species of animals, he found that there were more similarities than differences. He applied the similarities to human medicine.4,5,9 Unfortunately, this led to many inaccuracies.
His time as a doctor treating the gladiators proved to be very valuable. While there he learned much about hygiene, nutrition and anatomy. He spoke of the gladiators being “windows” in which he could look into. We often consider concepts of hygiene and nutrition to be modern ideas, but these are things that Galen documented about and he gave them considerable importance.4,9
In general, many social works improved the overall hygiene and health of the populace. Public baths, toilets, aqueducts, fountains, sewers and other such infrastructure were major health benefits.5 His observations working with the gladiators and in Rome itself taught him the importance of hygiene and nutrition in preventing illness. His travel had taken him all over the empire and he noted that the health of those in Rome was better than those in outlying areas. His theories for why hygiene and nutrition were important were incorrect, but his observations were sound.9
There was one other important factor in why medicine made so much progress during this era: War. The Roman Emperors hungered to dominate the world and to do so they had to conquer other countries. This meant that the empire was in an almost constant state of war. This had several effects on medicine. The first being that the need for surgery became a constant and heavy demand. War injuries were used to study anatomy. Medicine and medical research was well funded. Those within the medical field had status and respect.9
Treating wounded warriors and gladiators offered physicians the opportunity to gain an understanding of physiology. An opportunity that Galen took full advantage of. He was able to develop surgeries to treat numerous conditions (cataracts) and was able to improve upon long established surgical procedures (trepanation).7
Galen used his experience and experiments to gain practical knowledge which he compared to the formal education that he had received. He tried to confirm the knowledge that he had learned. If he could, he would use it. He believed that it was important to experiment, observe and to document. He did not believe in blindly following medical books. Which is ironic because his work was blindly followed for 1500 years.9 However, this set the stage for his students (much later on) to question everything. It led to the concept of questioning and advancing theories rather than accepting established knowledge.10
Those who are enslaved to their sects are not merely devoid of all sound knowledge, but they will not even stop to learn! -Galen18
Discussion Topic: What does this quote mean?
Galen used vivisection* of animals to perform experiments to gain understanding about how the body works. Because of these experiments, he was able to learn a great deal about nerve function and was able to develop treatments that were able to help many people.9,10 Additionally, he was able to glean knowledge from colleges in Alexandria who were vivisecting criminals condemned to death.
- Vivisection: “the practice of subjecting living animals [or humans] to cutting operations, especially in order to advance physiological and pathological knowledge” when there is no gain to the subject.2
Discussion Topic: What are the ethical implications of vivisection? How do these implications compare to the implications of dissection?
– animal vs human vivisection, are the implications different?
– animal rights
– life value
– one vs many
– do the ends justify the means?
“Galen viewed the body as consisting of three connected systems: the brain and nerves, which are responsible for sensation and thought; the heart and arteries, responsible for life-giving energy; and the liver and veins, responsible for nutrition and growth.”9
Discussion Topic: the risks of ego.
The chief merit of language is clearness. -Galen1
Discussion Topic: As a doctor, why would clear and precise language be so important to Galen? Hippocrates felt that documentation was a key piece to good medical practice. How do these two men’s ideas of communication compare?
*Words to know
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