Galen – Famous Thoughts and Quotes
Claudius Galenus, better known as Galen (anglicized) or Galen of Pergamon, a Greek physician, philosopher and writer is often considered the most significant contributor to ancient medicine following Hippocrates.
He was born in Pergamum (129 CE, Pergamum, Mysia, Anatolia [now Bergama, Turkey]—died c. 216), an ancient center of civilization, where he received extensive training in philosophy and medicine.
With his father’s guidance at the age of 14, Galen began his studies in mathematics and philosophy. His education also included an examination of the four major philosophical schools of the time: The Platonists, Peripatetics, Stoics, and Epicureans.
When he was 16, he changed his career to that of medicine, which he studied at Pergamum, at Smyrna (modern İzmir, Turkey), and finally at Alexandria in Egypt, which was the greatest medical centre of the ancient world.
From 162 A.D., he lived in Rome where he gained reputation as an experienced physician, served Marcus Aurelius and the later emperors Commodus and Septimius Severus as a physician, and spent the rest of his time writing and experimenting.
The Roman Emperor Marcus Aurelius described him as
Primum sane medicorum esse, philosophorum autem solum
which might be translated as: “First among doctors and unique among philosophers.”
Galen’s final works were written after 207, which suggests that his Arab biographers were correct in their claim that he died at age 87, in 216/217.
Introducing the experimental method in medical investigation
Galen was a teacher, philosopher, pharmacist and a leading scientist of his day. He was the originator of the experimental method in medical investigation.
He identified seven of the twelve cranial nerves. One of his most significant observations was that arteries carry blood rather than air. He also differentiated arteries from veins, and described the valves of the heart. His research into the nervous system resulted in an understanding that nerves transmit information from the brain to various distinct components of the body.
He is arguably the most accomplished of all the medical researchers of antiquity and dominated the medical teaching in both the eastern and western world for nearly 1500 years.
The best doctor is also a philosopher
The son of a wealthy architect, he was educated as a philosopher and man of letters. Galen’s wealthy background, social contacts and a friendship with his old philosophy teacher Eudemus (a pupil of Aristotle) further enhanced his reputation as a philosopher and physician.
He worked in a historical period of Roman political domination, but all serious education in the late Empire had a classical and Hellenistic Greek curriculum that packaged the wisdom of the Greek arts and sciences under the grand term paideia. He was a product of this holistic educational system, which included the study of Greek poetry, history, rhetoric, and philosophy.
While he emphasized the importance of experience, he also made a significant role for theory in his medical writings. For Galen, a medical expert cannot afford to be ignorant of ‘natural philosophy’.
Yet, increasing scientific specialization led to an emphasis, especially among doctors, on practical, technical, and even business skills at the expense of theoretical and moral training in the non-scientific arts.
He had various responses to this type of question for his own time. But he evidently regarded the problem as significant enough to address explicitly in two separate treatises. Both of these offer Galen’s thinking about the best education for doctors, and articulate his belief in a broad, inter- and multi-disciplinary training.
The first gets right to the point with its title
The Best Doctor is Also a Philosopher
He was moved to write The Best Doctor by his discontent with the medical culture of his day.
He specifically identifies three interrelated problems: and, particularly, number (3) what he calls the “bad upbringing current in our times,” which encourages people to value wealth over virtue. For, as he asserts,
it is impossible to pursue financial gain at the same time as training oneself in so great an art [as medicine];
someone who is really enthusiastic about one of these aims will inevitably despise the other.” The profit motive, said Galen, was incompatible with a serious devotion to the art.
He also clashed with Aristotle, notably over a question that has both philosophical and anatomical aspects: which part of the body houses the ‘ruling faculty’ (hegemonikon) that controls the whole animal? Aristotle, and Galen’s favorite opponents the Stoics, thought this faculty was seated in the heart. Claiming solidarity with Plato and Hippocrates, he instead put it in the brain.
Introducing ‘phenotyping’ and ‘neuroendocrine immunology’ of common human diseases
In antiquity, humours were bodily fluids that influenced the health, physiognomy and character of man. The four primary humours, chole (bile), melanchole (black bile), sanguis (blood) flegma (phlegm), were understood in terms of a general cosmological theory in which fire, earth, air and water were the four basic elements of all things.
The Four Temperaments
Temperament traits can be defined as constitutionally determined dispositional characteristics that influence the manner in which a person’s actions are expressed. An intriguing notion has it that these temperament traits can be traced back to the system of four temperaments that is described in the works of Galen.
Temperament referred specifically to the blending of the four manifest qualities of the humours. For Galen psychological characteristics were expressions of bodily processes and as such they were influenced by the particular blend or balance of the four humours.
Building on earlier Hippocratic conceptions, Galen believed that human health requires an equilibrium between the four main bodily fluids, or humours—blood, yellow bile, black bile, and phlegm. Each of the humours is built up from the four elements and displays two of the four primary qualities: hot, cold, wet, and dry.
Unlike Hippocrates, he argued that humoral imbalances can be located in specific organs, as well as in the body as a whole. This modification of the theory allowed doctors to make more precise diagnoses and to prescribe specific remedies to restore the body’s balance. As a continuation of earlier Hippocratic conceptions, Galenic physiology became a powerful influence in medicine for the next 1,400 years.
In his work De temperamentis, He developed probably the first typology of four temperaments, and searched for physiologic reasons for different behaviors in humans – throughout history they had different names, but sanguine, choleric, melancholic and phlegmatic eventually became the most popular.
Importantly, while the term ‘temperament’ came to refer just to psychological dispositions, Galen used it to refer to bodily dispositions, which determined a person’s susceptibility to particular diseases as well as behavioral and emotional inclinations.
Thus, it was probably Galen who first integrated the ‘immune system’ or ‘cancer’ with the person’s emotional and physiologic processes – circa 200 A.D. he wrote that
melancholic women were more prone to develop ‘swellings’ of the breasts than were sanguine women.
Thus, Galen believed that cancer represents a growth arising from an excess of black bile. Melancholia, which means black bile in ancient Greek, was used to describe ailments associated with a depressed mood. The association between melancholia and cancer was reached by the observation that depression was common in patients with cancer.
Interestingly, and as per Andres Correa and Marc C. Smaldone, the theory of cancer melancholic diathesis dominated medical science for centuries to come, whereas in 1893, Herbert Snow, a British surgeon and cancer pioneer, performed the first epidemiological study linking cancer and depression. Of note, search (May 09, 2023) using the following keywords: (depression) AND (cancer) at PubMed provides 38,527 results (see Figure at right). This may also suggest that this link or association might be ‘re-discovered’ or ‘re-invented’.
Galen’s medical theory of the Four Temperaments was widely accepted up to 1858, until it was ‘displaced’ by Rudolf Virchow’s newly published premise of cellular pathology.
Galen – a few more quotes
“The physician is only nature’s assistant”.
“Look to the nervous system as the key to maximum health.”
“The chief merit of language is clearness, and we know that nothing detracts so much from this as do unfamiliar terms.”
“(Wine is) the nurse of old age.”
“Laziness breeds humors of the blood.”
“In that case there will be no danger of his performing any evil action, since he practises temperance and despises money: all evil actions that men undertake are done either at the prompting of greed or under the spell of pleasure.”
“Confidence and hope do more good than physic.”
“The reason that I keep writing is that all my most powerful messages about the fates of wild places that I care about need to have words as well as images.”
“He who has two cakes of bread, let him dispose of one of them for some flowers of the narcissus; for bread is the food of the body, and the narcissus is the food of the soul.”
“Who Are You? What do you want? Where Are You Going? Who do you serve and who do you trust?”
