THE LIFE AND CARBER OF GALEN THE LIFE AND CAREER OF GALEN

candidates at lengch on their understanding of the theories ofche great doctoes bis first job on bis return to Pergamum in autumn 157. He had been away a
of the past (advice that demands from the patient as substancial an acquaintllnce long time.
with the relevant medca:lliterature as from the book learning The significance of Galen's education cannot be overestimated, sinee it
Galen uses as a weapon against his competitors: he is a better Hippocratic tllan established, to his ever-repeated satisfaction, the hasic principIes of proper
they because he can interpret the words of the master through a more precise medicine as he understood it. But his education was unusual in various ways.
understanding of Hippocratie language. It is an argurnent that would appeal In the first place, Galen was a wealthy latecomer to medicine. There were
to intellectual tastes in an age of intellectuals and serve to rase Galen aboye humbler doctors who died at a younger age than Galen was when he embatked
the snotty-nosed cobblers. dyers, carpenters and tax collectors whom he saw on an educacional odyssey that was both longer and geographically more
as his competitors.
24
Equally, itwas liable to lead to pedantic textualism in the extensive than any other known to us.
16
Parallels can be found for doctors
hands of doctors less practically gifted than Galen. studying medicine with local physicians and travelling further afie Id to a
Such learning was essential nrst and foremost, in Galen's eyes, in order to more prestigious town, especially if, like Galen, they came from the well-to-
understand the greatest medical authority of them all, Hippocrates. This do sections of sodety in Asia MinorP But it isthe length of time that Galen
commitment to Hippocrates he had derived from his teachers, yet one may spent before entering upon his actual practice, and spedfically at Alexandria,
wonder whether any of them went as far as he did in the process of self- that is without precedent as fae as our evidence goes.
identification with Hippocraces.
25
When Galen disCU5ses medical ethics, it is . Galen's was also an extremely bookish education. He may have originally
withthe practical Hppocrates of the Epidemics and the Letters in mind, saving been intended for a career as. a professional sophist, a public intellectual like
Greeee and despising Persian gold.
26
He nnds proof in che Hippocratic Corpus Polemo of Laodicea or Herodes Atticus, demonstrating in public his skills
that the great man had carried out anatomy (although he had never found as a man oflearning and his Greek style. He may have had in prospect merely
time to write up all his discoveries), and Plato's passing comments are used te thelife of a culcivated gentleman dividing his time between his estates and
demonstrate Hippocrares' logical and philosopbical interests. Ir is not only the busy roundof citytheatres, clubs and polite conversatin, where the
that Galen found within theHippocratic Corpus .evidence to justify and ability to recognise quotations from long-dead poets or to alludegracefully
approve what he himself wished to do: he also imposed onhis heto theories, to the dininghabits of the ancient Athenians would ensure a welcome at the
beliefs and practices that he is unlikely tO have shared.
27
Sorne of these notions dinner tableof the good and great.
IS
At Ephesus, and probablyelsewhere,
he undoubtedly gained from his ownteachers: the pre-eminence ofThe Nature cloctors joined with other. intellectuals in a Museum, and official decisions on
01 Man, the theory of the four humours, the importance of prognosis,and.l cheir tax privHeges placed rhem in thesame context as sophists, grammarians
holistic approach to an individualist therapy. But Galen mayhave gone far and pbilosophers.1
9
;AUof them had enjoyed an educaton based on the ancient
beyond them in his creation of an unerring Hippocrates in bis own image. classics, on Homer and the dramatists, on Thucydides, Plato, the Atre orators,
He did chis rhroughout hiswritings, but principally by meaaS of a series and on other authors less familiar today. Although Galen was well capable
of contmentaries chat occupied bimon and off fur twenty years or more, from of competing in these intellectual games - his books indude expositions of
. the mid 170s at least until 'Che earIy 190s. In all he commented 00 eighteen obscurecolloquialisrns in.Attic comedy and an answer to the quesdon of whether
treatises, sorne of which, lke Prorrhetic, were, in his view, not entirely by the one could be a grarnmarian anda critic at the same time - he was no pedant.
handofthe masrer.
2l
His avowed aim was tO make dea.r to intelligent readers He despised those who devoted thei! timeentirely to a passion for etymology,
ust what Hippocrateshad meant in his writngs, without necessarily entering andhe tried to steer a midclle cOluse between those always itching fur novelty
into long discussions of thetruth or error of each passage.
29
Often he achieves and those whowould nor utter a word unless ithad been spoken five hundred
thisaim, eXplainingdearly;,if notalways succincdy, whattheHippocratic Greek . years ea.rlier by Demosthenes.l:!e preferred clarity to linguistic
had meant, linking it ro his ownand others' clnical experiences, and even

occasionally admitting the impossibility ofmakingsense of what were litde Clthers. His Greek style bears out bis claims, although
more than jottings without acontext. But, inevitably, his ,good intentions were it is marredby prolixity and constant repetitions,especially in'those W'Orks
somecimes castaside in the pursuit of intellecrual hares: The later commentaries 'chat were taken clown from an oral presentation. Bue his own enthusiasm for
on the Epidemics discuss variant readings andquestionsof authenticity;a few books -as,already.noted,21 his.own library was enormous and his own rate
,
Hnes of Hippocrates may extend into a wholesale discussion on contemporary of production astounding
22
..,.. led him to elevate a knowledge of books ro a
medical themes; and' commentators who disagree with Galen are roundly far higher level of importancethan others less forcunate thanhim would
conrroverted, sometimes at length. Here is scholatship, burat times!t detracts have done. His advice ro the .would-be patient in search fa doctoristhat if
from the educatiunal purposes foro which he wrote his commentaries. a personal.recommendation is not forthcomingheshould interrogate possible
219 218
THE LIFE AND CAREER OF GALEN
THE LIFE AND CAREER OF GALEN
Questions of good and bad medical practice inevitably enter in, as Galen
endeavours lO make sense ofobscure passages. Gaten is convinced of the didactic
aim of the Hppocradc textS he selects for comment, culminating in the
Aphorisms, which he sees as the summation ofall accumulated Hippocratic
knowledge.
30
The briefaphoristic form expresses succinctly and, more impor-
tantly, memorably the essential truths of Hippocratic doctrine, to which he
himself is utterly committed. But it is not always dear what these truths are or
were. The meaning of the words in che Corpus may be disputed, oc they may
not coerespond entirely to the facts of everyday practice half a millennium latero
Gaten'sresponse to the /irst problem is to support the general interpretation
ofhis teachees with an abundance ofvituperative scholarship that proves, to his
satisfaction, that no other view is possible.
31
The second problem he resolves by
dividing up the Hippocratic Corpus according to various degrees of authen-
ticityY Although he cites most of the texts in ir in his Hippocratic Glossary,
some of them, and indeed some sections of them, do nor come from the pen
ofHippocrates himself.
33
Instead, they are productions by other members ofhis
family, like Thessalus and Polybus, or by pupils, like modeen undergraduates,
not always accurate in their recollections of their master. Others reflece
something ofthe Hippocratic spirit, even if, like Prorrhetic and Andent Medicine,
they also contain a great deal that is at variance with what Galen considers true
Hippocratic doctrine. 34 The more error Galen detects in a treadse, the more
like1y it is not to have been written by HippbCrates, and hence it can be excluded
from his medical purview.
35
Thus Galeo thescholar-physician creates a picture
of an unetring Hippocratesthat, in turn, justifies and inspires Galen. The self-
identificaton of hero-worshipper with hero is alroost complete.
The other major strandin Galen's intellectual formation was a commitment
to philosophy. As we have already seen, the interrwining of medicine and
prulosophy wentback many centuries, and Galen's philosOphical interestsflnd
contemporaty parallels in the Sceptical doctor Sextus the Empiricist and
the well-traveUed Heraclitusof Rhodiapolis. 36 Galen's philosophical' writ..
ings enendover thewhole ofhis adult life. On MedicalExperience wasaproduct
of rus studeot days at Smyma; On My Own Opinio1is, his last work, was written
almost sixty years later.
37
They also covet a remarkably wide range of themes
and apptoaches. Galen could deliver short moralising sermons on howto.
proflt from one's enemies or avoid excessive grief, as well as write technically
sophisticatedstudies of the logicofpropositions. Above all, he was convinced
that ,no qne co.tld be a proper :RhysiC;!,lJ.,withtutphil9Sophy;althoughhe
an physici?ll withoUt
one wasalso aphilosopher.:Asevet,:Galen claimedHippoctatic;
authorityand precedent for hisviews.Effective medical practice required both
Figur 15.1 A frgrilent of Galen's commentary on theHippocratic Aphorifm", writtn
,
in theNearEast (N. Srria?) in the thirtenth orfour:teenth centuty, imd l'
preservedin n Arabic Gospel book, St Petersbnrg, IilStitlite of Oriental
", His studies as a'young man at Pergamum with philosophers from the four
Srudies e 263.
major sects, Stoic, Platonist, Aristotelian and Epicure?ll, not only gave him a
220
221
I
THE LIFE AND CAREER OF GALEN
decailed knowledge ofcheir conflicting doccrines butalsoproduced a
uncertainty,fromwhichhewas rescuedonlybyaconsiderationofthe
truthsofmathematicsandgeomecry.40Henceforth,tiUtheendofhislong
hewasconvincedofchefutiliryof manyof thequescionshodydebated
thephilosophicalschools- theeternityofche world, che namreofche
theexistence ofworlds beyond our own- since the evidence on either
feU far short evenofplausibilicy, letalone certainty.41 Instead, he devote<d!'
himself cowhathetermed'scientificdemonstration',theapplicationof
thoughtand evidential prQof. Hismosc extensive treatise onthis theme, Or,
Demonstration, survives only inafew scactered fragments, andwehave onl}'
the tides ofhis manyshorterwritingsattacking avariecy ofdogmas ofthe
individual philosophical schools, bur his Introduction to Logic and his On
Ambiguities in Speech areenoughcoshowhis impressiveexpercise.
42
TheArabs
credicedhimwithchediscoveryof theso-caUedfourthfigureofchesyUogism,
although itmightbemoreproperlyconsideredanextensionofearlierlogic
ratherchanacocally newdevelopment.
43
Hisownphilosophywas avowedlyedectic,for heregardeditas a markof
weaknesscocornmiconeselfunequivocaUytothedoctrinesofanyonesect(like
che ChristiansandJews, whose adherence co theirsacred texts and beliefin
miradeshe found excraordinarilynaive),and t0
His mechodologywas simple:
oc IJ:1agersonwhichtherewas general,,greemenu.ncl
proceedco beginningin
concorcf);tiighr"6e";6Iro bringone; adv;rsaryalong towards anagreed
conclusiorithat 'certain'and'precise',especiaUyif,asGalenregularly
did,oneproceededbyimpeccablyaccuratelogicalsteps.Theweaknessofchis
approach,however,resides inthenatureofthepremisesfromwhichitbegns,
whichareoftenneitheras obvious nOr as universallyagreedas theyappeared
toGalen.
45
Galen's eclecticism manifesteditselfinhisview oftheuniverseandofthe
microcosm ofthebody. Inhis concepts he ismost indebted to Aristode,
especiaUyforhistheoryofelements,
_CQIiID..Qs.46 Hisvi;dfthe'firulcIes,
functions,eachderivingfromaspecificcombinationofelementsandqualities
ac themostbasic level (a nice anticipationofmodern norions ofDNAancl
che stmctureofproteins); can only be understood against thebackground
ofAristotelianphysics. Buthis ()fthe_body
aJe dependent.especiaIry on the Timaeus, which, Galen
beneved, containecLmed:al clo,st1'jges.consonant widlthoseQfhis.1;Ilt:!<!ifal
hero Hippocrates:He rejectedtheunitarysoulofAristodeandthe in
he
whdeidtheveryexistenceofasoul(althoughhe refusedtocommithim-
selfonics namre,despitecomingverycloseattheendofhislifetoabeliefin
itsco:porealiry).47Similarly,
222
THE LIFE AND CAREER OF GALEN
(althoughwithoutpretendingtoknowledgeof thedivineessence)and
urposefulorganisation ofthenaturalwodd,producingarguments in
,.
48
ofteleologythatare arguablysuperiortothoseofAristotle.
Hisphilosophyandhismedicineinteractthroughouchislife. Theopening
oftheMethod o/ Heating are an exerclse inlogicapplied to thebasic
ofmedicine, and his diagnostic procedures are models ofcareful
accurateargument.
49
In mrn, his anatomical discoveries provide solid
\
bothforAriscotle'snocionofapurposefulcreatorinOn the Use o/Parts
Body andforPlaco'striparcicebodilysysteminOnthe Opinions o/Hippocrates
Plato. Galen's books on causation, a favourite copie among Stoics and
,ians, are atonceimportantcontributionstophilosophicaldiscourse
practicalguides for the thinking doctor. 50 Hisdiscussions onthe role
ofexperiencewithinmedicinehavebeengivenawidersignificancebyamodern
51
scholar as chaUenging reflections on the namre ofscience as a whole. In
'another areaofancientphilosophy, his ideas onechics and psychology both
drawonandcontributetohis experienceandunderstandingofcases ofmad-
ness, anger,griefandeventhe naughtiness of children, sorne ofwhom 'seem
cobebornnaughry'.5
2
Tattempttodividehisphilosophyfromhismedicine
is impossible,evenwhenconsidering hisday-co-day activities. Notonlydid
Galenassociatewichphilosophers,likeArria,thefemalePlatonisc,andbenefit
from theirideas, buche welcomedthemtohis anatomical displays andeven
tothebedside,andwrotetreatisesattheierequest.
53
Whateverthefailingsof
hisphilosophicalargumentsove!hislonglife- and thereare manyexamples
ofinconsistency, evasion and hectoring bluster- Galen also triumphantly
showed theimportanceofthephysicianthinkingabouthis work,hispatient
andhis moraluniverse.
Butitwas notphilosophy thatgained Galenhis first majorrecognition
onhis recurn co Pergamum in 157 buthis knowledge ofsurgery and, orte
mightalsosuspect,his family connectionswithsorne ofthewealthycitizens
ofPergamumandtheprovinceofAsia. 54 Hewas retainedbythehighpriest
ro lookafter his official troop ofgladiators that'performed in,the arena at
themajorfestivals.55 Gladiatorialcombatswereahighlypopularformofenter-
tainment among the Greeks ofthe Roman Empire; Pergamum itselfhad
amagnificentamphitheatre. Butgladiators, especiaUy good fighters,were
becomingexpensiveitems,forthosewhowereresponsiblefor thegreatfestivals
couldnolongerrelyonlargenumbersof capmredslavesandprisonerstomake
uptheirnumbers. 56 Galen'sdutywastokeephisgladiatorsalive,andnotonly
inthe immediateaftermath ofcheirappearanceinthearena. Heattendedto
theirdiet,cleanedand stitchedupthei!wounds,principaUytotheirthighs,
arms and buttocks (whichwouldproducemuchblood, butnot necessarily
lastingdamage),andoversaw theirgeneralhealth.
57
Heclaimsthatunderhis
supervisiononlytwogladiatorsdiedinhisfirstperiodinoffice,comparedwith
thesixteenlostbyhis predecessor, and he was thusre-engaged bythe next
58
highpries!,sevenandahalfmonthslater,andbyhisthreesuccessors.
223