Part III.-Galenian Medicine

We have now to give some account of the most remarkable genius of his age, perhaps of any age. Hippocrates we have extolled as the greatest man of his time; but Hippocrates was not a genius. He lacked the versatility and imagination of genius. He was great as a man; but Galen was great as a genius superposed upon a great man. To great natural gifts to begin with, he added the powers of great industrious activity. His father, whose name was Nicon, was a man of rank and fortune, distinguished in belles-lettres and philosophy, who resided at Pergamus, in Asia Minor, where his son was born A. D. 131. His wife's name is not given, but she is spoken of as being a good manager of household affairs and of good character, but given to mauvaise humeur, and behaving as a wife toward her husband after the manner of Xantippe. To his son he gave every advantage of education that the world possessed. To complete his education, young Galen visited every centre of learning of the known world, and absorbed knowledge of every description from all sources. Alexandria was in her zenith at that time, about the beginning of the second century of the Christian era, and thither he went, after spending a brief period in Rome, for the study of the arts more than the science of medicine. Its science and philosophy he took with him, having become acquainted with the

works of the Father of Medicine, and imbibed such of his doctrines as seemed rational, and improved on such of them as had become obsolete by the advancement in medical thought and practice, made by his disciples. Mentally, he was a prodigious gourmand, consuming everything within his reach, but digesting and assimilating only the helpful, rejecting the rest as cumbersome and valueless. Leaving Alexandria, he returned to his native city of Pergamus; thence he returned and, at the urgent request of the Emperor, Marcus Aurelius, settled at Rome, where he remained, for the most part, the rest of his life, and where he became a great celebrity.

Some men inherit greatness; others have it thrust upon them; still others acquire a kind of greatness by being clever in the art of politics and society, and possessing the genius of ruling men; others acquire greatness by the weight of their character and the force of solid achievements. Such a man as this last was Galen. His self-sufficiency and independence would have appeared self-conceit in any other man; in Galen it was recognized as something to be conceded. What was a matter of fact in him would have been arrogance in any other man in Rome. His opinion had the authority of an oracle. He was supreme in every department of knowledge, and what is even more remarkable is that his supremacy should have been so generally conceded by his contemporaries at home and abroad. He

over-bore opposition to his views, not because they were true, for he held too many hypotheses that were not demonstrable, but by the overpowering weight of evidence that he was able to bring to his support. Naturally, he was ranked with the Dogmatic sect in medicine, as that sect gave him greater latitude to exercise his genius as a theorist, of which he was the prince. His pathology, theory, and practice were Hippocratian in the main. In the domain of the hypothetical, in the place of Physis of the master, he seems to have substituted Pneuma (Пvɛūμ¤), the vital or determining principle in animal bodies. He also formulated the doctrine of contraries in therapeutics, which was brought forward by Hippocrates, namely, contraria contrariis curantur, which is held as a maxim among the orthodox or regular physicians to-day.

Galen wrote voluminously and with great versatility. Nearly two hundred treatises on the various branches of medicine and the sciences in general have come down to us. Nothing but the reverence with which his name was held by the Alexandrians who sacked Alexandria and destroyed its great library saved his works from destruction. The Christian vandals who succeeded them likewise preserved the books of Galen, though sparing few others of the ancient writings. Such was the hatred by them of everything pagan, or of pagan origin!

The contribution that Galen made to the art

of medicine was considerable. He enriched its literature by his versatility, and advanced its position by his great personality. He was an enthusiastic polypharmacist, and added an impetus to a custom of combining drugs in a prescription of questionable utility, which continued to be followed with great abuse until long after the advent of the single-remedy man, the distinguished Hahnemann. It is still in existence, though in a modified form.

He rendered some aid to diagnosis of considerable importance, in classifying the causes of disease into exciting and predisposing, remote and proximate-proximate meaning the organic effects which a malady may have left behind. This conception is well founded and wise, and is likely long to endure.

His observations on the pulse were too academic and complicated to be useful. Only a physician of precise and critical acumen could profit by them. Besides, without their diagnostic significance they are of no use. They have been superseded by the more practicable studies of John Mason Good, and enlarged upon by the introduction of the dynamometer and sphygmograph, or pulse writer, the invention of Dr. Dudgeon, London, 1870.

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Galen was an eminently successful practitioner and achieved great popularity at Rome by treating citizens of distinction; chiefly, its warriors wounded

in battle, and by his success in curing obscure diseases and derangements, many of which had baffled the skill of his less fortunate contemporaries. Le Clerc cites some of these cases. To us, however, it seems more probable that his great success in such cases was achieved more by the influence of his strong personality, his power to arouse confidence and inspire belief in him and hope of recovery in his patient, than to any curative virtues which his remedies possessed. The writer has seen the curative influence of personality illustrated in his own practice a thousand times. So valuable an aid is it at the bedside that no physician ever achieves distinguished success who does not recognize it and possess the power to make use of it, whatever his drugresources may be. More potent than learning or knowledge, and of vastly more consequence is it as a remedial or, better say, convalescing agency, than the best chosen medicaments of the pharmacopeias. To-day this agency is styled "Suggestive Therapeutics." A few years since, about 1855, it took the name of "Expectant Medicine," a phrase first advanced by Sir John Forbes, of England, and re-echoed on this side of the Atlantic by Dr. Oliver W. Holmes, the poet-professor of anatomy, at Harvard, Boston, Massachusetts.

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As to Galen's theory and practice but little need be said. They were for the most part like his great predecessor, Hippocrates'. He did not accept

• Nature in Disease.