A.D. 131, at Pergamus, a town in Asia Minor, celebrated, like the birth-place of his great predecessor, for a Temple of Esculapius. His father, by name Nicon, was "of surpassing skill in geometry, architecture, astronomy, arithmetic, and logic; but was best known on account of his justice, modesty, and goodness," according to his distinguished, but rather rhetorical son.1 Nicon must have been somewhat superstitious, for he was induced by a dream, to devote Galen to the study of medicine. After studying in his native place for some years, and obtaining honours in the schools of philosophy, he began his travels, which were for scientific purposes, such as the investigation of asphalte by the Dead Sea, not a safe or easy undertaking in those days. He then spent some time at Alexandria, the great school of anatomy at that period; and, returning to his native town at the age of twenty years, became physician to the temple, where, among his other duties, he had to attend to the accidents which occurred at the public games. Here he remained till the age of thirtyfour, when, in consequence of a political disturbance, he left Pergamus and went to Rome. The first thing he did when he got there, was to go to one of the gymnasia or fencing-schools, and, in a wrestle, he got a fall, which dislocated his shoulder. He himself gave directions how it was to be set, telling the attendants not to mind how loud he holloed out from the pain, but to do to him what he did to others. The operation was quite successful. He very soon acquired great renown in Rome, chiefly through his accuracy in prognosticating the course that cases would take, and he was called in by all the grandees. His fees seem to have been very handsome. For curing the wife of the consul Böethius, he received about £350,-a large sum, even in Rome, where every 1 De Euchymia et Cacochymia. Lib. VII. 2 De Medendi Methodo. Lib. IX. A. D. 200. thing was very dear. Another cure he made was very celebrated; it was that of a distinguished philosopher, Eudemius, who had brought on an illness by an excessive dose of theriacum. Strange to say, it was by administering this very medicine in proper measure, that Galen restored him! "Take a hair," &c. At this time, he gave public lectures in Rome; but very soon his splendid renown excited such diabolical hatred in the minds of his professional brethren, that he found his life no longer safe. It seems that another Greek physician, along with his two assistants, had actually been poisoned by their rivals, out of envy at their success.' So at the age of thirtyseven he was again adrift, and wandered over many lands in pursuit of natural history. At length he returned to Rome, at the requisition of the Emperor Commodus, to be his physician. However, he did not stay long there-probably he found little to his taste in that corrupt capital; and having been warned in a dream to return to his native country, he obeyed the omen, and spent the remainder of his life in the place of his birth. The exact date of his death is uncertain, but it is believed not to have occurred before he had attained the age of seventy years.2 Speech is silver, silence is gold," says the proverb. Hippocrates, the type of a physician, was sparing of words: Galen was a man of silver speech, copious to diffuseness. Le Clerk enumerates about two hundred treatises of his writing, which have been preserved. In fact, he was more of a savant than of a practitioner; and his influence is in a considerable measure due to his having written a sort of encyclopædia of medical literature. He was to the medicine of the five centuries which intervened between the age of Hippocrates and his own, what the poet 1 De Libr. Propt. Le Clerk and Sprengel. is to his era he rang out the old, he completed the record. His positive additions to the practice of the art are incomparably less important than his contributions to its literature; and the innovations of an enduring character which he introduced were rather the result of thought than observation. He was the first to make the important division, familiar to us now, of the causes of disease into "remote" and "proximate," and to divide the former into the "predisposing" and "exciting;" meaning, by predisposing, those which produced some change in the condition of a person which made him liable to noxious influence, as, for example, exhaustion or debility; by exciting, these noxious influences themselves-as pestilent vapours; while, by the proximate causes, or those in immediate connection with the disease itself, he meant the unnatural actions which were thus induced, and which gave rise to pain and general disturbance. Although essentially eclectic, and grievously displeased at the rampant hostilities of the prevailing sects of Dogmatists, Methodists, &c., he was evidently deeply imbued with the doctrines of the school called Pneumatic, (from pneuma,) which we have already largely discussed as a physiological speculation, but which has also had a lasting and powerful influence in pathology. With him the pneuma was different from the soul, but instrumental as a medium for the action and reaction of soul and body. The soul resided in the brain, to which the spirit, or pneuma, had access by means of the foramina, which he believed to communicate between the nostrils and the interior of the skull.1 Hence the use of sternutatories: the sneezing was supposed to clear the ventricules of the brain, and allow the soul to be refreshed with pneuma, or spirit, of a better kind. How How very material his notions of the spirit were, may be gathered from his description of the sense of sight, in which he speaks of the 2 Ibid. Lib. X. 1 De Usu Partium. Lib. VII. 200 pneuma as actually retained in its place by the mechanical distribution of the parts, and as receiving the rays of light and passing them on to the optic nerve.1 How far Galen concurred with the Pneumatic sect in regarding this spirit as itself liable to derangement, so as to act on the whole system like a poison, it is not easy to make out. This view is thus expressed by Aretæus, a writer supposed to have lived about the same time, and whose admirable descriptions of disease, from their refreshing conciseness and graphic power, present a strong contrast to the vicious. elaboration of style common at his time :-" My opinion," he says, when speaking of Cynanche, " is, that it is merely a disease of the breath (pneuma, spirit), from its being converted by some action into a very hot and acrid state, without any inflammation of the body; and there is nothing so very extraordinary in this notion, for the suffocation from mephitic caves is exceedingly severe, without there being any bodily disease, and persons die merely from a single inspiration before the body can be in any way affected; and again, a person becomes rabid from the tongue of a dog merely breathing on him in expiration, without his being bitten at all."2 According to this theory, an exciting cause, such as the poison of hydrophobia, might act primarily upon the pneuma, or spirit; this, in its turn, upon the brain or other organs, so as to cause death without any disturbance or alteration of the body itself. Against such spiritual disease, it is plain that the ordinary material remedies would be powerless. One cannot physic a ghost. Whether Galen coincided with this notion or not, he was certainly not a bit less fanciful in his pathology. Thus, he divides inflammation into the following kinds :-1st. The simple, which is caused by excess of blood alone in any part. 2nd. When pneuma enters along with the blood Sprengel. Vol. II. p. 155. 2 Aretæus, p. 9. 3rd. When yellow bile gains admission, it is erysipelatous. 4th. When phlegm, it is scirrhous or cancerous. Galen's greatest innovation was the introduction of the indications afforded by the pulse; and his chapters, or rather treatises, upon the pulse, are wonderful examples of perverse ingenuity. He gives tables of the various kinds of pulse, as, for example,— 1. Long, broad, high, large; 2. Long, broad, moderate; 3. Long, broad, low (humilis); 4. Long, moderate, high; 5. Long, moderate, moderate, slender; and so on, enumerating twenty-seven varieties of this quality alone-that is, of the sensation of the movement in respect to its fulness. Then we have another table 1. Quick, quick, slow; 2. Quick, quick, quick; 3. Quick, quick, moderate, &c., 1 also extending to twenty-seven varieties in respect to the rapidity of its beat. Besides the fulness, strength, and rate, there are a multitude of other distinctions which it has been found almost impossible to translate, such as caprizans, or jumping like a goat. Of the reality of these nominal differences there is no doubt; but the objection to this attempt to tabulate them in the way Galen has done, is, that no two physicians would agree whether to call a pulse "long, broad, large," or "long, broad, moderate." If these qualities were fixed by a dynamometer, then such tables would have at least an objective and positive foundation to begin with, instead of a merely-arbitrary one. The pulse is, undoubtedly, a most important index of the state of the health; but it requires the cultivated tact of long experience to interpret its signification. It cannot be 1 De Different. Puls. Lib. I. |