Saturday, 15 January 2011

THE HUMAN MIND: A STRANGE DICHOTOMY II

GREEK MEDICINE AND WAR MACHINES

I continue with the theme that the Human Mind displays a strange dichotomy. On the one hand it generates great benevolence and compassion; on the other hand ferocious barbarism. I pose the question again. Why is this?

Here I continue with the benevolent aspect before turning to the other aspect of the human Mind on the next blog.

We move on now, some 500 years or so to the time of another Greek physician GALEN. Let’s have a look at him.




PICTURE OF GALEN

What was Galen’s unique contribution to Medicine?  It has been rightly said, “Hippocrates sowed and Galen reaped.” What then was so special about him and his work?

Some background first, I think. After which, we can explore his methods of Medical Treatment and comment on the difference between Galen and Hippocrates.

His name was Aelius Galenus or Claudius Galenus but he is more commonly known as Galen of Pergamon.  He was a Greek  born in Pergamon in 129AD. This was an ancient Greek city around 16 miles from the Aegean Sea . It was  situated on a promontory or headland jutting out into the sea. Pergamon  was heavily influenced by Rome and was an outstanding centre of culture. The ideal place for a man with Galen’s cast of mind to be brought up.

Seemingly, in spite of the work of Hippocrates, discussed earlier, a unified system of Medicine did not take over all at once. Things take a long time to soak into the Collective Consciousness.

 




PICTURE OF PERGAMON: THE TEMPLE OF TRAJAN






A SKETCH OF ANCIENT PERGAMON



Galen’s father was a wealthy architect. As a result  of  his father’s affluence, Galen was able to travel extensively from a very early age and later to study philosophy and numerous Medical Theories. Eventually, he settled  in Rome when he was thirty three years old. Here he pursued his Medical vocation. In fact, his father had intended his young son to pursue a different career. However, according to Galen, when the young man was sixteen years old, his father had a dream. In this dream the God Aesculapius appeared and commanded his father, Nicon, to send his son to study medicine. So, as money was no problem, at the age of sixteen, the young Galen was sent to the prestigious local sanctuary or Asclepieum,  dedicated to Aesculapius, God of Medicine.

 




STATUE OF AESCULAPIUS WITH HIS SERPENT ENTWINED STAFF, THE SYMBOL OF MEDICINE AND THE HEALING ARTS.


 





THE MEDICAL SCHOOLOF AESCULAPIUS


In 148 AD, when Galen  was 19, his father died. This left the young man independently wealthy. At once he traveled throughout the Mediterranean area and studied assiduously. This involved absorbing the ideas of the various schools of thought in medicine. He finally studied at the renowned Medical School of Alexandria. All of this took place before he finally settled in Rome.





A SICK CHILD BROUGHT TO THE TEMPLE OF AESCULAPIUS


During his time in Alexandria it was  common practice for an anatomist to be able to take a prisoner and perform vivisection upon him. Whether Galen witnessed the infliction of such agony is not known. It is certain that he had access to the details of such practice as recorded by the anatomists. To what extent they were of use to him is open to question.

When he was 28, Galen returned to his native Pergamon and was employed by the High Priest of Asia as physician to the gladiators. This was a prestigious post as the High priest was one of the richest and most influential men in Asia. Galen was chosen in competition with the other physicians after he disemboweled an ape and challenged the other physicians to remedy the condition of the luckless animal. When they were unable to do so, Galen performed the necessary operation. His competence so impressed the High Priest that Galen was appointed to the staff of the High Priest immediately.

Galen remained in this position for four years and during this time he studied  the
importance of diet, physical fitness, personal hygiene and measures to prevent the occurrence of disease. Because of his work on the gladiators he acquired a deeper knowledge of human anatomy, also the treatment of fractures as well as the effects of trauma on his patients. At the same time he continued to study various medical theories and philosophy.

In AD 162 Galen went to Rome and established a reputation as a highly skilled physician. Because of his growing reputation he incurred the jealousy of the influential, but less competent physicians. Warned that they might attempt to poison him, Galen left Rome for a while.

In AD 169 a great plague broke out in Rome and the Emperor, Marcus Aurelius, ordered Galen back to Rome to try to deal with it. The plague was so severe that it has been estimated to have killed over half the population of the Roman Empire. The treatment of the day relied on divination and prophetic utterances. Which, of course were totally useless. The extent to which Galen was successful is not certain. What is known is that his Medical techniques relied on observation and attempting to treat the internal conditions of those affected. In short he distanced himself completely from the superstitious practices of his contemporaries. Even so, with all his skill, Galen could not stem the tide. The plage, generally considered to be Smallpox ripped through the Empire before it eventually abated for a time.

 



MARCUS AURELIUS THE ROMAN EMPEROR AT THE TIME OF GALEN




For a while Galen accompanied Marcus Aurelius as his Court Physiician and later was the personal Physician of the emperor Commodus for most of that Emperor’s life. Commodus was eventually strangled in his bath and some time later Septimus Severus took the throne. Once more Galen was appointed as the physician to the Emperor. Galen was then around 63 years old.

Enough on the background, I think. Let us look at what Galen actually did, in short what were his specific contributions to the practice of Medicine?

We need to keep in mind that this relentless pursuit of Medical treatment illustrates the capacity of the human mind for benevolence.

Right, what was Galen’s approach?

In some respects Galen BUILT UPON the work and theories of Hippocates. For example, a fundamental notion of Hippocates was that the Human body was composed of four Humours:  blood, yellow bile, black bile, and phlegm. In turn the personality or any pathological condition was determined by the BALANCE of the Four Humours.

In other words, as far as mood swings were concerned, the imbalance of the Humours dictated these swings, thus preponderance of blood produced a sanguine mood, black bile, a melancholic mood, yellow bile a choleric mood and phlegm, a –phlegmatic mood. Opening this out it meant a person displaying a SANGUINE disposition would be extroverted and social; a CHOLERIC person would have boundless energy, passion and charisma ; a MELANCHOLIC individual would be creative, kind and considerate; finally, a PHLEGMATIC person would be dependable, kind, and affectionate. Galen extended this idea and suggested that whichever Humour was DOMINANT AS PART OF ONE’S NORMAL MAKE-UP, this determined the personality of the individual.

The same was true of disease. Any imbalance of the four humours would result in disease of some sort.

Another contribution Galen made was a close study of ANATOMY. Although human vivesection had been practiced in Alexandria during Galen’s residence there, now in Rome this was no longer possible. Roman Law had prohibited the dissection of human corpses since 150 BC. As a result his anatomical investigations were performed on animals whether alive or dead.


















GALEN DISSECTS A PIG AND SHOWS THAT THE CUTTING OF THE LARYNGEAL NERVE STOPPED THE PIG FROM SQUEALING


In his anatomical dissections he mainly focused on primates and pigs. The reason for this is that the anatomical structures of these animals closely resemble those of humans. In the drawing above one can see his investigations into the anatomy of the trachea (the windpipe) and how by cutting the nerve the voice is lost. It is said that Galen discovered this by accident, making the wrong cut.

He also made a contribution to the CIRCULATORY SYSTEM. In fact, he was the first to note the difference between VENOUS (dark blood short on oxygen) and ARTERIAL (bright blood, oxygen enriched). His theories on circulation, however, were inaccurate and the idea that the blood engaged in a complete circuit of the body was not proved until 1628  by William Harvey.
Galen’s ideas concerning the blood were as follows: venous blood was produced in the liver. From there it was distributed and consumed by all organs of the body; arterial blood originated in the heart. From here it was distributed and consumed by all the organs of the body; the blood could be also produced in the liver.

He made a rather curious point that there were a group of blood vessels, which he named the rete mirabile (net of blood vessels) near the back of the human brain roughly in the neck. Whilst such a structure is present in some animals for efficient HEAT EXCHANGE, such is not present in humans at this point. He apparently deduced this from the dissection of a sheep.

It must be added that Galen was a highly skilled surgeon, particularly when he operated on human patients. Amongst his operations were those on the brain and the eyes. For instance, In order to correct  cataract  conditions (clouding of the eyes) he performed an operation using a needle-shaped instrument, to remove the cataract from behind the lens of the eye. Bearing in mind he was using unaided, naked eye techniques and none of the modern technology, his was a remarkable achievement. It seems that surgeons did not have the courage to emulate his methods for centuries.

I think I have said enough to indicate what I am getting at. Just to repeat it:
The Human Mind has a great capacity for compassion and humane treatment towards others. Both Hippocrates and Galen demonstrated this by the SENSITIVE  and ARDUOUS PAINSTAKING work in which they engaged. Had this not been the case, I think they would perhaps have chosen some other profession.
In the Next Post I intend to look at the other side of the Human Mind.
I hope you have enjoyed the blog.
Any Comments from the Learned?
KS (UK)
Picture Credits
Wikimedia Commons













3 comments:

  1. So what has this historical research to tell us about todays challenges?
    What can we learn from this remarkable people of the past?
    How can we better confront the challenges that we face today as a result of their work and lives?
    What relevance is there?

    ReplyDelete
  2. Galen drew conclusions based on imperfect information.

    They seem odd today, as many of our theories will appear to future scientists.

    If nothing else, a study of Galen should incline the scientifically minded to a bit of humility.

    ReplyDelete
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