Under the Ptolemies a powerful stimulus
was given to biological studies at Alexandria.
Scientific knowledge was carried a step or two beyond
the limit reached by Aristotle. Thus Erasistratus
and Herophilus thoroughly investigated the structure
and functions of the valves of the heart, and were
the first to recognize the nerves as organs of sensation.
But, unfortunately, no complete record of the interesting
work carried on by these men has come down to our
times. The first writer after Aristotle whose
works arrest attention is Caius Plinius Secundus,
whose so-called “Natural History,” in
thirty-seven volumes, remains to the present day as
a monument of industrious compilation. But, as
a biologist properly so called, Pliny is absolutely
without rank, for he lacked that practical acquaintance
with the subject which alone could enable him to speak
with authority. Of information he had an almost
inexhaustible store; of actual knowledge, the result
of observation and experience, so far as biological
studies were concerned, he had but little. This
was largely due to the encyclopædic character of
the work he undertook; his mental powers were weighed
down by an enormous mass of unarranged and ill-digested
materials. But it was due also to the peculiar
bent of Pliny’s mind. He was not, like
Aristotle, an original thinker; he was essentially
a student of books, an immensely industrious but not
always judicious compiler. Often his selections
from other works prove that he failed to appreciate
the relative importance of the different subjects
to which he made reference. His knowledge of the
Greek language appears, too, to have been defective,
for he gives at times the wrong Latin names to objects
described by his Greek authorities. To these defects
must be added his marvellous readiness to believe
any statement, provided only that it was uncommon;
while, on the other hand, he showed an indefensible
scepticism in regard to what was really deserving of
attention. The chief value of his work consists
in the historical and chronological notes of the progress
of some of the subjects of which he treats fragments
of writings which would otherwise be lost to us.
Pliny was killed in the destruction of Pompeii, A.D.
79.
Claudius Galenus was born at Pergamus,
in Asia Minor, in the hundred and thirty-first year
of the Christian era. Few writers ever exercised
for so long a time such an undisputed sway over the
opinions of mankind as did this wonderful man.
His authority was estimated at a much higher rate
than that of all the biological writers combined who
flourished during a period of more than twelve centuries,
and it was often considered a sufficient argument
against a hypothesis, or even an alleged matter of
fact, that it was contrary to Galen.
Endowed by nature with a penetrating
genius and a mind of restless energy, he was eminently
qualified to profit by a comprehensive and liberal
education. And such he received. His father,
Nicon, an architect, was a man of learning and ability a
distinguished mathematician and an astronomer and
seems to have devoted much time and care to the education
of his son. The youth appears to have studied
philosophy successively in the schools of the Stoics,
Academics, Peripatetics, and Epicureans, without attaching
himself exclusively to any one of these, and to have
taken from each what he thought to be the most essential
parts of their system, rejecting, however, altogether
the tenets of the Epicureans. At the age of twenty-one,
on the death of his father, he went to Smyrna to continue
the study of medicine, to which he had now devoted
himself. After leaving this place and having travelled
extensively, he took up his residence at Alexandria,
which was then the most favourable spot for the pursuit
of medical studies. Here he is said to have remained
until he was twenty-eight years of age, when his reputation
secured his appointment, in his native city of Pergamus,
to the office of physician in charge of the athletes
in the gymnasia situated within the precincts of the
temple of AEsculapius. For five or six years
he lived in Pergamus, and then a revolt compelled him
to leave his native town. The advantages offered
by Rome led him to remove thither and take up his
residence in the capital of the world. Here his
skill, sagacity, and knowledge soon brought him into
notice, and excited the jealousy of the Roman doctors,
which was still further increased by some wonderful
cures the young Greek physician succeeded in effecting.
Possibly it was owing to the ill feeling shown to Galen
that, on the outbreak of an epidemic a year afterwards,
he left the imperial city and proceeded to Brindisi,
and embarked for Greece. It was his intention
to devote his time to the study of natural history,
and for this purpose he visited Cyprus, Palestine,
and Lemnos. While at the last-named place, however,
he was suddenly summoned to Aquileia to meet the Emperors
Marcus Aurelius and Lucius Verus. He
travelled through Thrace and Macedonia on foot, met
the imperial personages, and prepared for them a medicine,
for which he seems to have been famous, and which is
spoken of as the theriac. It was probably
some combination of opium with various aromatics and
stimulants, for antidotes of many different kinds were
habitually taken by the Romans to preserve them from
the ill effects of poison and of the bites of venomous
animals.
With the Emperor M. Aurelius he returned
to Rome, and became afterwards doctor to the young
Emperor Commodus. He did not, however, remain
for a long period at Rome, and probably passed the
greater part of the rest of his life in his native
country.
Although the date of his death is
not positively known, yet it appears from a passage
in his writings that he was living in the reign of
Septimius Severus; and Suidas seems to have reason
for asserting that he reached his seventieth year.
Galen’s writings represent the
common depository of the anatomical knowledge of the
day; what he had learnt from many teachers, rather
than the results of his own personal research.
Roughly speaking, they deal with the following subjects:
Anatomy and Physiology, Dietetics and Hygiene, Pathology,
Diagnosis and Semeiology, Pharmacy and Materia
Medica, Therapeutics.
The only works of this voluminous
writer at which we can here glance are those dealing
with Anatomy and Physiology. These exhibit numerous
illustrations of Galen’s familiarity with practical
anatomy, although it was most likely comparative rather
than human anatomy at which he especially worked.
Indeed, he seems to have had but few opportunities
of carrying on human dissections, for he thinks
himself happy in having been able to examine at Alexandria
two human skeletons; and he recommends the dissection
of monkeys because of their exact resemblance to man.
To this disadvantage may, perhaps, be attributed the
readiness, which sometimes appears, to assume identity
of organization between man and the brutes. Thus,
because in certain animals he found a double biliary
duct, he concluded the same to be the case in man,
and in one instance he proceeded to deduce the cause
of disease from this erroneous assumption.
He supposed that there were three modes of existence in man,
namely
(1) The attractive.
(2) The alterative or assimilative.
(3) The retentive or digestive.
(4) The expulsive.
Like his predecessors, he asserted
that there were four humours, namely, blood, yellow
bile, black bile, and aqueous serum. He held that
it was the office of the liver to complete the process
of sanguification commenced in the stomach, and that
during this process the yellow bile was attracted
by the branches of the hepatic duct and gall-bladder;
the black bile being attracted by the spleen, and
the aqueous humour by the two kidneys; while the liver
itself retained the pure blood, which was afterwards
attracted by the heart through the vena cava,
by whose ramifications it was distributed to the various
parts of the body.
Following Aristotle especially, he
regarded hair, nails, arteries, veins, cartilage,
bone, ligament, membranes, glands, fat, and muscle
as the simplest constituents of the body, formed immediately
from the blood, and perfectly homogeneous in character.
The organic members, e.g. lungs, liver, etc.,
he looked upon as formed of several of the foregoing
simple parts.
The osteology contained in Galen’s
works is nearly as perfect as that of the present
day. He correctly names and describes the bones
and sutures of the cranium; notices the quadrilateral
shape of the parietals, the peculiar situation
and shape of the sphenoid, and the form and character
of the ethmoid, malar, maxillary, and nasal bones.
He divides the vertebral columns into cervical, dorsal,
and lumbar portions.
With regard to the nervous system,
he taught that the nerves of the senses are distinct
from those which impart the power of motion to muscles that
the former are derived from the anterior parts of the
brain, while the latter arise from the posterior portion,
or from the spinal cord. He maintained that the
nerves of the finer senses are formed of matter too
soft to be the vehicles of muscular motion; whereas,
on the other hand, the nerves of motion are too hard
to be susceptible of fine sensibility. His description
of the method of demonstrating the different parts
of the brain by dissection is very interesting, and,
like his references to various instruments and contrivances,
proves him to have been a practical and experienced
anatomist.
In his description of the organs and
process of nutrition, absorption by the veins of the
stomach is correctly noticed, and the union of the
mesenteric veins into one common vena portae
is pointed out. The communications between the
ramifications of the vena portae and of the
proper veins of the liver are supposed by Galen to
be effected by means of anastomosing pores or channels.
Although it is evident that Galen was ignorant of
the true absorbent system, yet he appears to have been
aware of the lacteals; for he says that in
addition to those mesenteric veins which by their
union form the vena portae, there are visible
in every part of the mesentery other veins, proceeding
also from the intestines, which terminate in glands;
and he supposes that these veins are intended for
the nourishment of the intestines themselves.
Some of Galen’s contemporaries asserted that
upon exposing the mesentery of a sucking animal several
small vessels were seen filled first with air,
and afterwards with milk. They had, doubtless,
mistaken colourless lymph for air; but Galen ridicules
both assertions, and thereby shows that he had not
examined the contents of the lacteals. This is
somewhat remarkable, because as a rule he omitted
no opportunity of determining with certainty, by vivisection
and experiments on living animals, the uses of the
various parts of the body. As an illustration
of this, we have his correct statement, established
by experiment, that the pylorus acts as a valve only
during the process of digestion, and that it is relaxed
when digestion is completed.
He recognizes that the flesh of the
heart is somewhat different to that of the muscles
of voluntary motion. Its fibres are described
as being arranged in longitudinal and transverse bundles;
the former by their contractions shortening the organ,
the latter compressing and narrowing it. Such
statements show that he regarded the heart as essentially
muscular. He thought, however, that it was entirely
destitute of nerves. Although he admitted that
possibly it had one small branch derived from the
nervus vagus sent to it, yet he entirely overlooked
the great nervous plexus surrounding the roots of
the blood-vessels, from which branches proceed in
company with the branches of the coronary arteries
and veins, and penetrate the muscular substance of
the ventricles. He endeavoured to prove, by experiment,
observation, and reasoning, that the arteries as well
as the veins contained blood, and in this connection
he tells an amusing story. A certain teacher of
anatomy, who had declared that the aorta contained
no blood, was earnestly desired by his pupils, who
were ardent disciples of Galen, to exhibit the requisite
demonstration, they themselves offering animals for
the experiment. He, however, after various subterfuges,
declined, until they promised to give him a suitable
remuneration, which they raised by subscription among
themselves to the amount of a thousand drachmae (perhaps
L30). The professor, being thus compelled to
commence the experiment, totally failed in his attempt
to cut down upon the aorta, to the no small amusement
of his pupils, who, thereupon taking up the experiment
themselves, made an opening into the thorax in the
way in which they had been instructed by Galen, passed
one ligature round the aorta at the part where it
attaches itself to the spine, and another at its origin,
and then, by opening the intervening portion of the
artery, showed that blood was contained in it.
The arteries, Galen thought, possessed
a pulsative and attractive power of their own, independently
of the heart, the moment of their dilatation being
the moment of their activity. They, in fact, drew
their charge from the heart, as the heart by its diastole
drew its charge from the vena cava
and the pulmonary vein. The pulse of the arteries,
he also thought, was propagated by their coats, not
by the wave of blood thrown into them by the heart.
He taught that at every systole of the arteries a
certain portion of their contents was discharged at
their extremities, namely, by the exhalents and secretory
vessels. Though he demonstrated the anastomosis
of arteries and veins, he nowhere hints his belief
that the contents of the former pass into the latter,
to be conveyed back to the heart, and from it to be
again diffused over the body. He made a near
approach to the Harveian theory of the circulation,
as Harvey himself admits in his “De Motu Cordis;"
but the grand point of difference between Galen and
Harvey is the question whether or not, at every systole
of the left ventricle, more blood is thrown out than
is expended on exhalation, secretion, and nutrition.
Upon this point Galen held the negative, and Harvey,
as we all know, the affirmative.
The famous Asclepiads held that respiration
was for the generation of the soul itself, breath
and life being thus considered to be identical.
Hippocrates thought it was for the nutrition and refrigeration
of the innate heat, Aristotle for its ventilation,
Erasistratus for the filling of the arteries with
spirits. All these opinions are discussed and
commented upon by Galen, who determines the purposes
of respiration to be
(1) to preserve the animal heat;
(2) to evacuate from the blood the products of combustion.
He conjectured that there was in atmospheric
air not only a quality friendly to the vital spirit,
but also a quality inimical to it, which conjecture
he drew from observation of the various phenomena
accompanying the support and the extinction of flame;
and he says that if we could find out why flame is
extinguished by absence of the air, we might then
know the nature of that substance which imparts warmth
to the blood during the process of respiration.
On another occasion he says that it
is evidently the quality and not the quantity
of the air which is necessary to life. He further
shows that he recognized the analogy between respiration
and combustion, by comparing the lungs to a lamp,
the heart to its wick, the blood to the oil, and the
animal heat to the flame.
From certain observations in various
parts of his works, it appears that, although ignorant
of the doctrine of atmospheric pressure, he was acquainted
with some of its practical effects. Thus, he says,
if you put one end of an open tube under water and
suck out the air with the other end, you will draw
up water into the mouth, and that it is in this way
that infants extract the milk from the mother’s
breast.
Again, Erasistratus supposed that
the vapour of charcoal and of certain pits and wells
was fatal to life because lighter than common
air, but Galen maintained it to be heavier.
He describes two kinds of respiration,
one by the mouths of the arteries of the lungs, and
one by the mouths of the arteries of the skin.
In each case, he says, the surrounding air is drawn
into the vessels during their diastole, for the purpose
of cooling the blood, and during their systole the
fuliginous particles derived from the blood and other
fluids of the body are forced out.
He considers the diaphragm to be the
principal muscle of respiration, but he makes a clear
distinction between ordinary respiration, which he
calls a natural and involuntary effort, and that deliberate
and forced respiration which is obedient to the will;
and he says that there are different muscles for the
two purposes. Elsewhere he particularly points
out the two sets of intercostal muscles and their mode
of action, of which, before his time, he asserts that
anatomists were ignorant.
He describes various effects produced
on respiration and on the voice by the division of
those nerves which are connected with the thorax; and
shows particularly the effect of dividing the recurrent
branch of his sixth pair of cerebral nerves (the pneumogastric
of modern anatomy). He explains how it happens
that after division of the spinal cord, provided that
division be beneath the lower termination of
the neck, the diaphragm will still continue to act in
consequence, namely, of the origin of the phrenic
nerve being above the lower termination of the
neck.
Before the time of Galen the medical
profession was divided into several sects, e.g.
Dogmatici, Empirici, Eclectici, Pneumatici,
and Episynthetici, who were always disputing with
one another. After his time all sects seem to
have merged in his followers. The subsequent
Greek and Roman biological writers were mere compilers
from his works, and as soon as his writings were translated
into Arabic they were at once adopted throughout the
East to the exclusion of all others. He remained
paramount throughout the civilized world until within
the last three hundred years. In the records
of the College of Physicians of England we read that
Dr. Geynes was cited before the college in 1559 for
impugning the infallibility of Galen, and was only
admitted again into the privileges of his fellowship
on acknowledgment of his error, and humble recantation
signed with his own hand. Kurt Sprengel
has well said that “if the physicians who remained
so faithfully attached to Galen’s system had
inherited his penetrating mind, his observing glance,
and his depth, the art of healing would have approached
the limit of perfection before all the other sciences;
but it was written in the book of destiny that mind
and reason were to bend under the yoke of superstition
and barbarism, and were only to emerge after centuries
of lethargic sleep.”