Another Roman surgeon, Heliodorus, not only describes the use of the ligature in stopping hemorrhage, but also the practice of torsion–twisting smaller vessels, which causes their lining membrane to contract in a manner that produces coagulation and stops hemorrhage. It is remarkable that so simple and practical a method as the use of the ligature in stopping hemorrhage could have gone out of use, once it had been discovered; but during the Middle Ages it was almost entirely lost sight of, and was not reintroduced until the time of Ambroise Pare, in the sixteenth
century.
Even at a very early period the Romans recognized the advantage of surgical methods on the field of battle. Each soldier was supplied with bandages, and was probably instructed in applying them, something in the same manner as is done now in all modern armies. The Romans also made use of military hospitals and had established a rude but very practical field-ambulance service.
“In every troop or bandon of two or four hundred men, eight or ten stout fellows were deputed to ride immediately behind the fighting-line to pick up and rescue the wounded, for which purpose their saddles had two stirrups on the left side, while they themselves were provided with water-flasks, and perhaps applied temporary bandages. They were encouraged by a reward of a piece of gold for each man they rescued. ‘Noscomi’ were male nurses attached to the military hospitals, but not inscribed ‘on strength’ of the legions, and were probably for the most part of the servile class.”[6]
From the time of the early Alexandrians, Herophilus and Erasistratus, whose work we have already examined, there had been various anatomists of some importance in the Alexandrian school, though none quite equal to these earlier workers. The best-known names are those of Celsus (of whom we have already spoken), who continued the work of anatomical investigation, and Marinus, who lived during the reign of Nero, and Rufus of Ephesus. Probably all of these would have been better remembered by succeeding generations had their efforts not been eclipsed by those of Galen. This greatest of ancient anatomists was born at Pergamus of Greek parents. His father, Nicon, was an architect and a man of considerable ability. Until his fifteenth year the youthful Galen was instructed at home, chiefly by his father; but after that time he was placed under suitable teachers for instruction in the philosophical systems in vogue at that period. Shortly after this, however, the superstitious Nicon, following the interpretations of a dream, decided that his son should take up the study of medicine, and placed him under the instruction of several learned physicians.
Galen was a tireless worker, making long tours into Asia Minor and Palestine to improve himself in pharmacology, and studying anatomy for some time at Alexandria. He appears to have been full of the superstitions of the age, however, and early in his career made an extended tour into western Asia in search of the chimerical “jet-stone”–a stone possessing the peculiar qualities of “burning with a bituminous odor and supposed to possess great potency in curing such diseases as epilepsy, hysteria, and gout.”
By the time he had reached his twenty-eighth year he had perfected his education in medicine and returned to his home in Pergamus. Even at that time he had acquired considerable fame as a surgeon, and his fellow-citizens showed their confidence in his ability by choosing him as surgeon to the wounded gladiators shortly after his return to his native city. In these duties his knowledge of anatomy aided him greatly, and he is said to have healed certain kinds of wounds that had previously baffled the surgeons.
In the time of Galen dissections of the human body were forbidden by law, and he was obliged to confine himself to dissections of the lower animals. He had the advantage, however, of the anatomical works of Herophilus and Erasistratus, and he must have depended upon them in perfecting his comparison between the anatomy of men and the lower animals. It is possible that he did make human dissections surreptitiously, but of this we have no proof.
He was familiar with the complicated structure of the bones of the cranium. He described the vertebrae clearly, divided them into groups, and named them after the manner of anatomists of to-day. He was less accurate in his description of the muscles, although a large number of these were described by him. Like all anatomists before the time of Harvey, he had a very erroneous conception of the circulation, although he understood that the heart was an organ for the propulsion of blood, and he showed that the arteries of the living animals did not contain air alone, as was taught by many anatomists. He knew, also, that the heart was made up of layers of fibres that ran in certain fixed directions–that is, longitudinal, transverse, and oblique; but he did not recognize the heart as a muscular organ. In proof of this he pointed out that all muscles require rest, and as the heart did not rest it could not be composed of muscular tissue.