His systems of treatment were far in advance of his theories regarding the functions of organs, causes of disease, etc., and some of them are still first principles with physicians. Like Hippocrates, he laid great stress on correct diet, exercise, and
reliance upon nature. “Nature is the overseer by whom health is supplied to the sick,” he says. “Nature lends her aid on all sides, she decides and cures diseases. No one can be saved unless nature conquers the disease, and no one dies unless nature succumbs.”
From the picture thus drawn of Galen as an anatomist and physician, one might infer that he should rank very high as a scientific exponent of medicine, even in comparison with modern physicians. There is, however, another side to the picture. His knowledge of anatomy was certainly very considerable, but many of his deductions and theories as to the functions of organs, the cause of diseases, and his methods of treating them, would be recognized as absurd by a modern school-boy of average intelligence. His greatness must be judged in comparison with ancient, not with modern, scientists. He maintained, for example, that respiration and the pulse-beat were for one and the same purpose–that of the reception of air into the arteries of the body. To him the act of breathing was for the purpose of admitting air into the lungs, whence it found its way into the heart, and from there was distributed throughout the body by means of the arteries. The skin also played an important part in supplying the body with air, the pores absorbing the air and distributing it through the arteries. But, as we know that he was aware of the fact that the arteries also contained blood, he must have believed that these vessels contained a mixture of the two.
Modern anatomists know that the heart is divided into two approximately equal parts by an impermeable septum of tough fibres. Yet, Galen, who dissected the hearts of a vast number of the lower animals according to his own account, maintained that this septum was permeable, and that the air, entering one side of the heart from the lungs, passed through it into the opposite side and was then transferred to the arteries.
He was equally at fault, although perhaps more excusably so, in his explanation of the action of the nerves. He had rightly pointed out that nerves were merely connections between the brain and spinal-cord and distant muscles and organs, and had recognized that there were two kinds of nerves, but his explanation of the action of these nerves was that “nervous spirits” were carried to the cavities of the brain by blood-vessels, and from there transmitted through the body along the nerve-trunks.
In the human skull, overlying the nasal cavity, there are two thin plates of bone perforated with numerous small apertures.
These apertures allow the passage of numerous nerve-filaments which extend from a group of cells in the brain to the delicate membranes in the nasal cavity. These perforations in the bone, therefore, are simply to allow the passage of the nerves. But Galen gave a very different explanation. He believed that impure
“animal spirits” were carried to the cavities of the brain by the arteries in the neck and from there were sifted out through these perforated bones, and so expelled from the body.
He had observed that the skin played an important part in cooling
the body, but he seems to have believed that the heart was equally active in overheating it. The skin, therefore, absorbed air for the purpose of “cooling the heart,” and this cooling process was aided by the brain, whose secretions aided also in the cooling process. The heart itself was the seat of courage; the brain the seat of the rational soul; and the liver the seat of love.
The greatness of Galen’s teachings lay in his knowledge of anatomy of the organs; his weakness was in his interpretations of their functions. Unfortunately, succeeding generations of physicians for something like a thousand years rejected the former but clung to the latter, so that the advances he had made were completely overshadowed by the mistakes of his teachings.
XI. A RETROSPECTIVE GLANCE AT CLASSICAL SCIENCE