Galen of Pergamon

Roma -SPQR- Story 29 - Bellum Horarium

Quote: Dealing with the Followers of Set is, in effect, dealing with the Devil. Yes, they have their uses, but then so does an atomic bomb. Like said A-bomb, the Setites should be handled with extreme caution.

Sobriquet: Physician or simple Galen

Appearance: Galen stands out in a crowd, regardless of what crowd he might be in, he stands out. Among the Kindred, he stands out by having been embraced in his mortal senescence, late sixties or early seventies. The second reason is his archaic style of dress, for Galen often wears a variety costumes and uniforms similar to those of a historical nature and varying from ancient Rome to the early 20th century. This unique behavior draws a certain amount of bemused criticism from his younger Kindred and from the mortals who interact with him, despite this, or perhaps in-spite of this, Galen continue to luxuriate in the costumes of his past and by doing so he has earned a grudging degree of respect from the callow neonates of Houston.

Physically, Galen appears to be a nearly perfect specimen of an elderly male in excellent health. He is quite short for the modern age, standing just about five foot tall and weighing no more than a hundred and forty pounds. Though quite clearly not an athlete, he does appear to be in excellent physical condition. His hair is a dark silver, which is coiffed in oiled ringlets across his forehead, but is otherwise simply kept. He also sports a neatly trimmed silver beard that delineates his face rather than concealing some imagined defect and his arching silver eyebrows frame dark brown eyes that convey centuries of empathy and experience. He wears no jewelry whatsoever, though he does often wear a variety of bladed weapons that accessorize his historical costumes.

Behavior: Galen radiates solidity, and regardless of the circumstances, a deep and abiding calm that is both infections and sedative in nature. While given to a certain degree of pomp and circumstance, which seems easily forgivable in a creature his age, Galen can be surprisingly forthright and direct in conversation. He is also unusual in that he bears a distinct sardonic sense of humor, but with a carefully calculated degree of acerbic amusement for those less fortunate than himself and for those he finds unworthy, a downright caustic vitriol. Despite this, Galen is characterized by his empathy, not only for the mortal masses, but for his fellow Kindred and he can be surprisingly kind to the other vampires of Houston, if a touch patronizing in a pedagogic fashion. Though clearly well meaning, he is extremely cautious of the other Kindred, often to the degree of paranoia, for in the past or so he claims, his well meaning empathy was mistaken for pity with dire results.

History: Aelius Galenus or Claudius Galenus, better known as Galen of Pergamon was a prominent Greek physician, surgeon and philosopher in the Roman empire.Arguably the most accomplished of all medical researchers of antiquity, Galen influenced the development of various scientific disciplines, including anatomy, physiology, pathology, pharmacology, and neurology, as well as philosophy and logic.

The son of Aelius Nicon, a wealthy architect with scholarly interests, Galen received a comprehensive education that prepared him for a successful career as a physician and philosopher. He traveled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome, where he served prominent members of Roman society and eventually was given the position of personal physician to several emperors.

Galen's understanding of anatomy and medicine was principally influenced by the then-current theory of humorism, as advanced by ancient Greek physicians such as Hippocrates. His theories dominated and influenced Western medical science for more than 1,300 years. His anatomical reports, based mainly on dissection of monkeys, especially the Barbary Macaque, and pigs, remained uncontested until 1543, when printed descriptions and illustrations of human dissections were published in the seminal work De humani corporis fabrica by Andreas Vesalius where Galen's physiological theory was accommodated to these new observations. Galen's theory of the physiology of the circulatory system endured until 1628, when William Harvey published his treatise entitled De motu cordis, in which he established that blood circulates, with the heart acting as a pump. Medical students continued to study Galen's writings until well into the 19th century. Galen conducted many nerve ligation experiments that supported the theory, which is still accepted today, that the brain controls all the motions of the muscles by means of the cranial and peripheral nervous systems.

Galen saw himself as both a physician and a philosopher, as he wrote in his treatise entitled That the Best Physician is also a Philosopher. Galen was very interested in the debate between the rationalist and empiricist medical sects, and his use of direct observation, dissection and vivisection represents a complex middle ground between the extremes of those two viewpoints. Many of his works have been preserved and/or translated from the original Greek, although many were destroyed and some credited to him are believed to be spurious. Although there is some debate over the date of his death, he was no younger than seventy when he died.

Early life

AD 129–161

Galen's name Γαληνός, Galēnos comes from the adjective "γαληνός", "calm".

Galen describes his early life in On the affections of the mind. He was born in September 129 AD; his father, Aelius Nicon, was a wealthy patrician, an architect and builder, with eclectic interests including philosophy, mathematics, logic, astronomy, agriculture and literature. Galen describes his father as a "highly amiable, just, good and benevolent man". At that time Pergamon (modern-day Bergama, Turkey) was a major cultural and intellectual center, noted for its library (Eumenes II), second only to that in Alexandria, and attracted both Stoic and Platonic philosophers, to whom Galen was exposed at age 14. His studies also took in each of the principal philosophical systems of the time, including Aristotelian and Epicurean. His father had planned a traditional career for Galen in philosophy or politics and took care to expose him to literary and philosophical influences. However, Galen states that in around 145 AD his father had a dream in which the god Asclepius (Aesculapius) appeared and commanded Nicon to send his son to study medicine. Again, no expense was spared, and following his earlier liberal education, at 16 he began studies at the prestigious local sanctuary or Asclepieum dedicated to Asclepius, god of medicine, as a θεραπευτής (therapeutes, or attendant) for four years. There he came under the influence of men like Aeschrion of Pergamon, Stratonicus and Satyrus. Asclepiea functioned as spas or sanitoria to which the sick would come to seek the ministrations of the priesthood. The temple at Pergamon was eagerly sought by Romans in search of a cure. It was also the haunt of notable people such as Claudius Charax the historian, Aelius Aristides the orator, Polemo the sophist, and Cuspius Rufinus the Consul.

In 148, when he was 19, his father died, leaving him independently wealthy. He then followed the advice he found in Hippocrates' teaching and traveled and studied widely including such destinations as Smyrna (now Izmir), Corinth, Crete, Cilicia (now Çukurova), Cyprus, and finally the great medical school of Alexandria, exposing himself to the various schools of thought in medicine. In 157, aged 28, he returned to Pergamon as physician to the gladiators of the High Priest of Asia, one of the most influential and wealthiest men in Asia. Galen claims that the High Priest chose him over other physicians after he eviscerated an ape and challenged other physicians to repair the damage. When they refused, Galen performed the surgery himself and in so doing won the favor of the High Priest of Asia. Over his four years there he learned the importance of diet, fitness, hygiene and preventive measures, as well as living anatomy, and the treatment of fractures and severe trauma, referring to their wounds as "windows into the body". Only five deaths among the gladiators occurred while he held the post, compared to sixty in his predecessor's time, a result that is in general ascribed to the attention he paid to their wounds. At the same time he pursued studies in theoretical medicine and philosophy.

Later years

AD 162–217

Galen went to Rome in 162 and made his mark as a practicing physician. His impatience brought him into conflict with other doctors and he felt menaced by them. His demonstrations there antagonized the less able and original physicians in the city. They plotted against him and he feared he might be driven away or poisoned, so he left the city.

Rome engaged in foreign wars in 161. Marcus Aurelius and his colleague Lucius Verus were in the north fighting the Marcomanni. During the autumn of 169 when Roman troops were returning to Aquileia, the great plague broke out, and the emperor summoned Galen back to Rome. He was ordered to accompany Marcus and Verus to Germany as the court physician. In the following spring Marcus was persuaded to release Galen after receiving a report that Asclepius was against the project. He was left behind to act as physician to the imperial heir Commodus. It was here in court that Galen wrote extensively on medical subjects. Ironically, Lucius Verus died in 169, and Marcus Aurelius himself died in 180, both victims of the plague.

Galen was the physician to Commodus for much of the emperor’s life and treated his common illnesses. According to Dio Cassius 72.14.3–4, in about 189, under Commodus’ reign, a pestilence occurred, the largest of which he had knowledge, in which 2,000 people died in Rome each day. It is most likely that this was the same plague that struck Rome during Marcus Aurelius’ reign.

Galen became physician to Septimius Severus during his reign in Rome. Galen compliments Severus and Caracalla on keeping a supply of drugs for their friends and mentions three cases in which they had been of use in 198.

The Antonine Plague

The Antonine Plague was named after Marcus Aurelius’ family name of Antoninus. It was also known as the Plague of Galen and holds an important place in medicinal history because of its association with Galen. Galen had first hand knowledge of the disease. He was in Rome when it struck in 166 AD, and was also present in the winter of 168–69 during an outbreak among troops stationed at Aquileia. He had experience with the epidemic, referring to it as very long lasting, and describes its symptoms and his treatment of it. Unfortunately, his references to the plague are scattered and brief. Galen was not trying to present a description of the disease so that it could be recognized in future generations; he was more interested in the treatment and physical effects of the disease. For example, in his writings about a young man afflicted with the plague, he concentrated on the treatment of internal and external ulcerations. According to Niebuhr "this pestilence must have raged with incredible fury; it carried off innumerable victims. The ancient world never recovered from the blow inflicted upon it by the plague that visited it in the reign of M. Aurelius." The mortality rate of the plague was 7–10 percent; the outbreak in 165–6–168 would have caused approximately 3.5 to 5 million deaths. Otto Seek believes that over half the population of the empire perished. J. F. Gilliam believes that the Antonine plague probably caused more deaths than any other epidemic during the empire before the mid-3rd century. It is believed that the Antonine Plague was smallpox, because though his description is incomplete, Galen gave enough information to enable a firm identification of the disease.

Galen notes that the exanthema covered the victim’s entire body and was usually black. The exanthem became rough and scabby where there was no ulceration. He states that those that were going to survive developed a black exanthem. According to Galen, it was black because of a remnant of blood putrefied in a fever blister that was pustular. His writings state that raised blisters were present in the Antonine plague, usually in the form of a blistery rash. Galen states that the skin rash was close to the one Thucydides described. Galen describes symptoms of the alimentary tract via a patient’s diarrhea and stools. If the stool was very black, the patient died. He says that the amount of black stools varied. It depended on the severity of the intestinal lesions. He observes that in cases where the stool was not black, the black exanthema appeared. Galen describes the symptoms of fever, vomiting, fetid breath, catarrh, cough, and ulceration of the larynx and trachea.

Eudemus

When Peripatetic philosopher Eudemus became ill with Quartan fever, Galen felt obliged to treat him "since he was my teacher and I happened to live nearby." Galen wrote: "I return to the case of Eudemus. He was thoroughly attacked by the three attacks of quartan ague, and the doctors had given him up, as it was now mid-winter." Some Roman physicians criticized Galen for his use of the prognosis in his treatment of Eudemus. This practice conflicted with the then-current standard of care, which relied upon divination and mysticism. Galen retaliated against his detractors by defending his own methods. Garcia-Ballester quotes Galen as saying: "In order to diagnose, one must observe and reason. This was the basis of his criticism of the doctors who proceeded alogos and askeptos." However, Eudemus warned Galen that engaging in conflict with these physicians could lead to his assassination. "Eudemus said this, and more to the same effect; he added that if they were not able to harm me by unscrupulous conduct they would proceed to attempts at poisoning. Among other things he told me that, some ten years before, a young man had come to the city and had given, like me practical demonstrations of the resources of our art; this young man was put to death by poison, together with two servants who accompanied him."

Garcia-Ballester says the following of Galen’s use of prognosis: "In modern medicine, we are used to distinguishing between the diagnostic judgment (the scientific knowledge of what a patient has) and the prognostic judgment (the conjecture about what will happen to him.) Galen, like the Hippocratics, was not. For him, to understand a clinical case technically, ‘to diagnose’, was among other things, to know with greater or lesser certainty the outcome for the patient, ‘to prognosticate’. Prognosis, then, is one of the essential problems and most important objectives of Galenic diagnosis. Galen was concerned to distinguish it from divination or prophecy, both to improve diagnosis technically and to enhance the physician’s reputation.

His Death

The 11th-century Suda lexicon states that Galen died at the age of 70, which would place his death in about the year 199. However, there is a reference in Galen's treatise "On Theriac to Piso" (which may, however, be spurious) to events of 204. There are also statements in Arabic sources that he died at age 87, after 17 years studying medicine and 70 practicing it, which would mean he died about 217. Nutton believes that "On Theriac to Piso" is genuine, that the Arabic sources are correct, and that the Suda has erroneously interpreted the 70 years of Galen's career in the Arabic tradition as referring to his whole lifespan. Boudon-Millot more or less concurs and favors a date of 216.

Future Events: See: Houston

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