Prince of Medicine: Galen in the Roman World by Susan P. Mattern (review)

A giant in the history of medicine, Galen (A.D. 129-c.216/7) is famous for his anatomical studies, his writings about health, medical practices, and proper care of the body, and for his criticism of intensive athletic training. Previously accessible largely only to classicists, Galen now can have the broader audience he deserves thanks to Mattern’s new study, which demonstrates significant connections between ancient medicine and sport and spectacle—both Greek and Roman and athletic and gladiatorial—in the Roman Empire.

Mattern constructs a detailed life of Galen from his corpus of works, which, in the most modern edition “. . . runs to twenty-two volumes, including about 150 titles, and is one-eighth of all the classical Greek literature that survives” (p. 3). Born in Pergamum in Asia Minor under Emperor Hadrian, Galen was the son of a wealthy architect who educated him in mathematics, rhetoric, philosophy, and medicine. He remained a pious follower of Asclepius, believing that the god of healing and doctors had sent him a revelatory dream concerning his early and recurrent abdominal pains (possibly dysentery). He revered his father and lamented his death when Galen was nineteen, after which he moved to study medicine at Smyrna and Alexandria.

Returning to Pergamum in 157, Galen impressed the high priest of the emperor cult with an anatomical demonstration. He disemboweled a live monkey and challenged his medical rivals to replace the intestines; when none dared, he did so successfully himself. Impressed, the priest appointed him to care for a troupe of gladiators. Disdaining earlier “doctors” whose treatments left injured gladiators dead or disabled, he developed surgical instruments and techniques that saved many lives. Treating severe wounds, he sutured deep layers of muscle together, joined severed tendons, and used sutures to align wound edges. He treated shallower slashes by applying constantly moist cloths soaked in wine, which acted as an antiseptic.

The gladiators’ wounds allowed him to see systems and connections in human bodies, but dissecting human corpses was taboo for Romans, so Galen, moving on to Rome, mainly researched anatomy by vivisecting animals (e.g., pigs, goats). He preferred monkeys as anatomically closest to humans. By modern standards he was intolerant of the suffering of animals as he performed many public (unsedated) vivisections as demonstrations or entertainments. Such cruelty, of course, recalls the staged wild beast hunts in the arena by which Romans claimed mastery over all creatures and nature itself.

As Mattern relates, Galen fiercely condemned the excessive routines of athletic trainers for making professional combat athletes brutish oafs who ate too much and thought too little. Advocating regular, moderate exercise routines that would sustain health (e.g., in his Exercise with a Small Ball), he declared that his philosophical and anatomically based approach was far superior to the trainers’ medical ignorance and bodily abuse of athletes. Galen also “lived” his knowledge of human health. Fastidious about his diet, he exercised daily at the gymnasium. At age thirty-four he suffered a dislocated collarbone while wrestling. After the gymnasium trainers tried and failed, Galen properly diagnosed himself, treated himself for forty days and fully recovered. He also writes about a youthful wrestler injured by a blow to the sternum. When others could not help him, an abscess formed and the youth might have died, but Galen excised the diseased sternum and the youth survived.

News of Galen’s expertise reached Emperor Marcus Aurelius, who appointed Galen personal physician to his heir Commodus. Galen also received an imperial salary for preparing Aurelius’ daily potion of theriac (a mixture of over sixty ingredients from viper flesh to opium), which supposedly helped the emperor sleep. Despite losing many of his writings in a fire in 192, Galen continued to write and treat patients well into his old age.

Readers interested in the history of medicine and ancient sport will appreciate Mattern’s work. Her precise prose gets...