Galen on Erasistratus

GALEN ON ERASISTRATUS RONALD V. CHRISTIE* Prologue In the third century b.c., the School of Medicine in Alexandria produced two great men, Herophilus and Erasistratus, who were probably the first to demonstrate dissection of the human body. According to Celsus [1] "they laid open men whilst still alive—criminals received out of prison from the kings—and while they were still breathing observed parts which before hand nature had concealed" [I]. This story may well be an invention, but there is clear evidence that they dissected live animals . The custom of embalming was an ancient one in Egypt [2], and it is also likely that the removal of the viscera that was part of this procedure gave these Greek physicians a unique opportunity to study the human body, particularly in disease. Herophilus was mainly concerned with anatomy, while Erasistratus is usually considered to be the first experimental physiologist. Erasistratus discarded most of the humoural theory of disease and instead linked diseases with the abnormal changes found in individual organs. Unfortunately, this glimpse of the truth—which could have had a profound influence on medical progress—was soon to be forgotten, perhaps partly because these observations could not be confirmed since postmortems were not countenanced elsewhere and partly because they contradicted the humoural theories of Hippocrates and Galen. Erasistratus distinguished sensory from motor nerves and was probably the first to trace the origin of both to the brain. He believed that the brain— and not the heart, as was taught by Aristotle—was the centre of intelligence and suggested that certain palsies were a consequence of cerebral lesions. He made many other contributions to physiology and medicine, only a few of which are mentioned in the pages that follow. The school of the Erasistrians survived until after the time of Galen, *Dr. Christie died September 27, 1986, at the University of British Columbia. The address of Mrs. Christie is: 79 David Lane, Easthampton, New York 11937.© 1987 by The University of Chicago. All rights reserved. 003 1 -5982/87/3003-05 1 8$0 1 .00 440 Ronald V. Christie ¦ Galen on Erasistratus who did a great disservice to medical progress by destroying its credibility with rhetoric based on sarcasm and ridicule. None of the writings of Erasistratus has survived, although he apparently published many books [3]. Outside the writings of Galen there are but few contemporary references to the works of Erasistratus; one is from Aulius Gallius [3], and another is from Celsus [1], but neither has much to offer. Galen, who was born about a.D. 130, was to become the outstanding figure in medical education during the centuries that followed. At the age of 16 he started his studies in anatomy, first in Pergamon and then in Alexandria, which at that time was the most famous centre of medical learning, with a library which was even greater than that of Pergamon. During this period of about 10 years, he must have absorbed most of the anatomical and medical knowledge that had accumulated from the time of Hippocrates. After 4 years of medical practice in Pergamon, he went to Rome, where he quickly gained a reputation as a successful physician, serving as the personal physician of Marcus Aurelius. He continued his interest in anatomy and physiology and became a prolific writer as well as a respected physician. Unlike those of his predecessors, most of his writings have survived and can be considered authentic. Galen claimed to be an "eclectic"—which he certainly was, in the true sense of the word. An eclectic has been defined as a person "selecting such doctrines as pleased him in every school, borrowing freely from various sources" (Concise Oxford Dictionary). He accepted Hippocrates as the ultimate authority but igriored those parts of the Hippocratic writings , such as tradition in medicine, that were not in accord with his own views. To his credit, Galen was certainly a brilliant and industrious scholar who brought together the knowlege then available to build a system of medicine that at that time seemed plausible. His style was dogmatic, and he believed that every disease had its cure—an outlook that to this day is popular with patients and...