L. Israelson, Die materia medica 'X. 817-IQ.

142 MAGIC AND EXPERIMENTAL SCIENCE chap.
of breathing plenty of fresh, invigorating, and unpolluted air, free from any intermixture of impurity from mines, pits, or ovens, or of putridity from decaying vegetable or animal matter, or of noxious vapors from stagnant water, swamps, and rivers.^ As was usual in ancient and medieval times, he attributes plagues to the corruption of the air, which poisons men breathing it, and tells how Hippocrates tried to allay a plague at Athens by purifying the air by fumigation with fires, odors, and unguents.^ Two of Two specimens may be given of Galen's accounts of his
cases. own cases. In the first, some cheese, which he had told his
servants to take away as too sharp, when mixed with boiled salt pork and applied to the joints, proved very helpful to a gouty patient and to several others whom he induced to try it.^ In the second case Galen administered the following heroic treatment to a woman at Rome who was afflicted with catarrh to the point of throwing up blood.* He did not deem it wise to bleed her, since for four days past she had gone almost without food. Instead he ordered a sharp clyster, rubbed and bound her hands and feet with a hot drug, shaved her head and put on it a medicament made of doves' dung. After three hours she was bathed, care being taken that nothing oily touched her head, which was then covered up. At first he fed her only gruel, afterwards some bitter autumn fruit, and as she was about to go to sleep he administered a medicament made from vipers four months before. On the second day came more rubbing and binding except the head, and at evening a somewhat smaller dose of the viper remedy. Again she slept well and in the morn- ing he gave her a large dose of cooked honey. Again her body was well rubbed and she was given barley water and a little bread to eat. On the fourth day an older and therefore stronger variety of viper- remedy was administered and her head was covered with the same medicament as before. Its properties, Galen explains, are vehemently drying and heat-
*X, 843. 'XII, 270-71.
'XIV, 281. *X, 368-71.
IV GALEN 143
ing. Again she was given a bath and a little food. On the fifth day Galen ventured to purge her lungs, but he returned at intervals to the imposition upon her head. Meanwhile he continued the process of rubbing, bathing, and dieting, until finally the patient was well again, — a truly remark- able cure !
These two cases, however, do not give us a just compre- His power hension of Galen's abilities at their best. In his medical obs«-va-
practice he could be as quick and comprehensive an observer t'on and
inference, and as shrewd in drawing inferences from what he observed
as the famous Sherlock Holmes, so that some of his slower- witted contemporaries accused him of possessing the gift of divination. His immediate diagnosis of the case of the Sicilian physician by noting as he entered the house the excrements in a vessel which a servant was carrying out to the dungheap, and as he entered the sick-room a medicine set on the window-sill which the patient-physician had been preparing for himself, amazed the patient and the philo- sopher Glaucon^ more than, let us hope in this case in view of his profession, they would have amazed the estimable Dr. Watson.
Puschmann has pointed out that Galen employs certain His happy expressions which seem happy guesses at later discoveries. ^"^^^^^• He writes : "Galen was supported in his researches by an extremely happy imaginative faculty which put the proper word in his mouth even in cases where he could not possibly arrive at a full understanding of the matter, — where he could only conjecture the truth. When, for instance, he declares that sound is carried 'like a wave' (Kiihn, HI, 644), or expresses the conjecture that the constituent of the atmos- phere which is important for breathing also acts by burning (IV, 687), he expresses thoughts which startle us, for it was only possible nearly two thousand years later to under- stand their full significance."^
'Kiihn, VIII, 2,6^. Finlayson ^Puschmann (iSgr), pp. 105-6.
(189s), pp. 39-40, gives an English Vitruvius, too, however (V, iii),
translation of Galen's full account states that sound spreads in waves'
of the case. like eddies in a pond.
144
MAGIC AND EXPERIMENTAL SCIENCE chap.
Tendency towards scientific measure- ment.
Psycho- logical tests with the pulse.
Galen was keenly alive to the need of exactness in weights and measurements. He often criticizes past writers for not stating precisely what ailment the medicament rec- ommended is good for, and in what proportions the ingredi- ents are to be mixed. He also frequently complains be- cause they do not specify whether they are using the Greek or Roman system of weights, or the Attic, Alexandrine, or Ephesian variety of a certain measure.-^ Moreover, he saw the desirability of more accurate means of measuring the passage of time.^ When he states that even some illustrious physicians of his acquaintance mistake the speed of the pulse and are unable to tell whether it is slow, fast, or nor- mal, we begin to realize something of the difficulties under which medical practice and any sort of experimentation labored before watches were invented, and how much de- pended upon the accuracy of human machinery and judg- ment. Yet Galen estimates that the chief progress made in medical prognostication since Hippocrates is the gradual development of the art of inferring from the pulse.^ Galen tried to improve the time-pieces in use in his age. He states that in any city the inhabitants want to know the time of day accurately, not merely conjecturally ; and he gives di- rections how to divide the day into twelve hours by a com- bination of a sun-dial and a clepsydra, and how on the water clock to mark the duration of the longest, shortest, and equinoctial days of the year.^
Delicate and difficult as was the task of measuring the pulse in Galen's time, he was clever enough to anticipate by seventeen centuries some of the tests which modern psy- chologists have urged should be applied in criminal trials. He detected the fact that a female patient was not ill but in love by the quickening of her pulse when someone came in from the theater and announced that he had just seen Py-
^XIII, 435, 893, are two in- stances.
» V, 80 ; XIV, 670.
* Various treatises on the pulse by Galen will be found in vols. V, IX, and X of Kiihp's edition.
* Galen's contributions to the arts of clock-making and time- keeping have been dealt with in an article which I have not had ac- cess to and of which I cannot now find even the author and title.
IV GALEN 14s
lades dance. When she came again the next day, Galen had purposely arranged that someone should enter and say that he had seen Morphus dancing. This and a similar test on the third day produced no perceptible quickening in the woman's pulse. But it bounded again when on the fourth day Pylades' name was again spoken. After recounting an- other analogous incident where he had been able to read the patient's mind, Galen asks why former physicians have never availed themselves of these methods. He thinks that they must have had no conception of how the bodily health in general and the pulse in particular can be affected by the "psyche's" suffering.^ We might then call Galen the first experimental psychologist as well as the first to elaborate the physiology of the nervous system.
It would scarcely be fair to discuss Galen's science at Galen's all without saying something of his remarkable work in anat- an^^p^ysj, omy and physiology. Daremberg went so far as to hold ology. that all there is good or bad in his writings comes from good or bad physiology, and regarded his discussion of the bones and muscles as especially good.^ He is generally considered the greatest anatomist of antiquity, but it is barely possible that he may have owed more to predecessors and contem- poraries and less to personal research than is apparent from his own writings, which are the most complete anatomical treatises that have reached us from antiquity. Herophilus, for example, who was born at Chalcedon in the closing fourth century B. C. and flourished at Alexandria under the first Ptolemy, discovered the nerves and distinguished them from the sinews, and thought the brain the center of the nervous system, so that it is perhaps questionable whether Payne is justified in calling Galen "the founder of the physiology of the nervous system," and in declaring that
*XIV, 631-34. Muscular Anatomy" at the Inter-
' C. V. Daremberg, Exposition national Congress of Medical
des connaissances de Galien sur Sciences held at London in 1913;
I'anatomie, la physiologic, et la see pp. 389-400 of the volume de-
pathologie du systemc nervcux, voted to the history of medicine,
Paris, 1841. J. S. Milne dis- Section XXIII.
cussed "Galen's Knowledge of
146 MAGIC AND EXPERIMENTAL SCIENCE chap.
"in physiological diagnosis he stands alone among the an- cients." ^ However, if Galen owed something to Herophilus, we owe much of our knowledge of the earlier physiologist to Galen.^ Experi- Aristotle had held that the heart was the seat of the sen-
Sss'ection. sitive soul ^ and the source of nervous action, "while the brain was of secondary importance, being the coldest part of the body, devoid of blood, and having for its chief or only function to cool the heart." Galen attacked this theory by showing experimentally that "all the nerves originated in the brain, either directly or by means of the spinal cord, which he thought to be a conducting organ merely, not a center." "A thousand times," he says, "I have demon- strated by dissection that the cords in the heart called nerves by Aristotle are not nerves and have no connection with nerves." He found that sensation and movement were stopped and even the voice and breathing were affected by injuries to the brain, and that an injury to one side of the brain affected the opposite side of the body. His public demonstration by dissection, performed in the presence of various philosophers and medical men, of the connection be- tween the brain and voice and respiration and the commen- taries which he immediately afterwards dictated on this point were so convincing, he tells us fifteen years later, that no one has ventured openly to dispute them."* His "experi- mental investigation of the spinal cord by sections at differ- ent levels and by half sections was still more remarkable." ^ Galen opposed these experimental proofs to such unscien- tific arguments on the part of the Stoic philosopher, Chry- sippus, and others, as that the heart must be the chief organ because it is in the center of the body, or because one lays
^Lancet (1896), p. 1139. chick led Aristotle to locate in it
* I have failed to obtain K. F. H. the central seat of the soul.
Mark, Herophilus, ein Beitrag s:ur '' XIV, 626-30.
Geschichtc der Medicin, Carls- "11, 683, 696, This and the
ruhe, 1838. other quotations in this para-
'D'Arcy W. Thompson (1913), graph are from Dr. Payne's Har-
22-23, thinks that the precedence veian Oration as printed in Tht
of the heart over all other organs Lancet (1896), pp. 1137-39- in appearing in the embryo of the
IV GALEN 147
one's hand on one's heart to indicate oneself, or because the lips are moved in a certain way in saying "I"( eyco).'^ Another noteworthy experiment by Galen was that in which, by binding up a section of the femoral artery he proved that the arteries contain blood and not air or spiritus as had been generally supposed.- He failed, however, to perform any experiments with the pulmonary veins, and so the no- tion persisted that these conveyed "spirit" and not blood from the lungs to the heart. ^
It has usually been stated that Galen never dissected Did Galen
ever the human body and that his inferences by analogy from dissect
his dissection of animals involved him in serious error con- ^ '?-^":>
bodies?
cerning human anatomy and physiology. Certainly he speaks as if opportunities to secure human cadavers or even skeletons were rare.^ He mentions, however, the possibil- ity of obtaining the bodies of criminals condemned to death or cast to beasts in the arena, or the corpses of robbers which lie unburied in the mountains, or the bodies of in- fants exposed by their parents.^ It is not sufficient, he states in another passage,^ to read books about human bones; one should have them before one's eyes. Alexan- dria is the best place for the student to go to see actual ex- hibitions of this sort made by the teachers."^ But even if one cannot go there, one may be able to procure human bones for oneself, as Galen did from a skeleton which had
^Kiihn, V, 216, cited by Payne. *II, 384-86.
*Kiihn, II, 642-49; IV, 703-36, e tt
"An in arteriis natura sanguis , ^ u 1.
contineatur." J. Kidd, A Cursory ^Augustine testifies in two pas-
Analysis of the Works of Galen sages of his Dc anima et eius
so far as they relate to Anatomy origine (Migne PL 44, 475-548),
and Physiology, in Transactions that vivisection of human beings
of the Provincial Medical and was practiced as late as his time,
Surgical Association, VI (1837), the early fifth century: IV, 3,
299-336. "Medici tamen qui appellantur
^Lancet (1896), p. 1137, where anatomici per membra per venas
Payne states that Colombo {De per nervos per ossa per medullas
re anatomica, Venet. 1559, XIV, per interiora vitalia etiam vivos
261) was the first to prove by ex- homines quamdiu inter manus
periment on the living heart that rimantium vivere potuerunt dis-
these veins conveyed blood from siciendo scrutati sunt ut naturam
the lungs. corporis nossent"; and IV, 6
*II, 146-47. (Migne, PL 44, 528-9).
148 MAGIC AND EXPERIMENTAL SCIENCE chap.
been washed out of a grave by a flooded stream and from the corpse of a robber slain in the mountains. If one can- not get to see a human skeleton by these means or some other, he should dissect monkeys and apes. Dissection Indeed Galen advises the student to dissect apes in any
case, in order to prepare himself for intelligent dissection of the human body, should he ever have the opportunity. From lack of such previous experience the doctors with the army of Marcus Aurelius, who dissected the body of a dead German, learned nothing except the position of the entrails. Galen at any rate dissected a great many animals. Tiny animals and insects he let alone, for the microscope was not yet discovered, but besides apes and quadrupeds he cut up many reptiles, mice, weasels, birds, and fish.^ He also gives an amusing account of the medical men at Rome gathering to observe the dissection of an elephant in order to discover whether the heart had one or two vertices and two or three ventricles. Galen assured them beforehand that it would be found similar to the heart of any other breathing animal. This particular dissection was not, how- ever, performed exclusively in the interests of science, since it was scarcely accomplished when the heart was carried off, not to a scientific museum, but by the imperial cooks to their master's table.^ Galen sometimes dissected animals the moment he killed them. Thus he observed that the lungs always sensibly shrank from the diaphragm in a dying animal, whether he killed it by suffocation in water, or strangling with a noose, or severing the spinal medulla near the first vertebrae, or cutting the large arteries or veins. ^ Surgical Surgical operations and medical practice were a third
operations, ^ay of learning the human anatomy, and Galen complains of the carelessness of those physicians and surgeons who do not take pains to observe it before performing an oper- ation or cure. He himself had had one case where the * n, 537, * II, 619-20. • II, 701.
IV GALEN 149
human heart was laid bare and yet the patient recovered.^ As a young practitioner before he came to Rome Galen worked out so successful a method of treating wounds of the sinews that the care of the health of the gladiators in his native city of Pergamum was entrusted to him by sev- eral successive pontifices - and he hardly lost a life. In the same passage he again speaks contemptuously of the doctors in the war with the Germans who were allowed to cut open the bodies of the barbarians but learned no more thereby than a cook would. When Galen came from Pergamum to Rome he found the professions of physicians and surgeons distinct and left cases to the latter which he before had at- tended to himself.^ We may note finally that he invented a new form of surgical knife.*
In Galen's opinion the study of anatomy was important Galen's for the philosopher as well as for the physician. An under- froJJJ"^"* standing of the use of the parts of the body is helpful to design, the doctor, he says, but much more so to "the philosopher of medicine who strives to obtain knowledge of all nature." ^ In the De iisu partium ^ he came to the conclusion that in the structure of any animal we have the mark of a wise workman or demiurge, and of a celestial mind; and that "the investigation of the use of the parts of the body lays the foundation of a truly scientific theology which is much greater and more precious than all medicine," and which reveals the divinity more clearly than even the Eleusinian mysteries or Samothracian orgies. Thus Galen adopts the argument from design for the existence of God. The mod- ern doctrine of evolution is of course subversive of his premise that the parts of the body are so well constructed for and marvelously adapted to their functions that nothing better is possible, and consequently of his conclusion that this necessitates a divine maker and planner.
^IT, 631 ff. cal bearing.
''XIII, 599-600. Galen states ' X, 454-55.
that the pontifex's term of * II, 682.
office was seven months, a fact ^11, 291.
which perhaps had some astrologi- " IV, 360, et passim.
150
MAGIC AND EXPERIMENTAL SCIENCE chap.
Queries concerning the soul.
No super- natural force in medicine.
In the treatise De foetuum formatione Galen displays a similar inclination but more tentatively and timidly. He thinks that the human body attests the wisdom and power of its maker/ whom he wishes the philosophers would re- veal to him more clearly and tell him "whether he is some wise and powerful god."^ The process of the formation of the child in the womb, the complex human muscular system, the human tongue alone, seem to him so wonderful that he will not subscribe to the Epicurean denial of any all-ruling providence.^ He thinks that nature alone cannot show such wisdom. He has, however, sought vainly from philosopher after philosopher for a satisfactory demonstra- tion of the existence of God, and is by no means certain himself.*
Galen is also at a loss concerning the existence and sub- stance of the soul. He points out that puppies try to bite before their teeth come and that calves try to hook before their horns grow, as if the soul knew the use of these parts beforehand. It might be argued that the soul itself causes the parts to grow,^ but Galen questions this, nor is he ready to accept the Platonic world-soul theory of a divine force permeating all nature.^ It offends his instinctive piety and sense of fitness to think of the world-soul in such things as reptiles, vermin, and putrefying corpses. On the other hand, he disagrees with those who deny any innate knowl- edge or standards to the soul and attribute everything to sense perception and certain imaginations and memories based thereon. Some even deny the existence of the rea- soning faculty, he says, and affirm that we are led by the affections of the senses like cattle. For these men courage, prudence, temperance, continence are mere names. "^
In commenting upon the works of Hippocrates, Galen insists that in speaking of "something divine" in diseases
^ IV, 687. soul constructs the parts and
* IV, 694, 696. another soul incites them to vol-
* IV, 688. untary motion. *IV, 700. ejY „j
' IV, 692 ; II, 537. Others con- " ' 7"^'
tend, he says (IV, 693), that one *II, 28.
IV GALEN 151
Hippocrates could not have meant supernatural influence, which he never admits into medicine in other passages. Galen tries to explain away the expression as having ref- erence to the effect of the surrounding air.^ Thus while Galen might look upon nature or certain things in nature as a divine work, he would not admit any supernatural force in science or medicine, or anything bordering upon special providence. In the De usu partiiim Galen states that he agrees with Moses that "the beginning of genesis in all things generated" was "from the demiurge," but that he does not agree with him that anything is possible with God and that God can suddenly turn a stone into a man or make a horse or cow from ashes. "In this matter our opinion and that of Plato and of others among the Greeks who have written correctly concerning natural science differs from the view of Moses." In Galen's view God attempts nothing contrary to nature but of all possible natural courses invariably chooses the best. Thus Galen expresses his admiration at nature's providence in keeping the eye- brows and eyelashes of the same length and not letting them grow long like the beard or hair, but this is because a harder cartilaginous flesh is provided for them to grow in, and the mere will of God would not keep hairs from growing in soft flesh. If God had not provided the carti- laginous substance for the eyelashes, "he would have been more careless, not merely than Moses but than a worthless general who builds a wall in a swamp." ^ As between the views on God of Moses and Epicurus, Galen prefers to steer a middle course.
Already in describing Galen's dissections and tests with Galen's the pulse we have seen evidence of the accurate observation mental and experimental instincts which accompanied his zest for '"^t*"*^** hard work and zeal for truth. In one of his treatises he
* XVIII B, I7ff. Moses Maimonides in the twelfth
^ De usu partium, XI, 14 (Kiihn, century took exception at some
111,905-7). The passage seems to length, in the 2Sth Particula of
me an integral part of the work his Aphorisms from Galen, to this
and not a later interpolation. criticism of his national lawgiver.
152
MAGIC AND EXPERIMENTAL SCIENCE chap.
Attitude towards authori- ties.
confesses that it was a passion of his always to test every- thing for himself. "And if anyone accuses me of this, I will confess my disease, from which I have suffered all my life long, that I have trusted no one of those who narrate such things until I have tested it myself, if it was possible for me to have experience of it," ^ Galen also recognized that general theories were not sufficient for exact knowledge and that specific examples seen with one's own eyes were indispensable.^ He maintains that, if all teachers and writers would realize and observe this, they would make comparatively few false statements. He saw the danger of making absolute assertions and the need of noting the particular circumstances of each individual case.^ Galen more than once declared that things, not names, were im- portant and refused to waste time in disputing about termin- ology and definitions which might be spent in "pursuing the knowledge of things themselves." * Thus we see in Galen a pragmatic scientist intent upon concrete facts and exact knowledge ; but at the same time it must be recognized that he accepted some universal theorems and general views.
Galen did not believe in merely repeating in new books the statements of previous authorities. Ever since boy- hood, he writes in his Anatomical Administrations, it has seemed to him that one should record in writing only one's new discoveries and not repeat what has been said already.^ Nevertheless in some of his writings he collects the pre- scriptions of past physicians at great length, and a previous treatise by Archigenes is practically embodied in one of Galen's works on compound medicines. On another occa- sion, however, after stating that Crito had combined previ- ous treatises upon cosmetics, including the work of Cleo- patra, into four books of his own which constitute a well- nigh exhaustive treatment of the subject, Galen says that
^IV, 513; see also II, 55, cos ?7w7e 'XIII, 964.
irpwrov niv &Kovaai t6 yivonevov, kdavfxaaa ''II, 136; X, 3^5 J XII, 3II > he
Kal avrbs e^ovXrjdijv aiiTowTrjs airov Kara- credited Plato with the same atti-
CT^j'tti. tude, see II, 581.
'X, 608; XIII, 887-88. MI, 659-60.
IV
GALEN 153
he sees no profit in copying Crito's work again and merely reproduces its table of contents.^ On the other hand, as this passage shows, Galen thought that the ancients had stated many things admirably and he had little patience with contemporaries who would learn nothing from them but were always ambitiously weaving new and complicated dog- mas, or misinterpreting and perverting the teachings of the ancients.^ His method was rather first to "make haste and stretch every nerve to learn what the most celebrated of the ancients have said ;" ^ then, having mastered this teach- ing, to judge it and put it to the test for a long time and determine by observation how much of it agrees and how much disagrees with actual phenomena, and then embrace the former portion and reject the latter.
This critical employment of past authorities is frequently Adverse illustrated in Galen's works. He mentions a great many of p^st names of past physicians and writers, thereby shedding some writers, light upon the history of Greek medicine; but at times he criticizes his predecessors, not sparing even Empedocles and Aristotle. Although he cites Aristotle a great deal, he declares that it is not surprising that Aristotle made many errors in the anatomy of animals, since he thought that the heart in large animals had a third ventricle.^ As we have already seen in discussing the topic of weights and measurements, Galen especially objects to the vagueness and inaccuracy of many past medical writers,^ or praises in- dividuals like Heras who give specific information.^ He also shows a preference for writers who give first-hand information, commending Heraclides of Tarentum as a trustworthy man, if there ever was one, who set down only those things proved by his own experience.'^ Galen declares that one could spend a life-time in reading the books that have already been written upon medicinal simples. He urges his readers, however, to abstain from Andreas and
'XII, 446. 'XIII, 891.
"11, 141, 179. 6YTTT Ain IT
"11, 179; X, 609. ^^^^' 430-31.
*II, 621. ^XIII, 717.
IS4
MAGIC AND EXPERIMENTAL SCIENCE chap.
Galen's estimate of Dios- corides.
Galen's dogma- tism : logic and ex- perience.
other liars of that stamp, and above all to eschew Pamphilus who never saw even in a dream the herbs which he describes. Of all previous writers upon materia niedica Galen pre- ferred Dioscorides. He writes, "But Anazarbensis Dios- corides in five books discussed all useful material not only of herbs but of trees and fruits and juices and liquors, treat- ing besides both all metals and the parts of animals." ^ Yet he does not hesitate to criticize certain statements of Dios- corides, such as the story of mixing goat's blood with the terra sigillata of Lemnos. Dioscorides had also attributed marvelous virtues to the stone Gagates which he said came from a river of that name in Lycia; Galen's comment is that he has skirted the entire coast of Lycia in a small boat and found no such stream.^ He also wonders that Dios- corides described butter as made of the milk of sheep and goats, and correctly states that "this drug" is made from cows' milk.^ Galen does not mention its use as a food in his work on medicinal simples, and in his treatise upon food values he alludes to butter rather incidentally in the chap- ter on milk, stating that it is a fatty substance and easily recognized by tasting it, that it has many of the properties of oil, and in cold countries is sometimes used in baths in place of oil.^ Galen further criticizes Dioscorides for his unfamiliarity with the Greek language and consequent fail- ure to grasp the significance of many Greek names.
Daremberg said of Galen that he represented at the same time the most exaggerated dogmatism and the most ad- vanced experimental school. There is some justification for the paradox, though the latter part seems to me the truer. But Galen was proud of his training in philosophy and logic and mathematics; he stood fast by many Hippo- cratic dogmas such as the four qualities theory, he thought ^ that in medicine as in geometry there were a certain num- *XI, 794; also XIII, 658; XIV, "XII, 272.
61-62, and many other passages of the Antidotes.
*XII, 203. Pliny, NH XXXVI, 34, makes the same statement as Dioscorides.
* Pliny, NH XXVIII, 35, how- ever, both tells how butter is made and of its use as food among the barbarians.
"^X, 40-41
IV GALEN 155
ber of self-evident maxims upon which reason, conforming to the rules of logic, might build up a scientific structure. In the De methodo medendi ^ he makes a distinction be- tween the discovery of drugs and medicines, simple or com- pound, by experience and the methodical treatment of dis- ease which he now sets forth and which should proceed log- ically and independently of mere empiricism, and he wishes that other medical writers would make it clear when they are relying merely on experience and when exclusively upon reason.^ At the same time he expresses his dislike for mere dogmatizers who shout their ipse dixits like tyrants with- out the support either of reason or experience.^ He also grants that the ordinary man, taught by nature alone, often instinctively pursues a better course of action for his health than "the sophists" are able to advise.* Indeed, he is of the opinion that some doctors would do well to stick to experi- ence alone and not try to mix in reasoning, since they are not trained in logic, and when they endeavor to divide or analyze a theme, perform like unskilled carvers who fail to find the joints and mutilate the roast. ^ Later on in the same work ^ he again affirms that persons who will not read and profit by the books of medical authorities and whose own reasoning is defective, should limit themselves to ex- perience.
Normally, however, Galen upholds both reason and ex- Galen's perience as criteria of truth against the opposing schools account of of Dogmatics and Empirics. The former attacked experi- pirics. ence as uncertain and impossible to regulate, slow and un- methodical. The latter replied that experience was con- sistent, adaptable to art, and proof enough.'^ Galen's chief objection to the Empirics is that they reject reason as a cri- terion of truth and wish the medical art to be irrational.^ "The Empirics say that all things are discovered by experi-
^X, 127, 962. «X, 915-16.
'X, 31. 'I, 75-76: XIV, 367.
\ X, 29. » I, 145 ; II. 41-43 ; X, 30-31, 782-
*X, 668. 83; XIII, 188, 366, 375, 463, 579,
X, 123. 594, 892 ; XIV, 245, 679.
156 MAGIC AND EXPERIMENTAL SCIENCE chap.
ence, but we say that some are found by experience and some by reason." ^ Galen also objects to Herodotus's ex- planation of the medical art as originating in the conversa- tion of patients exposed at crossroads who told one another of their complaints and recoveries and thus evolved a fund of common experience.^ Galen criticizes such experience as irrational and not yet put into scientific form (ov-koo Xoyut?) . Of the Empirics he tells us further that they regard phenomena only and ignore causes and put no trust in rea- soning. They hold that there is no system or necessary order in medical discovery or doctrine, and that some rem- edies have been discovered by dreams, others by chance. They also accepted written accounts of past experiences and thus to a certain extent trusted in tradition. Galen argues that they should test these statements of past authorities by reason.^ His further contention that, if they test them by experience, they might as well reject all writings and trust only to present experience from the start, is a sophistical quibble unworthy of him. He adds, however, that the Em- pirics themselves say that past tradition or "history" ( taTOpla) should not be judged by experience, but it is unlikely that he represents their view correctly in this par- ticular. In another passage ^ he says that they distinguish three kinds of experience, chance or accidental, offhand or impromptu, and imitative or the repetition of the same thing. In a third passage ^ he repeats that they held that observation of one or two instances was not enough, but that oft-repeated observation was needed with all conditions the same each time. In yet another place ® he says that the Empirics observe coincidences in things joined by experi- ence. He himself defines experience as the comprehending and remembering of something seen often and in the same condition,'^ and makes the good point that one cannot ob- serve satisfactorily without use of reason.^ He also admits
^X, 159- "I. 135.
' XIV, 675-76. ' XIV, 680.
*I, T44-SS. 'I, 131.
'XVI. 82. 'I, 134-
IV GALEN 157
in one place that some Empirics are ready to employ reason as well as experience.-^
Having noted Galen's criticism of the Empirics, we may How the imagine what their attitude would be towards his medicine, ^i^h*"^^ They would probably reject all his theories — which we, too, have
criticized
have finally discarded — of four elements and four qualities Galen, and the like, and would accept only his specific recommenda- tions for the cure of disease based upon his medical experi- ence; except that they would also be credulous concerning anything which he assured them was based upon his own or another's experience, whether it truly was or not. They would, however, have probably questioned much of his anatomical inference from the dissection of the lower ani- mals, since he tells us that they "have written whole books against anatomy." ^ Considering the state of knowledge in their time, their refusal to attempt any large generalizations or to hazard any scientific hypotheses or to build any risky medical system was in a way commendable, but their cre- dulity as to particulars was a weakness.
On the whole Galen's attitude towards experience seems Galen's an improvement upon theirs. He was apparently more criti- of "eason
cal towards the "experiences" of past writers than the and ex-
perience. average Empiric, and in his combination of reason and ex- perience he came a little nearer to modern experimental method. Reason alone, he says, discovers some things, experience alone discovers some, but to find others requires use of both experience and reason.^ In his treatise upon critical days he keeps reiterating that their existence is proved both by reason and experience. These two instruments in judging things given us by nature supplement each other.* "Logical methods have force in finding what is sought, but in believing what has been well found there are two criteria for all men, reason and experience." ^ "What can you do with men who cannot be persuaded either by reason or by
'XVI, 82. *XIII, 1 16-17.
^11, 288.
" IX, 842 ; XIII, 887. " X, 28-29.
158
MAGIC AND EXPERIMENTAL SCIENCE chap.
Simples knowable only from experi- ence.
practice ?" ^ Galen also speaks of discovering a truth by logic and being thereby encouraged to try it in practice and of then verifying it by experience.^ This, however, is not quite the same thing as saying that the scientist should aim to discover new truth by purposive experiments, or that from a number of experiences reason may infer some gen- eral law of nature.
It is perhaps in his work on medicinal simples that Galen lays most stress upon the importance of experience. In- deed he sees no other way to learn the properties of natural objects than through the experience of the senses.^ *'For by the gods," he exclaims, "how is it that we know that fire is hot? Are we taught it by some syllogism or persuaded of it by some demonstration? And how do we learn that ice is cold except from the senses ?" * And Galen sees no advantage in spending further time in arguments and hair- splitting where one can learn the truth at once from the senses. This thought he keeps repeating through the trea- tise, saying, for example, "The surest judge of all will be experience alone, and those who abandon it and reason on any other basis not only are deceived but destroy the value of the treatise." ^ Moreover, he restricts his account of me- dicinal simples to those with which he is personally ac- quainted. In the three books treating of plants he does not mention all those found in all parts of the world, but only as many as it has been his privilege to know by experience.* He proposes to follow the same rule in the ensuing discussion of animals and to say nothing of virtues which he has not tested or of substances mentioned in the writings of past physi- cians but unknown to him. He dares not trust their state- ments when he reflects how some have lied in such matters. In the middle ages Albertus Magnus talks in much the same strain in his works on animals, plants, and minerals, and perhaps he was stimulated to such ideals, consciously or un-
^X, 684.
'X, 454-55. •XI, 420.
'XI, 434-35.
'XI, 456.
XII, 246.
IV GALEN 1 59
consciously, directly by reading Galen or indirectly through Arabic works, by Galen's earlier expression of them. Galen mentions some virtues ascribed to substances which he has tested by experience and found false, such as the medicinal properties attributed to the belly of a seagulP and some of those claimed for the marine animal called torpedo.^ Anointing the place with frog's blood or dog's milk will not prevent eyebrows that have been plucked out from grow- ing again, nor will bat's blood and viper's fat remove hair from the arm-pits.^ Also the brain of a hare is only fairly good for boys' teeth.*
In beginning his work on food values ^ Galen states that Experi-
cncG 3.11(1
many have discussed the properties of aliments, some on the food basis of reason alone, some on the basis of experience alone, science, but that their statements do not agree. On the whole, since reasoning is not easy for everyone, requiring natural sagac- ity and training from childhood, he thinks it better to start from experience, especially since not a few physicians are of the opinion that only thus can the properties of foods be learned.
The Empirics contended that most compound medicines Experi- had been hit upon by chance, and Galen grants that the com- Dogmatics usually are unable to give reasons for the in- Po^-" gredients of their doses and find difficulty in reproducing a lost prescription.^ But he holds that reasons can be given for the constituents of the compound and that the logical discovery of such remedies differs from the empirical.'^ His own method was to learn the nature of each disease and the varied properties of simples, and then prepare a compound suited to the disease and to the patient.^ On the other hand, we see how much depends upon experience from his con- fession that sometimes he has hastily prepared a compound from a few simples, sometimes from more, sometimes from a great variety. If the compound worked well, he would
'XII, 336. "VI, 453-55.
•XII, 365. "XIII, 463.
•XII, 258, 262, 269, 331. ■'XII, 895.
* XII, 334. ' XIV, 222.
i6o
MAGIC AND EXPERIMENTAL SCIENCE chap.
Sugges- tions of experi- mental method
continue to use it, sometimes making it stronger and some- times weaker,^ For as you cannot put together compounds without rational method, so you cannot tell their strength certainly and accurately without experience.^ He admits that no one can tell the exact quantity of each ingredient to employ without the aid of experience,^ and says, "The proper proportions in the mixture we shall find conjectur- ally before experience, scientifically after experience." ^ In these treatises upon compound medicines, unlike that on medicinal simples, Galen gives the prescriptions of former physicians as well as some tested by his own experience.*^ Sometimes, however, he expresses a preference for the med- icines of those writers who were "most experienced" ; and once says that he will give some compounds of the more recent writers, who in their turn had selected the best from older writers of long experience and added later discoveries.® We suspect, however, that some of these prescriptions had not been tested for centuries.
Galen gives a few directions how to regulate medical observation and experience, although they cannot be said to carry us very far on the road to modern laboratory research. He saw the value of "long experience," a phrase which he often employs.'^ He states that one experience is enough to learn how to prepare a drug, but to learn to know the best medicines in each kind and in different places many experi- ences are required.^ Medicinal simples should be frequently inspected, "since the knowledge of things perceived by the senses is strengthened by careful examination." ® Galen ad- vises the student of medicine to study herbs, trees, and fruit as they grow, to find out when it is best to pluck them, how to preserve them, and so on. But elsewhere he states that it is possible to estimate the general virtue of the simple
*XIII, 700-701. *XIII, 706-707. "Xlll, 467.
*XIII, 867.
'XII, 392-93, 884; XIII, 116-17, 123, 125, 128-29, 354, 485, 502-503,
582, 656.
"XII, 968, 988.
'See XII, 988 XIV, 12, 60, 341.
«XIV, 82.
•XIII, S70.
XIII, 960-61;
IV GALEN i6i
from one or two experiences.-^ However, he suggests that their effect be noted in the three cases of a perfectly heahhy person, a sHghtly aihng patient, and a really sick man.^ In the last case one should further note their varying effects as the disease is marked by any excess of heat, cold, dryness, or m.oisture. Care should be taken that the simples them- selves are pure and free from any admixture of a foreign substance.^ "It is also essential to test the relation to the nature of the patient of all those things of which great use is made in the medical art." ^ One condition to be observed in experimental investigation of critical days is to count no cases where any slip has been made by physician or patient or bystanders or where any other foreign factor has done harm.^ Galen was acquainted with physical experiments in siphoning, for he says that, if one withdraws the air from a vessel containing sand and water, the sand will follow be- fore the water, which is the heavier {sic?).^
Galen also points out some of the difficulties of medi- Difficulty cal experimentation. One is the extreme unlikelihood of experi-*'^^ ever being able to observe in even two cases the same com- ment. bination of symptoms and circumstances.'^ The other is the danger to the life of the patient from rash experiment- ing.^ Thus Galen more than once tells us of abstaining from testing some remedy because he had others of whose effects he was surer.
In the treatise on easily procurable remedies ascribed Empirical to Galen,^ in which we have already seen evidence of later interpolation or authorship, some recipes are concluded by
^XII, 350. book, O Glaucon, ends thus. If it
*XVI, 86-87; XI, 518. has been useful to you, you will
* XI, 485. readily follow what I've written *XVI, 85. to Salomon the archiater." But *IX, 842. then the present second book *II, 206. opens with the words (XIV, 390), ' I, 138. "Since you've asked me to write
* XVI, 80. you about easily procurable reme-
* There would seem to be some- dies, O dearest Solon," and goes thing wrong, at least with its ar- on to say that the author will state rangement as it now stands, for what he has learned from experi- the first book ends (XIV, 389) ence beginning with the hair and with the words, "This my fourth closing with the feet.
remedies.
1 62
MAGIC AND EXPERIMENTAL SCIENCE chap.
Galen's influence upon medieval experi- ment.
such expressions as, "This has been experienced; it works unceasingly," ^ or "Another remedy tested by us in many cases." ^ This became a custom in many subsequent medi- cal works, including those of the middle ages. One recipe is introduced by the caution, "But don't cure anybody un- less you have been paid first, for this has been tested in many cases." ^ But we are left in some doubt whether we should infer that remedies tested by experience are so su- perior that they call for cash payment rather than credit, or so uncertain that it is advisable that the physician secure his fee before the outcome is known. In the middle ages the word experimentiim was used a great deal as a synonym for any medical treatment, recipe, or prescription. Galen ap- proaches this usage, which we have already noticed in Pliny's Natural History, when he describes "a very important ex- periment" in bleeding performed by certain doctors at Rome.*
Indeed Galen appears to have exerted a great influence in the middle ages by his passages concerning experience in particular as well as by his medicine in general. Medieval writers cite him as an authority for the recognition of ex- perience and reason as criteria of truth.^ Gilbert of Eng- land cites "experiences from the book of experiments ex- perienced by Galen," ^ and we shall find more than one such apocryphal work ascribed to Galen in the middle ages. John of St. Amand seems to have developed seven rules '^ which he gives for discovering experimentally the prop- erties of medicinal simples from what we have heard Galen say on the subject, and in another work, the Concordances, John collects a number of passages about experience from
^ XIV, 378.
'XIV, 462.
'XIV, 534.
^XI, 205.
°John of St. Amand, Expositio in Antidotarium Nicolai, fol. 231, in Mesuae niedici clarissimi opera, Venice, 1568. Pietro d'Abano, Conciliator, Venice, 1526, Difif. X, fol. 15; Difif. LX, fol. 83. Arnald
of Villanova, Repetitio super Canon "Vita brevis," fol. 276, in his Opera, Lyons, 1532.
" Gilbertus Anglicus, Compen^ dium mcdicinae, Lyons, 15 10, fol. 328V., "Experimenta ex libro ex- perimentorum Gal. experta."
' In his Expositio in Antido- tarium Nicolai, as cited above (note 5).
IV GALEN 163
the works o£ Galen. ^ Peter of Spain, who died as Pope John XXI in 1277, cites Galen in his discussion of "the way of experience" and "the way of reason" in his Com- mentaries on Isaac on Diets. ^ We have already suggested Galen's possible influence upon Albertus Magnus, and we might add Roger Bacon who wrote some treatises on medi- cine. But it is hardly possible to tell whether such ideas were in the air, or were due to Galen individually either in their origin or their transmission. But he made a rather close approach to the medieval attitude in his equal regard for logic and for experimentation.
The more general influence of Galen upon all sides of His more the medicine of the following fifteen centuries has often medieval been stated in sweeping terms, but is difficult to exaggerate, influence. His general theories, his particular cures, his occasional mar- velous stories, were often repeated or paraphrased. Ori- basius has been called "the ape of Galen," and we shall see that the epithet might with equal reason be applied to Aetius of Amida. Indeed, as in the case of Pliny, we shall find plenty of instances of Galen's influence in our later chap- ters. Perhaps as good a single instance of medieval study of Galen as could be given is from the Concordances of John of St. Amand already mentioned, which bear the alterna- tive title, "Recalled to Mind" {Revocativum memoriae), since they were written to "relieve from toil and worry scholars who often spend sleepless nights in searching for points in the books of Galen." ^ Or we may note how the associates of the twelfth century translator from the Arabic, Gerard of Cremona, added a list of his works at the close of his translation of Galen's Tegni, "imitating Galen in the commemoration of his books at the end of the same trea- tise," as they themselves state.*
Not that medieval men did not make additions of their
^J. L. Pagel, Die Concordanciae XXI, 263-65).
dcs Johannes de Sancto Amando, ^ ed. Lyons, 1515, fols. 19V-20V.
Berlin, 1894, pp. 102-104. John 'Berlin, 902, I4tli century, fol.
also wrote commentaries on Galen, 175; Berlin 903, 1342 / .D., fol. 2.
(Histoire Litteraire de la France, * Boncompagni (1851), pp. 3-4.
164
MAGIC AND EXPERIMENTAL SCIENCE chap.
own to Galen. For instance, the noted Jewish philosopher, Moses Maimonides, in adding his collection of medical Aphorisms to the many previous compilations of this sort by Hippocrates, Rasis (Muhammad ibn Zakariya), Mesne (Yuhanna ibn Masawaih), and others, states that he has drawn them mainly from the works of Galen, but that he supplements these with some in his own name and some by other "moderns."^ Not that Galen was not sometimes criti- cized or questioned. A later Greek writer, Symeon Seth, ventured to devote a special treatise to a refutation of some of Galen's physiological views. In it, addressing himself to those "persons who regard you, O Galen, as a god," he endeavored to make them realize that no human being is infalHble.^ Among the medical treatises of Gentile da Fo- ligno, who was papal physician and performed a public dis- section at Padua in 1341,^ is found a brief argument against Galen's fifth aphorism.* But such criticism or opposition
^ Moses ben Maimon, Apho- risms, 1489. "Incipiunt aphorismi excellentissimi Raby Moyses se- cundum doctrinam Galieni medi- corum principis . . . coUegi eos ex verbis Galieni de omnibus libris suis. . . . Et ego protuli super his aflforismis quedam dicta que circumspexi et ea m.eo nomine nominavi et similiter protuli ali- quos aphorismos aliquorum mod- ernorum quos denominavi eorum nomine."
* Ed. C. V. Daremberg, Notices et Extraits dcs manuscrits mcdi- caux, 1853, pp. 44-47, Greek text; pp. 229-33, French translation.
* Garrison, History of Medicine, 2nd edition, 1917, p. 141. But at p. 151 Garrison would seem mistaken in stating that Gentile died in 1348, for in the MS of which I shall speak in the next footnote his treatise on critical days is dated back in the year 1362: "Tractatus de enumeratione die- rum creticorum m'i Gentilis anni 1362," at f ol. 125 ; while at fol. 162 we read, "Explicit questio . . . m'i Zentilis anno Domini 1359 de
mense marcii, et scripta Pisis de mense octobris 1359." It is pos- sible but rather unlikely that the dates later than 1348 refer to the labors of copyists. Venetian MSS contain not only a De reductione medicinarum isd actum by Gen- tile, written at Perugia in April, 1342 (S. Marco, XIV, 7, 14th cen- tury, fols. 44-48) ; but also "Sug- gestions concerning the pestilence which was at Genoa in 1348," by him (S. Marco, XIV, 26, 15th century, fols. 99-iGO, consilia de peste quae fuit lanuae anno 1348). Valentinelli's catalogue of the MSS in the Library of St. Mark's does not help, however, to clear up the question when Gentile died, since in one place (IV, 235) Va- lentinelli assures us that he died at Bologna in 13 10, and in another place (V, 19) says that he died at Perugia in 1348.
* Cortona no, early years of 15th century, fol. 128, Rationes Gentilis contra Galenum in quinto aphorismi. This MS contains sev- eral other works by Gentile da Foligno.
IV
GALEN i6s
only shows how generally Galen was accepted as an author- ity.