philosopher as well as for the physician. An understanding of the
use of the parts of the body is helpful to the doctor, he says, but
much more so to “the philosopher of medicine who strives to obtain
knowledge of all nature.”[654] In the _De usu partium_[655] 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 modern 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.
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,[656] whom he wishes the
philosophers would reveal to him more clearly and tell him “whether he
is some wise and powerful god.”[657] 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.[658] He thinks that
nature alone cannot show such wisdom. He has, however, sought vainly
from philosopher after philosopher for a satisfactory demonstration of
the existence of God, and is by no means certain himself.[659]
[Sidenote: Queries concerning the soul.]
Galen is also at a loss concerning the existence and substance 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,[660] but Galen questions this,
nor is he ready to accept the Platonic world-soul theory of a divine
force permeating all nature.[661] 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 knowledge 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 reasoning
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.[662]
[Sidenote: No supernatural force in medicine.]
In commenting upon the works of Hippocrates, Galen insists that in
speaking of “something divine” in diseases 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
reference to the effect of the surrounding air.[663] 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 partium_
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 eyebrows 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 cartilaginous 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.”[664] As between the views on God of
Moses and Epicurus, Galen prefers to steer a middle course.
[Sidenote: Galen’s experimental instinct.]
Already in describing Galen’s dissections and tests with the pulse
we have seen evidence of the accurate observation and experimental
instincts which accompanied his zest for hard work and zeal for truth.
In one of his treatises he confesses that it was a passion of his
always to test everything 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.”[665] Galen also recognized that general theories
were not sufficient for exact knowledge and that specific examples
seen with one’s own eyes were indispensable.[666] 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.[667] Galen more than once
declared that things, not names, were important and refused to waste
time in disputing about terminology and definitions which might be
spent in “pursuing the knowledge of things themselves.”[668] 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.
[Sidenote: Attitude towards authorities.]
Galen did not believe in merely repeating in new books the statements
of previous authorities. Ever since boyhood, 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.[669] Nevertheless in some of his writings he
collects the prescriptions 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 occasion, however,
after stating that Crito had combined previous treatises upon
cosmetics, including the work of Cleopatra, into four books of his
own which constitute a well-nigh exhaustive treatment of the subject,
Galen says that he sees no profit in copying Crito’s work again and
merely reproduces its table of contents.[670] 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 dogmas, or misinterpreting and perverting the teachings
of the ancients.[671] His method was rather first to “make haste and
stretch every nerve to learn what the most celebrated of the ancients
have said;”[672] then, having mastered this teaching, 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.
[Sidenote: Adverse criticism of past writers.]
This critical employment of past authorities is frequently illustrated
in Galen’s works. He mentions a great many names of past physicians
and writers, thereby shedding some 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.[673] 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,[674] or praises individuals like Heras who give
specific information.[675] 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.[676] Galen declares that one could
spend a lifetime in reading the books that have already been written
upon medicinal simples. He urges his readers, however, to abstain
from Andreas and other liars of that stamp, and above all to eschew
Pamphilus who never saw even in a dream the herbs which he describes.
[Sidenote: Galen’s estimate of Dioscorides.]
Of all previous writers upon _materia medica_ Galen preferred
Dioscorides. He writes, “But Anazarbensis Dioscorides in five books
discussed all useful material not only of herbs but of trees and fruits
and juices and liquors, treating besides both all metals and the
parts of animals.”[677] Yet he does not hesitate to criticize certain
statements of Dioscorides, 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.[678]
He also wonders that Dioscorides described butter as made of the milk
of sheep and goats, and correctly states that “this drug” is made from
cows’ milk.[679] 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 chapter 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.[680] Galen further criticizes Dioscorides for
his unfamiliarity with the Greek language and consequent failure to
grasp the significance of many Greek names.
[Sidenote: Galen’s dogmatism: logic and experience.]
Daremberg said of Galen that he represented at the same time the most
exaggerated dogmatism and the most advanced 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 Hippocratic dogmas such
as the four qualities theory, he thought[681] that in medicine as in
geometry there were a certain number of self-evident maxims upon which
reason, conforming to the rules of logic, might build up a scientific
structure. In the _De methodo medendi_[682] he makes a distinction
between the discovery of drugs and medicines, simple or compound, by
experience and the methodical treatment of disease which he now sets
forth and which should proceed logically 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.[683] At the same time he expresses his dislike for mere
dogmatizers who shout their _ipse dixits_ like tyrants without the
support either of reason or experience.[684] 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.[685] Indeed, he is of the opinion that some doctors would
do well to stick to experience 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.[686] Later on in the same work[687] 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 experience.
[Sidenote: Galen’s account of the Empirics.]
Normally, however, Galen upholds both reason and experience as
criteria of truth against the opposing schools of Dogmatics and
Empirics. The former attacked experience as uncertain and impossible
to regulate, slow and unmethodical. The latter replied that experience
was consistent, adaptable to art, and proof enough.[688] Galen’s
chief objection to the Empirics is that they reject reason as a
criterion of truth and wish the medical art to be irrational.[689]
“The Empirics say that all things are discovered by experience, but
we say that some are found by experience and some by reason.”[690]
Galen also objects to Herodotus’s explanation of the medical art as
originating in the conversation of patients exposed at crossroads who
told one another of their complaints and recoveries and thus evolved
a fund of common experience.[691] Galen criticizes such experience
as irrational and not yet put into scientific form (οὔπω λογική). Of
the Empirics he tells us further that they regard phenomena only and
ignore causes and put no trust in reasoning. They hold that there is
no system or necessary order in medical discovery or doctrine, and
that some remedies 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.[692] 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 Empirics themselves say that past tradition or “history”
(ἱστορία) should not be judged by experience, but it is unlikely that
he represents their view correctly in this particular. In another
passage[693] 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[694] 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[695] he says that the Empirics
observe coincidences in things joined by experience. He himself defines
experience as the comprehending and remembering of something seen
often and in the same condition,[696] and makes the good point that
one cannot observe satisfactorily without use of reason.[697] He also
admits in one place that some Empirics are ready to employ reason as
well as experience.[698]
[Sidenote: How the Empirics might have criticized Galen.]
Having noted Galen’s criticism of the Empirics, we may imagine what
their attitude would be towards his medicine. They would probably
reject all his theories—which we, too, have finally discarded—of
four elements and four qualities and the like, and would accept only
his specific recommendations for the cure of disease based upon
his medical experience; 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 animals, since he tells us that they
“have written whole books against anatomy.”[699] 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 credulity as
to particulars was a weakness.
[Sidenote: Galen’s standard of reason and experience.]
On the whole Galen’s attitude towards experience seems an improvement
upon theirs. He was apparently more critical towards the “experiences”
of past writers than the average Empiric, and in his combination of
reason and experience 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.[700] 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.[701] “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.”[702] “What can you do with men who cannot
be persuaded either by reason or by practice?”[703] 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.[704] 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 general law of nature.
[Sidenote: Simples knowable only from experience.]
It is perhaps in his work on medicinal simples that Galen lays most
stress upon the importance of experience. Indeed he sees no other way
to learn the properties of natural objects than through the experience
of the senses.[705] “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?”[706] 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 treatise, 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.”[707] Moreover, he restricts his account of medicinal
simples to those with which he is personally acquainted. 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.[708] 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
physicians but unknown to him. He dares not trust their statements 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 unconsciously, 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 seagull[709] and some of those claimed for the marine
animal called torpedo.[710] Anointing the place with frog’s blood or
dog’s milk will not prevent eyebrows that have been plucked out from
growing again, nor will bat’s blood and viper’s fat remove hair from
the arm-pits.[711] Also the brain of a hare is only fairly good for
boys’ teeth.[712]
[Sidenote: Experience and food science.]
In beginning his work on food values[713] Galen states that many have
discussed the properties of aliments, some on the basis of reason
alone, some on the basis of experience alone, but that their statements
do not agree. On the whole, since reasoning is not easy for everyone,
requiring natural sagacity 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.
[Sidenote: Experience and compounds.]
The Empirics contended that most compound medicines had been hit upon
by chance, and Galen grants that the Dogmatics usually are unable to
give reasons for the ingredients of their doses and find difficulty
in reproducing a lost prescription.[714] 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.[715]
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.[716] On the other hand, we see
how much depends upon experience from his confession 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 continue to use it, sometimes making it stronger
and sometimes weaker.[717] For as you cannot put together compounds
without rational method, so you cannot tell their strength certainly
and accurately without experience.[718] He admits that no one can
tell the exact quantity of each ingredient to employ without the
aid of experience,[719] and says, “The proper proportions in the
mixture we shall find conjecturally before experience, scientifically
after experience.”[720] 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.[721]
Sometimes, however, he expresses a preference for the medicines 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.[722] We suspect, however, that some of these prescriptions
had not been tested for centuries.
[Sidenote: Suggestions of experimental method.]
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.[723] 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
experiences are required.[724] Medicinal simples should be frequently
inspected, “since the knowledge of things perceived by the senses is
strengthened by careful examination.”[725] Galen advises 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 from one or two experiences.[726] However, he
suggests that their effect be noted in the three cases of a perfectly
healthy person, a slightly ailing patient, and a really sick man.[727]
In the last case one should further note their varying effects as the
disease is marked by any excess of heat, cold, dryness, or moisture.
Care should be taken that the simples themselves are pure and free
from any admixture of a foreign substance.[728] “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.”[729] 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.[730]
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 before the water, which is the heavier
(_sic?_).[731]
[Sidenote: Difficulty of medical experiment.]
Galen also points out some of the difficulties of medical
experimentation. One is the extreme unlikelihood of ever being able
to observe in even two cases the same combination of symptoms and
circumstances.[732] The other is the danger to the life of the patient
from rash experimenting.[733] Thus Galen more than once tells us of
abstaining from testing some remedy because he had others of whose
effects he was surer.
[Sidenote: Empirical remedies.]
In the treatise on easily procurable remedies ascribed to Galen,[734]
in which we have already seen evidence of later interpolation or
authorship, some recipes are concluded by such expressions as,
“This has been experienced; it works unceasingly,”[735] or “Another
remedy tested by us in many cases.”[736] This became a custom in many
subsequent medical works, including those of the middle ages. One
recipe is introduced by the caution, “But don’t cure anybody unless you
have been paid first, for this has been tested in many cases.”[737] But
we are left in some doubt whether we should infer that remedies tested
by experience are so superior 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 _experimentum_ was used a great deal as a synonym for any medical
treatment, recipe, or prescription. Galen approaches this usage, which
we have already noticed in Pliny’s _Natural History_, when he describes
“a very important experiment” in bleeding performed by certain doctors
at Rome.[738]
[Sidenote: Galen’s influence upon medieval experiment.]
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 experience and reason as criteria of truth.[739]
Gilbert of England cites “experiences from the book of experiments
experienced by Galen,”[740] 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[741] which he gives for
discovering experimentally the properties 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 the works of Galen.[742] 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 _Commentaries on Isaac on Diets_.[743]
We have already suggested Galen’s possible influence upon Albertus
Magnus, and we might add Roger Bacon who wrote some treatises on
medicine. 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.
[Sidenote: His more general medieval influence.]
The more general influence of Galen upon all sides of the medicine
of the following fifteen centuries has often been stated in sweeping
terms, but is difficult to exaggerate. His general theories, his
particular cures, his occasional marvelous stories, were often repeated
or paraphrased. Oribasius has been called “the ape of Galen,” and we
shall see that the epithet might with equal reason be applied to Aëtius
of Amida. Indeed, as in the case of Pliny, we shall find plenty of
instances of Galen’s influence in our later chapters. 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 alternative 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.”[744] 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
treatise,” as they themselves state.[745]
Not that medieval men did not make additions of their 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), Mesuë
(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.”[746] Not that Galen was
not sometimes criticized 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 infallible.[747] Among the medical
treatises of Gentile da Foligno, who was papal physician and performed
a public dissection at Padua in 1341,[748] is found a brief argument
against Galen’s fifth aphorism.[749] But such criticism or opposition
only shows how generally Galen was accepted as an authority.
III. _His Attitude Towards Magic_
From Galen’s habits of critical estimation rather than blind
acceptation of authority, of scientific observation, careful
measurement, and personal experiment, from his brilliant demonstrations
by dissection, and his medical prognostication and therapeutics, sane
and shrewd for his time,—from these we have now to turn to the other
side of the picture, and examine what information his works afford us
concerning the magic and astrology in ancient medicine, concerning the
belief in occult virtues, suspensions, characters, incantations, and
the like. We may first consider what he has to say concerning magic and
divination as he understands those words, and then take up his attitude
to those other matters which we look upon as almost equally deserving
classification under those heads.
[Sidenote: Accusations of magic against Galen.]
Apollonius of Tyana and Apuleius of Madaura were not the only
celebrated men of learning in the early Roman Empire to be accused of
magic; we have already alluded to the charges of magic made against
Galen by the envious physicians of Rome during his first residence
in that city. It is hard to escape the conviction that at that time
learned men were very liable to be suspected or accused of magic.
Indeed, Galen makes the general assertion that when a physician
prognosticates aright concerning the future course of a malady, this
seems so marvelous to most men that they would receive him with great
affection, if they did not often regard him as a wizard.[750] Soon
after saying this, Galen begins the story of the prognostications
he made and the cure he wrought, when all the other doctors took an
opposite view of the case.[751] One of them then jealously suggested
that Galen’s diagnosis was due to divination.[752] When asked by what
kind of divination, he gave different answers at different times
and to different persons, sometimes saying by dreams, sometimes by
sacrificing, again by symbols, or by astrology. Afterwards such charges
against Galen kept multiplying.[753] As a result, Galen says that
since then he has not gone about advertising his prognostications
like a herald, lest the physicians and philosophers hate him the more
and slander him as a wizard and diviner, but that he now reveals his
discoveries only to his friends.[754] In another treatise he represents
Hippocrates as saying that a proficient doctor should be able to
prognosticate the course of diseases, but adds that contemporary
physicians call such a doctor a sorcerer and wonder-worker (γόητά τε
καὶ παραδοξολόγον).[755] Again in his work on medicinal simples[756]
he states that he abstained from testing the supposed virtue of
crocodile’s blood in sharpening the vision, and the blood of house mice
in removing warts, partly because he had other reliable eye-medicines
and cures for warts—such as _myrmecia_, a gem with wart-like lumps,
partly because by employing such substances he feared to incur the
reputation of a sorcerer, since jealous physicians were already
slandering his medical prognostications as divination. This last
passage affords a good illustration of the close connection with magic
of certain natural substances supposed to possess marvelous virtues,
while Galen’s wart stone also seems magical to the modern reader.
[Sidenote: His charges of magic against others.]
Galen himself sometimes calls other physicians magicians. Certain men
with whom he does not agree are called by him “liars or wizards or I
don’t know what to say,”[757] and another man who used mouse dung to
excess he calls superstitious and a sorcerer.[758] In the same work
on simples[759] he says that he will list herbs in alphabetical order
as Pamphilus did, but that he will not like him descend to old wives’
tales, Egyptian sorceries and incantations, amulets and other magical
devices, which not only do not belong in the medical art but are
utterly false. Pamphilus never saw most of the herbs he mentioned,
much less tested their virtues, but copied anything he found, piling
up names, incantations, and wizardry. Galen accuses Xenocrates
Aphrodisiensis also of not having eschewed sorcery, and he notes
that medical writers have either said nothing about sweat or what is
superstitious and bordering upon magic.[760]
[Sidenote: Charms and wonder-workers.]
Philters, love-charms, dream-draughts, and imprecations Galen regards
as impossible or injurious, and intends to have nothing to do with
them. He thinks it ridiculous to believe that by such spells one can
bewitch one’s adversaries so that they cannot plead in court, or
conceive or bear children. He considers it worse to advertise and
perpetuate such false or criminal notions in writings than to practice
such a crime but once.[761] In one passage,[762] however, to illustrate
his theory that the gods prepare the sperms of plants and animals, and
set them going as it were, and afterwards leave them to themselves,
Galen compares them to the wonder-workers—who were perhaps not
magicians but men similar to our sidewalk fakirs who exhibit mechanical
toys—who start things moving and then go away themselves while what
they have prepared moves on artificially for a time.
[Sidenote: Animal substance inadmissible in medicine.]
Galen’s own works are not entirely free from the magical devices of
which he accuses others. We may begin with animal substances, since
he himself has testified that the use of sweat, crocodile’s blood,
and mouse’s dung is suggestive of magic. Moreover, he attributes more
bizarre virtues to the parts of animals than to herbs or stones. In
a passage somewhat similar to that in which Pliny[763] expressed his
horror at the use of human blood, entrails, and skulls as medicines,
Galen declares that he will not mention the abominable and detestable,
as Xenocrates and some others have done. The Roman law has long
forbidden eating human flesh, while Galen regards even the mention of
certain secretions and excrements of the human body as offensive to
modest ears.[764] Nevertheless, before long he offends against his
own standard and describes how he administered to patients the very
substance which he had before characterized as most unmentionable.[765]
It may also be noted that he repeats unquestioningly such a tale as
that the cubs of the bear are born unformed and licked into shape by
their mother.[766]
[Sidenote: Nastiness of ancient medicine.]
Further milder illustrations of the fact that such nasty substances
were then not merely recommended in books but freely employed in actual
medical practice, are seen in the frequent use by one of Galen’s
teachers of the dung of dogs who for two days before had eaten nothing
but bones,[767] in Galen’s own wonderfully successful treatment of a
tumor on a rustic’s knee with goat dung—which is, however, too sharp
for the skins of children or city ladies,[768] and in his discovery by
repeated experience that the dung of doves who take little exercise
is less potent than that of those who take much,[769] Galen also says
that he has known of doctors who have cured many persons by giving them
burnt human bones in drink without their knowledge.[770]
[Sidenote: Parts of animals.]
Galen’s medicinal simples include the bile of bulls, hyenas, cocks,
partridges, and other animals.[771] A digestive oil can be manufactured
by cooking foxes and hyenas, some alive and some dead, whole in
oil.[772] Galen discusses with perfect seriousness the relative
strength of various animal fats, those of the goose, hen, hyena, goat,
pig, and so forth.[773] He decides that lion’s fat is by far the
most potent, with that of the pard next. Among his simples are also
found the slough of a snake, a sheepskin, the lichens of horses, a
spider’s web,[774] and burnt young swallows, for whose introduction
into medicine he gives Asclepiades credit.[775] Of Archigenes’
prescriptions for toothache he repeats that which recommended holding
for some time in the mouth a frog boiled in water and vinegar, or a
dog’s tooth, burnt, pulverized, and boiled in vinegar.[776] Cavities
may be filled with toasted earthworms or spiders’ eggs diluted with
unguent of nard. Teething infants are benefited, if their gums are
moistened with dog’s milk or anointed with hare’s brains.[777] For
colic he recommends dried cicadas with three, five, or seven grains of
pepper.[778]
[Sidenote: Some scepticism.]
Galen is less confident as to the efficacy for earache of the
multipedes which roll themselves up into a ball, and which, cooked in
oil, are employed especially by rural doctors.[779] He is still more
sceptical whether the liver of a mad dog will cure its bite.[780] Many
say so, and he knows of some who have tried it and survived, but they
took other remedies too.[781] Galen has heard that some who trusted to
it alone died. In one treatise[782] Galen discusses the strange virtues
of the basilisk in much the usual way, but in his work on simples[783]
he remarks drily that it is obviously impossible to employ it in
pharmacy, since, if the tales about it be true, men cannot see it and
live or even approach it without danger. He therefore will not include
it or elephants or Nile horses (hippopotamuses?) or any other animals
of which he has had no personal experience.
[Sidenote: Doctrine of occult virtue.]
Galen tries to find some satisfactory explanation of the strange
properties which he believes exist in so many things. The attractive
power of the magnet and of drugs suggests to him that nature in us is
divine, as Homer says, and leads like to like and thus shows its divine
virtues.[784] Galen rejects Epicurus’s explanation of the magnet’s
attractive power.[785] It was that the atoms flowing off from both the
magnet and iron fit one another so closely that the two substances
are drawn together. Galen objects that this does not explain how a
whole series of rings can be suspended in a row from a magnet. Galen’s
teacher Pelops, who claimed to be able to tell the cause of everything,
explained why ashes of river crabs are used for the bite of a mad dog
as follows.[786] The crab is efficacious against hydrophobia because it
is an aquatic animal. River crabs are better for this purpose than salt
water crabs because salt dries up moisture. He also thought the ashes
of crabs very potent in absorbing the venom. But this type of reasoning
is unsatisfactory to Galen, who finds the best explanation of all such
action in the peculiar property, or occult virtue, of the substance
as a whole. Upon this subject[787] he proposes to write a separate
treatise, and in the fragment _De substantia facultatum naturalium_
(περὶ οὐσίας τῶν φυσικῶν δυνάμεων) he again discusses the matter.[788]
[Sidenote: Virtue of the flesh of vipers.]
Among parts of animals Galen regarded the flesh of vipers as especially
medicinal, particularly as an antidote to poisons. Of the following
cures wrought by vipers’ flesh which Galen narrates[789] two were
repeated without giving him credit by Aëtius of Amida in the sixth,
and Bartholomew of England in the thirteenth century, and doubtless by
other writers. When Galen was a youth in Asia, some reapers found a
dead viper in their jug of wine and so were afraid to drink any of it.
Instead they gave it to a man near by who suffered from the terrible
skin disease elephantiasis and whom they thought it would be a mercy to
put quietly out of his misery. He drank the wine but instead of dying
recovered from his disease. A similarly unexpected cure was effected
when a slave wife in Mysia tried to kill her husband by offering him
a like drink. A third case was that of a patient whom Galen told of
these two previous cures. After resorting to augury to learn if he too
should try it and receiving a favorable response, the patient drank
wine infected by venom with the result that his elephantiasis changed
into leprosy, which Galen cured a little later with the usual drugs.
A fourth man, while hunting vipers, was stung by one. Galen bled him,
extracted black bile with a drug, and then made him eat the vipers
which he had caught and which were prepared in oil like eels. A fifth
man, warned by a dream, came from Thrace to Pergamum. Another dream
instructed him both to drink, and to anoint himself with, a concoction
of vipers. This changed his disease into leprosy which in its turn was
cured by drugs which the god prescribed.
[Sidenote: Theriac.]
The flesh of vipers was an important ingredient in the famous antidote
and remedy called theriac, concerning which Galen wrote two special
treatises[790] besides discussing it in his works on simples and
antidotes. Mithridates, like King Attalus in Galen’s native land,
had tested the effects of various drugs upon condemned criminals,
and had thus discovered antidotes against spiders, scorpions,
sea-hares, aconite, and other poisons. He then combined the results
of his research into one grand compound which should be an antidote
against any and every poison. But he did not include the flesh of the
viper, which was added with some other changes by Andromachus, chief
physician to Nero.[791] The divine Marcus Aurelius used to take a dose
of theriac daily and it had since come into general use.[792] Galen
gives a long list of ills which it will cure, including the plague
and hydrophobia,[793] and adds that it is beneficial in keeping a man
in good health.[794] He advises its use when traveling or in wintry
weather, and tells Piso that it will prolong his life.[795] He explains
more than once[796] how to prepare the viper’s flesh, why the head
and tail must be cut off, how it is cleaned and boiled until the flesh
falls from the backbone, how it is mixed with pounded bread into pills,
how the flesh of the viper is best in early summer. Galen also accepts
the legend,[797] quoting six lines of verse from Nicander to that
effect, that the viper conceives in the mouth and then bites off the
male’s head, and that the young viper avenges its father’s death by
gnawing its way out of its mother’s vitals. The _Marsi_ at Rome denied
the existence of the _dipsas_ or snake whose bite causes one to die of
thirst, but Galen is not quite sure whether to agree with them.
[Sidenote: Magical compounds.]
Already we have had occasion to refer to Galen’s two works on compound
medicines which occupy the better part of two bulky volumes in Kühn’s
edition and contain a vast number of prescriptions. It is not uncommon
for one of these to contain as many as twenty-five ingredients.
It seems unlikely that such elaborate concoctions would have been
discovered by chance, as the Empirics held, but the modern reader is
ready to agree that it was chance, if anyone was ever cured of anything
by one of them. Yet Galen, as we have seen, believes that reasons can
be given for the ingredients and would not for a moment admit that they
are no better than the messes of witches’ cauldrons. He argues that, if
all diseases could be cured by simples, no one would use compounds, but
that they are essential for some diseases, especially such as require
the simultaneous application of contrary virtues.[798] Also where a
simple is too strong or weak, it can be toned up or down to just the
right strength in a compound. Plasters and poultices seem always to be
compounds. Of panaceas Galen is somewhat more chary, except in the case
of theriac; he opines that a medicine which is good for a number of
ills cannot be very good for any one of them.[799]
[Sidenote: Amulets.]
Procedure as well as substances suggestive of magic is found to some
extent in Galen’s works. He instructs, for example, to pluck an
herb with the left hand before sunrise.[800] He also recommends the
suspension of a peony to cure epilepsy.[801] He saw a boy who wore this
root remain free from that disease for eight months, when the root
happened to drop off and the boy soon fell in a fit. When another peony
root was hung about his neck, he remained in good health until Galen
for the sake of experiment removed it a second time, whereupon another
epileptic fit ensued as before. In this case Galen suggests that
perhaps some particles from the root were drawn in by the patient’s
breathing or altered the surrounding air. In another passage he holds
that there is no medical reason to account for the virtues of amulets,
but that those who have tested them by experience say that they act by
some marvelous antipathy unknown to man.[802] A ligature recommended by
Galen is to bind about the neck of the patient a viper which has been
suffocated by tying several strings, preferably of marine purple, about
its neck.[803] Galen marvels that _stercus lupinum_, even when simply
suspended from the neck, “sometimes evidently is beneficial.”[804] It
should not have touched the ground but should have been taken from
trees or bushes. It also works better, as Galen has found in his own
practice, if suspended by the wool of a sheep who has been torn by a
wolf.
[Sidenote: Incantations and characters.]
While Galen thus employs ligatures and suspensions and sanctions
magic logic, he draws the line at use of images, characters, and
incantations. In the passage just cited he goes on to say that he has
found other suspended substances efficacious, but not the barbarous
names such as wizards use. Some say that the gem jasper comforts the
stomach if bound about the abdomen,[805] and some wear it in a ring
engraved with a dragon and rays,[806] as King Nechepso directs in his
fourteenth book. Galen has employed it suspended about the neck without
any engraving upon it and found it equally beneficial. In illustrating
the virtue of human saliva, especially that of a fasting man, Galen
tells of a man who promised him to kill a scorpion by means of an
incantation which he repeated thrice. But at each repetition he spat
on the scorpion and Galen afterwards killed one by the same procedure
without any incantation, and more quickly with the spittle of a fasting
than of a full man.[807]
[Sidenote: Belief in magic dies hard.]
The preceding paragraph gives a good illustration of the slow
progress of human thought away from magic and towards science. Men
are discovering that marvels can be worked as well without characters
and incantations. Similar passages may be found in Arabic and Latin
medieval writers. But while Galen questions images and incantations,
he still clings to the notions of marvelous virtue in a fasting man’s
spittle or in a gem suspended about the neck. And these and other
passages in which he clung to old superstitions were unfortunately
equally influential upon succeeding writers, who sometimes, we fear,
took them as an excuse for further indulgence in magic. Indeed, we
shall find Alexander of Tralles in the sixth century arguing that Galen
finally became a believer in the efficacy of incantations. Thus the old
notions and practices die hard.
[Sidenote: _On easily procurable remedies._]
In the treatise on easily procurable remedies, where popular and rustic
remedies enter rather more largely than in Galen’s other writings,
superstitious recipes are also met with more frequently, and, if that
be possible, the doses become even more calculated to make one’s
gorge rise, it being felt that the unfastidious tastes and crude
constitutions of peasants and the poorer classes can stand more than
daintier city patients. Another reason for separate consideration of
the contents of this treatise is the possibility, already mentioned,
that it is interpolated and misarranged, and the fact that it is in
part of much later date than Galen.
[Sidenote: Specimens of its superstitious contents.]
We must limit ourselves to a hasty survey of a few specimens of its
prescriptions. Following Archigenes, ligatures and crowns are employed
for headaches.[808] In contrast to Galen’s previous scepticism
concerning depilatories for eyebrows we now find a number mentioned,
including the blood of a bed-bug.[809] To cure lumbago,[810] if the
pain is in the right foot, reduce to powder with your right hand the
wings of a swallow. Then make an incision in the swallow’s leg and draw
off all its blood. Skin it and roast it and eat it entire. Then anoint
yourself all over with the oil for three days and you will marvel at
the result. “This has been often proved by experience.” To prevent
hair from falling out take many bees and burn them and mix with oil
and use as an ointment.[811] For a sty in the eye catch flies, cut
off their heads, and rub the sty with the rest of their bodies.[812]
A cooked black chameleon performs the double duty of curing toothache
and killing mice.[813] To extract a tooth in the upper jaw surround it
with the worms found in the tops of cabbages; for a lower tooth use the
worms on the lower parts of the leaves.[814] Pain in the intestines
will vanish, if the patient drinks water in which his feet have been
washed.[815] A net transferred from a woman’s hair to the patient’s
head acts as a laxative, especially if the net is first heated.[816]
Various superstitious devices are suggested to insure the birth of a
child of the sex desired.[817] Bituminous trefoil,[818] boiled and
applied hot, cures snake or spider bite, but let no one use it who
is not so afflicted or it will make him feel as if he was.[819] For
cataract is recommended a mixture of equal parts of mouse’s blood,
cock’s gall, and woman’s milk, dried.[820] For pain on one side of
the head or face smear with fifteen earthworms and fifteen grains of
pepper powdered in vinegar.[821] To stop a cough wear the tongue of
an eagle as an amulet.[822] Wearing a root of rhododendron makes one
fearless of dogs and would cure a mad dog itself, if it could be tied
on the animal.[823] A “confection” covering three pages is said to
prolong life, to have been used by the emperors, and to have enabled
Pythagoras, its inventor, who began to make use of it at the age of
fifty, to live to be one hundred and seventeen without disease. “And he
was a philosopher and unable to lie about it.”[824]
[Sidenote: External signs of the temperaments of internal organs.]
It remains to note what there is in Galen’s works in the way of
divination and astrology. We are not entirely surprised that
contemporary doctors confused his medical prognostic with divination,
when we read what he has to say concerning the outward signs of hot
or cold internal organs. In the treatise, entitled _The Healing Art_
(τέχνη ἰατρική),[825] which Mewaldt says was the most studied of
Galen’s works and spread in a vast number of medieval Latin manuscript
translations,[826] he devotes a number of chapters to such subjects
as signs of a hot and dry heart, signs of a hot liver, and signs of a
cold lung. Among the signs of a cold brain are excessive excrements
from the head, stiff straight red hair, a late birth, mal-nutrition,
susceptibility to injury from cold causes and to catarrh, and
somnolence.[827]
[Sidenote: Marvelous statements repeated by Maimonides.]
In his commentary on the _Aphorisms_ of Hippocrates Galen adds
other signs by which it may be foretold whether the child will be a
boy or girl to those signs already mentioned by Hippocrates.[828]
Some of these seem superstitious enough to us. And it was a case of
the evil that men do living after them, for Moses Maimonides, the
noted Jewish physician of Cordova in the twelfth century, in his
collection of _Aphorisms_, drawn chiefly from the works of Galen,
repeats the following method of prognostication: _Puerum cum primo
spermatizat perscrutare, quem si invenis habere testiculum dextrum
maiorem sinistro_, you will know that his first child will be a male,
otherwise female. The same may be determined in the case of a girl
by a comparison of the size of her breasts. Maimonides also repeats,
from Galen’s work to Caesar on theriac,[829] the story of the ugly man
who secured a beautiful son by having a beautiful boy painted on the
wall and making his wife keep her eyes fixed upon it. Maimonides also
repeats from Galen[830] the story of the bear’s licking its unformed
cubs into shape.[831]
[Sidenote: Dreams.]
In another treatise on _Diagnosis from Dreams_ Galen makes a closer
approach to the arts of divination.[832] He states that dreams
are affected by our daily life and thought, and describes a few
corresponding to bodily states or caused by them. He thinks that if
you dream you see fire, you are troubled by yellow bile, and if you
dream of vapor or darkness, by black bile. In diagnosing dreams one
should note when they occurred and what had been eaten. But Galen also
believes that to some extent the future can be predicted from dreams,
as has been testified, he says, by experience.[833] We have already
mentioned the effect of his father’s dream upon Galen’s career. In
the Hippocratic commentaries[834] he says that some scorn dreams and
omens and signs, but that he has often learned from dreams how to
prognosticate or cure diseases. Once a dream instructed him to let
blood between the index and great fingers of the right hand until
the flow of blood stopped of its own accord. “It is necessary,” he
concludes, “to observe dreams accurately both as to what is seen and
what is done in sleep in order that you may prognosticate and heal
satisfactorily.” Perhaps he had a dim idea along Freudian lines.
[Sidenote: Lack of astrology in most of Galen’s medicine.]
In the ordinary run of Galen’s pharmacy and therapeutics there is very
little mention or observance of astrological conditions, although
Hippocrates is cited as having said that a study of geometry and
astronomy—which may well mean astrology—is essential in medicine.[835]
In the _De methodo medendi_ he often urges the importance of the time
of year, the region, and the state of the sky.[836] But this expression
seems to refer to the weather rather than to the position of the
constellations. The dog-star is also occasionally mentioned,[837] and
one passage[838] tells how “Aeschrion the Empiric, ... an old man most
experienced in drugs and our fellow citizen and teacher,” burned live
river crabs on a plate of red bronze after the rise of the dog-star
when the sun entered Leo and on the eighteenth day of the moon. We are
also informed that many Romans are in the habit of taking theriac on
the first or fourth day of the moon.[839] But Galen ridicules Pamphilus
for his thirty-six sacred herbs of the horoscope—or decans, taken from
an Egyptian Hermes book.[840] On the other hand, one of his objections
to the atomists is that “they despise augury, dreams, portents, and all
astrology,” as well as that they deny a divine artificer of the world
and an innate moral law to the soul.[841] Thus atheism and disbelief in
astrology are put on much the same plane.
[Sidenote: _The Prognostication of Disease by Astrology._]
Whereas there is so little to suggest a belief in astrology in most
of Galen’s works, we find among them two devoted especially to
astrological medicine, namely, a treatise on critical days in which the
influence of the moon upon disease is assumed, and the _Prognostication
of Disease by Astrology_. In the latter he states that the Stoics
favored astrology, that Diodes Carystius represented the ancients as
employing the course of the moon in prognostications, and that, if
Hippocrates said that physicians should know physiognomy, they ought
much more to learn astrology, of which physiognomy is but a part.[842]
There follows a statement of the influence of the moon in each sign
of the zodiac and in its relations to the other planets.[843] On this
basis is foretold what diseases a man will have, what medical treatment
to apply, whether the patient will die or not, and if so in how many
days. This treatise is the same as that ascribed in many medieval
manuscripts to Hippocrates and translated into Latin by both William of
Moerbeke and Peter of Abano.
[Sidenote: Critical days.]
The treatise on critical days discusses them not by reason or dogma,
lest sophists befog the plain facts, but solely, we are told, upon the
basis of clear experience.[844] Having premised that “we receive the
force of all the stars above,”[845] the author presents indications of
the especially great influence of sun and moon. The latter he regards
not as superior to the other planets in power, but as especially
governing the earth because of its nearness.[846] He then discusses
the moon’s phases, holding that it causes great changes in the air,
rules conceptions and birth, and “all beginnings of actions.”[847] Its
relations to the other planets and to the signs of the zodiac are also
considered and much astrological technical detail is introduced.[848]
But the Pythagorean theory that the numbers of the critical days are
themselves the cause of their significance in medicine is ridiculed,
as is the doctrine that odd numbers are masculine and even numbers
feminine.[849] Later the author also ridicules those who talk of seven
Pleiades and seven stars in either Bear and the seven gates of Thebes
or seven mouths of the Nile.[850] Thus he will not accept the doctrine
of perfect or magic numbers along with his astrological theory. Much
of this rather long treatise is devoted to a discussion of the
duration of a moon, and it is shown that one of the moon’s quarters
is not exactly seven days in length and that the fractions affect the
incidence of the critical days.
[Sidenote: _On the history of philosophy._]
A treatise on the history of philosophy, which is marked “spurious” in
Kühn’s edition, I have also discovered among the essays of Plutarch
where, too, it is classed as spurious.[851] In some ways it is
suggestive of the middle ages. After an account of the history of Greek
philosophy somewhat in the style of the brief reviews of the same to
be found in the church fathers, it adds a sketch of the universe and
natural phenomena not dissimilar to some medieval treatises of like
scope. There are chapters on the universe, God, the sky, the stars, the
sun, the moon, the _magnus annus_, the earth, the sea, the Nile, the
senses, vision and mirrors, hearing, smell and taste, the voice, the
soul, breathing, the processes of generation, and so on.
[Sidenote: Divination and demons.]
In discussing divination[852] the treatise states that Plato and the
Stoics attributed it to God and to divinity of the spirit in ecstasy,
or to interpretation of dreams or astrology or augury. Xenophanes and
Epicurus denied it entirely. Pythagoras admitted only divination by
_haruspices_ or by sacrifice. Aristotle and Dicaearchus admit only
divination by enthusiasm and by dreams. For although they deny that
the human soul is immortal, they think that there is something divine
about it. Herophilus said that dreams sent by God must come true.
Other dreams are natural, when the mind forms images of things useful
to it or about to happen to it. Still others are fortuitous or mere
reflections of our desires. The treatise also takes up the subject of
heroes and demons.[853] Epicurus denied the existence of either, but
Thales, Plato, Pythagoras, and the Stoics agree that demons are natural
substances, while heroes are souls separate from bodies, and are good
or bad according to the lives of the men who lived in those bodies.
[Sidenote: Celestial bodies.]
The treatise also gives the opinions of various Greek philosophers on
the question whether the universe or its component spheres are either
animals or animated. Fate is defined on the authority of Heracleitus
as “the heavenly body, the seed of the genesis of all things.”[854]
The question is asked why babies born after seven months live, while
those born after eight months die.[855] On the other hand, a very brief
discussion of how the stars prognosticate does not go into particulars
beyond their indication of seasons and weather, and even this
Anaximenes ascribed to the effect of the sun alone.[856] Philolaus the
Pythagorean is quoted concerning some lunar water about the stars[857]
which reminds one of the waters above the firmament in the first
chapter of Genesis.