in ancient Greece, that of the Pneumatists.

Galen and
the Circulation
of the
Blood. It is unnecessary to detail here the various ways in which Galen’s physiological views differ from those of the Moderns, as most of these are noticed in footnotes to the text of the present translation. His ignorance of the circulation of the blood does not lessen the force of his general physiological concluPg xxxvisions to the extent that might be anticipated. In his opinion, the great bulk of the blood travelled with a to-and-fro motion in the veins, while a little of it, mixed with inspired air, moved in the same way along the arteries; whereas we now know that all the blood goes outward by the arteries and returns by the veins; in either case blood is carried to the tissues by blood-vessels, and Galen’s ideas of tissue-nutrition were wonderfully sound. The ingenious method by which (in ignorance of the pulmonary circulation) he makes blood pass from the right to the left ventricle, may be read in the present work (p. 321). As will be seen, he was conversant with the “anastomoses” between the ultimate branches of arteries and veins, although he imagined that they were not used under “normal” conditions.

Galen’s
Character. Galen was not only a man of great intellectual gifts, but one also of strong moral fibre. In his short treatise “That the best Physician is also a Philosopher” he outlines his professional ideals. It is necessary for the efficient healer to be versed in the three branches of “philosophy,” viz.: (a) logic, the science of how to think; (b) physics, the science of what is—i.e. of “Nature” in the widest sense; (c) ethics, the science of what to do. The amount of toil which he who wishes to be a physician must undergo—firstly, in mastering the work of his predecessors and afterwards in studying disease at first hand—makes it absolutely necessary that he should Pg xxxvii possess perfect self-control, that he should scorn money and the weak pleasures of the senses, and should live laborious days.

Readers of the following pages will notice that Galen uses what we should call distinctly immoderate language towards those who ventured to differ from the views of his master Hippocrates (which were also his own). The employment of such language was one of the few weaknesses of his age which he did not transcend. Possibly also his mother’s choleric temper may have predisposed him to it.

The fact, too, that his vivisection experiments (e.g. pp. 59, 273) were carried out apparently without any kind of anaesthetisation being even thought of is abhorrent to the feelings of to-day, but must be excused also on the ground that callousness towards animals was then customary, men having probably never thought much about the subject.

Galen’s
Greek Style. Galen is a master of language, using a highly polished variety of Attic prose with a precision which can be only very imperfectly reproduced in another tongue. Every word he uses has an exact and definite meaning attached to it. Translation is particularly difficult when a word stands for a physiological conception which is not now held; instances are the words anadosis, prosthesis, and prosphysis, indicating certain steps in the process by which nutriment is conveyed from the alimentary canal to the tissues.

Pg xxxviii

Readers will be surprised to find how many words are used by Galen which they would have thought had been expressly coined to fit modern conceptions; thus our author employs not merely such terms as physiology, phthisis, atrophy, anastomosis, but also haematopoietic, anaesthesia, and even aseptic! It is only fair, however, to remark that these terms, particularly the last, were not used by Galen in quite their modern significance.

Summary. To resume, then: What contribution can Galen bring to the art of healing at the present day? It was not, surely, for nothing that the great Pergamene gave laws to the medical world for over a thousand years!

Let us draw attention once more to:

(1) The high ideal which he set before the profession.

(2) His insistence on immediate contact with nature as the primary condition for arriving at an understanding of disease; on the need for due consideration of previous authorities; on the need also for reflection—for employment of the mind’s eye (ἡ λογικὴ θεωρία) as an aid to the physical eye.

(3) His essentially broad outlook, which often helped him in the comprehension of a phenomenon through his knowledge of an analogous phenomenon in another field of nature.

Pg xxxix

(4) His keen appreciation of the unity of the organism, and of the inter-dependence of its parts; his realisation that the vital phenomena (physiological and pathological) in a living organism can only be understood when considered in relation to the environment of that organism or part. This is the foundation for the war that Galen waged à outrance on the Methodists, to whom diseases were things without relation to anything. This dispute is, unfortunately, not touched upon in the present volume. What Galen combated was the tendency, familiar enough in our own day, to reduce medicine to the science of finding a label for each patient, and then treating not the patient, but the label. (This tendency, we may remark in parenthesis, is one which is obviously well suited for the standardising purposes of a State medical service, and is therefore one which all who have the weal of the profession at heart must most jealously watch in the difficult days that lie ahead.)

(5) His realisation of the inappropriateness and inadequacy of physical formulae in explaining physiological activities. Galen’s disputes with Asclepiades over τὰ πρῶτα ἐκεῖνα σώματα τὰ ἀπαθῆ, over the ἄναρμα στοιχεῖα καὶ ληρώδεις ὄγκοι, is but another aspect of his quarrel with the Methodists regarding their pathological “units,” whose primary characteristic was just this same ἀπάθεια (impassiveness to environment, “unimpressionability”). We have of course Pg xl our Physiatric or Iatromechanical school at the present day, to whom such processes as absorption from the alimentary canal, the respiratory interchange of gases, and the action of the renal epithelium are susceptible of a purely physical explanation.4

(6) His quarrel with the Anatomists, which was in essence the same as that with the Atomists, and which arose from his clear realisation that that primary and indispensable desideratum, a view of the whole, could never be obtained by a mere summation of partial views; hence, also, his sense of the dangers which would beset the medical art if it were allowed to fall into the hands of a mere crowd of competing specialists without any organising head to guide