REFUTATION OF THE CHARGES OF COWARDICE MADE AGAINST GALEN By JOSEPH WALSH, M.D. PHILADELPHIA, PA. UMEROUSN and successful anceship (xix, 16) with some of its investigations in anatomy well-known medical men, he went to and physiology elevated Smyrna (11, 217; v, 112) fifty miles Galen to a unique pedestal. to the south, and took two years of While agreeing on this eminence, and a post-graduate course. Still dissatis- rightly so, modern medical historians fied with his knowledge, and with the also agree, though wrongly, in making repute of the University of Alexandria him out a coward. This has not only in mind, he made the six hundred reflected an unfavorable light on him mile journey and spent five years as a man to be imitated, but has under the influence of the world tended to impair his standing as a renowned Egyptian Museum or Tem- scientist. With the evidence before ple of the Muses (11, 217; vn, 635; x, us, that his life was a manifestation of 53 et seq.; xvih, 806). resolution and courage, it is a satis- Four of the five summers in Alex- faction in this year, the eighteenth andria he suffered from an intermit- centenary of his birth1 to refute the tent fever, due he thought to overwork slander. and improper eating, though possibly He has been accused of cowardice a continuation of the condition which on two counts: First, that he ran away made him delicate as a child. in a discreditable fashion from an He returned home in the summer uprising associated with, or endanger- of the fifth year ill with what he diag- ing, his native city Pergamum in nosed as an abscess between his liver Asia Minor;2 second, that he ran away and diaphragm (vi, 756), but what I from a pestilence in Rome. For a believe was a right pleural effusion, complete understanding of his conduct because he became well on bleeding in both instances, a little sketch of his as suggested to him by Aesculapius life and times is necessary. in a dream (xi, 314; xvi, 222) appar- Delicate in childhood (vi, 309)3 ently in the celebrated shrine of that Galen took the studies commonly god in Pergamum.4 pursued in the elementary grades from After recovery he entered on his his father, but at the age of fourteen career at the age of twenty-eight we find him in attendance at the (xiii , 599), having spent eleven years philosophical school (v, 41 et seq.). in medical schools. He was a brilliant He entered medicine in his native and industrious student, and had city Pergamum at the age of seven- profitted by every hour of this pro- teen still a little delicate (vi, 309, tracted course. As a consequence, 755) , and finished at twenty-one. within a year his repute was such Shortly before, his father died (vi, that he was appointed to the impor- 756) and left him such a competence tant post of physician to the gladia- that he never knew the need of tors: important to him on account money (v, 44 et seq.; xiv, 623). of its prominence and the associated Enthused by personal acquaint- practice of surgery, important to subsequent ages because it gave him the experiment on other pigs, and a well-equipped operating room and then on many other domestic as well animals without number to dissect as the wild animals of the amphi- and experiment on. theater, like the lion, and even the In Smyrna he had studied under long-necked crane and ostrich6 with Pelops, one of the two or three best the result that their peculiar cry or known medical teachers in the empire. utterance was invariably lost, he In agreement with his contemporaries the great Pelops incorrectly taught realized he had the nerve of speech that the diaphragm alone controlled which if cut or interfered with would respiration and that the expansion prevent man from talking (11, 218; of the chest walls was produced by iv, 278; xiv, 629 et seq.). the expansion of the lungs (11, 657). This not only meant the discovery From frequent dissections Galen early of the function of the recurrent laryn- recognized the additional action of the geal nerve, but practically the dis- intercostal muscles. Taking up this covery of the function of the brain, investigation into the mechanics of since it was commonly taught to be breathing he learned so much that for the cooling of the blood. The popu- almost nothing remained to be added. lar argument backed by the authority He described for us the diaphrag- of the philosophers Aristotle, Chrysip- matic muscle, its innervation, and pus and Diogenes of Babylon was: what happens when one and both we talk with the vocal cords, the phrenic nerves are cut. He was the impulse to their movement comes first to note the obliquity and decussa- from the lungs, intelligence must be tion of the fibers of the intercostal some place neighboring, and probably muscles and to explain the reason in the heart (v, 241). therefor, namely, that one part was In fact later in Rome, while he was active in the expansion, the other in promulgating this discovery, his op- contraction of the chest walls. He ponents brought forward what ap- sectioned the nerves to the inter- peared to them an absolutely clinch- costals and watched the action of the ing comparison (v, 245): diaphragm alone. Finally he showed “Urine,” they said, “is passed the influence of the thoracic muscles through the urethra by the compres- (11, 660-680; hi , 409 et seq.; iv, 465 sion of the bladder wall; words are et seq.). passed through the larynx by the The importance of this magnificent compression of the lungs,—it would piece of work can scarcely be over- be as logical to say that urine comes estimated, yet while pursuing it he from the brain as that speech does.” lighted on another discovery much Just as he had concluded these two more dramatic and interesting: I remarkable investigations on the am referring to the nerve of speech.5 mechanics of breathing and the func- Sectioning one at a time each of the tion of the recurrent laryngeal nerve, nerves entering the thorax to learn if and in the midst of the peace and it had an influence on breathing, he quiet of his charming native city was cut the recurrent laryngeal, and to pursuing others of equal importance his amazement the pig previously of which we will speak later, there squealing became silent. Repeating was an uprising of the Parthians (xiv, 622, 647, 648) under their new intelligence. Their continuance, how- and enterprising ruler Vologeses hi . ever, made it difficult to carry on Proceeding from the interior of other work, especially his beloved Asia the Parthians advanced to Elcgia in Armenia where they annihilated a Roman Army of about 11,000 men7 marching to intercept them. Elegia is 800 miles east of Pergamum, but with the principal Asiatic contingent of the Roman army destroyed, Asia Minor naturally became alarmed. The barbarians, however, instead of ad- vancing on the cities of Pergamum, Smyrna, Ephesus and Rhodes, turned their steps southward toward Antioch, the Eastern Capital of the Empire,3 and never came within 700 miles of Pergamum. The uprising took place in March 161 a .d .,9 and Vologeses’ first success was practically speaking also his last, for although he actually moved his army almost to the walls of Antioch and took some of the lesser cities on the way, he got no further. In the meantime legions with more com- research. Now was the time to learn petent generals from Moesia, Pan- what was being done in the much nonia, Noricum, Rhetia, Gaul, Brit- talked of philosophical and medical ain, Italy and Africa began to pour schools of the Capital and he pro- by land through Asia Minor, and by ceeded to take advantage of it. The boat through Antioch, and before a very fact that he intended (xiv, 622) year had passed the danger to Per- to return and did return, shows that gamum and the other coastal cities he did not leave under discreditable was removed. circumstances. It was about six months later, in In spite of the fact, however, that other words, somewhat more than a Vologeses and his army never came year and a half after the war began, within seven hundred miles of Perga- and six months after the crisis had mum, a thirty-live day march, it subsided that Galen made up his mind might still be asked why Galen did to visit Rome.10 Pergamum was gain- not enlist? To answer this requires ing in courage daily with the constant only the slightest comprehension of success of the Imperial troops, but military conditions at the time. conditions were far from normal. The standing army of the Empire The activities at the beginning of the was composed of thirty legions of revolt in which he was glad to partici- Roman soldiers, which together with pate, had settled down to an estab- the auxiliaries impressed from the lished routine requiring but little provinces amounted to over 300,000 fighting men.11 Some of these were exempted by law, even in great stationed in Italy, particularly in the emergencies. Among these were ofli- CapitaI,Hmt the great majority were cials of government, priests, physi- distributed over the various frontiers. cians,13 philosophers, sophists and sev- On every side beyond the Roman eral other varieties of teachers. And boundaries were barbarians, and the all of them accepted their prerogative, frequency of revolt can be seen from except of course, those who wished to the fact that during the nineteen-year enlist in the regular army.