Medical Sects and
Galen
Tensions in Ancient Medicine
Rationalists
 Hippocratics
 Theory guided
medical practice
 Speculative
 Humoural theory
 Anatomy &
Physiology
Empiricists
 Medical knowledge
gained by
experience
 Training in the art
of observation
 Empiricist
medicine still an art
 Still separated medicine from other
healers
 Apprenticeship model of medical
education persisted until 19th century
Rise of the Methodists
(1st Century CE)
 Challenged
both Rationalist and
Empiricist medicine
 All illness result of either constriction
or dilation of pores of body
 Denied
the learned basis of medicine
 Anyone could learn medicine in 6
months
Thumbing Noses at Learned
Medicine
Hippocrates:
Life is short, the art
long, opportunity
fleeting,
experiment
dangerous and
judgment difficult
Methodists:
Life is long and the
art is short.
Galen of Pergamon
(129-c.219 CE)
 Born
in what is now Turkey
 Son of an architect
 Began medical studies at age 16
 Studied in Alexandria
 Travelled widely in Egypt
 Began
medical practice in late 20s
 Physician to the gladiators in
Pergamon
 Moved to Rome
 Gained
fame for
– Public anatomical displays
– His philosophical acumen
– His successful medical treatments of the
elite
 Why
– He
– He
– He
– He
was Galen successful?
was
was
was
was
a
a
a
a
Roman citizen
member of the elite
shameless self-promoter
prolific writer
The Context of Galen’s Practice
 Regarded
himself as Hippocrates’
heir
 In some ways, he invented
Hippocrates
 Loathed the Methodists
 Systematized
 Believed
universe
 Believed
Hippocratic medicine
in a divinely ordered
it could only be discerned
through reason and intellect
Elaborating Hippocrates
 Extended
the humoural theory
 Believed
it confirmed Plato’s tripartite
human soul
– Liver (nutrition)
– Heart (vitality)
– Brain (reason/sensation)
 Humoural
theory also extended
Aristotelian physics
– Four
– Four
– Four
– Four
humours
elements
seasons
primary qualities
Galen’s Innovations:
Nosology
 Classification of diseases
 Diagnosis
 Prognosis
 Diseases are specific entities, not
malleable
Galen’s Contributions
Experimentation
 Groundbreaking work in anatomy &
physiology
 Existence of psychosomatic disease
 Belief in primacy of reason
 Diminished
the work of those he
disagreed with
 Plagiarized the work of those he did
agree with
Medieval Medicine
(c. 400- 1000 BCE)
 Split
in Roman Empire
– 4th century BCE
 Eastern
Empire
– Byzantine
– Greek speaking
– Centred in Constantinople (now
Istanbul)
 Constantinople
century
 Empire
sacked in 14th
reduced to city & its
hinterland
 Western
– Latin speaking
– Centred in Rome
 Rome
sacked in 410 CE
 Political,
social, & economic chaos
 De-urbanization
– Return to agricultural economy
 Loss
of trade relationships
 Loss
of traditional ways of
transmitting knowledge
– Decline in intellectual life
– No centres of higher learning
– Few masters training apprentices in
medicine
 Often
referred to as the “Dark Ages”
 Result
was 2 types of medical
literature
1.Latin
– Encyclopedia
– commentary
2.Vernacular
– Written by lay people
– e.g.: Old English (Anglo Saxon) texts
– Date from 10th century
 Leechbook
of Bald
 Lacnunga
 Non
theoretical
 Drawn
from diverse sources
 Indications
of pre-Christian traditions
– Magic
 Overlaid
with Christian elements
 Impact
of rise of Christianity
– Issues of adjustment between “pagan”
& Christian thought
1.Intellectual
– What causes disease
– What cures disease
2.Practical
– Healing institutions
 Healing
shrines
 Hospices
 Monasteries
Medicine in Islam
Or How the East Saved
Western Medicine
Important Variables
 Former
Greek
 Political
 Greek
Eastern Roman empire spoke
stability
speaking physicians from the
old eastern empire moved further
east
Islamic Empire
 Mohammed
 After
(d. 632 C.E.)
his death, new faith spread
rapidly in Arabian peninsula

By 642 C.E.:
–
–
–
–
Armenia
Mesopotamia
Much of Persia
Much of Egypt

By 743 C.E.:
–
–
–
–
–
–
North Africa
Much of Spain
Almost France
Persia
Kashmir
Punjab
The Islamic World c. 730 C.E.
The Islamic Intellectual World
 Centred
in Bagdad
 Presence
of Greek speaking
intellectuals
 Sponsored
by Islamic court
 Translations
of Greek medical texts
 Muslim
intellectuals drawn to rigour
of Greek philosophy & medicine
 100
texts by Galen translated
 Muslim
intellectuals sought to build
on the work already done
Both faithful to Greek/Roman
traditions & innovative
Integrated their own knowledge of
remedies
Advances in surgical procedures
Rhazes (865-925 C.E.)
 Differentiated
measles
between small pox and
 Much
more difficult than it may
appear
 Other
Muslim physicians described
person-to-person spread of disease
Ibn Sina (Avicenna) 980-1037 C.E.
 Distinguished
between episodic
diseases and epidemics
 Believed air was the principal vehicle
for spreading disease
 Also, “evil eye”
Later Western Medicine’s
Assessment of Islamic Medicine
 Described
 Unfair
as unoriginal
on several counts
– Great respect for tradition
– Difficulties associated with translation
Islamic Medicine’s Legacy
 Preserved
and advanced early
western medicine
 Avicenna
– Prolific writer
– The Cannon
– Became known as the “Galen of Islam”
Spain under Muslim Rule
 Important
site for re-entry of ancient
medicine into medieval Europe
 Contribution
of Spanish Jews
– Moses Maimonides
 Philosopher
& physician
 Guide for the Perplexed