The Feuding Physician of Ancient Rome

Interview with classicist and scholar of the history of medicine Luis Alejandro Salas

Galen of Pergamum wrote his way into history as one of the most important medical minds in the annals of science and philosophy. “It’s hard to overstate how deeply Galen has influenced medicine in the Islamic and European traditions,” says Luis Alejandro Salas, a Faculty Fellow and assistant professor of classics. “His writing was of central importance to elite medical practice through the 16th century.” Harnessing the power of the page (and the 4 million words he left behind), Galen broadened his sphere of influence far beyond the streets of 2nd-century CE Rome, where competing factions engaged in vigorous debate and splashy experimentation to substantiate their ideas and discredit those of their competitors.

How did Galen’s doctrine come to dominate Western and Arabic medicine for close to 1500 years? Read on for a preview of Salas’ current book project, “Cutting Words: Polemical Dimensions of Galen’s Anatomical Experiments.”

Galen of Pergamum (129–ca. 216 CE)

Briefly, what is your book about? What new contribution to your field does this project make?

“Cutting Words” examines a series of narratives in the work of Galen of Pergamum, an influential Greek physician and philosopher writing in the late 2nd century CE, about anatomical experiments. Often these experiments were public, spectacular, and part of a broader competitive discourse among Greek and Roman intellectuals of the time. I use Galen’s accounts of these experiments to explore his intellectual and professional engagement with rival practitioners, painting a fuller picture of what theoretical issues were at stake in his own work and how medical debate in the 2nd century played out in the public sphere. One of my aims in writing this book has been to contribute to a growing movement among scholars of Greco-Roman antiquity that engages with science writing as a part of the rich range of ancient literary production rather than as writing apart from it.

Set the scene for us: what was medical practice like in the 2nd century CE Greco-Roman world?

A theme that runs throughout “Cutting Words” is that experiments (and accounts of them) often perform a credentialing or licensing function in the Greco-Roman world. Throughout Greco-Roman antiquity there were no diplomas or white coats, no socially sanctioned places of medical practice or learning like hospitals and universities. We are so accustomed to a multitude of culturally accepted signs of professional authority that it can be difficult to imagine how patients and practitioners alike might make judgments about legitimacy in their absence. We see that public demonstrations were one way in which this kind of social function was fulfilled for ancient Greeks and Romans. One important takeaway from this observation is that for them professional legitimacy was a highly contested space, in which intellectual elites, especially in the bustling world of 2nd century Rome, strove for authority in dazzling displays of learning, technical skill, and dramatic persuasion.

What were some of the hotly debated questions?

I’ll mention a general and a specific question that were subjects of intense debate in the 2nd century. First a general point of dispute: what degree of theoretical modeling was acceptable in medical theory and practice? If surviving literature accurately reflects the situation on the ground, philosophers and physicians were keenly focused on this question from at least the 3rd century BCE to the 3rd century CE. Anatomy played a role in this debate but not as you might expect, since an influential medical tradition thought that the conclusions drawn from anatomical observations turned out to be too theoretical for their comfort (the story is fascinating but too long to fit here!).

One of the particular disputes you would be likely to hear a lot about involves the location of identity in the body. The two main candidates for its place were the heart and the brain, with an astounding array of arguments for each position. Perhaps Galen’s most famous experiment is aimed at establishing that the body’s control center is in the brain. In the experiment, which was conducted before a public audience, he would block a series of nerves responsible for voice production to show that the brain is the source of sensory-motor function rather than the heart, typically by dissection or ligation. These experiments were performed exclusively on animal subjects, often chosen to maximize the effect of the spectacle on audience-goers.    

Sixteenth-century woodcut illustration of Galen’s experiments to determine the brain’s role in regulating behavior. In an age when dissecting human cadavers was taboo, animal models were the most important source for anatomical learning. Image source.

What was Galen’s standing within this culture, and what were the important practices and tactics he used to establish his authority and discredit his rivals? Why were those effective in this particular culture?

Some of what I’ve said already bears on Galen’s strategies in establishing his professional authority. One of the arguments that I make in my book is that Galen leverages book technology to (re)perform the sorts of public demonstrations typically held before a live audience for readers, whose experience of these experiments was not limited by the practical considerations of a live performance. Galen’s written performances and reading audiences were not limited by time, place, or by the many observational challenges that might affect members of a live anatomical demonstration.  

It’s both easy and hard to answer your first question. First the easy answer: Galen, like nearly all of the voices that survive in literature from Greece and Rome, was a cultural elite. Most practicing physicians would not have enjoyed the wealth or education that he did. For example, by the middle of his career Galen was a physician to one emperor, Marcus Aurelius, and by the end of it to his son, Commodus.

It is more difficult to answer what Galen’s standing was among other intellectual elites of his day. The main source for Galen’s career is, well, Galen. But, while we don’t have very much independent evidence for his career outside of his own words (there is some), his influence even immediately after his death in the early 3rd century CE was profound.

How does this book connect to your broader research interests? Where might it lead next?

Right now I’ve been working on different forms of knowledge classification or data management in the 2nd century (Galen makes an appearance of course). In particular, I’m investigating how animal taxonomies were used to support arguments about human anatomy on the basis of analogy to the anatomy of other animals. My interest in taxonomical models has also led me to investigate systems for the definition and classification of disease, mainly between the 3rd century BCE and Galen’s time, the 2nd century CE.

Check out Luis Salas’ interview with the Hold That Thought podcast below to hear more about 2nd-century Rome’s medical rivalries and a revealing story about the dissection of an elephant’s heart.