Diana - So we know that the Romans were practicing some forms of medicine in the second century AD, but how much did they really understand about the human body? Professor Vivian Nutton studies the history of medicine at University College London, but one particular physician he works on is Galenus of Pergamon. Vivian, when and where was Galenus practising?
Vivian - Galen was born in 129AD in the Greek speaking area of what is now Turkey. He trained at Alexandria in Egypt and then he spent 60 years or more of his life in Rome as a practitioner, as a doctor to a succession of Roman emperors. He’s really a Roman doctor.
Diana - And he was quite the anatomist as well so how did he actually look at the anatomy of the human body?
Vivian - He believed that anatomy was the key to medicine. He himself had never dissected human specimens successively. What he did was he took – he was a surgeon so he had surgical training but he believed in practising surgery on animals to look and see how a living body worked. He used skeletons. He used his surgical practice and he used experiments on animals.
Diana - Was he actually allowed to look at human bodies in the second century AD?
Vivian - No, not really. There’s a taboo rather than a legal prohibition. He could certainly see skeletons and he advised people to take the best opportunity they could to look at a body. For instance, wander over a battlefield and poke around in corpses or look at somebody hanging from a gibbet.
Diana - Yuk. You’ve managed to locate the document that describes some of his work. Where did you find it and what does it add to the story?
Vivian - Well I’ve been working on a text which has been almost forgotten for five hundred years. It’s called ‘On problematical movements of the body’ in which Galen tries to understand how the body works which is the relationship between the brain and other parts of the body. He asks all the right questions and comes up with all the wrong answers.
Diana - And what exactly are those wrong answers?
Vivian - He believes very strongly that the brain, if you like, controls things. Many people believe the brain worked through nerves. He then said well, possibly it doesn’t always work through nerves. Sometimes, he says for the tongue: it is filled with air. When you stick your tongue out the brain sends signals that pump air into the tongue. Alternatively, he said each part of the body may in some way communicate directly like a living being with the brain. He sees each part of the body as having, in a sense, life within it and an almost independent existence that can talk to the brain and chat with the brain. If the brain thinks of something that part of the body immediately responds.
Diana - If each part of the body has effectively its own soul – and I feel a bit like that sometimes I have to say – then how did Galenus describe our control over it?
Vivian - he believed that sometimes the brain sometimes directly controls things through nerves. He did enormous amounts of experiments on nerves. Effectively he discovered many new pathways of the nerves. For him the brain and nerves work together. At times this thing doesn’t quite work. Certainly it isn’t a conscious decision and one of the things he talks about in the book is the relationship between consciousness and activity. Do we do things because we want to do – because we decide to do or does imagination play a role?
Diana - And how did his findings feed into practical medicine of today – or even medieval medicine?
Vivian - his views became dominant in medieval medicine, except that the medieval people, on the whole, took his conclusions without his experimental attitude. He believed in experimental dissection. The sixteenth century re-discovered the merits of dissection as the very basis for human anatomy. For a long while Galen’s views, taken up by his later followers dominated but he didn’t believe in the circulation of blood. Gradually his ideas fell out of fashion. In one sense they don’t contribute but in another they do because they stimulated lots of people to think about anatomy and the role of anatomy in practical medicine.
Diana - What else can we learn from his approach to medicine?
Vivian - What one can learn is two things: the first is that to be a doctor you’ve got to observe and he’s an enormously powerful observer. The second thing is that he says if you observe you also need to think. That is a powerful message that he gives and very important for any doctor today: linking observation and thinking.