GALEN OF PERGAMUM (130-201)

161 – Rome, Italy

Bust of GALEN

GALEN

‘A body of work consisting 129 volumes. Some of the deductions were wrong’

Born in Pergamum (now Bergama in Turkey) in the reign of the Emperor Hadrian (76-138AD)
Studied in Corinth and Alexandria
157 – became surgeon to the Pergamum gladiators
161 – became physician to the emperors Marcus Aurielius and Commodus

Famous for the sheer volume of medical thought which he presented. He summarized his observations in books such as ‘On The Usefulness of Parts of The Body’. His works on medical science became accepted as the only authority on the subject for the following 1400 years. One explanation is that Galen not only incorporated the results of his own findings in his texts, but also compiled the best of all other medical knowledge that had gone before him into a single collection, such as that of Hippocrates.
In particular, Galen adopted Hippocrates’ ‘four humors’ approach to the body. This resulted from a desire to see in bodily conditions the attributes of the four Aristotelian elements. Thus earth was reflected in the body as black bile or melancholy; air as yellow bile or choler; fire as blood and water as phlegm.

After the move to Rome in 161 Galen became physician to emperors Marcus Aurelius, Lucius Verus, Commodus and Septimus Severus. This position allowed him the freedom to undertake dissection in the quest for improved knowledge.
Galen was not permitted to scrutinise human cadavers, so he dissected animals and Barbary apes. His most important conclusions concerned the central operation of the human body. Sadly they were only influential in that they limited the search for accurate information for the next millennia and a half.

Many people visited the shrine of Asklepios, the god of healing in Galen’s hometown, to seek cures for ailments and Galen observed first-hand the symptoms and treatment of diseases. After spells in Smyrna (now Izmir), Corinth and Alexandria studying philosophy and medicine and incorporating work on the dissection of animals, he returned to Pergamum in 157, where he took a position as physician to gladiators, giving him further first-hand experience in practical anatomical medicine. He realized that there were two types of blood flow from wounds. In one the blood was bright red and came spurting out, and in the other it was dark blue and flowed out in a steady stream. These observations convinced him these were two different types of blood. He also believed there was a third form of blood that flowed along nerves.

Galen believed that blood was formulated in the liver, the source of ‘natural spirit’. In turn this organ was nourished by the contents of the stomach that was transported to it. Veins from the liver carried blood to the extremes of the body where it was turned into flesh and used up, thus requiring more food on a daily basis to be converted into blood. Some of this blood passed through the heart’s right ventricle, then seeped through to the left ventricle and mixed with air from the lungs, providing ‘vital spirit’ which then passed into the body through the arteries and regulated the body’s heat. A portion of this blood was transported to the brain where it blended with ‘animal spirit’, which was passed through the body by the nerves. This created movement and the senses. The combination of these three spirits managed the body and contributed to the make-up of the soul. It was not until 1628 that WILLIAM HARVEY‘s system of blood circulation conclusively proved the idea of a single, integrated system.

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WILLIAM HARVEY (1578-1657)

1628 – London, England

‘Circulation of the blood’

Portrait of WILLIAM HARVEY ©

WILLIAM HARVEY M.D.

As WILLIAM GILBERT had begun in physics, and FRANCIS BACON had subsequently implored, Harvey was the first to take a rational, modern, scientific approach to his observations in biology. Rather than taking the approach of the philosophers, which placed great emphasis upon thinking about what might be the case, Harvey cast aside prejudices and only ‘induced’ conclusions based on the results of experiments and dissections, which could be repeated identically again and again.

After what GALEN had begun and VESALIUS had challenged, Harvey credibly launched perhaps the most significant theory in his field of biology. He postulated and convincingly proved that blood circulated in the body via the heart – itself little more than a biological pump.

Galen had concluded that blood was made in the liver from food, which acted as a fuel, which the body used up, thereby requiring more food to keep a constant supply. Vesalius added little to this theory. Harvey, physician to Kings James I and later Charles I proved his theory of circulation through rigorous and repeated experimentation. He correctly concluded that blood was not used up, but is recycled around the body.

An illustration depicting William Harvey (April 1, 1578 - June 3, 1657), the medical doctor credited with first describing the properties of the human circulatory system, seeing a patient. ©

 

His dissections proved that the arteries took blood from the heart to the extremities of the body, able to do so because of the heart’s pump-like action. He could see that the pulses in arteries came immediately after the heart contracted, and became certain that the pulse was due to blood flowing into the vessels.
By careful observation he found that blood entered the right side of the heart and was forced into the lungs, before returning to the left side of the heart. From there it was pumped via the aorta into the arteries around the body.

Harvey realized that the amount of blood flowing around the system was too much for the liver to produce. The blood had to be circulating back to the veins; which, with their series of one-way valves, brought blood back to the heart.
Without a microscope it was impossible to see the minute capillaries that linked the arteries to the veins.

Exercitatio anatomica de motu cordis et sanguinis in animalibus William Harvey (1628)

Harvey published his findings in the 720 page ‘Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus‘ ( Anatomical Exercise on the Motion of The Heart and Blood in Animals ) at the Frankfurt Book Fair in 1628.

Initially supported by some academics, an equal number rejected his ideas. One area of weakness was that he was unable to offer a proven explanation for how the blood moved from the arteries to the veins. He speculated that the exchange took place through vessels too small for the human eye to see, which was confirmed shortly after his death with the discovery of capillaries by Marcello Malphigi with the recently invented microscope.

Even then, nobody knew what blood was doing. It would take another hundred years before ANTOINE LAVOISIER discovered oxygen and worked out what it did in the body.

In 1651, Harvey published ‘Exercitationes de Generatione Animalium‘ ( Essays on the Generation of Animals ), a work in the area of reproduction which included conjecture that rejected the ‘spontaneous generation’ theory of reproduction which had hitherto persisted. His belief that the egg was at the root of life gained acceptance long before the observational proof some two centuries later.

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