Galen by Vivian Nutton;

Author:Vivian Nutton; [Vivian Nutton]
Language: eng
Format: epub
ISBN: 9780367357221
Publisher: Taylor & Francis (Unlimited)
Published: 2020-11-15T00:00:00+00:00

5 Galen the doctor

The good doctor

Around the year 178 Galen wrote a treatise offering advice on how to choose a physician. He believed this to be necessary because Rome was filled with charlatans and fortune-hunters, eager for gain and ignorant of the Hippocratic principles of proper medicine. Patients, too, unless they were in such pain as to choose the first healer available, were liable to be swayed by fashion, flattery and unscrupulous promises. Some of this was the fault of the wealthy sufferers themselves, addicted to pleasure and frivolity rather than sober philosophical learning, but much could be laid at the feet of the doctors too. In Rome, an anonymous metropolis where medical failure could easily pass unnoticed, choosing a doctor or a surgeon might be literally a matter of life and death.1

Galen delivered his advice in the first instance to an audience or readership that already knew him personally or at least had heard of some of his achievements, and he emphasised his own successes as a criterion for judging others. It was an elite audience, literate, well-educated and with the leisure to spend time observing doctors at work and, if necessary, questioning them. Indeed, some of these “medical amateurs” might know far more than most doctors. In the plague, when doctors regularly failed, these laymen were experienced enough to decide simply from smelling a person’s breath whether they should expect the worst.2 Besides, Rome, with its abundance of healers, was very different from a small or isolated town where one was forced to rely on local assistance or wait for a visit from a travelling druggist or the fortuitous arrival of a doctor.3 The aim of this tract was less to instruct a potential patient where someone might be found to provide healing than to show how to discriminate between a range of practitioners, if friends, family, or past experience failed to provide a guide.4

Galen’s first requirement was that the physician should be a Hippocratic, not only because through the art of prognosis one could predict the course of an illness and prepare for it by having to hand the appropriate drugs and instruments, increasing the likelihood of success, but also because a detailed knowledge of the Hippocratic writings would suggest many sound therapies that might otherwise be forgotten.5 A long series of examples of treatment by diet, drugs, emesis, purgation and so on emphasises Galen’s infallibility as a follower of Hippocrates. Reliance on a passage from Aphorisms VI on treating pains in the eyes by drinking neat wine and bathing, advice never acted upon by his teachers or any contemporary, had resulted in years of unfailing success. A Hippocratic method of treating a prolapsed uvea with a series of different lotions gave him the reputation of a wonder-worker or a prophet (something he always denied vigorously, pointing to Hippocratic precedents).6 Above all, the accomplished doctor who wished to follow Hippocrates must also be constantly aware of the individuality of the patient, adapting treatment to fit the particular

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