Galen On Anatomical Procedures

Dissection might be a religious experience for Galen, but most practitioners studied anatomy for guidance in surgical operations, the treatment of traumatic injuries, ulcers, fistulae, and abscesses. Systematic dissection was essential preparation for the surgeon, because a practitioner without anatomical knowledge could inadvertently or negligently injure his patients. Where the surgeon could choose the site of incision, knowledge of anatomy would allow him to do the least damage possible. On the other hand, if the surgeon had to sever muscles to treat an abscess, his anatomical knowledge would allow him to predict subsequent damage and thus escape blame.

Anatomy could also be used to settle larger philosophical issues, such as the controversy about the seat of reason in the human body. Aristotelians placed reason in the heart, while others placed it in the head. One Aristotelian argument was that the voice, which is the instrument of reason, came from the chest. Thus, Galen's demonstration that the recurrent laryngeal nerves control the voice vindicated those who argued for control by the brain and explained what happened when surgeons accidentally severed these nerves. Galen thought that it was unnecessary to justify research by tenuous links to practical benefits, but, of course, he did not have to prepare grant proposals or yearly progress reports.

Until the sixteenth century, Galen was generally accepted as the ultimate authority on anatomical and physiological questions despite the fact that, because of Roman prohibitions on human dissections, his ''human anatomy'' was based on dissection of other species. Often critical of his predecessors, especially Erasistratus and Herophilus, Galen obviously envied their resources and privileges. Certainly, Galen did not conceal the fact that his work was based on studies of other animals, including pigs, elephants, or that ''ridiculous imitation of man,'' the Barbary ape.

While Galen could not do systematic human anatomies, this does not mean that he never studied human cadavers. His extensive anatomical experience made it possible for him to put fortuitous opportunities to good advantage. On one occasion, a flood washed a corpse out of its grave and deposited the body on the bank of the river; the flesh rotted away, but the bones were still closely attached to each other. The enthusiasm with which Galen described such events suggests their rarity, but some scholars believe that certain passages in On Anatomical Procedures suggest that human dissection may have been performed on criminals left unburied and exposed infants. As Celsus had suggested, a physician could learn a good deal about the form and functions of the internal organs by exploiting the wounds and injuries of his patients as ''windows'' into the body. Certainly, Galen would have taken full advantage of the opportunities he had enjoyed while binding up the gruesome wounds of the gladiators. Indeed, Galen told his readers that when observing wounds, physicians who had prepared themselves by systematic dissection of animals knew ''what to expect, but the ignorant learn nothing thereby.''

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