Dawakhan Hakim Ajmal Khan

Jalinoos (Claudius Galen)

Claudius Galen [Jalinoos] was the best physician (hakim) of Asia Minor (The Roman Empire). His work in the field of medicine has influenced ancient Arabs and Greeks for almost fifteen centuries. Jalinoos was an apprentice of Aristotle (Arastoo) and Hippocrates (Buqrat). He was born in 129 A.D. at an ancient Greek city Pergamon, Mysia, Anatolia (Asia Minor), modern Turkey. In 138 A.D., the charge of Pergamon was given to the Roman Republic. Therefore, Galen was a Greek and became the Roman kingdom’s greatest physician (hakim), writer (musanif), researcher (muhaqiq), and philosopher (Mahir e falsafa) after Hippocrates (Buqrat).

Claudius Galen [Jalinoos] was the best physician (hakim) of Asia Minor (The Roman Empire). His work in the field of medicine has influenced ancient Arabs and Greeks for almost fifteen centuries. Jalinoos was an apprentice of Aristotle (Arastoo) and Hippocrates (Buqrat). He was born in 129 A.D. at an ancient Greek city Pergamon, Mysia, Anatolia (Asia Minor), modern Turkey. In 138 A.D., the charge of Pergamon was given to the Roman Republic. Therefore, Galen was a Greek and became the Roman kingdom’s greatest physician (hakim), writer (musanif), researcher (muhaqiq), and philosopher (Mahir e falsafa) after Hippocrates (Buqrat).

Galen’s Family History

Galen of Pergamon was the son of a great mathematician and architect, Aelius Nicon. He was a zealous and committed person blessed with wealth and prosperity. His family was among the slaveholders.

Galen’s mother was irascible, fiery, and brusque. She always fought with Galen’s father. His attachment with his father was more as compared to his mother. Nicon always wanted to see his son on a higher rank in his future.

Impact of parents of Galen’s behavior

Galen’s father Nicon had influenced his life very much. He gave him the best education and schooling to enrich his mind with advanced knowledge. He also worked on his social behavior, moral values, and spiritual beliefs to enlighten his soul. All this led him to become a down-to-earth and noble person with extraordinary mental abilities. He listened to others and respected them. He always believed in his abilities to magnify the truth and made good decisions. Contrary to his mother, Galen tried to avoid a sharp tongue and remain calm. He had chosen a peaceful and painless way for his life. 

Galen’s Early Education (129-146 A.D.)

Claudius Galen took his early education from his father. His father raised his standard in the classic Greek subjects. These included philosophy, logic, mathematics, literature, and geometry. Galen mindlessly followed the route enlightened by his father. His father, being a wealthy person, arranged the best tutors for improving Galen’s philosophical attributes. Therefore, he learned philosophy more than other subjects he did from his childhood to adolescence. The names of his teachers are not exactly mentioned by Galen divulged them in his writing as, ‘a stoic, a pupil of Philopater’, ‘a student of Aspasius the Peripatetic ’, ‘an Epicurean from Athens’, and ‘a Platonist from Gaius’.

Galen Enroot to Medicine (Adviyat) and physiology (ilm e tashreeh)

When Galen was 16, his father Aelius dreamed of Asclepius – a Greco-Roman god of Medicine. It was a turning point in the Jalinoos’ educational history when his career diverted to physiology (Hikmat) and anatomy (ilm e tashreeh). Galen narrated this event in his greatest work ‘On the Order of Own Books’.

Galen always had faith in Asclepius for this virtue. Galen was a mastermind. He spent 14 years of his life from 147 A.D to 157 A.D. in medical training. First, he was sent as a trainee under the supervision of Satyrus (a pupil of Quintus). Satyrus was his first anatomy coach from Smyrna. Later, he got a chance to learn and practice under the supervision of Stratonicus, Ephicianus, and Aeschrion.

Soon, Galen developed a strong belief that we must not follow a single school of thought. It is like mental enslavement. A good physician must have a good command of other disciplines too. Sticking to his notion, he walked into other schools of thought for more understanding. He believed that a combination of good education and refined natural qualities always produces the best scholar. Soon, he made up his mind to leave Pergamon for his educational practice in different disciplines, especially in anatomy and medicine. 

Unfortunately, his father died in 148, when he was 20. Galen was sorrowful at this moment. However, he got an inheritance from his father. Still, he was at his mother’s mercy. In addition, his anatomy tutor, Satyrus returned to Smyrna. Galen has left no reason to stay anymore in Pergamon. He made up his mind to fulfill the dream of his father. He became an elite and eternal student. He went to Smyrna, a renowned city where he had received tutelage from Pelops for one year. Then, he headed towards the Mediterranean region and stayed in Alexandria (Bride of The Mediterranean) for studying medicine and anatomy in detail. He followed Numissianus at Corinth and Alexandria. He spent 5 years (from 152 A.D. to 157 A.D) in Alexandria. In 157 A.D., Galan came back to Pergamon at the age of 28. By this time, he became an eternal student who was inspired by Aristotle and Hippocrates. He keenly studied the work of these two scientists. He spent 12 precious years of his life learning doctrines.

Galen’s Professional History

As a physician of Gladiators in the Temple of Pergamon

After returning to Pergamon, Galen was appointed as a physician of the Temple of Pergamon’s High Priest. Here, he practiced his work for four years and gained expertise in human anatomy. He tried his medications and treatment, initially derived from Aristotle’s work, on Roman swordsmen. He assembled the most comprehensive and elaborated understanding of anatomy by exposure to gladiator’s wounds. The rate of death decreased a lot by his methodologies.

Galen served as a physician in the Temple of Pergamon for three years. However, he became disappointed when he realized that he could not practice all his abilities in Pergamon. Therefore, he left Pergamon and moved towards Rome to refine his skills as both a physician and a philosopher.

Galen holding fame in Rome

In 162 A.D., he headed to the Eternal City of Rome where he stayed for a short period. From 162-163 A.D., he served his old philosophy teacher Eudemus and helped him in recovery from illness by practicing his medications. He also started his practice in anatomy, investigation and explanation, medicine, healing, and physiology on local patients. He not only treated the patients but also gave lectures and wrote down his observations and experiments. He treated many patients during this time. He also introduced his methods and falsified those that were conventionally used.

Jalinoos gained fame due to his exceptional service as a physician with philosophic skills and rich family background. Nevertheless, dealing with Eudemus and a close association with consoler Boethus gave him motivation for continuing his anatomical research. He completed the first part of his writing ‘On the Use of Parts’ before 165 A.D. and sent it to Boethus. He also discovered arteries and recurrent laryngeal nerves. 

Galen’s fame period was accompanied by sedition and a regime change among the oppositions. They were not ready to accept him and his methods. Galen mentioned in his writing that Rome was filled with gold diggers who were playing with human lives. The Roman natives believed in superstitions and credulity. The old Roman physicians were merely practicing their tricks to grasp money from wealthy people. Thessalus (son of Hippocrates) introduced a six months curriculum for locals to indulge them in the study of medicine. Such an attitude and tricks by different physicians had developed a state of intellectual war. This situation convinced Galen to discontinue his practice at Rome in 166 A.D.

Plague (Taoon) spread out as a pandemic in Rome

Another reason behind Galen’s departure from Rome was the plague (Taoon) spread in 165 A.D. This pandemic lasted for 15 years and ended in 180 A.D. Later, Galen invented the treatment of plague (Taoon) in his second visit to Rome.

Galen’s exceptional work and treatment methods caught the sight of consular Flavius Boethius, and then, of Emperor Marcus Aurelius. Marcus Aurelius and Lucius Verus were joint emperors of Rome at that time. Lucius Verus was the adopted brother of Marcus. Marcus called Galen for his services in Aquileia headquarters in 168-169 A.D., where they were engaged in warfare with Germans. At this time, he accepted his invitation and heeded Aquileia towards the military campaigns. After the sudden death of Emperor Lucius Verus in 169 A.D., Marcus instructed Galen to return and work as royal physician of the Roman Empire. After returning from Aquileia (north of Adriatic), he moved to Rome for the rest of his life with Marcus and his son Commodous. At this time, he practiced his methods to cure the locals against Plague (Taoon) disease. He refined and rehearsed his practice along with his writing and research in Rome until his death in 216 A.D. 

Galen’s Work and Achievements

Claudius Galen has contributed much to building the foundation of physiology and medicine. He was not only confined to these two fields only, he also wrote and researched other fields as well. For our ease, we ramify his work and achievement under four broad categories.

Galen as physician (Hakim)

Jalinoos was the best among physicians and unparalleled as a philosopher.

Adulteration in Rome

In ancient times, the old medications and treatment methods were derived from therapeutics (Dafaa E Amraaz) and pharmacology (Ilm Adwiyat). They employ various single herbs and compound medicines (adviyat e murakkabiya) for this purpose. The ancient physicians in Rome were playing a deadly game with local people. They were grasping money from the rich. Adulteration and drugs were common. Galen openly mentioned this evil. Sadly, he got more opposition in response. He said a good physician could always detect such impurities and frauds easily, which was an impossible task for those trained by Thessalus’s six-month physician curriculum.

Role of observation and experimentation

Galen always believed in observation and experimentation power in his anatomical research. He took guidance from previous works of Aristotle. Then, he added his findings to their work via experimental proofing.

Dietotherapy (Ilaj bil Ghiza)

Galen is considered the first scientist who had introduced the concept of Dietotherapy (Ilaj bil Ghiza) in the Unani treatment. He developed this notion when he was dealing with the wounds of gladiators. He proposed that a good diet is necessary to avoid the risk of any disease. We can enjoy a healthy life only if we stick to a healthy diet.

Treatment of Plague (Taoon) disease by Venesection (Nasbandi)

Galen made the initial foundation of Phlebotomy or Venesection (Nasbandi). The great scientist Hippocrates proposed that existence is symbolized by a combination of four elements (arkan) i.e., earth (arz), air (hawa), water (maa), fire (nar). Hippocrates also gave a doctrine of four humor (akhlat) for humans. For humans, he implemented this idea as a set of four humors-bodily fluids (akhlat); blood (dam), phlegm (balgham), black bile (sauda), yellow bile (safra). Galen also refined these groups and added his observations. He observed that a specific organ in our body secreted all these. He added that an illness could be an outcome of an imbalance in any of these fluids.

From early times bloodletting (Venesection) has been used for the treatment of many diseases. But Galen, continuing with the Hippocrates ideology, introduced the bloodletting method as a cure for plague diseases. Plague disease was a pandemic that spread in Rome by soldiers coming back. He added his contribution to Hippocrates’s concept by saying that the most prominent humor-bodily fluid (akhlat) in the human body is blood. This method is so effective that Europe and the Western world still use them. Once it was only limited as a treatment of inflammations and increased iron levels in the ancient world. Galen also worked on the improvement of the Venesection process and debated the efficiency of the method by the power of his writing. He proved the reliance of the method. The Arab and India have employed the venesection process for the treatment of some other diseases.

Galen’s work on Mithridatium (Tariyaaq)

Mithridatium (Tariyaaq) is an antidote that was first formulated by Mithridate IV Eupator (Lord of Pontus). It is a partially mythical remedy formulated as a precautionary measure against Plague (Taoon) and acne (mahasay). It consists of more than 50 natural components including animal flesh and herbs. Mithridatium (Tariyaaq) is an anti-poison that builds up resistance in our immune system to nullify the effect of many poisonous effects. Mithridatium IV saved the recipe of this natural medicine in his court’s cabinet. 

Pompey (a Roman statesman) brought this remedy to ancient Rome, where the recipe was translated into Latin and improved by Andomachus. He confirmed that the recipe contains 55 components in total and 14 out of these 55 components are herbal products.

Galen took part in the research on Mithridatium (Tariyaaqantidote and said that his version of Mithridatium (Tariyaaq) had only 41 components. The concoction made from drying the mixture was usable after storing it for 12 years. He also proved the effectiveness of his product. He gave his concoction to Marcus for 2 months almost and he did not develop any sign of illness. 

Developments in surgical methods (ilm e jirahat)

Galen normally used different birds and animals for dissections to clear his queries. He wrote his results in his compositions. He had used Barbary apes, pigs, goats, and other lower animals by following his perceptions that these have a little functional and structural similarity with humans. This self-exposure to biological bodies improved his surgical skills, which he quoted in his manuscripts.

Galen as Researcher (Muhaqiq)

Anatomical research (ilm e tashreeh)

During his stay at the Temple of Pergamon, he got an opportunity to study human anatomy. He used to deal with gladiator’s wounds and traumas. He took advantage of these exposures to understand the functions and morphology of different body parts (aaza).

Dissection of Human Cadavers (Naish)

Galen was more in the favor of Herophillus and Erasistratus regarding his anatomical research on the structure of the body. Herophillus in Alexandria made the foundation of a school of anatomy (ilm e tashreeh) in old Greeks. He was the first person to dissect the human cadavers (dead bodies) publically. He studied the nervous system and cardiovascular system believing in the four-humor concept of Hippocrates. Erasistratus on the other hand, studied the nervous system, muscular system, and respiration in detail. Galen, deliberately following the footprints of these two, made his observations. He claimed that our brain is involved in the coordination process, not the heart. He falsified the old concept that feeling, sensation, intelligence – these all are associated with the heart, not the brain. 

Dealing with deceptive treatment methods

Locals in Asia Minor had many false notions about different diseases. They were simple people. Due to a lack of advancement in medicine and research, old physicians added up many myths and superstitions for the cure of diseases. They did not try to find the reasons behind an issue. They took it as they wanted to. 

For illustration, there was a myth that a bath with human urine, eating a wolf’s liver, and drinking an elephant’s blood could cure tuberculosis. 

This myth seems ridiculous but old Roman and Greeks believed in such ideas. Galen took a bold step and through his power of pen and experimental tries for suggesting an appropriate method of treatment, he proved himself.

An overview of Galen’s research and observations

 Here is a list of Galen’s observations and conclusions from research on biological systems:

  • He studied the functions and working of the heart (qalb), lungs, nerves (Aasab), muscles (Azlaat), liver, gallbladder, and reproductive organs (Toleedi Aaza).
  • Galen identified the role of the diaphragm in respiration (Amal e Tanaffus).
  • He reported the systolic and diastolic functions of the heart (qalb). He gave the concept of arteries and veins. He was among the first scientists who gave an idea of the circulatory system (Nizam doran e khoon) for blood flow.
  • He identified the 7 bones of the cranium and 16 of the nerves.
  • Jalinoos explained the relationship between tendons and bones. He investigated how the movements result from the combination of bones.
  • He worked on male and female reproductive organs. He exposed that testis in male and ovaries in female takes part in sexual reproduction. This finding opened new ways to secure male and female health from related reproductive issues.
  • Claudius Galen studied the disease related to women (Amraz e Niswan) in detail.
  • He confirmed the unidirectional flow of urine from the kidney to the urethra. Before his confirmation, people believed that urine flows from an organ (azu) other than the kidney.
  • The explanation regarding the coordination of nerves (tashree asab) and the role of the brain and spinal cord was also a huge contribution of Jalinoos in understanding human physiology.

Galen as Writer (Musanif)

As a writer, Galen had eloquent, polemical, polemical, and articulate writings. He wrote more than 20,000 pages of his research and findings. His writings comprise 20 volumes of ancient Greek times. According to an estimation, he was a writer of more than 300 books but we have persevered on only 150 of them. He has mentioned all his work, observation, and results in the form of manuscripts. He wrote his methods and questioned some of the conventional methods that were erroneous and inaccurate. He gave a detailed view of various aspects of physiology, anatomy, medicine, therapeutics, philosophy, and logistics. Galen’s writing seems intemperate at times. This interpretive verbal attitude was somehow a feature of his mother who used to bawl at others to her short-tempered nature.  

Galen’s manuscripts demolished

Woefully, the largest part of his work could not be saved. It is a misfortune that happened in the life of Galen when he was serving as a physician in the Roman Empire. He used to save his compositions and manuscripts in the Temple of Peace. In winter 191 and 192 A.D., a blazing firestorm affected the Roman Empire. This fire affected the Temple of peace at Sacred Way and libraries in Palatine hill. Galen used to store his writing samples in a room rented near the Temple of Peace. This fire perished all Galen’s work, especially his writing covering philosophical and logical dogmas. Still, we have enough work to regard his extraordinary intellectual level.

Most of Galen’s writings were in Greek only. The ancient Greek language was a barrier in the translation of his manuscript because we could not find the exact meaning of some of the Greek terminologies. Printing errors also contributed much to losing the original context of his writing. His manuscripts were plain and simple. His writing samples reflect his intellectual level. Galen was a writer with an original mind. He has narrated his research in his writing like a living man. He has described all the major and minor aspects of his daily dealings both as a physician and as a philosopher.

There is no complete edition of his writing sample leftover. Yet, some of his single works were collected and published by Helmreich and his coworkers.

Galen published two books on compound medicines (adviyat e murakkabiya)

Unfortunately, along with Galen, the fire burnt other writers’ work at that time. Even some of them committed suicide in their grief. Galen was unaffected despite his loss. He engaged himself in writing again. He again managed his work on compound medicines (adviyat e murakkabiya) until the early Severan dynasty (193-235 A.D.). He gave two publications on compound medicines (adviyat e murakkabiya). 

De usu partium”- A composition of 16 books (maqalahs)

Galen’s composition of 16 books (maqalahs) with the title of “On the Usefulness of the Parts (kitab fe munafi ul aaza)” was subjected to Alexandria as a teaching guide for new physicians. The Latin name of this composition is “De usu partium”. Galen wrote about different body parts, their functions, and blood flow. It was a misconception promoted by the four humor (nazaria-e-akhlat) theory of Hippocrates that blood vessels supply air in the body. Galen corrected this concept and identified the arteries and veins using his methods and techniques during cadaver dissections.

Galen’s best manuscripts

Galen wrote his treaties more on anatomical and physiological aspects after the demolishment of his previous work in winter 192 A.D. Some of the best of Galen’s manuscripts united in the two volumes of ‘On His Own Books’ and ‘On the Order of His Own Books’ are mentioned below:

  1. On the Natural FacultiesOn the Art of Medicine
  2. Of the Atrabilis or Black Bile
  3. Is Blood Naturally Contained in the Arteries
  4. On the Elements According to Hippocrates
  5. The Best Doctor is also a Philosopher
  6. On Anatomical Procedures
  7. On Good and Bad Humours
  8. Of the Method of Curing Diseases
  9. A Concise Treatment on the Pulse

Some of Galen’s information rejected with time

Although Galen has played a significant role in the correction of ancient beliefs that did not share any scientific and experimental evidence. He also has some theories and findings that have been accepted for a long time. After the advancement of science and technology, new research has rejected them. Galen was among the followers of the four-humor theory (nazaria-e-akhlat). This theory was wrong according to modern and classical research. For example,

  • Galen believed that excess bile in the heart was responsible for anger and frustration. Now, we know that heart has nothing to do with bile. Rather, live secretes the bile and normally collects in the gallbladder.
  • Galen has pinned down 61 kinds of cancers, for which he used the Greek word ‘karkinos’, meaning ‘crab’. He also considered increased black bile – a component of the four-humor theory, in an account.

In the 9th century, Arabic physicians showed their interest in the writings of Galen. They collected his manuscripts at that time. Hunayn ibn Ishaq, who has been a great Arab physician, collected and translated 129 manuscripts of Galen. He and his coworker give Arabic or Syriac translations of Galen’s work. It is not wrong to say that the development of ancient Arabs in the field of medicine is beholden by Galen’s research and theories.

Galen as a philosopher (Mahir e falsafa)

Galen was a physician and philosopher. He started learning philosophy in his childhood. Later, he stepped forward in medicine by the virtue of Asclepius advising his father in his dream, Galen decided to pari pssue (equal foot) both the fields later in his life. He intensively indulged himself in medicine after the age of 16 but during his professional life, he usually wrote manuscripts based on philosophy.

Although most of Jalinoos’ writing reflecting his spiritual value was demolished. Yet we can observe a glimpse of his enlightened soul in his other anatomical and medical manuscripts. Galen had a strong belief in the oneness of God. He has doubts about the presence of multiple gods, as he was a monotheist. However, he was quite clear from the very beginning that medicines (adwiyat) are the manmade solution for treating and preventing an illness. As a philosopher, he followed the great philosopher of the time, Aristotle. Galen concluded from his observation and anatomical research that the human body is a well-organized and astonishing miracle of nature. After 200 A.D. until his death, Galen was engaged in philosophical writing which includes:

  • On the Equality of Sin and Punishment
  • The Slight Significance of Popular Honor and Glory
  • The Refusal to Divulge Knowledge
  • Introduction to Dialectics

Galen’s Benefaction Unani Medicine (tibb yunani)

Greek classical medical history provides evidence of Galen’s contribution to medicine (adwiyat). The work and devotion from three medical schools, Hippocratic, Alexandrian, and Galenic made the foundation of Unani medicine (tibb Yunani). They have nourished the Unani medicine (tibb Yunani) with their research and theories. They followed the work of their pioneers and added their contributions to give modified and refined ideas. 

Galen and Theory of Elements (nazaria-e-akhlat)

Theory of Elements (nazaria-e-akhlat) played a prominent role. Hippocrates, Alexandria, and Galen all added their observations and modified the theory with time. Originally, it was Hippocrates’ concept in which he identified the four humor elements (akhlat) present inside a human body. Galen accepted this theory of Hippocrates and correlated it with Empedocles’ theory of Elements and their qualities. He connected the two theories by saying that;

  • Yellow bile (safra) resembled fire
  • Blood (dam) being warm, corresponds to air
  • Phlegm (balgham) was more like water due to humidity
  • Black bile (sauda), being cold and dry was like the earth

Galen not only correlated the two theories but all produced his theory of Element that leads towards a new direction in Unani medicine (Tibb Yunani). He supported the role of blood among all the body fluids-humors (akhlat). He observed that blood in the body did not come back to the heart or liver. It is used in the body. He considered it as the most dominating element (akhlat) among all the humors.

He explained that all humans have four types of humors but their concentrations are different in different people. Any imbalance in the concentration and condition of a person puts a millstone towards disease. 

Galen’s theory of pulse

None other but Galen alone discovered the arteries in our body. During his cadaver dissections in Egypt, Galen had a golden chance to explore human anatomy in detail. After returning to Rome, he continued his practice on ape monkeys, birds, and other animals. He gave his theory introducing the circulatory system for the flow of blood. He discovered the systolic and diastolic functions of the heart and diverted the intentions towards pulse rate. He described that a pulse is a result of blood fluctuations in arteries. Relating to the importance of blood in the four-humor theory, he claimed pulse sensation plays a crucial role in the diagnosis of disease. He proved his statement through deductive reasoning. He confirmed in his writing De diff pulsuum that the arteries carry red blood only. He identified the passage of blood circulation. 

Galen’s theory of hygiene

According to Galen, we must balance five factors to improve hygienic conditions. A person can have a healthy body if he takes care of:

  1. Food and drink (Ma’kul-o-Mashrub)
  2. Sleep and Wakefulness (Nawm-o-Yaqza)
  3. Rest and Physical activity (Harkat wa sakoon e badani)
  4. Retention and evacuation (Ehtibas wa Istafraagh)
  5. Emotions and temperament (Mizaj)

Galen is honored for implementing philosophy in physiology. He had accepted all the challenges in his medicinal practice and proved his extraordinary skills in all the disciplines he stepped. He not only lived for the well-being of humans but also noted down his works in his manuscripts for others following his work behind. His theories contributed a lot in laying the foundation of Unani medicine (Tibb Yunani). He emphasized the significance of prognostication and inspection in clinical methods. He was among the inventors of experimental techniques in ancient Rome. His medical teachings have influenced Europe from the medieval period.

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