Galen

Galen (129-216 CE) was a Greek physician, author, and philosopher, working in Rome, who influenced both medical theory and practice until the middle of the 17th century CE. Owning a large, personal library, he wrote hundreds of medical treatises including anatomical, physiological, pharmaceutical, and therapeutic works. With principles based on his anatomical dissections, he spoke and wrote extensively on the anatomy of the body emphasizing the role of the heart, brain, and blood. While he criticized many of his contemporaries, he embraced the ideas put forth by the Greek physician and theorist Hippocrates (460-370 BCE), primarily his concept of the four humours that controlled the human condition: blood, phlegm, black bile, and yellow bile.

Much of our knowledge of early medicine comes from Galen's writings. Like Hippocrates and other theorists Galen believed that illness was caused by an imbalance, so how does one restore the balance: bleeding, enemas, and vomiting. Aside from his writings on medicine, he wrote extensively on language, logic, psychology, ethics, and even moral philosophy. Regrettably, most of his works no longer exist or survive only in fragments. He lost many of his writings, instruments, and medicines in a storeroom fire in 192 CE.

Early Life & Education

Born in 129 CE in the Asia Minor city of Pergamon, Galen was the son of the wealthy architect Nikon and was initially educated in both rhetoric and philosophy. The Pergamon of his youth was home to a sanctuary dedicated to the god of medicine Asclepius. His father, a member of the Roman elite, had assisted in the renovation of Pergamon's temple complex dedicated to Zeus. At the age of 16, Galen changed educational directions, possibly at the suggestion of his father, and decided to study medicine, eventually completing his schooling at both Smyrna, located on the Aegean coast, and Alexandria where he studied both anatomical science and physiological theory. At the time Alexandria was the premier center for the study of medicine in the ancient world. After the death of his father in 149/50 CE, he continued his studies as he traveled throughout the Mediterranean. In 157 CE he returned to his home town of Pergamon to be the physician to a group of gladiators; a position that provided him with an opportunity to study anatomy.

Plague in the Ancient & Medieval World

The word 'plague', in defining a lethal epidemic, was coined by the physician Galen (l. 130-210 CE) who lived through the Antonine Plague (165 - c. 180/190 CE) but the disease was recorded long before in relating the affliction of the Plague of Athens (429-426 BCE) which killed many of the city's inhabitants, including the statesman Pericles (l. 495-429 BCE). This epidemic, and some of the others that followed, may or may not have been actual plague as it was later defined; ancient writers tended to use the term plague for any widespread outbreak of pestilence.

Plagues certainly may have existed prior to the Athenian outbreak – and almost certainly did – but most studies of the epidemic begin with Athens as it is the first recorded by an eyewitness and survivor, the historian Thucydides (l. 460/455 - 399/398 BCE). Plagues are routinely named either for the person who reported them, the monarch at the time of the outbreak, the region afflicted, or by an epithet as in the case of the Black Death.

The major recorded plagues of the ancient and medieval world are:

Plague of Athens

Antonine Plague

Plague of Cyprian

Plague of Justinian

Roman Plague

Near East Plagues

Black Death

Columbian Exchange Epidemics

Of these, the Columbian Exchange Epidemics are not considered plague as they were a sweeping contagion of smallpox and other diseases but were just as lethal to the indigenous people of the Americas as plague was elsewhere. Other epidemics not considered plagues but which still ravaged populations were leprosy – especially during the 11th century CE in Europe – and the Japanese smallpox epidemic of 735-737 CE. Epidemics and pandemics continued into the modern era and, among the deadliest, were the 1918-1919 CE Spanish Flu epidemic and the HIV/AIDS epidemic (1981-present) though there were many others. At the time of this writing, the Covid-19/coronavirus is proving itself the latest addition to the list of most lethal pandemics in world history.

Nature & Types of Plague

The cause of the plague was unknown until the 19th century CE when the bacterium Yersinia pestis was isolated and identified in 1894 CE. Prior to that time, plague was thought to be supernatural in origin, a punishment from the gods or God, and/or the result of a population's sin. The actual cause was Yersinia pestis which was carried in the fleas of rodents, most often rats, which transmitted the bacterium to humans through bites. Other animals could catch the plague by eating rats – or other rodents – which were infected and this would lead to an epizootic outbreak which then spread to human beings. People die of the plague because of the toxic nature of Yersinia pestis which compromises one's immune system while, at the same time, multiplying in the body. Since the compromised immune system can no longer fight against the toxins, the person dies.

Plague is always described as beginning with symptoms resembling the flu, which appear, usually, 3-7 days after one has become infected. The symptoms at first are chills, body aches, fever, and overall weakness, which then progresses to vomiting, diarrhea, dehydration, respiratory failure (in some cases), and death. The three types of plague are:

Bubonic: caused by the bite of a carrier flea. This plague attacks the lymph nodes, inflaming them, and the swollen nodes are then called buboes, hence the name.

Septicemic: caused by either an infected flea or contact with an infected animal. It attacks by entering the bloodstream and multiplying.

Pneumonic: caused by contact with an infected animal and spreads person-to-person through coughing. It attacks the lungs, rapidly multiplying, which triggers an immuno-response eventually shutting the lungs down and leaving the person to die of respiratory failure.

Of the following, the first three may or may not have been plague. Descriptions of them by eyewitnesses suggest they may have been typhus or smallpox outbreaks but could have been plague.

Rome conquered armies—but could it survive an invisible enemy? 🏛️

The Antonine Plague spread across the empire and changed Roman history forever.

🎧 **Hear the full story through the link in the description.**