GALEN’S MEDICAL EDUCATION

Academic Medicine


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There was no single, unified track for the study of medicine in the ancient world. The field itself was divided into different groups and subgroups (historically referred to as medical sects), each predicated upon different understandings of the body. Some practitioners privileged empirical observation, while others placed a higher value on theoretical knowledge. Some healers believed in divine intervention, while others relied on magic. Galen described the medical landscape of his day:

“The aim of the art of medicine is health. . . . Doctors have to know by which means to bring about health, when it is absent, and by which means to preserve it, when it is present. . . . But whence one may come by the knowledge of these is no longer universally agreed upon.”

Likewise, there was no agreed-upon standard of accreditation for the medical profession—anyone who called himself (or occasionally herself) a doctor became one—and the training among different kinds of healers varied dramatically.

Gray horizontal rectangle carved with a scene in bas relief. Three figures queue before a man seated on a platform. Behind them is a tree with a snake in its branches. The top left corner of the relief has broken off.

Funerary or votive relief depicting a heroized doctor; near the doctor’s head is an open box or cabinet with surgical instruments. Roman, 1st century BCE–1st century CE. Marble. Probably made in the Peloponnese, Greece. H. 67 cm; W. 83 cm; D. 7.5 cm. Antikensammlung der Staatlichen Museen zu Berlin – Preußischer Kulturbesitz: SK 804. Photo: Ingrid Geske. © Antikensammlung der Staatlichen Museen zu Berlin – Preußischer Kulturbesitz.

Just as he had received instruction in different philosophical schools in his younger years, hoping to draw on the best each had to offer, Galen embarked upon a broad study of medicine and sought out different kinds of practitioners. He repeatedly proclaimed that it was his practice

“to follow no one sect or party but to hear and judge them all, to despise honor and glory, and to magnify truth alone.”

While he approached each healing modality with an open mind, Galen quickly arrived at an assessment of the major medical sects of his day: his conclusions were never neutral, but always well considered. For Galen the lesson he internalized from his father—to prioritize independence of thought rather than strict adherence to a specific sect, school, or approach—drove his evaluations.

The intellectual landscape of Roman medicine, a world characterized by competitive and even cutthroat debate, was firmly embraced by Galen. At the very beginning of his medical training in Pergamon, an eighteen-year-old Galen humiliated one of his teachers, an adherent of the Pneumatist sect. Galen studied with an Empiricist teacher at the same time, and although he was also critical of this medical sect, he remained more open to its principles than to other schools of thought. Despite his hostile language and the combative scenes that Galen depicted to critique his peers—shocking by our contemporary expectations of dispassionate rational thought in the sciences—his rhetoric was not out of place for his time and social stratum. 

 

Gray horizontal rectangle with short lines of text. A vertical line divides the inscription in half.

Inscription recording a slave doctor, Tyrannus, from the household of the Empress Livia. Roman, ca. 1st century CE. Rome. Musei Vaticani. Photo: A.E. Gordon and J.S. Gordon Collection, Center for Epigraphical and Palaeographical Studies, The Ohio State University.

Galen’s family background and wealth strongly determined the kind of medical education he received. In an unregulated system that offered multiple paths to the study of medicine, he pursued an academic, intellectual track rather than a hands-on, applied approach. Divisions within the ancient medical profession were driven not only by a range of sects organized around varying intellectual principles and training approaches, but also by the different social classes of practitioners. In the Roman Empire, many doctors were enslaved people or freedmen practicing in the manner of craftspeople, while academic doctors like Galen were in the minority.

His fellow medical students remarked that even within the more privileged milieu, Galen’s training was unique:

“Several of my fellow students said to me, ‘You enjoy both an excellent nature and a marvelous education because of your father’s ambition, and you are still in a stage of life suitable to learning, and you have the wealth necessary to provide leisure time for study; we, on the other hand, have a different lot. For we were untaught in our early childhood and not sharp-witted like you, and we have no money to squander.’”

A rectangular stone plaque inscribed with five lines of Greek text. The beige plaque is significantly cracked and chipped.

Funerary plaque for a teenage doctor, inscribed “Niketes, son of Glykon, from the city of Tieion, doctor, hero, nineteen years old. May whoever tampers with this plaque never find a burial.” 2nd century CE. Marble. Smyrna, Turkey. H. 29 cm; W. 45 cm. Rijksmuseum van Oudheden, Leiden: I 1901/5.1. Photo: Rijksmuseum van Oudheden, Leiden. Public domain.

Archaeological evidence attests to the imperative for some people to begin their medical practice sooner rather than later: multiple epitaphs survive commemorating teenage doctors. Galen, on the other hand, only began his medical studies at age sixteen and spent a decade furthering his education at different places across the Roman Empire.

When Galen was twenty years old, his father died. Although Galen makes no mention of his feelings about the loss, he decided to leave Pergamon the same year to advance his medical studies.

Fig.-2.1.4_a

Map showing Galen's travels during his medical education: Pergamon, Smyrna, Corinth, Alexandria, and Rome. Base map: d-maps.com.

He first went to Smyrna (like Pergamon, also in present-day Turkey) and then to Corinth (in present-day Greece), where he followed new teachers on their rounds. During this period, he also traveled to other locales where he studied with various doctors.

Six wide arches of gray and tan stone blocks stand outdoors. In the background, Corinthian columns rise above the arches.

Left: Arches from the ancient city of Smyrna (present-day Izmir, Turkey). Photo: Benh Lieu Song / Wikimedia. CC BY-SA 2.0. Right: Ruins from the Temple of Apollo in ancient Corinth (present-day Greece). Photo: imageBROKER / Alamy Stock Photo.

Galen’s medical education included a clinical component right from the beginning, and working in different places brought him into contact with a wide variety of people in both cities and villages. Eventually his curiosity, ambition, and drive took him to Alexandria in Egypt, perhaps the most important and prestigious medical center in the ancient world.

Black-and-white print depicting people moving around a colonnaded room, reading and carrying scrolls. The columns have carved heads as capitals.

Otto von Corvin (German, 1812–1886). A Hall in the Library of Alexandria. Engraving. From Otto von Corvin and Friedrich Wilhelm Held, Illustrierte Weltgeschichte für das Volk (Leipzig: Otto Spamer, 1880), vol. 2, 91. Photo: Wikimedia. Public domain.

Although the city did not have a medical school in the sense that we understand today—medical education took place primarily between individuals rather than at institutions—Alexandria’s long, storied history made it a destination for some of the most important medical thinkers of Galen’s time. He spent four or five years there, attending lectures and studying clinical medicine from noted physicians. Yet Galen’s writings provide less detail than scholars today would have hoped to find. He mentions few of his instructors by name, and still fewer favorably. His time in Egypt was nonetheless extremely productive: Galen was well received in Alexandria and made friends (he notes that they exerted a negative influence on his diet), examined human skeletons, studied Hippocratic texts, explored pharmacology, performed animal dissections, observed daring surgeries, continued to deliver patient care, and further sharpened his skill for rhetorical attacks.