THE COST OF TREATMENT

Galen’s Finances


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When Galen’s rivals charged him with using magic instead of science in developing his prognoses, it was a clear attempt to tarnish his reputation. For an academic doctor, this was a serious accusation and an insult akin to being called a quack. The anxiety it evoked was certainly intellectual—Galen was committed to medicine as a rational science—but the indictment also carried an ethical charge. Magical healers typically exchanged their services for fees, and some of these practitioners were indeed motivated by greed. But ethical failing was not limited to those who used magic or lacked scientific integrity. In Galen's opinion:

“It is impossible for someone who puts wealth before virtue, and studies the art [of medicine] for the sake of personal gain rather than public benefit, to have the art itself as his goal. It is impossible to pursue financial gain at the same time as training oneself in so great an art; someone who is really enthusiastic about one of these aims will inevitably despise the other.”

Certainly, the vast majority of his medical colleagues of all stripes depended on the money they earned from their practice for their livelihood, and Galen was well aware of this. But, for him, the true division between doctor and charlatan was not based so much on method or on financial standing as on motivation: regardless of whether or not they accepted fees, real doctors practiced the art for the good of humanity, not for the money.

Vertical stone object with two male figures in bas relief. An older man, seated, places his hand on the belly of an unclothed, standing boy. A Greek inscription appears below.

Funerary monument depicting a physician examining a patient with swollen abdomen and wasted limbs; on the right is a cupping vessel. Roman, 2nd century CE. Marble. Athens. H. 80 cm; W. 55.9 cm; D. 8.9 cm. British Museum: 1865,0103.3. Photo: © The Trustees of the British Museum. CC BY-NC-SA 4.0.

Galen boasts that he never charged patients for medical services and even dispensed medications for free to those who could not afford a prescription. He also mentions donating medical instruments and books to colleagues in need. There is only one mention of a payment, from the husband of a patient—four hundred gold coins, an enormous sum—but this is described as a reward rather than a fee. Galen was almost undoubtedly paid by some patients, and he certainly received a salary for his service in the imperial court as physician to the emperor; but working for the ruler did not prevent him from seeing other patients at the same time. That we have less definitive information about his personal finances than we do about other aspects of his professional life is itself a suggestion that he was keen on having his medical practice seen as something separate from a revenue source. Moreover, Galen followed the Hippocratic principle that a good doctor cares for the poor. 

A large colonnaded building with an orange tile roof. A porch wraps around the building, while a green space with trees stretches in front.

An example of a preserved villa from the late 1st century CE. Villa Poppaea, possibly owned by Emperor Nero. Built ca. 50 BCE, submerged 79 CE. Campania, Italy. Photo: Miguel Hermoso Cuesta / Wikimedia. CC BY-NC-SA 4.0.

Drawing upon his writings as well as informed inferences about his family’s social status, historians today speculate that Galen’s resources were considerable. Although he represented himself as a man of only “moderate wealth,” even without definitive numbers to quantify his means, it seems probable that this is an understatement. Galen likely lived off revenue from the estate in Pergamon that he inherited from his father, and we know that he also owned two additional properties: a house in Rome and another estate in Campania, southern Italy. Galen wasn’t among the top 1 percent, but his financial situation was more than secure.