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Galen - Lecture 23.doc

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Classical Studies
Classical Studies 2900
Beate Gundert

Last Lecture Rete Mirabile • Web of arteries at the neck and mixture of spirituous blood in the arteries which is refined into psychic pneuma Eight different wrong mixtures • Too hot or too moist, too cold and too dry • Combinations ◦ too hot too moist ◦ too hot and too dry ◦ too cold too dry ◦ too moist too cold • Eight possibilities which affect the proper functioning of the four faculties and the functions of the organs. Diseases of the organs are the wrong arrangement of the homiomeres which will often lead to obstruction. Blood formation will fail if the liver is obstructed. Galen Passage 254 • Diagnosis by questioning. • Galen is showing what a very good diagnostician he is; at very first signs he can di- agnose the disease. • Galen is coming to Rome at the beginning of his career and needs to become known. • Knows about medicine and probably has some idea himself of what the disease is. Galen is very proud to be acquainted with philosophers. • Wants to know the past, present and future which refers to Homer; makes state- ments about the past present and future by observing certain signs that come from the Gods. • May Galen's technique is based on divine intervention but of course Galen actually makes these diagnoses by understanding how the body functions. • It depends on what sort of symptom this patient has but only a physician who un- derstands can diagnose and understand the symptoms. • This is a sign of a weakened liver function Galen says. This means that the liver has a disease and probably has some type of dyscrasia. This weakens its au- tomative function. Bile and black bile might not be separated properly and does not go to the gallbladder and spleen and is not discharged. This yellow and black bile are not properly separated out and go to the stomach? Since they are not pure and do not aid in digestion the discharge may be watery. • Weakness of liver function would be main symptom, disease is dyscrasia and this is complicated by inflammation (second condition). If this also harms liver, it will be a disease and could be a wrong mixture of qualities. It might be a hot dyscra- sia. If there is a swelling in one of the ducts or vessels due to inflammation, then this could lead to an obstruction. One part could have two diseases at the same time; one organic or one ….disease or two of these. • Movement might change the pulse and finds in the pulse indication of inflammatory disease. The heat has reached the heart and the heart suffers from a hot dyscra- sia and the heart has to pump harder in order to get a mixture of air and blood through the arteries which can then be noticed through the pulse. This way one can diagnose fever and inflammation through the pulse. • Galen tells us in which way the pulse changes in a certain disease. • Galen makes another observation; relates to relief about the disease. Galen knows by the pulse that the liver disease in complicated by inflammation and pain. Pain you might find in many different diseases. • Certain type of discharge is always a sure sign of a liver disease. This is the sec- ondary symptom, primary symptom is failed liver function. • Through his observation, there are other signs that are connected with the liver dis- ease but are not always connected with liver disease (pleurisy a certain type of pain). • Pleurisy is connected to a cough but not really in a liver disease, doesn't explain why there would be a cough. • This is a sensation that is common to liver disease and pleural disease when he tells the patient to do something. • Galen is cautious, complication of inflammation might not make the sensation very clear. • Patient thinks that he has pleurisy. • Galen says there are some symptoms specific to certain diseases (discharge for liver disease) and other symptoms common with other diseases (type of pain). • Galen's personality and method of diagnosis are shown here. Such prognosis are connected a bit with divination and that it enhances reputation. Can diagnose a disease and affected part from certain signs. Other signs that are common to oth- er diseases and help with diagnosis. • We don't know exactly what type of dyscrasia the patient might have had. Byzantine Medicine Passage 239 (3rd c. B.C.) - Quintus Serenus (3rd C. B.C.) • Galen died in 216 or 199 (based on wrong calc.) • Leaving the educated
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