BMCR 2021.06.38

Cutting words: polemical dimensions of Galen’s anatomical experiments

, Cutting words: polemical dimensions of Galen's anatomical experiments. Studies in ancient medicine, volume 55. Leiden; Boston: Brill, 2020. Pp. x, 328. ISBN 9789004439184 €119,00.

Studying anatomy today—whether for medical, artistic, or any other purpose—is a matter of learning a large set of specific facts about the composition of the human body. Anatomy textbooks generally reflect this understanding of the subdiscipline as comprising of fairly dry and technical knowledge. They are rarely page-turners; in fact, they often read like reference works, and the experience of reading an anatomy textbook is about as exciting as reading a phonebook. Yet the notion of anatomy as a highly technical area of study, accompanied by appropriately technical texts, only emerged in the 19th century. Before then, different understandings of anatomy were dominant and, as a result, anatomical texts were written in different ways. Galenism was an important part of this tradition, and Galen’s anatomical texts are far from being dry accounts of facts. For one, they are narratives. More importantly, they are narratives with interjections, detours, and literary embellishments. So much so that a contemporary reader might find herself thinking that there is not much ‘proper’ anatomy here at all. L.A. Salas’ Cutting Words: Polemical Dimensions of Galen’s Anatomical Experiments presents a much-needed elucidation of Galenic anatomy and Galenic anatomical writing. By carefully contextualizing the accounts of Galenic anatomical experiments, this study shows that the Galenic anatomical texts are evocative of public dissections which were spectacles designed to establish the performer’s authority, to demonstrate his technical acumen and, oftentimes, to reduce any rivals to shame.

The blurb on the back cover states that this monograph is centered around four case studies of Galenic experiments: voice production, the bladder, the heart, and the femoral artery. However, these case studies do not feature equally prominently in the book. The experiment concerning the ureters is discussed in just one section of Chapter 2 (consisting of approximately 7 pages), while the femoral artery experiment is discussed in two Chapters (Chapters 6 and 7), with the preceding Chapter 5 already introducing some of the pertinent themes as well. The case of the bone in an elephant’s heart also receives two Chapters (Chapters 3 and 4), and the discussions of the voice production experiment can be found in dedicated sections of Chapters 1 and 2. It is also worth noting that there is an important discussion of the gallbladder in Chapter 3. Although some of its conclusions overlap with the conclusions of the case study concerning the elephant heart, the problem of the gallbladder produces some interesting discussion of Galen’s humouralism against the background of the Aristotelian biology. It seems to play a more prominent role in the argument of the book overall than the experiment with the ureters, and not simply owing to the fact that it is longer.

The four main case studies are framed by the Chapter on writing about experiments (Chapter 1) and the reception of Galen in Vesalius’ Fabrica (Chapter 8). The former contains an illuminating discussion of a range of issues pertaining to the practicalities of Galen’s anatomical writing. In Salas’ reading, Galen emerges as a strategizing manager of the distribution of his writings, taking great care to spread his works widely. At the same time, he protected himself from the accusations of excessive self-promotion by presenting himself as only composing the treatises at the insistence of friends, colleagues, and famous persons. The Chapter also contains an explanation of the competitive nature of ancient medicine. The importance of this point cannot be overestimated: it is crucial for understanding multiple aspects of both Galen’s medical practice and medical writings. Thus, one of the key contributions of this monograph emerges early in the book, when Salas very convincingly shows that even written accounts of dissections are often performative, evocative of the awe-inspiring spectacles of live public dissections. This theme is again revisited in the final Chapter, showing that Vesalius’ engagement with Galenism included not only anatomical facts but also the replication of the performative rhetoric.

The way in which Galen manages to convey the liveliness of public dissection in his texts is elucidated in the discussion of the voice production experiment. During this experiment, Galen demonstrates that animal voice production depends on the intercostal nerves by ligating these nerves, and thus making the dissected animal mute. If the nerves are later untied, the voice is regained, and the animal cries out astounding the audience. Salas convincingly demonstrates that Galen’s description of this procedure involves very vivid depictions of an imagined audience and their reactions in order to reproduce the status-establishing significance of the public demonstrations. Both live dissections and their descriptions in anatomical texts, therefore, have a prominent element of performance and spectacle aimed to not only educate but also amaze. The key aim of such descriptions is of course to establish Galen’s authority in anatomical matters. Galen attempts to secure his image as a highly accomplished, precise and accurate anatomist go beyond describing his own spectacular dissections. He also never shies away from polemics, as anyone with even a limited familiarity with the Galenic corpus well knows. In Chapter 5 of this book, Salas goes beyond the surface and examines the rhetoric and language of Galen’s rebuff of the shortcoming of anatomical and theoretical knowledge of Erasistratus and his followers. This discussion shows that Galen satirizes his opponents in an erudite way by using evocative language associated with Menander’s comedies.

The preceding two chapters concerning the dissection of an elephant contain a number of fascinating points about Galen’s anatomical practice. For example, Chapter 3 presents a discussion of how Galen chose which animals to dissect for studying human anatomy and how his choices were motivated theoretically. Salas’ explanation is both illuminating and a useful point of reference for anyone working on Galenic anatomy, physiology or Galen’s understanding of human nature in general. Arguably, the most controversial claim also occurs in these chapters. It concerns the dissection of an elephant’s heart. Salas points out that Galen describes the elephant heart as containing a bone—he even claims to have touched it during a public dissection in Rome. Galen furthermore states that the extracted bone lays on his desk as he is writing his Anatomical Procedures Book 7, and his visitors often end up in a state of disbelief that such a large bone was missed by certain doctors. However, there is no such bone in an African elephant’s heart. Salas argues that Galen’s theoretical commitments to the teleological structure of the animal body led him to posit the existence of such a bone on the basis of the anatomy of an ox (p.163ff.). While the reading showing that Galen drew overtly direct parallels between the heart of an ox and the heart of an elephant is convincing, the argument that Galen effectively made up the existence of the bone for theoretical reasons and ‘perhaps he also never went looking for it’ (p.162) could be challenged. Such a conclusion would have some wide-reaching implications for our understanding of Galenic methodology, because it would point out a major inconsistency in the Galenic corpus. While Galen consistently advocates grounding any theory about the functioning of the body in anatomical evidence, according to the reading presented in this book, in fact he himself prioritized theoretical considerations and made empirical findings subordinate to theoretical inferences. In short, he did not practice what he preached.

Although the manifestation of such an inconsistency is not impossible, the principle of charity requires strong evidence to support such a conclusion. Arguably, there are some alternative readings of the key passage, viz. AA 7.10 (662-6 Garofalo=11.619-621 Kühn). For example, the key premise of this argument is Galen’s claim that the larger the dissected animal, the more visible the anatomical structures. This claim receives no critical examination. Such an observation is undoubtedly true when comparing a mouse and one of the larger animals Galen prefers, such as a goat. One might reasonably wonder whether the same is actually the case when the animal is very large, and the dissectors have to wade through, quite literally, tons of bodily tissues. The text also tells us that the dissection of the elephant was a busy public event, with many doctors presents and some heckling taking place. Of course, he was wrong to think he touched the heart bone with his finger, but there seems to be little reason to doubt the evidence of the text, namely, that Galen believed he touched such a bone, thus obtaining empirical grounds for his theoretical inference about the uniformity of animal heart structure.

Furthermore, it was not Galen himself who extracted the alleged bone from the heart. The text states that Galen sent one of his trained associates to the kitchens of the emperor to ask to excise the bone, and a bone was produced. Without speculating what may or may not have happened in the kitchen (although it seems fair to note that if the kitchen had a carcass of an elephant, there was no shortage of large bones that could be picked up, on purpose or by accident, as the heart bone), there is no reason to think Galen did not receive some bone or that, having received a bone from his associate, he did not actually think it was the bone he had touched earlier. The methods by which he inferred the existence of the heart bone in an elephant are not his finest, but making an error owing to shoddy methods of collecting empirical data and treating such data as subordinate to theoretical commitments are two very different things. One might argue that, by Occam’s razor, it is more likely that Galen himself mistakenly, but genuinely, believed that the bone on his desk came from the elephant’s heart rather than that he made up its existence.

 Although the elephant heart experiment plays a fairly prominent role in the book, the experiment concerning the femoral artery is discussed even more extensively. The key argument, grounded in a subtle but convincing reading of Galenic text, is that the experiment was originally devised by Erasistratus, even though Galen was using it against the Erasistrateans. The ensuing discussion covers not only the nuanced anatomical details of the experiment itself, but also the physiological underpinnings and conclusions in both iterations of the experiment, the Erasistratean and the Galenic (esp. Chapter 7).

Overall, this book is a very welcome addition to the Galenic scholarship. It sheds much-needed light on Galen’s anatomical writing qua anatomical writing by locating in its cultural context, studying its interactions with tradition, contemporary rivals, and the perceived readers. As mentioned at the beginning of this review, Galen’s anatomical writing is very different from highly technical and dry anatomical texts we encounter these days. In order to appreciate the medical work presented in such an unusual style to the contemporary eye, it is necessary to have a guide for contextualizing, clarifying and elucidating the complex style of writing. This book is exactly such a guide.

 The book contains a general index and an index locorum, as well as one illustration in color (p.284). Although overall the volume is nicely produced, there are quite a few copyediting issues.