ven when he had not seen it for years, Galen always called Pergamum home. It was the jewel in the Greek Middle East’s crown of cities, sprawling over the plain near the river Caicus 16 miles from the Aegean Sea, in what is now western Turkey. Over its maze of streets and markets loomed the rock spur of the acropolis on which it was founded. In Hellenistic times the entire city was settled on its steep slopes, within the crowning perimeter wall built by its kings, in the decades after the death of Alexander the Great. In Galen’s time this remained the old part of the city, home to its most prominent families, perhaps including his own—a crowded, dense settlement of steep, narrow, stepped streets and level after level of terracing.
On the acropolis’s height the Attalids, Pergamum’s ruling dynasty, constructed the most magnificent building complex of any Hellenistic city. The royal palace rose step by step in a sequence of terraced plateaus, flanked by buildings and monuments famous throughout the Greek world. Among these was the Great Altar of Zeus, one hundred feet long, covered (as was the wall that enclosed it) in a sculpted frieze depicting the mythical battle of gods and giants. Reconstructed in the Pergamon Museum in Berlin, this frieze is perhaps the most spectacular artistic work to survive from antiquity. Another renowned monument stood further up the slope, in a plaza dedicated to Athena: a bronze group of sculptures commemorating King Attalus I’s victory over the migrant Celts of neighboring Galatia, in the 230s B.C.E. The bronzes have disappeared, but two survive in marble copies, and today the “Dying Gaul” is famous for the pathos it evokes and for its image of the shaggy-haired, mustachioed “barbarian.” Above Athena’s precinct stood Pergamum’s famous library, second in size and renown only to that of Alexandria in Egypt. (Rumor told that together the libraries of Pergamum contained 200,000 scrolls, considered an astounding number at that time; and that in Roman times they were all transported to Alexandria, a gift from Mark Antony to Queen Cleopatra.)1 And into the hill’s precipitous western slope was set a stone theater, with seating for 10,000, where spectacles were played out against a heart-stopping backdrop view of western Turkey’s austere, arid landscape. The acropolis of Pergamum is a most eloquent monument to the egotism, manic militarism, and cultural pretensions of the Hellenistic world’s dynastic families.
The city boasted all of the usual Greek amenities, on a magnificent scale reflecting centuries of patronage by its kings and, later, the ambitions of its aristocracy to emulate and impress the Roman emperors. The social epicenter of every Greek city was its marketplace, or agora. The cultural epicenter was its gymnasium, a public space for the nude exercises, especially wrestling, that defined the lifestyle of Greek men of elite status.
Within the Hellenistic walls, Pergamum had at least two monumental agorai, three gymnasia, and four major bathing complexes (and, like all cities and towns, a host of minor ones). Besides the theater on the acropolis, Pergamum had theaters attached to its Upper Gymnasium and to the precinct of Asclepius, and a Roman-style freestanding theater on the plain, in the newer part of the town, that could seat 30,000. Nearby was an amphitheater, the city’s largest public building and one of the few of its kind in the Roman East. Today Pergamum’s buildings testify to the urban culture that dominated the Middle East of Galen’s time.2
Galen’s world and experience was that of a Greek in the Roman Empire. To understand his life is impossible without understanding the ancient intertwining between Greek culture and Roman imperialism, a topic illustrated very conveniently by the history of his city. I offer, then, a brief political and cultural history of Pergamum by way of orienting the reader to Galen’s world; and also, as a way of introducing Galen himself. His city—its monuments, its great and eccentric kings, its foundation legends, and its culture heroes—was a large part of Galen’s identity. He was proud of his origin and identified as a Pergamene until the end of his life.3
Pergamum had been a Greek city probably since the eighth century B.C.E., but its early history is lost in myth. The Pergamenes traced their ancestry to Telephus, bastard child of Heracles and an Arcadian princess, abandoned to drift across the Aegean in a chest. The city became important late in the fourth century B.C.E., in the wake of Alexander the Great’s death, when his generals, the so-called Diadochi, fought for control over his empire. What is now western Turkey, including Pergamum, changed hands several times in the early decades of this ferocious struggle. In the course of affairs an opportunistic man of ordinary background, named Philetaerus, acquired control over the city and its large treasury, which he proceeded to make into the capital of a new, emergent kingdom.
In the reign of Attalus I, whose victory over the Galatians was commemorated in the famous bronze statue group, and largely through his own actions, the tentacles of Roman imperialism reached Asia. Threatened by the Macedonian King Philip V, who was seeking to expand his territory into Asia, Attalus appealed to Rome for help. Pergamum proved a loyal ally in Rome’s subsequent conflicts with the kingdoms of Macedonia and Syria, and Attalus’s successor, Eumenes II, was rewarded with a large swath of territory wrested from Syria, comprising the most fertile and populous region of Asia Minor. From a petty principality Pergamum overnight became a large kingdom. It was this Eumenes who planned and paid for the spectacular building program on the acropolis—the Altar of Zeus with its famous frieze, the precinct and temple of Athena, the Upper Agora, the theater, the library, and a new fortification wall of which large sections survive today. Like his predecessors he fought constantly with the Celts and with rival kings and chiefs, celebrated his militaristic achievements loudly and visibly, and died exhausted.
The last of the Pergamene kings was the notoriously unstable, misanthropic, and bloodthirsty Attalus III, about whom historians tell us little other than that he murdered most of his family and sent homegrown poisons to his friends for his own amusement. Galen, however, mentions with praise his pharmacological discoveries and his complex antidote, even complaining that Attalus did not leave enough written records. (Attalus’s antidote, however, was not as famous as that of Rome’s great enemy, the ill-fated Mithradates VI “Eupator”—see below.)4
Attalus III died without heirs at age thirty-six, after ruling less than five years, and left his kingdom in his will to the Roman people. The Romans had not expected this legacy; they usually avoided annexing new lands that they were ill-equipped to garrison and preferred to rule hegemonically through local kings. But Pergamum was a wealthy kingdom and, although they gave away some of its territory to local allies, most of Attalus’s former realm became the Roman province of Asia. From most of the province Rome collected a hefty tax, which every five years was auctioned to corporations of wealthy Roman citizens and sold to the highest bidder. The tax collectors did their job ruthlessly, keeping any profits over whatever they had promised to pay the treasury. To communities unable to pay the tax, wealthy Romans lent money at exorbitant rates of interest—Marcus Junius Brutus’s loan to the city of Salamis on Cyprus, at 50 percent interest, was not considered exceptionally usurious—and they found other ingenious ways to exploit the province economically.5 As for Pergamum itself, Attalus had specifically left the city free, and there were many similarly “free” cities in Asia and in the Greek East. By his bequest he probably intended Pergamum to be subject to its own magistrates and laws and relieved of taxation, but it is not clear what privileges the Romans actually recognized.
This was the situation in the early first century B.C.E., when the Near East was roiled by the spectacular career of King Mithradates VI “Eupator” of Pontus. Mithradates was one of Rome’s great enemies, along with Hannibal of Carthage and Cleopatra VII of Egypt—cruel, unscrupulous, shrewd, arrogant, and manically energetic; demonized as evil incarnate, lionized as that rare phenomenon, a truly worthy adversary. Rumor made him superhuman in size and strength and portraits display him as a young Heracles and Alexander the Great, with fanged lion’s head helmet. Rumor also credited him with extraordinary intelligence and erudition: reportedly he could speak all twenty-two languages of his kingdom. His prowess in pharmacology was legendary, his recipe for theriac—an antidote of profound complexity—is cited not only in Galen but in several other ancient sources, and he remained famous for this through modern times. (“Mithridate” mixed according to ancient prescriptions was a highly prized drug in the Renaissance and is the subject of a poem by A. E. Housman.) Galen adds what is also repeated in other sources, that after his defeat and exile by the Roman general Pompey, Mithradates tried twice to commit suicide by poisoning himself, but the antidote to which he had accustomed his body was so effective that he had to beg one of his officers to run him through with a sword instead (Antid. 1.1, 14.3–4K).
Mithradates ruled the kingdom of Pontus, the southeastern coast of the Black Sea. By the age of thirty-one he had already vastly extended his territory and set his sights on much more, perhaps all of Alexander’s former empire. Again and again he sparred with the Romans over the control of the neighboring kingdoms of Bithynia and Cappadocia, until finally in 89 B.C.E. the Romans declared war on Mithradates through their proxy, the king of Bithynia. The Pontic king promptly defeated him with a small contingent of infantry and his famous scythed chariots. Mithradates then swept southeast-ward to the Roman province with the bulk of his army, said to have numbered 150,000, proclaiming himself the liberator of the Greeks. Three generals sent from Rome with much smaller forces were routed or fled. Most cities received him with enthusiasm, though some remained loyal to the Romans and stood siege. Pergamum was in the former category and surrendered immediately.
Mithradates appointed “satraps” to rule the former territory of the Romans. And then, notoriously, he proclaimed a genocidal slaughter of all Romans and Italians in Asia, male and female, adults, children, and slaves. Ancient sources tell us, but with no basis for accuracy, that 80,000 or 150,000 were murdered on the fatal day. Among the most enthusiastic participants were the cities of Pergamum and Ephesus, both of whom hunted down and massacred their Roman populations even as they took refuge in the sacred precincts of the gods.
The Roman general Sulla defeated Mithradates a few years later. The Romans reimposed taxes and tax collectors with a vengeance, with the additional burden of a colossal indemnity payment. Mithradates himself survived to plague the Romans for twenty-five years and two more major military campaigns, until finally driven into exile and suicide by Pompey the Great in 63 B.C.E.6
Pergamum suffered in the decades after the massacre of its Roman residents. Its “free” status was revoked; building languished; the festival in honor of its mythical ancestor Heracles ceased because no one was able to pay for it. But gradually the city’s fortunes picked up. In the brief dictatorship of Julius Caesar, it regained its “freedom.” Caesar also reduced the amount of tribute that Asia owed to Rome and put an end to the practice of collecting it through corporations of publicans, shifting the burden onto local aristocrats. The economy slowly recovered from years of merciless exploitation.
In the relatively peaceful imperial period, freed from the burden of warfare and the aggressions of its neighbors, Pergamum and the Greek East’s other cities flourished. The resources that they had once poured into war now fueled cultural rivalry—each city wanted the best theaters and gymnasia, the most splendid festivals, and the most renowned orators and philosophers. Aristocrats who had once competed for military commands now bankrupted themselves in their efforts to win the gratitude and respect of their fellow-citizens, paying for games and festivals, handouts, and gargantuan public buildings. In the second century C.E., Pergamum reached its apogee; its temple of Asclepius, the god of medicine, was renowned the world over; its population, as Galen claimed, was 120,000; it boasted famous orators and culture heroes.7
The nobility defined itself by its participation in Greek urban culture. They held the civic offices that supervised and paid for the city’s festivals and its elite gymnasia; their names were inscribed on its public buildings, as donors; they competed in the games as athletes, poets, and even as doctors (medical competitions are attested in at least one city of Asia Minor—see chapter 3). In their leisure time they wrestled in the gymnasia and took massages at the baths. They debated each other in the agorai, temple precincts, and other open spaces. They proudly styled themselves Pergamene citizens, bouleutai (members of the local senate), officeholders, and members of the gymnasium. They thought of themselves, above all, as Greeks.8
Rome ruled through the social ties between its ruling class and the elite classes of cities like Pergamum. Those ties were very complicated. Many of Pergamum’s aristocratic citizens held Roman citizenship too, including, probably, Galen’s father and Galen himself. There is some doubt about this—Galen never mentions his citizen status—but two inscriptions from Pergamum from about the right time, honoring an Aelius Nicon, an architect, may refer to his father.9 Citizens usually took their Roman names from the emperor who granted them citizenship: Aelius was one of the names of Emperor Hadrian, who ruled from 117 to 135.
Galen mentions in passing a youthful connection with another prominent Roman citizen:
I was still living in my homeland at that time, studying under Satyrus; he was then spending his fourth year in Pergamum with Costunius Rufinus, who was constructing the new temple of Zeus Asclepius for us.
(Anat. Admin. 1.2, 2.224–225K)
Other sources tell us that the proper name of this benefactor was L(ucius) Cuspius Pactumeius Rufinus (it was probably distorted by copying error in Galen’s text), a Pergamene appointed to the Roman senate by Emperor Hadrian. Galen goes on to mention Satyrus’s teacher Quintus, another Roman citizen and very famous doctor who taught and practiced at Rome—that is, Galen’s teacher Satyrus had studied in Rome.
The entanglements between the Pergamene aristocracy and the Roman ruling class can also be read in the archaeological record; for Pergamene culture increasingly linked it to Rome. The Upper Gymnasium, on the acropolis, had baths adjoining, which were put together in such a way that the complex resembled the great imperial baths at Rome; although in which direction the influence extended, we do not know. Rufinus’s new temple of Zeus Asclepius was a miniature replica of the renovated Pantheon, Hadrian’s latest architectural triumph in Rome, complete with a domed roof. At the same time, on the crown of the acropolis, an elegant and highly visible temple dedicated jointly to Zeus Philios (“Friendly” Zeus) and the deified Emperor Trajan was also under construction. (The temple was completed in Hadrian’s reign, and contained cult statues of both emperors, so that in Galen’s time it was probably called the “Temple of Hadrian.”) Pergamum already had, in common with many Greek cities, a temple of Augustus and Rome and associated games; in fact, it proudly advertised that it had been granted the first imperial temple and cult, in 29 B.C.E. The Roman emperors were worshipped as gods, like the Hellenistic kings before them, and not only after they were dead and officially “deified.” Their festivals, their temples, their statues—mostly funded not by the emperors themselves, but by eager members of Pergamum’s local nobility—were only the most blatant advertisements of Pergamum’s place in the Roman Empire.10
It is therefore not surprising then that Galen made the journey to Rome, twice, and lived there most of his life. But his attitude to Roman culture was ambivalent at best. He proudly portrays himself as Greek. If he had a Roman name, he never used it; no reference to himself as “Aelius” survives. He never quotes a Latin author and, although he lived in Rome for many decades, we have no real evidence that he knew Latin at all. He did not need to; every educated person at Rome, and most of their slaves, spoke Greek. He considered his connection to the emperor Marcus Aurelius his highest accomplishment; but he otherwise remained aloof from Roman culture and vested all his political loyalty in his home city.
Greek culture in some ways reached its height of aggressive self-consciousness in the Roman Empire and especially in Galen’s time. In the second century the movement that scholars today call the “Second Sophistic”—and it is called this also in one ancient source—reached its height. The “sophists” were professional orators, but much more than that—they were entertainers, educators, public benefactors, culture heroes, and ambassadors. They could capture audiences of thousands with their virtuoso performances, often in the city’s huge public theaters. Disdaining prepared topics, they made a display of soliciting random topics from the audience and then declaiming on them. Certain themes were traditional, mostly from the classical and Hellenistic Greek past; for example, “Demosthenes denounces himself after the battle of Chaeronea.” They affected the classical Athenian dialect, which had not been spoken in many centuries but which survived in the works now considered the foundations of Greek culture. The most famous sophists commanded enormous fees and prizes. They and their students came from the highest classes of the Hellenized East, and they embodied Hellenism itself.11
Sophists competed with each other for prestige and students; cities competed for famous sophists. Polemo, perhaps the most illustrious sophist who ever lived, was won over to the city of Smyrna (modern Izmir, about 66 miles by road from Pergamum in Galen’s day) by the deluge of honors they voted him, opened a school there, and was commonly believed to be a native of the city although he was actually born in Laodicea on the Lycus, some 150 miles to the southeast.12
The sophists’ complex relationship to Rome and to the empire, like Galen’s, illustrates the paradox of Greek culture: Hellenism’s high prestige among its conquerors. The sophists’ disdain for the Romans mixed awkwardly with subservience and assimilation. Polemo’s family included consuls in the Roman senate; many sophists held office by imperial appointment; some were “friends” or regular advisors to emperors. Sophists often served as ambassadors from their cities to the emperor, pleading a cause—disaster relief, or a new gymnasium, or asking for judgment in one of the continual disputes with other cities over some minute signifier of primacy. Every self-respecting sophist had met at least one emperor and had a story to tell about the experience. Polemo was famous for having thrown the Emperor Antoninus Pius out of his house in Smyrna in the middle of the night. Of Dio Chrysostomus of Prusa, a sophist of the early second century C.E. from what is now Bursa in northwestern Turkey, a biographer writes that the Emperor Trajan let him ride next to him in his chariot during a triumphal procession and often said “I don’t understand what you are saying, but I love you as myself.” Here as often, the emperor is the butt of the story; sophists affected an arrogance that no one else could get away with. To the empire’s proudly Hellenic population the sophists represented the antiquity, sophistication, and superiority of Greek culture; but for all their posturing, they were not in conflict with the Roman ruling class nor even distinct from it. They held positions of power in the imperial bureaucracy, they often held Roman citizenship and came from the same families as Roman senators, and they educated the sons of Roman aristocrats.13
I mention the sophists because in many ways Galen was one of them. Erudition, competitiveness, Hellenism; public displays of skill; rivalries, political power, and an intimate but complicated relationship with Roman authority—the sophists were the most visible exemplars of these qualities, but the latter were typical of the Greek urban aristocracy generally and of Galen in particular. Like the sophists, Galen was an expert on classical Athenian language: for most of his writing he used a more straightforward, pedestrian style suitable for its technical subject, but he was perfectly capable of high Sophistic style, which he adopted for florid polemical passages. His longest work, now lost, was a two-part dictionary of Attic words. Like the sophists he was an educator; like them he staged dramatic public speeches, debates, and performances; like them he mingled with the Roman aristocracy and was proud of his association with the emperor. Like most of them, he came from a Greek city in Asia Minor. Galen is a very accurate mirror or microcosm of Greek elite society in his time.14
Women were a shadowy presence in Greek public life. Hellenic aristocratic culture prized modesty above all things in women; and its ideals relegated them to the domestic sphere, to the thalamoi or “chambers,” the more private areas of the house. When women appeared outside in the Greek East, they were heavily draped and veiled. Besides the production of new citizens, religion was their primary duty to the city—the celebration of cults, some of them very ancient. Pergamene women held some civic offices and even, like their male counterparts, occasionally appeared on coins. Many were wealthy and could be honored as public benefactors. But they did all of these things much less frequently than men, and with important differences in how the inscriptions that honored them described their accomplishments.15
For the most part, life was lived in the open air. Even within houses, life centered around courtyards and, in larger houses, colonnaded interior gardens. Not enough of residential Pergamum has been excavated to describe it specifically; but it was probably like other cities of the Roman Mediterranean. Commercial and private life mixed promiscuously. Among the houses, on every block and street corner one found workshops, bakeries, bars, and brothels. Artisans clustered in certain areas of the city, well known to the patrons who needed to find them—shoemakers, glassmakers, barbers, butchers; on the outskirts the more noxious professions, potters, fullers (who used human urine to prepare cloth), and blacksmiths. Some merchants occupied stalls in the city’s spacious, monumental fora; others hawked their wares in the streets. Office buildings and schools did not exist. Professionals worked at home; later, in Rome, Galen’s clinic was in his house. Schoolteachers taught their pupils outside, wherever they could find shelter, for example under the porticoes that lined some streets. Libraries and temples lacked indoor space—one read outside, where the light was better. Temple buildings functioned mainly as repositories for the items dedicated to the god and as imposing frames and shelters for the cult statue. The action—debates and speeches, spectacles, processions, sacrifices, contests, and festivities—occurred in the space around, the open temple precinct and nearby theaters. All Greco-Roman theaters and amphitheaters were open air, though some had awnings that could be unfurled in hot weather. Likewise the gymnasium was mostly open space—a large inner courtyard for wrestling and other sports, and an attached theater.16
The main activity that occurred indoors was bathing. Baths were the only structures with heat, and at Pergamum they were likely a welcome refuge from the cold in winter, when average low temperatures dip to the thirties Fahrenheit, and snow is not unheard of. Today baths are often recognized by their hypocaust floors, raised on brick pillars, beneath which steam from the boilers circulated. These floors were dangerously hot; at Rome one master’s slaves attacked him in the baths and then threw him on the floor to test whether he was really dead. Stoking the boilers and cleaning up after the patrons was the unhappy duty of public slaves.17
Today, tourists and archaeologists know the ancient city as a scattered collection of bleached stone: some of it reasonably intact, some of it rebuilt as poignant ruins, most of it foundations and rubble, requiring a great effort to imagine the original structure. It is even more difficult, confronted only with these remains, to capture the squalor of the ancient city, in which sanitation was rudimentary, animals were herded through the streets and also butchered there, settlement was much denser than modern Westerners are used to, and plague and famine were frequent events. Average life expectancy at birth in the Roman Empire was probably about twenty-five or thirty. Because most people died of infectious disease, that figure varied with ecological conditions and was lower in the cities and somewhat higher in the countryside, though it was probably not higher than about thirty-five anywhere. (It may be helpful to note for comparison that in Bangladesh today, average life expectancy at birth is close to seventy.)18 The city best attested in ancient literature is Rome, bigger and fouler than any other in the empire; I will describe it in its own place. Pergamum was a miniature version, although probably safer from malaria and some other diseases because of its elevated situation.
Baths were undrained, the water often visibly filthy:
Someone recently asked us why we piss cold in the [hot water of the] baths, but outside [we piss] hot, not understanding that the piss itself is lukewarm...
(Simp. Med. 3.8, 11.554K)
Baths were also common sites of violence, theft, and illicit sex. Fainting at the baths was common, especially if the wood from the boilers gave off too much smoke. Houses lacked indoor plumbing and many people emptied their refuse into the streets rather than use the few public latrines. At the gymnasium, wrestling injuries—such as a crushed larynx, fractured ribs, or dislocated shoulder—were common (Galen will suffer a dislocation himself, in chapter 5). Galen does however praise the fountains of Pergamum; their water, some of it brought 43 miles from Soma by aqueduct, is not “smelly or toxic or muddy or hard,” as it is in many locations in which, Galen explains, he has given patients boiled water.19
Some of Galen’s most vivid experiences of famine and epidemic date to his childhood and young adulthood in Pergamum. While an adolescent student of the physician Satyrus, he and his teachers witnessed an epidemic outbreak of what he calls “anthrax” (the disease was perhaps the most common, cutaneous form of what is now called anthrax, transmitted by infected livestock; this has a fatality rate of about 20 percent if untreated): “of many patients parts were stripped of skin, and of some also of the very flesh” (Anat. Admin. 1.2, 2.224–25K). In a famous passage, he describes the effects on the peasantry of a famine that raged for years in many parts of the empire. The good grain and other produce went to the cities, as was customary. Peasants, forced to eat green twigs, bulbs, and grasses, began to suffer from a huge variety of noxious symptoms, especially ulcerative skin disease, dysentery, and fever; their sweat smelled foul; when doctors let their blood it oozed thick and dark, and the wounds refused to heal (Bon. Mal. Suc. 1, 6.749K). In another passage, Galen writes that during food shortages the peasants in his homeland consume the acorns they normally feed to pigs; first they slaughter the pigs, then eat the acorns (Aliment. Fac. 2.21, 6.620K). In a bad year farmers neglect to remove the darnel, a toxic weed, from the wheat that they send to the city, and consumers become sick with headaches and ulcerated skin (Aliment. Fac. 1.37, 6.553K).
In Galen’s view, food flows from the countryside to the city as from (he believed) the intestines to the liver—along roads, which are like veins (Hipp. Nat. Hom. 2.6, 15.145K). The city was parasitic on the countryside and had power over it—not only economic power as the sole consumer market for the land around it, but the power to extort its produce if necessary, as taxes, rent, or by requisition. Cities were not, however, immune from food shortages, which are well-attested and occurred frequently. Most cities had an official especially in charge of the grain supply; when it failed, mob violence often resulted. A fourth-century grammarian recalls rioting during a food shortage, and he himself was in danger of being stoned by the crowd when he defended the local magistrates from accusations of corruption; this was in his hometown of Antioch (modern Antakya, then in the Roman province of Syria, today a part of Turkey). The pagan saint Apollonius of Tyana is supposed to have rescued a magistrate from being burnt alive at Aspendus in southern Asia Minor, where a hungry mob besieged him as he clung to a statue of the emperor. At Prusa, a mob beset the property of the philosopher and wealthy citizen Dio Chrysostomus, intending to burn it, because they suspected he was hoarding grain. In his speech on this episode he refers to “stones and fire” as the habitual weapons of the city’s populace—here as elsewhere, lynching is represented as the normal behavior of an urban population under stress, not a ghastly aberrant act. A stone-wielding mob set on another sophist of Dio’s generation, Lollianus, who at the time was the official in charge of the food supply in Athens, during a riot in the baker’s district.20
Lynchings did not only happen during famine, as we know from familiar passages of the New Testament and other sources. In Ephesus, a mob incited by the guild of silversmiths kidnapped two associates of the apostle Paul and dragged them to the theater, where a menacing crowd shouted “Great is Artemis of the Ephesians” in unison for two full hours. In the gospel of John, an adulteress narrowly escapes death by stoning. In Apuleius’s novel The Golden Ass, a mob condemns a woman to death by stoning as a witch, and a widow is nearly lynched at her husband’s funeral by a crowd that suspects her of murder. All of these are routine episodes mentioned in passing or invented to flesh out a story with plausible detail, and many of them are set in Asia Minor (both Prusa and Ephesus are within 100 linear miles of Pergamum). Emperor Trajan considered the province of Bithynia to the north—Prusa was one of its cities—so volatile that he banned all trade organizations and would not even allow a fire brigade.21
Despite its occasional horrors, Galen considered city life normal. To him, the countryside was an alien environment and peasants were almost another species. Urbanites were not cut off from the country—they traveled through it, slowly, on foot; they owned property there, since real property was the mainstay of most wealthy citizens’ income; they managed those properties and visited them and dealt with their tenants. In middle age, Galen’s father took up residence in the countryside as a gentleman-farmer and taught himself, among other things, to distinguish the seeds of different kinds of grain and weeds; weeds, as he thought based on experiments of his own design, resulted from spontaneous changes in the cultivated plant (Aliment. Fac. 1.37, 6.552–53K). Galen often refers to the peasants in the environs of his home city and of other areas—especially in his works on food, where he is interested in local diet, and on drugs, where he remarks on indigenous herbal remedies and on the challenges of treating patients with only locally grown ingredients, far from the marketplaces of the city. Sometimes he speaks admiringly of the simplicity and self-sufficiency of peasant life; but he also portrays the countryside as a world of isolation and hardship where people live more like animals. Peasants eat food indigestible to city folk; they suffer sickle wounds and snakebite; they often self-treat or their problems go untreated; their bodies are harder than those of city-dwellers (Simp. Med. 10.2.22, 12.299K) and require adjusted remedies for that reason. While Galen’s urbane fellow-citizens work out in the gymnasium, backbreaking labor is the peasant’s exercise.22
The Greek culture with which Galen identified was urban culture. In some of the rural hinterlands of Asia Minor, Greek was not even spoken; about two dozen native languages are attested, including Luwian, the ancient language of the Hittites still spoken by the bandit tribes of the Cilician highlands to the south. Galen never mentions meeting a peasant who did not speak Greek or speaking through an interpreter; but he barely mentions Latin either, though he lived in Rome for decades, and we do not really know what language or languages the peasants he encountered spoke.23 (For more on Galen’s encounters with peasants, see chapter 4.)
To the east of the city of Pergamum, far outside the Hellenistic walls and on the outskirts of the Roman development, stood the temple of Asclepius, the Greek god of medicine. It was founded around 200 B.C.E., in the time of king Eumenes II. In 88 B.C.E., on the day of Mithradates’ genocidal edict, the city’s Roman population took refuge in Asclepius’s sacred precinct. The Pergamenes tracked them down and slaughtered them where they stood. As a result, after the Roman reconquest, the temple temporarily lost its status as asylum—a devastating blow, since temples were their own jurisdiction, their power coextensive with the territory sacred to them. The temple regained its status in 44 B.C.E., the same year that Pergamum was once again declared a “free” city, and in the next centuries Asclepius became Pergamum’s most important god and his temple was renowned everywhere.24
The Roman Emperor Hadrian visited Pergamum in 123 C.E. He typically traveled with a corps of architects and engineers and was renowned for his love of Greek culture, his skill at architecture, and his generous support of large-scale building projects in the Greek world. His visit inspired a massive remodeling of the temple precinct that swept away its accumulated clutter of small buildings and replaced them with a spacious complex of grand and opulent design. A covered colonnade enclosed an area almost twice that of an American football field (100 meters by 93 meters) on three sides. The builders leveled the precinct, cutting into rock to the north and supporting the long southern portico with elaborate subterranean vaulting. On the eastern side stood a porticoed, monumental gateway and the new temple of Zeus Asclepius, a miniature replica of Hadrian’s most famous project, the renovated Pantheon at Rome. Its domed roof and circular, niched interior were the height of modern innovation at the time and were reduplicated faithfully at Pergamum. The complex also included a theater; a library; two sets of latrines; a large, round structure with semicircular niches usually called the Rotunda, which was probably not constructed until about 200 C.E.; and in the center a number of old Hellenistic cult buildings including the main temple of Asclepius, several sacred wells and fountains, and an incubation complex where pilgrims slept and where Asclepius spoke to them, and healed them, in dreams. A colonnaded “Sacred Way” (the last hundred feet or so survive) led from the city to the temple precinct.25
In the Greco-Roman world, healing was the main business of medicine. On inscriptions thanking gods for favors, healing is the benefit most often mentioned, by a wide margin. Most gods could heal, but Asclepius was the healing god par excellence, and his temples stood all over the Mediterranean world:
We never find any country, or any city, without places where recovery is sought through divine medicine, some named after Asclepius, others after Apollo.
(Opt. Med. Cogn. 1, tr. Iskandar)
Some were small and local, while others—like the temple at Pergamum—attracted pilgrims from far and wide. By Galen’s time Pergamum was so closely tied to Asclepius that the latter was often called “the god of Pergamum” and Galen calls him his “ancestral god” (Libr. Propr. 2, 19.18–19K; San. Tuend. 1.8, 6.41K). Those who were healed dedicated offerings, often simple terracotta models of the part healed: feet, ears, breasts, and genitalia festooned the temple precinct. Wealthier patrons sometimes dedicated plaques with scenes of healing, or more expensive treasures. Each object commemorated a story of healing, and the stories also circulated as testimony to Asclepius’s power. At some sanctuaries the priests collected and published the temple’s stories on stone inscriptions for pilgrims to admire. The most famous and complete of these collections is at Epidaurus in Greece and dates to the fourth century B.C.E., but there are examples from the Roman period, including one inscription from Pergamum in which the god cured the dedicator by prescribing a diet of onions and white pepper.26
The cult of Asclepius was not hostile to rational medicine, or vice-versa. Asclepius was the god of doctors. Legend told how he learned the art of medicine from the centaur Chiron. Many doctors visited his shrine and made dedications to him, including medical instruments. Medical families often named their offspring Asclepiades or “son of Asclepius” and the Hippocratic Oath invokes him. The god’s prescriptions, as communicated in dreams, were baths, vomiting, purging, plasters—the same things that doctors prescribed. But Asclepius’s cures could have extreme or counterintuitive twists, and the legends that surrounded his cures attracted the exaggerated, unlikely elements typical of oral history:
Nicomachus of Smyrna’s whole body grew so disproportionately [huge], that he finally was unable to move; but Asclepius cured him.
(Morb. Diff. 9, 6.869K)
The god healed Galen himself when he contracted a dangerous illness as a teenager (see chapter 2); as a result of which Galen “proclaimed myself a servant of the ancestral god” (Libr. Propr. 2, 19.18–19K). Galen occasionally expresses frustration at patients’ greater willingness to consult or obey the god rather than their doctors, but he never criticizes the god’s cures or doubts their efficacy.27
The temple at Pergamum is well-known today through the diaries of Aelius Aristides, a sophist and older contemporary of Galen who spent a lot of time there. Aristides lived most of his life in Smyrna and identified with that city. He visited Rome at age twenty-six and met the emperor. The journey was a nightmarish one during which he became very ill and never fully recovered. He spent the rest of his life seeking cures at temples of Asclepius, surrounded by his entourage of doctors along with his friends and servants. Dreams were the normal method by which gods communicated with humans, and Asclepius instructed Aristides in dreams, which the latter recorded—in an immense work of some 300,000 lines now lost to us, compiled over the years, but also in the six Sacred Tales that survive among his orations. Most of the time Aristides did not dream about the god directly—he dreamt about declaiming, or about his nurse or his foster father, his friends, the temple personnel; or about the emperors or the governor or the king of Parthia. His dreams are quite ordinary, but he interprets elements of them as divine instruction—for example, the excavation of a drainage ditch signifies vomiting (Sacred Tales 1.46, 50).28
Aristides recounts a long history of ailments, most notably a monstrous tumor on his thigh, and a plague that killed much of his household at Smyrna (Sacred Tales 2.4). This was the same plague Galen faced in 166 C.E. (see chapter 6), probably smallpox; Aristides was narrowly spared when, as he believed, his foster son died in his place. During one of his extended stays at Pergamum, the god advised him to cover himself with mud and bathe in the Sacred Well. It was a very cold day, but Aristides obeyed Asclepius’s commands, as always. He also bathed in a linen tunic in freezing weather, ran naked around the temple complex in icy winds, went barefoot throughout the whole winter, and slept in the open air everywhere in the temple precinct. Very frequently Aristides’ entourage of friends and doctors would object to the god’s advice; but Asclepius was always right. Aristides’ devotion to the god was profound. He kept up a running dialogue with him, through dreams, all his life; he joined the community of initiates at Pergamum; he considered the god his savior multiple times over; he believed the god had the power to predict and remit death.
Pergamum, the city founded on pilfered treasure, the city of Attalus and of Asclepius, the city that had turned on its Roman inhabitants and slaughtered them by the thousands on one dark day in 88 B.C.E., and had then become the light of Roman Asia, beloved of Hadrian, adorned with every architectural glory—Pergamum was Galen’s city.
We do not know how long his family had lived there, but it seems that they were prominent citizens. Galen’s father and grandfather were architects. In the Greek world that placed high value on skill and intellectual accomplishment, work of this type was no disgrace but, depending on the profession, could be very prestigious. Like sophists, architects could command huge fees or gifts from their clients; but as a point of pride Galen’s ancestors, like Galen himself, probably declined to be paid by the piece or by the day. Galen writes that he never charged a patient a fee and even donated medicine and servants to those who could not afford them. I will say more about Galen’s clientele in chapter 7, but I note here that in his surviving works Galen scrupulously portrays himself as a man of independent means, living off the landed property he inherited from his father. Galen owned property in Pergamum—which he kept, with its staff of slaves, long after he had ceased to live there—and a house in Rome and a country home in Campania, in southern Italy. He owned a large contingent of slaves, including domestic servants, professional assistants, and stenographers. He mentions all of these things in passing, without comment, as a matter of course. There is no doubt that Galen’s prowess and renown as a physician brought material advantage. He mentions with pride a huge gift of 400 aurei—gold coins—that he accepted from his enormously wealthy and powerful friend, the senator and ex-consul Flavius Boethus, for curing his wife; although this is the only time Galen describes receiving money for a cure, it was probably not the only time it happened. But Galen would have been horrified if people thought he practiced medicine to amass money. He was a gentleman, a Greek, a leading citizen of Pergamum. His lifestyle came to him by birthright; but his skill and reputation, by hard work, exhaustive study, experiment, experience, and proven superiority over his rivals. Galen’s sense of professionalism was highly developed, and its various aspects will be explored in the chapters that follow. But it did not include working for money.29
Galen no doubt inherited these values from his father, whom he idolized. A late antique encyclopedia, the Suda, tells us that his father’s name was Nicon and that he was an architect. Galen confirms the detail about his father’s profession in his treatise Avoiding Distress, a work long thought lost but rediscovered, along with new manuscripts of several other Galenic treatises, in 2007 at a monastery in Thessaloniki. Among other things Galen reports that his father and his father’s father were architects, and that his great-grandfather was also a professional, a geometer—most likely an engineer, but possibly a land surveyor. The Suda’s information on the name of Galen’s father probably traces to one of Galen’s lost works. If it is correct, he may be attested in Pergamene inscriptions honoring an Aelius Nicon, a Roman citizen, as I have mentioned. The Nicon of the inscriptions is a small-scale public benefactor and a man of great erudition, composer of a poetic diatribe on geometry and a hymn to the Greek sun-god Helios; it is quite plausible, but by no means certain, that he was Galen’s father.30
Galen tells us very little about his childhood. We know, calculating from later events, that he was born in 129, and, perhaps more tenuously, from a chance comment, that he was born around the time of the autumn equinox in September.31 None of his autobiographical anecdotes takes place before his mid-teens. We do not know whether he had siblings or pets or a nurse or favorite caretaker, or how he remembered his childhood years, if he did at all. This may be related to Galen’s reticence on the subject of “private” or family life in general. That is, while he talks about his postsecondary education, his friends, his classmates, and his father, Galen never mentions a wife or concubine, a child, a male or female lover, or a sibling. It is possible that he had all of these and never found them worthy of mention. It is also possible that he had none of them. Siblings, in particular, may have died very young in a population with horrific child mortality; and aristocratic families often sought to limit the number of heirs. (Galen writes as though he were the only heir to his father’s estate.) One patient he describes, Theagenes the Cynic, when he died was mourned only by a crowd of friends:
No one inside was wailing. For Theagenes had neither servant nor boy nor wife, but only his philosopher friends were around him, who behave properly in the care of the dead, not being inclined to mourn.
(Meth. Med. 13.15, 10.915K)
For Galen, Theagenes lived an ideal; and his own life, what he lets us see of it, is defined by his intensely competitive, masculine relationships with friends and rivals and not by domestic attachments. Our image of Galen is a very public one in that sense. The sole woman in his family whom he mentions is his mother, in one notorious passage:
My mother was very irascible, so that she sometimes would bite her maidservants, and she constantly screamed at my father and fought with him, like Xanthippe with Socrates. When I compared the good actions of my father with the disgraceful passions of my mother it occurred to me to embrace and love the former, and to avoid and hate the latter.
(Anim. Affect. Dign. 8, 5.40–41K)
It would, of course, be irresponsible, based on this passage alone, to speculate about the long-term effects of growing up in a troubled household with a violent and irascible mother. We should remember that Galen’s mother was probably not his primary caretaker; most likely, he was raised by domestic servants. The minor significance of women in his later works (and perhaps in his life) is not necessarily the result of bad mothering; it is comparable to what we see in other Greek autobiographical writers, such as Aelius Aristides and Libanius, especially if we consider that Galen offers us only anecdotes in medical treatises and no extended narrative of his life.
Still, the contrast with Galen’s father is very obvious. Galen mentions the latter many times and always with the deepest reverence, emphasizing his moral qualities and the values that he transmitted to Galen.
I had a father who attained the height of geometry, architecture, logic, mathematics, and astronomy; and those who knew him praised him for his justice, goodness, and moderation beyond all the philosophers.
(Bon. Mal. Suc. 1, 6.755K)
My father accustomed me to disdain reputation and honor, and to value truth alone.... If a cow, a horse or a domestic servant died, it was not enough to make me grieve, when I remembered what my father advised, not to grieve for the loss of material goods as long as what remained was adequate for the care of the body.... If means beyond this existed, he said they ought to be used for good works.
(Anim. Affect. Dign. 8, 5.43–44K)
I had the great good fortune to have the least irascible, most just, best and most philanthropic of fathers...
(Anim. Affect. Dign. 8, 5.40K)
He was drawn into political business by his fellow-citizens, since he seemed to them to be the only one who was just and above material wealth, and approachable and mild.
(Anim. Affect. Dign. 8, 5.41K)
Here Galen’s father embodies the sober reserve that Greek and Roman philosophers alike espoused as their ethical ideal. A gentleman did not indulge in lavish displays of emotion, did not hit slaves in anger, was neither acquisitive of luxuries nor aggrieved at material losses, did not pursue romantic passions (a subject Galen barely mentions in all his works), and scorned fame.
And yet for all his insistence on these values, the vices they were meant to suppress—competitiveness, rancor, anger with occasional explosive violence, and especially the pursuit of prestige at all costs—were very characteristic of Galen’s class. The tension between philosophy and reality is obvious in some passages:
I have never struck any of my servants with my hand, which was also my father’s practice, and he reproved many of his friends, seeing their bruises from hitting servants in the teeth, saying that they deserved to have convulsions and die from the inflammation that resulted.
(Anim. Affect. Dign. 4, 5.17K)
Widely held values about emotional restraint did not prevent some of Galen’s contemporaries, including his own mother as I have mentioned, from brutalizing their domestic servants. Most disingenuous is Galen’s oft-professed lack of concern for honor and reputation. Nothing, as we shall see in the following chapters, drove him more. It drove his father too:
not a few of my fellow-students answered me, “you have the advantage of an excellent nature and an astounding education because of the ambition (philotimia, love of honor) of your father, and you are at the stage of life when it is possible to learn, and you have wealth with which to obtain leisure for studies. And we do not have these things.”
(Meth. Med. 8.3, 10.560–61K)
Philotimia, the defining quality of the Greek urban aristocracy, is ambivalently praised, critiqued, and dissected in the ethical treatises of the philosophers who nearly invariably came from its ranks, including Galen himself. It was philotimia that built the architectural wonders of the East and adorned them so splendidly; and that fueled the incessant litigation, rancor, stasis or internal unrest, even low-level insurrection endemic in the East at all times, as the wealthy competed for rank and honor and drew their friends, families, and dependents into the struggle. Philotimia was even arguably the basis of Roman rule; Roman emperors and senators participated in the drama as arbiters or allies, heard cases, resolved round after round of disputation, suppressed violence when necessary and feasible, and occasionally rescued the colossal wreckage of failed, hugely expensive architectural projects with their engineers and expertise.32
As I have mentioned, Galen acknowledges, hints, or boasts in several places that he lived off the assets he inherited from his father, which gave him leisure to devote all his time to his intellectual and professional life, to disdain fees, and to be magnanimous in the tradition of his class. But he also attributes to his father his most important asset of all, his education. Philotimia drove Galen’s father to desire for his offspring all the cultural capital—paideia, education—that alone, along with landed wealth, could ensure his success in the exclusive and intensely competitive society into which he was born. Nicon homeschooled Galen rigorously in geometry, mathematics, and arithmetic, just as he had been educated by his own father and grandfather. Nicon also was deeply versed in grammar and taught Galen proper Greek. For the rest of his life Galen claimed expertise in geometry, mathematics, and logic, and brought all of these to bear on medicine in both valuable and infelicitous ways. Later, he claimed that no physician could be competent without a background in these disciplines; and one of his longest works, On Demonstration in fifteen books (now lost), expounded on the principles of geometric proof, which he considered far superior to the kinds of proof offered by most philosophers.33
Galen’s education in philosophy, the specialty that his father first chose for him, began quite young. As Galen explains, when he was about fourteen, Nicon became more active in city politics and had less leisure to supervise Galen’s education himself; but he interviewed and handpicked his son’s philosophical teachers with care. Galen studied with a Stoic, a Platonist, a Peripatetic, and an Epicurean; and attributes to his father’s advice one of the defining features of his own intellectual life:
“These commands,” I said, “of my father I hold to and preserve to this day, never professing myself an adherent of any sect, making rigorous investigation of them with all diligence...”
(Anim. Affect. Dign. 8, 5.43K)
Had Galen uncritically adopted the ideology of the Empiricists, his first medical teachers—who forswore anatomy, among other things—his life and Western medical history would have taken a very different course. But Galen went to his grave insisting that he was neither Dogmatist, nor Empiricist, nor Methodist—the three main “sects” we today identify in Greco-Roman medicine, based largely on a simplified reading of Galen’s works, our main source. I shall discuss them further in the next chapter.
From what Galen tells us of his father, combined with the barest scraps available from other sources and a moderate amount of speculation, a brief biography of the latter can be sketched. Nicon may have been a Roman citizen; if so, he was probably the first one in his family. He was a professional architect like his own father and was trained in mathematics, geometry, logic, and architecture by his father and grandfather. He also laid claim to the linguistic erudition in Greek that partly defined his class. He owned a house in the city with some domestic staff and land in the countryside. His marriage was troubled and Galen was perhaps his only surviving child. He invested heavily in his legacy, schooling Galen himself in the disciplines traditional to his family and supervising his later education closely. He deeply impressed on his off spring the values of temperance, self-control, and magnanimity. In Galen’s mid-teens, perhaps under pressure from his peers who felt he was shirking his fair share of the expense involved, he became more active in city politics, probably holding office. A few years later—psychologically and financially depleted?—he retired to the countryside and the life of a gentleman-farmer. When Galen was nineteen he died, probably still in middle age. At the time his son had not yet left Pergamum, and he could never have foreseen the remarkable career in store for him.