Another great burden has been laid upon me. For after I had written out the books of the work ‘On Anatomical Dissections’, as I was very nearly at the end of them, it so happened that there broke out that great fire in which the Temple of Peace was burnt down together with many warehouses and storehouses … in which were stored those books of mine on Anatomical Dissections, together with all my other books. None of my works survived, except what I had already handed over to be transcribed.
(Anat. Admin. 11.12, 135 Simon, tr. Duckworth)
alen writes here and in several other places of a great fire that scoured Rome in 192 C.E. We know about this fire from independent sources: the historians Herodian and Cassius Dio both mention it; in the historiographic tradition, it was an omen of the death of Commodus, who died on the last day of that year. Galen tells us that it happened in late winter or early spring; he was sixty-two years old.1
The fire consumed the Temple of Peace and the area all around it. This was a cultural catastrophe as well as a human one because the fire spread to the Palatine and consumed the libraries and archives located there, intellectual plunder from centuries of conquest and probably the most extensive collection of books in the world, unless Alexandria’s collection was larger. Furthermore, and especially important for Galen, the fire destroyed the storage rooms (apothekai) near the Temple of Peace and along the Sacred Way. These were supposed to be fireproof; only the doors were made of wood, and they were not near any residences, which is where fires normally broke out (and, according to Cassius Dio, where the fire of 192 actually started). They were kept safe under military guard because certain imperial archives were housed there, and they fetched extravagant rents. Galen stored all his most precious possessions in one of these storerooms, possibly located in the Horrea piperataria, the spice warehouse where Arabian and Egyptian imports were kept. Also, by a stroke of bad luck he was visiting his estate in Campania when the fire broke out and had moved the valuable items from his home into storage for safekeeping while he, and probably most of his household, were away.2
Galen had survived the deaths of his beloved father and of his best friend Boethus. He had lost his friend Teuthras and most of his own household slaves in the great plague. He had witnessed famines and epidemics and the deaths of innumerable patients, attacked by gruesome and terrifying infectious diseases rarely seen in the West today. He endured chronic, life-threatening illness and enforced separation from his homeland, not to mention the continuous and ruthless assaults on his reputation that were a normal part of life in his world. But the fire seems to have been, in his subjective experience, the worst catastrophe that he ever experienced. Certainly it is the only one to which he records his emotional reaction. He seems to have struggled with this reaction; the fire tested his ability to cope in a way that the other events, perhaps, did not.
Galen’s treatise Avoiding Distress (Peri Alupias or De Indolentia, literally “On Non-Grief”), written directly in response to the fire and long believed lost, was recently discovered in a collection of thirteen Galenic treatises at a monastery in Thessaloniki. (Galen mentions the work in On My Own Books, and fragments had survived in Arabic.)3 It takes the form of a letter addressed to an unknown and longtime friend, someone educated with Galen (Ind. 57), perhaps a compatriot, who has expressed surprise that he has never seen Galen distressed by anything. Galen writes from Rome to the addressee, who is living elsewhere, perhaps (but not certainly) at Pergamum.
Galen’s treatise resembles other philosophical works of the Hellenistic and Roman period, many of which concerned ethics, and notably Plutarch’s On the Tranquility of the Soul. It is related to the ancient philosophical genre of consolatio, consolation for a loss, although Galen himself does not seem to have placed his work in that category.4 “Consolations” classically addressed the loss of a person, especially a child; but Galen laments, or rather resists lamenting, the loss of property. Indeed Galen may strike readers as cold in his casual references, in this very treatise, to the deaths of his household slaves and of Teuthras in the plague (Ind. 1, 35). But this may be misleading. Galen wrote no surviving treatise on the human catastrophe of the plague, which was mostly in the past by 192, and the ethical stance of Avoiding Distress, as also of his treatises on the soul discussed below, makes it clear that he would resist expressing any tender emotion he might feel. This attitude may, indeed, qualify him as cold and uncaring, but we must also remember that for all his privilege, Galen experienced suffering and witnessed horrors throughout his long life of a kind that modern readers can scarcely imagine, and it would be unsurprising if his attitudes were affected in ways that seem alien today. We might also speculate that Galen found it easier to talk about the loss of material possessions than of people precisely because it was thus easier to avoid indulging in the emotions he sought to control.
Thanks to the recovery of Avoiding Distress, we have a good idea of what Galen lost and also new insight into how he acquired his library and published his own works. The fire destroyed gold, silver, silver plate, and IOUs for the debts that people owed him (in an era without bank drafts or credit cards, Ind. 4). He lost medical instruments, including the irreplaceable wax prototypes of instruments he had designed himself (Ind. 4–5, 10). He lost medicines, both simple and complex, and pharmaceutical ingredients, including eighty Roman pounds, by weight, of theriac, and a large quantity of cinnamon, difficult to acquire except by imperial gift.5
But more than any other loss by far, Galen mourned the destruction of his books. He lost two rare collections of drug recipes, some of them “most amazing” and, to his knowledge, unique in the Roman world. One of his friends, a fellow Pergamene, had amassed a large collection of recent and historic recipes at great expense, paying as much as a hundred gold pieces for some recipes. These were preserved on parchment, and when the unknown collector died his heir, spontaneously and to the recipient’s surprise, gave them to Galen. Galen inherited another collection, also on parchment, from Teuthras when he died. Teuthras had himself inherited it from a Pergamene doctor, Eumenes. Galen augmented these collections himself by trading copies of individual recipes for new ones, so that his recipes all told ran to some eighty ancient books.6 All of these perished, but much worse than that—as Galen writes—was the loss of the original text of On the Composition of Drugs by Type, of unknown length, one of three major and massive pharmacological works that he composed.7 Galen was certain that some one among his friends must have a copy of the first two books, which he had circulated, but he was unable to find anyone who admitted possessing them and had to rewrite the whole treatise. He thought the first two books might still turn up, and felt obliged to explain why two different versions of these books might be in circulation.8
Galen writes that only a few of his recipes survived, those he had given to his students (Ind. 37). Either he is failing to mention some other collection in his possession or his rewritten treatise On the Composition of Drugs by Type and its sequel, On the Composition of Drugs by Part, represent the great labor of his declining years. As I have mentioned, Galen had already written one version of On the Composition of Drugs by Type, which was entirely lost; at least part of that earlier work had been completed by the early 170s, when he mentions it to Glaucon in his treatise On the Method of Healing to Glaucon. To this earlier era also belong the first eight books of On the Mixtures and Powers of Simple Drugs, Galen’s long work on medical ingredients and pharmacological theory, which survives. The surviving versions of the two later works on compound drugs were both written after the fire, as were the last two books of On the Mixtures and Powers of Simple Drugs.9
Together, they run to seventeen books. The recipes Galen records—like the ones he lost—were the products of long tradition and have much of the character of folk medicine. The pharmacological works are vast, nearly impenetrable collections of hundreds of remedies culled from previous authors, organized by form (for On the Composition of Drugs by Type, that is, plasters, laxatives, and so forth), or part treated (for On the Composition of Drugs by Part, which begins at the top of the head with remedies for hair loss). Galen annotates the recipes with much commentary reflecting his own experience, sometimes including stories of patients healed, and occasionally the results of deliberate experiment. It is in On the Composition of Drugs by Type that he transmits recipes for the plasters he used on wounded gladiators, describing his own experience, mentioning the low number of gladiators that died of their wounds in his care, and also that he had given out his recipes to the other doctors of Pergamum and other cities “so that their efficacy could be confirmed by use” (Comp. Med. Gen. 3.2, 13.599–603K). This was, as he would have us understand, an unselfish gesture in a time when medicine was competitive and much knowledge was kept secret. In another work, On the Organ of Smelling, he describes an experiment with a nasal drug: a person, perhaps a patient of Galen’s, had tried inhaling a concoction containing black caraway (melanthion, probably the modern Nigella sativa) up through his nose to cure a chronic sinus problem; the remedy worked but gave him a terrible headache on the fourth day, from which Galen concluded that the drug was affecting the ventricles of the brain. The headache resolved, and Galen decided to test the promising remedy on his household servants. “Some perceived no pain and some a slight one, and some a grave one deep in the head” (Instr. Oder. 4, 2.868–69K).
Whatever we may think of Galen’s human-subjects ethics, the point is that his pharmacological works were intended to reflect his own experience and also that of others: “I gave some of my writings also to my friends, when they asked for drugs like these; the drugs, tested by these very people, seem to have lived up to their promise” (Comp. Med. Gen. 1.18, 13.453K). He describes the first version of On the Composition of Drugs by Type, incinerated in the fire, as “a handbook [pragmateia] that I composed with great accuracy about the composition of drugs, in which I recalled how I myself prepared the most famous of my drugs” (Ind. 37).
In his practice, Galen missed the medicines and recipes destroyed in the fire every day (Ind. 12). He also lost a large number of the rare books he had collected and edited himself. In his decades at Rome he had pored over the libraries there and had found genuine texts not listed in the official catalogues of ancient works and thus unknown to the world, and texts whose authors had been misidentified, including, perhaps, a genuine work of Aristotle misattributed to his pupil Theophrastus.10 The fire destroyed this precious discovery and Galen’s only copy of it on the same day. Further, Galen was a diligent editor and textual critic and kept his own editions of many ancient works in the storeroom—he names the philosophers Theophrastus, Aristotle, Eudemus [of Rhodes], Cleitus, Phainias [of Eresus], Chrysippus, “and all the ancient doctors” (Ind. 15).
Galen also lost much of his own work, which devastated him, although we should not exaggerate the extent of what was destroyed. He lost the original text of On the Composition of Drugs by Type, as I have mentioned (Comp. Med. Gen. 1.1, 13.362–63K); and books twelve through fifteen of On Anatomical Procedures (Anat. Admin. 11.12, 135 Simon). He also lost the second half of his massive dictionary of words in classical Athenian authors. The half that survived, on prose writers, ran to an astounding forty-eight books. The lost half, on comic writers, was perhaps the more precious to Galen, who admired the comedians for their command of common idiom.11
This may exhaust the list of major original works that perished in the fire, although Galen does not offer a full accounting. He seems to have believed that On Prognosis, his autobiographical treatise on his rise to prominence in Rome, was lost, because he does not list it in his catalogs On My Own Books and On the Order of My Own Books, although he mentions it a few times in earlier works.12 Much of Galen’s writing—more than half of all known treatises, including the very substantial philosophical treatise On Demonstration in fifteen books, which had already partly disappeared in Greek by the ninth century, as well as the forty-eight books of his Attic dictionary that had survived the fire, and dozens of other treatises listed in On My Own Books—has since disappeared for other reasons.13 But a great deal survived the fire, because Galen circulated most of his works. He addressed them to friends and gave copies of them away; sometimes he expresses horror that works circulated beyond his intended, private audience, but there is no sharp distinction between these and works that he produced for broader publication. The procedure was the same: he had copies made for friends, students, followers, or anyone who asked for them, and copies in turn might be made from those copies. Some probably ended up in Rome’s public libraries, although he does not say this. Some books circulated in more than one edition; an early version, intended for a friend or student, might acquire its own life even after a newer version, corrected by Galen, had also been released. Draft copies of a work, with marginal corrections, might also circulate without Galen’s knowledge.14
Plagiarism and forgery were also problems. Books might be stolen and published under someone else’s name. Or books might be forged and falsely attributed to famous authors, to increase their value. In a well-known story I have mentioned already, Galen was in the Sandaliarion, the district where “most of the booksellers in Rome” could be found, when he overheard an argument that had broken out about the authorship of a book that someone had just bought, called The Physician. The buyer thought it was by Galen, whose name was on the volume; but a bystander, not recognizing the title and inquiring about the subject, pronounced it a forgery after hearing only the first two lines. Galen was no doubt delighted by this stranger’s intimate knowledge of his work, and at this point launches into a moralizing disquisition on the benefits of the old-fashioned Greek education possessed, as he imagined, by this gentleman but not, unfortunately, by most of those pretending to study medicine or philosophy in his time. This particular forgery may survive today as the treatise commonly called Introductio seu Medicus (“Introduction, or The Physician”), transmitted under Galen’s name through the Renaissance, but not by Galen.15
One could retrieve lost copies of books from friends, if they had copies (Libr. Propr. 14, 19.41K); thus Galen’s irritation with the friends who lost the first two books of On the Composition of Drugs by Type. Boethus, too, had died in possession of the original, short version of On Anatomical Procedures; Galen’s copy had perished in a mishap of unknown date (not the fire of 192, which came later). Boethus’s copy may have survived, but since he had died in Palestine, Galen was unable to lay hands on it and had to rewrite the work (Anat. Admin. 1.1, 2.215K). Galen also did his best to keep copies of his works in multiple locations (this is analogous to today’s “remote back-up storage”). He regularly had two copies of his works made, and stocked his house in Campania with one set, while he donated the other to a public library at Pergamum, at the request of friends there. In fact, as he writes, had the fire struck two months later, copies of all his works would have been safely stored in Campania and in Pergamum. The most recent batch of copies was in the storeroom awaiting transport when it burned (Ind. 20–22). We should not, by the way, imagine Galen making all these copies himself, although it is one of the tragedies of the fire that it destroyed “works of the ancients, [copied] by my own hand” (Ind. 6). He employed a staff of slave stenographers, trained at great expense in shorthand, as well as fine bookhand, and criticized as materialistic those who preferred to spend their money on other things (Anim. Affect. Dign. 9, 5.48–49K). Twice he mentions that friends, Teuthras and Boethus, sent stenographers, probably slaves from their households, to transcribe lectures he had delivered.16 Galen also apparently used hired scribes, because he complains that his copies of the rare works he had acquired from Rome’s libraries, that perished together with the originals in the fire, had been expensive to obtain (Ind. 19).
The tools available to Galen for managing his grief were the ethical principles of Hellenistic philosophy, a discipline to which he devoted himself all his life. Galen had written pointedly and at length on the soul in his youth, in On the Doctrines of Hippocrates and Plato; he returned to the subject later in life with a somewhat different emphasis, in a number of short works including the curious treatise That the Soul Follows the Mixtures of the Body, as well as On Diagnosing and Curing the Affections and Errors of the Soul; and the treatise Avoiding Distress, which I have mentioned. The other works that Galen lists, in a passage from On My Own Books, as his contributions to ethical philosophy have all disappeared, including some that one wishes especially had survived: his work On Characters (or On Ethics) in four books, of which only a summary comes down to us, in Arabic translation; and “On Slander, in which [there is] also [material about] my own life” (Libr. Propr. 15, 19.46K).17Avoiding Distress was written directly in response to the fire of 192, as I have described, and On Diagnosing and Curing the Affections and Errors of the Soul seems closely related and may have been written at about the same time. That the treatise On Characters seems to date to the same period is a further indication that the subject of ethics preoccupied Galen in the wake of the fire.18
In both Avoiding Distress and in the corresponding section of On Diagnosing and Curing the Affections and Errors of the Soul, Galen responds to an interlocutor who asks him how it is possible that he has never seen Galen express the emotion of lupe, grief or distress. The two interlocutors are different people. The addressee of the Avoiding Distress is a compatriot living abroad who posed his question in a letter (Ind. 1), but Galen’s interlocutor in On Diagnosing and Curing the Affections and Errors of the Soul, although also apparently a Pergamene (Anim. Morb. Dign. 7, 1.46K) is someone nearby:
One of the youths among my intimate acquaintance, who denied that he became upset over small things, later became aware of it; he visited me at daybreak, and said that he had been sleepless the whole night because of this matter; and meanwhile somehow he arrived at the recollection that I did not become as upset over great matters, as he did over small ones.
(Anim. Affect. Dign. 7, 5.37K)
That is, unless one or both of these interlocutors is imaginary (which is quite possible), more than one of Galen’s friends noticed his extraordinary resilience and asked him about it. Galen seems especially proud of his response to the fire, a great catastrophe. He knew more than one person who perished of grief in its wake. In his commentary on the sixth book of Hippocrates’ Epidemics he mentions the example of Callistus, the grammarian, “whose books were destroyed in the great fire in Rome in which the … Temple of Peace burned.” Callistus developed insomnia, and then fever, and then wasted away until he died, like other cases of anxiety or despair that Galen describes in that passage.19 This Callistus may or may not be the same grammarian he mentions in Avoiding Distress, here called Philides, who died “consumed by depression [dysthymia] and grief” (Ind. 7). In On the Composition of Drugs by Type, which he had to rewrite after the fire, Galen comments that he knows one doctor who died of distress after losing his remedies in the same way, and another who, in despair, stopped practicing medicine (Comp. Med. Gen. 2.1, 13.458–59K). More even than the plague that claimed almost his entire household, Galen considered the fire a nearly unendurable disaster (Ind. 1–2).
Not everyone, according to Galen, is by nature capable of great virtue. This he considered abundantly clear from his observation of personality differences in children. Some are temperate and generous; others are greedy, violent, and selfish. While our rational souls may share a universal preference for the good and beautiful, we differ greatly from one another in the strength or weakness of this soul, relative to the passions and appetites—anger, fear, and grief; lust, greed, and gluttony—that compete for influence over us. Galen had good cause to wonder, in childhood and perhaps in adolescence, about the nature of the soul he had inherited; for the contrast in his parents’ characters was very great, as I have described (see chapter 1). But he had always, as he writes, naturally preferred the qualities of his father and strove to imitate them.20
Some characters are, then, hopeless from birth; but some respond to training. Education, in philosophy and in sciences such as geometry and astronomy, strengthens the rational soul. One must also diligently work to maintain a sense of perspective. The purpose of the appetites, and of the “vegetative” soul in the liver (so called because it shares its nature with both animals and plants), is to keep the body alive and to reproduce; beyond that, if our basic needs for food and shelter are met, the appetites can only cause grief and despair when we fail to satisfy them or when we lose something we have acquired. Galen advises constantly reminding oneself that what is adequate for one’s basic needs is enough: “Always have in mind the idea of self-sufficiency.” The philosopher Artisippus of Cyrene, when he had lost one of the four estates he owned in his homeland, and one of his fellow citizens expressed sympathy for him, laughed and asked why his friend should feel pity when Aristippus still owned much more property than he did? “Perhaps,” said Aristippus to his interlocutor, “I should feel sorry for you.” Following the hero’s advice in Euripides’ lost tragedy Theseus (a passage famous in his time and preserved in other authors), Galen meditated every day on the worst possible calamities, physical torment, exile, and premature death:
I bring calamities to mind always,
I set before myself exile from my country, and premature deaths, and other ways of evil,
so that, if one day I should suffer one of the things I have imagined,
it will not sting my soul the more for being new.21
Galen recommends recruiting a brutally honest friend, perhaps someone older of Galen’s own generation, to correct one’s moral faults constantly, and to point out failures to control the passions and appetites until good habits are internalized. We cannot see our own faults, writes Galen, but only those of others, correctly identifying what modern psychologists would call self-serving bias. Whether he practiced this method himself we do not know (he nowhere mentions having such a mentor), but this friend is only a more efficient substitute for the self-monitoring of one’s own reactions that he also recommends. He advises beginning every day with the thought of how much better it is to maintain self-control than to be a slave of the passions, constantly keeping the ugliness of anger in mind, constantly taking note of mistakes of overindulgence in food, wine, and sex. With this kind of practice one may see slow improvement over years and must not become discouraged if change does not occur right away. Finally, in his unusual treatise That the Soul Follows the Mixtures of the Body, he explains that because the character of the soul depends on the elemental qualities (hot, cold, wet, and dry) of the body it inhabits, some faults in character can be corrected with the proper diet. There is a question, in this view, whether those of evil character are truly responsible for their faults, since some people are by natural temperament incapable of virtue. But for Galen it does not follow that we should not be punished for our vices, even with death.22
Galen’s ethical ideas were not original to him, and he borrowed freely from the Stoics, the Epicureans, Plato, Aristotle, and their followers (even as he criticizes, especially, certain Stoic doctrines). He drew, that is, on the common wisdom of his culture regarding the regulation of emotion and behavior. This advice on moral improvement was quite sound. Psychologists tell us that the daily practice of self-control can increase willpower over time, that the monitoring of one’s own emotions and reactions is an important part of this process, and that an “attitude of gratitude” is a helpful safeguard against depression. Galen’s therapies were both cognitive (avoiding certain thoughts, cultivating other thoughts) and behavioral (monitoring and modifying certain behaviors, especially angry reactions, until the desired behavior becomes routine). Scientists today often acknowledge modern cognitive behavioral therapy’s debt, or at least resemblance, to ancient ethical philosophy, usually singling out Stoicism, though similar principles are found in the other traditions from which Galen also draws. Even Galen’s dietetic approach to ethics in That the Soul Follows the Mixtures of the Body is not alien to modern ideas of nutrition or of mental disease as chemical imbalance, although he offers no specific advice in this treatise and I would not make extravagant claims for his insights.23
While grief has a special place in Galen’s work because of the fire of 192, the main focus of much Hellenistic and Roman-era ethical thought was anger and the control of violence, and this theme is also prominent in Galen. Examples often involved anger against slaves, perhaps reflecting a pervasive ethical challenge for the aristocratic class who studied and wrote philosophy. Galen’s memorable story about the Cretan who almost murdered two of his slaves in a rage over lost luggage, which impressed itself on his memory and which he repeated often, is an example of this theme. Galen was a slave owner himself; his anecdotes mention domestic servants and stenographers, and the presence of slaves can be inferred in many stories where they are not specifically mentioned. He often calls them “mine” (“my [people]”), using a single substantive pronoun. He tested a nasal drug on his household, as I have mentioned, and lost a large number of household slaves to the great plague.24
As I have mentioned before in chapter 1, Galen argues that one should never hit slaves with one’s own hands and especially not in the heat of anger; rather, he suggests delaying punishment until good judgment has returned and substituting lectures for blows where it is possible to do so. A similar argument is made by Seneca in his treatise On Anger, and this idea that slaves should not be punished in the heat of anger or hit with one’s own hands was a philosophic commonplace. Galen tells us that this is how Plato treated his own slaves. Although Galen claims never to have hit a slave himself, arguments like this, and other references, like the story of the Cretan, are discomfiting and even shocking in the level of everyday, casual violence they imply. Galen condemns friends of his father’s who bruised their hands hitting slaves in the teeth, wounds that often became infected later. Galen’s notorious passage about his own mother, quoted in chapter 1, describes how she would fly into rages and bite her slaves. In another treatise, Galen treats a master who wounded his finger while hitting a slave. Galen claims to have seen a man poke a slave in the eye with a reed-pen, something the emperor Hadrian is also supposed to have done. While Galen himself condemns these brutal acts, he does not oppose the corporal punishment of slaves per se, and elsewhere he accepts violence against slaves as routine and commonplace, as virtually all ancient writers do. A passage from On the Doctrines of Hippocrates and Plato refers, in a general way, to the grisly punishments such as burning or beating meted out to slaves “even now”; they are inflicted upon the offending limb (for example, legs, for runaways), and Galen does not seem to find this offensive but to appreciate the poetic justice of the system.25
Galen treated slaves in his practice, often (but not always) at the request of their masters. He also treated peasants, as I have mentioned, and spent his formative years as a physician treating gladiators, men of ambiguous, but certainly not high, social status. It is in his relationship to slave patients, and not in his ethics as slaveholder, that we find some challenge to, or discrepancy with, the normal role of slaves in ancient culture. It is difficult to show that Galen treated his enslaved patients differently from his free ones and easier to show that he treated them the same; that is, he talked to them, visited several times a day if necessary, and generally gave them his best—sometimes heroic—efforts, as in the case of Maryllus’s slave, saved by thoracic surgery that exposed his heart. Galen most often does not mention a patient’s social status, because his self-image as a professional rested on other factors; the difficulty of the case, the humiliation of his rivals, the skills deployed, and the success achieved.26
These factors, rather than a humanistic view of medical ethics, may account for Galen’s otherwise surprising lack of condescension for his low-status patients, although evidence for such humanism is not completely lacking: Did not Hippocrates himself, as Galen writes, treat the poor? Galen did not accept fees and would sometimes provide patients with necessities that they lacked, whether food, or medicine, or servants. The only patient for whom he openly expresses disdain is a wealthy “medicine-loving” (philopharmakos) fool who enjoys treating his own slaves but only exacerbates their injuries in his incompetence, demands drugs with expensive, smelly ingredients, and lies about taking remedies that Galen has forbidden.27
Galen acknowledges that his character has never been tested by the greatest imaginable disaster: for him, this would be the loss of all his possessions, so that he no longer had enough left to survive, or the total loss of status that might come from public condemnation or exile; or, perhaps, the destruction of his homeland, or a friend coerced by a tyrant (he appears to consider this much more terrible than the loss of a friend to natural causes). He prays for health too, preferring to imagine horrific injury rather than actually to experience it for the sake of strengthening his spirit. He gave specific thought, in this later period of his life, to the precise limits of his fortitude: “I am indifferent to all loss of money as long as enough remains in my possession to avoid hunger, cold, and thirst … and I am indifferent to pain as long as it remains possible for me to converse with a friend or follow the words of someone who is reading me a book.” With uncharacteristic humility, then, Galen doubts his ability to endure all the contingencies that might come his way, and perhaps he looked forward with apprehension to the inevitable trials of declining health and death. He prays to Zeus not, as the Stoic Musonius Rufus did, to send him whatevever circumstances the god wished; rather, Galen asks Zeus to send him no circumstance that he cannot endure.28 He may have planned suicide if his sufferings surpassed his capacity to bear them, but we do not know what actually happened.
Old age cast a long shadow.29 It is true that Galen mentions no emperors by name after Septimius Severus, who ruled from 193 to 211, and no specific events after the fire of 192, except for the Secular Games of 204 (if the treatise On Theriac to Piso is genuine). The Suda, an encyclopedia in Greek of the tenth century C.E, records in its entry on Galen that he lived to age seventy. Western scholars long believed this, while finding it difficult to understand how he could have composed, in just six years, the lengthy list of his works that must postdate the fire. These include not only the two long works on compound drugs, but his diagnostic masterpiece On the Affected Parts in eight books; lost dictionaries on Attic usage in certain comic writers (though he never rewrote the comprehensive work that was destroyed); the last four books of On Anatomical Procedures; the last three books of On the Mixtures and Powers of Simple Drugs; the second half, in seven books, of On the Method of Healing; On Antidotes in two books; the three treatises on ethics that I have described above; the treatise The Art of Medicine; the two bibliographic treatises; the treatise On My Own Opinions; and other minor works.
Many testimonies to Galen’s longevity far beyond age seventy survive. His old enemy, Alexander of Aphrodisias, is supposed to have quipped about On My Own Opinions that it took Galen eighty years to figure out that he knew nothing. Byzantine historians record that he was still alive in the reign of Caracalla, which began in 209; and sources in Arabic are unanimous in the view that he died at age eighty-seven (except for two that place his death a year or two later, in the reign of Elagabalus). The authors of the Suda misunderstood a tradition that his career lasted seventy years, after seventeen years of childhood and early education. If the Arabic tradition is accurate, Galen lived a further twenty-three years after the great fire and died in 216 or 217.
We do not know where he died. Only sources in Arabic (and one in Persian) comment on the location of his tomb, and their testimony sounds more like legend than fact. According to one version of the story, Galen went to the city of Lycopolis (Asyut) in Upper Egypt to study the properties of opium; there he decided to return to Pergamum, his homeland, but on the way he died. His place of death was Pelusium on the eastern Nile delta, where his tomb, according to these sources, could be found. Another story, impossible to reconcile with historical fact, tells that Galen heard of the miracles of Jesus, and set out from Rome for Palestine to meet Jesus’ disciples. But he died on the journey, in Palermo, Sicily, which also claimed his tomb.
As he advanced in years he gave thought to the fate of his literary legacy. In On My Own Opinions, perhaps his last work—impossible to date precisely, but later than On My Own Books, and no other work of Galen’s refers to it—he summarizes his views on innate heat and the heart, nutrition and the liver, the humors, the temperaments and stages of life, the efficacy of drugs, the nervous system, the embryo, creation, and (especially) the soul, condensing all of this to a single book. His purpose was to confirm and authenticate the ideas expressed over a lifetime. Like On My Own Books, which begins with Galen’s story about overhearing an argument on a falsified work attributed to himself, On My Own Opinions also opens with an anecdote about authenticity: the poet Parthenius of Nicaea, who lived in the first century B.C.E., while travelling happened upon two schoolteachers (grammatici) debating the meaning of his poems. When Parthenius tried to intervene in the argument, claiming at first to have heard himself, the poet, expounding the correct meaning, his opponent refused to believe him; Parthenius, lamenting his failure at argumentation, could only win his point by calling on witnesses from his entourage to prove that he was the author of the poems in dispute (Plac. Propr. 1, 172 Boudon-Millot and Pietrobelli).30
It is this problem that Galen sought to forestall, looking forward, no doubt, to the time after his death when he would no longer be able to authenticate his own works or prove the fraudulence of forgeries. On My Own Opinions and On My Own Books, also written late in life—after the fire of 192 but before On My Own Opinions, and thus possibly as late as 210 or so, although the most recent historical event it mentions is the reign of Pertinax in 19331—suggest anxiety on this point. In another treatise he remarks:
Some do not have successors for their teaching, and some do not publish books while they are alive, and then when they are dead, the one or two surviving copies are lost. For it can happen that they [the authors] are disdained, and their works are neglected and, in time, completely destroyed. And sometimes certain jealous people hide them, or even erase the books of older writers. Others do the same thing by saying that what is written in them is their own.… To set aside all other causes, I will mention only two of those that recently happened in Rome. Often temples have burned, and often they have fallen down in earthquakes, or for some other reason, and they [these causes] seem to be responsible for the loss of many books.
(Hipp. Nat. Hom. 1.1, 15.23–24K)
In the background was Galen’s own long and painstaking labor on the Hippocratic Corpus, identifying those works he deemed orignial to the legendary physician based on style, language, manuscript tradition, and also dogma, and correcting the mistakes of generations of venal or incompetent scribes and commentators.32 But in the passage quoted above he also seems to recall his own intellectual ancestors. Quintus published little; Pelops and Heraclianus suppressed the writings of Numisianus, Pelops’s teacher and Heraclianus’s father; Pelops’s and Numisianus’s works were eventually destroyed by fire. When Galen writes that “often temples have burned,” he may well be thinking of the event of 192, which would date this passage and the work it comes from to that year or later. Thus the fire, as well as advancing age, caused Galen to ruminate on the fragility of his legacy.
Galen could not control the text of his works, which were doomed to be transmitted imperfectly. Even during his lifetime, to his frustration, multiple versions of some works circulated, some uncorrected, some altered by authors who passed them off as their own. But he did his best to help future generations distinguish his genuine treatises. On My Own Books is a catalog of Galen’s genuine works, by title; it has helped modern scholars greatly in understanding his contribution and in identifying some inauthentic works. On My Own Opinions, on the other hand, is a guide to Galen’s genuine views on a variety of medical subjects including, as I have mentioned, the creator and the substance of the soul. He represents these ideas as perfectly consistent and unchanging with only one exception (for he describes, not entirely accurately, a development over time in his views on the order in which the parts of the embryo are formed).33 Finally, On the Order of My Own Books, written at about the same time as On My Own Books, describes the proper sequence in which the diligent student or amateur ought to read his works. A similar, but shorter, list of recommended reading appears at the end of the roughly contemporary treatise The Art of Medicine. On My Own Books, On the Order of My Own Books, and On My Own Opinions are unique works; it occurred to no other ancient writer to attempt to guarantee his legacy in this way. But it is just the sort of thing that Galen would do.34
Galen was aware that, by his time, much writing of great value had already been lost—“even among the Athenians there are found some famous comic and tragic poets whose plays no longer survive” (Hipp. Nat. Hom. 1.2, 15.24K)—and he felt keenly the losses that occurred in his own lifetime, as I have described. His own works were not immune to the wreckage of time, but a relatively large proportion has nevertheless survived. This is in some ways surprising, as Galen’s fears seem to have been reasonable: we are well-informed about his enemies, but we know the name of no devoted student who carried on his teachings.
In fact, we know little about the Greco-Roman medical tradition after Galen at all. Later medical writers—Oribasius, Caelius Aurelianus, Paul of Aegina—published excerpts and translations of older authors, Galen and his predecessors and contemporaries. It is as though, after Galen, nothing noteworthy was written. We do not know why. Surely one factor was the political crisis of the mid-third century C.E., which rocked the Roman Empire to its foundation and coincides with a steep drop in surviving intellectual product. In the fourth and fifth centuries the rise of Christianity, ambivalent at best in its attitude toward science, made its own contribution to the decline of medicine. Although medicine continued to be valued, taught, and practiced in the Byzantine period, there were virtually no new theories or anatomical discoveries, no sectarian rivalries or bitter public feuds—no Galen. In his time, medicine was still very much alive. After Galen it became more antiquarian in focus, preserving his works as though in a refrigerator, but without the vibrant context of debate, rivalry, and performance that produced them, and without which their meaning is so much impoverished.35