Cutting Words: Polemical Dimensions of Galen’s Anatomical Experiments

Luis Alejandro Salas, Cutting Words: Polemical Dimensions of Galen’s Anatomical Experiments (Leiden: Brill, 2020). 9789004439184.

Reviewed by Matthew J. Chalmers, Independent Scholar, mattjchal@gmail.com.

Medical literature has historically received less attention from classicists than it deserves, as is generally the case with ancient technical literature.¹ Nevertheless, specialist study has flourished, especially since the important work of Heinrich von Staden in the 1980s brought attention to the complexity of medical debate in antiquity.² Salas’s book, illuminating the Galenic interplay of observational method and hypothetical theory, is an important addition to that discussion, especially proving the value of placing Galen’s work in the broader context of second-century CE elite intellectual writings and the Second Sophistic.³ 

Chapter 1 observes that Galen grounded his medical practice in public demonstration, exhibitions that have received attention from Maud Gleason and Julius Rocca.⁴ Salas argues, distinct from Gleason’s attention to embodiment and more in line with Rocca’s synthetic approach, that this public medical competition feeds a comparable agonistic emphasis in Galen’s writings. The need to compete for clients and prestige did not stop when the knife-work did. To be sure, as Salas notes, our main source of evidence for Galen is Galen (pp. 16–17), and Salas accordingly provides a cautious roadmap, tracing Galen’s rhetorical presentation of public and private medical demonstrations as well as situating Galen’s writing in an antiquarian mode typical of Roman elite writing in the period.

In Chapter 2, Salas makes his most distinctive argument: the relationship between technical writing and public demonstration was not symmetrical (as, for example, Rocca argues). Credentialing via the circulation of technical writings, he says, not only complimented but superseded the idea of credentialing via public demonstration. Salas grounds this observation with detailed examination of some of Galen’s own representations of his practice, particularly in On Joints and with respect to exhibition surgeries on the intercostal nerves. Most strikingly, he identifies Galen’s preoccupation with his own capacity for logic (p. 69), as Galen often places less emphasis on the physical outcome of demonstration and more on his literary representation of audience reaction and his own expertise. 

Chapter 3 turns from Galen’s literary recreation of the “social functions of live experimentation” to his use of written technologies for “theoretical ends” (p. 103). Salas puts Galen’s discussion of elephants in his works on human anatomy—Anatomical Procedures and The Function of the Parts—on the table. What, he asks, does Galen gain from the discussion of elephants? The answer lies in the theoretical function of scaling. The elephant magnifies what is also present in human anatomy as a “heuristic” (p. 133). It also serves as an observable body over which physicians might dispute an Aristotelian account of the teleological functions of living organisms. This chapter does raise a few more questions than answers, specifically given the absence of one part of the body in question—the elephant’s gallbladder—and I’ll return to that at the end of this review. 

In Chapter 4, Salas examines Galen’s technical uses of an elephant’s cardiac structure that does not exist: a bone, the os cordis, found in some ruminants but not elephants. Given elephants lack an os cordis, Salas asks, why does Galen write so much about how obvious their os cordis is? The answer combines technical analogy with literary persuasion. Galen would have thought it necessary, Salas argues, that this bone existed. These theoretical and teleological commitments give him the confidence, then, to use the bone in narratives that confirm the value of empirical study. Aristotle turns out to be the target of Galen’s cardiac revisionism. Had Aristotle investigated, Galen suggests, he would have known that this bone existed. 

Chapter 5 provides some explanation for Galen’s persuasive choices by noting that his representation of confrontation with rivals, especially the followers of the Hellenistic Greek anatomist Erasistratus, as well as agonistic experimentation more broadly, draws on a variety of genre tropes, including classical oratory and New Comedy (p. 169). Salas’s dissection of Galen’s strategy against the Erasistrateans is particularly insightful. He demonstrates, convincingly, that Galen convicts them of not having the technical, experimental experience to buttress any of their readings of Erasistratus. They are book-learners only. 

Chapter 6 continues the tale of Galen and the Erasistrateans. The opportunity for debate here is the femoral artery and Galen’s two discussions of surgery on it, although the chapter quickly becomes a commentary on Galen’s vascular physiology. It is possible to get a little lost in the stacked explanations of medical minutiae. The main point of all this, however, is to specify Galen’s own thought and differentiate it from Erasistratus in preparation to understand the polemical deployment of that difference in Chapter 7.

In Chapter 7, then, Salas’s emphasis on Galen’s narrative legacy is strongest. The construction of Galen’s narratives about experimentation, he argues, provided a learned opportunity to showcase the superiority of his knowledge of Erasistratus combined with his experimentational capacity to refuse the theories he knows better. Galen, at least as he himself tells his stories, arbitrates the truthfulness of medical knowledge, whether that knowledge belonged to the theories of his contemporaries or to the venerable palaioi, the great thinkers of old. And as Salas also points out, Galen’s compelling polemical presentation meant that Galen was taken as the victor by aspiring medical writers of much later centuries as well.

Chapter 8 reflects on the appropriation of Galen by Andreas Vesalius in his De humani corporis fabrica (1543), a work which cemented Vesalius for posterity as a “modern” medical mind but in which Vesalius attacks complacent “Galenists” while appropriating Galen wholesale. Salas’s contribution to this intellectual history suggests that Vesalius adapted both Galen’s method and his literary exhibitionism, that is, his penchant for writing his experiments in the forms that would most effectively position himself against his opponents. 

Taken as a whole, Cutting Words is an achievement. Salas knows the relevant Galenic literature very well, both in its details and in the context of ancient medical writings. He also situates Galen effectively in the paideia characteristic of the Second Sophistic. Each chapter supplies compelling, if technical, readings of a tricky corpus. The reflection on Galen through Vesalius is inspired and in line with more recent awareness that Galen’s reception matters just as much as anything else about him.⁵ The history of medicine has long made a similar argument;⁶ but classicists have sometimes been slow to move their discussions of manuscript history out of the technical footnotes.

Chapters 3 and 4, as I foreshadowed in my summary of Chapter 3, did leave me with more questions than answers. That Galen might have been more interested in theoretical and discursive triumph than “real” demonstration seems very plausible. But I am unclear as to how Galen’s claims to have seen body parts that do not exist—the elephant gallbladder and os cordis—are persuasive even in the context of literary representation. Salas cautions us to avoid expectations of “strict fidelity to historical events” in Galenic literature (p. 168). But is this sufficient? What we read is not a deviation from fidelity to history. It is a full-chested, conscious invention nevertheless used to prove opponents wrong. Perhaps we need to understand Galen as more reliant on like-minded audiences who care just as much for his cleverness than for true public demonstration.

If I might offer one final thought, it would be that Salas doesn’t quite immerse Galen in the broader intellectual currents of the second century to full effect.⁷ Salas limits himself to the medical-philosophical tradition when it comes to connecting Galen’s enmeshing of experimental and literary demonstration to the social, cultural, and intellectual dynamics of his time. But, to choose a particularly proximate example: early Christian heresiology is frequently medicalized, Galen comments on Christian epistemology (in On the Usefulness of the Parts and On the Differences of the Pulse), and that comparison has proved fruitful in both directions.⁸ Salas’s argument represents an opportunity almost—but not quite—taken to both understand Galen in context and rethink how we should configure the intellectual context of ancient medical literature. In my opinion, then, he does not quite incorporate a large enough sample of second-century intellectual life to fully render Galen’s rhetoric in context. In being a superb representation of Galen’s approaches, nevertheless, this book is an indispensable work both for specialists in medical literature in particular—and they will likely not share my complaint about scope!—and those more broadly interested in ancient polemic and persuasion.

Table of Contents

Introduction (1–15)
1. Experiment and Experimental Writing (16–55)
2. Galen and Agonistic Anatomical Demonstration (56–102)
3. Magnification and the Elephant (103–43)
4. Fighting with the Heart of a Beast: Galen’s Use of the Elephant’s Cardiac Anatomy against Cardiocentrists (144–68)
5. It Is Difficult Not to Write Anatomy: Galen on Erasistratus and the Arteries (169–95)
6. Galen and the Experiment on the Femoral Artery (196–226)
7. Drawing Blood: Galen’s Use of the Arterial Experiment against Erasistratus (227–64)
8. De Galeni corporis fabrica: Writing Galen and the Greek Past in Vesalius’ Fabrica (265–84)
9. Conclusion (285–88)

Notes

1. Thorsten Fögen, “Technical Literature,” in A Companion to Greek Literature, ed. Martin Hose and David Schenker (Hoboken: Wiley, 2016).

2. Heinrich von Staden, Herophilus: The Art of Medicine in early Alexandria (Cambridge: Cambridge University Press, 1989).

3. See, in general, Christopher Gill, Tim Whitmarsh, and John Wilkins, eds., Galen and the World of Knowledge (Cambridge: Cambridge University Press, 2009); more specifically, Heinrich von Staden, “Galen and the ‘Second Sophistic,’” Bulletin of the Institute of Classical Studies 41 (1997): 33–54; Caroline Petit, “Galen, Rhetoric, and the Second Sophistic,” in The Oxford Handbook of Galen, ed. P. N. Singer and Ralph M. Rosen (Oxford: Oxford University Press, 2024), 87–99.

4. Maud Gleason, “Shock and Awe: The Performance Dimension of Galen’s Anatomy Demonstration,” in Gill, Whitmarsh, and Wilkins, Galen and the World of Knowledge, 85–114; Julius Rocca, Galen on the Brain: Anatomical Knowledge and Physiological Speculation in the Second Century AD (Leiden: Brill, 2003).

5. See a full third of the newly published Oxford Handbook of Galen (see n. 3).

6. One point of origin is the work of Vivian Nutton, beginning with John Caius and the Manuscripts of Galen (Cambridge: Cambridge Philological Society, 1987).

7. If we compare this work to the variegated approach in, for example, Kendra Eshleman, The Social World of Intellectuals in the Roman Empire: Sophists, Philosophers and Christians (Cambridge: Cambridge University Press, 2012).

8. Heinrich von Staden, “Hairesis and Heresy: The Case of the haireseos iatrikai,” in Jewish and Christian Self-Definition, vol. 3, Self-Definition in the Greco-Roman World, ed. B. F. Mayer and E. P. Sanders (London: SCM Press, 1982), 76–100. Rebecca Fleming discusses Galen’s strategies of legitimation with respect to Christians in “Galen and the Christians,” in Texts and Authority in the Second Century AD, ed. James Carleton Paget and Judith Lieu (Cambridge: Cambridge University Press, 2017), 171–87.