J. Ganz, Doctor of Philosophy,
Fellow of the Royal College of Surgeons, Ulverston (UK)
There are two areas where Galen’s competence with neurosurgical procedures is documented. The first is his clinical work described in the De methodo medendi (Method of Medicine). He states that his writing is merely an extension and perhaps a clarification of the writings of Hippocrates. His comments on the various instruments and their correct use would seem to be characteristic of any competent and concerned surgeon. The second area is his experiments. They included both dissection and vivisection of animals. He described a big vein in the depth of the brain, which was named after him (the vein of Galen) and pineal gland (he coined its name). He considered that the latter was involved in the movement of the psychic pneuma from the lateral ventricles to the ventricle in cerebellum. In a famous book by Thomas Willis pineal gland is shown as spherical, that might be a result of its distortion during dissection. Thanks to his superb technique Galen could also follow the course of the recurrent laryngeal nerve. He operated on pigs and goats rather than apes for sentimental reasons. His experimental surgery included compression and then incision on cerebral ventricles. Some animals survived after operations which were performed without effective means of brain haemostasis, suction and modern illumination. This would seem to indicate he must have operated without intradural haemorrhage and also an ability to retain vision and maybe even retract the brain without doing irreversible damage. All this would suggest that while Galen would not have been a neurosurgeon in the modern sense of the word there is good reason to believe he had a neurosurgical technique which would be acceptable even today.
Keywords: Galen, surgical technique, dissection, experimentation, neurosurgery