Galen and neurosurgical procedures

Abstract

There are two documented areas where Galen's competence with neurosurgical procedures is evident. The first area is his clinical work, as described in his treatise *De methodo medendi* (Method of Medicine). Galen viewed his writing as an extension and clarification of Hippocratic texts. His detailed comments on the various surgical instruments and their proper use demonstrate his competence and concern as a surgeon.

The second area is Galen's experiments, which involved both dissection and vivisection of animals. He identified and described a large vein deep within the brain, later named the "vein of Galen," and coined the term "pineal gland," which he believed played a role in moving the psychic pneuma from the lateral ventricles to the cerebellar ventricle. His superb dissection technique allowed him to trace the course of the recurrent laryngeal nerve accurately.

Galen's choice of pigs and goats for his experimental surgeries, rather than apes, stemmed from sentimental reasons. His experimental procedures included compressing and then incising the cerebral ventricles. Some animals survived these operations, which were performed without modern surgical tools such as effective brain haemostasis, suction, or advanced lighting. This suggests that Galen managed to operate without causing intradural hemorrhage and was likely able to manipulate the brain without causing irreversible damage.

Although Galen would not be considered a neurosurgeon by modern standards, his neurosurgical techniques were advanced for his time and would likely be deemed acceptable even today.