Misplaced Pages

#75924

144-421: Claudius Galen was perhaps the first physiologist to describe the pulse. The pulse is an expedient tactile method of determination of systolic blood pressure to a trained observer. Diastolic blood pressure is non-palpable and unobservable by tactile methods, occurring between heartbeats. Pressure waves generated by the heart in systole move the arterial walls. Forward movement of blood occurs when

288-488: A child has a serious illness. With respect to the effect of antipyretics on the risk of death in those with infection, studies have found mixed results, as of 2019. Fever is one of the most common medical signs . It is part of about 30% of healthcare visits by children, and occurs in up to 75% of adults who are seriously sick. About 5% of people who go to an emergency room have a fever. A number of types of fever were known as early as 460 BC to 370 BC when Hippocrates

432-526: A comprehensive education that prepared him for a successful career as a physician and philosopher. Born in the ancient city of Pergamon (present-day Bergama , Turkey), Galen traveled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome , where he served prominent members of Roman society and eventually was given the position of personal physician to several emperors . Galen's understanding of anatomy and medicine

576-461: A difference between their pulse rate and heart rate. It can be observed by simultaneous palpation at the radial artery and auscultation using a stethoscope at the PMI, near the heart apex , for example. Typically, in people with pulse deficit, heart beats do not result in pulsations at the periphery, meaning the pulse rate is lower than the heart rate. Pulse deficit has been found to be significant in

720-444: A dream in which the god Asclepius appeared and commanded Nicon to send his son to study medicine. Following his earlier liberal education, Galen at age 16 began his studies at the prestigious local healing temple or asclepeion as a θεραπευτής ( therapeutes , or attendant) for four years. There he came under the influence of men like Aeschrion of Pergamon , Stratonicus and Satyrus. Asclepiea functioned as spas or sanitoria to which

864-581: A feeling of cold or chills . This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed , and may begin to sweat . Rarely a fever may trigger a febrile seizure , with this being more common in young children. Fevers do not typically go higher than 41 to 42 °C (106 to 108 °F). A fever can be caused by many medical conditions ranging from non-serious to life-threatening . This includes viral , bacterial , and parasitic infections —such as influenza ,

1008-577: A fever recover without specific medical attention. Although it is unpleasant, fever rarely rises to a dangerous level even if untreated. Damage to the brain generally does not occur until temperatures reach 42.0 °C (107.6 °F), and it is rare for an untreated fever to exceed 40.6 °C (105.1 °F). Treating fever in people with sepsis does not affect outcomes. Small trials have shown no benefit of treating fevers of 38.5 °C (101.3 °F) or higher of critically ill patients in ICUs, and one trial

1152-404: A male, preferably of an older, wiser, age, as well as free from the control of the passions. These passions, according to Galen, caused the psychological problems that people experienced. Galen may have produced more work than any author in antiquity, rivaling the quantity of work issued from Augustine of Hippo . So profuse was Galen's output that the surviving texts represent nearly half of all

1296-729: A materialist reading of Galen's philosophy of mind. According to this materialist reading, Galen identifies the soul with the mixtures of the body. Another one of Galen's major works, On the Diagnosis and Cure of the Soul's Passion , discussed how to approach and treat psychological problems. This was Galen's early attempt at what would later be called psychotherapy . His book contained directions on how to provide counsel to those with psychological issues to prompt them to reveal their deepest passions and secrets, and eventually cure them of their mental deficiency. The leading individual, or therapist, had to be

1440-725: A medical text both in the Latin Middle Ages and Medieval Islam . The 11th-century Suda lexicon states that Galen died at the age of 70, which would place his death in about the year 199. However, there is a reference in Galen's treatise "On Theriac to Piso" (which may, however, be spurious) to events of 204. There are also statements in Arabic sources that he died in Sicily at age 87, after 17 years studying medicine and 70 practicing it, which would mean he died about 216. According to these sources,

1584-422: A more complete understanding of the circulatory system, nervous system , respiratory system , and other structures, his work contained scientific errors. Galen believed the circulatory system to consist of two separate one-way systems of distribution, rather than a single unified system of circulation. He believed venous blood to be generated in the liver, from where it was distributed and consumed by all organs of

SECTION 10

#1732845087076

1728-555: A number of works attributed to Galen. As a consequence, research on Galen's work is fraught with hazard. Various attempts have been made to classify Galen's vast output. For instance Coxe (1846) lists a Prolegomena, or introductory books, followed by 7 classes of treatise embracing Physiology (28 vols.), Hygiene (12), Aetiology (19), Semeiotics (14), Pharmacy (10), Blood letting (4), and Therapeutics (17), in addition to 4 of aphorisms, and spurious works. The most complete compendium of Galen's writings, surpassing even modern projects like

1872-517: A pestilence occurred which at its height killed 2,000 people a day in Rome. This was most likely the same plague (the so-called "Antonine Plague" and most likely smallpox) that struck Rome during Marcus Aurelius' reign. Galen was also physician to Septimius Severus during his reign in Rome. He complimented Severus and Caracalla on keeping a supply of drugs for their friends and mentioned three cases in which they had been of use in 198. The Antonine Plague

2016-511: A phenomenon known as fever phobia, which is based in both caregiver's and parents' misconceptions about fever in children. Among them, many parents incorrectly believe that fever is a disease rather than a medical sign , that even low fevers are harmful, and that any temperature even briefly or slightly above the oversimplified "normal" number marked on a thermometer is a clinically significant fever. They are also afraid of harmless side effects like febrile seizures and dramatically overestimate

2160-492: A physician and a philosopher, as he wrote in his treatise titled That the Best Physician Is Also a Philosopher . Galen was very interested in the debate between the rationalist and empiricist medical sects, and his use of direct observation, dissection, and vivisection represents a complex middle ground between the extremes of those two viewpoints. Many of his works have been preserved and/or translated from

2304-472: A pig, and while it was squealing he would tie off the recurrent laryngeal nerve, or vocal cords, showing they controlled the making of sound. He used the same method to tie off the ureters to prove his theories of kidney and bladder function. Galen believed the human body had three interconnected systems that allowed it to work. The first system that he theorized consisted of the brain and the nerves, responsible for thought and sensation. The second theorized system

2448-462: A practicing physician. His public demonstrations and impatience with alternative views on medicine brought him into conflict with other doctors practicing in the city. When the Peripatetic philosopher Eudemus became ill with quartan fever , Galen felt obliged to treat him "since he was my teacher and I happened to live nearby". He wrote: "I return to the case of Eudemus. He was thoroughly attacked by

2592-544: A previous study showing the EP3 subtype is what mediates the fever response. Hence, the hypothalamus can be seen as working like a thermostat . When the set point is raised, the body increases its temperature through both active generation of heat and retention of heat. Peripheral vasoconstriction both reduces heat loss through the skin and causes the person to feel cold. Norepinephrine increases thermogenesis in brown adipose tissue , and muscle contraction through shivering raises

2736-399: A pyrogen, mediated by interleukin 1 (IL-1) release. These cytokine factors are released into general circulation, where they migrate to the brain's circumventricular organs where they are more easily absorbed than in areas protected by the blood–brain barrier . The cytokines then bind to endothelial receptors on vessel walls to receptors on microglial cells , resulting in activation of

2880-420: A reaction to an incompatible blood product. Fever is thought to contribute to host defense, as the reproduction of pathogens with strict temperature requirements can be hindered, and the rates of some important immunological reactions are increased by temperature. Fever has been described in teaching texts as assisting the healing process in various ways, including: A fever response to an infectious disease

3024-519: A young man had come to the city and had given, like me practical demonstrations of the resources of our art; this young man was put to death by poison, together with two servants who accompanied him." When Galen's animosity with the Roman medical practitioners became serious, he feared he might be exiled or poisoned, so he left the city. Rome was engaged in foreign wars in 161; Marcus Aurelius and his then co-Emperor and adoptive brother Lucius Verus were in

SECTION 20

#1732845087076

3168-989: Is atrial fibrillation . The degree of expansion displayed by artery during diastolic and systolic state is called volume. It is also known as amplitude, expansion or size of pulse. A weak pulse signifies narrow pulse pressure . It may be due to low cardiac output (as seen in shock , congestive cardiac failure ), hypovolemia , valvular heart disease (such as aortic outflow tract obstruction , mitral stenosis , aortic arch syndrome ) etc. A bounding pulse signifies high pulse pressure. It may be due to low peripheral resistance (as seen in fever , anemia , thyrotoxicosis , hyperkinetic heart syndrome  [ de ] , A-V fistula , Paget's disease , beriberi , liver cirrhosis ), increased cardiac output, increased stroke volume (as seen in anxiety, exercise, complete heart block , aortic regurgitation ), decreased distensibility of arterial system (as seen in atherosclerosis , hypertension and coarctation of aorta ). The strength of

3312-463: Is 35.5–37.5 °C (95.9–99.5 °F) among men and 35.7–37.5 °C (96.3–99.5 °F) among women. Normal body temperatures vary depending on many factors, including age, sex, time of day, ambient temperature, activity level, and more. Normal daily temperature variation has been described as 0.5 °C (0.9 °F). A raised temperature is not always a fever. For example, the temperature rises in healthy people when they exercise, but this

3456-408: Is a mixture of nutritious blood from the liver and the vital spirit (the soul) which was attained from the lungs. The vital spirit within this medium was necessary for the body to function and eventually completely absorbed. This process was then repeated indefinitely, according to Galen, so that the body could be replenished with the soul, or the vital spirit. Several schools of thought existed within

3600-450: Is a symptom of organism's anti-infection defense mechanism that appears with body temperature exceeding the normal range due to an increase in the body's temperature set point in the hypothalamus . There is no single agreed-upon upper limit for normal temperature: sources use values ranging between 37.2 and 38.3 °C (99.0 and 100.9 °F) in humans. The increase in set point triggers increased muscle contractions and causes

3744-462: Is activation of the arachidonic acid pathway . PGE2 release comes from the arachidonic acid pathway. This pathway (as it relates to fever), is mediated by the enzymes phospholipase A2 (PLA2), cyclooxygenase-2 (COX-2), and prostaglandin E2 synthase . These enzymes ultimately mediate the synthesis and release of PGE2. PGE2 is the ultimate mediator of the febrile response. The setpoint temperature of

3888-512: Is also superior to aspirin in children with fevers. Additionally, aspirin is not recommended in children and young adults (those under the age of 16 or 19 depending on the country) due to the risk of Reye's syndrome . Using both paracetamol and ibuprofen at the same time or alternating between the two is more effective at decreasing fever than using only paracetamol or ibuprofen. It is not clear if it increases child comfort. Response or nonresponse to medications does not predict whether or not

4032-541: Is an intracranial hemorrhage . Other causes in emergency room settings include sepsis , Kawasaki syndrome , neuroleptic malignant syndrome , drug overdose , serotonin syndrome , and thyroid storm . Fever is a common symptom of many medical conditions: Adult and pediatric manifestations for the same disease may differ; for instance, in COVID-19 , one metastudy describes 92.8% of adults versus 43.9% of children presenting with fever. In addition, fever can result from

4176-408: Is associated with reduced mortality. Temperature is regulated in the hypothalamus . The trigger of a fever, called a pyrogen, results in the release of prostaglandin E2 (PGE2). PGE2 in turn acts on the hypothalamus, which creates a systemic response in the body, causing heat-generating effects to match a new higher temperature set point. There are four receptors in which PGE2 can bind (EP1-4), with

4320-430: Is coexisting aortic regurgitation). The delay can also be observed in supravalvar aortic stenosis . Several pulse patterns can be of clinical significance. These include: Sites can be divided into peripheral pulses and central pulses. Central pulses include the carotid, femoral, and brachial pulses. Although the pulse can be felt in multiple places in the head, people should not normally hear their heartbeats within

4464-446: Is generally agreed to be present if the elevated temperature is caused by a raised set point and: In adults, the normal range of oral temperatures in healthy individuals is 35.7–37.7 °C (96.3–99.9 °F) among men and 33.2–38.1 °C (91.8–100.6 °F) among women, while when taken rectally it is 36.7–37.5 °C (98.1–99.5 °F) among men and 36.8–37.1 °C (98.2–98.8 °F) among women, and for ear measurement it

Pulse - Misplaced Pages Continue

4608-461: Is generally not required. Treatment of associated pain and inflammation, however, may be useful and help a person rest. Medications such as ibuprofen or paracetamol (acetaminophen) may help with this as well as lower temperature. Children younger than three months require medical attention, as might people with serious medical problems such as a compromised immune system or people with other symptoms. Hyperthermia requires treatment. Fever

4752-453: Is generally regarded as protective, whereas fever in non-infections may be maladaptive. Studies have not been consistent on whether treating fever generally worsens or improves mortality risk. Benefits or harms may depend on the type of infection, health status of the patient and other factors. Studies using warm-blooded vertebrates suggest that they recover more rapidly from infections or critical illness due to fever. In sepsis , fever

4896-523: Is more commonly seen in people receiving immune-suppressing chemotherapy than in apparently healthy people. Hyperpyrexia is an extreme elevation of body temperature which, depending upon the source, is classified as a core body temperature greater than or equal to 40 or 41 °C (104 or 106 °F); the range of hyperpyrexia includes cases considered severe (≥ 40 °C) and extreme (≥ 42 °C). It differs from hyperthermia in that one's thermoregulatory system's set point for body temperature

5040-411: Is not considered a fever, as the set point is normal. On the other hand, a "normal" temperature may be a fever, if it is unusually high for that person; for example, medically frail elderly people have a decreased ability to generate body heat, so a "normal" temperature of 37.3 °C (99.1 °F) may represent a clinically significant fever. Hyperthermia is an elevation of body temperature over

5184-598: Is often established by identifying possible causes. Various patterns of measured patient temperatures have been observed, some of which may be indicative of a particular medical diagnosis : Among the types of intermittent fever are ones specific to cases of malaria caused by different pathogens. These are: In addition, there is disagreement regarding whether a specific fever pattern is associated with Hodgkin's lymphoma —the Pel–Ebstein fever , with patients argued to present high temperature for one week, followed by low for

5328-432: Is one of the most common medical signs . It is part of about 30% of healthcare visits by children and occurs in up to 75% of adults who are seriously sick. While fever evolved as a defense mechanism, treating a fever does not appear to improve or worsen outcomes. Fever is often viewed with greater concern by parents and healthcare professionals than is usually deserved, a phenomenon known as "fever phobia." A fever

5472-453: Is seen in aortic regurgitation. A slow rising and slowly falling pulse (pulsus tardus) is seen in aortic stenosis. Comparing pulses and different places gives valuable clinical information. A discrepant or unequal pulse between left and right radial artery is observed in anomalous or aberrant course of artery, coarctation of aorta, aortitis , dissecting aneurysm , peripheral embolism etc. An unequal pulse between upper and lower extremities

5616-445: Is seen in coarctation to aorta, aortitis, block at bifurcation of aorta , dissection of aorta , iatrogenic trauma and arteriosclerotic obstruction. A normal artery is not palpable after flattening by digital pressure. A thick radial artery which is palpable 7.5–10 cm up the forearm is suggestive of arteriosclerosis. In coarctation of aorta, femoral pulse may be significantly delayed as compared to radial pulse (unless there

5760-404: Is set above normal, then heat is generated to achieve it. In contrast, hyperthermia involves body temperature rising above its set point due to outside factors. The high temperatures of hyperpyrexia are considered medical emergencies , as they may indicate a serious underlying condition or lead to severe morbidity (including permanent brain damage ), or to death. A common cause of hyperpyrexia

5904-567: Is usually accompanied by sickness behavior , which consists of lethargy , depression , loss of appetite , sleepiness , hyperalgesia , dehydration , and the inability to concentrate. Sleeping with a fever can often cause intense or confusing nightmares , commonly called "fever dreams". Mild to severe delirium (which can also cause hallucinations ) may also present itself during high fevers. A range for normal temperatures has been found. Central temperatures, such as rectal temperatures, are more accurate than peripheral temperatures. Fever

Pulse - Misplaced Pages Continue

6048-503: The Corpus Medicorum Graecorum/Latinorum  [ de ] , is the one compiled and translated by Karl Gottlob Kühn of Leipzig between 1821 and 1833. This collection consists of 122 of Galen's treatises, translated from the original Greek into Latin (the text is presented in both languages). Over 20,000 pages in length, it is divided into 22 volumes, with 676 index pages. Many of Galen's works are included in

6192-703: The Thesaurus Linguae Graecae , a digital library of Greek literature started in 1972. Another useful modern source is the French Bibliothèque interuniversitaire de médecine Archived 2014-04-21 at the Wayback Machine (BIUM). In his time, Galen's reputation as both physician and philosopher was legendary, the emperor Marcus Aurelius describing him as "Primum sane medicorum esse, philosophorum autem solum" (first among doctors and unique among philosophers Praen 14: 660 ). Other contemporary authors in

6336-574: The Pyrrhonists . Galen was concerned to combine philosophical thought with medical practice, as in his brief work That the Best Physician is also a Philosopher he took aspects from each group and combined them with his original thought. He regarded medicine as an interdisciplinary field that was best practiced by utilizing theory, observation, and experimentation in conjunction. Galen combined his observations of his dissections with Plato's theory about

6480-515: The Renaissance . Some of Galen's treatises have appeared under many different titles over the years. Sources are often in obscure and difficult-to-access journals or repositories. Although written in Greek, by convention the works are referred to by Latin titles, and often by merely abbreviations of those. No single authoritative collection of his work exists, and controversy remains as to the authenticity of

6624-538: The arachidonic acid pathway . Of these, IL-1β, TNF, and IL-6 are able to raise the temperature setpoint of an organism and cause fever. These proteins produce a cyclooxygenase which induces the hypothalamic production of PGE2 which then stimulates the release of neurotransmitters such as cyclic adenosine monophosphate and increases body temperature. Exogenous pyrogens are external to the body and are of microbial origin. In general, these pyrogens, including bacterial cell wall products, may act on Toll-like receptors in

6768-491: The common cold , meningitis , urinary tract infections , appendicitis , Lassa fever , COVID-19 , and malaria . Non-infectious causes include vasculitis , deep vein thrombosis , connective tissue disease , side effects of medication or vaccination, and cancer . It differs from hyperthermia , in that hyperthermia is an increase in body temperature over the temperature set point, due to either too much heat production or not enough heat loss . Treatment to reduce fever

6912-590: The extant literature from ancient Greece. It has been reported that Galen employed twenty scribes to write down his words. Galen may have written as many as 500 treatises, amounting to some 10 million words. Although his surviving works amount to some 3 million words, this is thought to represent less than a third of his complete writings. In 191, or more likely in 192, a fire in the Temple of Peace destroyed many of his works, in particular treatises on philosophy. Because Galen's works were not translated into Latin in

7056-419: The metabolic rate . If these measures are insufficient to make the blood temperature in the brain match the new set point in the hypothalamus, the brain orchestrates heat effector mechanisms via the autonomic nervous system or primary motor center for shivering. These may be: When the hypothalamic set point moves back to baseline—either spontaneously or via medication—normal functions such as sweating, and

7200-464: The pulmonary circulation contradicted the Galenic theory on the heart. The influence of Galen's writings, including humorism, remains strong in modern Unani medicine , now closely identified with Islamic culture, and widely practiced from India (where it is officially recognized) to Morocco. Maimonides was influenced by Galen, whom he cited most often in his medical works, and whom he considered to be

7344-514: The sympathetic output system, which evokes non-shivering thermogenesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface. It is presumed that the innervation from the POA to the PVN mediates the neuroendocrine effects of fever through the pathway involving pituitary gland and various endocrine organs . Fever does not necessarily need to be treated, and most people with

SECTION 50

#1732845087076

7488-572: The "medical refrigerators of antiquity". In late antiquity, medical writing veered increasingly in the direction of the theoretical at the expense of the practical, with many authors merely debating Galenism. Magnus of Nisibis was a pure theorist, as were John of Alexandria and Agnellus of Ravenna with their lectures on Galen's De Sectis . So strong was Galenism that other authors such as Hippocrates began to be seen through Galen's eyes, while his opponents became marginalised and other medical sects such as Asclepiadism slowly disappeared. Greek medicine

7632-434: The 13th century. However, Galen's influence was so great that when dissections discovered anomalies compared with Galen's anatomy, the physicians often tried to fit these into the Galenic system. An example of this is Mondino de Liuzzi , who describes rudimentary blood circulation in his writings but still asserts that the left ventricle should contain air. Some cited these changes as proof that human anatomy had changed since

7776-477: The Arabic. In some cases scholars have even attempted to translate from the Latin or Arabic back into Greek where the original is lost. For some of the ancient sources, such as Herophilus , Galen's account of their work is all that survives. Even in his own time, forgeries and unscrupulous editions of his work were a problem, prompting him to write On His Own Books . Forgeries in Latin, Arabic or Greek continued until

7920-571: The Byzantine Empire. All of the extant Greek manuscripts of Galen were copied by Byzantine scholars. In the Abbasid period (after 750) Arab Muslims began to be interested in Greek scientific and medical texts for the first time, and had some of Galen's texts translated into Arabic, often by Syrian Christian scholars (see below). As a result, some texts of Galen exist only in Arabic translation, while others exist only in medieval Latin translations of

8064-656: The Greek world confirm this including Theodotus the Shoemaker , Athenaeus and Alexander of Aphrodisias . The 7th-century poet George of Pisida went so far as to refer to Christ as a second and neglected Galen. Galen continued to exert an important influence over the theory and practice of medicine until the mid-17th century in the Byzantine and Arabic worlds and Europe. A few centuries after Galen, Palladius Iatrosophista stated in his commentary on Hippocrates that Hippocrates sowed and Galen reaped. Galen summarized and synthesized

8208-456: The Greek, such as Burgundio of Pisa 's translation of De complexionibus . Galen's works on anatomy and medicine became the mainstay of the medieval physician's university curriculum, alongside Ibn Sina's The Canon of Medicine , which elaborated on Galen's works. Unlike pagan Rome, Christian Europe did not exercise a universal prohibition of the dissection and autopsy of the human body and such examinations were carried out regularly from at least

8352-530: The Rationalist sect and from the Empiricist sect. Galen was well known for his advancements in medicine and the circulatory system, but he was also concerned with philosophy. He developed his own tripartite soul model following the examples of Plato; some scholars refer to him as a Platonist. Galen developed a theory of personality based on his understanding of fluid circulation in humans, and he believed that there

8496-519: The Stoics' lack of scientific justification discredited their claims of the separateness of mind and body, which is why he spoke so strongly against them. There is an intense scholarly debate about soul–body relations in Galen's psychological writings. In his brief treatise Quod animi mores , Galen says both that the soul "follows" the mixtures of the body, and that the soul is a bodily mixture. Scholars have offered ways of reconciling these claims, arguing for

8640-523: The advice he found in Hippocrates' teaching and traveled and studied widely including such destinations as Smyrna (now İzmir ), Corinth , Crete , Cilicia (now Çukurova ), Cyprus , and finally the great medical school of Alexandria , exposing himself to the various schools of thought in medicine. In 157, aged 28, he returned to Pergamon as physician to the gladiators of the High Priest of Asia, one of

8784-614: The affections of the mind . He was born in September 129 AD. His father, Aelius Nicon , was a wealthy patrician , an architect and builder, with eclectic interests including philosophy, mathematics, logic, astronomy, agriculture and literature. Galen describes his father as a "highly amiable, just, good and benevolent man". At that time Pergamon (modern-day Bergama , Turkey) was a major cultural and intellectual centre, noted for its library , second only to that in Alexandria, as well as being

SECTION 60

#1732845087076

8928-507: The age of fifteen. An older term, febricula (a diminutive form of the Latin word for fever), was once used to refer to a low-grade fever lasting only a few days. This term fell out of use in the early 20th century, and the symptoms it referred to are now thought to have been caused mainly by various minor viral respiratory infections . Fever is often viewed with greater concern by parents and healthcare professionals than might be deserved,

9072-610: The alimentary tract via a patient's diarrhea and stools. If the stool was very black, the patient died. He says that the amount of black stools varied. It depended on the severity of the intestinal lesions. He observes that in cases where the stool was not black, the black exanthema appeared. Galen describes the symptoms of fever, vomiting, fetid breath, catarrh , cough, and ulceration of the larynx and trachea. Galen continued to work and write in his final years, finishing treatises on drugs and remedies as well as his compendium of diagnostics and therapeutics, which would have much influence as

9216-701: The ancient period, and because of the collapse of the Roman Empire in the West, the study of Galen, along with the Greek medical tradition as a whole, went into decline in Western Europe during the Early Middle Ages , when very few Latin scholars could read Greek. However, in general, Galen and the ancient Greek medical tradition continued to be studied and followed in the Eastern Roman Empire , commonly known as

9360-458: The blood back into the lungs to be exhaled. In order to receive air from the lungs in the left ventricle, the new blood needed to get there from the right ventricle. Thus, Galen asserted that there are small holes in the septum dividing the left and right sides of the heart; these holes allowed the blood to pass through easily to receive air and exchange the aforementioned waste products. Although his anatomical experiments on animal models led him to

9504-407: The blood component hemoglobin under oxygenated vs. deoxygenated conditions allows the technology of pulse oximetry . The rate of the pulse can be observed and measured on the outside of an artery by tactile or visual means. It is recorded as arterial beats per minute or BPM. Although the pulse and heart beat are related, they are not the same. For example, there is a delay between the onset of

9648-479: The body and that the soul, as a whole, contributed to the health of the body, strengthening the "natural functioning capacity of the organ or organs in question". The rational soul controlled higher level cognitive functioning in an organism, for example, making choices or perceiving the world and sending those signals to the brain. He also listed "imagination, memory, recollection, knowledge, thought, consideration, voluntary motion, and sensation" as being found within

9792-617: The body or direct submersion in ice water ). In general, people are advised to keep adequately hydrated. Whether increased fluid intake improves symptoms or shortens respiratory illnesses such as the common cold is not known. Medications that lower fevers are called antipyretics . The antipyretic ibuprofen is effective in reducing fevers in children. It is more effective than acetaminophen (paracetamol) in children. Ibuprofen and acetaminophen may be safely used together in children with fevers. The efficacy of acetaminophen by itself in children with fevers has been questioned. Ibuprofen

9936-454: The body to its function indicated the role of an intelligent creator. His creationism was anticipated by the anatomical examples of Socrates and Empedocles . Although the main focus of his work was on medicine, anatomy, and physiology, Galen also wrote about logic and philosophy. His writings were influenced by earlier Greek and Roman thinkers, including Plato , Aristotle , the Stoics , and

10080-483: The body will remain elevated until PGE2 is no longer present. PGE2 acts on neurons in the preoptic area (POA) through the prostaglandin E receptor 3 (EP3). EP3-expressing neurons in the POA innervate the dorsomedial hypothalamus (DMH), the rostral raphe pallidus nucleus in the medulla oblongata (rRPa), and the paraventricular nucleus (PVN) of the hypothalamus. Fever signals sent to the DMH and rRPa lead to stimulation of

10224-940: The body. The "pyrogenicity" of given pyrogens varies: in extreme cases, bacterial pyrogens can act as superantigens and cause rapid and dangerous fevers. Endogenous pyrogens are cytokines released from monocytes (which are part of the immune system ). In general, they stimulate chemical responses, often in the presence of an antigen , leading to a fever. Whilst they can be a product of external factors like exogenous pyrogens, they can also be induced by internal factors like damage associated molecular patterns such as cases like rheumatoid arthritis or lupus. Major endogenous pyrogens are interleukin 1 (α and β) and interleukin 6 (IL-6). Minor endogenous pyrogens include interleukin-8 , tumor necrosis factor-β , macrophage inflammatory protein -α and macrophage inflammatory protein-β as well as interferon-α , interferon-β , and interferon-γ . Tumor necrosis factor-α (TNF) also acts as

10368-503: The body. He posited that arterial blood originated in the heart, from where it was distributed and consumed by all organs of the body. The blood was then regenerated in either the liver or the heart, completing the cycle. Galen also believed in the existence of a group of blood vessels he called the rete mirabile in the carotid sinus. Both of these theories of the circulation of blood were later (beginning with works of Ibn al-Nafis published c.  1242 ) shown to be incorrect. Galen

10512-453: The body. More important is that it includes details of more than 150 single and compound formulations of both herbal and animal origin. The book provides an insight into understanding the traditions and methods of treatment in the Greek and Roman eras. In addition, this book provides a direct source for the study of more than 150 single and compound drugs used during the Greco-Roman period. As

10656-599: The boundaries are pliable and compliant. These properties form enough to create a palpable pressure wave. Pulse velocity, pulse deficits and much more physiologic data are readily and simplistically visualized by the use of one or more arterial catheters connected to a transducer and oscilloscope . This invasive technique has been commonly used in intensive care since the 1970s. The pulse may be further indirectly observed under light absorbances of varying wavelengths with assigned and inexpensively reproduced mathematical ratios. Applied capture of variances of light signal from

10800-436: The brain. He conducted many anatomical studies on animals, most famously an ox, to study the transition from vital to psychic pneuma . Although highly criticized for comparing animal anatomy to human anatomy, Galen was convinced that his knowledge was abundant enough in both anatomies to base one on the other. In his treatise On the usefulness of the parts of the body , Galen argued that the perfect suitability of each part of

10944-452: The child's sleep to give the child more medicine. Fever is an important metric for the diagnosis of disease in domestic animals . The body temperature of animals, which is taken rectally, is different from one species to another. For example, a horse is said to have a fever above 101 °F ( 38.3 °C ). In species that allow the body to have a wide range of "normal" temperatures, such as camels , whose body temperature varies as

11088-475: The circulatory system. The blood created in the liver would eventually flow unidirectionally into the right ventricle of the heart via the great vein. Galen also proposed a theory on how blood receives air from the lungs to be distributed throughout the body. He declared that the venous artery carried air from the lungs into the left ventricle of the heart to mix with created blood from the liver. This same venous artery allowed for an exchange of waste products from

11232-442: The circumstances surrounding it and its response to anti-pyretic medications. In infants, the autonomic nervous system may also activate brown adipose tissue to produce heat (non-shivering thermogenesis). Increased heart rate and vasoconstriction contribute to increased blood pressure in fever. A pyrogen is a substance that induces fever. In the presence of an infectious agent, such as bacteria, viruses, viroids, etc .,

11376-573: The context of premature ventricular contraction and atrial fibrillation . A normal pulse is regular in rhythm and force. An irregular pulse may be due to sinus arrhythmia , ectopic beats , atrial fibrillation , paroxysmal atrial tachycardia , atrial flutter , partial heart block etc. Intermittent dropping out of beats at pulse is called "intermittent pulse". Examples of regular intermittent (regularly irregular) pulse include pulsus bigeminus , second-degree atrioventricular block . An example of irregular intermittent (irregularly irregular) pulse

11520-511: The crystalline lens is located in the anterior aspect of the human eye. At first reluctantly but then with increasing vigor, Galen promoted Hippocratic teaching, including venesection and bloodletting , then unknown in Rome. This was sharply criticized by the Erasistrateans , who predicted dire outcomes, believing that it was not blood but pneuma that flowed in the veins. Galen, however, staunchly defended venesection in his three books on

11664-544: The curriculum at the universities of Naples and Montpellier . From that time, Galenism took on a new, unquestioned authority, Galen even being referred to as the "Medical Pope of the Middle Ages". Constantine the African was amongst those who translated both Hippocrates and Galen from Arabic. In addition to the more numerous translations of Arabic texts in this period, there were a few translations of Galenic works directly from

11808-425: The difference between motor and sensory nerves , discussed the concept of muscle tone , and explained the difference between agonists and antagonists . Galen's work on animals led to some inaccuracies, most notably his anatomy of the uterus which largely resembled a dog's. Though incorrect in his studies of human reproduction and reproductive anatomy, he came very close to identifying the ovaries as analogous to

11952-402: The dissection of human cadavers since roughly 150 BC. Because of this restriction, Galen performed anatomical dissections on living ( vivisection ) and dead animals, mostly focusing on primates . Galen believed that the anatomical structures of these animals closely mirrored those of humans. Galen clarified the anatomy of the trachea and was the first to demonstrate that the larynx generates

12096-531: The environmental temperature varies, the body temperature which constitutes a febrile state differs depending on the environmental temperature. Fever can also be behaviorally induced by invertebrates that do not have immune-system based fever. For instance, some species of grasshopper will thermoregulate to achieve body temperatures that are 2–5 °C higher than normal in order to inhibit the growth of fungal pathogens such as Beauveria bassiana and Metarhizium acridum . Honeybee colonies are also able to induce

12240-411: The epidemic, referring to it as very long lasting, and described its symptoms and his treatment of it. His references to the plague are scattered and brief. Galen was not trying to present a description of the disease so that it could be recognized in future generations; he was more interested in the treatment and physical effects of the disease. For example, in his writings about a young man afflicted with

12384-455: The evidence on both sides of the argument appears to be mostly equivocal. Limited evidence supports sponging or bathing feverish children with tepid water. The use of a fan or air conditioning may somewhat reduce the temperature and increase comfort. If the temperature reaches the extremely high level of hyperpyrexia , aggressive cooling is required (generally produced mechanically via conduction by applying numerous ice packs across most of

12528-494: The greatest physician of all time. In India many Hindu physicians studied Persian and Urdu languages and learnt Galenic medicine. This trend of studies among Hindu physicians began in the 17th century and lasted until the early 20th century (Speziale 2018). From the 11th century onwards, Latin translations of Islamic medical texts began to appear in the West, alongside the Salerno school of thought, and were soon incorporated into

12672-445: The head. This is called pulsatile tinnitus , and it can indicate several medical disorders. Pulse rate was first measured by ancient Greek physicians and scientists. The first person to measure the heart beat was Herophilus of Alexandria , Egypt (c. 335–280 BC) who designed a water clock to time the pulse. Rumi has mentioned in a poem that "The wise physician measured the patient's pulse and became aware of his condition." It shows

12816-410: The heart beat and the onset of the pulse, known as the pulse transit time , which varies by site. Similarly measurements of heart rate variability and pulse rate variability differ. In healthy people, the pulse rate is close to the heart rate , as measured by ECG . Measuring the pulse rate is therefore a convenient way to estimate the heart rate. Pulse deficit is a condition in which a person has

12960-685: The human body. His anatomical reports remained uncontested until 1543, when printed descriptions and illustrations of human dissections were published in the seminal work De humani corporis fabrica by Andreas Vesalius , where Galen's physiological theory was accommodated to these new observations. Galen's theory of the physiology of the circulatory system remained unchallenged until c.  1242 , when Ibn al-Nafis published his book Sharh tashrih al-qanun li' Ibn Sina ( Commentary on Anatomy in Avicenna's Canon ), in which he reported his discovery of pulmonary circulation . Galen saw himself as both

13104-679: The hypothalamus and elevate the thermoregulatory setpoint. An example of a class of exogenous pyrogens are bacterial lipopolysaccharides (LPS) present in the cell wall of gram-negative bacteria . According to one mechanism of pyrogen action, an immune system protein, lipopolysaccharide-binding protein (LBP), binds to LPS, and the LBP–LPS complex then binds to a CD14 receptor on a macrophage . The LBP-LPS binding to CD14 results in cellular synthesis and release of various endogenous cytokines , e.g., interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNFα). A further downstream event

13248-443: The immune response of the body is to inhibit their growth and eliminate them. The most common pyrogens are endotoxins, which are lipopolysaccharides (LPS) produced by Gram-negative bacteria such as E. coli . But pyrogens include non-endotoxic substances (derived from microorganisms other than gram-negative-bacteria or from chemical substances) as well. The types of pyrogens include internal (endogenous) and external (exogenous) to

13392-399: The likelihood of permanent damage from typical fevers. The underlying problem, according to professor of pediatrics Barton D. Schmitt, is that "as parents we tend to suspect that our children's brains may melt." As a result of these misconceptions parents are anxious, give the child fever-reducing medicine when the temperature is technically normal or only slightly elevated, and interfere with

13536-401: The male testes. Reproduction was a controversial topic in Galen's lifetime, as there was much debate over if the male was solely responsible for the seed, or if the woman was also responsible. Through his vivisection practices, Galen also proved that the voice was controlled by the brain. One of the most famous experiments that he recreated in public was the squealing pig: Galen would cut open

13680-673: The medical field during Galen's lifetime, the main two being the Empiricists and Rationalists (also called Dogmatists or Philosophers), with the Methodists being a smaller group. The Empiricists emphasized the importance of physical practice and experimentation or "active learning" in the medical discipline. In direct opposition to the Empiricists were the Rationalists, who valued the study of established teachings in order to create new theories in

13824-649: The medieval and early modern Islamic Middle East. Job of Edessa is said to have translated 36 of Galen's works into Syriac, some of which were later translated into Arabic by Hunain ibn Ishaq . Galen's approach to medicine became and remains influential in the Islamic world. The first major translator of Galen into Arabic was the Arab Christian Hunayn ibn Ishaq . He translated ( c.  830–870 ) 129 works of "Jalinos" into Arabic . Arabic sources, such as Muhammad ibn Zakarīya al-Rāzi (AD 865–925), continue to be

13968-420: The mental and the physical. This was a controversial argument at the time, and Galen agreed with some Greek philosophical schools in believing that the mind and body were not separate faculties. He believed that this could be scientifically shown. This was where his opposition to the Stoics became most prevalent. Galen proposed organs within the body to be responsible for specific functions. According to Galen,

14112-491: The most influential and wealthy men in Asia. Galen claims that the High Priest chose him over other physicians after he eviscerated an ape and challenged other physicians to repair the damage. When they refused, Galen performed the surgery himself and in so doing won the favor of the High Priest of Asia. Over his four years there, he learned the importance of diet, fitness, hygiene, and preventive measures, as well as living anatomy, and

14256-483: The name of medical advancements. The Methodists formed somewhat of a middle ground, as they were not as experimental as the Empiricists, nor as theoretical as the Rationalists. The Methodists mainly utilized pure observation, showing greater interest in studying the natural course of ailments than making efforts to find remedies. Galen's education had exposed him to the five major schools of thought (Platonists, Peripatetics, Stoics, Epicureans, Pyrrhonists), with teachers from

14400-407: The nervous system. Galen went on to be the first physician to study what happens when the spinal cord is transected on multiple different levels. He worked with pigs and studied their neuroanatomy by severing different nerves either totally or partially to see how it affected the body. He even dealt with diseases affecting the spinal cord and nerves. In his work De motu musculorum , Galen explained

14544-519: The next week, and so on, where the generality of this pattern is debated. Persistent fever that cannot be explained after repeated routine clinical inquiries is called fever of unknown origin . A neutropenic fever , also called febrile neutropenia, is a fever in the absence of normal immune system function. Because of the lack of infection-fighting neutrophils , a bacterial infection can spread rapidly; this fever is, therefore, usually considered to require urgent medical attention. This kind of fever

14688-580: The north fighting the Marcomanni . During the autumn of 169 when Roman troops were returning to Aquileia , a great plague, most likely one of the first appearances of smallpox (then referred to as the Antonine Plague ) in the Mediterranean world, broke out, and the emperor summoned Galen back to Rome. He was ordered to accompany Marcus and Verus to Germany as the court physician. The following spring Marcus

14832-468: The original Greek, although many were destroyed and some credited to him are believed to be spurious. Although there is some debate over the date of his death, he was no younger than seventy when he died. Galen's Greek name Γαληνός ( Galēnós ) comes from the adjective γαληνός ( galēnós ) 'calm'. Galen's Latin name (Aelius or Claudius) implies he had Roman citizenship . Galen describes his early life in On

14976-490: The plague, he concentrated on the treatment of internal and external ulcerations. According to Niebuhr, "this pestilence must have raged with incredible fury; it carried off innumerable victims. The ancient world never recovered from the blow inflicted upon it by the plague that visited it in the reign of M. Aurelius." The mortality rate of the plague was 7–10 percent; the outbreak in 165–168 would have caused approximately 3.5 to 5 million deaths. Otto Seeck believes that over half

15120-479: The pleasures of the body and was moved by feelings of enjoyment. This third part of the soul is the animalistic, or more natural, side of the soul; it deals with the natural urges of the body and survival instincts. Galen proposed that when the soul is moved by too much enjoyment, it reaches states of "incontinence" and "licentiousness", the inability to willfully cease enjoyment, which was a negative consequence of too much pleasure. In order to unite his theories about

15264-510: The population of the empire perished. J. F. Gilliam believes that the Antonine plague probably caused more deaths than any other epidemic during the empire before the mid-3rd century. Although Galen's description is incomplete, it is sufficient to enable a firm identification of the disease as related to smallpox . Galen notes that the exanthema covered the victim's entire body and was usually black. The exanthem became rough and scabby where there

15408-541: The practice was common during Rumi's era and geography. The first person to accurately measure the pulse rate was Santorio Santorii who invented the pulsilogium , a form of pendulum which was later studied by Galileo Galilei . A century later another physician, de Lacroix , used the pulsilogium to test cardiac function. Galen Aelius Galenus or Claudius Galenus ( Greek : Κλαύδιος Γαληνός ; September 129 – c.  216 AD), often anglicized as Galen ( / ˈ ɡ eɪ l ən / ) or Galen of Pergamon ,

15552-472: The pulse can also be reported: Also known as compressibility of pulse. It is a rough measure of systolic blood pressure . It corresponds to diastolic blood pressure . A low tension pulse (pulsus mollis), the vessel is soft or impalpable between beats. In high tension pulse (pulsus durus), vessels feel rigid even between pulse beats. A form or contour of a pulse is palpatory estimation of arteriogram . A quickly rising and quickly falling pulse (pulsus celer)

15696-426: The rational soul. The functions of "growing or being alive" resided in the spirited soul. The spirited soul also contained our passions, such as anger. These passions were considered to be even stronger than regular emotions, and, as a consequence, more dangerous. The third part of the soul, or the appetitive spirit, controlled the living forces in our body, most importantly blood. The appetitive spirit also regulated

15840-503: The reverse of the foregoing processes (e.g., vasodilation, end of shivering, and nonshivering heat production) are used to cool the body to the new, lower setting. This contrasts with hyperthermia , in which the normal setting remains, and the body overheats through undesirable retention of excess heat or over-production of heat. Hyperthermia is usually the result of an excessively hot environment ( heat stroke ) or an adverse reaction to drugs. Fever can be differentiated from hyperthermia by

15984-426: The sick would come to seek the ministrations of the priesthood. Romans frequented the temple at Pergamon in search of medical relief from illness and disease. It was also the haunt of notable people such as the historian Claudius Charax, the orator Aelius Aristides , the sophist Polemo , and the consul Cuspius Rufinus . Galen's father died in 148, leaving Galen independently wealthy at the age of 19. He then followed

16128-489: The site of a large temple to the healing god Asclepius . The city attracted both Stoic and Platonic philosophers, to whom Galen was exposed at age 14. His studies also took in each of the principal philosophical systems of the time, including Aristotelian and Epicurean . His father had planned a traditional career for Galen in philosophy or politics and took care to expose him to literary and philosophical influences. However, Galen states that in around 145 his father had

16272-441: The soul and how it operated within the body, he adapted the theory of the pneuma , which he used to explain how the soul operated within its assigned organs, and how those organs, in turn, interacted together. Galen then distinguished the vital pneuma , in the arterial system, from the psychic pneuma , in the brain and nervous system. Galen placed the vital pneuma in the heart and the psychic pneuma ( spiritus animalis ) within

16416-480: The soul as having one part, which was the rational soul and they claimed it would be found in the heart. Galen, following Plato's idea, came up with two more parts to the soul. Galen also rejected Stoic propositional logic and instead embraced a hypothetical syllogistic which was strongly influenced by the Peripatetics and based on elements of Aristotelian logic. Galen believed there is no sharp distinction between

16560-440: The soul. Plato believed that the body and the soul were separate entities, rivaling the Stoics. Plato proclaimed that the soul is immortal, so it must exist before one is born, beyond the human body. This influenced Galen's thinking that the soul had to be acquired because the soul does not always reside within the human body. Plato's influence in Galen's model showed itself most prominently in what Galen dubbed arterial blood, which

16704-611: The source of discovery of new or relatively inaccessible Galenic writings. One of Hunayn's Arabic translations, Kitab ila Aglooqan fi Shifa al Amrad , which is extant in the Library of Ibn Sina Academy of Medieval Medicine & Sciences , is regarded as a masterpiece of Galen's literary works. A part of the Alexandrian compendium of Galen's work, this 10th-century manuscript comprises two parts that include details regarding various types of fevers (Humyat) and different inflammatory conditions of

16848-479: The study of Galen and other Greek works almost disappeared in the Latin West. In contrast, in the predominantly Greek-speaking eastern half of the Roman empire (Byzantium), many commentators of the subsequent centuries, such as Oribasius , physician to the emperor Julian who compiled a Synopsis in the 4th century, preserved and disseminated Galen's works, making them more accessible. Nutton refers to these authors as

16992-548: The subject and in his demonstrations and public disputations. Galen's work on anatomy remained largely unsurpassed and unchallenged up until the 16th century in Europe. In the middle of the 16th century, the anatomist Andreas Vesalius challenged the anatomical knowledge of Galen by conducting dissections on human cadavers. These investigations allowed Vesalius to refute aspects of Galen's theories regarding anatomy. Galen's interest in human anatomy ran afoul of Roman law that prohibited

17136-473: The temperature set point, due to either too much heat production or not enough heat loss . Hyperthermia is thus not considered fever. Hyperthermia should not be confused with hyperpyrexia (which is a very high fever). Clinically, it is important to distinguish between fever and hyperthermia as hyperthermia may quickly lead to death and does not respond to antipyretic medications. The distinction may however be difficult to make in an emergency setting, and

17280-479: The three attacks of quartan ague, and the doctors had given him up, as it was now mid-winter." Some Roman physicians criticized Galen for his use of the prognosis in his treatment of Eudemus. This practice conflicted with the then-current standard of care , which relied upon divination and mysticism . Galen retaliated against his detractors by defending his own methods. Garcia-Ballester quotes Galen as saying: "In order to diagnose, one must observe and reason." This

17424-456: The time of Galen. The most important translator of Galen's works into Latin was Niccolò di Deoprepio da Reggio, who spent several years working on Galen. Niccolò worked at the Angevin Court during the reign of king Robert of Naples . Among Niccolò's translations is a piece from a medical treatise by Galen, of which the original text is lost. Fever Fever or pyrexia in humans

17568-559: The title of Doubts on Galen by al-Rāzi implies, as well as the writings of physicians such as Ibn Zuhr and Ibn al-Nafis , the works of Galen were not accepted unquestioningly, but as a challengeable basis for further inquiry . A strong emphasis on experimentation and empiricism led to new results and new observations, which were contrasted and combined with those of Galen by writers such as al-Rāzi, Ali ibn Abbas al-Majusi , Abu al-Qasim al-Zahrawi , Ibn Sina (Avicenna), Ibn Zuhr, and Ibn al-Nafis. For example, Ibn al-Nafis' discovery of

17712-513: The tomb of Galenus in Palermo was still well preserved in the tenth century. Nutton believes that "On Theriac to Piso" is genuine, that the Arabic sources are correct, and that the Suda has erroneously interpreted the 70 years of Galen's career in the Arabic tradition as referring to his whole lifespan. Boudon-Millot more or less concurs and favors a date of 216. Galen contributed a substantial amount to

17856-427: The treatment of fractures and severe trauma, referring to their wounds as "windows into the body". Only five deaths among the gladiators occurred while he held the post, compared to sixty in his predecessor's time, a result that is in general ascribed to the attention he paid to their wounds. At the same time he pursued studies in theoretical medicine and philosophy. Galen went to Rome in 162 and made his mark as

18000-866: The understanding of pathology. Under the Hippocratic bodily humors theory, differences in human moods come as a consequence of imbalances in one of the four bodily fluids : blood, yellow bile, black bile, and phlegm. Galen promoted this theory and the typology of human temperaments . In Galen's view, an imbalance of each humor corresponded with a particular human temperament (blood – sanguine, black bile – melancholic, yellow bile – choleric, and phlegm – phlegmatic). Thus, individuals with sanguine temperaments are extroverted and social; choleric people have energy, passion, and charisma; melancholics are creative, kind, and considerate; and phlegmatic temperaments are characterised by dependability, kindness, and affection. Galen

18144-414: The unity of the two subjects and their views. Using their theories, combined with Aristotle's, Galen developed a tripartite soul consisting of similar aspects. He used the same terms as Plato , referring to the three parts as rational, spiritual, and appetitive. Each corresponded to a localized area of the body. The rational soul was in the brain, the spiritual soul was in the heart, and the appetitive soul

18288-471: The voice. In one experiment, Galen used bellows to inflate the lungs of a dead animal. Galen's research on physiology was largely influenced by previous works of philosophers Plato and Aristotle, as well as from the physician Hippocrates. He was one of the first people to use experiments as a method of research for his medical findings. Doing so allowed him to explore various parts of the body and its functions. Among Galen's major contributions to medicine

18432-469: The work of his predecessors, and it is in Galen's words (Galenism) that Greek medicine was handed down to subsequent generations, such that Galenism became the means by which Greek medicine was known to the world. Often, this was in the form of restating and reinterpreting, such as in Magnus of Nisibis' 4th-century work on urine, which was in turn translated into Arabic. Yet the full importance of his contributions

18576-446: Was a Roman and Greek physician , surgeon , and philosopher . Considered to be one of the most accomplished of all medical researchers of antiquity , Galen influenced the development of various scientific disciplines, including anatomy , physiology , pathology , pharmacology , and neurology , as well as philosophy and logic . The son of Aelius Nicon , a wealthy Greek architect with scholarly interests, Galen received

18720-424: Was a physiological basis for mental disorders. Galen connected many of his theories to the pneuma and he opposed the Stoics ' definition of and use of the pneuma . The Stoics, according to Galen, failed to give a credible answer for the localization of functions of the psyche, or the mind. Through his use of medicine, he was convinced that he came up with a better answer, the brain. The Stoics only recognized

18864-404: Was also a pioneer in research about the human spine. His dissections and vivisections of animals led to key observations that helped him accurately describe the human spine, spinal cord , and vertebral column . Galen also played a major role in the discoveries of the central nervous system . He was also able to describe the nerves that emerge from the spine, which is integral to his research about

19008-415: Was also a skilled surgeon, operating on human patients. Many of his procedures and techniques would not be used again for centuries, such as the procedures he performed on brains and eyes. His surgical experiments included ligating the arteries of living animals. Although many 20th-century historians have claimed that Galen believed the lens to be in the exact center of the eye, Galen actually understood that

19152-444: Was his work on the circulatory system . He was the first to recognize that there are distinct differences between venous (dark) and arterial (bright) blood. In addition to these discoveries, Galen postulated much more about the nature of the circulatory system . He believed that blood originated in the liver, which follows the teachings of Hippocrates. The liver converted nutrients gathered from ingested food into blood to be used in

19296-440: Was in the liver. Galen was the first scientist and philosopher to assign specific parts of the soul to locations in the body because of his extensive background in medicine. This idea is now referred to as localization of function. Galen's assignments were revolutionary for the time period, which set the precedent for future localization theories. Galen believed each part of this tripartite soul controlled specific functions within

19440-456: Was named after Marcus Aurelius' family name of Antoninus. It was also known as the Plague of Galen and held an important place in medicinal history because of its association with Galen. He had first-hand knowledge of the disease, and was present in Rome when it first struck in 166, and was also present in the winter of 168–69 during an outbreak among troops stationed at Aquileia. He had experience with

19584-426: Was no ulceration. He states that those who were going to survive developed a black exanthem. According to Galen, it was black because of a remnant of blood putrefied in a fever blister that was pustular. His writings state that raised blisters were present in the Antonine plague, usually in the form of a blistery rash. Galen states that the skin rash was close to the one Thucydides described. Galen describes symptoms of

19728-466: Was not appreciated until long after his death. Galen's rhetoric and prolificity were so powerful as to convey the impression that there was little left to learn. The term Galenism has subsequently taken on both a positive and pejorative meaning as one that transformed medicine in late antiquity yet so dominated subsequent thinking as to stifle further progress. After the collapse of the Western Empire

19872-451: Was part of Greek culture, and Syrian Christians came in contact with it while the Eastern Roman Empire (Byzantium) ruled Syria and western Mesopotamia, regions that were conquered in the 7th century by the Arabs . After 750, these Syrian Christians made the first translations of Galen into Syriac and Arabic . From then on, Galen and the Greek medical tradition in general became assimilated into

20016-524: Was persuaded to release Galen after receiving a report that Asclepius was against the project. He was left behind to act as physician to the imperial heir Commodus . It was here in court that Galen wrote extensively on medical subjects. Ironically, Lucius Verus died in 169, and Marcus Aurelius himself died in 180, both victims of the plague. Galen was the physician to Commodus for much of the emperor's life and treated his common illnesses. According to Dio Cassius 72.14.3–4, in about 189, under Commodus' reign,

20160-425: Was practicing medicine including that due to malaria (tertian or every 2 days and quartan or every 3 days). It also became clear around this time that fever was a symptom of disease rather than a disease in and of itself. Infections presenting with fever were a major source of mortality in humans for about 200,000 years. Until the late nineteenth century, approximately half of all humans died from infections before

20304-880: Was principally influenced by the then-current theory of the four humors : black bile, yellow bile, blood, and phlegm, as first advanced by the author of On the Nature of Man in the Hippocratic corpus . Galen's views dominated and influenced Western medical science for more than 1,300 years. His anatomical reports were based mainly on the dissection of Barbary apes . However, when he discovered that their facial expressions were too much like those of humans, he switched to other animals, such as pigs . While dissections and vivisections on humans were practised in Alexandria at this time, Galen did not have Imperial permission to perform his own, and had to use animals instead. Galen would encourage his students to go look at dead gladiators or bodies that washed up in order to get better acquainted with

20448-640: Was terminated early because patients receiving aggressive fever treatment were dying more often. According to the NIH, the two assumptions which are generally used to argue in favor of treating fevers have not been experimentally validated. These are that (1) a fever is noxious, and (2) suppression of a fever will reduce its noxious effect. Most of the other studies supporting the association of fever with poorer outcomes have been observational in nature. In theory, these critically ill patients and those faced with additional physiologic stress may benefit from fever reduction, but

20592-419: Was the basis of his criticism of the doctors who proceeded alogos and askeptos." However, Eudemus warned Galen that engaging in conflict with these physicians could lead to his assassination. "Eudemus said this, and more to the same effect; he added that if they were not able to harm me by unscrupulous conduct they would proceed to attempts at poisoning. Among other things he told me that, some ten years before,

20736-453: Was the heart and the arteries, which Galen believed to be responsible for providing life-giving energy. The last theorized system was the liver and veins, which Galen theorized were responsible for nutrition and growth. Galen also theorized that blood was made in the liver and sent out around the body. One of Galen's major works, On the Doctrines of Hippocrates and Plato , sought to demonstrate

#75924