GALEN ON THE BRAIN: Anatomical Knowledge and Physiological Speculation in the Second Century AD Julius Rocca BRILL GALEN ON THE BRAIN STUDIES IN ANCIENT MEDICINE EDITED BY JOHN SCARBOROUGH PHILIP J. VAN DER EIJK ANN HANSON NANCY SIRAISI VOLUME 26 GALEN ON THE BRAIN Anatomical Knowledge and Physiological Speculation in the Second Century AD BY JULIUS ROCCA BRILL LEIDEN •BOSTON 2003 Cover Illustration Galen in Roman dress forms part of a striking stained-glass triptych in the Old Medical School, University of Sydney, Australia. With kind permission of Professor Jonathan Stone, Department of Anatomy, and Professor Anne Sefton, Department of Physiology, University of Sydney. This book is printed on acid-free paper. Die Deutsche Bibliothek - CIP-Einheitsaufnahme Rocca, Julius: Galen on the brain Anatomical knowledge and physiological speculation in the second century AD/ by Julius Rocca. – Leiden ; Boston : Brill, 2003 (Studies in ancient medicine ; Vol. 26) ISBN 90-04-12512-4 Library of Congress Cataloging-in-Publication Data The Library of Congress Cataloging-in-Publication Data is also available ISSN 0925–1421 ISBN 90 04 12512 4 © Copyright 2003 by Koninklijke Brill NV, Leiden, The Netherlands All rights reserved. No part of this publication may be reproduced, translated, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission from the publisher. Authorization to photocopy items for internal or personal use is granted by Brill provided that the appropriate fees are paid directly to The Copyright Clearance Center, 222 Rosewood Drive, Suite 910 Danvers MA 01923, USA. Fees are subject to change. printed in the netherlands To my mother, Joan Alice and to the memory of her parents, Emma Jane Crowley and Thomas Samuel Bull This page intentionally left blank CONTENTS Acknowledgments ...................................................................... xi Abbreviations .............................................................................. xiii Illustrations .................................................................................. xv Note to the Reader .................................................................... xvii Preface ........................................................................................ xix General Introduction: Galen and his time .............................. 1 PART ONE THE FRAMEWORK OF GALEN’S ANATOMICAL METHODOLOGY Chapter One: The development of the hegemonic concept: the medical and philosophical background 1.1 Introduction .................................................................. 17 1.2 Presocratic knowledge of the brain ............................ 21 1.3 The brain in the Hippocratic Corpus ........................ 24 1.4 Aristotle on the brain and the heart .......................... 28 1.5 Hellenistic medicine and the hegemonikon .................... 31 1.6 The second century AD: a recovery of anatomical knowledge ...................................................................... 42 1.7 Conclusion ...................................................................... 46 Chapter Two: Galen’s methods and materials for the investigation of the brain 2.1 Introduction .................................................................. 49 2.2 Galen’s claims for anatomical demonstration ............ 50 2.3 Galen’s pneumatic physiology ...................................... 59 2.4 Galen’s empirical substrate: animal material .............. 67 2.5 Conclusion ...................................................................... 77 viii  PART TWO THE ARCHITECTURE OF THE BRAIN Chapter Three: The exposure and dissection of the brain 3.1 Introduction .................................................................. 81 3.2 The parts of the brain: orientation and nomenclature .................................................................. 82 3.3 The cranial cavity and the anatomical exposure of the brain ........................................................................ 86 3.4 The meninges (i): the dura mater and the dural foldings ............................................................................ 91 3.5 The meninges (ii): the dural venous sinuses .................. 94 3.6 The meninges (iii): the venous sinuses and the torcular Herophili .......................................................................... 96 3.7 The meninges (iv): the pia mater ...................................... 104 3.8 Ventricular protection and support: the brain’s deeper bodies ................................................................ 106 3.9 Conclusion ...................................................................... 112 Chapter Four: The anatomy of the ventricular system 4.1 Introduction .................................................................. 113 4.2 Ventricular symmetry: a constructed harmony .......... 114 4.3 An overview of Galen’s ventricular system ................ 116 4.4 The anterior ventricles .................................................. 119 4.5 The middle ventricle .................................................... 135 4.6 The “duct of Erasistratus” and the vermiform epiphysis ........................................................................ 151 4.7 The “cavity of Herophilus”: the fourth ventricle ...... 160 4.8 Conclusion ...................................................................... 167 PART THREE A PHYSIOLOGY OF THE BRAIN Chapter Five: A methodology of ventricular function 5.1 Introduction .................................................................. 171 5.2 Galen’s method of ventricular experimentation .......... 172 5.3 The effects of pressure: chance and the youth from Smyrna .......................................................................... 181  ix 5.4 Pressure as an experimental technique ...................... 187 5.5 The effects of ventricular incision ................................ 192 5.6 The soul and the ventricles .......................................... 196 5.7 Conclusion ...................................................................... 198 Chapter Six: The elaboration of psychic pneuma 6.1 Introduction .................................................................. 201 6.2 The anatomy of the retiform plexus .......................... 202 6.3 The physiology of the retiform plexus: Galen’s “paradigm” for pneumatic elaboration ........................ 208 6.4 The anatomy and physiology of the choroid plexus .. 219 6.5 The experiment of carotid ligation .............................. 224 6.6 The limits of Galenic pneumatic physiology .............. 235 6.7 Conclusion ...................................................................... 237 Chapter Seven: Conclusion ...................................................... 239 Appendix One The doctrine of ventricular localisation .................................. 245 Appendix Two Galenism and the status of the retiform plexus ...................... 249 Glossary of Anatomical Terms ................................................ 255 Bibliography ................................................................................ 261 Index of Sources and List of Editions .................................... 283 General index ............................................................................ 299