Galen of Pergamon: Rome’s Most Famous Physician

He began his career in the blood and dust of the gladiatorial arena, stitching wounds and saving fighters in Pergamon’s amphitheater. Yet Galen would rise far beyond the roar of the crowds, becoming the most celebrated physician of the Roman world. Called to Rome, he served emperors, dazzled audiences with his public demonstrations, and wrote works that defined medicine for more than a thousand years.

Healing in the Heart of Rome

Today Galen of Pergamon is remembered as the most prolific medical author of antiquity, whose writings shaped education for centuries across Byzantium and medieval Europe. Yet Galen never saw himself chiefly as an anatomist or theorist.

At his core, he was a practicing doctor—one who spent decades treating patients in Rome from the 160s until his death sometime after 203 CE. His clientele ranged from emperors such as Marcus Aurelius and their households to ordinary people met in the streets, peasants from the countryside, and even slaves brought to his home clinic.

In a lost work, surviving only in Arabic, Galen claimed never to have charged a fee. The hundreds of patient stories scattered through his writings paint a picture not of an aloof court physician, but of a public figure known across Rome, stopped in the street, challenged to debate, and surrounded by students, servants, and supporters.

Practicing medicine in the Roman capital demanded both skill and courage. There were no antibiotics, anaesthetics, or sanitation. In cramped, foul-smelling rooms, Galen tended the sick as they burned with fever, convulsed, vomited, or slipped into death.

Rome’s teeming streets were rife with infection, and life expectancy was brutally short. Malaria was common; Galen classified fevers by their rhythms—daily, every other day, or every three days—echoing the traditions of Hippocrates.

He also faced waves of smallpox, the “great plague” that first struck in 166 CE and ravaged the empire for years. At Aquileia he treated stricken soldiers as the disease swept through the army; later in Rome, he lost friends and even most of his household slaves to the epidemic. Other ailments included tuberculosis, snakebites, wounds, and countless chronic afflictions.

Galen examined his patients with relentless attention. He felt for minute shifts in pulse and temperature, studied their bodily fluids, and listened closely to their own words about pain or discomfort. He probed their recent histories for clues—diet, travel, or emotional upheaval—and even diagnosed one man with a swallowed leech after he admitted drinking from a filthy fountain.

Another, overheated and distraught after a quarrel at the baths, collapsed into fever. Galen believed emotional states like anxiety and anger could trigger or worsen illness, and he described cases of melancholy rooted in excessive worry, such as the patient convinced Atlas would one day drop the sky.

His treatments were intimate and often intense. Galen visited homes, bathed patients, cooked for them, massaged their bodies, and administered purgatives or bloodletting. He could be ruthless—on one occasion bleeding a man so copiously that rival doctors joked he had butchered him like an animal.

Yet Galen refused to abandon even the dying, insisting that honesty in prognosis, rather than withdrawal, protected a physician’s reputation. Most of his detailed case histories center on educated men of his own class, but Galen also treated women, children, and slaves. He respected their modesty—asking midwives to handle intimate procedures—but otherwise offered the same close care as with his male patients.

His writings reveal a man both shrewd and uncompromising, whose identity rested not on theories but on what he called his “deeds among the patients.” Though later generations would dismiss many of his physiological ideas, Galen’s relentless clinical practice secured his place as one of the true founders of Western medicine. (The art of medicine. Galen and his patients, by Susan Mattern History Department, University of Georgia, Athens)

From Pergamon to Rome

Galen was born in September 129 CE in Pergamon, a flourishing city on the Ionian coast of Asia Minor, and he lived into the second decade of the third century, most likely dying in Rome in his eighties. Over this long and productive life, he dictated a staggering number of works—often several at once to relays of scribes—on subjects ranging from medicine and philosophy to philology and literary criticism.

Many of these writings are now lost, yet what remains shows the scope of his intellect. He came from a prosperous family. His father, Nicon, was an architect and engineer, a man Galen admired deeply for his moral and intellectual virtues.

His mother, by contrast, he remembered as quarrelsome and prone to fits of violence. From his father, Galen received not only a fine education in grammar, mathematics, and logic, but also a model of integrity and a disdain for wealth and reputation.

He began studying philosophy at fourteen with teachers from the major schools—Platonist, Aristotelian, Stoic, and Epicurean—though he often criticized their arguments. He seemed destined for a philosopher’s career until, guided by a dream, Nicon directed his son toward medicine.

Galen pursued his medical studies with characteristic determination. In Pergamon he trained under Satyrus, whom he later accused of misinterpreting Hippocrates. After his father’s death in 149 CE, he inherited a fortune and set out to broaden his education, studying in Smyrna under Pelops, a prominent Rationalist physician, and attending the lectures of the Platonist Albinus.

He traveled further to Corinth and then Alexandria in search of Numisianus, the leading anatomist of the day. Returning to Pergamon in 157 CE, Galen was appointed physician to the local gladiatorial school—“even though I was young, only 28,” he recalled.

The position gave him unrivaled training in trauma and surgery, and he proudly noted that while his predecessors had lost many fighters, he “hardly lost a single patient.” His contract was renewed four times, and he held the post until 161.

Soon after, he left Pergamon for Rome. He attributed this decision partly to unrest at home—describing it with the grave word stasis—and partly to his own ambitions. Before arriving, he traveled widely through the eastern Mediterranean, investigating herbs, minerals, and remedies.

He recorded plant names in Thrace and Macedonia, explored Cypriot copper mines in search of medicinal ore, and even ventured to the Dead Sea in Palestine to study bitumen. In Rome, Galen’s ascent was, by his own account, dazzling. He claimed that his brilliance alone secured him success, though his family’s connections surely helped. He quickly moved in elite circles, impressing philosophers as well as physicians.

Early in his Roman career he recounted a case that won him fame: in the street he encountered the philosopher Glaucon, who tested him by bringing him to a patient suffering from diarrhea often mistaken for dysentery. Galen diagnosed liver inflammation after observing bloody serum in the stool and confirming it by palpation and pulse. The patient, himself a doctor, had wrongly treated himself for pleurisy. Galen stunned Glaucon further by predicting the man’s intermittent cough, which occurred moments later.

“From this time onwards,”

Galen recalled,

“Glaucon held both myself and the entire medical art in the highest regard, whereas previously he had not esteemed it highly, simply because he had never come across men worthy of respect who were versed in it”

Galen, On the Affected Parts

For Galen, the lesson was clear: physicians must distinguish which symptoms belong uniquely to a disease, which appear frequently, and which only rarely. But skill alone was not enough—one also had to seize opportunities.

“For while good fortune often provides many opportunities for achieving a great reputation, still most people are unable to avail themselves of them on account of their ignorance”

Galen, On the Affected Parts

This story, like others Galen preserved, highlights both his sharp diagnostic eye and his flair for self-presentation. He wanted to be respected as both a philosopher and a physician, and in Rome he achieved just that. (The man and his work, by  R. J. Hankinson in The Cambridge Companion to Galen)

Plague, Emperors, and Galen’s Place in Society

In 166 CE a devastating pandemic swept through the Roman Empire, carried west by the army returning from Lucius Verus’ Parthian campaign. At this moment Galen abruptly departed Rome for Pergamon—whether, as he sometimes claimed, to escape the plague, or simply to avoid being detained by the emperors.

Yet in 168 he was summoned back, joining Marcus Aurelius and Lucius Verus at Aquileia in northern Italy as the disease tore through the ranks. Lucius himself succumbed, and Galen, overwhelmed by patients, later recalled tending countless victims of what he called “the great plague.”

By his own account, Galen escaped following the army to the front thanks to a dream in which Asclepius forbade him. From then until the end of his life he lived mainly in Italy, above all in Rome, though he continued to travel.

Galen’s education had been unusually broad: not only medicine but also philosophy, mathematics, and geometry, which he considered essential for the practice of medicine. His travels and his prestigious Roman practice further marked him as a man of high social standing.

He styled himself as an independently wealthy member of Pergamon’s ruling elite, the city’s decurial class, and maintained estates in Rome, Pergamon, and Campania. The question of whether Galen lived by his medical earnings remains uncertain. He avoided speaking of fees, sometimes claiming he never demanded them, though in another anecdote he admitted to accepting a lavish reward for curing a senator’s wife.

In all cases, he presented himself as a man conscious of his class position. Indeed, class runs through his writings as one of their most persistent themes. To understand Galen’s world is to grasp not just his medicine, but also his self-image as a member of Rome’s intellectual and social elite.

Rome: A City of Disease and Death

Galen’s case histories are vivid, but they cannot be treated as a statistical mirror of Rome’s population or its health. He selected which patients and illnesses to describe for professional and cultural reasons, and his disease categories differ so sharply from modern ones that diagnosis is often uncertain. Still, his writings, combined with other evidence, help illuminate the precarious conditions of life in Rome.

Life expectancy in the empire hovered between twenty and thirty years, and was lower in cities than in the countryside. Rome itself has been called a “death-trap.” Despite its aqueducts and sewers, living conditions for most were squalid.

Tenements were overcrowded, prone to collapse, and often without proper latrines. Waste was dumped into pits or the streets, alongside animal carcasses and even human corpses. Animals were sold and slaughtered in public, while water supplies could easily be contaminated.

The city’s baths, widely used for treatment and daily life, were never disinfected and often described as filthy. These conditions created fertile ground for disease: cholera, dysentery, typhoid, tetanus, parasites, and more. Malaria was perhaps the most dangerous, its fevers filling Galen’s pages and its victims especially young children and newcomers.

Tuberculosis also stalked the population, cutting lives short in young adulthood. Epidemics frequently swept Rome, none more infamous than the “great plague” beginning in 166 CE, which modern scholars identify as smallpox. It may have killed up to 30 percent of the city’s people when it first struck.

Even the rich could not escape disease, though they fared better. Aristocrats lived on Rome’s higher ground, fled to country estates in dangerous seasons, and had private baths and better food. Yet their life expectancy, like that of emperors themselves, was scarcely higher than that of the general population. Among the poor, average life expectancy may have been in the high teens, with Rome’s numbers sustained only through constant immigration.

That Galen survived into his eighties was extraordinary. His writings, though often triumphant in tone, hint at a grimmer reality: every fever, every cut, every strange sensation carried the risk of death. In such conditions, medicine was not just science or skill—it was a contest for survival in which the physician’s reputation and the patient’s life were bound together in every diagnosis.

The Survival and Transformation of Galen’s Works

The writings of Galen have reached us across a long and complex journey of transmission. Roughly 170 works survive under his name, though many are fragmentary, forged, or altered through centuries of copying and translation. None of his original manuscripts remain.

Alarmed by the circulation of spurious texts even in his own lifetime, Galen compiled two catalogs—On My Own Books and On the Order of My Own Books—to distinguish the genuine from the false. Still, because many of his works were written for friends, then copied and circulated without his approval, multiple versions of the same treatise often existed.

Galen himself acknowledged the instability of the written word, noting that texts could be falsified, corrupted, or poorly composed, and should always be scrutinized. Fragments of his works survive on papyrus, and their influence in late antiquity was immense.

Oribasius excerpted him in the fourth century; his writings shaped the Alexandrian curriculum; they were translated into Syriac in the fifth century and Arabic in the eighth; and from there, into Latin for the medieval West. Galen’s ideas dominated medical education in Europe, the Middle East, and beyond, accumulating vast traditions of commentary and interpretation in Latin, Arabic, and Hebrew.

In the sixteenth century, a wave of new translations and discoveries—some genuine, some forged—renewed interest in him. The first collection of his Greek works appeared in print in 1525, allowing scholars to return directly to Galen himself.

Yet this same era saw his authority challenged. Vesalius, in his groundbreaking Fabrica, honored Galen but corrected him through human dissection, exposing mistakes born of Galen’s reliance on animal anatomy. Paracelsus, more radical still, rejected textual tradition entirely, advocating medicine based on personal experience and the powers of natural substances.

Over time, discoveries such as Harvey’s demonstration of blood circulation and the decline of Aristotelian natural philosophy dismantled Galen’s physiological system. Still, Galen’s therapies endured in practice long after his theories were overturned. His central place in medical history was reaffirmed in the nineteenth century, when Karl Gottlob Kühn published a monumental twenty-volume edition of Galen’s works, a collection that remains the standard today. (Galen and the rhetoric of healing, by Susan P. Mattern)

Galen, Diet, and the Medicine of the Elite

Roughly 80 percent of the patients Galen recorded came from the social elite, with sophists representing about 46 percent and only 21 percent drawn from lower classes. Galen himself admitted that he wrote for Greeks—or for those who, though not Greek by birth, had cultivated the qualities of Greek culture. By this he meant men educated in literature and philosophy, a group firmly rooted in the wealthy strata of society.

His emphasis on dietetic medicine naturally reinforced this focus. Diet required an intimate knowledge of a patient’s lifestyle and habits—an attention to detail only the rich could afford, both in time and money. For physicians, prescribing a regimen of diet carried not only therapeutic value but also intellectual prestige.

In Galen’s system, diet was the cornerstone of health. Food had the power to unbalance the humors and cause disease, or to restore harmony and prevent illness. Prevention, therefore, was always preferable to cure. By contrast, harsher measures—drugs, bloodletting, cautery, or surgery—were last resorts, used only when diet failed.

This reliance on food had a moral as well as medical dimension. It reflected Stoic ideals: moderation and balance were the path to truth and to the good life. Eating thus rose above mere sustenance, acquiring a philosophical weight that gave dietetics its central place within medicine.

The boundary between food and drug, however, was not fixed. Galen noted that certain substances could shift categories depending on their preparation. Edder-wort, for instance, lost its medicinal potency only after being boiled several times.

For him, a food was anything that nourished without strongly altering the body, while a drug acted forcefully, as a purge, emetic, or vermifuge. Through careful preparation—cooking, seasoning, or dilution—even a drug could be transformed into food.

Galen’s story is one of ambition, intellect, and endurance. From the gladiatorial school of Pergamon to the courts of emperors, he built a reputation that survived long after his own world had vanished. He saw medicine not as detached theory but as lived practice, demanding courage, skill, and moral judgment.

Though many of his ideas were later overturned, his writings shaped the way physicians thought and worked for more than a millennium. To read Galen today is to glimpse not only a physician at the height of Roman power, but also a man who believed that healing was as much a measure of character as of knowledge.