In the middle of the 16th century, a talented young anatomist named Andreas Vesalius made a shocking discovery: the most famous human anatomy texts in the world were wrong. They not only failed to account for many details of the human body, they also described the organs of apes and other mammals. While Vesalius knew he was right, announcing these errors would mean challenging Galen of Pergamon– the most renowned physician in medical history. But who was this towering figure? And why did doctors working more than 1,300 years later so revere and fear him?
在 16 世纪中期, 才华横溢的年轻解剖学家 安德烈亚斯·维萨里有了惊人发现: 世上最著名的人体解剖理论是错的。 它们不仅没有正确描述人体细节, 还把描述人的器官描写成 猿人和其它哺乳动物的器官。 维萨里知道自己是正确的, 若宣布它是错误的话, 将意味着质疑帕加马的盖伦—— 医学史上最著名的医生。 但这位权威人物是何许人呢? 又为何 1300 年之后, 医生们依然尊敬和惧怕他呢?
Born in 129 CE, Galen left home as a teen to scour the Mediterranean for medical wisdom. He returned home a gifted surgeon with a passion for anatomy and a penchant for showmanship. He gleefully entered public anatomy contests, eager to show up his fellow physicians. In one demonstration, he caused a pig to lose its voice by tying off one of its nerves. In another, he disemboweled a monkey and challenged his colleagues to repair it. When they couldn’t, he did. These grizzly feats won him a position as surgeon to the city’s gladiators. Eventually, he would leave the arena to become the personal physician to four Roman Emperors.
盖伦生于公元前 129 年, 少年离家,前往地中海地区学医。 回家时,已是一名 才华横溢的外科医生, 热爱并喜欢表演解剖。 他积极地参加公开解剖比赛, 热心为同行们大展身手。 在一次示范中, 他阻断了猪的一条神经,猪就不叫了。 另一次,他把一只猴子开了膛, 并挑战同行们去缝合它, 当他们无法做到时,他却做到了。 这些艰辛的壮举,为他赢得了 角斗士学校的外科医生职位。 最终,他离开了竞技场, 成为四位罗马皇帝的私人医师。
While his peers debated symptoms and their origins, Galen obsessively studied anatomy. He was convinced that each organ had a specific function. Since the Roman government largely prohibited working with human cadavers, Galen conducted countless dissections of animals instead. Even with this constraint, his exhaustive investigations yielded some remarkably accurate conclusions.
盖伦的同龄人辩论症状及原因时, 他则痴迷于研究解剖学, 他相信每个器官都有特殊的功能。 由于罗马政府严禁解剖尸体, 所以,盖伦大量解剖动物。 即使有这项限制, 他的大量研究依然得出了 一些非常精确的结论。
One of Galen’s most important contributions was the insight that the brain, not the heart, controlled the body. He confirmed this theory by opening the cranium of a living cow. By applying pressure to different parts of the brain, he could link various regions to specific functions. Other experiments allowed him to distinguish sensory from motor nerves, establish that urine was made in the kidneys, and deduce that respiration was controlled by muscles and nerves.
盖伦最重要的贡献之一 是发现了控制身体的 是大脑,而不是心脏。 他打开了一头活牛的头颅, 来证实了这一理论。 通过对大脑不同部位施压, 他得以将不同的区域 与特定功能联系起来。 其它实验令他将感觉神经 与运动神经区分开来, 确立了尿液是由肾脏产生的, 并推断出呼吸由神经和肌肉控制。
But these wild experiments also produced extraordinary misconceptions. Galen never realized that blood cycles continuously throughout the body. Instead, he believed the liver constantly produces an endless supply of blood, which gets entirely depleted on its one-way trip to the organs. Galen is also credited with solidifying the popular theory of the Four Humours. Introduced by Hippocrates centuries earlier, this misguided hypothesis attributed most medical problems to an imbalance in four bodily fluids called humours. To correct the balance of these fluids, doctors employed dangerous treatments like bloodletting and purging. Informed by his poor understanding of the circulatory system, Galen was a strong proponent of these treatments, despite their sometimes lethal consequences.
但是这些疯狂的实验 也产生了大量错误结论。 盖伦从来没意识到 血液循环遍及全身, 相反,他认为肝脏 产生源源不尽的血液, 血液在流向器官途中耗尽。 盖伦还被认为巩固了 “四体液学说”的流行理论, 这个误导人的假设—— 由希波克拉底在几个世纪前提出, 它将大多数医学病症 归因于四种体液的不平衡。 为了纠正这些液体的平衡, 医生采用了危险疗法, 例如,放血和净化。 由于对循环系统了解不足, 盖伦大力支持这些疗法, 尽管这些疗法 有时带来致命后果。
Unfortunately, Galen’s ego drove him to believe that all his discoveries were of the utmost importance. He penned treatises on everything from anatomy to nutrition to bedside manner, meticulously cataloguing his writings to ensure their preservation. Over the next 13 centuries, Galen’s prolific collection dominated all other schools of medical thought. His texts became the standard works taught to new generations of doctors, who in turn, wrote new essays extolling Galen’s ideas. Even doctors who actually dissected human cadavers would bafflingly repeat Galen’s mistakes, despite seeing clear evidence to the contrary. Meanwhile, the few practitioners bold enough to offer conflicting opinions were either ignored or ridiculed.
很遗憾,盖伦的自负令他认为 他所有发现都很重要。 他都撰写大量著作,涵盖解剖学、 营养学,以及医生对患者的态度, 并精心编制目录以安全保存。 在接下来的 13 个世纪里, 盖伦的丰富著作主导了 所有其它医学思想流派。 他的著作成为新一代医生的教科书, 而后者又写出 赞扬盖伦理论的新文章。 即使那些解剖人类尸体的医生, 看到了与理论相左的确凿证据, 也莫名其妙地重复盖伦的错误。 同时,为数不多的大胆行医者 提出了与理论相左的意见, 结局是被置之不理或成为笑柄。
For 1,300 years, Galen’s legacy remained untouchable– until renaissance anatomist Vesalius spoke out against him. As a prominent scientist and lecturer, his authority influenced many young doctors of his time. But even then, it took another hundred years for an accurate description of blood flow to emerge, and two hundred more for the theory of the Four Humours to fade. Hopefully, today we can reap the benefits of Galen’s experiments without attributing equal credence to his less accurate ideas. But perhaps just as valuable is the reminder that science is an ever-evolving process, which should always place evidence above ego.
1300 年以来,盖伦理论 一直神圣不可侵犯—— 直到文艺复兴时期 解剖学家维萨里提出反对意见。 盖伦作为杰出的科学家和讲师, 他的权威性对当时的 许多年轻医生影响很大。 但是即使到那时, 一百年之后才出现了 对血流的准确描述, 之后,又过了两百年, 四体液理论才逐渐消失。 希望今天我们可对盖伦实验 取其精华、去其槽粕。 但也许同样有价值的是, 它提醒人们: 科学是一个不断发展的过程, 应始终将证据置于自我之上。