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?
十六世紀中期 一位聰穎的年輕解剖學家 名為安德雷亞斯·維薩里 發現了一件驚人的事 世上赫赫有名的人類解剖學 教科書都寫錯了! 它們不但沒有寫對人體的細節 還描述了猿類及其他哺乳類的器官 即使維薩里知道他是對的 宣布這些錯誤代表要挑戰蓋倫 醫學史上最著名的醫師 這位高高在上的傑出人物是誰?
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.
為什麼一千三百年後的醫師 會對他又敬又怕? 蓋倫出生於西元 129 年 他在青少年時離家 跑遍地中海尋求醫學知識 他返鄉時已經是一位天才外科醫師 並對解剖學充滿熱情 還超愛表演 他興高采烈地參加解剖公開賽 熱切地想在同行前大現一番 在某個示範教學上 他把一頭豬的神經紮起來 讓牠失去聲音 在另一場示範中 他把一隻猴子開膛剖腹取其內臟 還挑戰他的同行把牠復原 他們不行;但他可以 這些恐怖的表演為他贏得一席之地 成為當地角鬥士的外科醫師 他最終離開了競技場 當上四位羅馬大帝的御醫
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.
在他的同儕爭辯著症狀及病因的同時 蓋倫痴迷地研究解剖學 他深深相信每個器官 都有其獨特的功能 因為羅馬政府不准解剖大體 蓋倫只好拿無數隻動物來解剖 即使在這樣的限制下 他徹頭徹尾地調查 還是得到了一些非常正確的結論
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.
蓋倫有項極為重要的貢獻 就是洞悉了大腦——而非心臟—— 才是控制身體的主宰 他打開一頭活牛的頭蓋骨 以證明這項理論 他在牛腦的不同部位施加壓力 將各個區域跟特定功能連起來 還有些實驗讓他能區分 感覺及運動神經 證實尿液是由腎臟製造 並推斷出呼吸是由肌肉及神經控制
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.
但是這些瘋狂的實驗 也產生非常離譜的誤解 蓋倫從未意識到血液在體中 其實是循環不息 他一直以為是肝臟 在源源不斷地製造並供應血液 單向運送到各個器官後就消耗殆盡 蓋倫也有功於鞏固 廣為流傳的四體液學說 這項學說在幾個世紀之先 由希波克拉底首先提出 而這項錯誤的假設 把大多數的健康問題歸因於 身體內稱為體液的四種液體不平衡 為了矯正這四種體液的平衡 醫師會用危險的治療法 像是放血及淨化 由於他自己對循環系統的理解不足 蓋倫是這些治療法的強力支持者 儘管有時候這些方法會有致命的後果
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.
可惜的是,蓋倫的自負讓他相信 他的所有發現都極度重要 他對每一件事都寫下論文 無論解剖、營養 還是醫生對病人的態度都有 還精心編目他的著作 確保它們被保存下來 之後的十三個世紀 蓋倫豐富的著作 主導了所有醫學院的思想 他的文章變成新一代醫師的教科書 他們又因此寫下新的論文 頌讚蓋倫的想法 就算是真正解剖過大體的醫師 也會莫名其妙地重複蓋倫的錯誤 即使已經親眼見到清楚的反證 同時,有幾個夠大膽的醫師 提出相反的意見
For 1,300 years, Galen’s legacy remained untouchable–
也被忽視或嘲笑
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.
一千三百年來 無人敢挑戰蓋倫留下來的傳統 直到文藝復興時代的解剖學家 維薩里出聲反對 身為傑出的科學家及教師 他的權威影響了許多當代的年輕醫師 但即便如此,還是再等了數百年 才出現對血流的正確描述 再經過二百多年 四體液學說才慢慢消失 但願今天我們能從蓋倫的實驗中獲益 不用對他不太正確的想法 給予同等的讚揚 但是同樣有價值的 也許是提醒我們 科學是不斷演變的過程