[Surgical case reports in the Corpus Galenicum]

The case histories in the writings of the Greco-Roman physician Galen of Pergamum have so far been interpreted primarily in literary and sociohistoric terms. Analysis focused on the medical aspects is still incomplete.

Which surgical competences do the Galenic case reports communicate?

The 358 Galenic case histories were studied for anamnestic, diagnostic, therapeutic, and prognostic statements on surgical diseases.

In 38 case reports surgical disorders are presented. Most of the histories are found in the works On the composition of drugs according to kind (12), On the affected parts (5) and On anatomical procedures (3). Both individual persons, including many children and several women, and groups of patients are reported. The descriptions do not follow a fixed structure. The texts are governed by information on the anamnesis and catamnesis, the results of the physical examination and the description of the chosen intervention. The author has repeatedly combined the description of an individual case with theoretical remarks. The majority of the reports come from wound, visceral and thoracic surgery. The most common surgical diseases Galen encountered were soft tissue injuries of the extremities, traumatic thoracic and abdominal lesions, abscesses, peripheral nerve lesions, dislocations and tumors of the female breast. Gladiator wounds played an important role. In most cases, Galen was the attending physician. Second-hand medical histories are also told. Surgical interventions were regularly combined with conservative treatment methods, albeit in varying orders.

The case reports cover much of the spectrum of surgical diseases mentioned by Galen. The differential diagnostic and differential therapeutic reflections are the most original element in terms of content. The remarks on the choice of treatment show that to care for surgical diseases the physician of antiquity sometimes used subtle interventions on the chest and abdominal wall, on the extremities and on the vessels. The accompanying drug treatment is described in great detail.