Unlocking Ancient Medicine: How Researchers Brought 1,800-Year-Old Dissection Instructions to Life!

In a groundbreaking study, researchers have undertaken a dissection following the precise instructions of the renowned Greek physician Galen of Pergamon, an endeavor that has never been accomplished until now. Galen’s manuscript, penned in the second century AD, has undergone countless hand-copied iterations over the centuries, leading to numerous transcription errors. This recent practical test not only sheds light on Galen's original instructions but also allows for a partial reconstruction of his intent.

Galen of Pergamon is regarded as one of the preeminent medical figures of antiquity. His extensive work, particularly the 15-book series titled On the Procedures of Dissection, served as a critical manual for dissection practices that influenced medical education well into the Renaissance. However, due to the extensive hand-copying that occurred over more than 1,400 years, Galen's original texts now exist in multiple, sometimes conflicting, versions. This raises the question: which iteration most accurately reflects Galen's original teachings?

To address this concern, an interdisciplinary team, led by Andres Pelavski from the Hebrew University of Jerusalem, undertook a practical analysis of Galen’s dissection protocols. They meticulously executed a total of 95 steps to dissect the abdominal wall, cavity, and organs of a pig, which had been humanely euthanized for unrelated reasons, reflecting Galen’s original methodology.

The results of this ambitious undertaking were telling. The researchers reported that 66 of the steps could be performed or visualized satisfactorily, while 20 steps were only partially completed, and 9 steps could not be executed at all. Instances wherein the researchers fell short were typically due to the inability to locate an anatomical structure as detailed by Galen, or the challenges posed by the complexity of the required technique.

One specific term presented significant ambiguity: the word "kolon." In various versions of Galen's text, the term appears with different interpretations; in some, the first 'O' is depicted as a long omega, signaling the large intestine, while in others, it is a short omicron, which translates to “a part, a component.” Through their dissection, Pelavski and his team concluded that the latter interpretation was accurate, indicating that Galen was likely referring to the duodenum as an additional “component” of the stomach.

Beyond clarifying the textual inconsistencies within Galen’s instructions, the research team also gleaned new insights into the conditions prevalent during the time of the original writings. Pelavski and his colleagues speculate that at least the dissection techniques they examined were not intended to be transcriptions of Galen's public demonstrations, such as those famously conducted in the bustling Roman baths. The outcomes of their own dissections lacked the requisite dramatic flair characteristic of such public showcases.

“The lighting needed to discern intricate anatomical details, alongside the odors and fluids produced during the dissection, suggest that public baths were less than ideal for this task,” the researchers noted. They propose that more suitable environments for Galen’s dissections may have included libraries or temples that featured open, well-ventilated auditoriums.

Moreover, Pelavski emphasized the notion that Galen’s manuscript was likely not meant for novice individuals or the general public. Instead, it appears to have been directed towards fellow physicians, medical students, and individuals with a foundational understanding of anatomy. “Given the technical proficiency required for the dissection, we lean towards the notion that Galen anticipated some degree of prior anatomical knowledge among his readers,” the study elucidates.

This pioneering research not only provides a clearer understanding of Galen’s dissection methodology but also underscores the enduring complexity and significance of historical medical texts. By validating the principles laid out by one of history's greatest medical minds, this study exemplifies the potential for ancient methodologies to inform contemporary medical practice.

As we continue to explore Galen’s works and the historical context in which they were created, we not only honor a great figure of medicine but also enrich our collective understanding of anatomy and surgery. The insights gained from this practical test pave the way for future endeavors that seek to bridge the gap between the ancient and the modern, ensuring that the wisdom of the past is not lost to time but instead reintegrated into the fabric of contemporary medical education and practice.

(Proceedings of the National Academy of Sciences, 2024)