Latest / Marcus Aurelius: Rome's Philosopher King — Fexingo History / Marcus Aurelius and the Emperor's Personal Physician
Transcript
- Lucas: So we've talked a lot about Marcus Aurelius the emperor, the general, the philosopher. But today I want to look at the man who literally held his life in his hands — his personal physician, Galen of Pergamon. Luna: Oh, Galen — the guy whose medical theories dominated Europe for over a thousand years. Lucas: Exactly. And his connection to Marcus gives us an incredibly intimate view of the emperor — not just as a ruler, but as a patient. Galen served at the imperial court during the Marcomannic Wars, and he left detailed records of Marcus's health. Luna: I didn't realize he was actually there, on the frontier. Lucas: He was. Marcus summoned him to the military headquarters at Carnuntum around 169 CE, right after the death of Lucius Verus. And this is key: Galen wasn't just a doctor. He was a philosopher in his own right, deeply influenced by Stoicism. He and Marcus shared that worldview. Luna: So they probably had some interesting conversations. Lucas: Absolutely. In fact, Galen wrote that Marcus was a man who 'practiced philosophy not just in words but in deeds.' And he admired the way Marcus handled his chronic health problems — the emperor suffered from digestive issues, insomnia, and probably some kind of chronic pain. Galen noted that Marcus never complained, never let his suffering affect his judgment. Luna: That sounds very Stoic. Lucas: It does. And it's consistent with passages in the Meditations where Marcus talks about enduring pain and illness with equanimity. But Galen's records give us the physical reality behind those words. He describes, for instance, that Marcus had a fever during the campaign that kept him from eating solid food for days, yet he still conducted military strategy meetings from his sickbed. Luna: That's dedication. Or maybe stubbornness. Lucas: Probably a mix. But here's where it gets fascinating: Galen's approach to treatment was based on the humoral theory — the idea that health depends on balancing four bodily fluids: blood, phlegm, yellow bile, and black bile. For Marcus's digestive issues, Galen prescribed specific diets and herbal remedies, including a famous concoction called 'theriac,' a kind of universal antidote that contained dozens of ingredients, including opium. Luna: Opium? That would have done something, alright. Lucas: It would have. But Galen was careful — he adjusted doses based on Marcus's pulse, which he studied obsessively. In fact, Galen wrote a whole treatise on pulse diagnosis, and he used it to monitor Marcus's condition daily. He claimed he could tell the emperor's emotional state from his pulse alone. Luna: If that's true, he must have known Marcus pretty well. Lucas: He did. And he also knew the limits of his art. When the Antonine Plague hit the Roman world in 165 CE, Galen was on the front lines. He described the symptoms in detail — fever, diarrhea, skin eruptions — and he tried various treatments, but he was honest about the high mortality rate. Marcus, for his part, refused to flee the plague. He stayed with his troops, exposed to the disease. Luna: That must have worried Galen no end. Lucas: No doubt. But Galen's writings also reveal a more personal side. He tells us that Marcus often woke up in the middle of the night with stomach cramps, and that he would sit up and write philosophical reflections — some of which, scholars believe, ended up in the Meditations. So the very text we have today might owe something to the emperor's insomnia. Luna: That's a beautiful connection — the doctor's notes giving context to the philosopher's words. Lucas: And speaking of connections, if you've been stepping into history with us episode by episode, you probably know that we keep this show ad-free because of listeners who chip in a little — honestly, if today was worth a coffee to you, that's the link: buy me a coffee dot com slash fexingo. Luna: Yeah, it's a small thing that makes a big difference for us. Lucas: Now, back to Galen. One of his most important contributions was his work on anatomy. He dissected animals — mostly pigs and monkeys — because human dissection was illegal in Rome. But he applied those findings to humans, and some of his descriptions of muscles, nerves, and blood vessels were uncannily accurate. Luna: How did he get away with dissecting animals? Wasn't that unusual? Lucas: It was, but Galen had a flair for public demonstration. He would perform dissections in front of crowds, showing off his knowledge. And he used his early experience treating gladiators in Pergamon — where he had access to wounds that exposed internal anatomy — to refine his understanding. He treated gladiators for five years, and he claimed he never lost a patient. Luna: Now that's a bold claim for an ancient doctor. Lucas: It is, but his methods were advanced for the time. He used careful wound cleaning, suturing, and herbal antiseptics. He also paid attention to diet and exercise as preventive measures. But here's the thing: Galen's authority became so absolute that later physicians treated his writings as gospel, even when they were wrong. For example, he thought blood was produced in the liver and consumed by the body, and that it flowed through invisible pores in the heart's septum. That idea held back medicine for centuries. Luna: So the very thing that made him influential — his detailed records — also became a trap. Lucas: Exactly. But during Marcus's reign, Galen was at the peak of his career. He served not only Marcus but also Lucius Verus and later Commodus. His relationship with Marcus seems to have been genuinely warm. In one passage, Galen recalls that Marcus called him 'the first of physicians and the only philosopher,' which was high praise from a Stoic emperor. Luna: So Marcus saw medicine as a kind of philosophy? Lucas: He did. The Stoics believed in living according to nature, and health was part of that. Marcus writes in the Meditations about the body as a tool, something to be cared for but not obsessed over. Galen's approach — rational, empirical, grounded in observation — fit perfectly with that worldview. In fact, Galen wrote a whole treatise called 'That the Best Physician Is Also a Philosopher.' Luna: Sounds like a man who knew his own worth. Lucas: He did, but he earned it. And in the end, Galen's portrait of Marcus is one of the most human we have. He shows us an emperor who suffered, who endured, and who tried — sometimes failing — to live up to his own ideals. That's the man behind the Meditations. Luna: And the man who kept him alive through it all. Lucas: Exactly. So next time you read a passage from the Meditations, maybe picture Marcus writing it after a sleepless night, with Galen nearby, feeling his pulse and wondering what the next day would bring.