Wound Treatment According to Galen: A Paradigm of Ancient Pharmaceutical Science

During my fellowship at the CHS, I worked on transforming my PhD dissertation into the forthcoming monograph Wound Healing according to Galen: Ancient Pharmaceutical Science and the Logic of Therapy. The project began as an investigation into the ancient use of potentially antimicrobial substances. In recent years, ancient drugs have been reassessed from both historical and ethnopharmacological perspectives, with growing interest in ancient medical texts as possible repositories of therapeutically effective substances and potential leads for drug discovery. Despite this re-evaluation, historians of medicine have often regarded scientific approaches to ancient medical and pharmaceutical practices with suspicions because of the risk of anachronism and comparing practices shaped by intellectual constructs and cultural settings. Yet such caution should not prevent us from considering the potential efficacy of ancient remedies supported by experimental data and from taking seriously and fully understanding the explanations ancient authors themselves offered for natural phenomena, including the onset of disease and the rationale of treatment.

My study focuses on the pharmaceutical theory and practice of Galen of Pergamon (129-216 AD). A pivotal figure in the history of medicine, Galen systematized and transformed earlier traditions into a medical doctrine that endured for more than thirteen centuries. Despite growing interest in his work, his pharmacological and pharmaceutical writings remain comparatively understudied, and several still lack modern critical editions or translations. Their social, anthropological, philosophical, philological, and rhetorical dimensions have also tended to receive more attention than their scientific and technical content.

In his work On Simple Remedies, Galen discusses the properties of individual ingredients and how some major pharmaceutical substances behave and interact with the body. His works on compound remedies – On Compound Remedies according to Kinds (hereafter Kinds) and On Compound Remedies according to Places (hereafter Places) – turn instead to multi-ingredient formulations, the type of remedies commonly used in antiquity.

Galen collected centuries-old effective formulations, rationalising previous pharmaceutical knowledge and providing substantial theoretical and practical explanations. The seven books of Kinds were conceived by Galen as propaedeutic for the ten books of Places. As Galen explains, the former, which contains plaster formulations to treat mostly wounds and ulcers, teaches the method of compounding, while the latter applies this method and reports formulations of remedies arranged according to the affected part of the body. Despite the importance Galen assigns to it, Kinds has received even less scholarly attention than Places.

The preparation of plasters for wounds and ulcers therefore offered Galen an exemplary context in which to teach the compounding of remedies. Wound care also occupies a prominent place in his medicine: wounds deserve a distinct category within his disease classification and are treated at length in four books of On the Therapeutic Method, where he discusses different types of wounds, their causes, their healing process, the pharmacological properties required for treatment, and the personalization of therapy to the individual case.

Earlier studies by Majno and Salazar have reconstructed important aspects of ancient wound care. However, their aims were either highly ambitious and quite broad, extending across several ancient civilizations or deliberately restrained to particular contexts or categories of wounds. Moreover, access to Galen’s pharmacology for non-classicists has long been limited by the absence of translations for key texts. Focusing on wound healing in Galen has therefore allowed me not only to investigate Kinds in detail, but also to integrate the making of remedies into his pathology and pharmacological theory – an integration essential to a full understanding of pharmaceutical therapy. The study of wound-healing formulations also raises the question of whether some ingredients and combinations may illuminate ancient uses of antimicrobial substances and suggest new directions for modern pharmaceutical research.

During my time at the CHS, I was able to reshape the dissertation into a more focused monograph and to draft a portion of the revised manuscript. While the dissertation situated the study within a broader framework of natural substances, antimicrobial research, and experimental approaches, the monograph gives greater prominence to its central concern: Galen’s wound pathology, clinical reasoning, and pharmaceutical practice. A preliminary chapter on modern wound care introduces key concepts concerning wound aetiology and classification, physiological mechanisms of healing and their pathological developments, and current principles of treatment.

The core of the book examines ancient wound care. The first part addresses theory: the aetiology of wounds within Galen’s physiology of elemental qualities and bodily fluids, their classification, and their healing mechanisms, and how these interface with his pharmacological theory. The second part addresses practice, examining the technical elements involved in synthesizing wound-healing plasters as outlined in The Therapeutic Method and, above all, as discussed in detail in Kinds. Here I reconstruct ancient pharmaceutics through a close analysis of ingredients and their specific functions within the formulation, relative quantities, preparation and storage techniques, across a curated sample of 150 recipes.

The concluding chapter places ancient wound care within a broader history of medicine. It discusses scientific evidence for the potential efficacy of selected substances and formulations and reflects on what an experimental approach can contribute to the study of ancient science and to contemporary pharmaceutics and drug discovery.

By bringing pathology, pharmacology, and pharmaceutical practice into a single analytical framework, it aims to deepen our understanding of Galen’s medicine and of the rationale underlying ancient pharmacology and pharmaceutics. It will also provide a useful foundation for scholars of later, deeply Galenic medical traditions, offering a clearer historical perspective on medicine.

With its supportive staff, its rich library and its peaceful atmosphere, the CHS provided an ideal environment in which to restructure and expand my PhD dissertation and develop the resulting monograph. The Center’s engagement with ancient science – people, resources, tools, and projects devoted to the field – was particularly valuable in broadening my knowledge. I was also fortunate to become involved in a project evaluating the quality of machine translations of ancient Greek technical texts. This experience not only deepened my understanding of Galen but also gave me first-hand experience in the field of digital humanities.