Staying Healthy with Galen, or "Do Less, Live Longer"

Modern health authorities such as the World Health Organization predict that the main threats to health in all five inhabited continents by 2030 will be heart disease, depression, and diabetes—all illnesses produced in part by our modern lifestyles. The time may have come for a reconsideration of Galenic medicine, a system discarded by medical science since the discovery of microbiology in the 1850s, but that offered a robust framework for understanding the body in its social and cultural setting. In this article, I address Galen’s proposals for preventive medicine within Greco-Roman culture of the second century CE—that is, “preventive medicine” as a way of life which maintains a person’s health. In a final section, I consider how Galen might contribute to improving health and wellbeing in the twenty-first century. 

According to Galen, a person can remain healthy for life with little need of a doctor’s advice unless an accident or a serious illness supervenes. Once a doctor has assessed an individual and advised to what extent they deviate from the “best” constitution, the patient is able to follow a lifestyle tailored specifically for them. Galen bases the best constitution on both the external proportions of a body, which he judges according to the “standard” or “canon” of Polyclitus, and the internal mixture of qualities in its tissues and organs. Polyclitus’ lost work Canon discussed the perfect proportions of the male human body, on which he based his bronze statue called the Spear-Bearer around 440 BCE. This statue was copied many times in stone and often stood in the forum of a Roman town. Anyone who wished could check their physical proportions against the ideal. Very few attain such a physical state, Galen reassures us, and so the doctors must help the patient attain the best approximation to that ideal by attending to the internal constitution of their body. 

Even with a single, male-centric, ideal, Galen insists that health looks different at every age. His treatise proceeds through human life, starting with the newborn fed by its temperate mother or nurse, through childhood, adolescence, adulthood, maturity to old age, and extreme old age. At each stage a person can be healthy, especially when attention is paid to compensate for the gradual cooling and drying of the body, as we all move from the wetness and heat of infancy to the withered coldness of old age. The baby, for example, requires milk, the old man wine. 

At each stage, balance and restraint are vital, while extremes—even of exercise—prove unhealthy. From the earliest years, the baby needs to be trained in rhythm and balance, by cradling from the mother, singing, and even watching mimes in the temple of Asclepius. Such rhythm will train the body in order and balance. Much of one’s youth should be spent in the gym and in the massage rooms of the bathhouse, where any humoral imbalances can be eased out through the pores of the body. For the moderate, standard citizen, daily exercises at the gym and bath complex will set up the body for life, even as far as extreme old age. Some modifications are needed for the elderly (Galen prescribes an ideal daily routine for both an 80- and a 100-year-old man), but maintaining a lifestyle of basic balance will see the old person through. Throughout life, mealtimes must be as regular as possible, since the body likes what it is used to, and, for the old, meals based on lighter meat such as poultry and non-oily fish such as red mullet. Pork is for the young in their prime.