129CE

Birth of Galen in Pergamum. His “skills with fractures and dislocation, head injuries, lacerations, and draining blood and other fluids from wounds of the chest and abdomen served him well; he was shortly appointed surgeon to the city’s stable of gladiators.” But he insisted on applying animal findings to humans and, contra Celsus, held the ancient Greek belief that surgery was separate from, and a lesser mode of treatment than, medicine. In early 160ADs he moved to Rome, where he became a favorite of the elite. His works form almost half of all extant ancient Greco-Roman medical writings and, excepting the Corpus Hipplcraticum and De Medicina, almost 85% (Rutkow, ch 3 ). Galen’s understanding of gout represented his sole departure from his theory of humoral balance as cause of disease. With gout, it was a matter of unnatural accumulation of humors (usually phlegm) in the affected part (e.g., the big toe) (Coperman, loc 553). Areteus departed from Galen in suggesting the cause of gout might be not an excess of a regular humor at the site of inflammation, but a specific “pecant” [toxic] humor in the blood. Only in the mid-19th century did Garrod discover that the pecant substance was uric acid (loc 574-577).