Galen on “syncope”

Abstract

This paper studies the Galenic views on syncope. According to Galen, syncope is a sudden prostration of the vital powers, without suspension of the respiration and it is usually a sign or complication of fever. He believed that “cardiac syncope” was a primary illness of the mouth of the oesophagus or of the stomach that affected the heart “by sympathy”, meaning secondarily. The aetiology, the clinical manifestations and the treatment are presented, along with a special section referring to the connection between “marasmus”, which was supposed to be a wasting of the organism of the elders due to “dryness”, and syncope. Numerous authors before and after Galen treated the subject of the famous “cardiac affection”: Hippocrates (4th–5th century BC), Asclepiades (2nd–1st century BC), Celsus (1st century AD), Aretaeus (2nd century AD), Soranus of Ephesus (2nd century AD), and Caelius Aurelianus (5th century AD) all see cardiac syncope as a distinct disease. Based on the Galenic descriptions, several modern medical conditions may be identified, such as congestive heart failure, hypertrophic cardimyopathy, arrhythmogenic right ventricular dysplasia, congenital long QT syndrome or anomalies of the coronary arteries.