Europe following Galen.

Unlike previous chapters, this is not about the teachings of a specific individual. Rather, it traces the slow changes in milieu and practice in the centuries following the death of Galen. They were to be profound. The Roman Empire fell in the middle of the 5th century. The Christian religion became increasingly dominant in the west, not only in spiritual matters but also in every activity related to culture and learning. The Byzantine Empire became increasingly important in the east. Islam was founded and began to spread in competition with Christianity. Academic advances develop best in stable societies so that it is not surprising that this was not a period of new ideas. Galen had gained overwhelming authority. The most valuable work on surgery to be written during these times was Book VI of Paul of Ægina's encyclopedia.