Roman Medicine: An Introduction

The achievements of Roman civilization brought certain comforts. For the wealthy and the privileged, there were even luxuries. By today's standards, however, life was generally harsh. With the many hazards of daily life, physical illness and injury were significant concerns for the average Roman. No one was immune from these hazards. Slaves and the lower classes suffered a good deal more than the patricians and upper classes. How did the Romans deal with these harsh facts of life? What kind of medicine was available? It is only natural to wonder about these things.

Comparing the development of Roman medicine with the development of Roman law reveals something interesting. With the establishment of the decemviri around 450 B.C., Roman law grew up around an organized foundation of codes, laws, and punishments. Medicine did not develop in this way. In fact, the Romans did not promote organized ideas or theories in any of the natural sciences. They were much more interested in the practical side of things. In other words, when it came to medicine the Romans wanted results, not ideas or theories.

With this emphasis on practical results, it is not surprising that Roman medicine borrowed many traditional techniques from the Greeks, Etruscans and Egyptians. In fact, the Romans contributed almost nothing new to actual medical practices. They conserved the old and borrowed techniques. So there developed a disorganized body of treatments. Medicine was a jumble of efforts, trials and errors. It was not anything like the systematic science it is today. Its effects were not always reliable, and during the Republic especially the medical profession was a target for mistrust and ridicule. The physician had a very low social status.

The quackery and the honest efforts both made use of some treatments that would be considered strange or even ridiculous today. As a cure for fractured ribs Pliny the Elder (not a physician but a writer on natural science) favored a mixture of wine and goat's manure. For jaundice he recommended the ashes of a deer's antlers, along with the blood of an ass diluted with wine. Just about every physician had his own stock of potions and remedies. The formulae of these cures were often kept in secrecy, and this was understood as a mark of professionalism and expertise, even if it facilitated deception and fakery. Some cures were developed in accordance with the principle of similia similibus, which means 'similar (remedies) for similar (ailments)'. For example, many Emperors payed slaves to gather poisonous snakes so that their in order to use their venom to prepare antidotes. In this area of poisons and antidotes good physicians found their services busily and effectively employed, since the wealthy and the powerful often felt the need to protect themselves against assassination attempts. A concoction called theriac was widely used. This was an all-purpose mixture of 61 substances, including dried serpents, which was often prescribed when a diagnosis could not be made. It was felt that something in the medicine would be useful. There are stories of politicians who used the substance so often that they developed a total immunity to many of the more common poisons.

In the early stages of Roman medicine it was normal for one physician to claim expertise in all areas of medical practice. A good deal of this 'expertise' seems to have been invented on the spot by the physician, who was more interested in a fee than in a cure. Things changed eventually. Individual specialists became more common, especially surgeons and oculists. Under Caesar and Augustus, physicians were officially recognized and personal doctors were appointed to take care of the various leaders, the principes. In this way, the status of physicians and of medicine gradually improved. Antonius Pius took a great step forward by appointing State doctors who would administer to the health and physical welfare of the fourteen regions of Rome. Under the rule of the principes large military hospitals known as valetudinaria were established.

Even with the emphasis on practical results and with the improvements, which began with the Principate, Roman medicine was thoroughly mixed with religious and supernatural elements. For example, the cult of Asklepios (Latin: Aesculapius), patron god of healing, thrived from around 500 B.C. until 500 A.D. With its sanctuary at Epidauros, in Greece, the cult served as a center of healing for the entire Roman province of Asia. Sick or injured persons from anywhere in the Empire would make the journey to Epidauros, hoping to be healed. Typically they would sleep in a special room called the Abaton. Dreams sent from Aesculapius would come to them and heal their ailments. With inscriptions, attendants at the shrine would record the dreams and their miraculous results, so that today we have evidence of what went on at Epidauros. The attendants at the shrine of Aesculapius were trained there and often became the physicians of the Roman world. Religion and medicine were not entirely separate activities.

By far the most famous and important physician of the Greco-Roman world was Galen, born in 129 A.D. In his teens Galen was trained as an attendant of Aesculapius. After traveling a bit, near the age of thirty, he returned to his native town of Pergamum and was the physician for the gladiators there. To say the least, injuries were not uncommon among gladiators, and you can imagine how much practical experience Galen must have gained at this job. Several years later he moved to Rome, where he eventually became famous as the personal physician of the Emperor Marcus Aurelius. Galen died sometime after 210 A.D. His knowledge and methods were enormously influential in the field of medicine. As late as 1833 his written works were used as manuals for medical practitioners.

The legacy of Greco-Roman medicine is not one of great advances and innovations. Achievements were mostly the result of combining techniques borrowed from other cultures with religious rituals. However, the experience and seriousness of several physicians and naturalists (for example: Galen, Pliny the Elder, Symmachus and Celsus) kept the early stages of scientific medicine from dying out.