The History of Medicine in Ancient Rome

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The History of Medicine in Ancient Rome

medicine sanitary naturalist scientist

Romans got the majority of their knowledge of medicine from ancient Greeks. Hippocrates, the Ancient Greek doctor living in V century BC, made a description of all diseases known then and specified, how they should be treated. His works were based on medical education in Greece, and then in Rome. During a republican era in Rome medical schools were open and training to doctoring art began.

Sources about history and medicine of Rome:

Literature

The considerable part of ancient Roman literature was lost. It is only possible to judge upon their content by looking at the works of later authors. From writings which reached us up until today, for characteristics of the development of medicine in Ancient Rome, special attention can be paid to the following authors: Titus Lucretius Carus, Aulus Cornelius Celsus, and Galen. Ancient Greek and Latin epigrams can also be an interesting source of information about medicine of Ancient Rome, despite being short in length they are very rich in their content, reflecting activity of ancient doctors.

Archaeology

Excavation of ancient Roman cities allowed us to know about life of ancient people occupying them, acquainted us with development of crafts and branches of our knowledge, including medicine. In 1771 in one of the houses in Pompeii - the city which in August of 79 AD was buried under the ashes of Vesuvius volcano, - the full set of medical tools was found. Another set was found in Bingen in 1925. Antique medical tools were found as well in USSR at the excavations of Chersonesus Taurica and Olbia. In Chersonese a gravestone of a Roman doctor belongingto a large Roman military leader was found.

The great interest for history of medicine is represented by the ancient hydraulic engineering constructions which have remained in the territory of the Roman Empire in Europe, Asia and Africa. These are the well-known aqueducts, terms and waste systems of foul places.

Sanitary business

The earliest signs of attention of Romans to sanitariness are the «Laws of Twelve tables». Traced on copper tables, they were hung on columns in front of the Roman senate. Their brevity and simplicity is admired by lawyers today.

A number of paragraphs of Laws are devoted to protection of hygiene of the city and health of its inhabitants. In table X rules of burial of the dead are defined:

Law IX.

No bones shall be taken from the body of a person who is dead, or from his ashes after cremation, in order that funeral ceremonies may again be held elsewhere. When, however, anyone dies in a foreign country, or is killed in war, a part of his remains may be transferred to the burial place of his ancestors.

Law XVI.

No one, without the knowledge or consent of the owner, shall erect a funeral pyre, or a tomb, nearer than sixty feet to the building of another.

Supervision over implementation of these and other laws was assigned to elective officials - aediles who watched over public construction, city wellbeing and the organization of national shows.

For a drain of sewage in the capital of the empire Rome, since VI century BC numerous channels were constructed - foul places. Most known of them is cloaca maxima which functions even today. It is included into modern system of the Roman sewerage. Usually, foul places opened directly to the river Tiber. That is why in the IV century BC water from this river was forbidden to be used as drinking water.

Underground sources and small rivers couldn't provide water for all inhabitants of the capital, and consequently from IV century BC in Rome the construction of aqueducts - stone arch bridges and underground pipes for water supply from mountain sources began.

Aqueducts aren't inventions of Romans who borrowed this idea in the east during war campaigns. In VII century BC in Assyria during the ruling of Sennacherib at construction of irrigational system near Nineveh a dam, two reservoirs, and a channel in length of 48 km were built as well as arch bridges for carrying water over gorges. At the time of the Roman domination aqueducts began to be built both in east, and in the western provinces of the empire.

Organization of medical business

In ancient Rome up to II century BC professional doctors did not exist. People healed at home using folk remedies: herbs, roots and fruits, infusions and broths, often combining everything with magic and prayers. From the works of the prominent writer and politician M.P. Cato, the cabbage was considered as the most popular remedy: «Cabbage surpasses all vegetables. Eat it either cooked or raw. If you eat it raw, dress it with vinegar. It aids digestion remarkably and does the bowels good, and the urine will be beneficial for all purposes.»

Cato was the ardent opponent of the Greek medicine and its introduction to Rome, thinking it was an expression of delicacy and luxury. Such point of view in no small measure promoted stagnation in medicine development in Ancient Rome. Slaves from Greece, Asia Minor, Egypt were the first doctors here. Each wealthy Roman citizen aspired to get the slave doctor. The slave healed a family of the owner and his relatives.

High cultural level of the slave doctor gradually lifted him in the opinion of the owner. Free practice of such expert was very profitable to the slaveholder therefore slave doctors began to be released on free earnings.

The released slave doctor was obliged to treat free of charge the former owner, his family, his slaves and his friends and to give him a part of his income. By law, released slave doctors remained dependent on the slaveholder, and the Roman society for a long time treated them with some contempt. Among the Roman slaves there were outstanding politicians, doctors, writers and architects.

At the end of III - the beginning of the II century BC in the capital of the Roman Empire free doctors of the Greek origin began to appear. The first Greek doctor in the city of Rome is considered to be Archagathus. He arrived to the capital in 219 and was warmly met by citizens. He was provided with the right of the Roman citizenship and was allocated with the state house for private practice. The beginning of his job brought Archagathus great popularity. However soon cauterizations and surgeries which he performed sharply changed the relations of Romans to him: they nicknamed him 'fleecer' stopped coming to him. Some centuries passed before the Greek medicine gained recognition in Rome. An important part in this question was played by Julius Caesar who in 46 BC provided the honourable right of the Roman citizenship as to foreign doctors from Greece, Asia Minor, Egypt, and to the locals training medicine. Thus, in the Roman Empire elements of the state regulation of medical business began to be shown.

Ancient Rome made an essential contribution to the development of military medicine. The Roman army waging wide wars of conquest, demanded a large number of professional doctors. They were present in all types of military forces. Each cohort consisting of 1000 people, should have contained 4 doctors-surgeons. In fleet in each military ship there was one doctor. Each soldier needed to have with himself necessary material for first-aid treatment for himself and wounded companions. Special sanitary teams from 8-10 strong young soldiers who were called «deputati» were formed. Astride horses behind the fight line they picked up the wounded. For this purpose their saddle had two stirrups on the left side. «Deputati» carried with themselves flasks with water and, probably, did the first bandaging. For each rescued soldier they were paid with gold

After fight the wounded were brought to the next city or in military camp where military establishments for patients, one on each 3-4 legions were arranged. The service personnel of these establishments consisted of doctors, house-keepers, tools men and the younger personnel. Tools men managed tools, drugs and dressings. The younger personnel, mainly consisted of slaves, were used for the care of patients. Columella in the work 'De re rustica' ('About agriculture') wrote about such institutions for slaves who were served by slaves physicians. However in most cases slaves were not healed or treated. In the capital, sick slaves were sent on Bartolome Island and were left there to die. In case of recovery such slave became free and according to the decree of emperor Claudius, shouldn't come back to the slaveholder.

Along with military medicine medical matter in the cities and separate provinces where the governments founded paid positions to the doctors - archiaters developed. In the cities archiaters united in board and were under control of the city authorities and the central government which controlled their elections and appointments. Procedure of elections reminded strict examination after which the doctor received a rank 'The doctor confirmed by the state'. Archiaters worked at associations of handicraftsmen, in baths, theaters and circuses. The outstanding doctor of an antiquity Galen, Greek by origin, in his young years worked as the doctor at school of gladiators in Pergamum for a number fo years. There is data on the involvement of doctors as judicial physicians. This way, the doctor Antistius participated in investigation of the murder of Julius Caesar. Archiaters had a constant salary, but it was also allowed for them to carry out private practice.

Duties of head city archiaters included medicine teaching at special schools which were founded in Rome, Athens, Alexandria, Antioch, and other cities of the empire. The anatomy was taught on animals, and sometimes - on wounded and sick patients. Applied medicine was studied on patients.

The law strictly defined the rights and duties of pupils. They had to give all their time to the doctrine. It was forbidden for them to participate in feasts and to have suspicious acquaintances. Corporal punishment was used for those who broke these laws.

Along with the public medical schools in the Roman Empire there were a small number of private medical schools. One of them was based by Asclepiades of Bithynia.

Over time the position of doctors in Rome became stronger. They got many rights and even privileges. During war doctors and their sons were released from a compulsory military service. Similar privileges attracted foreign doctors which resulted in their surplus, which led to competition and as a result, to narrow specialization. Already by the end of the II century BC in the capital there were dentists and oculists, experts who treated only bladder diseases or surgeons who made only one operation.

Despite this, position of the doctor in the Roman Empire was considerably differed from position of the doctor in Ancient Greece where the doctor was released from duties to the state. In Greece, doctors were involved in service to the state only in case of epidemic and for the period of military campaigns with the consent of the doctor himself

Two directions in medicine

In medicine of Ancient Rome there were two directions: materialistic and idealistic.

Materialistic tendencies

The outlook of ancient Romans substantially came under the influence of Ancient Greek philosophy. The atomistic doctrine created by outstanding Greek philosophers materialists Leucippus, Democritus and Epicurus, was included into philosophy of ancient Rome and found its reflection in works of the most prominent representative of the Roman Epicureanism - poet Titus Lucretius Carus. His poem 'De retum natura' in six books was the encyclopedia of that time which reflected the advanced views of Romans in the field of philosophy, natural sciences, medicine, psychology and history.

In the poem 'About the nature of things' Lucretius approaches to medicine and natural sciences questions from the point of view of the atomistic doctrine. In a popular form he speaks about a difficult structure of living organisms from the smallest moving particles - atoms, comes up with idea of gradual development of a plant and animal life, on distinctions of organisms and transfer of features by inheritance, about extinction of unadapted and survival of the adapted organisms. He gives the characteristic to some diseases and very precisely describes separate symptoms.

Epicurus's doctrine and Lucretius's advanced views made a great impact on Asclepiades of Bithynia - the prominent Roman doctor, Greek by blood. Development of the materialistic direction in medicine of Ancient Rome is closely connected with the methodical school based on it. The success and Asclepiades' glory were promoted by simple and concordant with the nature rule 'to Tuto, celeriter et incunde curare' (heal safely, quickly and pleasantly). Such system favourably differed from methods of the 'fleecer' Archagathus, the Greek doctor of the previous century.

On Asclepiades' representations, the illness grew out of 'stagnation of particles' in pores and channels of a body and disorder of movement of pneuma(breath). According to these views the correct perspiration and breath of integuments had great value. Therefore Asclepiades' treatment was directed on restoration of the broken functions and consisted of simple and natural rules: a reasonable diet, observance of purity of the skin, balneotherapy, massage, baths and movement in the most various options. Asclepiades advised the patients to go on walks and to go astride horses, to travel in a tilt cart and by the ship - in other words, to be in continuous movement. For those who were paralysed, he advised to carry on carpets and to sway them. Asclepiades saw the main task of the treatment in expanding pores and to actuate stagnant particles. Each method of its treatment was in details developed and was applied strictly individually. Medicines were appointed extremely rarely.

Asclepiades was firmly convinced that the person having sufficient knowledge of medicine never will fall ill. He was the first example of it because he was never ill and died in extreme old age as a result of an accident.

Asclepiades' system made a great impact on further development of the ancient Roman medicine.

The systematic description of the medicines known since the emperors Claudius and Neron, gave the Roman doctor Pedanius Dioscorides, who come from Cilicia. He wrote 'De materia medica' (About medicines), originally made in Greek and known in Europe in its Arab translation, up to the XVI century used wide recognition and played a significant role in the development of plants.

From a methodical school based by Asclepiades, graduated one of the outstanding representatives of medicine of the Ancient world - Soranus of Ephesus. He made the most extensive in all ancient literature work on obstetric aid, gynecology and diseases of early children's age. Soranus studied in Alexandria and, most likely, came under the influence of a famous in this area doctor of the Alexandria school of Adrian.

Soranus described the embryotomy operation, receptions of the prevention of a rupture of the crotch at childbirth, umbilical cord bandaging, embryo turn on a leg and a head, various receptions of research: touching, listening, auscultation of sounds in the field of an embryo arrangement, research of pulse, phlegm, and urine.

In the course of obstetric aid he tried to depart as much as possible from rough and violent receptions, paid much attention to the treatment of female diseases and care for children at an early age.

During the subsequent eras the works of Soranus of Ephesus were widely adopted in the countries of Europe and up to the XVIII century were considered as the main source of knowledge of obstetric aid, gynecology, and treatment of diseases at an early children's age.

Extensive information about Roman medicine before Galen is given to us from the encyclopedic works by Aulus Cornelius Celsus, born in I century BC. Being a widely educated person and a rich slaveholder, he involved the big staff of translators and created the extensive encyclopedic collection which included more than 20 books on various branches of knowledge: philosophy, rhetoric, law, medicine, agriculture and military science. The considerable part of this outstanding work was lost. We only managed to get books of the VI-XIII under the general name 'De medicina'. In them knowledge known at that time about dietetics, hygiene, pathology, therapy and surgery is stated.

At creation of his multivolume encyclopedia Celsus in detail analysed and generalized numerous works of the Greek, Alexandrian and Indian doctors. The description of four signs of an inflammation provided by him (reddening, a swelling, pain, heat), most likely, is borrowed from Old Indian manuscripts. Thanks to Celsus we know about works of outstanding doctors of the Ancient world whose works didn't remain.

Celsus gave a special place to surgery. Without his encyclopedia our knowledge about surgeons of the Alexandria school would be much poorer. Celsus himself was engaged in medical practice: he healed slaves, considering their treatment more profitable as a loss of a professional was more tragic to him than a loss of a slave.

Celsus' encyclopeadia made an essential contribution to the development of scientific medical terminology. Language of his compositions - classical. According to Pliny the Elder, it is gold Latin unlike barbarous Latin of his time.

Idealistic tendencies

The political and economic crisis of the Roman Empire made a great impact on the destiniy of late Roman philosophy, culture and science. In I century BC ideas of the future Christianity started to arise.

In many branches of natural sciences dualistic tendencies became aggravated. It is accurately traced on the destiny of late antique astronomy. From one point of view, the antique astronomy by the end of the I century AD finally acquired achievements of the Babylon mathematical astronomy, from another - near scientific astronomy wide development in ancient Romans was received by the Hellenistic astrology which arose, as believed, in the III century BC at school Berosa. Horoscopes became the main task of the Roman astrology. Astrologers served in the palaces of the Roman emperors.

The contradictions peculiar to a late Roman science, were brightly reflected in Ptolemaeus' works. On the one hand, Ptolemaeus created the most outstanding work of antique astronomy in which in detail stated the doctrine standard at that time about geocentric movement of planets and their communication with each other and with the Earth. On the other hand, Ptolemaeus possesses one of the largest works on an antique astrology in which thought about influence of heavenly bodies on mankind, continents and the natural phenomena as a whole are stated. Such duality characterizes activity of many scientists of the period of late antiquity when idealistic moods amplified and fight between 'Democritus' Line' and 'Plato's Line' - two main movements in philosophy became aggravated. In the field of medicine this dualism was shown in activity of the greatest doctor of the ancient world - Galen.

Scientists and naturalists of ancient Greece and Rome paid a huge contribution to medicine development. They generalized semi-magic systems of ancient Egypt, Babylon, Persia and in a result of experiments, managed to transfer medicine from level of magic to a scientific level. Certainly, imperfection of equipment of that time and ignorance by people of the fundamental laws of nature didn't allow them to get rid completely of errors in the sphere of a human body, however what was made, really deserved the names of scientists and simple physicians of the ancient world to be mentioned and put into history.

With falling of the Western Roman Empire in 476 AD the ancient slaveholding system of the Western Mediterranean ceased to exist. There came the new period of history - feudalism era. Achievements of ancient slaveholding civilizations of Greece and Rome laid down in a basis of the subsequent European and world development.

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