Ancient Rome was a flourishing civilization that started around 800 BC and existed for approximately 1200 years. It started off in Rome, and grew into one of the largest and most powerful empires in ancient history. It was ruled initially by monarchs, then became an aristocratic republic, and shifted towards being a progressively more repressive empire. The empire spread to Southern, Western and parts of Eastern Europe, Asia Minor and North Africa. In many ways, the Roman and Greek empires shared a number values and systems.
As far as health was concerned, the Romans were more interested in prevention than cure. Public health facilities were encouraged throughout the empire. Roman medicine grew out of what military doctors learnt and demanded.
Initially, the Romans resisted the practices and theories that came from Greece. Roman medicine did not go backwards after Greece, it took a slightly different direction. Eventually, Roman scientists and doctors, many of them from Greece, continued researching Greek theories of diseases and physical and mental disorders.
The Romans were great warriors; the empire poured considerable resources into the basis of its power - the armies. It was by observing their soldiers' health that Roman leaders began to realize the importance of public health.
Greece's influence, nevertheless, on Roman medicine was huge. The first doctors in Rome came from Greece; they were prisoners of war. Later on Greek doctors would emigrate to Rome because they would earn more money there than back home.
When the Romans conquered Alexandria, they found various libraries and universities which the Greeks had set up. There was a wealth of documented knowledge of medicine in Alexandria, as well as several learning centers and places for research. The Romans allowed them to carry on their research. However, unlike the Greeks, the Romans did not like the idea of dissecting dead people.
The Romans eventually adopted the Greek theory about the four humors. The spiritual beliefs that surrounded medicine in Greece was also common in Roman medicine.
Roman civilization developed into a massive empire, unlike the Greek civilization which consisted of many small city-states. The Roman empire was centralized; the emperor in Rome was all-powerful and wielded his power, will and laws throughout the empire.
Roman wealth went more into practical projects and less into culture and philosophy. The Romans built aqueducts to pipe water to cites, sewers in their capital city, and public baths everywhere. They were proud of their projects, which they described as "useful", and not "useless Greek buildings" or "idle Egyptian pyramids".
The sewage system in Rome was so advanced, that nothing like it was built again until the late 17th century AD. Despite their impressive projects which helped improve public health, they were not yet aware of the association of germs with diseases.
The Romans had tools, painkillers and hospitals
Roman surgeons, most of whom got their practical experience on the battlefield, carried a tool kit which contained arrow extractors, catheters, scalpels and forceps. They used to sterilize their equipment in boiling water before usage.
Surgical procedures were performed using opium and scopolamine as painkillers, and acid vinegar (acetum) to clean up wounds. They did not have what we would consider as effective anesthetics for complicated surgical procedures; it is doubtful they carried out surgical operations deep inside the body.
The Romans also had midwifery instruments, many of which would seem rather barbaric today. Cesarean sections were performed, but the mother would not survive.
Unlike the Greeks who would place their patients in temples in the hope that the gods might help cure them, the Romans had purpose-built hospitals where patients could rest and have a much better chance of
recovering. In hospital settings, doctors were able to observe sick patients, instead of depending on supernatural forces to perform miracles.By not allowing doctors to dissect corpses, Roman doctors were rather limited in human anatomy research. Even though some of their progress was undermined by initially rejecting Greek ideas about medicine, they made great progress in trying to understand what causes diseases, and then finding ways of preventing them.
How did Roman doctors learn about the human body?
Gladiators were often wounded, sometimes badly, and doctors had to treat them, and learnt about the human body. Galen (AD 129 - circa 200/216) , a prominent Greek physician, had to make do with dissecting animals to further his research. Galen believed that monkeys that walked like humans, on two legs, would most likely provide scientists with knowledge that could be applied to humans.
Galen, who moved from Greece to Rome in 162AD, became an expert on human anatomy. He was a popular lecturer and soon became a well-known reputable, sought-after doctor. Consul Flavius Boethius, one of his patients, introduced him to the imperial court; he soon became Emperor Marcus Aurelius' personal physician.
Galen did dissect some corpses - once he dissected a hanged criminal, as well as some bodies that has become unearthed in a cemetery during a flood. Even so, he made several mistakes when analyzing how the human body works.
Galen wrote several medical books, in which he displayed excellent knowledge of bone structure. He realized that the brain tells muscles what to do when he cut the spinal cord of a pig and observed it.
Medical theories were sometimes very close to what we know today. Marcus Terentius Varro (116 BC - 27 BC) believed disease was caused by miniature creatures too small for the naked eye to see (bacteria and viruses are too small to see). Others were still looking up at the sky - Crinas of Massilia was sure that our illnesses were caused by the stars. Lucius Junius Moderatus Columella (AD 4 - circa AD 70), an agricultural writer, thought diseases came from swamp vapors. Many of these beliefs prevailed until a couple of hundred years ago.
How did Roman doctors diagnose and treat patients?
Roman physicians were strongly influenced by what the Greeks used to do, and would carry out a thorough physical exam of the patient. Many of their treatments were also influenced by Greek practices. Roman diagnosis and treatment of patients consisted of a combination of Greek medicine and some local practices.
Some Roman doctors were impressive in their claims. Galen said that by following Greek practice he never misdiagnosed or made a wrong prognosis. Progress in diagnosis, treatment and prognosis in Ancient Rome was slow and patchy; doctors tended to develop their own theories and diverged in several different directions.T
hey did have a wide range of herbal medicines and other remedies:
- Fennel - was widely used for people with nervous disorders. Romans believed fennel calmed the nerves.
- Unwashed wool - was used for sores
- Elecampane (horse heal) - was given to patients with digestive problems.
- Egg yolk - was given to patients with dysentery
- Sage - said to have had more religious value, and used by those who still believed that the gods could heal them.
- Garlic - doctors said garlic was good for the heart
- Boiled liver - was administered to patients with sore eyes
- Fenugreek - often administered to patients with lung diseases, especially pneumonia
- Silphium - was used as a form of contraceptive, as well as for fever, cough, indigestion, sore throat, aches and pains, warts. Nobody is sure what Silphium was; historians believe it is an extinct plant of the genus Ferula, possibly a variety of giant fennel.
- Willow - used as an antiseptic
Pedanius Dioscorides (circa 40-90 AD), was a Greek botanist, pharmacologist and physician who practiced in Rome when Nero was ruler. He became a famous Roman Army doctor. Dioscorides wrote a 5-volume encyclopedia - De Materia Medica - which listed over 600 herbal cures. It also had a pharmacopeia. De Materia Medica was used extensively by doctors for the following 1,500 years.Many Roman doctors came from Greece and strongly believed in achieving the right balance of the four humors and restoring the natural heat of patients.
Galen said that opposites would often cure patients. For a cold he would give the patient hot pepper. If a patient had a fever, he advised doctors to use cucumber.
The Romans believed in public health
Public health is all about maintaining the whole community in good health, and today involves preventing the spread of disease, vaccination programs, promoting healthy lifestyles and good eating habits, building hospitals, providing clean water for people to drink and wash themselves, etc. The Romans, unlike the Greeks and Egyptians, were strong believers in public health. They knew that hygiene was vital to prevent the spread of diseases.
They promoted facilities for personal hygiene in a big way by building public baths, toilets and sewage systems. Although their focus was on maintaining a motivated and healthy army, their citizens also benefited.
Public baths - there were nine public baths in Rome alone. Each one had pools of varying temperatures. Some of them had gyms and massage rooms. Government inspectors enforced high hygiene standards vigorously.
Hospitals - hospitals started in Ancient Rome. The first ones were built to treat soldiers and veterans.
The Romans were superb engineers and built several aqueducts to supply people with water.
They were careful to place army barracks well away from swamps. If marshes got in the way, they would drain them. The Romans were aware of the link between swamps and mosquitoes and the diseases they could transmit to humans.
On the next page, we look at medieval islamic medicine.