Medicine In Ancient Rome

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Medicine In Ancient Rome
Ancient Roman medicine combined various techniques using different tools and rituals. It included a number of specializations such as intemistic, ophthalmology and urology. Romans believed in supernatural causes such as the diseases/illnesses were brought on by disfavour from the Gods, they believed that transcendental practises such as superstition, rituals, and a belief in spells would rid them of disease. Since many of the diseases sooner or later went away, they believed they had managed to please the Gods by performing the correct religious and spiritual acts. However, the Romans favoured the prevention of diseases over the cures of them; unlike in Greek society where health was a personal matter. Public health was encouraged by the government at the time. The Romans believed that illnesses had a natural cause and ill health could be caused by bad water and sewage. Hence their desire to improve the public health system in the Roman Empire so that everyone in their empire benefited - not just the upper class. They introduced Roman baths showing they knew that cleanliness was important and the Roman government designed and built sewage systems. Those who worked for the Romans needed good health as did their soldiers, so in this sense the Romans were the first to introduce a programme of public health for everyone regardless of their health. Roman medicine was a mixture of new theories and developments of Greek practises. Medicine was improved through the study of Galen, through the desire to maintain a fit and healthy army through empirical observation. There are still things in modern medicine today that were first started in Rome: the house call, medical terms prescriptions and the Hippocratic Oath.

Roman Knowledge About The Body And Disease
Roman doctors learned a lot about the human body as they tended gladiators wounded in the amphitheaters. However, dissection of humans was forbidden in the Roman empire, so Roman anatomists such as Galen had to rely mainly on the dissections of animals to further their knowledge. Galen recommended dissecting monkeys that walked on two legs, like men.

He did manage to work a little with the human body, and described how he had human corpse to dissect when he found a hanged criminal, and when a flood washed some body's out of a cemetery. Despite this, he made various errors in his analysis on how human bodies work. Some of his errors were: He thought that muscles attach to the bone in the same way with humans and dogs. He thought that blood was created in the liver. He realised that it flowed around the body, but said that it was built up as fuel for the muscles. He thought he saw holes through the septum, which allowed the blood to flow from one side of the heart to the other. He made mistakes about the blood vessels in the brain. He thought the human jaw-bone was made up of two bones like a dogs. He was also mistaken about the shape of the human liver.
Galen's books show a good knowledge of bone structure. He also studied the lungs, the muscles, the heart and blood and the nervous system.He conducted experiments on pigs, and when he cut the spinal cord in different places he realised how the nervous system takes messages from the brain to the muscles.

Galen excepted the Greek theory of the four humours as the cause of disease. However the Romans did not continue the Greeks' investigation into disease and rejected Greek ideas, so Roman knowledge of disease did not progress. Roman ideas of disease were muddled. For example.
  • Crinas of Missila thought illness was caused by the starts.
  • Varro blamed creatures which were too tiny to be seen.
  • Columbella blamed poisonous vapours in the swamps.
All these ideas survived until the nineteenth century.

Galen (AD 130-200) as depicted in a book by the 16th century French surgeon Ambroise Pare.

Surgery In Ancient Rome
The surgery of ancient Rome set an early example for modern times offering a model on which to improve upon. Roman surgery was very strict as to what position the surgeon should be in. When sitting in a position, the surgeons :
  • Knees were slightly separated and above he groin.
  • Elbows were never to pass the front of the legs or go behind the chest
  • Their two hands were to be used at all times.
  • Their hands were never to be over the breast
  • Forearms were o be kept at right angles to the arms
When standing all of the above were kept the same with the addition of both feet needing to stay level on the ground at all times. Physicians of today know that the position taken during surgery has nothing to do with the health of the patient. It doesn't matter how the hands are held in relations to the arms or how the knees are positioned. As long as proper sterilization and hygiene are followed the way the surgeon is situated is irrelevant.

When a surgeon would employ the help of an assistant, the assistant was to be in any position to allow an efficient working enviroment for them both. In modern times, the relationship between the surgeon and the assistant is the same. The assistant is to be in an area so that any tool the surgeon may need is easily accessible.

We know that the Romans developed new surgical and midwifery instruments (though they would look barbaric to us now). They also developed the Caesarean section to remove a baby from the womb (although it is untrue that Julius Caesar was born this way). In those times the mother always died - Roman Caesareon sections were usually performed to save the baby of a women who had died during childbirth.

The Romans performed a few surgeries. One of these being a cataract surgery. In this way they would use a very thin needle, push it into the tissue of the eye, but only just through the surface, to break up the cataract and any remaining pieces would be suctioned through a long tube. The Romans also used a form of cosmetic surgery. For example, a released slave might want to have his brand removed, even though it was a costly process. Trepanation was a form of brain surgery designed to relieve pressure and cure headaches. Using a drill, a hole in the skull not only worked to relieve the pressure, but patients had a high survival rate. The Roman surgeons were highly skilled. They had a great knowledge of anatomy. This meant that they could perform many successful surgical operations. Some of the operations performed include: The removal of tumours and the removal of a hernia. More extensive operations were carried out under military supervision.

Appearance Of Surgeons
The appearance and grooming of surgeons was very important as it is now. In ancient Rome, the surgeon was expected to look his best at all times. His clothing was expected to be wrinkle free at all times. Surgeons also were to keep their fingernails no longer and no shorter than the edge of their fingertips. All of these regulations were put in place because the credibility of the surgeon was frequently determined by outward appearance and stature. It was believed that the better the person looked the better they were at their job.

Roman Surgical Tools
Scalpels- These were made of either bronze or steel and were used to make incisions Scalpels could be made of either steel, bronze, or a combination of the two metals.

Ancient Scalpels had almost the same form and function as their modern counterparts do today. The two long steel scalpels are examples of the most ordinary type of scalpel from antiquity. They could be used to make a variety of incisions, but were mostly suited to making deep or long cuts. The four bronze scalpels(shown in this image) are generally referred to as "bellied scalpels." This variety of scalpel was another favourite of physicians in antiquity since the shape of its handle allowed more delicate and precise cuts to be made.
Bone Hooks- Hooks, long thin metal instruments were used as probes and the maneuvering of small pieces of tissues more easily. Hooks were another common instrument used regularly by Greek and Roman doctors.

Bone Hooks

The hooks the ancient doctors used came in two shapes: Blunt and sharp. Both of these types of hooks are still used by modern surgeons' for many of the same purposes as ancient roman doctors used them. Blunt hooks were used for dissection and for raising blood vessels. Sharp hooks were used to lift and hold small pieces of tissue so they could be extracted and to retract the edges of wounds.
Bone Drills- Bone drills, looking like wine cork screws were used to remove diseased bone tissue from the skull and extract sizable foreign objects such as a weapon from a bone. Bone forceps were used to extract small pieces of bone that would be too difficult to remove with fingers.

Bone drills
Bone Forceps- In the case of impaction of the foetal cranium, the head might be opened with a sharp instrument and the pieces of the skull removed with bone forceps. Paul Aigenita (VI.xc) wrote that in a depressed fracture of the skull fractured bone is to be removed in fragments, with the fingers if possible, if not, then with bone forceps.

Bone Forceps
Vagina Speculum- Is one of the most spectacular, if not fearsome looking medical instruments. It was used in gynecology and in childbirth.

Vaginal Speculum
Bone Levers- From what Galen says, these instruments were used for levering fractured bones into position and may also have been used for levering out teeth.

Bone Levers
Rectal Speculum- The earliest mention of the rectal speculum is to be found in the treatise of fistula by Hippocrates(iii.31),"laying the patient on his back and examining the ulcerated part of the bowel by means of the rectal speculum.

Rectal Speculum
Probes or Curettes- The scope of the cyathiscomele in medical art is evidently, like the flat spathomele, to act occasionally as a sound, but mainly to mix, measure and to apply medicaments. Some are adopted for use as curettes.

Probes or Currets

Hospitals In Ancient Rome
Hospitals in ancient Rome were generally limited to military camps and the very late empire, after the establishment of Christianity. While legionary medical facilities were quite expensive, hospitals, as we know them today, simply didn't exist in the Roman world. Romans in general terms regarded a disease as an affliction of the Gods requiring prayer, sacrifice and pagan rites to alleviate.
Prior to the Christian era, there were temples such as the Aesculapium, where the sick would spend the night in prayer to the Gods hoping to receive a cure, and 'doctors' made rounds doing what little they could. There were establishments to house the dieing or infirm, essentially to keep them of the streets. The concept in doing so was not to cure or even to care, but to keep the wretched and sickly poor of the streets.

Prior to the hospital concept, wealthier estates may have had valetudinaria attached to their grounds. This was a sort of medical facility to deal with their sick or injured slaves and to isolate them from the rest of the staff and the family.

Roman Doctors
The doctors in ancient Rome were not nearly as highly regarded as the doctors in Greece. Many of the doctors were freed Greek slaves hence the social standing of doctors was quite low. While there were some who were respected, most were considered just as they were, cheaters, liars and quacks. Because cure rates were so low, many people were skeptical and scornful of doctors. Their skepticism is easily understood. Roman literature contains much which tells us about the reaction of individuals to medicine and doctors. To listen to the Roman doctors is to hear tales of quackery at all levels of society. Many doctors did try to find effective treatments and perform a valuable service to the community, but even more charged excessive prices for the most worthless medicine and drugs. Others in the craft attempted to deal with and treat diseases which they obviously didn't understand.

There were no licencing boards and no formal requirements to an entrance to the profession. Anyone could call himself a doctor. If his methods were successful, he attracted more patients, if not, he found himself another profession. Medical training consisted mainly by apprentice work, men trained as doctors by following around another doctor. Rome had two different types of physicians: The aristocrats had physicians as servants or they visited the private physicians and were willing to pay their high prices. Those who served the general public, their reputations weren't as prestigious. Many were illiterate, quacks, charlatans, and usually conned the poor and the needy.Unethical practises abounded. Plutarch grumbled that practitioners used all sorts of questionable methods to gain patients, ranging from escorting the prospective patient home from bars to sharing dirty jokes with them. According to Plutarch,"Some medical Quacks would to just about anything to acquire clients, from accompanying them to alcohol dens to telling dirty jokes. Still some were not above murdering their patients in cold blood for financial game, for example, they might be paid and told to just 'put the patient out of their misery'."

Wealthier and more respected physicians, set up shop like any normal practise today, with an office and staff. Others simply advertised their services on the streets, going as far as to perform simple surgeries in order to increase their notoriety. Others acted as 'snake oil' salesmen, selling any number of products along with their treatments. Beauty supplies and cosmetics were commonly purchases from doctors. Nearly all would attempt to treat any ailment provided, the price was right, knowing their treatments did little good, if not more harm. With the introduction of a medical school in the first century AD, the health care of ancient world became more uniform and practical; but for the average citizen, life was better without the need for a doctor. Surgeons however, especially those in the legions, were highly skilled and coveted in private life.

In surgery, the surgeons would use painkillers such as opium and scopolamine for treatments and acetum (the acid in vinegar) was used to wash wounds. Some ancient Roman herbs used in medicine were: Fennel: It was thought to have calming properties.
Elecampine: It was used to help with digestion. Sage: Although it had little medical value, it had great religious value. Garlic: Beneficial for health, particularly of the heart. Fenugreek: Used in the treatment for pneumonia. Siphium: Used for a variety and ailments and conditions--most noted for birth control.

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