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Roman Medicine
Ancient Roman medicine was a combination of some limited scientific knowledge, and a deeply rooted religious and mythological system.

While knowledge of anatomy was quite impressive, and many surgical techniques were only surpassed in the modern age, the application of medicines and cures was simplistic and largely ineffective. Much of the Roman system was adopted from the Greeks, and primarily the teachings of Hippocrates.

Hippocrates, (460 - 384 BC), is largely recognized as the father of modern medicine, as he created the concept of medicine in a separate scientific field away from a philosophical and mythic approach. The modern Hippocratic Oath stems directly from Hippocrates and continues to be the binding ethical law guiding all those in the field of medicine. He was primarily responsible for the foundation of recording illnesses, attempts at treatment, and the causes and effects.

The Romans expanded on Hippocrates scientific methods by combining it with the religious and mythological ceremony of the day. Adding to the concept of observation and record keeping, the Romans included prayers, offerings and sacrificing to the gods in hopes of greater success. Many of the Roman gods were believed to have healing powers, but one in particular played a prominent role in ancient medicine. Aesculapius, the god of healing, was the prominent deity that governed the Roman medical practice and his symbolic snake entwined staff continues to be used as a symbol of the medical field today.

Doctors themselves were basically craftsmen, like any other profession. Early on the profession was mainly one of trial and error with apprenticeships to pass on the art, but later, medical schools were established to make the field more widely uniform. While medicine in the civilian sector was highly dependent on 'doctors' of widely ranging skills and education, the legions had the benefit of highly experienced medical personnel. Civilian doctors were mostly Greeks, many of whom were socially low slaves or freedmen, with a few more prominent individuals who served the upper classes. While the practice of medicine was widely diverse for the common people, the legions had access to surgeons and hospital facilities that were far better than anything available after the fall of the empire.

Despite the reliance on a mystical approach to healing, Roman society maintained reasonably good health throughout its history. The exhaustive use of aqueducts and fresh running water, including toilets and sewer systems, prevented the proliferation of many standing water based diseases, and also washed away wastes away from heavily populated areas. Excellent hygiene and food supply also played a prominent role. The Roman baths were an integral part of society, in all social classes, and regular cleansing helped fight germs and bacteria. The Romans also tried, whenever practical, to boil medical tools and prevent using them on more than one patient without cleansing.

Galen (131 - 201 AD), a prominent physician in the ancient world, worked diligently to expand medical knowledge. Moving away from the mythical approach, he pursued Hippocrates' methods of observation and research. He dissected, studying the workings of human anatomy, and experimented with many procedures in order to find real workable solutions to medical issues. More important than his actual work, however, his greatest contribution was to diligently record his exhaustive studies in a series of books. Thanks to him, doctors for centuries afterward had at least a basic knowledge of practical medicine.

The Romans also had knowledge of harmful effects of many common materials. Asbestos and lead were two products causing potential problems that were documented as having ill effects from extended exposure. While the Romans had the knowledge of some of these things, they didn't understand the causes, nor how to stop it, other than limiting exposure.

While the Roman medical system was highly developed in comparison to its medieval successor, it was still highly flawed in its application. Certainly there were 'barbaric' practices as the use of bleeding cups, to take blood from a patient in a particular part of the body that was diseased; in order to cure that part of the body. While today, we would cringe at the thought of suffering ancient medical treatment, the Roman system was the most capable the world knew until the 19th and 20th centuries.

Roman Drugs and Pharmaceuticals
While medications today are intended to provide relief of symptoms or attack a disease itself, there were few successes in this in the ancient world. The Romans had an excellent knowledge of anesthetics but all other so called 'cures' were developed through practices as similar as mixing poisons.

In fact, as simple sickness was so difficult to determine by the average doctor, many deaths in the ancient world were attributed to poisoning. This paranoia led to the development of many antidotes, some of which worked, and others that didn't, but much of the research provided valuable information for later doctors.

Any mineral, plant, liquid or animal part could be used in treatment of diseases. Combinations of exotic ingredients, with the blessings of the gods were made in widely diverse mixtures depending on the location. While some may have been helpful, others did nothing, or were even more harmful. In fact, Mercury, a known human toxin, was a common ingredient in many medical 'cures'. One wound antiseptic was of particular value however. Acetum, was actually considered a more effective antiseptic than the carbolic acid developed by Joseph Lister in the 1860's.

While everyday treatments were met with an almost comical lack of success, anesthetics were another matter. Thanks to the highly developed military surgical system, Roman knowledge of pain deadening substances was excellent. Opium poppies (morphine), henbane seeds (scopolamine) and mandrake were used extensively. Morphine deadens the nerve endings and limits movement while Henbane induces sleep. Mandrake also deadens pain while slowing the heart rate, also to control bleeding. Despite this knowledge, the best tactic a doctor could use, was to finish as quickly as possible.

Did you know?

Dioscorides of Anazarbus a Greek physician born in southeast Asia Minor wrote between 50-70 AD his fundamental work "De materia medica" This study focused the preparation, properties, and testing of drugs and became one of the most central pharmacological work for the next sixteen centuries!

Roman Hospitals
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 extensive, hospitals, as we know them today, simply didn't exist in the Roman world. Romans in general terms regarded 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 on the Tiber Island, where the sick spent the night in prayer to the gods hoping to receive a cure, and 'doctors' made rounds doing what little they could. And there were establishments to house the dying or infirmed, essentially to keep them off the streets. The concept was not cure or even care, but to keep the wretched and sickly poor off the streets. Out of sight out of mind, so to speak.

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

The concept of the modern hospital (the actual care, 'hospitality' and treatment of visitors) for the civilian masses in Europe didn't come to fruition until post Constantine and the rise of Christianity. While these early Christian hospitals were grossly over their heads regarding medical capability (they essentially served as last stops for the dying or quarantine centers), the concept of providing care to the public was the actual intent. In this regard, the first civilian hospitals were developed.

Did you know?

Augustus Caesar assigned four doctors with a supervising legionary physician to each cohort. In addition, the soldiers themselves were well versed in first aid.

Caesarean Section
One form of surgery in ancient Rome was the Caesarean section childbirth procedure. A common misconception is that Gaius Julius Caesar himself was born under this procedure, but that is completely without merit.

A Caesarean Section in the ancient world was a last resort operation to comply with Roman ritual and religious custom and had little to do with saving either mother or child.

Roman, or Caesarean Law, demanded that when a pregnant woman died she could not be buried until the child had been delivered. Thus the procedure was developed to remove the infant prior to the burial. It later became more customary as a last ditch effort to save the child, depending on circumstances.

The law stated that a living, pregnant woman could not give birth under Caesarean section until she was into her 10th month of pregnancy (also indicating a fine knowledge of the reproductive cycle). As the mother assuredly wouldn't survive, the procedure was delayed as long as possible to give her a chance, before the baby might be in trouble. Knowing that Caesar's mother, Aurelia, survived well into Julius' adult life proves that he was not born of this procedure, or she would've died at his birth.

Ancient Roman Doctors
The 'doctors' in ancient Rome were not nearly as highly regarded as the doctors in Greece. The profession itself, outside of the legions, was considered a low social position, fit for slaves, freedmen and non-latin citizens, mainly Greeks. While there were some who were respected, most were considered just as they were, cheaters, liars and quacks. The bulk of doctors, at least early on, were self-taught or apprenticed practitioners who simply claimed to be healers, with little basis in real medical knowledge.

Many doctors did try to find effective treatments and perform a valuable service to the community, but even more were simply in it to con and cheat their patients. As there were no licensing boards, no formal requirements or education for entrance to the profession, anyone could call himself a doctor. If his methods were successful, he attracted more patients, if not, they simply moved on to another career.

Wealthier, and more respected physicians, set up shop like any normal practice today, with an office and staff. Others simply advertised their services on the streets, going so far as to perform simple surgeries in front of crowds 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 purchased 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. There is even evidence of doctors acting as assassins, willingly poisoning patients in the guise of giving them care, though this was rare and would lead to a short professional career.

With the introduction of a medical school in the 1st century AD, the health care of ancient world become 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. Research and advances made by doctors on the battlefield became the mainstay of human medicine for nearly 2 millenium.

Women also performed an important service to the field of medicine. As a tradition last lasted for centuries, midwives delivered babies and became experts in women's health. These skilled medical care givers often filled the void left by the ignorance of doctors, and despite high birth mortality rates, went a long way towards providing quality service to Roman women.

Roman Medical Tools
While the application of medicines and cures was a guessing methodology at best, with some undoubtedly dangerous use of elements such as toxic mercury, the Romans used very sophisticated medical tools.

Thanks to surviving images and actual tools, such as those at Pompeii, we have a very strong understanding of their use in the ancient world, and the advancement of Roman medicine. Archaeological digs have produced tools dating as far back as 500 BC, just about the time Hippocrates was writing the Hippocratic Oath. Among the items we know the Romans used were:



Scalpels made of bronze, iron and steel, and a wide variety of medical scissors were used.

Intricate and varying hooks or probes, were used in moving light tissues and for making the negotiation of the inner workings of the human body more manageable.

Bone drills, resembling the modern cork screw, were used to remove diseased bone tissue from various bones, or to drill holes to allow access to blocked parts of the body.

Metal forceps were used to extract small pieces of bone or other objects that would be otherwise difficult to remove with fingers.

Catheters, or long metal tubes, very much like those in use today were used to open blocked passages such as the urinary tract. Other similar devices were used to open spaces such as the nasal cavity in order to insert various medicinal treatments.



The bone saw was used in amputation, which the Romans knew prevented gangrene.



The vaginal speculum was used in gynecology and in childbirth.



Bone levers were used to put fractures back in place, or to remove teeth.

isn't that amazing? and creepy.

Roman Surgery
While civilian medical treatments, the so called doctors of the day were mostly inadequate at best, Roman surgeons were highly advanced and skilled professionals. A detailed knowledge of anatomy and its functions led to many surgical operations in line with success rates enjoyed in the modern era. Most surgeries in the ancient world were likely of the low impact variety such as tumor removal and hernia operations, while more extensive surgeries certainly occurred under military care.

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.

Cataract surgery was also known. A thin needle was pushed though the eye to break up the cataract and the remaining pieces suctioned out through a long tube. Evidence suggests this procedure at least had a moderate rate of vision improvement success.

A form of ancient cosmetic surgery was also practiced. Excess skin or tissues could be trimmed from various parts to improve the appearance. Freed slaves also were common customers of branding removal. While an expensive procedure, being able to mask the history of service as a slave was a valuable operation in Roman society.