Believe it or not, the Romans were actually very medically advanced for their time. They used different tools, methodology, and ingredients to treat and cure those that were sick.
The Romans took a lot of their medical knowledge from the Greeks, and Greek scientists and doctors came to Rome as they realized they could make good money with their skills and knowledge. The two most prominent Greek physicians during this time were Dioscorides and Galen, but Soranus and Asclepiades were also well known. Many of their theories were revived theories of Hippocrates of Kos, a Greek physician of the classical period.
Prior to the introduction of Greek medicine, Roman medicine was a combination of religion and magic. The first Roman physicians were religious figures with no medical training, or those at the head of the family. Tragic famines and plagues were often attributed to divine punishment. Appeasement of the gods through rituals was believed to alleviate such events.
In 46 BC, Julius Caesar granted Roman citizenship to physicians when the Roman army had a need for trained surgeons. Augustus also gave immunity to physicians from paying taxes and public duties in 10 AD. These incentives caused physicians to flood to Rome, although not all of them were educated physicians; some were practicing without the proper education or training.
The Romans conquered the city of Alexandria in 30 BC, which was an important center for learning. The Great Library of Alexandria held countless volumes of ancient Greek medical information. The Romans adopted many of the practices and procedures they found in the Great Library into their medical practices.
Hippocrates
Hippocrates of Kos lived from 460–370 BC. He made major contributions to medicine that persist today and founded the Hippocratic School of Medicine. Until the teaching at his school, medicine had been a part of philosophy and the practice of rituals, incantations, and the casting off of evil spirits, so Hippocrates helped to revolutionize medicine and the way in which it was perceived.
Hippocrates and his colleagues wrote the Hippocratic Corpus comprising around 60 early ancient Greek medical works.These early medical practitioners studied diseases by directly examining the living person. Hippocrates and his school were the first to use the medical terms acute and chronic, endemic and epidemic, convalescence, crisis, exacerbation, paroxysm, peak, relapse and resolution.
Famous Roman Physicians
There were a few Roman physicians that followed in Hippocrates’ footsteps, and revived Hippocrates’ view on diseases.
Galen (129 CE—c. 200 CE)
Galen is perhaps the most famous of all Greek physicians in Roman times. Because the dissection of human corpses was against Roman law, Galen used pigs, apes, sheep, goats, and other animals to apply theories of animal dissections to a theory of human anatomy. As a result of this, he displayed an excellent knowledge of bone structure. For example, after cutting the spinal cord of a pig and observing it, he also realized that the brain sends signals to control the muscles.
Galen followed Hippocrates’ theory of the four humours, believing that health depended on the balance between the four main fluids of the body — blood, yellow bile, black bile, and phlegm. Food was believed to be the stabilizer of these humours, and drugs, venesection, cautery and surgery were believed to be drastic and only used when diet and regimen could no longer help. Galen also said that opposites would often cure people. For a cold, he would give the person hot pepper. If they had a fever, he advised doctors to use cucumber.
He moved to Rome in 162, where he lectured, wrote extensively, and performed public demonstrations of his anatomical knowledge. He had a large number of patients, and he later became a physician to Emperor Marcus Aurelius.
Dioscorides (c. 40–90 CE)
Pedanius Dioscorides was a Greek botanist, pharmacologist, and physician who practiced in Rome when Nero was the ruler. He became a famous Roman army doctor and was able to experiment with the medical properties of many plants while travelling with the army. He also wrote a 5-volume pharmacopeia called “De Materia Medica,” which listed over 600 herbal cures, and was used by doctors extensively for the next 1,500 years.
Asclepiades (129/124 BC–40 BC)
Asclepiades was a Greek physician who practiced medicine in Asia Minor as well as Greece before he moved to Rome in the 1st century BC. He is most famous for developing his own version of the molecular structure of the human body. He believed that multi-shaped atoms (round, square or triangular) passed through bodily pores and, if the atoms were too large or the pores were too constricted, then illness would present in multiple symptoms such as fever, spasms, or in more severe cases paralysis.
Asclepiades was the first physician in Rome to use massage therapy. He did not inflict severe pain upon any of his patients and instead believed in hot and cold baths as a remedy for illness, listening to music to induce sedation, and consuming wine to cure headache and a fever
Soranus (98–138 CE)
Soranus was a Greek physician who trained at the medical school in Alexandria and practiced in Rome. Soranus was a part of the Methodist School of Asclepiades. His most notable work was his book Gynecology, in which he discussed many topics that are considered modern ideas such as birth control, pregnancy, midwife’s duties, and post-childbirth care. He also worked in embryology and surgery.
Roman Medicine – Diagnostic Methods
Physicians would carry out a thorough physical examination of the individual. However, diagnosis could be difficult, and often doctors tended to develop their own theories, which may not be correct and therefore may not be treated properly.
Marcus Terentius Varro (116–27 BCE) was one of the first who believed that disease occurred due to minute creatures too small for the naked eye to see. We now know about bacteria and viruses, which we can only see using a microscope.
However, others believed that the stars caused illness, and that they could be cured with divine messages. Gaps in physician-provided care and the lack of physicians to treat everyone caused these types of supernatural healthcare.
Dreams were used by physicians in diagnosis. It was though that sensation, pain, motion and other physiological concepts were the work of the soul, and that the soul continues to work even when the body is asleep. Therefore, dreams could show what ailed a person.
There were two types of dreams associated with medicine: prophetic and diagnostic. Prophetic dreams were divine in origin and told of either good or bad tidings for the future. Diagnostic dreams, on the other hand, were a result of the soul telling what afflicted the body. If the dreams were of normal everyday events, their body was healthy. Therefore, the farther from the norm, and the more chaotic the dreams were, the more ill the patient was.
Celestial movement was also used by physicians to diagnose illness. Many physicians at the time believed in the association of astrology and medicine. There were days that were considered critical including day seven, fourteen and day twenty which were considered favorable for a medical crisis to occur. Galen especially took the lead in this research, and wrote a treatise on diagnosis and prognosis by celestial movement.
Medicines
Roman physicians used a wide range of herbal and other medicines to treat their patients. These included:
| Substance | Effect |
|---|---|
| Fennel | Cures painful urination; expels menstrual flow; stops bowel discharge; brings out breast milk; breaks kidney and urinary stones |
| Rhubarb | For flatulence, convulsions, internal disorders (stomach, spleen, liver, kidneys, womb, peritoneum), sciatica, asthma, rickets, dysentery. |
| Gentian | Warming, astringent; for poisonous bites, liver disorders; induces abortion; treats deep ulcers, eye inflammation |
| Birthwort | Poisonous; assists in childbirth |
| Liquorice | Calms stomach; chest, liver, kidney and bladder disorders |
| Aloe | Heals wounds (applied dry); removes boils; purgative; treats alopecia |
| Elecampane | Sorts digestive problems |
| Egg yolk | Cures dysentry |
| Cabbage | Hangover remedy; cure for wounds and sores |
| Silphium | Contraceptive; treats fevers, coughs, indigestion, sore throat, warts |
| Fenugreek | Treats lung diseases, especially pneumonia |
| Willow | Antiseptic |
Roman Medicine – Treatments
Diet
Diet was considered to be very important in ensuring good health during Roman times. Food was considered to have a healing and preventative effect on disease and ailments. Meats, such as poultry, and plants, such as lentils, garden peas and figs, were believed to be used for sick individuals. Eggs and oysters were also used in treating the sick, and rice, chic-pea, olive and fig which were widely used by the Roman military to keep the soldiers healthy.
Surgery
When medicine didn’t work, Romans performed surgical procedures. Surgery was usually a last resort in Roman times because of the risk to the patient. If surgery did happen, it was usually limited to the surface of the body. This is because doctors realized that if the medical issue revolved around the brain, heart, intestines, kidneys, liver, arteries or spine, then it could usually not be cured.
As Roman doctors did not have permission to dissect corpses, they were somewhat limited in their understanding of human anatomy. However, soldiers and gladiators often had wounds, which could be severe, and doctors had to treat them. Therefore, doctors learnt about the human anatomy this way.
Doctors used opium and scopolamine to relieve pain and acid vinegar to clean up wounds. They did not have effective anesthetics for complicated surgical procedures. Cesarean sections took place, although it was unlikely that the mother would survive. However, the baby often survived.
Divine Messages
When a Roman was sick or injured, the physician who failed to cure them was often looked down on. Because many Romans believed in the power of divine messages and healing, sick or injured Romans would often flock to temples dedicated to Asclepius, the god of healing. It was believed that the god actually inhabited the temple and would provide healing.
The sick person would give a specified donation to the temple, and then undergo a process called “incubation”, in which they would relocate to a special room where the god would be able to contact them. This was often done through dreams; the god would either prescribe care or provide it themselves. Often the type of cure prescribed would be rather similar to the actual medical practices of physicians of the time.
Physicians would actually often recommend that patients go to a healing sanctuary when they were afflicted by an illness that the physician could not cure. This allowed the reputation of the physician to remain unharmed, as it was seen more as a referral than as a failure.
Surgical Instruments
There were a number of medical instruments used in Ancient Rome when performing surgery or examining a patient. Let’s take a look at some of them:
| Instrument | Purpose |
|---|---|
| Bone drills | Used to remove diseased bone tissue from the skull and to remove foreign objects (such as a weapon) from a bone |
| Bone forceps | Used to extract small fragments of bone which could not be grasped by the fingers |
| Bone levers | Used to leverage bones back into their proper place in a limb |
| Cupping vessels | Used for bloodletting |
| Dental forceps | Used for tooth removal |
| Epilation forceps | Used for hair removal |
| Male catheters | Used in order to open up a blocked urinary tract to let urine pass freely from the body. Early catheters were hollow tubes made of steel or bronze, and had two basic designs. Male catheters has a slight S curve, while females were straighter. |
| Obstetrical hooks | There were two basic types of hooks: sharp hooks and blunt hooks. Blunt hooks were used as probes for dissection and for raising blood vessels. Sharp hooks were used to hold and lift small pieces of tissue so that they could be extracted, and to retract the edges of wounds |
| Probes/Curettes | Used to mix and apply pharmaceuticals to the skin of the human body. Could also be used for lifting tissue |
| Rectal speculum | Used to examine the rectal cavity of a patient |
| Scalpels | Used to make a variety of incisions |
| Spatula | Used to mix and apply various ointments |
| Spatula probes | Used for mixing medicines and to spread the medications onto the affected part of the patient |
| Spoon of Diocles | Used to remove arrowheads and other barbed objects |
| Surgical saw | Used to cut through bones, primarily for amputations |
| Surgical scissors | Used for cutting tissue, but also for cutting hair |
| Tile cautery | Used for several purposes, such as stopping bleeding, cutting flesh or removing growth tumors |
| Tubes | Used to prevent adhesion or contractions after surgery. It would be inserted into sensitive areas such as the nose, rectum, or vagina |
| Uvula (crushing) forceps | Used for the amputation of the uvula. The physician crushed the uvula with forceps before cutting it off in order to reduce bleeding |
| Vaginal specula | Used in the diagnosis and treatment of vaginal and uterine disorders |
Roman Medicine – Public Health Facilities
Unlike the Greeks and Egyptians, the Romans understood the importance of public health. This led them to establish systems of public hygiene. For example, they buried the dead outside the city walls, they had large supplies of water available through aqueducts, they erected public bathing areas and built public sewage systems. They also began draining swamps in close proximity to cities.
There were nine public baths in Rome alone, and each one had pools at varying temperatures. Some also had gyms and massage rooms. Government inspectors would check the baths regularly, and were vigorous in their enforcement of proper hygiene standards. The entrance fee for the baths were extremely small – usually about a quadrans. This extremely low price was to ensure that everyone could bathe and everyone could afford it.
Roman houses and streets also had toilets. By 315 AD, it is said that Rome as a city had 144 public toilets which were flushed clean by running water.
Because the Romans were superb engineers, they built several aqueducts throughout their Empire. This allowed all Romans a supply of water. The aqueducts that fed Rome carried an estimated 1000 million litres of water a day. They also planned all their building around swamps, and would drain swamps if they got in the way. They were aware of the link between swamps and mosquitoes and understood that these insects could transmit diseases to humans.
Hospitals
Romans were the ones to establish the first hospitals. The earliest known Roman hospitals of the Roman Empire were built in the 1st and 2nd centuries AD. However, these were reserved for slaves and soldiers. Everyone else was treated at home.
The valetudinaria (plural of valetudinarium) were field hospitals or flying military camps and began as a small cluster of tents and fortresses dedicated to wounded soldiers. Because of the size of the army, the wounded could no longer be cared for in private homes, so valetudinarium were created.
Over time, these hospitals became bigger and more established. A standard valetudinarium was a rectangular building consisting of four wings. The building included a large hall, reception ward, dispensary, kitchen, staff quarters, and washing and latrine facilities. Hospitals also had drainage and sewage systems attached to them, to help with public health.
Military Doctors
Aside from military hospitals which helped to cure wounded soldiers, there were also specified military doctors. Emperor Augustus (reigned 31 BC-14 AD) established the first professional military medical units. Each legion had physicians, supporting medical staff, and a hospital that could accommodate between 250 and 500 soldiers.
The army made sure the physicians collected and shared their knowledge. They wrote medical manuals and incorporated medical knowledge from the conquered nations. During battles, Roman military physicians were stationed near the field headquarters to help wounded soldiers as quickly as possible. Some soldiers even had the task of riding along the battle lines, picking wounded soldiers, and carrying them to safety.
To attract more doctors to the army, the Romans offered citizenship, pensions, and land. The military physicians were also exempt from regular military duties and paid better than regular soldiers. They were part of the specialized forces, called the immunes. The name of the group referred to the fact that these soldiers were immune to the everyday hardships oflegionaries.
Although Roman physicians didn’t know about bacteria, they were aware of infections and were, therefore, very strict on sanitation. For example, they boiled surgical instruments and bandages before using them. Hospital rooms were isolated in order to separate sick soldiers from the wounded ones.
Roman Medicine FAQs
What were Roman doctors called?
Asclepiades and with the great Hippocrates of Cos, who both majorly influenced Roman medicine
Did the Romans invent medicine?
The Romans didn’t invent medicine, but they certainly helped to advance medical knowledge and practice. Much of Roman knowledge of ancient medicine actually came from the Greeks, and many physicians in Rome were actually Greek doctors who came over to Rome because of the good pay
Did the Romans have hospitals?
Romans did have hospitals, although these were largely reserved for wounded soldiers in the army. Everyone else was treated at home. Soldiers that were injured in battle were taken to special hospitals built for military use, because of the sheer size of the Roman army. These hospitals were very well equipped, and could accommodate up to 500 soldiers. They normally had a large hall, reception ward, dispensary, kitchen, staff quarters, and washing and latrine facilities
Why was public health so important to the Romans?
Public health was important to the Romans because they understood the link between hygiene and illness. Although they didn’t know exactly why sickness could occur due to bad hygiene, they knew that keeping themselves and their surroundings clean was a good way to fight it off. Because of this, they built public baths that were cheap to enter, so even the poorest could stay clean. They also built aqueducts so their cities had fresh water, public toilets for cleanliness, and buried the dead outside of the city walls. Swamps were also drained when closed to cities, as the Romans knew they attracted mosquitoes.
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