Roman medicine is derived from Greek Medicine, which is not at all surprising, considering that the Romans derived most of their cultural aspects from the Greeks and then improved on them. They studied the medical treatises and methods of the Greeks, the Etruscans, the Egyptians, the Persians, as well as the other people they conquered. They then came up with one of the best and most sophisticated medical systems of the ancient world.
Prior to the Greek influence, Roman medical tradition was confined to home remedies and superstitious rituals. The Roman army incredibly enough, had no medics, and the wounds during battles were cared for by other soldiers, with some or no experience in tending to them. The survival rates resultant were not very promising. As this affected the morale and the effectiveness of the army, and thereby the spread of the Empire, it became necessary to develop more professional medical knowledge. It was this necessity, actually, that led to the development of Roman medicine.
Most of the early Roman doctors were Greeks. The first of these to come to Rome was Arcagathus, according to Pliny's Natural History. Arcagathus, who hailed from the Greek Peloponnese, ariived in 219 B.C., and, as the one and only person in all of Rome with a claim towards professional medical knowledge, was initially inundated with patients.
However, it soon became apparent that his treatments were overwhelmingly dependent upon the knife and the cautery - in fact, they soon led to him being nicknamed 'the Executioner' - and not surprisingly, the numbers of his patients soon petered down to a trickle. No doubt they preferred to die of their own sufferings rather than any additional ones inflicted by him. This sort of thing did not work wonders for the medical cause and it took another 100 years before people decided to give another Greek practitioner, a chance. This was Asclepiades of Bithynia, who arrived in 100 B.C.
Soon enough, there were many doctors in Rome. It was very easy to become a doctor in Ancient Rome - you simply decided you wanted to become one and set up shop. Sometimes you apprenticed for the job by observing the methods of another medic of equally doubtful credentials. It was basically a trial and error method. If you were successful, the news spread and you got yourself a steady clientage, and could charge them the most exorbitant fees. If you failed or lost interest, well, you could always turn to some other profession.
This kind of attitude towards medicine and the ineffectiveness of most of the expensive - and often unnecessary - treatments, as well as the fact that most of the practitioners were Slaves and at the very bottom of the social ladder, naturally did not accord doctors with the prestige that they enjoy in modern times. Many of the less-than-flattering epigrams that have come down to us from Ancient Rome should give an idea of the esteem in which doctors were held -
"Until recently, Diaulus was a doctor; now he is an undertaker. He is still doing as an undertaker, what he used to do as a doctor." (Martial, Epigrams 1.47)
"I felt a little ill and called Dr. Symmachus. Well, you came, Symmachus, but you brought 100 medical students with you. One hundred ice-cold hands poked and jabbed me. I didn't have a fever, Symmachus, when I called you, but now I do." (Martial, Epigrams 5.9)
"Socles, promising to set Diodorus' crooked back straight, piled three solid stones, each four feet square, on the hunchback's spine. He was crushed and died, but he became straighter than a ruler." (Greek Anthology XI, 120)
Unethical practices abounded. According to Plutarch, some medical quacks would do just about anything to acquire clients, from accompanying them to alcohol dens, to telling them dirty jokes. Still others were not above murdering their patients in cold blood for financial gain - for example, they might be paid and told to just 'put the patient out of his misery'.
Under Gaius Marius, the Roman army became the world's best trained and disciplined force, and some of this rubbed off onto the medics too. The influence of superstitious quakery lessened and Roman medicine took on a more practical approach. It was still a trial and error process, but the medics were more observant and carefully noted down any treatment that worked. This knowledge was passed on and could be successfully utilized by the next doctor.
The first Roman Medical Corps was formed by Emperor Augustus, and as he gave land grants, dignified titles, special retirement gifts to the doctors, the profession lost its shoddy aspect and became respectable. It helped too that medical professionals hereafter were required to train at the new Army Medical School and could not practice unless they passed. This increased the success rates in treatments.
Roman Medics studied Medical texts by Hippocrates, who came from the Greek Island of Cos and is generally regarded as the Father of Medicine. Actually, he was only one of the longstanding line of medical practitioners, but his personal popularity ensured that his treatises were saved by his followers, while those written by his predecessors, which nobody saved, were lost to the coming ages.
Aside from Hippocrates, whose famous Hippocratic Oath is still in use today, there were other medical practitioners whose writings were equally revered -
- Aretaeus of Cappadocia, who wrote treatises on some acute and chronic diseases
- Celsus, who under Emperor Augustus, compiled informative Medical texts and manuals
- Pedanios Dioscorides (65 A.D.), who wrote a text on herbal Medicine that was referred to for the next 1500 years and is still in use today in Alternative Medicine
- Galen(130-200 A.D.), perhaps the most well-known of the Roman medics, who left detailed writing about physiology and surgical processes, including the various medical and surgical instruments then in use
- Onbasius, who compiled a 70 volume Medical Encyclopedia around 325 A.D.
- Soranus of Ephesus, who wrote on obstetrics and gynecology
Advanced Roman medicine and the surgical instruments used, were in many ways amazingly similar to the medical practices of the Nineteenth Century. Surgeries were performed by specialists and they used the following instruments made of steel or bronze - Scalpels, forceps, probes, extractors, catheters, hooks, bone drills, bone saws, vaginal specula, bleeding cups. Painkillers and sedatives, like Morphine (made from Opium poppies)and Scopolamine (made from Henbane Seeds), were widely used.
The Romans did not know the connection between germs and infections, but they unknowingly reduced the possibility of infection by boiling the instruments before surgery and by not using the same one twice, without first reboiling. Wounds were always washed first with an antiseptic, and amputations, performed often to prevent gangrene, were cauterized. The penchant for public baths and sewage systems, also ensured public cleanliness and helped prevent disease.
Roman doctors became very adept at dealing with various medical problems. They could set bones, drill holes in the skull (known as Trephination and done to relieve pressure and pain), perform surgery on the brain, perform internal and external suturing, and perform some minor plastic surgery - they could repair facial injuries, remove moles, perform male de-circumcision. Prostheses were used to replace lost limbs.
Of course, as in the present age, the best medical treatment was the most expensive and usually only the upper classes had recourse to it. The lower classes had to make do with quacks and superstitions.