Outlines of Greek and Roman Medicine

CHAPTER XIII.. Sanitation. 155

SANITATION. 155

Water-supply--Its extent--The Aqueducts--Distribution in city--Drainage--Disposal of the Dead--Cremation and Burial--Catacombs--Public Health Regulations

APPENDIX.

FEES IN ANCIENT TIMES 162

ILLUSTRATIONS.

Asklepios, the ancient Greek Deity of Healing frontispiece

Machaon (Son of Asklepios), the first Greek Military Surgeon, attending to the wounded Menelaus p. 17

PLATE I.--Bust of AEsculapius face p. 13

" II.--Hygeia, the Greek Deity of Health " 15

" III.--Facade of Temple of Asklepios, restored (Delfrasse) " 18

" IV.--Health Temple, restored (Caton) " 20

OUTLINES OF Greek and Roman Medicine

CHAPTER I.. Early Roman Medicine.

EARLY ROMAN MEDICINE.

Origin of Healing--Temples--Lectisternium--Temple of AEsculapius--Archagathus--Domestic Medicine--Greek Doctors--Cloaca Maxima--Aqueducts--State of the early Empire.

The origin of the healing art in Ancient Rome is shrouded in uncertainty. The earliest practice of medicine was undoubtedly theurgic, and common to all primitive peoples. The offices of priest and of medicine-man were combined in one person, and magic was invoked to take the place of knowledge. There is much scope for the exercise of the imagination in attempting to follow the course of early man in his efforts to bring plants into medicinal use. That some of the indigenous plants had therapeutic properties was often an accidental discovery, leading in the next place to experiment and observation. Cornelius Agrippa, in his book on occult philosophy, states that mankind has learned the use of many remedies from animals. It has even been suggested that the use of the enema was discovered by observing a long-beaked bird drawing up water into its beak, and injecting the water into the bowel. The practice of healing, crude and imperfect, progressed slowly in ancient times and was conducted in much the same way in Rome, and among the Egyptians, the Jews, the Chaldeans, Hindus and Parsees, and the Chinese and Tartars.

The Etruscans had considerable proficiency in philosophy and medicine, and to this people, as well as to the Sabines, the Ancient Romans were indebted for knowledge. Numa Pompilius, of Sabine origin, who was King of Rome 715 B.C., studied physical science, and, as Livy relates, was struck by lightning and killed as the result of his experiments, and it has therefore been inferred that these experiments related to the investigation of electricity. It is surprising to find in the Twelve Tables of Numa references to dental operations. In early times, it is certain that the Romans were more prone to learn the superstitions of other peoples than to acquire much useful knowledge. They were cosmopolitan in medical art as in religion. They had acquaintance with the domestic medicine known to all savages, a little rude surgery, and prescriptions from the Sibylline books, and had much recourse to magic. It was to Greece that the Romans first owed their knowledge of healing, and of art and science generally, but at no time did the Romans equal the Greeks in mental culture.

Pliny states that "the Roman people for more than six hundred years were not, indeed, without medicine, but they were without physicians." They used traditional family recipes, and had numerous gods and goddesses of disease and healing. Febris was the god of fever, Mephitis the god of stench; Fessonia aided the weary, and "Sweet Cloacina" presided over the drains. The plague-stricken appealed to the goddess Angeronia, women to Fluonia and Uterina. Ossipaga took care of the bones of children, and Carna was the deity presiding over the abdominal organs.

Temples were erected in Rome in 467 B.C. in honour of Apollo, the reputed father of AEsculapius, and in 460 B.C. in honour of AEsculapius of Epidaurus. Ten years later a pestilence raged in the city, and a temple was built in honour of the Goddess Salus. By order of the Sibylline books, in 399 B.C., the first lectisternium was held in Rome to combat a pestilence. This was a festival of Greek origin. It was a time of prayer and sacrifice; the images of the gods were laid upon a couch, and a meal was spread on a table before them. These festivals were repeated as occasion demanded, and the device of driving a nail into the temple of Jupiter to ward off "the pestilence that walketh in darkness," and "destruction that wasteth at noonday" was begun 360 B.C. As evidence of the want of proper surgical knowledge, the fact is recorded by Livy that after the Battle of Sutrium (309 B.C.) more soldiers died of wounds than were killed in action. The worship of AEsculapius was begun by the Romans 291 B.C., and the Egyptian Isis and Serapis were also invoked for their healing powers.

At the time of the great plague in Rome (291 B.C.), ambassadors were sent to Epidaurus, in accordance with the advice of the Sibylline books, to seek aid from AEsculapius. They returned with a statue of the god, but as their boat passed up the Tiber a serpent which had lain concealed during the voyage glided from the boat, and landing on the bank was welcomed by the people in the belief that the god himself had come to their aid. The Temple of AEsculapius, which was built after this plague in 291 B.C., was situated on the island of the Tiber. Tradition states that, when the Tarquins were expelled, their crops were thrown into the river, and soil accumulated thereon until ultimately the island was formed. In consequence of the strange happening of the serpent landing from the ship the end of the island on which the Temple of AEsculapius stood was shaped into the form of the bow of a ship, and the serpent of AEsculapius was sculptured upon it in relief.

The island is not far from the AEmilian Bridge, of which one broken arch remains.

Ovid represents this divinity as speaking thus:--

"I come to leave my shrine; This serpent view, that with ambitious play My staff encircles, mark him every way; His form--though larger, nobler, I'll assume, And, changed as gods should be, bring aid to Rome."

(Ovid, "Metamorphoses," xv.)

He is said to have resumed his natural form on the island of the Tiber.

"And now no more the drooping city mourns; Joy is again restored and health returns."

It was the custom for patients to sleep under the portico of the Temple of AEsculapius, hoping that the god of the healing art might inspire them in dreams as to the system of cure they should adopt for their illnesses. Sick slaves were left there by their masters, but the number increased to such an extent that the Emperor Claudius put a stop to the cruel practice. The Church of St. Bartholomew now stands on the ruins of the Temple of AEsculapius.

Even in very early times, however, Rome was not without medical practitioners, though not so well supplied as some other nations. The Lex AEmilia, passed 433 B.C., ordained punishment for the doctor who neglected a sick slave. In Plutarch's "Life of Cato" (the Censor, who was born in 234 B.C.), we read of a Roman ambassador who was sent to the King of Bithynia, in Asia Minor, and who had his skull trepanned.

The first regular doctor in Rome was Archagathus, who began practice in the city 219 B.C., when the authorities received him favourably and bought a surgery for him; but his methods were rather violent, and he made much use of the knife and caustics, earning for himself the title of "butcher," and thus having fallen into disfavour, he was glad to depart from Rome. A College of AEsculapius and of Health was established 154 B.C., but this was not a teaching college in the present meaning of the term.

The doctors of Ancient Rome took no regular course of study, nor were any standards specified, but as a rule knowledge was acquired by pupilage to a practising physician, for which a honorarium was paid. Subsequently the Archiatri, after the manner of trade guilds, received apprentices, but Pliny had cause to complain of the system of medical education, or rather, to deplore the want of it. He wrote: "People believed in anyone who gave himself out for a doctor, even if the falsehood directly entailed the greatest danger. Unfortunately, there is no law which punishes doctors for ignorance, and no one takes revenge on a doctor if through his fault someone dies. It is permitted him by our danger to learn for the future, at our death to make experiments, and, without having to fear punishment, to set at naught the life of a human being."

Before the time when Greek doctors settled in Rome, medical treatment was mainly under the direct charge of the head of each household. The father of a family had great powers conferred upon him by the Roman law, and was physician as well as judge over his family. If he took his new-born infant in his arms he recognized him as his son, but otherwise the child had no claim upon him. He could inflict the most dire punishments on members of his household for which they had no redress.

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