The Romans encouraged the provision of public health facilities throughout the Empire. Their medicine developed from the needs of the battlefield and learnings from the Greeks.
Among the practices that the Romans adopted from the Greeks was the theory of the four humors, which remained popular in Europe until the 17th century.
The temple of Aesculapius stood on the Tiber Island. The original is now long gone, but this Renaissance-era replica may bear some resemblance to it.
The Romans had their first introduction to Greek medicine when Archagathus of Sparta, a medical practitioner, arrived in Rome in 219 B.C.E.
Other scientists and doctors came from Greece, first as prisoners of war and later because they could earn more money in Rome. They continued researching Greek theories on disease and physical and mental disorders.
The Romans allowed them to carry on their research and adopted many of their ideas. However, unlike the Greeks, the Romans did not like the idea of dissecting corpses, so they did not discover much about human anatomy.
The spiritual beliefs surrounding medicine in Greece were also common in Rome.
By the 3rd century B.C.E., the Romans had adopted a religious healing system called the cult of Aesculapius, which took its name from a Greek god of healing. Initially, they built shrines, but these expanded in time to include spas and thermal baths with doctors in attendance.
When plagues occurred in Italy in 431 B.C.E, the Romans built a temple to the Greek god Apollo, who they believed had healing powers.
The Romans also took a sacred snake from the Greeks. It escaped but reappeared on the Tiber Island, where the Romans built a sanctuary for it. People would come to this place in search of healing.
On conquering Alexandria, the Romans found various libraries and universities that the Greeks had set up. They contained many learning centers and places for research as well as a wealth of documented knowledge of medicine.
Examples of medical practice
It was by observing the health of their soldiers that Roman leaders began to realize the importance of public health.
On the battlefield
Romans on the battlefield used surgical tools to remove arrowheads and carry out other procedures.
Most Roman surgeons got their practical experience on the battlefield. They carried a tool kit containing arrow extractors, catheters, scalpels, and forceps. They used to sterilize their equipment in boiling water before using it.
The Romans performed surgical procedures using opium and scopolamine to relieve pain and acid vinegar to clean up wounds.
They did not have effective anesthetics for complicated surgical procedures, but it is unlikely that they operated deep inside the body.
The Romans also had midwives, whom they treated with great respect. Records of medical instruments include a birthing stool, which was a four-legged stool with arm and back supports and a crescent-shaped opening for the delivery of the baby.
Cesarean sections did sometimes take place. The women would not survive, but the baby might.
In purpose-built hospitals, people could rest and have a better chance of recovery. In the hospital setting, doctors were able to observe people's condition instead of depending on supernatural forces to perform miracles.
Learning about the human body
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. In this way, they learned more about the human body.
Claudius Galen, who moved from Greece to Rome in 162 C.E., became an expert on anatomy by dissecting animals and applying his knowledge to humans.
He was a popular lecturer and a well-known doctor, eventually becoming Emperor Marcus Aurelius' physician. He also wrote several medical books.
Galen also dissected some human corpses. He dissected a hanged criminal and some bodies that a flood had unearthed in a cemetery.
As a result, Galen displayed an excellent knowledge of bone structure. After cutting the spinal cord of a pig and observing it, he also realized that the brain sends signals to control the muscles.
Learning about causes
The Romans made progress in their knowledge of what causes diseases and how to prevent them. Medical theories were sometimes very close to what we know today.
For example, Marcus Terentius Varro (116–27 B.C.E) 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.
Lucius Junius Moderatus Columella, who lived from 4 C.E. to around 70 C.E., was an agricultural writer. He thought that diseases came from swamp vapors.
Until two centuries ago, many of these beliefs were still popular.
Diagnosis and treatment
Roman diagnosis and treatment consisted of a combination of Greek medicine and some local practices.
As the Greeks did before them, Roman physicians would carry out a thorough physical examination of the individual.
Progress in diagnosis, treatment, and prognosis in ancient Rome was slow and patchy. Doctors tended to develop their own theories, which led them to diverge in several different directions.
The Romans used a wide range of herbal medicines and other remedies, including:
Fennel was a healing herb in Roman times.
Fennel: This plant was a standard treatment for nervous disorders because Romans believed that it calmed the nerves.
Unwashed wool: The Romans applied this to sores.
Elecampane: Also known as horseheal, people used this herb for digestive problems.
Egg yolk: Doctors prescribed egg yolk for dysentery.
Sage: This perennial had religious value. Its use was common among those who believed that the gods could heal them.
Garlic: Doctors advised that garlic was good for the heart.
Boiled liver: People with sore eyes used this.
Fenugreek: Doctors often prescribed this plant for lung diseases, especially pneumonia.
Silphium: People used this as a form of contraceptive and for fever, cough, indigestion, a sore throat, aches and pains, and warts. Historians are not sure exactly what silphium was, but they believe it to be an extinct plant of the genus Ferula, possibly a variety of giant fennel.
Willow: People used this as an antiseptic.
Pedanius Dioscorides lived around 40–90 C.E. He was a Greek botanist, pharmacologist, and physician who practiced in Rome when Nero was the ruler.
He became a famous Roman army doctor.
He wrote a 5-volume pharmacopeia called "De Materia Medica," which listed over 600 herbal cures. Doctors used "De Materia Medica" extensively for the next 1,500 years.
Many Roman doctors came from Greece. They firmly believed in achieving the right balance of the four humors and restoring the "natural heat" of people with medical conditions.
Galen 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.
Public health aims to keep the whole community in good health and prevent the spread of disease.
Today, among other things, it involves vaccination programs, promoting a healthful lifestyle and diet, building hospitals, and providing clean water for drinking and washing.
The Romans, unlike the Greeks and Egyptians, were firm believers in public health. They knew that hygiene was vital to prevent the spread of diseases.
Practical projects, such as creating a water supply, were very important to them. They built aqueducts to pipe water to cites. The sewage system in Rome was so advanced that nothing matching it was built again until the late 17th century.
One explanation of how the Romans were able to organize such major public projects is that they had a vast but centralized empire. The Emperor wielded his power across the Roman territory, and there was enough cheap labor and sufficient wealth to carry out these schemes.
Some of the wealthy even had underfloor heating in their homes.
The Romans also promoted facilities for personal hygiene by building public baths and washrooms. Their focus was on maintaining a motivated and healthy army, but their citizens also benefited.
Public health facilities
The Romans built baths, hospitals, and water supply channels throughout their Empire to encourage public health.
Examples of some Roman facilities include:
Public baths: There were nine public baths in Rome alone. Each one had pools at varying temperatures. Some also had gyms and massage rooms. Government inspectors were vigorous in their enforcement of proper hygiene standards.
Hospitals: Ancient Romans were responsible for setting up the first hospitals, which they initially designed to treat soldiers and veterans.
Water supply: The Romans were superb engineers, and they built several aqueducts throughout their Empire to supply people with water.
Planning: The Romans were careful to place army barracks well away from swamps. If marshes got in the way, they would drain them. They were aware of the link between swamps and mosquitoes and understood that these insects could transmit diseases to humans.
The Romans learned about medicine from the Greeks and Egyptians, and they made their own contribution to the discipline by focusing on public health and disease prevention.
However, they did not make significant progress in understanding how the human body works, and they were not yet aware of the association of germs with disease.
After the fall of the Roman Empire, medical knowledge in Europe did not make significant progress again until the Renaissance period.