<<Coniecturalem artem esse medicinam>>
<<Medicine is the art of divination>>
In its beginnings as a civilization Roman medicine resembled more a set of magical rites than a science proper.
Originally it was based on the use of medicinal plants and ointments, whose knowledge and applications were generally in the hands of the pater familias. It was also usual the use of incubatio, ritual imported from Greece by which after spending the night in a temple, sometimes on the skin of a sacrificed animal, the god in turn guided the patient through a state of consciousness located between the vigil and the dream with the steps to follow to heal. In practice, a Roman of this period was fortunate if a good barber was in charge of his treatment.
Among the several hundred cataloged plants that were used, mandrake juice and atropine were very famous as anesthetics, as well as henbane as a sedative or hypnotic, and the centaury as a cicatrizant.
The most famous potion in Rome, of which the state itself was responsible for its import, was the laserpicum. It was considered suitable to treat any disease.
In the monarchical period, the Etruscan influences were also important in the field of medicine, although in the only thing that rose above other cultures was in dentistry, whose mastery would inherit and magnify the Romans over the centuries.
True medicine was introduced in the imperial era, being this an extension of the Greek. Hippocrates (460 BC-370 BC) is considered the founding father of ancient medicine and developed the theory of the “four liquid humors”, practicing medicine in the so-called Pericles century. Another concept contributed by this great doctor was the concept of “crisis”, moment in which the patient either worsened and died, or recovered and healed.
The most important doctor of the Empire was also born in Greece and was a follower and admirer of Hippocrates, whom he considered the perfect doctor. We speak of Claudius Galen (129 AD-199 AD), who began his brilliant career in the school of gladiators, where he obtained fame and prestige enough to become the personal physician of Emperor Marcus Aurelius. He wrote a famous book: “Ars Medica”, which was valid for many centuries, and although it contained some errors due in part to the fact that in his time human autopsies were forbidden and he had to settle for experimenting with animals, he also had great successes, like proving that it was blood and not air circulating in the arteries, or that it was the heart that pumped it.
Another important figure was the Gallic Aulus Cornelius Celsus (25 BC-50 AD), more scholar than doctor, who bequeathed us the “De Re Medica Libri Octo“, another reference manual during the Middle Ages, where he compiled the Alexandrian medical knowledge.
In many respects the Romans were pioneers and precursors, e.g. they developed an organization by specialties similar to the current one: medici (for general medicine), chirurgi (for surgery), medici ab oculis (oculists), and also other specialists of the ear, dentists, etc. They were also precursors of public health, creating the first hospital for the poor on the Tiber Island, a public medical system with archiatri doctors who cared for the citizens of the entrusted districts.
The state promoted this system in different ways: on the one hand, its members were exempted from military service, and on the other, the visionary Julius Caesar gave Roman citizenship to doctors who did not have it. It is in times of this brilliant general when the first mentions to military doctors arise, showing interest in the health of those soldiers who covered him with glory, and who until then had to heal by themselves (they used their own plants, their bandages, etc.). With the Emperor Augustus, a military medical system is established with care for all soldiers. Such was the importance given to them, that it is worth mentioning that a chief physician possessed the rank of a centurion.
It is considered that the Romans were not very bright in the therapeutic branch, but they were in surgery, which probably developed in military campaigns. In what they were very successful was in seeing the importance of hygiene and to this end they devoted many resources and also legislated (preventive measures that made healing less necessary):
-In the year 450 BC the Senate issued an edict prohibiting the burial of dead within the walls, thus preventing diseases and epidemics.
-Other edict promoted cleanliness, and the construction of aqueducts and sewers was promoted. Until the modern world no civilization was able to carry out these works with the mastery that the Romans showed.
As a result of these measures, over time there was a population explosion.
-The practice and teaching of medicine was meticulously legislated.
-The valetudinaria, military hospitals, were developed as well organized as if they were a military camp.
Another renowned physician was Asclepiades of Bithynia (124 or 129 BC-40 BC), who founded the methodical school based on the works and ideas of Democritus, and opposed the Hippocratic theories of the four liquid humors. Their approaches based on the invisible particles, the atoms, that cross the pores of the skin are considered precursors of the microbial theory. He also recommended the moderate use of wine.
At the time when Christianity was dominant, the pneumatic school was developed, founded in Sicily by Athenaeus of Attalia in the 1st century AD in which the center of his theories was the pneuma or air spirit (gas).
Another personality was Pedanius Dioscorides (40 AD-90 AD), military doctor in the time of Nero, who wrote a pharmacology manual that lasted until the fifteenth century: “De materia medica“, which are cataloged among many other things, more than six hundred plants of curative uses.
Areteus of Cappadocia (1st century AD) was also renowned, of which we have little information, but it is supposed that he should be educated in Alexandria, because autopsies were allowed there and he possessed a very advanced knowledge of visceral anatomy. A follower to a large extent of the Hippocratic theories and revisionist critic of the work of Galen, he published one of the best clinical manuals of antiquity: “De causis et signis morborum” detailing and describing symptoms and methods of diagnosis for many diseases.
Author: Eduardo Ortiz Pardina