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Roman Medicine At The End Of The Republic And The Beginning Of The
The Later Roman And Byzantine Period
In The Reign Of The Caesars To The Death Of Nero
Augustus--His illnesses--Antonius Musa--Maecenas--Tiberius--
poisoners--Oculists in Rome.
Long before the settlement of the constitutional status of Augustus in
27 B.C., he had undertaken many reforms. In 34 B.C., Agrippa, under the
influence of Augustus, had improved the water supply of Rome by
restoring the Aqua Marcia, and Augustus had repaired and enlarged the
cloacae, and repaired the principal streets. Road commissions were
appointed 27 B.C. The Aqua Virgo was built 19 B.C. Many of the
collegia, or guilds, founded for the promotion of the interests of
professions and trades had been misused for political purposes, and
Augustus deprived many of them of their charters. Curae, or
commissions, were appointed to superintend public works, streets and the
water-supply; and the Tiber was dredged, cleansed and widened, and its
liability to overflow reduced. No new building could be built more than
70 ft. high. Augustus also established fire brigades. It has been said
that he found the city built of brick and left it built of marble.
He revived many old religious customs, such as the Augury of Public
Health, and identified himself closely with the rites and customs of the
people. He inculcated that sense of duty which the Romans called
pietas, and attempted to improve the morals of the citizens by the
enactment of sumptuary laws; the philosophers hoped to do good in the
same direction by appealing to the intellect and reason, a method that
was equally ineffectual. Marriages and an increased birth-rate were
encouraged, and parents were honoured and given special privileges. The
wisdom and prudence of Augustus were strangely accompanied by credulity
and superstition. He was a profound believer in omens, and attached
great importance to astrology. His horoscope showed that he was born
under the sign of Capricorn.
He suffered from various illnesses, although in his younger days he
looked handsome and athletic. He carefully nursed his health against his
many infirmities, avoiding chiefly the free use of the bath; but he was
often rubbed with oil, and sweated in a stove, after which he was bathed
in tepid water, warmed either by a fire, or by being exposed to the heat
of the sun. When, on account of his nerves, he was obliged to have
recourse to sea-water, or the waters of Albula, he was contented with
sitting over a wooden tub, (which he called by a Spanish name,
Dureta), and plunging his hands and feet in the water by turns.
His physician was Antonius Musa, to whom was erected, by public
subscription, a statue near that of AEsculapius. During an attack of
congestion of the liver when heat failed to give relief, Antonius Musa
advised cold applications for the Emperor, which had the desired effect.
Suetonius, the historian, wrote that this was "a desperate and doubtful
method of cure." A more desperate and doubtful method of cure, however,
was carried out by the same physician. He successfully banished an
attack of sciatica that greatly troubled Augustus by the expedient of
beating the affected part with a stick. Antonius Musa received honours
from Augustus, and the Emperor also exempted all physicians from the
payment of taxes, and from other public obligations.
In the time of Augustus natural philosophy made little progress, and
Virgil strongly desired its advancement. Human anatomy, as a study, had
not been introduced, and physiology was almost unknown. In medicine, the
standard of practice was the writings of Hippocrates, and the Materia
Medica consisted of remedies suggested by the whimsical notions of their
Pliny wrote that the water cure was the principal remedy in his day, as
it was indeed throughout the Empire, and it was certainly the most
popular. Seneca was very severe on the sentiment of a poem written by
Maecenas, the friend and counsellor of Augustus, but it serves to reveal
some of the most dreaded maladies of the time:--
"Though racked with gout in hand and foot,
Though cancer deep should strike its root,
Though palsy shake my feeble thighs,
Though hideous lump on shoulder rise,
From flaccid gum teeth drop away;
Yet all is well if life but stay."
Malaria was one of the principal causes of mortality in and near Rome in
the reign of Augustus Caesar.
Augustus's fatal illness occurred in A.D. 14 from chronic diarrhoea, and
the Emperor, like the true Roman that he was, displayed great calmness
and fortitude in his last days.
Tiberius succeeded to the throne in A.D. 14, and began a career of
infamy. How little knowledge was likely to gain from his patronage is
shown by the fact, recorded by Pliny, that the shop and tools of the
artist who discovered how to make glass malleable were destroyed.
Assassins and perpetrators of every abomination were the fit companions
of this tyrant.
Thrasyllus, the astrologer, lived with Tiberius, who was a firm believer
in the magic arts. This reign is made illustrious in the history of
medicine by the work of Celsus.
Caligula, who became Emperor in A.D. 34, was guilty of the most inhuman
conduct. Criminals were given to the wild beasts for their food, and
even people of honourable rank had their faces branded with hot irons as
a punishment by order of this mad tyrant.
Claudius, the successor of Caligula, completed some very important
public works in his reign, including great aqueducts and drains, but
learning was at a low ebb in his day. Claudius Etruscus, the freedman of
the Emperor Claudius, erected baths referred to by Martial. The ruins of
the arches of the Aqua Claudia still remain.
Thrasyllus, a son of the astrologer who lived in the time of Tiberius,
is said to have predicted to Nero the dignity of the purple. Nero would
have been favourably disposed towards physicians if he had heeded the
advice of his tutor, Seneca, who wrote: "People pay the doctor for his
trouble; for his kindness they still remain in his debt." "Great
reverence and love is due to both the teacher and the doctor. We have
received from them priceless benefits; from the doctor, health and life;
from the teacher, the noble culture of the soul. Both are our friends,
and deserve our most sincere thanks, not so much by their merchantable
art, as by their frank goodwill." The practice of necromancy in the
time of Nero had grown to such an extent that an edict of banishment
was issued against all magicians, but this did not lessen the popularity
of the magicians, who indeed prospered under the semblance of
persecution, and were honoured in times of public difficulty and danger.
The practice of astrology came from the Chaldeans, and was introduced
into Greece in the third century before Christ. It was accepted by all
classes, but specially by the Stoic philosophers. In 319 B.C., Cornelius
Hispallus banished the Chaldeans from Rome, and ordered them to leave
Italy within ten days. In 33 B.C., they were again banished by Marcus
Agrippa, and Augustus also issued an edict against them. They were
punished sometimes by death, and their calling must have been lucrative
to induce them to continue in spite of the severe punishments to which
they made themselves liable. The penal laws against them, however, were
in operation only intermittently. They were consulted by all classes,
from the Emperor downwards.
There were many physicians in the reign of Nero, but none of great
eminence. Andromachus was physician to the Emperor, and had the title of
archiater, which means "chief of the physicians."
An account of the archiaters is of interest. The name was applied to
Christ by St. Jerome. There were two classes of archiaters in time, the
one class called archiatri sancti palati; the other, archiatri
populares. The former attended the Emperor, and were court physicians;
the latter attended the people. Although Nero appointed the first
archiater, the name is not commonly used in Latin until the time of
Constantine, and the division into two classes probably dates from about
that time. The archiatri sancti palati were of high rank, and were the
judges of disputes between physicians. The Archiatri had many privileges
conferred upon them. They, and their wives and children, did not have to
pay taxes. They were not obliged to give lodgings to soldiers in the
provinces, and they could not be put in prison. These privileges applied
more especially to the higher class. When an archiater sancti palati
ceased attendance on the Emperor he took the title of ex-archiater. The
title comes archiatorum means "count of the Archiatri," and gave rank
among the high nobility of the Empire.
The archiatri populares attended the sick poor, and each city had
five, seven or ten, according to its size. Rome had fourteen of these
officers, besides one for the vestal virgins, and one for the gymnasia.
They were paid by the Government for attending the poor, but were not
restricted to this class of practice, and were well paid by their
prosperous patients. Their office was more lucrative but not so
honourable as that of the archiaters of the palace. The archiatri
populares were elected by the people themselves.
Suetonius describes the treatment Nero underwent for the improvement of
his voice: "He would lie upon his back with a sheet of lead upon his
breast, clear his stomach and bowels by vomits and clysters, and forbear
the eating of fruits, or food prejudicial to his voice." He built, at
great expense, magnificent public baths supplied from the sea and from
hot springs, and was the first to build a public gymnasium in Rome.
There is reason to believe that in the time of Nero there was a class of
women poisoners. Nero employed one of these women, Locusta by name, and
after she had poisoned Britannicus, rewarded her with a great estate in
land, and placed disciples with her to be instructed in her nefarious
There was also a very ignorant class of oculists in Rome in the time of
Nero, but at Marseilles Demosthenes Philalethes was deservedly
celebrated, and his book on diseases of the eye was in use for several
centuries. The eye doctors of Rome employed ointments almost entirely,
and about two hundred seals have been discovered which had been attached
to pots of eye salves, each seal bearing the inventor's and proprietor's
name. In the time of Galen, these quack oculists were very numerous, and
Galen inveighs against them. Martial satirized them: "Now you are a
gladiator who once were an ophthalmist; you did as a doctor what you do
as a gladiator." "The blear-eyed Hylas would have paid you sixpence, O
Quintus; one eye is gone, he will still pay threepence; make haste and
take it, brief is your chance; when he is blind, he will pay you
nothing." The oculists of Alexandria were very proficient, and some of
their followers, at various times throughout the period of the Roman
Empire, were remarkably skilful. Their literature has perished, but it
is believed that they were able to operate on cataract.
With the death of Nero in A.D. 68, the direct line of the Caesars became
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