Physicians are generally held in high esteem today, but first-century Romans viewed physicians with suspicion, even contempt, because many of them treated diseases they didn’t understand. The poet especially ridicules surgeons for their greed, their sexual advantage over their patients, and above all, their incompetence.
In his “Natural History,” Pliny the Elder, the admiral and scholar who died in AD 79 while trying to rescue desperate villagers fleeing the ruins of Mount Vesuvius, attempted to make public “on behalf of the Senate and the Romans” Against the medical man and 600 years of Rome. ’ Their charges were exorbitant, their remedies dubious, their quarrels intolerable. “The physicians risked our experience to gain experience, and by our death to carry out their experiments,” he wrote. The epitaph on more than one Roman tombstone read: “A bunch of doctors killed me. “
Medical treatments have improved since then—no more pounded snails, salted weasel meat, or the ashes of cremated dog heads—but surgical instruments have changed surprisingly little. Scalpels, needles, tweezers, probes, hooks, chisels and drills are as much a part of the standard medical tool kit today as they were in the days of the Roman Empire.
Archaeologists in Hungary recently unearthed a rare and puzzling set of such utensils. The items, found in a cemetery near Jászberény, about 35 miles from Budapest, were in two wooden boxes and included a pair of tweezers for tooth extraction; a curette for mixing, measuring and applying medicine, and three A copper alloy scalpel with a detachable steel blade and inlaid silver in Roman style. Next to it are the remains of a man, presumed to be a Roman citizen.
The seemingly 2,000-year-old site also unearthed a pestle, which may have been used to grind medicinal herbs, based on wear marks and medicinal residues. Most unusual are the bone lever, used to reset the fracture, and what appears to be a drill handle, used to drill into the skull and remove the affected weapon from the bone.
An instrument room for complex procedures offers a glimpse into the advanced medical practices of the Romans in the first century, and how far doctors might have traveled to provide medical care. “In ancient times, these tools were relatively complex tools made of the best materials,” said Tivadar Vida, director of the Institute of Archeology at Eötvös Loránd University in Budapest and leader of the excavations.
Two thousand years ago, Jászberény and its surrounding counties were part of Barbaricum, a vast area outside the empire’s borders that served as a buffer against possible external threats. “How could such a well-equipped man have died so far from Rome, in the middle of Barbaricum,” mused Leventu Samu, a researcher at ELTE and part of the excavation team. “Is he there to heal a local figure of repute, or is he accompanying the Roman legion on a military operation?”
Similar kits have been found throughout much of the empire; the largest and most diverse one was found in 1989 in the ruins of a 3rd-century doctor’s residence in Rimini, Italy. But the new find has been described as one of the most extensive known collections of first-century Roman medical instruments. So far, the oldest is thought to be a 1997 excavation of a cemetery in Colchester, England, and dates to around AD 70, early in the Roman occupation of Britain. The most famous set is from the so-called Surgeon’s House in Pompeii in the 1770s, which was buried under a layer of ash and pumice during the eruption of Mount Vesuvius.
Colin Webster, professor of classics at UC Davis and president of the Society for Ancient Medicine and Pharmacology, said the discovery illustrates the porous nature of cultural boundaries in the ancient world. “Medicine has long been one of the most active vehicles for cross-cultural communication,” he said. “And this discovery certainly helps to show physical evidence for these dynamics.”
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The Romans had high hopes for their medical experts. The first-century AD Roman encyclopedia writer Aulus Cornelius Celsus mused in his treatise “De Medicina,” or “On Medicine,” that “surgeons should be young, or at least closer to youth than age; to have strong and steady hands, never trembling, ready to use left and right hands; and sharp and clear eyes.” A surgeon should be fearless and compassionate, yet scream at the pain of his patients Indifference; his greatest wish should be the recovery of the sick.
Most of these brave Roman physicians were Greek, or at least Greek-speaking. Many were free men or even slaves, which may have contributed to their low social status. The man buried in the Hungarian cemetery was 50 or 60 when he died; whether he was actually a doctor is unclear, but he may not have been local, the researchers said.
“It was only possible to study medicine at the time in the large urban centers of the empire,” Dr Samu said. Doctors travel everywhere, and medical traditions vary from region to region. “Ancient medical writers, such as Galen, suggested that physicians should travel to learn about diseases that were common in certain areas,” said Patty Baker, former head of the Department of Archeology and Classics at the University of Kent in the United Kingdom.
Prospective surgeons were encouraged to apprentice with recognized physicians, to study in large libraries, and to attend lectures in far-flung places such as Athens and Alexandria, the centers of anatomical learning. To gain first-hand experience treating battle wounds, medics often interned in armies and gladiator schools, which may explain the existence of barbarian medical tools.
“There were no licensing boards and no formal barriers to entry into the profession,” says Lawrence Bliquez, an archaeologist emeritus at the University of Washington. “Anyone can call themselves a doctor.” If his method is successful, He’ll attract more patients; if not, he finds another career.
Surgery includes many procedures performed at body orifices to treat polyps, inflamed tonsils, hemorrhoids, and fistulas. In addition to trepanation, more radical surgeries include mastectomy, amputation, hernia reduction, and cataract surgery. “Surgery is a male domain,” Dr. Blix said. “But there are definitely a lot of women midwives, so who’s to say they don’t know anything about surgery, especially related to gynecology.”
Contrary to myth, caesarean sections did not enter the realm of medicine until long after the birth of Julius Caesar in 100 BC. However, the Romans did perform embryotomy, a surgical canal in which limbs were severed with a knife at birth. “Once the limbs, torso and head are cut, a hook is used to pull them out of the birth canal,” Dr. Baker said. “This was a horrific procedure used to save the mother’s life.”
Surgery is often the last resort of all medical treatments. “Any tool found in a Barbaricum grave could have resulted in death,” Dr. Baker said. “No knowledge of sterilization or germ theory. Patient likely died of sepsis and shock.”
The tool-laden tomb was discovered last year at a site where remains of the Bronze Age (4500-3500 BC) and Avarian (560-790 AD) periods have been found on the surface. Subsequent surveys using magnetometers identified the burial site of the Avars, a nomadic people of the Huns who succeeded Attila. Amid rows of graves, researchers dug up the man’s grave, revealing a skull, leg bones, and, at the foot of the body, a metal instrument case. “It may be a sign of respect that the deceased is buried with his equipment,” Dr Samu said.
This is not the only possibility. Dr Baker said she often cautions her students against interpreting ancient artifacts and asks them to consider alternative interpretations. What if, she suggested, what if the medical tools were buried with the so-called doctor because his practice was so bad that his family and friends wanted to get rid of everything connected with his terrible medical skills? “It was a joke,” Dr. Baker said. “But it’s designed to get students thinking about how we can draw quick conclusions about the objects we find in burials.”