Roman Medicine : Part 1

Outlines of Greek and Roman Medicine
by James Sands Elliott

(Page 5 of 15)

Roman Medicine at the End of the Republic and the Beginning of the Empire

Asclepiades of Prusa, in Bithynia, was a famous physician in Rome early in the first century before Christ. He studied both rhetoric and medicine at Alexandria and at Athens. He began as a teacher of rhetoric in Rome, but, although he was the friend of Cicero, he was not very successful, and abandoned this study for the practice of medicine. He had a great deal of ability and shrewdness, but no knowledge of anatomy or physiology, and he condemned all who thought that these subjects of study were the foundation of the healing art. He specially inveighed against Hippocrates, and with some reason, for the disciples of Hippocrates had elevated the teaching of their master almost into a religion, and were bound far too closely to his authority, to the exclusion of original thought and progress.

Asclepiades had many pupils, and his teaching led to the foundation of the Medical School of the Methodists. His most important maxim was that a cure should be effected "tuto, celeriter, ac jucunde," and he believed that what the physician could do was of primary importance, and vis medicatrix naturæ only secondary. He was thus directly opposed to the teaching of Hippocrates. He had little or no faith in drugs, and relied mainly upon diet, exercises and massage, and, to some extent, upon surgery. His practice of prescribing wine in liberal doses added to his popularity. It was the custom to take wine very much diluted with water, but Asclepiades ordered wine in full strength or only slightly diluted. He practised bronchotomy and tracheotomy, and recommended in suitable cases of dropsy scarification of the ankles, and advised that, in tapping, an opening as small as possible should be made.

He also observed spontaneous dislocation of the hip. He was a very famous man in the Roman Republic, and was well acquainted with philosophy, especially the philosophy of the Epicureans. Although he was almost entirely ignorant of anatomy, he was far from being a quack. He had great powers of observation and natural shrewdness, and his success largely contributed to the establishment of Greek doctors and their methods in Rome. There is grim humour in his description of the Hippocratic treatise on therapeutics, which he called "a meditation on death." Pliny relates that Asclepiades wagered that he would never die of disease, and he won the wager, for he lived to old age and died of an accident!

Themison, of Laodicea, lived in the first century before Christ, and was a pupil of Asclepiades of Prusa, the founder of the School of Methodism. His views on atoms and pores led him to adopt a very simple explanation of health and disease, for he considered that these pores must be either constricted or dilated, and the aim of the physician should be to dilate the constriction, and vice versa. This epitomized system of medicine did away with the use of many classes of drugs, and, from its simplicity, was quickly learned. A jeering opponent of the system of the Methodici said that it could be taught in six months, and Galen, in later years, ridiculed it, and called its practitioners "the asses of Thessaly."

The great fault of Dogmatism was its absolute reliance on the wisdom of Hippocrates, and Methodism was marred by its insufficiency and sophistry.

In spite of his extravagant theories, Themison possessed skill in practice. He was the first physician to describe rheumatism, and he also is thought to have been the pioneer in the medicinal use of leeches. A book on elephantiasis ascribed to him is not definitely known to be authentic. It is worthy of note that he was anxious to write on hydrophobia, but a case he had seen in early youth so impressed his mind with horror that the mere thought of the disease caused him to suffer some of the symptoms.

The views of the Methodists were less extreme than those of the Dogmatists and Empirics. Celsus wrote of the Methodists: "They assert that the knowledge of no cause whatever bears the least relation to the method of cure; and that it is sufficient to observe some general symptoms of distempers; and that there are three kinds of diseases, one bound, another loose, and the third is a mixture of these."

There were several physicians of the name of Themison at different times, and it is probably the founder of the Methodici who was satirized by Juvenal thus: -

"How many patients Themison dispatched
In one short autumn."

The joke which is based on attributing a cure to Nature alone, and death solely to the physician's want of skill, is one of the most time-honoured.

Themison lived at the close of the Roman Republic, and it will now be necessary to consider the state of the healing art in Rome under the rule of the emperors.

Julius Cæsar - one of the first triumvirate - invaded and conquered Gaul and Britain, and after these great military achievements, found that he could not sheath his sword until he had met in battle his rival Pompey. Cæsar defeated Pompey at Pharsalia, in Thessaly (48 B.C.), and pursued him to Egypt. Pompey was murdered in Egypt, and his last followers finally defeated in Spain, and in 45 B.C. Julius Cæsar returned to Rome, and was declared perpetual imperator. On March 15, 44 B.C., he was assassinated. It is possible that the career of this great man may have promoted the surgery of the battlefield, but his reign as Emperor was too short, and the political situation of his time too acute, to permit of much progress in the arts of peace generally, and in the medical art particularly. Julius Cæsar bestowed the right of Roman citizenship on all medical practitioners in the city.

Published in 1971 by Milford House Inc. Boston, MA.