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Roman History

Instruments

Thanks to archaeological digs at places such as Pompeii, Rome and even here at Hadrian's Wall, tools have been found that give an insight into Roman Surgery. We have a very strong understanding of their use in the Greco / Roman era. Among the items we know the Romans used were:

Roman Surgical Instruments
Roman Surgical Instruments
The vaginal speculum was used in gynaecology and in childbirth.
Tooth forceps
The saw for amputation.
Bone holders were used to put fractures back in place.
Scalpels
Scissors
Drills for Trepanning
Catheters (Metal)
Various Hooks, Holders, probes and scrapers

Despite the reliance on a mystical approach to healing, Roman society maintained reasonably good health throughout its history.
The exhaustive use of aqueducts and fresh running water, including toilets and sewer systems, prevented the proliferation of many standing water-based diseases, and also washed away wastes from heavily populated areas.
Excellent hygiene and food supply also played a prominent role.

The Roman baths were an integral part of society, in all social classes, and regular cleansing helped fight germs and bacteria. As I mentioned, the Romans also tried, whenever practical, to boil medical tools and prevent using them on more than one patient without cleansing.1

So, their Military history was to produce a nation of expansion and although they were concerned about the medical welfare of their population they were in the beginning, very dependent upon Greek and Egyptian expertise.
It was to Greece that the Romans first owed their knowledge of healing, and of art and science generally, but at no time did the Romans equal the Greeks in mental culture.
“Every citizen should be a soldier. This was the case with the Greeks and Romans and must be that of every free state.”2


Aulus Cornelius Celsus (ca 25 BC—ca 50)



Aurelius Celsus along with Galen is considered one of the most important contributors to medicine during the early Roman Empire He was neither a Physician nor surgeon;  he could probably be described as a medical data clerk.

Celsus
Celsus
His lifetime was under Emperors Tiberius and Caligula. He compiled an encyclopaedia entitled De Artibus (25-35 ad). The only surviving section was that of De Medicina , this collection of eight books is the most comprehensive library of medical histories of the times.
Because of its clarity and elegant Latinity, its author has been called the "Cicero of medicine".3

This book was about the surgical treatment for some internal and external diseases. These included cataract, goitre, and tonsillectomy.
This work became the first medical manuscript to be printed in 1478. In his writings, he also mentioned the use of mandrake as an anaesthetic.4
Not much is known of Celsus life and work apart from his books. He is believed to be a Roman citizen born in Gaul around 25B.C.
He was also one of the first to write about the Christian religion while many of the apostles and Paul were still alive. He was critical of a religion that had to rely on just faith.

The practise of any form of medicine or surgery was beneath the status of noble families, so it is suspected that is where he is from, as knowledge of medicine was usual among educated men, many of whom as head of the household practised medicine on ill family members, slaves, and livestock. Celsus could have been such a person. Never the less, he studied extensively and knew both Greek and Roman.
Celsus adhered to the teachings of Hippocrates, and there are some that believe a lot of his writings are derived from Hippocrates works. He also advocated the value of anatomical dissection, in general however this was prohibited by the Roman and Greek religions. It is believed he died in Rome at about 50 A.D.
Pliny the Elder and other great scholars of the first century-wrote with praise of Celsus, work which modern scholars called outstanding.

The Romans also discovered the signs and symptoms of inflammation. These were: Heat, Redness, Swelling, Pain and Loss of function.
This is one of their (the Christians) rules. "Let no man that is learned, wise, or prudent come among us: but if they be unlearned, or a child, or an idiot, let him freely come. So, they openly declare that none but the ignorant, and those devoid of understanding, slaves, women, and children, are fit disciples for the God they worship. Time is a violent torrent; no sooner is a thing brought to sight than it is swept by and another takes its place."5


Claudius Galenius (129-199)



The notable surgical contribution during the time of the great Roman Empire was made in the 2nd century AD; this was from a Greek born physician by the name of or Claudius Galenius, as the Romans named him.

Claudius Galenius
Claudius Galenius
Galen, his name means calm or peaceful was unusually, a monotheistic although not a Christian. The son of Aelius Nicon, a wealthy builder, Galen received a full education that prepared him for a successful career as a physician and philosopher.
He travelled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome, where he served prominent members of Roman society. There he healed Eudemus, a celebrated peripatetic philosopher, and other persons of distinction; and before long, by his learning and unparalleled success as a physician, earned for himself the titles of "Paradoxologus", the wonder-speaker, and "Paradoxopoeus", the wonder-worker, thereby incurring the jealousy and envy of his fellow practitioners.6
He was eventually given the position of personal physician to several of the Emperors.7

He first served as physician to the Gladiators and eventually to the Caesars, Marcus Aurelius (136-161) and Lucius Verus (161-180). Aurelius encouraged the buddy-buddy system where each soldier aided his comrade.

These were violent times in which there were many wars and a physician was worth his salt. Galen was the best that Rome had. It was Galen who firmly established that arteries contained blood, not air, as was presumed until that time, the common perception put forward by Aristotle although Herophilus had also made suggestions of this. He proved this by tying off two ends of an artery and then incising it.

Galen incredibly began writing at the age of 13 years and continued to do so until he died at the age of 70 years. His collection of writings overwhelmed the ancient world with its size, scope, and influence. Even if we were to eliminate the writings of the Corpus Hippocraticum, Galen’s prodigious output would still represent more than 80% of all surviving medical writings of antiquity.7
These books astonishingly remained unchallenged until the critical Renaissance period, this being mainly due to the restrictive influence of religion.

Galen was also one of a few physicians who gained notoriety as a surgeon, although he did little himself but supervised surgical “labourers”, it was a sad fact that Surgeons were not in ancient times, educated medical men, the result of this was the slow development and full understanding of the art.

In these early times Medical practices in general were not held in high esteem as is the case now, it is a fact that medical science progression required extensive anatomical research. The superstitious repugnance of the dissection of human remains to further anatomical knowledge, was frowned upon, mainly because of religious beliefs. This however did not mean it did not take place, as in Alexandria it was a regular occurrence.
It seems strange to us now, to imagine that anaesthetics and analgesics in obstetrics were opposed up to the middle of the last century (20th) in some parts of the world.

Marcus Aurelius a Roman Emperor at the time of Galen, uttered many quotes and in particular "Death is a release from the impressions of the senses, and from desires that make us their puppets, and from the vagaries of the mind, and from the hard service of the flesh." And also "A man's worth is no greater than his ambitions".62 It could be that Galen gave him the inspiration for some of them. Galen is reputedly to have said: “All who drink of this remedy recover in a short time except those whom it does not help” and also “Employment is Nature’s physician and is essential to human happiness.”
So here is the answer to a long life, keep working.
Galen, in his lifetime wrote many books on the study of anatomy.



Caesarean Section



'C' section has been part of human culture since ancient times, and there are tales in both Western and non-Western cultures of this procedure being performed on live mothers.

C Section
C Section
This however is hard to believe as the mother would surly bleed to death or die of infection or pain.
According to Greek mythology Apollo removed Aesculapius from his mother's womb via section.

Numerous references to caesarean section appear in ancient Hindu, Egyptian, Grecian, Roman, and other European folklore.

Ancient Chinese etchings depict the procedure on apparently living women.
The Mischnagoth and Talmud prohibited primogeniture when twins were born by caesarean section, and waived the purification rituals for women who delivered by this surgery.

The origin of the name is obscure but may derive from Roman law called Lex Regia from 715 BC (also called Lex Caesare or Caesarean Law), which states that if a woman with an advanced pregnancy died, the infant should be delivered soon after her death, i.e. the body could not be buried until the child had been removed.
The Christian church favoured the operation, being concerned with the saving of souls and lives. If the baby was alive, this operation would produce a living child able to be baptised. The term originates from the Latin “caesum” meaning having been cut, and the term “caesomes”, referring to the infants born by post-mortem operation.

It could not be performed in a living woman until the tenth month of gestation, as the mother would not survive the operation, and consequently it was rarely undertaken.8
It is also believed that caesarean law as it was known forbade the pregnant mother to be buried / cremated with the foetus in her womb.
It is not true however, that Julius Caesar was born by caesarean section, as there is evidence that his mother Aurelia was alive during his early years. Aurelia was still alive when he invaded Britain. She would have perished if they had sectioned her.9

"Veni, Vidi, Vici" the chant of the Romans "We came we saw we conquered" this was the famous saying of 55BC, when Julius Caesar's invasion of Britain was greeted in Rome as a triumph of the Roman military war machine. It was however in reality not really achieved it is true to say that the Danes, Norsemen and Vikings should have been credited with that saying and this all done 600 years later. He did not conquer Britannia. He led raids on the south-east coast in 55 and 54 BC and managed to gain some tribute in exchange for hostages.

claudius ceasar
Claudius Ceasar
In AD43, however, Claudius invaded Britain; each of his cohorts included a surgeon and a physician. It was as a direct result of the Roman occupation after the invasion that the first hospitals were set up in Britain, not hospitals, as we know them today, but a primitive type of nursing convalescent home. These were called Valetudinarians.7 It was here where the sick and wounded were conveyed after a battle. This was the major contribution to Medicine from Rome, the establishment of a form of hospital system. Each military camp had its own Valetudinarian to accommodate the sick and wounded. Today’s military would recognize this as a Medical Reception Station (MRS). After the Roman legions left Britain the Valetudinarians all but disappeared, only in Wales was there any resemblance to the Roman medical style facility, as there is a mention of the Medici attached to the Kings of Wales.

On Roman walls throughout Britain and the old Roman Empire, there are several mentions of Roman Surgeons; in Britain there is a special mention to one Ancius Ingenuus who was Medical Officer to the Tungrian Cohort.10

Rome remained an important and powerful nation long after the death of Christ, said to have been founded in 700 BC by Romulus and Remus, it was eventually destroyed as a world power when Alaric the Goth entered the city in 410 AD. Although the Eastern Roman Empire run from Constantinople (now Istanbul) carried on for several centuries, as a mighty empire it was finished.

"It is part of human nature to hate the man you have hurt."68

References:

1. http://www.unrv.com/culture/roman-medical-tools.php
2.Thomas Jefferson 3rd president of US (1743 - 1826)
3. http://www.answers.com/topic/celsus-aulus-cornelius
4. History of Spinal Surgery of the Ancient and Medieval World James Tait Goodrich, M.D., Ph.D
5. Marcus Aurelius 121 - 180 AD
6. http://russellmcneil.blogspot.com/2007/08/claudius-galen-c-130-bce-200bce.html
7. Gore The Story of our Services under the Crown Balliere Tindall & Cox (1879). P6
8. http://www.nlm.nih.gov/exhibition/cesarean/part1.html
9. http://www.turkishjournalpediatrics.org/?fullTextId=771&lang=eng
10. Gore The Story of our Services under the Crown Balliere Tindall & Cox (1879) p13
11. Tacitus c.56 - c.177 Ad


Ken True ODP
Author
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