Ancient Everyday: Medicus! – Physicians in the Roman Empire

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Going to the doctor’s office is never something one looks forward to.

For most, myself included, it gets the heart rate and stress levels up to step into a building that’s full of ‘sick people’.

Sitting around in a waiting room with a group of scared, nervous, fidgety folks, is enough to drive you mad, and the sight of a white coat and stethoscope makes one want to run screaming from the building.

It was probably the same for our ancient Greek and Roman ancestors. Most civilians would have been loath to visit with a physician. It might not have been someone you wanted around, unless absolutely necessary.

‘Oh dear. That cough doesn’t sound good, my dear Septimius!’

Not so for the soldiers in the field.

I’m not an expert in ancient medical history, but I do know that the level of injury on an ancient battlefield would have been staggering. The sight or sound of your unit’s medicus would have been something sent from the gods themselves.

Imagine a clash of armies – thousands of men wielding swords, spears and daggers at close quarters. Then lob some volleys of arrows into the chaos. Perhaps a charge of heavy cavalry? How about heavy artillery bolts or boulders slamming into massed ranks of men?

Ancient surgical instruments, including forceps

Ancient surgical instruments, including forceps

It would have been one big, bloody, savage mess.

Apart from the usual cuts, slashes, and puncture wounds, the warriors would have suffered shattered bones, fractured skulls, lost limbs, severed arteries, sword, spear and arrow shafts that pushed through armour on into organs.

If you weren’t dead right away, you most likely would have been a short time later.

This is where the ancient field medic could have made the difference for an army. He would have been going through numerous patients in a short period of time. He would have had to decide who was a lost cause, who could no longer fight, and who could be patched up before being sent back out onto the field of slaughter.

The medicus of a Roman legion was an unsung hero whose skill was a product of accumulated centuries of knowledge, study, and experience.

Asklepios and Igia

Asklepios and Igia

Many of the physicians in the Roman Empire were Greek, and that’s because Greece was where western medicine was born. Indeed, the ancient Greeks had patron gods of health and healing in the form of Asklepios, Igeia, and sometimes Apollo.

Artist rendering of the Asklepion of Kos

Artist rendering of the Asklepion of Kos

The greatest medical school of the ancient world was in fact on the Aegean island of Cos, where students came from all over the Mediterranean world to learn at the great Asklepion. Hippocrates himself, the 5th century B.C. ‘father of medicine’, was from Cos and said to be a descendant of the god Asklepios himself.

When it comes to Roman medicine, much of it is owed to what discoveries and theories the Greeks had developed before, but with a definite Roman twist.

Hippocrates

Hippocrates

The fusion of Greek and Roman medicine in the Empire consisted of two parts: the scientific, and the religious/magical.

The more scientific thinking behind ancient medical practices is a legacy owed to the Greeks, who separated scientific learning from religion. The religious aspects of medicine in the Roman Empire were a Roman introduction.

Because of this fusion of ideas and beliefs, you could sometimes end up with an odd assortment of treatments being prescribed.

‘To alleviate your hypertension over your new business venture, you should take three drops of this tincture before you sleep. You should also sacrifice a white goat to Janus as soon as possible.’

Many Roman deities had some form of healing power so it depended on one’s patron gods, and the nature of the problem, as to which god would receive prayers or votive offerings over another. Amulets and other magical incantations would have been employed as well.

Roman surgical instruments

Roman surgical instruments

Romans had a god for everything, and soldiers were especially superstitious.

Greek medical thought rejected the idea of divine intervention, opting more for practicality in the treatment of wounds, and injuries; cleaning and bandaging wounds would have been more logical than putting another talisman about the neck.

All the gods were to be honoured, but in the Greek physician’s mind they had much better things to look after than the stab wound a man received in a Suburan tavern brawl.

Roman Legionaries (illustrated by Peter Dennis)

Roman Legionaries (illustrated by Peter Dennis)

For the battlefield medicus, things must have been much simpler than for the physician who was trying to diagnose mysterious ailments. They were faced mostly with physical wounds and employed all manner of surgical instruments such as probes, hooks, forceps, needles and scalpels.

Removing a barbed arrowhead from a warrior’s thigh must have required a little digging.

Of course, in the Roman world, there was no anaesthetic, so successful surgeons would have had to have been not only dexterous and accurate, but also very fast and strong. Luckily, sedatives such as opium and henbane would have helped.

Medic helping a warrior tend a wound

Medic helping a warrior tend a wound

When it came to the treatment of wounds, a medicus would have used wine, vinegar, pitch, and turpentine as antiseptics. However, infection and gangrene would have meant amputation. The latter was probably terrifyingly frequent for soldiers, many of whom would end up begging on the streets of Rome.

It is interesting to note that medicine was one of the few professions that were open to women in the Roman Empire. Female doctors, or medicae, would also have been mainly of Greek origin, and either working with male doctors, or as midwives specializing in childbirth and women’s diseases and disorders. When it came to the army however, most doctors would have been male.

Roman shears

Roman shears

Army surgeons played a key role in spreading and improving Roman medical practice, especially in the treatment of wounds and other injuries. They also helped to gather new treatments from all over the Empire, and disseminated medical knowledge wherever the Legions marched. Many of the herbs and drugs that were used in the Empire were acquired by medics who were on campaign in foreign lands.

Early on, physicians did not enjoy high status. There was no standardized training and many were Greek slaves or freedmen. This began to improve, however, when in 46 B.C. Julius Caesar granted citizenship to all those doctors who were working in the city of Rome.

This last point really hits home when it has become common knowledge that foreign doctors who come to our own countries today find themselves driving taxis or buses because they are not allowed to practice.

Modern governments, take your cue from Caesar!

Galen

Galen

One of the most famous physicians of the Roman Empire is Galen of Pergamon (A.D. 129-c.199). Galen was a Greek physician and writer who was educated at the sanctuary of Asklepios at Pergamon in Asia Minor.

After working in various cities around the Empire, Galen returned to his home town to become the doctor at the local ludus, or gladiatorial school. He grew tired of that work and moved to Rome in A.D. 162 where he gained a reputation among the elite. He subsequently became the personal physician of the Emperors Marcus Aurelius, Commodus, and for a short time, Septimius Severus.

Galen’s work and writings provided the basis of medical teaching and practice on into the seventeenth century. No doubt many an army medicus referred to Galen’s work at one point or another.

Galen is also an important character in A Dragon among the Eagles, the FREE prequel in the Eagles and Dragon series. In the book, Galen, an old friend and colleague of Lucius Metellus’ late tutor, presents Lucius with a choice that could well change the direction of Lucius’ life. In fact and fiction, Galen is a fascinating person of history.

Re-created ancient surgical instruments

Re-created ancient surgical instruments

I’ve but barely scratched the vast surface of this topic.

For some, there is this assumption that ancient medicine was somehow false, crude and barbaric. But modern western medicine owes much to the Greeks and Romans, civilian and military, who travelled the Empire caring for their troops and gathering what knowledge and knowhow they could.

The fusion of science, religious practice, and magic provides for a fascinating mix. In truth, medical practices in medieval Europe might have been more barbaric than in the ancient world.

Thank you for reading, and may Asklepios, Igeia and Apollo grant you good health!

12th century mural of Galen and Hippocrates in conversation

12th century mural of Galen and Hippocrates in conversation

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Ancient Everyday – Childbirth in the Ancient World

Goddess Tellus on Ara Pacis

It’s been a while since I last posted in the Ancient Everyday series.

Last year we looked at the ritual of going to the public baths, the interesting experience of using a public toilet, and the use of mirrors in the ancient world.

Today, we’re going to take a very brief look at childbirth in ancient Egypt, Greece, and Rome.

Now, as a man, my input and views on childbirth are somewhat limited, so I would invite my female readers out there to jump in with their comments at any time. I’m a father, and I’ve been present at the birth of my own children, but I would never presume to fully comprehend mysteries, and agonies, that women go through when it comes to bringing a tiny human into the world.

ancient baby

Let’s face it, we’re extremely lucky today as far as obstetrics and the technologies we have to help mothers and children safely navigate the process of pregnancy and birth.

That was not the case in the ancient world. Pregnancy and birth were risky affairs, and as with many aspects of life, the ancients called on specific gods and goddesses for help when it came to childbearing and birth.

Egyptian God, Bes

Egyptian God, Bes

The Egyptians offered prayers to the god Bes, a god of marriage and jollity, but also a protector of women and children in childbirth. Bes was not your typical Egyptian god. He is portrayed as an ugly dwarf with a feather crown, sometimes holding a tambourine.

His consort, Tauert, was also prayed to as someone who assisted all females, regardless of station, in childbirth. Tauert was portrayed as a pregnant, female hippopotamus.

In ancient Greece the goddess two whom prayers and offerings were made was Artemis, under her two epithets Kourotrophos (nurse) and Locheia (helper in childbirth).

Now it might seem odd that people prayed to the virgin goddess for protection in childbirth, but in myth, Artemis was said to have been present when Leto, her mother, gave birth to Apollo on Delos. She was considered, in some ways, the first midwife.

Artemis

Artemis

It is interesting to note ancient Greeks believed that women who died suddenly in childbirth were helped to a painless death by Artemis who showed them mercy by piercing them with one of her arrows.

The ancient Greeks also prayed to Hecate as a goddess of women and nurturer of children, as well as Hera, the Queen of the Gods who sometimes served as a goddess of childbirth in her capacity as goddess of marriage.

Roman Goddess, Juno - Queen of the Gods

Roman Goddess, Juno – Queen of the Gods

The Romans had many gods and goddesses to whom they prayed for help, and Juno, Queen of the Gods, was first and foremost under the epithets of Lucina, and Opigena.

Another goddess with a major role to play was Carmentis, a water goddess who was also a prophetic goddess of protection in childbirth. Carmentis had her own festival, the Carmentalia, and a temple on the Capitoline Hill.

A third goddess whom the Romans prayed to for a safe and successful childbirth was Matuta, the goddess of dawn and young growth.

It must have been a comfort to have so many gods to pray to, but that may also be indicative of the high risks involved.

Ancient Coin with image of Silphium plant on one side, and heart-shaped Silphium seed on the other

Ancient Coin with image of Silphium plant on one side, and heart-shaped Silphium seed on the other

Because it was so dangerous to bring a child into the world, and because families could not always afford to feed or provide dowries for all their children, contraception was something that was used in ancient Egypt, Greece, and Rome.

Most of the methods used seem to be herb and plant-based, and included things like acacia, honey, Queen Anne’s Lace, date palm, willow, Artemisia, myrrh, and the now extinct silphium plant, among others. Some of these are apparently used in spermicides today.

The Egyptian Kahun Papyrus from c. 1850 B.C. actually contains a lot of information on birth control and is the oldest known gynaecological treatise.

Egyptian Kahun Papyrus - The World's first known gynaecological treatise

Egyptian Kahun Papyrus – The World’s first known gynaecological treatise

But we are talking about having children in the ancient world. Today, most husbands (I would hope) are in the room to support their wives and be there when their child are born. It happens at the hospital or birthing centre (most of the time), and there is a doctor/obstetrician to help the delivery.

In the ancient world, births took place at home. There were no hospitals, except for those at healing centres like Kos and Epidaurus, and oftentimes, anyone who had been ‘in touch’ with childbirth was not permitted to enter sacred sanctuaries anyway for fear of contaminating the place.

In Egypt, Greece, and Rome, midwifes were a constant. Today, midwifery seems to have made a big comeback, but in the ancient world, the midwife was always the one who helped women through childbirth. Their skills and knowledge were considerable. The only time a doctor might have been called in ancient Greece and Rome was if there were complications.

Egyptian birth - temple relief at the Ancient Egyptian Dendera Complex depicts a woman giving birth while squatting and attended by the two goddesses

Egyptian birth – temple relief at the Ancient Egyptian Dendera Complex depicts a woman giving birth while squatting and attended by the two goddesses

It appears that in most cases, no men were present at the birth of a child, though there were often several people in attendance, including the midwife, the women of the household (mothers, grandmothers, aunts etc.), and any female slaves that were needed to help.

It was not considered proper for men to be present, and the only man who might have been there was the doctor if he was called.

What about the position for giving birth?

Well, in Egypt, it seems that women often knelt in a shaded spot or shelter to give birth.

Ancient Greek relief of a woman in birthing chair

Relief of a woman in birthing chair

With modern hospital beds, women are in more of a lying-down position, with their backs propped up to give birth.

Interestingly, in ancient Greece and Rome, and in later centuries, birthing chairs were used. This was basically a wooden chair with arms, but no seat.

The midwife would kneel on the floor before the chair and help the woman from there, her hands wrapped in linen or papyrus so that the baby did not slip when she caught it.

It may be that couches were also used for giving birth, but I do wonder if midwives in ancient Greece or Rome might have had birthing chairs as part of their professional kit.

Roman birthing chair and midwife from plaque in Ostia

Roman birthing chair and midwife from plaque in Ostia

Mortality rates for women and children in pregnancy and childbirth were high in the ancient world, and from the little that I’ve read, the risk of death was extremely high in ancient Egypt. Many women died in pregnancy and childbirth, and infants who were born often did not survive the first few months.

Once a child was born, there was usually a ceremony for the naming and blessing of the child.

Funerary monument of a woman who died in childbirth showing her bidding farewell to her husband, mother and nurse who will care for her child

Funerary monument of a woman who died in childbirth showing her bidding farewell to her husband, mother and nurse who will care for her child

I could not find information on the specifics of an Egyptian ceremony (Egyptology is not my area of expertise), but I have read that water and ritual washing may have been a part of such a ceremony for newborns since water played a large part in Egyptian religious rituals. Perhaps my Egyptologist friends out there can shed some light on this subject?

In ancient Greece, on the fifth or seventh day after a child was born, there was a purification ceremony and feast called the amphidromia, at which the child received its name. This involved a ritual and an evening feast to which guests brought presents for the child. If a boy was born, the house was decorated on the outside with olive branches. If it was a girl, the outer decoration consisted of garlands of wool.

In ancient Rome, the naming ceremony was called a lustratio, and this took place nine days after the birth of the child. At this, offerings were made to the gods, there was a feast, and the child was introduced to guests.

In chapter twenty-one of my book, Killing the Hydra, I write about a Roman lustratio.

A Roman family making their offerings to the Gods

A family making their offerings to the Gods

Most people today cannot view the successful birth of a child with anything but gladness. And rightly so! It’s a beautiful thing, and most parents are happy when their child is born healthy, no matter if it is a boy or a girl.

However, in the ancient world, views of family and children could be quite different from our own.

It seems that ancient Egyptians were devoted to their families and that they loved their children. This can be seen in the many images that survive of happy families, babies in their mothers’ arms, and children playing.

Egyptian women and children

Egyptian women and children

In ancient Greece and Rome, children were meant to be less visible, and stayed inside with the women. At birth, a Greek father or guardian decided whether to keep a child. In Rome as well, the paterfamilias had the power of life and death over his family members, and this included newborn infants whom the father could deny the right to be reared.

Children could be exposed or killed in ancient Greece and Rome, and had no place in public life.

Practices also differed by place. For instance, in ancient Athens, if a child was kept, it was swaddled, whereas in Sparta children were not swaddled at all, presumably to start toughening them up, or cull the weak.

It certainly seems harsh to our modern sensibilities, but the truth is that if a child managed to survive birth, decisions about their usefulness and whether to keep them were more often based on the sex, the number of children the family already had, ability to provide for that child, the future need for a dowry, and general health.

Children's toys from ancient Greece

Children’s toys from ancient Greece

It’s odd, but most of the time, I tend to think that the past was much more exciting and interesting, more beautiful than our chaotic, modern society. I think most historians feel they were born in the wrong age!

But when I read about things like pregnancy, health, childbirth, and children in the ancient world, it makes me grateful we live in the age we do.

It’s not perfect by any stretch, but as far as childbirth, I would give that part of the ancient everyday a miss.

Statues of children from the sanctuary of Artemis at Brauron, Attica, site of an ancient orphanage

Statues of children from the sanctuary of Artemis at Brauron, Attica, site of an ancient orphanage

And let’s not think that all children in ancient Greece and Rome were treated badly. It is my hope that, despite the social mores of those sometimes harsher societies, Nature instilled in the mother and father of most children a love and need to care for their offspring that is timeless and powerful.

As ever, thanks for reading!

Aphrodite and Anchises with baby Aeneas

Aphrodite and Anchises with baby Aeneas

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