THE ROMAN EMPIRE
- controlled most of Southern Europe and North Africa and lasted over a thousand years
How did it contribute to medicine?
- large area = lots of different natural remedies from different climates and soils
- latin = common language, so easy to communicate
- need for a healthy army led to improvements in surgery
- seeing people die from open wounds in battle led to increased knowledge of physiology
- better communications led to spread of medicines (and diseases)
ROMAN PUBLIC HEALTH
Romans wanted good public health because most doctors were Greek and they didn't want to be treated by the Greeks if they were ill.
Also they valued each person in their empire because each person had a role (eg: farmers were needed for food etc)
AQUEDUCTS, SEWERS, TOILETS AND BATHS
Aqueducts were built on a slight incline so water could travel from rivers to cities down lead coated channels - they didn't have pumps. Viaducts were used to transport water through mountains.
Sewers were built under cities where waste could be carried underground, this prevented disease but they did not know it.
Water was constantly running underneath the toilets towards the sewers. A sponge and stick was used instead of toilet paper, a channel ran infront of the toilet to wash the sponges in. Going to the toilet was a public event, often shared with friends or colleagues.
At a roman bath, you would sweat in the warm room, then the hot room, then have a hot shower, then tepid shower, then cold shower and finally end up in the communal bath. The entrance fee was very cheap in an attempt to keep everyone clean.
DID ROMAN PH MEASURES WORK?
- fresh water flowed into cities daily due to aqueducts
- 5000 people in lincoln used local bath each week
- sewege system worked well
- public baths were cheap so available to everyone
- they sited settlements in places that would keep everyone healthy (not near marshes because they thought miasma caused illness, but it prevented mosquito bites)
- few houses received own water supply
- baths/toilets were only in cities
- water in lincoln bath only changed weekly, water full of germs/urine/skin/disease
- wooden sewege pipes rotted
- some stone pipes were too large so water didn't flow quick enough - led to bad smell and disease
- people threw waste out of windoes
- open sewege pipes often overflowed and weren't cleared up
HIPPOCRATES - THE FATHER OF MEDICINE (400's BC)
He taughter others to be practical doctors and use DPOT
- Diagnosis - write down what they say and you see
- Prognosis - predict what will happen
- Observation - see how they're getting on
- Treatment - trial and error treatments
Most importantly, he recorded and observed illnesses so others could look back to his noted and apply symptoms to others.
HIPPOCRATIC OATH: doctors promised:
- not to use their knowledge and position to harm patients
- not to abuse their position of trust
- to be confidential
He emphasized keeping healthy by exercising, good diet and enough rest. He thought good health depended on balance.
ARISTOTLE - 4 HUMOURS (liquids)
- pray to Asclepios - Greek God of healing
- make a sacrifice/offering to Asclepios
- bathe in the sea to cleanse and purify
- sleep in the abaton for atleast 1 night
- while asleep patients expected to be visted by the God, his daughters and the snake. The snake would lick the affected area to make patients better. Theories suggest it was the priests treating them or the doctors they visited prior to sleeping that were actually curing them.
- if they were cured, they would write their story on the brick wall for others to read, it would make people more positive that it would work.
Would it work?
Occasionally, but not due to supernatural causes, more to do with the fact they were able to rest, exercise, eat well and visit the doctor. Also the placebo affect would make the patients feel better.
- remedies made from plants, animal fats and minerals
- the remedies that worked were handed from one generation to another
- we now know that honey kills infection, valerian was a sedative and poppy juice a pain relief
- for the wealthy, the father would look up treatments in a medical book - including exercise and sweating
- you would have had to pay for a trained doctor if home remedies failed
- doctors were trained by being apprentices to experienced doctors or reading books by Hippocrates/Galen
- anybody could call themselves a doctor
HAVING A BABY
- women looked after eachother in child birth
- handbooks emphasized the need for cleanliness, oil, hot water, sponges, wool coverings and bandages
- if a problem occured during birth, someone would shake the woman 10 times to speed up birth or hurling a spear over the house 3 times to reduce labour pains.
GALEN EARLY LIFE
- father told by Asclepion that Claudius Galen would be a physician
- he began studying at 16 so had lots of experience
- became a surgeon at gladiators school so saw open wounds, gained knowledge of anatomy
- moved to rome and became a great showman, spreading ideas and techniques
- became the doctor for the royal family so his ideas were trusted as being correct.
GALEN VS. HIPPOCRATES
Galen similar to Hippocrates:
- advised good diet and exercise to prevent illness
- believed illness was caused by imbalance of 4 humours
- told doctors to use observation
Galen different to Hippocrates:
- great showman and showoff, he didn't record mistakes, only successes
- emphaszied doctors should learn with own eyes, not rely on what they're told
- concentrated on anatomy and physiology, not recording symptoms
- said doctors should dissect bodies to see for themselves
Galen developed Hippocrates ideas:
- made extensive bleeding a cure
- developed the idea of using opposites to balance the humours
GALENS MISTAKES AND PROGRESS
Galen did vivisections on pigs and occassionally dissections on humans that were often hung criminals that he stole, it was illegal.
- 5-lobes on liver (actually 2) - from vivisecting pigs
- blood passes through holes in the septum to other side of heart
- blood is remade (not circulated)
- network of veins covering brain
- NEVER RECORDED HIS MISTAKES! - he and others couldn't learn from his mistakes!
- wrote books - communication (on the other hand, he wrote wrong things but nobody opposed his opinion because he was such an important doctor)
- thought that brain was most important organ - not the heart
WITHDRAWAL OF ROMANS (410AD)
The empire weakened and others invaded, including: German invaders, the Angles, Saxons and Jutes.
effects on medicine:
- weak government
- no unity - worse communication
- focus turned to warfare, not education and medicine
- invaders brought disease
- roman baths destroyed to gain stone for houses
- everyone speaks different languages so communication is bad
- war injuries meant better knowledge of anatomy
- new religions led to war
- people didn't question the teachings of God because they feared hell
- sanitation was bad because animals and people shared houses
- no sewege system
- religion encourages praying instead of finding cures