Accepting Greek Medicine
- The Romans initially rejected the ideas of Greek medicine, which were still practised by Greeks around the Mediterranean.
- As the Greek cities fell to the Romans in the 3rd and 2nd centures BC many Greek doctors became slaves and some were brought to Rome. But some Romans were suspicious of their ideas.
- A plague in 293 BC led the Romans to establish an Asclepion in Rome, for which they brought a sacred snake from Epidaurus. This Asclepion survived throughout the Roman period and became a public hospital offering treatment to the poor and slaves.
- Medicine and its mainly Greek practitioners slowly improved in status until Julius Caesar allowed doctors to become Roman citizens in 46 BC.
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- The Romans were very practical people. They realised that to build an empire you need a strong and healthy army.
- The state paid for public doctors and hospitals for wounded soldiers called 'valetudinaria'.
- The Roman Army had doctors in its ranks who were expected to carry out operations such as removing arrows from soldiers who had been hit.
- Roman surgery became more advanced. Roman texts describe operations to remove bladder stones and cataracts that modern doctors believe would have been effective. Roman doctors had an increasingly sophisticated set of instruments.
- Galen, a Greek doctor working in Rome, famously removed the infected breastbone from a patient. In his writings he listed a wide variety of eye operations he expected a good doctor to be able to carry out.
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Public Health & Dioscorides
- The Romans noticed that exposure to bad smells, unclean drinking water, sewage, swamps and dirt made you more likely to get ill.
- They built aqueducts to carry clean water into cities. They also built public baths, toilets and sewers to remove waste. They drained swamps which were near towns.
- Roman-style buildings and ideas about public health spread around their huge empire, which included much of Britain. For example, Chesters Fort on Hadrian's Wall contains a well-preserved Roman bath house.
- Dioscorides was a Greek doctor, born in Turkey, working for the Roman army in the 1st century AD. His book 'De Materia Medica' was the first on plants as medicines without lots of superstition.
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Galen's Legacy and Reputation
- Galen was a Greek born in Pergamum (a Greek city in western Turkey) in AD 129. Pergamum had become part of the Roman empire in 133 BC.
- Pergamum had an important Asclepion at which Galen first began his training before going to Smyrna and Alexandria.
- He returned to Pergamum where he was doctor to the gladiators and then went to Rome in AD 161.
- He was very ambitious and worked hard at gaining a reputation. He became doctor to the Emperor's son and wrote over 100 medical texts.
- Galen had great influence on the doctors in the Arabic world and in medieval Christian Europe.
- His writings covered all aspects of medicine and many of the books that he wrote survived.
- His writing was very persuasive and he did not stress the polytheistic (more than one god) side of Roman culture - so he didn't offend the later monotheistic Muslims and Christians. This is one reason why his writings were copied and so survived.
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- Galen supported the theories of Hippocrates on ethics and observation. He also believed in the four humours.
- He increased his anatomical knowledge (gained from treating wounded gladiators) by dissecting animals. He described the role of the spine in controlling the rest of the body. He couldn't dissect humans or even study a skeleton outside of Alexandria - so he resorted to chance opportunities like a rotting corpse on a gibbet or a flash flood in a cemetery.
- Galen was deceived by having to use only animals. He thought that the rete mirabile (a network of blood vessels on the undersurface of the brain) which he found in animals would be found in humans - it wasn't. And he described livers as the wrong shape.
- He also let his ambition get the better of him. He only recorded his successful cases and he frequently let himself see what he wanted to see - such as tiny pores in the septum of the heart which would let blood pass from the right hand side of the heart to the left.
- He believed that the blood started life in the liver, then passed around the body picking up various 'spirits' (including 'pneuma' from the lungs). It did various jobs on the way, finally being consumed rather than recirculated. He thought the nervous system was part of this process.
- He believed in treatment by opposites. This was based on the idea of balance of the humours.
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