Helen KING Did Roman medicine exist?

This paper uses one of the many examples in the history of ancient medicine where an accident of survival distorts how we think about the past. Without the survival of the Hippocratic corpus, what would be our view of the classical Greek doctor and his place in the medical market-place? Without so much of the prolific output of Galen, what image would we have of medicine in the early Roman empire?

I investigate the accidents of survival of Pliny’s complementary statements on the absence from Rome of anything he would call ‘doctors’ - medici - before the arrival of the Greek Archagathus in the early third century BC. How can we use his account without being seduced into adopting his rhetorical image of a pristine Roman past based on the resources of the family and of the land? I suggest that the key may lie in examining the wide range of interpretations of his statements in American and British histories of medicine published from the seventeenth to the early twentieth centuries.

For example: Albert Buck, MD, in his The Growth of Medicine from the Earliest Times to About 1800 (1917), took Pliny entirely at face value. Pliny said there were no doctors (29.5.11), so there were no doctors. Discussing Roman medicine before the late second century BC, he elided this statement with more general attitudes to the manly vigor of the Romans:
‘There were, at this period, no regularly established physicians and no such thing as a medical practice. For several hundred years the Romans were almost constantly at war with the neighboring tribes and nations, and this life of outdoor exposure and active exercise kept them free from the numerous and very varied bodily ills of the later generations. This state of society alone was quite sufficient to prevent the thoroughly trained physicians of Greece and Alexandria from settling in Rome’ (1917: 117-8).

It was not that the doctors who could have arrived were no good - a contrast, as I shall show, with other attempts to reconstruct the history of Roman medicine in this period - it was rather that the Romans were just too busy to be ill: war is good for men. The date of this reaction is interesting; 1917, precisely the time when the experience of ‘shell shock’ in World War I challenged the stiff upper-lip, big boys don’t cry, mentality of Victorian manhood.

The paper will also investigate the use of Pliny and Cato in the changing rhetoric of self-help. Douglas Guthrie, MD, in his very influential general history of medicine first published in 1945, argued that Pliny was right to say there was no medicine, but that this did not mean there was no health care going on at Rome. He states that ‘Roman medicine did not exist as a separate entity. Medicine as a profession was beneath the dignity of the Roman citizen’ and adds that ‘Everyone was his own physician’ (1958 edn: 65).

There are two points worth noting about this assessment. First, as a historian of medicine, Guthrie would be well aware that the phrasing of this last sentence echoes through the history of medicine from 1600 onwards, in books attacking physicians’ monopoly on healing. But, second, as a physician himself Guthrie would not have approved of the Roman rejection of medicine; he is instead presenting the Romans as seriously misguided in their use of self-help. His uses of Cato thus require further investigation, as they contrast with Cato’s reception in early modern authors trying to attack the monopoly of the physicians of their own time.