Mark too, her cities, so many and so proud, Of mighty toil the achievement, town on town Up rugged precipices heaved and reared, And rivers gliding under ancient walls."[13]

The city of Rome was not a desirable place for medical practice, for the lower cla.s.ses were degraded and thriftless, and the relatively small upper cla.s.ses were tyrannical, debauched, superst.i.tious, selfish and cruel. The younger Pliny, who was one of the best type of Romans, tried to investigate the purity of the lives of the Christians, and did not hesitate to put to torture two women, deaconesses, who belonged to the new religion, but he "could discover only an obstinate kind of superst.i.tion carried to great excess." His conduct and his opinion speak eloquently of the nature of a Roman gentleman of the Empire. As for the state of the poor under Augustus, 200,000 persons in Rome received outdoor relief. Although the rich had every luxury that desire could suggest and wealth afford, the great need of the common people was food.

The city had to rely mainly on imported corn, and the price of this at times became prohibitive owing to scarcity--sometimes the result of piracy and the dangers of the sea, but often caused by artificial means owing to the merchants "cornering" the supply--and it was necessary for the State, through the Emperor, to intervene to make regulations and to distribute the grain free or below its market value. It has been computed that about 50,000 strangers lived in Rome, many of whom were adventurers.

The imperial city was the happy hunting-ground of quacks, who gave themselves high-sounding names and wore gorgeous raiment. They went about followed by a retinue of pupils and grateful patients. In some cases the patients were compelled to promise, in the event of being cured, that they would serve their doctor ever afterwards. The retinue of students, no doubt, was rather disturbing to a nervous patient, and Martial wrote:--

"Faint was I only, Symmachus, till thou Backed by an hundred students, throng'dst my bed; An hundred icy fingers chilled my brow: I had no fever; now I'm nearly dead."[14]

Besides quack doctors there were drug sellers (_pharmacopola_), who sold their medicines in booths or hawked them in the city and the country. In the time of the Empire the medicines of the regular pract.i.tioners were sold with a label which specified the name of the drug and of the inventor, the ingredients, the disease it was to be used for, and the method of taking it. Drug sellers dispensed cosmetics as well as medicines, and some of the itinerant dealers sold poison. The regular physicians bought medicines already compounded by the druggists, and the latter, as in our own day, prescribed as well as the physicians.

Depilatories were much in vogue, and were usually made of a.r.s.enic and unslaked lime, but also from the roots and juices of plants. They were first used only by women, but in later times also by effeminate men.

Tweezers have been discovered which were adapted for pulling out hairs, and most of the depilatories were recommended to be applied after the use of the tweezers. The duty of pulling out hairs was performed by slaves.

Most of the medical pract.i.tioners in the time of Augustus were either slaves or freedmen. Posts of responsibility and of honour were sometimes a.s.signed to freedmen, as is shown by the appointment by Nero of Helius, a freedman, to the administration of Rome in the absence of his imperial master. Cicero wrote letters to his freedman Tiro in terms of friendship and affection. The master of a great household selected a slave for his ability and apt.i.tude, and had him trained to be the medical adviser of the household; and the skill shown by the doctor sometimes gained for him his freedom.

There were 400 slaves in one great household of Rome, and they were all executed for not having prevented the murder of their master.[15] It is recorded that physicians were sometimes compelled to do the disgusting work of mutilating slaves.[16] The price of a slave physician was fixed at sixty solidi.[17] The great majority of physicians in Rome were freedmen who had booths in which they prescribed and compounded, and they were aided by freedmen and slaves who were both a.s.sistants and pupils. The medical profession, as has been shown, never attained the same dignity as in Greece. It should be understood that there was a cla.s.s of practising physicians in Rome quite distinct from the slave doctors. The following account of Lucius Horatillavus, a Roman quack of the time of Augustus, is taken from the _British Medical Journal_ of June 10, 1911, and originated in an article in the _Societe Nouvelle_, written by M. Fernand Mazade:--

"He was a handsome man, and came from Naples to Rome, his sole outfit being a toga made of a piece of cloth adorned with obscene pictures and a small Asiatic mitre. Like many of his kind at that day, he sold poisons and invented five or six new remedies which were more or less haphazard mixtures of wine and poisonous substances. He had the good luck to cure his first patient, t.i.tus Cnus Leno, who, being a poet, straightway const.i.tuted himself the _vates sacer_ of his physician, and induced some of his fashionable mistresses to place themselves under his hands. So profitable was Horatillavus's practice that he is said to have saved 150,000 sesterces in a few months. But for a moment his good fortune seemed to abandon him. A Roman lady, Sulpicia Pallas, died suddenly under his ministrations. This may have been due to his ignorance or carelessness; but he was accused of having poisoned his patient. This event might have been expected to bring his career to an end; but it was not long before he recovered the confidence of the people whom he deluded with his mystical language and promises of cure.

He had three methods of treatment, all consisting of baths--hot, tepid, or cold--preceded or followed by the taking of wonder-working medicines.

Horatillavus treated every kind of disease, internal and external; he even practised midwifery, which was then in the hands of women. Ten years after he settled in Rome he had acc.u.mulated a fortune of some 6,000,000 sesterces. He had a villa at Tusculum, whither he went three times a month; there he led a luxurious life in the most beautiful surroundings, and there his evil fate overtook him. His orchard was his especial pride. One day he found that birds had played havoc with his figs, the like of which were not to be found in Italy. Determined to prevent similar depredations in future, he poisoned the fig trees.

Continuing his walk, he plucked fruits of various kinds here and there.

While eating the fruit he had culled and drinking choice wine, he put into his mouth a poisoned fig, which he had inadvertently gathered, and quickly died in convulsions. Before pa.s.sing away, however, he is said to have composed his own epitaph. This M. Mazade believes he has found. It reads: "The manes of Sulpicia Pallas have avenged her. Here lies Lucius Horatillavus, physician, who poisoned himself." If the epitaph is genuine, it is a confession of guilt. The death of the quack by his own poison is a curious Nemesis. The manner of his death proves that it was accidental, as few quacks are bold enough to take their own medicines."

FOOTNOTES:

[11] "De Medic.," lib. 1.

[12] "Sat.," x, 221.

[13] Rhodes's version.

[14] Handerson's translation.

[15] "Tacit. Annal.," xiv, 43.

[16] "Paulus aegin.," vol. ii, p. 379.

[17] "Just. Cod.," vii.

CHAPTER VI.

IN THE REIGN OF THE CaeSARS--TO THE DEATH OF NERO.

Augustus--His illnesses--Antonius Musa--Maecenas--Tiberius-- Caligula--Claudius--Nero--Seneca--Astrology--Archiater--Women poisoners--Oculists in Rome.

Long before the settlement of the const.i.tutional status of Augustus in 27 B.C., he had undertaken many reforms. In 34 B.C., Agrippa, under the influence of Augustus, had improved the water supply of Rome by restoring the Aqua Marcia, and Augustus had repaired and enlarged the cloacae, and repaired the princ.i.p.al streets. Road commissions were appointed 27 B.C. The Aqua Virgo was built 19 B.C. Many of the _collegia_, or guilds, founded for the promotion of the interests of professions and trades had been misused for political purposes, and Augustus deprived many of them of their charters. _Curae_, or commissions, were appointed to superintend public works, streets and the water-supply; and the Tiber was dredged, cleansed and widened, and its liability to overflow reduced. No new building could be built more than 70 ft. high. Augustus also established fire brigades. It has been said that he found the city built of brick and left it built of marble.

He revived many old religious customs, such as the Augury of Public Health, and identified himself closely with the rites and customs of the people. He inculcated that sense of duty which the Romans called _pietas_, and attempted to improve the morals of the citizens by the enactment of sumptuary laws; the philosophers hoped to do good in the same direction by appealing to the intellect and reason, a method that was equally ineffectual. Marriages and an increased birth-rate were encouraged, and parents were honoured and given special privileges. The wisdom and prudence of Augustus were strangely accompanied by credulity and superst.i.tion. He was a profound believer in omens, and attached great importance to astrology. His horoscope showed that he was born under the sign of Capricorn.

He suffered from various illnesses, although in his younger days he looked handsome and athletic. He carefully nursed his health against his many infirmities, avoiding chiefly the free use of the bath; but he was often rubbed with oil, and sweated in a stove, after which he was bathed in tepid water, warmed either by a fire, or by being exposed to the heat of the sun. When, on account of his nerves, he was obliged to have recourse to sea-water, or the waters of Albula, he was contented with sitting over a wooden tub, (which he called by a Spanish name, _Dureta_), and plunging his hands and feet in the water by turns.[18]

His physician was Antonius Musa, to whom was erected, by public subscription, a statue near that of aesculapius. During an attack of congestion of the liver when heat failed to give relief, Antonius Musa advised cold applications for the Emperor, which had the desired effect.

Suetonius, the historian, wrote that this was "a desperate and doubtful method of cure." A more desperate and doubtful method of cure, however, was carried out by the same physician. He successfully banished an attack of sciatica that greatly troubled Augustus by the expedient of beating the affected part with a stick. Antonius Musa received honours from Augustus, and the Emperor also exempted all physicians from the payment of taxes, and from other public obligations.

In the time of Augustus natural philosophy made little progress, and Virgil strongly desired its advancement. Human anatomy, as a study, had not been introduced, and physiology was almost unknown. In medicine, the standard of practice was the writings of Hippocrates, and the Materia Medica consisted of remedies suggested by the whimsical notions of their inventors.

Pliny wrote that the water cure was the princ.i.p.al remedy in his day, as it was indeed throughout the Empire, and it was certainly the most popular. Seneca was very severe on the sentiment of a poem written by Maecenas, the friend and counsellor of Augustus, but it serves to reveal some of the most dreaded maladies of the time:--

"Though racked with gout in hand and foot, Though cancer deep should strike its root, Though palsy shake my feeble thighs, Though hideous lump on shoulder rise, From flaccid gum teeth drop away; Yet all is well if life but stay."

Malaria was one of the princ.i.p.al causes of mortality in and near Rome in the reign of Augustus Caesar.

Augustus's fatal illness occurred in A.D. 14 from chronic diarrha, and the Emperor, like the true Roman that he was, displayed great calmness and fort.i.tude in his last days.

Tiberius succeeded to the throne in A.D. 14, and began a career of infamy. How little knowledge was likely to gain from his patronage is shown by the fact, recorded by Pliny, that the shop and tools of the artist who discovered how to make gla.s.s malleable were destroyed.

a.s.sa.s.sins and perpetrators of every abomination were the fit companions of this tyrant.

Thrasyllus, the astrologer, lived with Tiberius, who was a firm believer in the magic arts. This reign is made ill.u.s.trious in the history of medicine by the work of Celsus.

Caligula, who became Emperor in A.D. 34, was guilty of the most inhuman conduct. Criminals were given to the wild beasts for their food, and even people of honourable rank had their faces branded with hot irons as a punishment by order of this mad tyrant.

Claudius, the successor of Caligula, completed some very important public works in his reign, including great aqueducts and drains, but learning was at a low ebb in his day. Claudius Etruscus, the freedman of the Emperor Claudius, erected baths referred to by Martial. The ruins of the arches of the Aqua Claudia still remain.

Thrasyllus, a son of the astrologer who lived in the time of Tiberius, is said to have predicted to Nero the dignity of the purple. Nero would have been favourably disposed towards physicians if he had heeded the advice of his tutor, Seneca, who wrote: "People pay the doctor for his trouble; for his kindness they still remain in his debt." "Great reverence and love is due to both the teacher and the doctor. We have received from them priceless benefits; from the doctor, health and life; from the teacher, the n.o.ble culture of the soul. Both are our friends, and deserve our most sincere thanks, not so much by their merchantable art, as by their frank goodwill."[19] The practice of necromancy in the time of Nero had grown to such an extent that an edict of banishment was issued against all magicians, but this did not lessen the popularity of the magicians, who indeed prospered under the semblance of persecution, and were honoured in times of public difficulty and danger.

The practice of astrology came from the Chaldeans, and was introduced into Greece in the third century before Christ. It was accepted by all cla.s.ses, but specially by the Stoic philosophers. In 319 B.C., Cornelius Hispallus banished the Chaldeans from Rome, and ordered them to leave Italy within ten days. In 33 B.C., they were again banished by Marcus Agrippa, and Augustus also issued an edict against them. They were punished sometimes by death, and their calling must have been lucrative to induce them to continue in spite of the severe punishments to which they made themselves liable. The penal laws against them, however, were in operation only intermittently. They were consulted by all cla.s.ses, from the Emperor downwards.

There were many physicians in the reign of Nero, but none of great eminence. Andromachus was physician to the Emperor, and had the t.i.tle of _archiater_, which means "chief of the physicians."

An account of the archiaters is of interest. The name was applied to Christ by St. Jerome. There were two cla.s.ses of archiaters in time, the one cla.s.s called _archiatri sancti palati_; the other, _archiatri populares_. The former attended the Emperor, and were court physicians; the latter attended the people. Although Nero appointed the first archiater, the name is not commonly used in Latin until the time of Constantine, and the division into two cla.s.ses probably dates from about that time. The _archiatri sancti palati_ were of high rank, and were the judges of disputes between physicians. The Archiatri had many privileges conferred upon them. They, and their wives and children, did not have to pay taxes. They were not obliged to give lodgings to soldiers in the provinces, and they could not be put in prison. These privileges applied more especially to the higher cla.s.s. When an _archiater sancti palati_ ceased attendance on the Emperor he took the t.i.tle of ex-archiater. The t.i.tle _comes archiatorum_ means "count of the Archiatri," and gave rank among the high n.o.bility of the Empire.

The _archiatri populares_ attended the sick poor, and each city had five, seven or ten, according to its size. Rome had fourteen of these officers, besides one for the vestal virgins, and one for the gymnasia.

They were paid by the Government for attending the poor, but were not restricted to this cla.s.s of practice, and were well paid by their prosperous patients. Their office was more lucrative but not so honourable as that of the archiaters of the palace. The _archiatri populares_ were elected by the people themselves.

Suetonius describes the treatment Nero underwent for the improvement of his voice: "He would lie upon his back with a sheet of lead upon his breast, clear his stomach and bowels by vomits and clysters, and forbear the eating of fruits, or food prejudicial to his voice." He built, at great expense, magnificent public baths supplied from the sea and from hot springs, and was the first to build a public gymnasium in Rome.

There is reason to believe that in the time of Nero there was a cla.s.s of women poisoners. Nero employed one of these women, Locusta by name, and after she had poisoned Britannicus, rewarded her with a great estate in land, and placed disciples with her to be instructed in her nefarious trade.

There was also a very ignorant cla.s.s of oculists in Rome in the time of Nero, but at Ma.r.s.eilles Demosthenes Philalethes was deservedly celebrated, and his book on diseases of the eye was in use for several centuries. The eye doctors of Rome employed ointments almost entirely, and about two hundred seals have been discovered which had been attached to pots of eye salves, each seal bearing the inventor's and proprietor's name. In the time of Galen, these quack oculists were very numerous, and Galen inveighs against them. Martial satirized them: "Now you are a gladiator who once were an ophthalmist; you did as a doctor what you do as a gladiator." "The blear-eyed Hylas would have paid you sixpence, O Quintus; one eye is gone, he will still pay threepence; make haste and take it, brief is your chance; when he is blind, he will pay you nothing." The oculists of Alexandria were very proficient, and some of their followers, at various times throughout the period of the Roman Empire, were remarkably skilful. Their literature has perished, but it is believed that they were able to operate on cataract.

With the death of Nero in A.D. 68, the direct line of the Caesars became extinct.

FOOTNOTES:

[18] Suetonius: "Lives of the Caesars," lx.x.xii.