Scalpel, tweezers, bone drill: modern medicine in ancient Rome
Physicians are generally held in high esteem today, but the first-century Romans viewed physicians with skepticism and even contempt, many of whom dealt with diseases they did not understand. Poets made fun of surgeons mostly because of their greed, sexual exploitation of patients, and mostly because of their incompetence.
In his “Natural History,” Pliny the Elder, the admiral and scholar who died in AD 79 while trying to save desperate villagers fleeing the rubble of Mount Vesuvius, tried “in the name of the Senate and Rome” against the Doctors to take a stand People and 600 years of Rome.” Their fees were excessive, their legal remedies dubious, their quarrels unbearable. “Doctors gain experience at our peril and conduct their experiments on our deaths,” he wrote. The epitaph on more than one Roman tombstone read: “A gang of doctors killed me.”
Medical remedies have improved since then—no more smashed snails, salted weasels, or the ashes of cremated dog heads—but surprisingly little has changed in the surgical instruments. Scalpels, needles, tweezers, probes, hooks, chisels and drills are just as much part of the standard medical toolbox today as they were in Rome’s imperial days.
Archaeologists recently unearthed a rare and startling array of such devices in Hungary. The items were found in a necropolis near Jászberény, about 35 miles from Budapest, in two wooden boxes and contained forceps for pulling teeth; a curette for mixing, measuring and applying medication; and three copper alloy scalpels with detachable steel blades and Roman-style silver inlays. Next to it were the remains of a man believed to be a Roman citizen.
A pestle was also found at the site, which appeared to have remained untouched for 2,000 years. Judging by the signs of abrasion and residues of medicines, it was probably used to grind medicinal herbs. Most unusual were a bone lever to set fractures back in place and the handle of what appeared to be a drill to drill the skull and extract pounded weapons from the bone.
Suitable for performing complex surgeries, the set of instruments offers a glimpse into the advanced medical practices of the first-century Romans and shows how far physicians might have traveled to provide care. “In ancient times, these were comparatively sophisticated tools made of the finest materials,” said Tivadar Vida, director of the Institute of Archeology at Eötvös Loránd University (ELTE) in Budapest and leader of the excavation.
Two millennia ago, Jászberény and the surrounding county belonged to the Barbaricum, a vast area that lay beyond the Empire’s borders and served as a buffer against possible outside threats. “How could such a well-equipped individual die so far from Rome in the middle of the Barbaricum,” mused Leventu Samu, a research fellow at ELTE and a member of the excavation team. “Was he there to heal a notable local figure, or was he perhaps accompanying a military movement of the Roman legions?”
Similar kits have been found throughout most of the Empire; The largest and most diverse was discovered in 1989 in the ruins of a third-century doctor’s house in Rimini, Italy. However, the new find is described as one of the largest known collections of first-century Roman medical instruments. The oldest find was previously believed to be a find of objects excavated in 1997 from a burial site in Colchester, England, dating to around AD 70, very early in Roman history occupation of Great Britain. The most famous set was found in the so-called House of the Surgeon in Pompeii in the 1770s, buried under a layer of ash and pumice during the eruption of Mount Vesuvius.
Colin Webster, professor of classical philology at the University of California, Davis and president of the Society for Ancient Medicine and Pharmacology, said the discovery highlights the porosity of cultural boundaries in antiquity. “Medicine has long been one of the most active vectors for cross-cultural exchange,” he said. “And this finding certainly helps show the physical evidence of this dynamic.”
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The Romans had high hopes for their medical experts. In his treatise De Medicina, or On Medicine, the first-century Roman encyclopedist Aulus Cornelius Celsus mused: “A surgeon should be youthful, or at least nearer youth than old age; with a strong and steady hand that never trembles, ready to use both left and right hands; with sharp and clear sight.” The surgeon should be bold and sensitive, but unmoved by the patient’s cries of pain; His greatest wish should be to make the patient healthy.
Most of these intrepid Roman physicians were Greeks, or at least spoke the Greek language. Many were freedmen or even slaves, which might explain their low social status. The man buried in the Hungarian necropolis was 50 or 60 years old when he died; Whether he was actually a doctor is unclear, researchers say, but he likely wasn’t a local.
“At that time, studying medicine was only possible in a large urban center of the Reich,” said Dr. samu Physicians were migrants and medical traditions varied by area. “Ancient medical writers like Galen advised physicians to travel to learn about diseases that were common in certain areas,” said Patty Baker, former head of archeology and classics at the University of Kent in England.
Aspiring surgeons were encouraged to apprentice with recognized physicians, study in great libraries, and attend lectures in places as far away as Athens and Alexandria, a center of anatomical learning. For their first-hand experience treating battle wounds, medics were often interned in the army and gladiator schools, which may explain the presence of medical equipment in the Barbaricum.
“There were no licensing boards and no formal requirements to enter the profession,” said Lawrence Bliquez, archaeologist emeritus at the University of Washington. “Anyone could call themselves a doctor.” When his methods were successful, he attracted more patients; if not, he found another career.
Operations included many performed on the orifices of the body to treat polyps, inflamed tonsils, hemorrhoids and fistulas. In addition to trepanation, the more radical interventions also included mastectomy, amputation, hernia reduction and treatment of the cataract. “Surgery was a male domain,” said Dr. Bliquez. “But there were certainly a lot of midwives, so who can say they didn’t know anything about surgery, especially as far as gynaecology is concerned.”
Contrary to myth, cesarean sections did not take place until long after Julius Caesar was born in 100 BC. Entry into medicine. However, the Romans practiced embryotomy, an operation in which an infant’s limbs were severed with a knife while it was stuck in the birth canal. “A hook was used to remove the limbs, trunk and head from the birth canal after they were severed,” said Dr. Baker. “It was a cruel procedure designed to save a mother’s life.”
Surgery was often the last resort of all medical treatments. “Any of the tools found in the Barbaricum tomb could have resulted in death,” said Dr. Baker. “There was no knowledge of sterilization or germ theory. It was likely that the patients died from sepsis and shock.”
The tomb, laden with tools, was discovered last year at a site where relics dating from the Copper Age (4500 BC to 3500 BC) and the Avar Period (560 to 790 AD) had been found. Subsequent examination with a magnetometer identified a necropolis of the Avars, a nomadic people who succeeded Attila’s Huns. Between the rows of graves, researchers uncovered the man’s grave, revealing a skull, leg bones, and chests of metal instruments at the base of the body. “The fact that the deceased was buried with his equipment is perhaps a mark of respect,” said Dr. samu
That’s not the only option. dr Baker said she often cautioned her students against interpreting ancient artifacts and encouraged them to consider alternative explanations. What if, she suggested, the medical instruments were buried with the so-called doctor because he was so bad at his practice that his family and friends wanted to get rid of anything related to his poor medical skills? “That was a joke,” said Dr. Baker. “But it should get students thinking about how we make quick inferences about objects we find in burials.”
