Money question: Ancient Rome AD 160- early 200s

[guy]

I read somewhere that Galen, Rome's "celebrity physician," was paid 400 gold coins for a single operation (15X the standard rate typically charged for the same procedure). Galen practiced in Rome from the early AD 160s to sometime around 200.

 

This doesn't seem correct or possible to me.

 

Any thoughts? And how much would this be in relation to a worker's daily wages?

 

Thanks ahead of time,

 

guy also known as gaius

[Primus Pilus]

I read somewhere that Galen, Rome's "celebrity physician," was paid 400 gold coins for a single operation (15X the standard rate typically charged for the same procedure). Galen practiced in Rome from the early AD 160s to sometime around 200.

 

This doesn't seem correct or possible to me.

 

Any thoughts? And how much would this be in relation to a worker's daily wages?

 

Thanks ahead of time,

 

guy also known as gaius

 

A legionary after the time of Domitian would've been making 300 denarii per annum gross. That converts to 12 aureii per year meaning that a legionary wouldn't even have had the annual wage to pay for the standard rate of this procedure (roughly 27 aureii, or 1/15 of Galen's rate). This also does not account for standard deductions and of course other costs of living.

 

A professional Roman soldier was well paid in comparison to standard laborers or "private sector" employment.

[caldrail]

Galen was a capable physician, well pracvtised by virtue of dealing with gladiatorial injury. If he turned out to be an equivalent of a Harley St physician, it doesn't suprise me. Also, its a mistake to believe the common man had easy access to medical care - he didn't, it was (as often happened in the past) a matter of cash. The legions were different in that they had physicians amongst them for practical reasons, thus giving them access to 'free' health care. But then... they had to serve twenty odd years for it.

[M. Porcius Cato]

Also, its a mistake to believe the common man had easy access to medical care - he didn't, it was (as often happened in the past) a matter of cash.

 

Sigh.

 

Free medical care was dispensed at the temples to Aesculapius. The first of these temples was imported to Rome from Epidaurus in 293 BCE, and nearly the whole of Insula Tiberina was devoted to the Aesculapium and a long-term recovery center. Being free, these centers were sometimes abused, with unprofitable slaves sent to the Aesculapium and abandoned there, a practice that led Claudius to legislate that such slaves were to be granted their freedom. Like all temples, the temples to Aesculapius and Apollo the healer would have been supported by private donations and the public treasury under the supervision of popularly-elected magistrates (at least during the republic).

 

Additionally, the fees collected by celebrity physicians like Galen were vastly greater than those collected by the physicians consulted by most Romans. The first recorded private medical practice in Rome was sponsored by the consuls in 219, when Archagathus visited Rome and was persuaded to stay by being given citizenship and a shop near the compitium Acilii. The fees paid by the poor were very small. According to the Plautus (Aulularia 448), "It was less than a nummus" (i.e., one sestercius).

[ASCLEPIADES]

Salve, GG

I read somewhere that Galen, Rome's "celebrity physician," was paid 400 gold coins for a single operation (15X the standard rate typically charged for the same procedure). Galen practiced in Rome from the early AD 160s to sometime around 200.

 

This doesn't seem correct or possible to me.

 

Any thoughts? And how much would this be in relation to a worker's daily wages?

 

Thanks ahead of time,

 

guy also known as gaius

 

(BTW, this passage was presumably one of the inspirations behind Moli

Edited December 1, 2008 by ASCLEPIADES

[Northern Neil]

I read somewhere that Galen, Rome's "celebrity physician," was paid 400 gold coins for a single operation (15X the standard rate typically charged for the same procedure). Galen practiced in Rome from the early AD 160s to sometime around 200.

 

This doesn't seem correct or possible to me.

 

I agree - this would be over three kilos weight in gold.

[ASCLEPIADES]

Salve, Amici

I read somewhere that Galen, Rome's "celebrity physician," was paid 400 gold coins for a single operation (15X the standard rate typically charged for the same procedure). Galen practiced in Rome from the early AD 160s to sometime around 200.

 

This doesn't seem correct or possible to me.

 

I agree - this would be over three kilos weight in gold.

As 1 Aureus = 100 sestertii at the II century AD, "400 gold coins" = 40,000 sestertii; ie, one fifth of the fee asked by the physician Charmis in Nero's time, even without adjusting for the inflation rate (please check out the plinian quotation within my previous post).

Edited October 31, 2008 by ASCLEPIADES

[guy]

There were no hospitals in Ancient Rome (except for Military hospitals and clinics for gladiators) till AD 300s with the emergence of Christianity.

 

 

I agree with Audrey Cruse when she writes: "...such cult centers [including the temple of Asclepius] cannot be regarded as early types of a 'hospital' because the sick were not given any form of continuous therapy, nursing care or food. The cures were mostly one-off miraculous interventions."

 

Other factoids about the temples of Asclepius:

 

Temple of Asclepius (Aesculapius in Latin): Healing God

 

Temples built in his name to heal the sick. They represent a fusion of supernatural or magical healing with practical advice.

Serpents sacred to Aesclepius: Only species with ability to slough its skin. Symbol of American medicine is the rod of Asclepius with a single serpent.

Sanctuaries of Asclepius were like dormitories: People would sleep in them hoping the healing god would visit them at night, bringing healing, cleansing, and advice of a cure. This practice was known as incubation.

Priests of Asclepius would prescribe a treatment based on their dreams: herbal medicine, exercise, or baths. The priest would also recommend a sacrifice.

The last words of Socrates after swallowing hemlock (roughly): "Crito, we owe a cock to Asclepius. Pay it and do not forget."

 

 

Cult of Asclepius

First appeared in Greece late 6th century BCE.

Brought to Athens 420 BCE after the plaque that killed Pericles

Introduced to Rome 293 BCE to avert a plague

 

As a sidenote: As crazy as this cult may seem, it lasted for more than 800 years.

 

guy also known as gaius

Edited October 31, 2008 by guy

[M. Porcius Cato]

Of course there are anecdotes of physicians (like Charmis) asking for large sums of money. I could add that Augustus' physician Antonius Musa was reportedly paid 300,000 sesterces as Augustus' private physician. Sounds like a lot doesn't it? Given the current value of silver, that amounts to about $150,000/year--which isn't too far off the salary of an early-career physician today.

 

The problem with these anecdotes is that they shouldn't blind us to what the main trend was. In the Pliny source, for example, we're reminded of some basic economics that it would be foolish to ignore: "it being no moderation on their part, but the rivalry existing between such numbers of practitioners, that keeps their charges within moderation." Thus, as soon as some Charmis is successful in charging 200,000 sesterces for his services (was that yearly?), a multitude of other practitioners will be happy to undercut Charmis with lower prices, as will their rivals and their rivals' rivals.

 

A second problem with the Charmis anecdote is that -- like all anecdotes -- it necessarily reflects the extraordinary rather than the ordinary. The ordinary medicus would have been able to line his instruments in gold if he had been routinely paid (by whom, one wonders) like Charmis. Yet the archaeological and epigraphical evidence at best shows physicians to have lived much like any moderately successful merchant, with their names appearing only sporadically in regional inscriptions and their collegia bearing no more influence than any other.

 

Finally, the whole idea that physicians were normally paid like Charmis has to raise the obvious question: Who the heck could pay such a fee? If the answer is, "hardly nobody", and we know that there were both large numbers of medici practicing throughout Rome and large numbers of people obtaining medical services, then the fee paid to Charmis must have been an outlier. Indeed, given the efficacy of Roman medicine (attested to by the use of the Lex Aquilia to recover damages from physicians), this shouldn't be surprising--indeed, some of the remedies probably weren't even worth the fee that Plautus found typical--"less than a nummus" (i.e., one sestercius).

[guy]

A Roman medicus at work:

 

 

 

 

The use of honey for its antibacterial properties and its ability to promote wound healing is recognized even today.

 

Edited March 27, 2022 by guy

[ASCLEPIADES]

Indeed, given the efficacy of Roman medicine (attested to by the use of the Lex Aquilia to recover damages from physicians), this shouldn't be surprising--indeed, some of the remedies probably weren't even worth the fee that Plautus found typical--"less than a nummus" (i.e., one sestercius).

We can't agree more.

Edited December 1, 2008 by ASCLEPIADES

[guy]

ASCLEPIADES said:

We can't agree more; the whole classical medicine (as opposed to unprofessional contemporary {or even neolithic} health care) was mostly unable to positively affect the natural history and/or outcome of almost any disease; anyway, even today what we pay for our health care has often no direct relationship with its quality.

 

Althought I disagree with this statement (and I will elaborate on this issue later), I agree that medical care in the Ancient world was nonstandardized.

 

What were the qualifications for non-military physicians? None.

 

No medical or disciplinary boards.

No recognized qualifications for physicians.

Success was based on reputation.

Reputation depended on luck, skill, and bedside manner.

There was no medical malpractice except for property loss; i.e., the loss of a valued slave.

 

"There is alas no law against incompetence; no striking example is made. They [physicians] earn by our bodily jeopardy and make experiments until the death of the patients, and the doctor is the only person not punished for murder."

Pliny the Elder

 

Edited May 1, 2022 by guy

[ASCLEPIADES]

We can't agree more; the whole classical medicine (as opposed to unprofessional contemporary {or even neolithic} health care) was mostly unable to positively affect the natural history and/or outcome of almost any disease; anyway, even today what we pay for our health care has often no direct relationship with its quality.

 

Althought I disagree with this statement (and I will elaborate on this issue later), I agree that medical care in the Ancient world was nonstandardized.

As I may possibly have exagerated a little bit in my previous statement, I will also elaborate on this issue later and more carefully.

Edited December 1, 2008 by ASCLEPIADES

[Lost_Warrior]

A Roman medicus at work:

 

Great video!!!

 

My leg hurts just watching it.

[ASCLEPIADES]

A Roman medicus at work:

 

http://uk.youtube.com/watch?v=Aaq0KzvX_E4

 

The use of honey for its antibacterial properties and its ability to promote wound healing is recognized even today.

 

guy also known as gaius

Great video!!!

 

My leg hurts just watching it.

Great Video indeed, LW!

Gratiam habeo for such nice material, GG!

 

A 2002 two minutes-plus hiqh quality renactment of Roman military surgery by John Smith aka Marcus Longinus Cato from Leg II AUG.

 

Some of those military physicians were undoubtedly among the best of the best regarding global pre-Renaissance surgery.

 

At the same time, it's a good reminder of how the surgery without aseptic technique, anesthesia, modern sutures, antibiotics, blood transfusion and real physiologic knowledge would have been like.

 

(Anyway, not so different from a Navy surgeon at Trafalgar)