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    Roman Medicine by Audrey Cruse

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    Book Review by Pertinax

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    This title is a publication from the year 2004. It is a very well presented volume with a considerable range of quality illustrations.The whole presentation of this work is a constant reminder to modern scholars that one must always try to take a step back from any historical material ( and previous scholarly works) to avoid imposing the "modern" on the behaviour and goals of our various ancestors. Cruse is rigorous in attempting to step aside from judgements based on contemporary usage, this is most immediatley obvious in the references to healing plants, as materia medica plants can have a stratlingly wide range of uses for very different medical conditions though within historical eras they have a tendency to be fashionable for one predominant disease.The Opium Poppy was the esteemed painkiller it is today, so our assumptions of the use of the poppy latex in anasthesia are not unreasonable;contrast this to the use of Mandrake (nowadays considerd a byword for medieval superstition and not in conventional usage) it contains hyoscine which prior to the development of modern anasthesia and the use of ether it would have been one of the main tools of anasthesia.

    It is in the details that Cruse shows her skill throughout the text but her generalisations are also pertinent.We are reminded very cogently that medicine is specific to its culture, time and place ."Our" medicine is no freer from its own "superstitions", no Roman doctor would have had a massive layer of insulating bureaucracy abetween himself and his patient, indeed in contemporary terms the process would be more holistic.Cruse outlines the origins of our medicine in archaic Greece,its evolution under Plato and the rise of cult related healing sites.the developmennt of hospitals is shown as a result of Rome's military aspirations.The healer gods and their sanctuaries are discussed.

    It is interesting to note where disease and morbidity diverge from our present experience, for instance eye conditions were of great concern in the Ancient world ( I would personally suggest that this is strongly linked to the incidence of parasitical infections) and there wasa large volume trade in solidified eye salves( and fistula medication) for travellers mirroring our own airport trade in medicaments .Healing sleep within shrines of a healing deity stood alongside the "rational" intervention of medication, the widespread use of votive objects (as thanks or for concentration of the deities efforts) is attested, and there is particular mention of the conflation of Gallic votive practises into the Roman sphere.

    A section which resonated very amusingly was where the use of ritual chanting /prayer /music was used to effect a cure or palliative: ie midwives being able to relieve birth pangs by chant and song-exactly how different is that to modern whale song and ambient music in birthing pools?

    When Cruse moves onto the use of plants her writing covers ceremonial,spiritual and clinical properties and I was delighted to see the continuity with modern herbalism (elsewhere on UNRV in thre Gallery section I have posted a few illustrations) .Healers in Rome were well aware of the potential deadliness of Opium,henbane, Stramonium and Nightshade but also were able to deduce that a weakened poppy could be cultivated with less toxic side effects -from which we see the escaped poppies across British fields.We see that the Pax Romana was a huge impetus to the trading of plants on a continet wide scale either for commerce or medicine, and that finds from Pompeii evidence a range of cultivated plants for processing into medicines.

    Health and hygeine are covered , the provision of water and sewerage seem to be rather superior to contemporay usage certainly the constant flushing of sewers by waste fountain water would be a step forward!A short history of the Cloaca Maxima is included and some information on the use of lead for water distribution. The unfortunate side effects of the widespread lead technology are also considerd, the chronic anemia caused by constant overuse of water and food exposed to lead is explained in an excellent study of Poundbury in Roman Britain (chronic fatigue,infertility, depression), with an excellent rejoinder showing how taking of iron rich waters was used as a cure.

    Cruse gives us a brief history of the supply of Rome itself with water and what a great undertaking this was and how rapidly the city outgrew each of these schemes.The item which struck me most forcibly was that the Romans were quite aware that putrid matter must be kept away from clean water but that germ theory was not mooted in any form given that internal wcs were often close by to the kitchen and we are reminded of the collection and use of urine on a wide scale for fulling( and the olfactory problems that arose) .The provision of vast comunal latrines is also described in quite sufficient detail.

    The Baths as a cultural and hygenic force are explored and their elevation to a central role in the community; and the description from the younger Seneca of the poseurs (grunting away loudly whilst weight lifting-very bourgeoise) , nostril pluckers, sausage vendors, and fat wheezy old men in the baths is gruesomely modern.

    I think it is in the description of possible valetudinarii (hospitals) that the strength of the author's rigorousness comes through, the essence of this being: we know of the hospital from primary sources, we see many ruins and have many finds of medical instruments but what we have long considered to be "standard pattern" wards may be general purpose building constructed for a whole range of logistical uses . It is also a possibility that many of the Soldiery carried medical equipment as well as those dedicated to medicine (frequently Greek) in the field .From these two strands of thought it is then a reasonable conclusion to look harder at our conventional wisdom in all matters relating to built environment.

    The section on diseases and operations (rather vividly illustrated in HBOs Rome when Titus Pullo has his head wound treated) makes the reader think :are we any more advanced or knowing in certain areas of medicine ? what have we perhaps forgotten? Its very easy to be self congratulatory and say that our surgical skills are greatly advanced but the rate of Iatrogenic deaths (admitted) is vast. We do have great advantadges in some fields but sophisticated instruments abound in Rome for many purposes (if in or visiting the UK I reccommend the Pitt-Rivers Museum Oxford if you wish to examine ancient/folk surgical tools) and one has a constant sense of feeling within touching distance of the Roman healer.

    On a site note...this book is excellently illustrated ,in fact ive been a bit remiss not to say that the photos and illustrations are top notch

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