Scalpel and forceps reveal modern medicine in ancient Rome – 06/14/2023 – Science

Physicians are generally held in high regard today, but the 1st century Romans^th they were skeptical, even dismissive, of doctors, many of whom treated illnesses they did not understand. Poets, especially, ridiculed surgeons for being greedy, for taking advantage of patients sexually, and, above all, for their incompetence.

In his “Natural History”, Pliny the Elder, an admiral and scholar who died in 79 AD while trying to rescue desperate villagers fleeing the eruption of Mount Vesuvius, devoted himself to criticizing the medical profession “on behalf of the Senate and the people Roman and 600 Years of Rome”. His fees were excessive, his remedies questionable, and his quarrels unbearable. “Doctors gain experience at our peril and conduct their experiments through our deaths,” he wrote. Epitaphs on some Roman tombstones read: “A bunch of doctors killed me.”

Medicinal remedies have improved since then — no more crushed snails, salt-cured weasel meat or cremated dog-head ashes — but surgical instruments have changed surprisingly little. Scalpels, needles, forceps, probes, hooks, chisels and drills are as much a part of today’s standard medical tool kit as they were in Rome’s imperial era.

Archaeologists in Hungary recently unearthed a rare and intriguing set of these devices. The items were found in a necropolis near Jaszbereny, about 56 km from Budapest, in two wooden chests, and included tweezers for extracting teeth; a curette, for mixing, measuring and applying medicines; and three scalpels of copper alloy, equipped with detachable steel blades and inlaid with silver in Roman style. Next to it were the remains of a man who was supposed to be a Roman citizen.

The site, apparently untouched for 2,000 years, also contained a pestle which, judging by the abrasion marks and drug residue, was likely used to grind medicinal herbs. Most unusual was a bone lever, to set the fractures back in place, and the handle of what appears to have been a drill, to burrow into the skull and extract weaponry impacted on the bone.

The “instrumentarium”, suitable for performing complex operations, offers insight into the advanced medical practices of the 1st century Romans^O and how far doctors would have traveled to provide care. “In ancient times, these were comparatively sophisticated tools made from the finest materials,” said Tivadar Vida, director of the Institute of Archeology at Eotvos Lorand University (ELTE) in Budapest and leader of the excavation.

Two millennia ago, Jaszbereny and the surrounding county were part of the Barbaricum, a region that lay beyond the borders of the Roman empire and was a barrier against possible external threats. “How could such a well-equipped individual die so far from Rome, in the middle of the Barbaricum?” mused Leventu Samu, an ELTE researcher and member of the excavation team. “Was he there to heal a prestigious local figure, or perhaps he was accompanying a military movement by the Roman legions?”

Similar sets were found across most of the empire; the largest and most varied was discovered in 1989 in the ruins of a 3rd-century doctor’s house^O in Rimini, Italy. But the new discovery is described as one of the most extensive known collections of first-century Roman medical instruments.

Until now, the oldest was thought to be a hoard of objects unearthed in 1997 in a cemetery in Colchester, England, which dated to around AD 70, right at the beginning of the Roman occupation of Britain. The most famous set appeared in the 1770s in the so-called Surgeon’s House in Pompeii, which was buried under a layer of ash and pumice (lava) during the eruption of Mount Vesuvius.

Unnecessary license

The Romans had high hopes for medical specialists. In “De Medicina” or “On Medicine”, the 1st century Roman encyclopedist^O Aulus Cornelius Celsus mused that “a surgeon must be young, or at any rate closer to youth than age; with a strong, steady hand that never trembles, and ready to use both his left and right hand; with clear vision it’s clear”. The surgeon must be fearless and empathetic, but indifferent to the patient’s cries of pain; your greatest desire must be to heal the patient.

Most of these fearless Roman doctors were Greeks, or at least Greek speakers. Many were freedmen or even slaves, which may explain their low social status. The man buried in the Hungarian necropolis was in his 50s or 60s when he died; it’s unclear whether he actually was a doctor, researchers said, but he likely wasn’t a local.

“Studying medicine was only possible, at the time, in a large urban center of the empire”, said Samu. Physicians were peripatetic and medical traditions varied by territory. “Ancient medical writers such as Galen advised doctors to travel to learn about common illnesses in certain areas,” said Patty Baker, former head of archeology and classical studies at the University of Kent in England.

Candidate surgeons were encouraged to learn from distinguished physicians, study in large libraries, and listen to lectures as far away as Athens and Alexandria. In order to gain first-hand experience in treating combat wounds, physicians often interned in army and gladiatorial schools, which may explain the presence of medical tools in the Barbaricum.

“There were no licensing boards or formal requirements to enter the profession,” said Lawrence Bliquez, an archaeologist emeritus at the University of Washington. “Anyone could call themselves a doctor.”

Second opinions are welcome.

The instrument-laden grave was discovered last year at a site where relics from the Copper Age (4500 BC to 3500 BC) and Avar Period (560 to 790 AD) were found on the surface. A later probe with a magnetometer identified a necropolis of the Avars, the nomadic people who succeeded Attila’s Huns. Among the rows of tombs, researchers uncovered a man’s, revealing a skull, leg bones and, at the foot of the body, chests of metallic instruments. “The fact that the deceased was buried with his equipment is perhaps a sign of respect,” said Samu.

Baker said he frequently warned his students about the interpretation of ancient artifacts and asked them to consider alternative explanations. What if, she proposed, the medical tools were buried with the so-called doctor because he was so bad at his practice that the family wanted to get rid of everything associated with his poor medical skills? “It was a joke,” Baker said. “But the point was to get students thinking about how we draw quick conclusions about objects we find at burial sites.”

^{Translated by Luiz Roberto M. Gonçalves}