The Colosseum in Rome Copyrighted image Credit: OU

The Greeks combined medicines, surgery and dietetics (regulating the whole life-style) in their treatment of ailments. Surgical skills were developed on the battlefield, whereas training for the army and athletic competition (e.g. the Olympics) created specialists who focused on exercise, bathing, massage and regulation of food and drink. Hippocrates developed the concept of the four humours, in line with this ‘prevention is better than cure’ philosophy and the Romans adopted both concepts, as well as employing Greek and Egyptian physicians.

The basis of Greek medicine was the body’s natural ability to heal itself (pepsis), so diet and exercise were more important than taking medicines. Hippocrates of Kos (c450-370 BCE), the ‘father of medicine’ whose school produced over 60 medical texts (the Hippocratic Corpus), claimed that the four humours must be balanced, with a person’s environment and lifestyle being responsible for imbalances. Treatment consisted of a prescription of diet, exercise and limited medicines.

Element earth air fire water
Humour black bile yellow bile blood phlegm
Quality dry cold hot wet
Temperament melancholic choleric sanguine phlegmatic
Body Part spleen blood liver brain (pituitary)
Season autumn spring summer winter
Age of Man maturity infancy youth old age
Imbalance Causes   frenzy, diarrhoea   epilepsy, winter colds

A religious healing system, the cult of Aesculapius (Greek god of healing), began in Greece in the 3rd century BCE and soon spread to Rome and throughout the Roman Empire. As the cult spread the original shrines developed into great spa complexes with hostels, baths, gymnasia and theatres growing up around the healing waters of the thermal or mineralised springs. The Roman penchant for bathing, which could take an entire afternoon and include a massage and having your eyebrows plucked, as well as your sauna and swim, may account for the continuing popularity of these spas, such as that at Bath, which was recently reopened for public use. The Romans were particularly concerned with hygiene, building baths and flushing toilets in every town and military fort, as well as ensuring a clean water supply via aqueducts, some of which remain in use today.

The first hospitals were the Roman military hospitals built in forts across the Empire. These hospitals, such as one at Chester, were designed with rooms opening off a square corridor and primarily cared for the sick, rather than those injured on the battlefield.

The Romans made use of home remedies, such as Cato’s universal panacea, the cabbage, for which he describes endless uses, both internal and external, from a hangover cure to treatment for wounds and sores. Dioscorides’ De materia medica (‘On Medicines’) gave detailed descriptions of how to harvest, prepare, store and test for contamination of medicinal herbs and continued in use well into the Renaissance.

Midwives were highly respected in Roman society and were either slaves or freedwomen (ex-slaves), often attached to a household. Soranus’ Gynaecology, the first medical text concerned with obstetrics, describes various methods of assisting childbirth, quashes the Greek notion that the uterus wandered around a woman’s body, causing hysteria, and introduces the use of a birthing stool, a four-legged stool with arm and back supports and a crescent-shaped opening for delivery of the baby.

Doctors were either slaves or foreigners, exempt from military service and taxation and were attached to a household, independent or paid by the town. Galen, a Greek doctor living in Rome (c.129-200/210 CE), based his practise on the four humours, but is best known for writing the first anatomy. Galen’s observations were based on animal dissections and vivisections transferred to humans. His only anatomical observations of humans were made during his time as a gladiators’ surgeon, where the gaping wounds resulting from combat provided windows into the internal structure of the human body.