The Romans were curiously badly off for regular doctors until Julius Cæsar specially tempted some to come from Greece and Egypt by offers of citizenship. Augustus, too, warmly encouraged the settlement in the city of trained medical men.
Pharmacy in the Roman Empire.
The separation of the practices of medicine, pharmacy, and surgery, which became general though never universal, was of course a gradual process. Galen expresses the opinion that Hippocrates prepared the medicines he prescribed with his own hands, or at least superintended the production of them. According to Celsus, it was in Alexandria and about the year 300 B.C. that the division of the practice of medicine into distinct branches was first noticeable. The sections he names were Dietetics, Surgery and Pharmaceutics.
The physicians who practised dietetics were like our consultants, only more so. They were above all things philosophers, the recognised successors of the Greek thinkers and theorists, and but too often their imitators. Although they owed their designation to their general authority on régime, they prescribed and invented medicines. The pharmaceutical section came to be called in Latin medicamentarii, and their history corresponds closely with that of our English apothecaries. At first they prepared and administered the medicines which the physicians ordered. But in Alexandria and Rome they gradually assumed the position of general practitioners. To another class, designated by Pliny Vulnerarii, was left the treatment of wounds, and probably of tumours and ulcers. The necessity of a lower grade of medical practitioners in Rome is manifest from a remark of Galen’s to the effect that no physician, meaning a person in his own rank, would attend to diseases of minor importance.
It is worthy of note that the Latin designation medicamentarius, which was nearly equivalent to the Greek pharmacopolis, was similarly used to mean a poisoner, while pharmakon in Greek and medicamentus in Latin might mean either a medicine or a poison.
It is noted elsewhere (page [52]) that the word pharmakeia when it occurs in the New Testament is universally translated in our versions by the term sorcery or some similar word. At the time when the Apostles wrote this was evidently the prevalent meaning attached to the term. But in earlier Greek literature the reputable and the disgraceful ideas associated with the word seem to have run side by side for centuries. Homer uses pharmakon in both senses; Plato makes pharmakeuein mean to administer a remedy, while Herodotus adopts it to signify the practice of sorcery. Apparently this word came from an earlier, pharmassein, which was derived from a root implying to mix, and the gradual sense development was that of producing an effect by means of drugs. They might produce purging, they might produce a colour, or they might produce love.
The multiplication of names for the various classes connected with medicine and pharmacy in the Roman world is rather confusing. As the language of medicine up to and including Galen was largely Greek, many of the designations employed were those which had been drawn from that tongue. The name Pharmacopeus, used in Greek to denote certain handlers of drugs, had always a sinister signification. It suggested a purveyor of noxious drugs, a compounder of philtres, a vendor of poisons. The men who kept shops for the sale of drugs generally were called pharmacopoloi. This term was not free from reproach, because it was a common appellation, not only of the shopkeepers strictly so-called, but was also applied to the periodeutes, or agyrtoi, travelling quacks or assembly gatherers, or as they came to be named in Latin, circulatores or circumforanei.
These itinerant drug sellers are occasionally referred to by the classic authors. Lucian speaks of one hawking a cough mixture about the streets; and Cicero, in his Oratia pro Cluentio, suggests that the travelling pharmacopolists who attended the markets of country towns were not unwilling to sell poisons as well as medicines when they were wanted. One of these is specifically named, Lucius Clodius, and the orator suggests that he was bribed to supply medicines to a certain lady which were to have a fatal effect.
The designation Periodeutes meant originally, and always in strict legal terminology, physicians who visited their patients. The term was also used among the Christians to describe the ministers charged to visit the sick and poor in their dioceses.
The tramp doctor in time gets tired of his vagabond life, and, it may be, a little weary of hearing his own voice. If he has saved a little money, therefore, the attractions of a shop in the city, where he can exercise his healing on people who seek him, appeal strongly to him. So in Greece and in the Roman Empire the charlatans settled in little shops and were called iatroi epidiphrioi or sellularii medici, meaning sedentary doctors. But all these were pharmacopoloi.