Different societies employed doctors; the theatres, gladiators, and the circus retained surgeons.
The art of ophthalmic surgery first became a separate branch of the medical profession in the city of Alexandria. Celsus states that Philoxenus, who lived two hundred and seventy years before Christ, was the most celebrated of the Alexandrian oculists.[448]
Oculists were a numerous but ignorant class of practitioners in ancient Rome; their treatment was almost always by salves, each eye-doctor having his own specialty. Nearly two hundred seals with the proprietors’ names have been discovered which have been attached to the pots containing the ointments. Galen speaks contemptuously of the science of the eye-doctors of his time. Martial satirises them. “Now you are a gladiator who once were an ophthalmist; you did as a doctor what you do as a gladiator.” In another epigram he says, “The blear-eyed Hylas would have paid you sixpence, O Quintus; one eye is gone, he will still pay threepence; make haste and take it, brief is your chance, when he is blind he will pay you nothing.” Under Nero, Demosthenes Philalethes, the famous doctor of Marseilles, was a celebrated oculist, whose work on eye diseases was the chief authority on the subject until about A.D. 1000. Paulus Ægineta, in his treatise on Ophthalmology, recommends crocodile’s dung in opacity of the cornea, and bed-bugs’ and frogs’ blood in trichiasis; yet with all this absurdity he distinguished between cataract and amaurosis.
The ophthalmological literature of the Greeks and Romans has for the most part perished. Puschmann says that this branch of surgery must have been able to show remarkable results. “Not only trichiasis, hypopyon, leucoma, lachrymal fistula, and other affections of the external parts of the eye were subjected to operative treatment, but even cataract itself.”[449]
Although the surgeons of the time were ignorant of the true nature of some of the diseases which they treated, they could cure them. Cataract was treated by “couching,” or depressing the diseased lens by means of a needle, in order to extract it.[450]
A patient would sometimes require a consultation, when several doctors would meet and discuss his case, with much difference of opinion more or less violently expressed. Regardless of the sufferings of the patient, they wrangled over his symptoms, and behaved as if they were engaged in a pugilistic encounter, each man far more anxious to exhibit his parts and display his dialectical skill than to alleviate the sufferings of the unfortunate client. Pliny, Galen, and Theodorus Priscianus have left realistic descriptions of these medical encounters.
With respect to the professional income of the early Roman physicians, Pliny says[451] that Albutius, Arruntius, Calpetanus, Cassius, and Rubrius gained 250,000 sesterces per annum, equal to £1,953 2s. 6d.; that Quintus Stertinius made it a favour that he was content to receive from the emperor 500,000 sesterces per annum, or £3,906 5s., as he might have made 600,000 sesterces, or £4,687 10s., by his private practice. He and his brother, also an Imperial physician, left between them at their death the sum of thirty millions of sesterces, or £234,375, notwithstanding the large sums they had spent on beautifying Naples.[452] Galen’s fee for curing the wife of the consul Boethus, after a long illness, was about equal to £400 of our money.
Manlius Cornutus, according to Pliny, paid his doctor a sum amounting to £2,000 for curing him of a skin disease; and the doctors Crinas and Alcon, according to the same authority, were immensely rich men. But these were all exceptional cases, and there is no reason to suppose that Roman doctors made on the average more than sufficient to keep them decently.[453]
School of the Methodists.
Asclepiades, of Prusa, in Bithynia, was a physician of great celebrity and influence, who flourished at Rome in the beginning of the first century B.C. He passed his earlier years at Alexandria, then went to Athens, where he studied rhetoric and medicine. He is said to have travelled much. He ultimately settled at Rome as a rhetorician. He was the friend of Cicero. Being unsuccessful as a teacher of rhetoric, he devoted himself to medicine. He was a man of great natural ability, but he was quite ignorant of anatomy and physiology; so he decried the labours of those who studied these sciences, and violently attacked Hippocrates. His conduct was that of an early Paracelsus. He had many pupils, and the school they founded was afterwards called that of the Methodists. His system was original, though it owed somewhat to the Epicurean philosophy. He conceived the idea that disease arose in the atoms and corpuscles composing the body, by a want of harmony in their motion. Harmony was health; discord, disease. Naturally his treatment was as pleasant as that of the most fashionable modern physician. He paid great attention to diet, passive motions, frictions after the method now called massage, and the use of cold sponging. He entirely rejected the humoral pathology of Hippocrates, and totally denied his doctrine of crises, declared that the physician alone cures, nature merely supplying the opportunities. His famous motto was that the physician should cure “tuto, celeriter, ac jucunde.” In the beginning of fevers he refused his patients permission even to rinse the mouth. He originated the method of cyclical cures by adopting certain methods of treatment at definite periods. He first applied the term “phrenitis” in the sense of mental disturbance. In drugs he was a sceptic, but he allowed a liberal use of wine. He was said to have experimented in physiology, though he knew nothing of it. Tertullian ridicules him thus: “Asclepiades may investigate goats, which bleat without a heart, and drive away flies, which fly without a head.”