A college of Æsculapius and of Health was established in Rome 154 B.C. An inscription has been discovered in the excavations of the Palatine which has preserved the memorial of its foundation.[437] The medical profession of ancient Rome was quite free, and such instruction as its followers considered it necessary to acquire could be obtained how and where they chose. There was no uniform system of education; the training was private in early times, and was imparted by such physicians as cared to take pupils for a certain specified honorarium. It was not till later times that the Archiatri in their colleges, which were somewhat on the model of the mediæval guilds, took pupils for instruction in medicine and surgery. Pure medical schools did not exist amongst the Romans.[438] Pliny complained[439] “that people believed in any one who gave himself out for a doctor, even if the falsehood directly entailed the greatest danger.” “Unfortunately there is no law which punishes doctors for ignorance, and no one takes revenge on a doctor if, through his fault, some one dies. It is permitted him by our danger to learn for the future, at our death to make experiments, and, without having to fear punishment, to set at naught the life of a human being.”
Cato hated physicians, partly because they were mostly Greeks, and, partly because he was himself an outrageous quack, who thought himself equal to a whole college of physicians. Plutarch tells us[440] that he had heard of the answer which Hippocrates gave the king of Persia, when he sent for him and offered him a reward of many talents: “I will never make use of my art in favour of barbarians who are enemies of the Greeks.” He affected to believe that all Greek physicians took a similar oath, and therefore advised his son to have nothing to do with them. But there is no doubt his objection to the faculty arose from the fact that he had “himself written a little treatise in which he had set down his method of cure.” Cato’s guide to domestic medicine was good enough for the Roman people; what did they want with Greek physicians? His system of diet, according to Plutarch, was peculiar for sick persons; he did not approve of fasting, he permitted his patients to eat ducks, geese, pigeons, hares, etc., because they are a light diet suitable for sick people. Plutarch adds, that he was not in his own household a very successful practitioner, as he lost his wife and son. Pliny[441] tells us all about Cato’s book of recipes, which the Roman father of a family consulted when any of his family or domestic animals were ill. The family doctor of those days was the father or the master of the household, and no doubt Cato was a very generous, if not a very skilful practitioner. Seneca sums up the healing art of the time thus: “Medicina quondam paucarum fuit scientia herbarum quibus sisteretur fluens sanguis, vulnera coirent.”[442]
Cato attempted to cure dislocations by magic songs (carmina): “Huat, hanat, ista, pista sista damniato damnaustra,” or nonsense simply. What his success in the treatment of luxations on this principle we are not informed. The practice of medicine and surgery before the time of Cæsar was not an honourable one in Rome. This may possibly have arisen from the fact that the only professors of the art were Greeks, who for the most part left their country for their country’s good and went to Rome merely to make money, honestly if possible—perhaps—but at all events to make it. Rome offered greater facilities for doing this than their native land, and the process was doubtless very similar to that with which our own colonies and the United States of America have in the past been only too familiar.[443]
During the severe epidemics which often raged in ancient Rome the oracles were consulted as to the means to be adopted to be rid of them; prayers were offered up to the Greek gods of healing as well as those of the state. But Greece had done more for the art of healing by her physicians than her gods could do, and in process of time the Romans found this out, and the native doctors were compelled to yield before the advance of Greek science. The works of the Greek physicians and surgeons, who had done so much for medical knowledge and advancement, gradually made their way amongst the Romans. These paved the way for Hellenic influence, in spite of the disreputable behaviour of some of the professors of the art of medicine, on whom the Romans with good excuse looked as quacks and foreigners whose only object was gain. We read of the erection at Rome of a temple in honour of Apollo the healer, 467 B.C., and of the building of a temple to Æsculapius of Epidaurus, 460 B.C. Ten years later the Romans built a temple to the goddess Salus when the pestilence raged in their city. Lucina was first worshipped there 400 B.C. In 399 B.C. the first lectisternium, a festival of Greek origin, was held in Rome by order of the Sybilline books; it was held on exceptional occasions, the present being a time of fresh public distress on account of a pestilence which was raging. The images of the gods were laid on a couch; a table spread with a meal was placed before them, and solemn prayers and sacrifices were offered. A third lectisternium was held at Rome 362 B.C. That he might obtain a cessation of the pestilence then raging in Rome, L. Manlius Imperiorus fixed a nail in the temple of Jupiter, B.C. 360. This holding of lectisternes and driving nails in the temple walls became the recognised method of dealing with such scourges, and painfully exhibits the powerlessness of mankind to deal with disease by theurgic means. Science alone can combat disease, the bed and board offered to the gods who cannot use them are now bestowed on health officers who can; we no longer drive nails in temple walls to remind deities that we are in trouble, but we send memorials to our colleges of physicians demanding suggestions for escaping a visitation of cholera; it is not sufficient to fix “a nail in a sure place,” it must be fixed in the right one. In the year 291 B.C., on the occasion of a pestilence in Rome, ten ambassadors were sent to Epidaurus to seek aid from the temple of Æsculapius. The god was sent to the afflicted city under the figure of a serpent. He comes to our towns now under the figure of a cask of carbolic acid.
Archagathus was the first person who regularly practised medicine in Rome. He was a Peloponnesian who settled in the city B.C. 219, and was welcomed with great respect by the authorities, who purchased a surgery or shop for him at the public expense, and gave him the “Jus Quiritium.”
As he treated his patients chiefly with the knife and powerful caustics, his severe remedies gave great offence to the people and brought the profession of surgery into contempt. He was called a “butcher,” and had to leave the city.[444]
Alexander Severus (225-235 A.D.) was the first who established public lecture rooms for teachers of medicine and granted stipends to them. In return they were compelled to teach poor state-supported students gratuitously. Constantine demanded like services from the doctors in return for certain immunities.[445]
There was no regular curriculum, nor period of studentship; everything depended upon the ability and industry of the individual pupil. Clinical instruction was given by the teachers, as Martial tells in a satirical verse:—
“Faint was I only, Symmachus, till thou,
Backed by an hundred students, throng’dst my bed;