The Roman army provided excellent medical care. In fact, Roman medical care was not equaled until the 18th Century. As with other fields, the Romans built from a Greek foundation. In conquering southern Italy, the Romans came in contact with Greek doctors who were far ahead of Roman doctors. One year before the start of the Second Punic War, Archagathus of Sparta became the first Greek doctor in Rome. But the big jump in Roman military medicine came after the conquest of Greece. Specifically, the arrival of Galen in 162 A.D. advanced Roman medicine immensely. Doctors were brought to Rome as slaves and some were assigned to legions. The first mention of an organized medical corps comes from Caesar’s description of the Gallic wars. That means we have no idea how advanced medical care was in the legions of the Scipios in Hispania. The following is a description of medicine during the Empire.
The Roman army was on the cutting edge (pun not intended) of medical care because a legion could provide practice on almost every malady. The wounded would usually be first attended by their comrades after the fighting ended. Legionaries knew that blood flow needed to be stanched. The next step was to call over a capsarii (“bandager”). These legionaries were equivalent to a modern medic. They carried a capsa which was a leather pouch with medical supplies. They could treat sword cuts. A capsarii used wine, vinegar, or olive oil to clean the wound. As the name implies, their skill did not go far beyond simple bandaging and stabilizing the wounded. The soldier would then be put on a stretcher and taken to the tent where the doctor worked. A doctor was called a medicus. He was equivalent to a centurion in rank. But no two positions could have been more different. One oversaw killing, the other tried to heal the results of battles.
The most common cases the medicus dealt with were wounds from stabbings and slashings and projectiles that needed extraction. They had several instruments that a modern surgeon would recognize. They used arrow extractors, catheters, scalpels, and forceps. Historian Pat Southern describes the cyathiscus: “This instrument had a curved end with a hole in it, and it had to be inserted next to the weapon lodged in the flesh, until the hole connected with the point of the weapon and then the two could be drawn out together.” (There were others, but trust me, you do not want to know about them. See below if you want to know.) The medicus knew to sterilize the instruments. The Romans had no concept of germs and bacteria, but they knew an uncleansed wound would get infected. Some doctors posited that there were very small creatures that entered the body through the mouth or nose. They believed these creatures lived in marshes, so a medicus might insist on his tent being located as far away from a marsh as possible. On a similar note, the doctors knew about sanitation. The latrines were always located downstream or if there was no stream in the camp, the latrine had a ditch that went outside the wall and used gravity flow.
Roman surgery was very advanced for its time. They used tourniquets and clamps to stop loss of blood. The medicus used acid vinegar to clean wounds. They could stitch up wounds. They got a lot of practice in this because soldier wounds were usually the result of sword slashes. Fortunately, the Romans seldom faced enemies that stabbed into vital organs like the gladius did. The medicus was aware of gangrene, so he performed amputations. He had anesthesias like opium (poppy juice) and scopolamine (from henbane seeds). He had several herbs that were thought to be effective for various maladies. Sylphion was very popular in the Mediterranean world. It was used as a juice. It was an antiseptic, laxative, and even a contraceptive. It was so valuable that the Romans of the Empire period had a state monopoly. Doctors also used curly rhubarb for flatulence. It could help improve stomach problems and dysentery. Yes, the Romans were not immune to this disease that has been the bane of soldiers until the 20th Century. Figs were used for wounds. Honey was used in dressings and for cleaning the wounds.
Let us not get carried away with our admiration for Roman military medicine. There was a lot of religion and superstition. Many legionaries wore amulets to protect them. They would leave votive offerings in temples to get the gods to cure them or a friend. Most doctors adhered to Hippocrates’ Theory of the Four Humours. It is unclear if legionaries were bled to improve their health. In spite of these ineffective, sometimes harmful “cures”, a Roman legionary could expect to live longer than the average male Roman citizen.
- from The Scipios in Spain
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