FOOTNOTES

"How many patients Themison dispatchedIn one short autumn."[2]

The joke which is based on attributing a cure to Nature alone, and death solely to the physician's want of skill, is one of the most time-honoured.

Themison lived at the close of the Roman Republic, and it will now be necessary to consider the state of the healing art in Rome under the rule of the emperors.

Julius Cæsar—one of the first triumvirate—invaded and conquered Gaul and Britain, and after these great military achievements, found that he could not sheath his sword until he had met in battle his rival Pompey. Cæsar defeated Pompey at Pharsalia, in Thessaly (48B.C.), and pursuedhim to Egypt. Pompey was murdered in Egypt, and his last followers finally defeated in Spain, and in 45B.C.Julius Cæsar returned to Rome, and was declared perpetualimperator. On March 15, 44B.C., he was assassinated. It is possible that the career of this great man may have promoted the surgery of the battlefield, but his reign as Emperor was too short, and the political situation of his time too acute, to permit of much progress in the arts of peace generally, and in the medical art particularly. Julius Cæsar bestowed the right of Roman citizenship on all medical practitioners in the city.

Referring to the death of Julius Cæsar, Suetonius writes that among so many wounds there was none that was mortal, in the opinion of the surgeon Antistus, except the second, which he received in the breast.

Octavianus was appointed one of the second triumvirate, his colleagues being Mark Antony and Lepidus. Lepidus was first forced out of the triumvirate, and Octavianus and Mark Antony then came into conflict. During these rivalries, a great civic work was accomplished by Marcus Agrippa, who built the aqueduct known asAqua Julia. A landmark in history is the battle of Actium, in which Octavianus defeated Mark Antony and his ally Cleopatra, and within a few years Octavianus was proclaimed Emperor as Augustus Cæsar (27B.C.). Under his rule Romegreatly prospered, and we shall now consider the state of medicine and of sanitation during his illustrious reign.

In the Roman Empire there was a spirit of toleration abroad, "and the various modes of worship which prevailed in the Roman world were all considered by the people as equally true; by the philosopher, as equally false; and by the magistrate, as equally useful. And thus toleration produced not only mutual indulgence, but even religious concord" (Gibbon).

The systems of philosophy in vogue were those of the Stoics, the Platonists, the Academics, and the Epicureans, and of these only the Platonists had any belief in God, who was to them an idea rather than a Supreme Being. The great aim of both the wise and the foolish was to glorify their nationality, and their beliefs, their rites, and their superstitions, were all for the glory of mighty Rome.

Educated Romans were able to speak and write both Latin and Greek, and the latter language was the vehicle used by men of science and of letters.

The population of the city of Rome at the beginning of the Augustan age was not less than half a million of people, and probably exceeded this number. There was no middle class, a comparatively small number of gentry, a very numerousplebsor populace, and many slaves. The Emperor Augustus boasted that after the warwith Sextus Pompeius he handed over 30,000 slaves, who had been serving with the enemy, to their masters to be punished. The slaves were looked upon by their masters as chattels. The plebs had the spirit of paupers and, to keep them contented and pacific, were fed and shown brutalizing spectacles in the arenas. Augustus wrote that he gave the people wild-beast hunts in the circus and amphitheatres twenty-six times, in which about 3,500 animals were killed. It was his custom to watch the Circensian games from his palace in view of a multitude of spectators.

Throughout the country generally agriculture prospered, and the supply of various grasses for feeding cattle in the winter increased the multitude of the flocks and herds; great attention was given also to mines and fisheries and all forms of industry. Virgil praised his beautiful and fertile country:—

"But no, not Medeland with its wealth of woods,Fair Ganges, Hermus thick with golden silt,Can match the praise of Italy....Here blooms perpetual spring, and summer hereIn months that are not summer's; twice teem the flocks:Twice does the tree yield service of her fruit.Mark too, her cities, so many and so proud,Of mighty toil the achievement, town on townUp rugged precipices heaved and reared,And rivers gliding under ancient walls."[3]

The city of Rome was not a desirable place for medical practice, for the lower classes were degradedand thriftless, and the relatively small upper classes were tyrannical, debauched, superstitious, selfish and cruel. The younger Pliny, who was one of the best type of Romans, tried to investigate the purity of the lives of the Christians, and did not hesitate to put to torture two women, deaconesses, who belonged to the new religion, but he "could discover only an obstinate kind of superstition carried to great excess." His conduct and his opinion speak eloquently of the nature of a Roman gentleman of the Empire. As for the state of the poor under Augustus, 200,000 persons in Rome received outdoor relief. Although the rich had every luxury that desire could suggest and wealth afford, the great need of the common people was food. The city had to rely mainly on imported corn, and the price of this at times became prohibitive owing to scarcity—sometimes the result of piracy and the dangers of the sea, but often caused by artificial means owing to the merchants "cornering" the supply—and it was necessary for the State, through the Emperor, to intervene to make regulations and to distribute the grain free or below its market value. It has been computed that about 50,000 strangers lived in Rome, many of whom were adventurers.

The imperial city was the happy hunting-ground of quacks, who gave themselves high-sounding names and wore gorgeous raiment. They went about followed by a retinue of pupils and gratefulpatients. In some cases the patients were compelled to promise, in the event of being cured, that they would serve their doctor ever afterwards. The retinue of students, no doubt, was rather disturbing to a nervous patient, and Martial wrote:—

"Faint was I only, Symmachus, till thouBacked by an hundred students, throng'dst my bed;An hundred icy fingers chilled my brow:I had no fever; now I'm nearly dead."[4]

Besides quack doctors there were drug sellers (pharmacopola), who sold their medicines in booths or hawked them in the city and the country. In the time of the Empire the medicines of the regular practitioners were sold with a label which specified the name of the drug and of the inventor, the ingredients, the disease it was to be used for, and the method of taking it. Drug sellers dispensed cosmetics as well as medicines, and some of the itinerant dealers sold poison. The regular physicians bought medicines already compounded by the druggists, and the latter, as in our own day, prescribed as well as the physicians.

Depilatories were much in vogue, and were usually made of arsenic and unslaked lime, but also from the roots and juices of plants. They were first used only by women, but in later times also by effeminate men. Tweezers have been discovered which were adapted for pulling out hairs, and most of the depilatories were recommendedto be applied after the use of the tweezers. The duty of pulling out hairs was performed by slaves.

Most of the medical practitioners in the time of Augustus were either slaves or freedmen. Posts of responsibility and of honour were sometimes assigned to freedmen, as is shown by the appointment by Nero of Helius, a freedman, to the administration of Rome in the absence of his imperial master. Cicero wrote letters to his freedman Tiro in terms of friendship and affection. The master of a great household selected a slave for his ability and aptitude, and had him trained to be the medical adviser of the household; and the skill shown by the doctor sometimes gained for him his freedom.

There were 400 slaves in one great household of Rome, and they were all executed for not having prevented the murder of their master.[5]It is recorded that physicians were sometimes compelled to do the disgusting work of mutilating slaves.[6]The price of a slave physician was fixed at sixty solidi.[7]The great majority of physicians in Rome were freedmen who had booths in which they prescribed and compounded, and they were aided by freedmen and slaves who were both assistants and pupils. The medical profession, as has been shown, never attained the same dignity as in Greece. It should be understood that therewas a class of practising physicians in Rome quite distinct from the slave doctors. The following account of Lucius Horatillavus, a Roman quack of the time of Augustus, is taken from theBritish Medical Journalof June 10, 1911, and originated in an article in theSociété Nouvelle, written by M. Fernand Mazade:—

"He was a handsome man, and came from Naples to Rome, his sole outfit being a toga made of a piece of cloth adorned with obscene pictures and a small Asiatic mitre. Like many of his kind at that day, he sold poisons and invented five or six new remedies which were more or less haphazard mixtures of wine and poisonous substances. He had the good luck to cure his first patient, Titus Cnœus Leno, who, being a poet, straightway constituted himself thevates sacerof his physician, and induced some of his fashionable mistresses to place themselves under his hands. So profitable was Horatillavus's practice that he is said to have saved 150,000 sesterces in a few months. But for a moment his good fortune seemed to abandon him. A Roman lady, Sulpicia Pallas, died suddenly under his ministrations. This may have been due to his ignorance or carelessness; but he was accused of having poisoned his patient. This event might have been expected to bring his career to an end; but it was not long before he recovered the confidence of the people whom he deluded with his mystical language and promises of cure. He hadthree methods of treatment, all consisting of baths—hot, tepid, or cold—preceded or followed by the taking of wonder-working medicines. Horatillavus treated every kind of disease, internal and external; he even practised midwifery, which was then in the hands of women. Ten years after he settled in Rome he had accumulated a fortune of some 6,000,000 sesterces. He had a villa at Tusculum, whither he went three times a month; there he led a luxurious life in the most beautiful surroundings, and there his evil fate overtook him. His orchard was his especial pride. One day he found that birds had played havoc with his figs, the like of which were not to be found in Italy. Determined to prevent similar depredations in future, he poisoned the fig trees. Continuing his walk, he plucked fruits of various kinds here and there. While eating the fruit he had culled and drinking choice wine, he put into his mouth a poisoned fig, which he had inadvertently gathered, and quickly died in convulsions. Before passing away, however, he is said to have composed his own epitaph. This M. Mazade believes he has found. It reads: "The manes of Sulpicia Pallas have avenged her. Here lies Lucius Horatillavus, physician, who poisoned himself." If the epitaph is genuine, it is a confession of guilt. The death of the quack by his own poison is a curious Nemesis. The manner of his death proves that it was accidental, as few quacks are bold enough to take their own medicines."

FOOTNOTES[1]"De Medic.," lib. 1.[2]"Sat.," x, 221.[3]Rhodes's version.[4]Handerson's translation.[5]"Tacit. Annal.," xiv, 43.[6]"Paulus Ægin.," vol. ii, p. 379.[7]"Just. Cod.," vii.

[1]"De Medic.," lib. 1.

[2]"Sat.," x, 221.

[3]Rhodes's version.

[4]Handerson's translation.

[5]"Tacit. Annal.," xiv, 43.

[6]"Paulus Ægin.," vol. ii, p. 379.

[7]"Just. Cod.," vii.

Augustus — His illnesses — Antonius Musa — Mæcenas — Tiberius — Caligula — Claudius — Nero — Seneca — Astrology — Archiater — Women poisoners — Oculists in Rome.

Long before the settlement of the constitutional status of Augustus in 27B.C., he had undertaken many reforms. In 34B.C., Agrippa, under the influence of Augustus, had improved the water supply of Rome by restoring the Aqua Marcia, and Augustus had repaired and enlarged the cloacæ, and repaired the principal streets. Road commissions were appointed 27B.C.The Aqua Virgo was built 19B.C.Many of thecollegia, or guilds, founded for the promotion of the interests of professions and trades had been misused for political purposes, and Augustus deprived many of them of their charters.Curæ, or commissions, were appointed to superintend public works, streets and the water-supply; and the Tiber was dredged, cleansed and widened, and its liability to overflow reduced. No new building could be built more than 70 ft. high. Augustus also established firebrigades. It has been said that he found the city built of brick and left it built of marble.

He revived many old religious customs, such as the Augury of Public Health, and identified himself closely with the rites and customs of the people. He inculcated that sense of duty which the Romans calledpietas, and attempted to improve the morals of the citizens by the enactment of sumptuary laws; the philosophers hoped to do good in the same direction by appealing to the intellect and reason, a method that was equally ineffectual. Marriages and an increased birth-rate were encouraged, and parents were honoured and given special privileges. The wisdom and prudence of Augustus were strangely accompanied by credulity and superstition. He was a profound believer in omens, and attached great importance to astrology. His horoscope showed that he was born under the sign of Capricorn.

He suffered from various illnesses, although in his younger days he looked handsome and athletic. He carefully nursed his health against his many infirmities, avoiding chiefly the free use of the bath; but he was often rubbed with oil, and sweated in a stove, after which he was bathed in tepid water, warmed either by a fire, or by being exposed to the heat of the sun. When, on account of his nerves, he was obliged to have recourse to sea-water, or the waters of Albula, he was contented with sitting over a wooden tub,(which he called by a Spanish name,Dureta), and plunging his hands and feet in the water by turns.[1]His physician was Antonius Musa, to whom was erected, by public subscription, a statue near that of Æsculapius. During an attack of congestion of the liver when heat failed to give relief, Antonius Musa advised cold applications for the Emperor, which had the desired effect. Suetonius, the historian, wrote that this was "a desperate and doubtful method of cure." A more desperate and doubtful method of cure, however, was carried out by the same physician. He successfully banished an attack of sciatica that greatly troubled Augustus by the expedient of beating the affected part with a stick. Antonius Musa received honours from Augustus, and the Emperor also exempted all physicians from the payment of taxes, and from other public obligations.

In the time of Augustus natural philosophy made little progress, and Virgil strongly desired its advancement. Human anatomy, as a study, had not been introduced, and physiology was almost unknown. In medicine, the standard of practice was the writings of Hippocrates, and the Materia Medica consisted of remedies suggested by the whimsical notions of their inventors.

Pliny wrote that the water cure was the principal remedy in his day, as it was indeed throughoutthe Empire, and it was certainly the most popular. Seneca was very severe on the sentiment of a poem written by Mæcenas, the friend and counsellor of Augustus, but it serves to reveal some of the most dreaded maladies of the time:—

"Though racked with gout in hand and foot,Though cancer deep should strike its root,Though palsy shake my feeble thighs,Though hideous lump on shoulder rise,From flaccid gum teeth drop away;Yet all is well if life but stay."

Malaria was one of the principal causesofmortality in and near Rome in the reign of Augustus Cæsar.

Augustus's fatal illness occurred inA.D.14 from chronic diarrhœa, and the Emperor, like the true Roman that he was, displayed great calmness and fortitude in his last days.

Tiberius succeeded to the throne inA.D.14, and began a career of infamy. How little knowledge was likely to gain from his patronage is shown by the fact, recorded by Pliny, that the shop and tools of the artist who discovered how to make glass malleable were destroyed. Assassins and perpetrators of every abomination were the fit companions of this tyrant.

Thrasyllus, the astrologer, lived with Tiberius, who was a firm believer in the magic arts. This reign is made illustrious in the history of medicine by the work of Celsus.

Caligula, who became Emperor inA.D.34, was guilty of the most inhuman conduct. Criminals were given to the wild beasts for their food, and even people of honourable rank had their faces branded with hot irons as a punishment by order of this mad tyrant.

Claudius, the successor of Caligula, completed some very important public works in his reign, including great aqueducts and drains, but learning was at a low ebb in his day. Claudius Etruscus, the freedman of the Emperor Claudius, erected baths referred to by Martial. The ruins of the arches of the Aqua Claudia still remain.

Thrasyllus, a son of the astrologer who lived in the time of Tiberius, is said to have predicted to Nero the dignity of the purple. Nero would have been favourably disposed towards physicians if he had heeded the advice of his tutor, Seneca, who wrote: "People pay the doctor for his trouble; for his kindness they still remain in his debt." "Great reverence and love is due to both the teacher and the doctor. We have received from them priceless benefits; from the doctor, health and life; from the teacher, the noble culture of the soul. Both are our friends, and deserve our most sincere thanks, not so much by their merchantable art, as by their frank goodwill."[2]The practice of necromancy in the time of Nero had grown to suchan extent that an edict of banishment was issued against all magicians, but this did not lessen the popularity of the magicians, who indeed prospered under the semblance of persecution, and were honoured in times of public difficulty and danger. The practice of astrology came from the Chaldeans, and was introduced into Greece in the third century before Christ. It was accepted by all classes, but specially by the Stoic philosophers. In 319B.C., Cornelius Hispallus banished the Chaldeans from Rome, and ordered them to leave Italy within ten days. In 33B.C., they were again banished by Marcus Agrippa, and Augustus also issued an edict against them. They were punished sometimes by death, and their calling must have been lucrative to induce them to continue in spite of the severe punishments to which they made themselves liable. The penal laws against them, however, were in operation only intermittently. They were consulted by all classes, from the Emperor downwards.

There were many physicians in the reign of Nero, but none of great eminence. Andromachus was physician to the Emperor, and had the title ofarchiater, which means "chief of the physicians."

An account of the archiaters is of interest. The name was applied to Christ by St. Jerome. There were two classes of archiaters in time, the one class calledarchiatri sancti palati; the other,archiatri populares. The former attended the Emperor, and were court physicians; the latter attended the people. Although Nero appointed the first archiater, the name is not commonly used in Latin until the time of Constantine, and the division into two classes probably dates from about that time. Thearchiatri sancti palatiwere of high rank, and were the judges of disputes between physicians. The Archiatri had many privileges conferred upon them. They, and their wives and children, did not have to pay taxes. They were not obliged to give lodgings to soldiers in the provinces, and they could not be put in prison. These privileges applied more especially to the higher class. When anarchiater sancti palaticeased attendance on the Emperor he took the title of ex-archiater. The titlecomes archiatorummeans "count of the Archiatri," and gave rank among the high nobility of the Empire.

Thearchiatri popularesattended the sick poor, and each city had five, seven or ten, according to its size. Rome had fourteen of these officers, besides one for the vestal virgins, and one for the gymnasia. They were paid by the Government for attending the poor, but were not restricted to this class of practice, and were well paid by their prosperous patients. Their office was more lucrative but not so honourable as that of the archiaters of the palace. Thearchiatri populareswere elected by the people themselves.

Suetonius describes the treatment Nero underwent for the improvement of his voice: "He would lie upon his back with a sheet of lead upon his breast, clear his stomach and bowels by vomits and clysters, and forbear the eating of fruits, or food prejudicial to his voice." He built, at great expense, magnificent public baths supplied from the sea and from hot springs, and was the first to build a public gymnasium in Rome.

There is reason to believe that in the time of Nero there was a class of women poisoners. Nero employed one of these women, Locusta by name, and after she had poisoned Britannicus, rewarded her with a great estate in land, and placed disciples with her to be instructed in her nefarious trade.

There was also a very ignorant class of oculists in Rome in the time of Nero, but at Marseilles Demosthenes Philalethes was deservedly celebrated, and his book on diseases of the eye was in use for several centuries. The eye doctors of Rome employed ointments almost entirely, and about two hundred seals have been discovered which had been attached to pots of eye salves, each seal bearing the inventor's and proprietor's name. In the time of Galen, these quack oculists were very numerous, and Galen inveighs against them. Martial satirized them: "Now you are a gladiator who once were an ophthalmist; you did as a doctor what you do as a gladiator." "The blear-eyed Hylas would have paid you sixpence, OQuintus; 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." The oculists of Alexandria were very proficient, and some of their followers, at various times throughout the period of the Roman Empire, were remarkably skilful. Their literature has perished, but it is believed that they were able to operate on cataract.

With the death of Nero inA.D.68, the direct line of the Cæsars became extinct.

FOOTNOTES[1]Suetonius: "Lives of the Cæsars," lxxxii.[2]Seneca "De Benefic.," vi.

[1]Suetonius: "Lives of the Cæsars," lxxxii.

[2]Seneca "De Benefic.," vi.

Celsus — His life and works — His influence on Medicine — Meges of Sidon — Apollonius of Tyana — Alleged miracles — Vettius Valleus — Scribonius Longus — Andromachus — Thessalus of Tralles — Pliny.

Aulus Cornelius Celsus lived in the reigns of Augustus and Tiberius. References in his works show that he either lived at the same time as Themison or shortly after him. Verona has been claimed as his birthplace, but the purity of his literary style shows that he lived for a considerable time in Rome, and he was probably educated there. In Pliny's account of the history of medicine, Celsus is not mentioned as having practised in Rome, and it is almost certain that he combined the practice of medicine with the study of science and literary pursuits; his practice was not general, but restricted to his friends and dependents. His writings show that he had a clinical knowledge of disease and a considerable amount of medical experience. He wrote not only on medicine but also on history, philosophy, jurisprudence and rhetoric, agriculture and military tactics. His great medical work, "De Medicina," compriseseight books. He properly begins with the history of medicine, and then proceeds to discuss the merits of the controversy between the Dogmatici and the Empirici. The first two books deal with general principles and with diet, and the remaining books with particular diseases; the third and fourth with internal diseases, the fifth and sixth with external diseases and pharmacy, and the last two are surgical, and of great merit and importance. In his methods of treatment there can be discerned the influence of Asclepiades of Prusa, and the Hippocratic principle of aiding rather than opposing nature, but some of his work displays originality. His devotion to Hippocrates hindered very much the exercise of his own powers, and set a bad example, in this respect, to his successors.

He was rather free in the use of the lancet, but not to the same extent as his contemporaries, and he advocated the use of free purgation as well as bleeding. He never could rid his mind of the orthodox humoral theories of his predecessors.

(1)Surgery.—Although Celsus is the first writer in Rome to deal fully with surgical procedures, it must not be inferred that the practice of this art began to be developed in his time, for surgery was then much more advanced than medicine. Many major operations were performed, and it is very instructive for doctors of the present day to learn that much that is considered modern was wellunderstood by the ancients. There is no greater fallacy than to suppose that medical practice generally, and surgery in particular, has reached no eminence except in very recent times. The operation of crushing a stone in the bladder was devised at Alexandria by Ammonius Lithotomos, (287B.C.), and is thus described by Celsus:—

"A hook or crotchet is fixed upon the stone in such a way as easily to hold it firm, even when shaken, so that it may not revolve backward; then an iron instrument is used, of moderate thickness, thin at the front end but blunt, which, when applied to the stone and struck at the other end, cleaves it. Great care must be taken that the instrument do not come into contact with the bladder itself, and that nothing fall upon it by the breaking of the stone."

Celsus describes plastic operations for the repair of the nose, lips and ears, though these operations are generally supposed to have been recently devised.

He describes lithotomy, and operations upon the eye, as practised at Alexandria, both probably introduced there from India. Subcutaneous urethrotomy was also practised in his time.

Trephining had long been a well-known operation of surgery. There is an account in detail of how amputation should be performed.

The teaching of Celsus in reference to dislocations and fractures is remarkably advanced. Dislocations,he points out, should be reduced before inflammation sets in, and in failure of union of fractures, he recommends extension and the rubbing together of the ends of the broken bone to promote union. If necessary, after minor measures have failed to promote union, he recommends an incision down to the ends of the bones, and the open incision and the fracture will heal at the same time.

It is interesting to find that Celsus knew of the danger of giving purgatives in strangulated rupture of the bowels. For uncomplicated rupture he recommends reduction by taxis and operation. Cauterization of the canal is part of the operation. He also gives careful directions for removing foreign bodies from the ears.

Celsus writes very fully on hæmorrhage, and describes the method of tying two ligatures upon a blood-vessel, and severing it between the ligatures. His method of amputating in cases of gangrene by a simple circular incision was in use down to comparatively modern times. He describes catheterization, plastic operations on the face, the resection of ribs for the cure of sinuses in the chest walls, operation for cataract, ear disease curable by the use of the syringe, and operations for goitre. These goitre operations are generally supposed to be a recent triumph of surgery.

Celsus also had knowledge of dentistry, for he writes of teeth extraction by means of forceps,the fastening of loose teeth with gold wire, and a method of bursting decayed and hollow teeth by means of peppercorns forced into the cavity. He has described also many of the most difficult operations in obstetrics.

When it is remembered that Celsus lived centuries before the introduction of chloroform and ether, it is wonderful to contemplate what was accomplished long ago.

The qualities which should distinguish a surgeon were described by Celsus thus: "He should not be old, his hand should be firm and steady, and he should be able to use his left hand equally with his right; his sight should be clear, and his mind calm and courageous, so that he need not hurry during an operation and cut less than required, as if the screams of the patient made no impression upon him."

(2)Anatomy.—Celsus understood fairly well the situation of the internal organs, and knew well the anatomy of the chest and female pelvis. His knowledge of the skeleton was particularly complete and accurate. He describes very fully the bones of the head, including the perforated plate of the ethmoid bone, the sutures, the teeth, and the skeletal bones generally. Portal states that Celsus knew of the semicircular canals. He understood the structure of the joints, and points out that cartilage is part of their formation.

Celsus wrote: "It is both cruel and superfluousto dissect the bodies of the living, but to dissect those of the dead is necessary for learners, for they ought to know the position and order which dead bodies show better than a living and wounded man. But even the other things which can only be observed in the living, practice itself will show in the cures of the wounded, a little more slowly but somewhat more tenderly."

(3)Medicine.—His treatment of fevers was excellent, for he recognized that fever was an effort of Nature to throw off morbid materials. His recipes are not so complicated, but more sensible and effective than those of his immediate successors. He understood the use of enemas and artificial feeding. In cases of insanity he recognized that improvement followed the use of narcotics in the treatment of the accompanying insomnia. He recognized also morbid illusions. He recommended lotions and salves for the treatment of some eye diseases.

Although Celsus practised phlebotomy, he discountenanced very strongly its excessive use. The physicians in Rome, in his time, carried bleeding to great extremes. "It is not," wrote Celsus, "a new thing to let blood from the veins, but it is new that there is scarcely a malady in which blood is not drawn. Formerly they bled young men, and women who were not pregnant, but it had not been seen till our days that children, pregnant women, and old men were bled." The reason forbleeding the strong and plethoric was to afford outlet to an excessive supply of blood, and the weak and anæmic were similarly treated to get rid of evil humours, so that hardly any sick person could escape this drastic treatment.

Emetics were greatly used in the time of Celsus. Voluptuaries made use of them to excite an appetite for food, and they used them after eating heavy meals to prepare the stomach for a second bout of gluttony. Many gourmands took an emetic daily. Celsus said that emetics should not be used as a frequent practice if the attainment of old age was desired.

Celsus excelled as a compiler, and had the faculty of selecting the most admirable contributions to the art of healing from previous medical writers. His writings also give an account of what was best in the medical practice of Rome about his own time. He had a great love for learning, and it is remarkable that he was attracted to the study of medicine, for he was a patrician, and members of his class considered study of that kind beneath the dignity of their rank.

In the Augustan age, when literature in Rome reached its highest level, the literary style of Celsus was fit to be classed with that of the great writers of his time. He was never quoted as a great authority on medicine or surgery by later medical writers; and Pliny refers to him as a literary man, and not as a practising physician.From the fact that he elaborated no new system, and founded no new medical sect, it is not strange that he had no disciples.

In later centuries his works were used as a textbook for students, not only for the information they supplied, but also because of their excellence as literature.

Parts of the foregoing synopsis of the writings of Celsus are drawn from the writings of Hermann Baas and of Berdoe.

Meges of Sidon(20B.C.) was a famous surgeon who practised in Rome shortly before the time of Celsus. He was regarded by Celsus as the most skilful surgeon of that period, and his works, of which nothing now remains, were quoted by Celsus, and also referred to by Pliny. Meges was a follower of Themison. He is said to have invented instruments used in cutting for stone, and he wrote on tumours of the breast and dislocation of the knee. There have been several famous doctors calledEudemus. One of these was an anatomist in the third century before Christ, and a contemporary, according to Galen, of Herophilus and Erasistratus. He gave great attention to the anatomy and physiology of the nervous system. There was, however, another Eudemus, a physician of Rome, who became entangled in an intrigue with the wife of the son of the Emperor Tiberius. He aided her in an attempt to poison her husband inA.D.23. He was put to torture, and finally executed by order of Tiberius.

Apollonius of Tyanawas born four years before the Christian era, in the time of Augustus Cæsar, and is known chiefly for the parallel that has been drawn by ancient and modern writers between his supposed miracles and those of the Saviour. His doings as described by Philostratus are extraordinary and incredible, and he was put forward by the Eclectics in opposition to the unique powers claimed by Christ and believed in by His followers. Apollonius is said to have studied the philosophy of the Platonic, Sceptic, Epicurean, Peripatetic and Pythagorean schools, and to have adopted that of Pythagoras. He schooled himself in early manhood in the asceticism of that philosophy. He abstained from animal food and strong drink, wore white linen garments and sandals made of bark, and let his hair grow long. For five years he preserved a mystic silence, and during this period the truths of philosophy became known to him. He had interviews with the Magi in Asia Minor, and learned strange secrets from the Brahmans in India. In Greece he visited the temples and oracles, and exercised his powers of healing. Like Pythagoras, he travelled far and wide, disputing about philosophy wherever he went, and he gained an extraordinary reputation for magical powers. The priests of the temples gave him divine honours and sent the sick to him to be cured. He arrived in Rome just after an edict had been promulgated by Nero against magicians. He was tried beforeTelesinus, the consul, and Tigellinus, the base favourite of the Emperor. He was acquitted by Telesinus because of his love of philosophy, and by Tigellinus because of his fear of magic. Subsequently, at Alexandria, Apollonius, in virtue of his magic power, affirmed that he would make Vespasian emperor, and afterwards became the friend of Titus, Vespasian's son. On the accession of Domitian, Apollonius stirred up the provinces against him, and was ordered to be brought in custody to Rome, but he surrendered himself to the authorities, and was brought into the presence of the Emperor to be questioned. He began to praise Nerva, and was immediately ordered to prison and to chains. It is said that he miraculously escaped, and spent the remainder of his days in Ephesus.

The relation of Apollonius to the art of medicine is connected with his visits, on his travels, to the temples of Æsculapius, and his healing of the sick and alleged triumph over the laws of Nature. He was also credited with raising the dead, casting out devils and other miracle-working that appears to have been borrowed from the life of Christ. No doubt he was a genuine philosopher and follower of Pythagoras. His history is, on the whole, worthy of belief, except the part relating to miracles. It is noteworthy that he did not claim for himself miraculous power. Newman in his "Life of Apollonius" takes the view that the account of the miracles of Apollonius is derived from the narrativeof Christ's miracles, and has been concocted by people anxious to degrade the character of the Saviour. The attempt to make him appear as a pagan Christ has been renewed in recent years.

In the realm of medical practice he succeeded by imposture probably, but also in a genuine way by means of suggestion, and no doubt he had also acquired medical knowledge from study and travelling among people who had healing powers and items of medical knowledge perhaps unknown at the present day.

Vettius (or Vectius) Valleus, was of equestrian rank but he did not confer any honour on the medical profession. He was one of the lewd companions of Messalina, the wife of the Emperor Claudius, and was put to death inA.D.48. He was a believer in Themison's doctrines, and is said by Pliny[1]to have founded a new medical sect, but nearly all the Methodici attempted to create a new sect by adding to, or subtracting a little from, the tenets of Methodism.

Scribonius Largus(aboutA.D.45) was physician to Claudius and accompanied him to Britain. He wrote several medical books, and is reputed to have used electricity for the relief of headaches.

Andromachus, the elder, was physician to Nero, and the first archiater. He was born in Crete. He was the inventor of a compound medicinecalled after himself, "Theriaca Andromachi." He gave directions for making it in a poem of 174 lines. This poem is quoted by Galen, who explains that Andromachus gave his instructions a poetical form to assist memory, and to prevent the likelihood of alteration.

Andromachus, the younger, was the son of the first archiater, and was, like his father, physician to Nero. He wrote a book on Pharmacy, in three volumes.

Thessalus of Tralles, in Lydia, lived in Rome in the reign of Nero, and dedicated one of his books to the Emperor. He was a charlatan with no medical knowledge, but with a good deal of ability and assurance. He said that medicine surpassed all other arts, and he surpassed all other physicians. His father had been a weaver, and in his youth Thessalus followed the same calling, and never had any medical training. This did not prevent him, however, from acquiring a great reputation as a doctor, and making a fortune from medical practice. At first, he associated himself with the views of the Methodici, but afterwards amended them as he thought fit, until he had convinced the public, and perhaps also himself, that he was the founder of a new and true system of medicine. He spoke in very disrespectful and violent terms of his predecessors, and said that no man before him had done anything to advance the science of medicine. Besides having an endowment of naturalshrewdness and ability, he was equipped with great powers of self-advertisement, and could cajole the rich and influential. He was an adept in the art of flattery. Galen often refers to him, and always with contempt. Thessalus was able, so he said, to teach the medical art in six months, and he surrounded himself with a retinue of artisans, weavers, cooks, butchers, and so on, who were allowed to kill or cure his patients. Sprengel states that, after the time of Thessalus, the doctors of Rome forbore to take their pupils with them on professional visits.

He began a method of treatment for chronic and obstinate cases. The first three days of the treatment were given up to the use of vegetable drugs, emetics, and strict dietary. Then followed fasting, and finally a course of tonics and restoratives. He is said to have used colchicum for gout. The tomb of Thessalus on the Appian Way was to be seen in Pliny's time. It bore the arrogant device "Conqueror of Physicians." The success of Thessalus seems a proof of the cynical belief that the public take a man's worth at his own estimate.

Pliny, the elder, lived fromA.D.23 to 79, dying during the eruption of Vesuvius when Pompeii and Herculaneum were destroyed. He was not a scientific man, but was a prodigious recorder of information on all subjects. Much of this information is inaccurate, for hewas not able to discriminate between the true and the false, or to assign to facts their relative value.

His great book on Natural History includes many subjects that cannot properly be considered as belonging to Natural History. It consists of thirty-six books and an index, and the author stated that the work dealt with twenty thousand important matters, and was compiled from two thousand volumes.

Although Pliny was not a physician he writes about medicine, and paints a picture of the state of medical knowledge of his time. His own opinions on the subject are of no value. He believed that magic is a branch of medicine, and was optimistic enough to hold that there is a score of remedies for every disease. His writings upon the virtues of medicines derived from the human body, from fish, and from plants are more picturesque than accurate.

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