There is a tremendous difference between today's medical techniques and that of doctors' in the Roman Empire. To begin with, no one had to go to school to learn how to become a doctor. Most doctors were trained by apprenticeship, like most trades from weaver to politician. There were some schools where medicine was part of the cirriculum, such as at the university at Alexandria, perhaps the most famous medical school of all. Some doctors were simply born into a `medical' family, specifically, a family devoted to the cult of a healing god. Aesculapius was the principal healing god of the Roman Empire, and Galen, the famous physician and medical writer of the 2nd century AD, was one example of a doctor from a medical/ or priestly family.

Since there were no licences granted to doctors, there was little to prevent anyone from setting out a shop-sign declaring him or herself open for medical business, or sometimes just setting up in the public baths and providing medical services like a hawker of pastry or sausages. The only way to get rid of such quacks was perhaps mob violence, but this seems not to have happened.

Comments in the ancient sources on doctors range from extremely complementary to the opposite. The epigrammatist Martial writing at the end of the 1st and into the 2nd century was perhaps most vitriolic. He compared doctors to morticians, declaring there was little difference in the end result of their services. Seneca, Nero's advisor, praises the devotion to duty of his own doctor as well as his skill, while another author comments that the quality of medical services were always better for more important or wealthier patients than they were for slaves. Tacitus, a contemporary of Martial relates how the Emperor Claudius' doctor was too skilled: he was induced by Agrippina to poison the aged Emperor, effecting a kill which was decidedly worse than the cure.

Many doctors, however, doubtless did the very best they could in an age without proper antiseptics or medicines-both are recent innovations which in this century have radically changed medical care for the better and vastly increased the patients' chances of survival. Many other aspects of Roman medical practice have also changed, one such being the range of the doctors instrumentarium or set of instruments. Modern methods of steel manufacture have greatly improved the cutting edges of scalpels, saws and lancets, and the strength and quality of needles, probes, hooks, forceps, clamps and specula, which are devices for opening and viewing the insides of various bodily orifices, such as the ear.

Roman metal smithing was generally quite fine; the techniques had been developed by the culturally superior Etruscans, and then later adopted and improved by the Romans. The shapes of physicians' tools are usually readily identifiable to those familiar with such instruments, and the decorative touches the Roman metalsmiths added to these instruments, so plainly manufactured today, would have been quite normal to a Victorian doctor. These decorative touches could include animals' heads at ends of handles, vegetal, beaded or scrolled patterns anywhere except the blade or `working' edge or surface of the instrument. Iron was the metal of choice for fine and strong blades, although the handle could be of another metal, usually an alloy of copper, which gave it a `bronze' look, and joined to the blade or working surface of the tool with a solder. Some tools were `steeled' for extra strength; primitive methods of steel smelting were known but don't seem to have been often used. Most tools were probably made by blade-makers, who likely made swords and butcher knives as well. A very few instruments have been found with makers' names on them, but so far we do not know too much about the manufacturing process nor the manufacturers themselves. Pompeii, of course, has yielded surgical instruments and some instrumentaria have been found buried in graves, presumably with the deceased doctor.

Many individual instruments and also some instrumentaria are identifiable as belonging to a specialist physician; cataract needles would be used by the eye doctor to repair some types of cataracts; there were a whole range of ear, nose and throat `gadgets'used to clean, inspect, and operate on tonsils, infected uvulae, infected ears and stuffy noses. There are plenty of identifiable orthopedic instruments, bone saws, pins and giant forceps. Obstetricians already had cranial forceps to use on babies being born. Almost all doctors would have had a range of scalpels, lancets and cupping instruments: these last two were very important. The lancet was used in blood-letting, a standard treatment for just about everything which lasted, incidentally, through the 19th century. If the patient bled enough, the ailment would be let out with the blood. Sometimes it was thought effective even to stop bleeding: if one had a wound in one arm which was bleeding too much, the other arm was bled, to equalize the pressure and thus stop the bleeding. Cupping was a lesser form of blood-letting. A flame was held under a cup device; when the oxygen was burned off, the cup was placed on the skin and the suction was thought to draw out the malady. What resulted was a drawing of blood resulting in a livid bruise.

©L.L. Neuru,  Labyrinth ( 48) 1990