Nov 1, 2022

Popular Beliefs about Doctors in Ancient Rome

Ancient Romans held a wide range of often contradictory views about physicians. Medical writers tended to praise the knowledge and skills of physicians, while other sources often described physicians as dishonest, incompetent and deadly charlatans. I will describe some of the most common beliefs about physicians in non-medical Roman sources such as Pliny the Elder, Martial, inscriptions and graffiti. But first, a few words about the ancient medical art as background to these popular beliefs.

Medical art in ancient Rome

Traditional Roman medicine – before the introduction of Greek medical theories – was based on natural treatments administered by family members, not by professional physicians. The head of the family, paterfamilias, was responsible for the wellbeing of his family and servants. Greek doctors started to move to Rome during the first centuries BC and brought with them new theories, which were slowly incorporated into Roman medicine. Many Romans were skeptical of the Greek influence, but Greek doctors were eventually accepted, especially among the aristocracy.

Aeneas treated by a surgeon.
(National Archaeological Museum of Naples, photo: Joonas Vanhala)

There were several competing theories on the human physiology and how ailments should be treated. One of the most well-known theories is that of the bodily fluids, but other aspects such as diet, heat and climate were thought to affect one’s health as well. The physician’s job was to make a diagnosis and suggest a course of treatments. Some of the most common treatments included diets, cold and hot baths, bloodletting and vomiting to balance the bodily fluids, medicines, herbs, magical cures, surgery and so on. Many of these treatments were, of course, ineffective and sometimes even dangerous to the patient. Healing was also sought in the sanctuaries of the gods of healing such as Aesculapius or through magical aids such as potions and amulets. A great number of votive gifts, offered as thanks to the gods for healing, have been found.

Roman votive gifts depicting healed parts of the body.
(Archaeological Museum of Bologna, photo: Joonas Vanhala)

There were various medical practitioners. Most of the physicians in Rome were Greek and usually from the lower classes. Greek doctors were the ones with the greatest theoretical knowledge, but there were others whose learning was based on a more practical take on medicine such as surgeons, midwives and herbalists. Most of these could be called medici in Latin, although in many instances this term refers specifically to the Greek learned physicians.

A relief depicting a midwife.
(Isola Sacra, photo: Joonas Vanhala)

There was no standardized education, and no qualifications were needed to be able to call oneself a physician. This was naturally reflected in the quality of treatment. On the other hand, we know of doctors specialized in the treatment of eyes, ears, teeth and fistulae, for instance, which indicates a dedication to a particular field of medicine.

Roman medical instruments also show that the ancient doctors could perform a number of practical treatments such as placing a catheter to aid urination, cauterize unhealthy tissue, remove teeth, and perform some basic surgical operations such as removing cataracts from the eye.

Roman medical instruments found in Pompeii.
(National Archaeological Museum of Naples, photo: Joonas Vanhala)

Cato the Elder: Greek physicians trying to destroy the Romans

One of the earliest accounts on physicians comes from Cato the Elder. He wanted to uphold traditional Roman values and practices and was skeptical of the Greek influence in Rome. Of the Greeks and their medicine, he had this to say:

They [Greeks] are a quite worthless people, and an intractable one, and you must consider my words prophetic. When that race gives us its literature it will corrupt all things, and even all the more if it sends hither its physicians. They have conspired together to murder all foreigners with their physic, but this very thing they do for a fee, to gain credit and to destroy us easily. (Pliny the Elder, Natural history 29.7)

For Cato the two main points of complaint were that Greek physicians were ill-willed and wanted to harm people, and that they demanded money for their services. These ideas are expressed in later Roman sources as well. Cato’s view is based on a general prejudice against the Greeks and their culture that he saw as corrupting the Roman society.

Pliny the Elder: dishonest, greedy and dangerous physicians

Another well-known account on medicine and physicians was written by Pliny the Elder. His description reflects many of the beliefs and prejudices held by the Romans. Pliny follows Cato when he describes Greek physicians as dangerous and willing to kill:

Physicians acquire their knowledge from our dangers, making experiments at the cost of our lives. Only a physician can commit homicide with complete impunity. (Pliny the Elder, Natural History 29.8)

While Cato argued that the Greek physicians were simply malicious, Pliny saw a clear motive for the harm done by physicians, medical knowledge through experiments.

Pliny laid down further accusations of poisonings, conspiracies and adulteries:

For what has been a more fertile source of poisonings? Whence more conspiracies against wills? Yes, and through it too adulteries occur even in our imperial homes… (Pliny, NH 29.8)

He also accused physicians of avarice and greed:

Let me not even bring charges against their avarice, their greedy bargains made with those whose fate lies in the balance, the prices charged for anodynes, the earnest-money paid for death… (Pliny, NH 29.8)

Pliny portrays physicians as deliberately harming their patients for their own gain. This may have some basis in reality considering the number of accounts in Roman sources of such nefarious dealings, especially in aristocratic and imperial households.

One more criticism that Pliny raises against physicians is their incompetence:

It is plainly a showy parade of the art, and a colossal boast of science. And not even the physicians know their facts… (Pliny, NH 29.8)

Pliny is opposed to Greek doctors much the same as Cato, because of a general prejudice against the Greeks. It seems that many upper-class Romans were skeptical about the corrupting influence of Greek ideas and their threat to traditional Roman values and virtues even in the 1st century AD.

This aversion to Greek physicians seems to have spilled over to more popular forms of art such as Roman comedy and satire. In these genres the focus is not as clearly on the Greek aspect of medicine, but it still lingers in the background. The point of these biting descriptions is more specifically on the misconducts of doctors and the dangers they pose to their patients.

Martial: incompetent and deadly physicians

One of the most prolific writers of satirical epigram was Martial who wrote many poems specifically about doctors. In this poem the doctor and his students do more harm than good:

I was out of sorts; but at once you visited me, Symmachus, accompanied by a hundred pupils. A hundred hands chilled by the north wind touched me. I did not have a fever, Symmachus. Now I do. (Mart. 5.9) 

Many of the physicians in Martial’s epigrams end up killing their patients. An extreme case is this one where the mere sight of a doctor is enough to kill a man:

Andragoras bathed with us, ate a cheerful dinner; the same man was found dead in the morning. Do you enquire the cause of so sudden a demise, Faustinus? In his dreams he had seen Doctor Hermocrates. (Mart. 6.53)

The doctors in Martial's poems almost always have Greek names, which may simply reflect the fact that most physicians of his time were still of Greek descent, but there may be a hint of prejudice embedded in there too. The focus is not so much on the physicians being Greek but on their general lack of competence and their questionable morals.

The fact that this kind of abuse against physicians was not solely a matter of prejudice against Greeks is especially evident when we compare the poems of Martial with Greek epigrams, where many of the same themes appear. An incompetent doctor ends up killing his patient in this ridiculously exaggerated account:

Socles, promising to set Diodorus’ crooked back straight, piled three solid stones, each four feet square, on the hunchback’s spine. He was crushed and died, but he has become straighter than a ruler. (Greek Anthology 11.120)

Just like the patient in Martial’s poem who was killed after seeing a doctor in his dream, here remembering the doctor’s name is enough to kill a man:

Phidon did not purge me with a clyster or even feel me, but feeling feverish I remembered his name and died. (Greek Anthology 11.118)

And here is an example of the recurring topic of greed and avarice of the physicians:

Rhodo removes leprosy and scrofula by drugs, but he removes everything else [i.e. steals] even without drugs. (Greek Anthology 11.333)

Invective against physicians had clearly become a literary topos that was expressed in both Greek and Latin writings and over a span of centuries. The Greek epigrams cited above were roughly contemporary with Pliny and Martial, that is from the 1st and 2nd centuries AD. The collection of Greek epigrams, however, contains similar material even from previous centuries.

Cicero: positive mentions of physicians

The remarks on physicians in Roman literature are not entirely negative, however. There are occasions when doctors are remembered in a positive light such as when Cicero laments the death of one of his doctors:

What a misfortune about Alexio! – – It is his love for me, his kindness and charming manner that I miss. There is another thing, too. What have we not to fear, when so temperate a person and so skillful a physician can be overcome suddenly by such a disease? (Cicero, Letters to Atticus 15.1.1)

Or when Cicero recommends a physician to a friend:

To you I most earnestly recommend Glyco, the physician of Pansa, who has the sister of our man Achilles for his wife. – – Besides, he is steady and a worthy fellow who, you would think, could not even be driven to crime by the prospect of gain. (Cicero, Letters to Brutus 1.6.2)

Here Cicero is mindful of one of the common complaints against physicians, namely their willingness to commit crimes in hopes of monetary gain. On other occasions Cicero does voice similar criticism against physicians as seen in Cato, Pliny and Martial.

Inscriptions: praise and blame of physicians

Physicians are mentioned in many inscriptions, especially in funerary contexts. These inscriptions offer a glimpse into the thoughts and views of social classes outside of the literary circles of Rome. Many of these inscriptions were produced by and for slaves and freed slaves. Roman inscriptions express both praise and blame for doctors.

Here is a votive inscription offered to the gods of healing by a Roman officer Ulpius, praising a doctor named Lucius Julius Helix:

CIL VI 19
(Photo: Catalogo dei Musei Vaticani)

Dedicated to Aesculapius and Hygia – Marcus Ulpius Honoratus, cavalry officer, for his health and of his family, and that of Lucius Julius Helix, the physician who diligently took care of me according to the gods, has fulfilled his vow willingly and happily. (CIL VI 19, Rome, 131–179 AD) 

Another inscription, written in the first person, portrays a physician praising himself, which is not unusual in funerary inscriptions. Judging by his name, Claudius was most likely a freed slave. The inscription may have been commissioned by Claudius himself before his death or by someone else.

IGUR III 1247
(Photo: Ashmolean Museum, University of Oxford)

I, physician Claudius Agathemeros, who swiftly learned a remedy against all kinds of illness, rest here. This memorial is common to me and my wife Myrtale. We are in Elysium with the pious ones. (IGUR III 1247, Rome, ca. 50–100 AD)

Praise of a doctor is not unexpected in a votive inscription dedicated to the gods of healing and is quite formulaic in a physicians own funerary inscription. Still, such complimentary remarks show that physicians were not always the target of disparaging invective, but could be remembered fondly, just as in Cicero’s remarks about his doctors.

There are, however, many examples of more negative opinions expressed even in inscriptions. In a few inscriptions physicians are remembered for their inefficient treatments such as here:

CIL VI 68
(Photo: Wikimedia Commons)

Felix Asinianus, public slave of the priests, fulfilled his vow to Bona Dea Agrestis Felicula willingly after his eyesight was restored. Abandoned by doctors he was cured after ten months through medicine by the aid of his Mistress… (CIL VI 68, Rome, ca. 1–30 AD)

In this second one the doctors killed the patient:

CIL VI 37337
(Photo: Corpus inscriptionum Latinarum, Archiv)

To the spirits of the dead; Euhelpistus, a freed slave, who is also a Manes, lived 27 years, 4 months and 11 days. A sudden death took away his joyous years, a most innocent soul whom doctors cut up and killed. Publius Aelius Peculiaris, a freed slave of the emperor, [made this] to his fellow slave. (CIL VI 37337, Rome, ca. 101–150 AD)

Inscriptions such as these follow certain traditional forms and are not necessarily a good reflection of popular attitudes, although their content could be varied according to individual tastes and requests. We should look for further evidence in Roman graffiti which tended to be more spontaneous in both their content and how they were produced. The problem is, there are very few graffiti that mention physicians at all, and the ones that do, usually do so in passing.

Graffiti: few mentions of physicians

From Herculaneum we have this famous graffito:

CIL IV 10619
(Photo: Wikimedia Commons)

Apollinaris, doctor, slave of emperor Titus, pooped well here. (CIL IV 10619)

This description of Apollinaris is quite neutral. And even if we want to detect an aspect of insult, it has more to do with the fact that he was defecating, not that he was a doctor.

In this graffito found in Ostia are threatened with oral rape:

– – Shit well and fuck the doctors in the mouth. (AE 1941,8)

This is clearly a hostile take on doctors, but we know nothing about the context or the motives of the writer of this graffito.

Among the Pompeian graffiti I have only found this mention of a man treating another man:

Pierus Celadus, priest of the cult of Augustus, treated Amandus, Papirius' slave. (CIL IV 8810)

The fact that illness was a common occurrence is reflected in a number of graffiti from Pompeii, such as this one making fun of a person suffering from hemorrhoids, which were believed to be the result of anal sex:

CIL IV 1820
(Photo: Varone 2012)

Chios, I hope your piles become sore again, so that they smart more than they smarted before. (CIL IV 1820)

In a few Pompeian graffiti the writer wishes disease for someone else, resembling a curse: 

I hope you will fall ill. (CIL IV 2960)

Greetings Asbestus, you should get ill. (CIL IV 762)

Insults against doctors are almost completely absent from Roman graffiti. It is difficult to say why this is when abuse against them is so prominent in Roman literature. There were physicians even in small towns like Pompeii. The most likely explanation for the absence of invective against physicians from the graffiti is that doctors simply did not warrant much attention in people’s lives. A visit to a doctor may have been a rare occurrence. And if the doctors were mostly itinerant ones, writing about them on the walls wouldn’t have made much sense. The prejudice against physicians expressed in Roman literary sources probably was familiar even to the non-elite, but this was simply not expressed in wall inscriptions.

Invective against physicians seems to have been a matter of literary expression and a point of discussion among the upper classes, rather than a popular topic among the ordinary people. The criticism of physicians in literary sources was, at least in part, based on a more general prejudice against the Greeks and their growing influence in Rome. The accusations of malpractice and harmfulness of the physicians was likely based on reality because the ancient medical theories led to ineffective and dangerous treatments. The negative beliefs about physicians discussed here were popular in the sense ”widely held”, at least among certain literary circles, but not ”popular” in the sense that the wider public would have expressed them in their occasional writings.



This blog post is based on a paper I gave at the 14th annual conference of the International Society for Cultural History in Verona, Italy in August titled "Popular beliefs about physicians in ancient Rome". The PowerPoint slides can be found through this link.

Translations:

Cicero in Twenty-Eight Volumes. XXVIII, ed. M. Cary, Cambridge 1989.

Cicero. Letters to Atticus, ed. E.O. Winstedt, Cambridge–London 1987.

The Greek Anthology, Books X–XII, ed. by W. R. Paton, Loeb Classical Library 85, Cambridge MA 1918.

Martial, Epigrams, Vol. 1–3, ed. by D. R. Shackleton Bailey, Loeb Classical Library 94, 95 & 480, Cambridge MA 1993.

Pliny the Elder, Natural History, Volume VIII: Books 28-32, ed. W. H. S. Jones, Loeb Classical Library 418, Cambridge MA 1963.

The translations of inscriptions and graffiti are my own.

Other sources:

AE = L’Année épigraphique

CIL IV = Corpus inscriptionum Latinarum, vol. 4, Inscriptiones parietariae Pompeianae Herculanenses Stabianae, Berlin, 1871–.

CIL VI = Corpus inscriptionum Latinarum, vol. 6, Inscriptiones urbis Romae Latinae, Berlin, 1876– 

IGURInscriptiones Graecae urbis Romae

Varone 2012 = A. Varone, Titulorum graphio exaratorum qui in C.I.L. vol. IV collecti sunt, imagines, ”L’Erma” di Bretschneider, Roma 2012.

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