In Ancient Rome, the most common treatment for any illness, ranging from migraines to fevers to a broken foot, was bloodletting. Bloodletting, or the withdrawal of blood from patients, was widely accepted due to the humoral theory created by the Greek physician Hippocrates. The humoral theory states that the body is composed of four fluids, or humors: blood, phlegm, black bile, and yellow bile. This theory directly coincided with the theory of Claudius Galen, a Greek physician who moved to Rome in 162 CE and reasoned that blood did not return to the heart or liver where it was formed, but traveled through veins to nourish and be consumed by the body, eventually needing to be replenished again. Sometimes, the liver would produce too much blood, causing illness due to the imbalance of humors. Thus, bloodletting became a cure to reset the internal equilibrium of the body. Though now discredited, the theory of the four humors remained popular in Europe until the 17th century.
Before doctors, heads of households were responsible for treating their sick with herbal cures and sufficient medicines. Some herbal remedies included garlic for a good heart, egg yolk for dysentery, and fennel to calm nerves. Eventually, Roman ‘doctors’ emerged and these health ‘professionals’ were considered what they were, liars and quacks. Most early doctors were self-taught or apprentice practitioners, claiming to be healers with no medical knowledge, and would often con and cheat their patients. Although rare, some would even act as assassins and poison their patients with false antidotes. To increase their notoriety, doctors who were not wealthy enough to own a shop would perform simple surgeries for crowds on the streets. Simple surgeries in the ancient world included removing brandings from freed slaves and trepanation, a brain surgery in which a hole was drilled into the skull to relieve pressure and cure headaches, and had a surprisingly high survival rate.
However, with the expansion of the Roman Empire, Greek doctors came to Rome and became more highly regarded than Roman doctors. The first Greek physician, Archagathus of Sparta, arrived in Rome in 219 BCE. Other Greek scientists and doctors followed, first as prisoners of war, then practicing physicians allowed to continue their research in Rome. The Romans adopted most of the Greeks’ ideas, yet prohibited the dissecting of corpses and thus, didn’t discover much about human anatomy. Nevertheless, even though Galen was restricted to dissecting animals, he was able to apply his knowledge to humans and become an expert in anatomy.
Furthermore, much of the medicine which developed came from battlefield needs. Surgeons would use boiling water to sterilize their tools, such as arrow extractors, scalpels and forceps, and then perform surgeries on the battlefield without any effective anesthetics. During the rule of Nero, one famous Greek army doctor practicing in Rome was Pedanius Dioscorides. Also being a botanist and pharmacologist, Dioscorides wrote De Materia Medica, a five volume pharmacopeia with 600 herbal cures which would continue to be used by doctors for the next 1500 years. Additionally, army barracks were built away from swamps to avoid disease which the Romans realized were caused by mosquitoes and insects spawning in the marshes. Marcus Terentius Varro speculated that diseases were caused by creatures too small to be seen with the naked eye which we now know to be bacteria and viruses. Lucius Junius Moderatus Columella, an agricultural writer, would later theorize that swamp vapors caused diseases. Others continued to believe that the stars were the source of illness.
Upon observing the health of their soldiers, Roman leaders realized the importance of public health. Aqueducts were created to pipe clean water into cities from springs and an advanced sewage system was constructed for waste. To facilitate personal hygiene, public baths and washrooms were installed, accessible to all with the entrance fee only costing one quadrant (1/16th of a penny). As said by the famous phrase mens sana in corpore sano, the Romans also prioritized exercise as they believed that a healthy body equated a healthy mind.
Overall, the Romans worked hard to maintain a healthy and continually advancing society.