persons into Rome. A vocal critic of these changes, Cato’s de-
fense of traditional medicine coincided with a denunciation
of professional Greek physicians as greedy and even murder-
ous. Cato’s remedies nevertheless show his familiarity with
Greek medicine.
Ambivalence characterizes the Roman experience with
Greek medicine. In 293 b.c.e., aft er three years of plague, the
Roman Senate summoned the healing god Aesculapius from
his shrine in Epidaurus, in the Greek Peloponnese. According
to the myth, the god traveled in the form of a snake to Rome
and promptly ended the plague. His cult was established
on Tiber Island, where the river Tiber takes a double bend
through the city of Rome, and later spread throughout the Ro-
man world, attracting patients from all backgrounds. Romans
also continued to appeal to the healing gods of their native
pantheon and patronize older shrines, such as that of Diana
Nemorensis at Nemi in central Italy, established perhaps as
early as the eighth century b.c.e. about 16 miles from Rome.
Th e fi rst mortal Greek doctor, Archagathus (later known
as Caecilius of Calacte), who arrived in Rome in 219 b.c.e. on
the invitation of the Roman Senate, did not assimilate as eas-
ily. He was granted citizenship, and a practice was set up with
public funds. Soon, however, his harsh techniques earned
him the nickname “the executioner,” and he left Rome. Greek
medicine found a more successful representative in Asclepia-
des of Bithynia (fl. ca. 120–50 b.c.e.). Asclepiades arrived in
Rome toward the end of the second century b.c.e. and gained
renown for his gentle therapies. His teachings were modifi ed
by his student Th emison of Laodicea (fl. ca. 50 b.c.e.), who
identifi ed three causes of disease, called the commonalities:
“tightness” in the body, “looseness,” and a mixture of the two;
the physician simply noted the state of the patient’s body and
prescribed the appropriate cure. His ideas were elaborated in
the next century by Th essalus of Tralles, the founder of the
“Methodist” school of medicine, which essentially saw dis-
ease as an imbalance of solid particles and spaces in the body.
By this time Greek medicine was well established in Rome.
Julius Caesar had granted citizenship to all physicians in 49
b.c.e., and the emperor Augustus exempted them from taxes
in 23 b.c.e. Yet while many elite men consulted physicians,
they continued to value self-suffi ciency, and the care of the
body was an important component in Roman practices of
self-mastery.
While the Methodist school was popular at Rome, prac-
titioners competed for patients with physicians loyal to medi-
cal doctrines developed in Hellenistic Alexandria. Empiricists
believed that physicians should rely on past experiences with
a disease when determining the proper response to symp-
toms. Others, called Dogmatists by their adversaries, argued
that the physician needed knowledge of the human body and
the hidden causes of disease to treat patients successfully.
Galen of Pergamum (129–200 c.e.) brought the theory and
practice of medicine together. He was an expert anatomist,
well versed in philosophical debates about health and disease,
the emperor Marcus Aurelius’s personal physician, and a pro-
digious writer. Galen’s version of medicine, which developed
Hippocratic ideas about the importance of balance between
humors, elemental fl uids inside the body, infl uenced Byzan-
tine, Arabic, and medieval Western medicine.
Imperial expansion brought physicians into contact with
new medicaments and herbs. Exotic substances were in high
demand as both remedies, such as mithridatium, a drug com-
posed of thirty-seven diff erent ingredients, and cosmetics. Th e
most famous treatise on pharmacology, or the study of drugs,
was written in Greek in 64 c.e. by Pedanius Dioscorides of
Anazarbus (fl. ca. 40–90 c.e.). His fi ve-book De materia med-
ica is an attempt to provide a complete list of known medicinal
substances, organized according to their eff ects. Dioscorides’
work was consulted for the next 1,500 years.
Th e Roman army benefi ted from some of the most ad-
vanced medical care under the empire. With the establish-
ment of a permanent military presence on the frontiers, care
became more institutionalized. Production of Greco-Roman
surgical instruments sharply increased in the fi rst century
c.e., and many of the new fortresses included hospitals. Ci-Altar from Roman Britain (second century c.e.) dedicated to the
goddess Fortuna (who set life’s course), the healing god Aesculapius,
and Salus, goddess of health. (© Th e Trustees of the British Museum)
554 health and disease: Rome