Physicians From The Time Of Augustus To The Death Of Nero
Celsus--His life and works--His influence on Medicine--Meges of
Sidon--Apollonius of Tyana--Alleged miracles--Vettius
Valleus--Scribonius Longus--Andromachus--Thessalus of
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 claim
d 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," comprises eight 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 well understood 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, (287 B.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
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 haemorrhage, 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 superfluous to 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
(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 for bleeding the strong and
plethoric was to afford outlet to an excessive supply of blood, and the
weak and anaemic 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 (20 B.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 called Eudemus.
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 in A.D. 23.
He was put to torture, and finally executed by order of Tiberius.
Apollonius of Tyana was born four years before the Christian era, in
the time of Augustus Caesar, 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 before Telesinus,
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 AEsculapius, 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
narrative of 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
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 in A.D. 48. He was a believer in Themison's doctrines, and is
said by Pliny 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 (about A.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
medicine called 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
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 natural shrewdness 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 from A.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 he was 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
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.