It is a rare event when an author can review a book that carries the same title as one he wrote 35 years ago, and even more unusual if the earlier writer recommends the new book with some enthusiasm. So it is with my comments on Cruse’s welcome synopsis of medicine among the Romans, an aspect of ancient medical studies that has undergone a rapid expansion in scholarly depth and breadth since the appearance of my Roman Medicine in 1969. To be sure, Cruse focuses on Roman medicine as it functioned in Britannia, and she does not address many of the questions that face us as we analyze texts and sources that testify to the provincial variations of medical practice in the Empire as a whole,1 but that is not her purpose. Cruse intends to present some of the salient facets of a British Roman medicine, and does so lucidly with a good control of the best references now available. Archaeology is key to her view of how a ‘Roman’ medicine developed in the island province just across the channel from Gaul, and did so with marked local features. Non-specialists may not realize that ancient medical historians rarely took up issues of archaeological importance as recently as the 1960s,2 so I am pleased, indeed, to suggest Cruse’s Roman Medicine not only to colleagues wishing a good summary of ‘what we know at the moment,’ but also to students who frequently express a curiosity about medicine among the Romans.
Cruse’s book is characterized by an admirable blending of disparate topics. A reader is led immediately to the materials of an ancient medicine that emphasized healing cults, the role of magic and soothsaying, and other presumably irrational aspects of individuals pursuing health and avoiding disease in ways uncommon in the post-industrial West (but still quite ordinary in much of the world today). There is a continual reminder that most citizens of a Romanized Britain, and in the Empire generally, lived close to the land that produced their livelihoods, and thus many therapies as understood by both patient and physician (of whatever stripe) were rooted in very old folk customs, folk medicine that demonstrated local variations fused with the lore of farms and the technologies of agriculture. Roman Britain displayed what provinces generally were proud to display: urban hearts resplendent in public architecture that served basic needs of peace and security, that well-documented array of all-weather commercial centers, aqueducts, those rigidly straight paved roads connecting Roman military and civilian settlements, and the dominant structures that served public law as they connoted imperial order. Cruse melds these topics with medicinally useful plants as gathered by rural experts, with Greek doctors who served in the legions, with a firm accounting of why Roman aqueducts were essential to what we would term “public health,”3 and with the social institutions that were the baths, in their own way promoting a general sense of salus. There is a good summary of modern analytical techniques as used by archaeologists as they determine disease, life-spans, causes of death, and diet (examples range from Herculaneum to the Romano-British cemetery at Poundbury), and the Roman physician makes his appearance with his theoretical constructs derived from various Hellenistic medico-philosophic sects. Patients, of course, might or might not comprehend or care about what the learned medicus or iatros might think about causes, but would pay close attention to a medical personage whose reputation suggested that his ministrations produced good results.
Primary sources for Roman medicine are carefully chosen, explicitly cited, and appropriately linked with particular topics (e.g. Scribonius Largus on tooth decay, Cornelius Celsus on surgery and surgical tools, Pliny the Elder on the extinct cure-all called silphium). Cruse selects exactly those surgical implements to illustrate special operations (rightly citing the fundamental work of Lawrence Bliquez and Ralph Jackson), so that even a beginning student can come away from her Roman Medicine with a limpid mental picture of an active medical profession, practicing at levels ranging from the hawkers of wonder drugs in the fora and the unlettered rootcutters selling freshly gathered herbs to military physicians, to the ordinary midwives and to those practitioners in the cities who saw and doctored many patients with a dose of Greek theory. Opinions about military medicine in the legions are not as firm as Cruse suggests, but her presentation of the evidence from Roman Britain leaves little doubt that soldiers often received medical care on levels that matched the best available anywhere in the Empire.
In addition to the numerous black and white photographs, and many line drawings scattered throughout the book, there are 34 deliciously clear color shots nestled between pages 192 and 193. Here are the refulgencies of mandrake apples, the night lilies ( Datura) growing and thriving at Wolfson College (Oxford), henbane in its pointed greenery and distinctive bell-shaped white flowers pocketed with purple anthers, wormwood, pomegranates, and valerian, along with oculists’ stamps, a scene from Bath, surgical tools, and the usual variety of mosaics, Greek vase paintings, statuary, and temples. Cruse’s Roman Medicine is ideally suited as a beginning text for any course in ancient medicine, and the book should find wide application in the ever-multiplying courses on the subject.
Notes
1. This is apparent in Roman military medicine; the famous valetudinaria suggest regional variations, where the structures can be reliably documented, and are not uniformly distributed on the frontiers; moreover, recent work reveals a pervasive presentism in accounts of military hospitals. See esp. Patricia Anne Baker, Medical Care for the Roman Army on the Rhine, Danube and British Frontiers in the First, Second and Early Third Centuries AD (Oxford: British Archaeological Reports, 2004 [BAR International Series 1286]).
2. An excellent monograph that pulls together many aspects of a Roman archaeology that elucidates the practice of medicine (especially surgery) is Ralph Jackson, Doctors and Diseases in the Roman Empire (London and Norman: British Museum and University of Oklahoma Press, 1988). Unhappily the book has gone out of print.
3. It has become fashionable in some quarters to deny that the Romans did much about “public health” in their cities, in spite of the architectural and sanitary achievements represented by the aqueducts, e.g. Vivian Nutton, “Medical Thoughts on Urban Pollution,” in Valerie M. Hope and Eireann Marshall, eds., Death and Disease in the Ancient City (London and New York: Routledge, 2000), pp. 65-73. Supporting Cruse’s assessment (and most other authorities since the 19th century) is Neville Morley, “The Salubriousness of the Roman City,” in Helen King, ed., Health in Antiquity (London and New York: Routledge, 2005), pp. 192-204.