Jane Draycott (D.) embarks on an ambitious project: to describe and clarify the medical habits and practices that characterized households in Latium during the period in which Romans were transforming themselves from bellicose farmers and herdsmen into Mediterranean imperialists. The slim volume begins with a 21-page introduction, establishing as D.'s central concern the health and sense of well-being experienced by the autarkic Roman population, and the manner in which the building and location of their domiciles, the laying out of an adjacent kitchen garden, and the very structuring of the Roman family itself are all fodder for investigation into how the members of the Roman familia interacted for the good of all in their daily lives. Prior to the end of the volume with its four pages of summation, an extensive excursus suggests the various means by which medical knowledge came to, and circulated among, family members.
A particularly nice touch is that every chapter begins with a quotation from a Roman writer or an image of a Roman artifact with a medical theme. Thus, the introductory chapter begins with two lines from Horace's First Satire (80‒81), listing tasks the paterfamilias, when confined to his sickbed, needs done for him by those who dwell in his house: sitting by his bedside to keep him company, preparing soothing lotions to lessen his fever, summoning the doctor should he take a decided turn for the worse. Similarly, the concluding chapter begins with the juxtaposition of Vergil's description of the wounding of Aeneas (Aen. 12.391‒424) and the Pompeian mural in the house of Vedius Siricus (Regio 7) in which the painter gathered Vergil's characters around the wounded hero. It depicts Iapyx laboring in vain to extract the barbed arrow from Aeneas's thigh as Aeneas's son, the boy Iulus/Ascanius, sobs and dries his tears on his garment, and Aeneas's faithful comrade, Achates, looks glum. Meanwhile, in the foreground, Aeneas's goddess mother, Venus, clasps sprigs of Cretan dittany and brings ambrosial juices to heal her son, more or less instantaneously (“subitoque … iamque,” Aen. 12.421‒23). Throughout the volume most images are well reproduced and accordingly amplify the impact of D.'s text.
There is much here to learn and to like, but there are also details with which I disagree, such as D.'s claim that Julius Caesar's conferring citizenship upon those practicing medicine in the city automatically resulted in his acquiring his own private physician in a manner similar to Cicero, Verres, and Octavian.Footnote 1 There are also signs of carelessness in the preparation of the text, especially in the Greek, as, for example, the adjective “helpful,” πρόςφορον (44). In what follows, I highlight some areas where the author's emphasis may be questioned or where there is room for productive expansion.
The continued influence of Greek medicine and Greek practitioners on Roman medicine
I find the short shrift given to “Greco-Roman medicine” uncomfortable once D. has moved into the 2nd c. BCE. By then the Carthaginians had been defeated twice; Seleucid and Macedonian monarchs were put in their places in the years that followed and, more or less at mid-century, the great old cities of Corinth and Carthage were sacked by Roman forces. It appears to me that D. largely avoids the “Greco-” of Greco-Roman medicine at least in part because of her apparent efforts to stress Latinity and Roman-ness in her presentation, and especially to avoid lists of immigrant doctors, about many of whom we know nothing beyond the fact that they left their homelands and came to Rome, eventually to die and be buried with a grave marker in Koine that survived to modern times. In other words, I miss at least a nod in the direction of V. Nutton's description of the energetically competitive medical marketplace that not only thrived in Rome but eventually became operative in large towns and cities throughout the Mediterranean basin, certainly by the later decades of the 2nd c. BCE, and most likely by the middle of that century. Nutton writes: “The assimilation of Greek medicine into the Latin-speaking world of central Italy, and thence over time into Western Europe, is one of the most momentous developments in the history of medicine.”Footnote 2
At the same time, I do sympathize with D.'s desire to avoid turning Roman medicine into a constant parade of practitioners flowing into the city in search of the fame and fortune that they hoped would compensate them for having abandoned their homelands. Further, the fact that she has singled out for attention Asclepiades from Prusa (Bithynia) seems to me totally appropriate. He well deserves the paragraph devoted to him (32) because of his efforts to make Greek medicaments more palatable to Romans, such that they named him “the wine giver” (οἰνοδώτης). Asclepiades also stressed the salubriousness of passive exercises, such as riding on horseback or in a boat propelled by one's slaves, singing in a chorus, and reading aloud. Recent work by D. Leith has further clarified both Asclepiades himself and his followers, the Asclepiadians, arguing that the sect itself continued to flourish for centuries after the master's death, apart from and often in opposition to the Methodists.Footnote 3
Transplants to Italy: Scribonia Attice and M. Ulpius Amerimnus as a case study
This interesting discussion concerns two medical practitioners buried in the necropolis at Isola Sacra near Ostia. I consider both the midwife, Scribonia Attice (as her cognomen appears on the Latin inscription that she had affixed to Tomb 100), and her doctor-husband, M. Ulpius Amerimnus (ἀμέριμνος = “free from care”), to be transplants to Italy from somewhere in the eastern half of the empire during the 2nd c. CE. D. introduces this couple early on (5‒6), reproducing the splendid terracotta images affixed to either side of the doorway into the family's tomb. Both husband and wife here advertise their profession. The surgeon is apparently phlebotomizing the leg of a patient. His knives and scalpels are displayed in his instrumentarium, while Attice displays her special midwife's chair (δίφρος μαιωτικός), on which she has seated a patient in the process of birthing her baby, sending the infant safely through the perforation in the chair's seat and dropping it into the waiting arms of a midwife who kneels in front of the chair, much as Soranus of Ephesus prescribed in his Gynaecology (2.3). The same chair could be used again should Attice intend to apply a fumigation: setting her patient back in the chair with fumigant spices over burning coals placed underneath and a reed ascending through the perforated seat to deliver fumes where they were needed ‒ most likely into the vagina; these were evil-smelling fumes when the uterus prolapsed and needed to be sent upward to its usual position in the pelvis, and sweet-smelling fumes to attract the uterus down should it have wandered too high and choked the patient, the so-called “hysterical suffocation” (ὑστɛρικὴ πνίξ). The Elder Cato already knew how to use this type of chair for fumigations (Agr. 157.11).
As the inscription at Isola Sacra makes clear, Scribonia Attice built the tomb for herself, for her husband, who predeceased her, for her still-living mother, Scribonia Callityche, and for a Diocles, perhaps also close kin. Both mother and daughter had some connection to the Scribonian gens. Attice and her mother were both widows, probably because they had married men a half-generation or older than they. As with many of the interments at Isola Sacra, the family probably lived pleasantly in the nearby seaside community of Portus, the hexagonal harbor town recently built by Trajan as he sought to expand shipping potential at the mouth of the Tiber. Amerimnus is likely to have belonged to the familia Caesaris prior to the manumission that brought him Roman citizenship, for he shares Trajan's praenomen and nomen. Attice's husband was as likely as his wife to have been a medical immigrant to Rome, but where they met or became a couple is unknown.
Due to their professional competence, the family was able to own male and female slaves who, along with their descendants, would also receive burial within the family's tomb, except for two slaves, Panaratus and Prosdocia, who were specifically excluded from the tomb by name (their misdeeds are not recorded). The couple's worldly success was sufficient for Attice to erect the modest tomb and provide burial spaces for others attached to her household. She boasts of having paid for the tomb, its marble inscription, and its lintel, as well as the individualized terracotta plaques for herself and Amerimnus. Although their cognomina attest to an origin among Greek-speakers of the empire, the couple's social habits were not unlike those of the Romans in whose country they were spending their adult lives. The language of the inscription is Latin, its abbreviated formulae speaking to a Latinate audience.
Harm introduced by immigrant medical personnel
The Elder Pliny claimed that most Romans displayed scant interest in pursuing a career in medicine, and very few native Romans seem to have practiced medicine, which he attributes to their inherent seriousness (Romana gravitas, NH 29.8.16‒17; see also 23.19.32). He made plentiful use of the written works attributed to M. Porcius Cato Maior, often referring to him as “Cato the Censor.” The majority of the 37 books of Natural History contain at least an aside that gives Cato's instructions, at times in addition to fuller explications interspersed with other authorities, as in Book 14 on viticulture and wine production.
Pliny's “negative” history of medicine in Book 29 begins with the god Asclepius, struck by lightning because he dared to restore life to Tyndareus, and a dishonorable Hippocrates, who plagiarized for his own use cures inscribed by grateful patients at healing shrines and temples. Pliny then moves on to the disgraceful immigrant doctors of the early Principate who garnered outlandish fees, in the manner of the Methodist Thessalus in Nero's day.
Pliny saves the peak of harm brought to Roman patients by foreign medical personnel for the end of his short history of medicine, beginning, in non-chronological order, with the Peloponnesian Arcagathus, said to be the first Greek doctor invited to Rome by the Senate, just before the outbreak of the Second Punic War (219 BCE). He notes that this account is borrowed from the annalist L. Cassius Hemina, who continued the story with Arcagathus's overuse of cutting and burning, surgery and cautery, that led the Romans to call him carnifex (“murderer”). The implication is that Arcagathus was driven back to the Peloponnese in disgrace, even though no ancient source explicitly states that he was forced out of Rome. However, both Latin and Greek versions of recipes attributed to him were still in circulation centuries later (Celsus, Med. 5.8.27; P.Mert. 1.12.14‒15).Footnote 4
After the affair of Arcagathus, Pliny's narrative segues to more negative exempla, and what he claims are the ipsissima verba of Cato from the letter the latter wrote to his elder son on Greeks and Greek culture in general, and especially Greek doctors. Plutarch's Life of the Elder Cato 23.2‒3 provides a Greek version of that letter in indirect statement, while interweaving his own view that Cato was wrong when he opined that Greek culture had a dampening effect on Rome's prosperity ‒ quite the contrary, Plutarch continues, for Roman power was at its height when Greek influences were everywhere throughout the Roman world.
Pliny updates Cato on the importance of cabbage (brassica) since the early days of Rome
Most extraordinary in the Elder Pliny's account is, I think, his updating of Cato's enthusiastic discussion of cabbage and the medicinal techniques and recipes that occupy chapters 156 and 157 of Cato's handbook on farming, De agricultura. Pliny begins his own account in Book 20 by observing that it would take considerable time to catalogue all the praises that have been heaped on cabbage by both Greeks and Romans. He echoes Cato's account but seldom copies it verbatim; nevertheless, he insists that paying close attention to what Cato says about cabbage would teach us the medicine that the Roman people had used for 600 years (counting, I suppose, from the founding of the Republic to Pliny's own day?). Both Cato and Pliny repeat the popular notion that eating cabbage serves as an antidote to drunkenness, a tradition that can be still found in Calabria. Cato thought of brassica as a garden vegetable to be eaten both raw with vinegar and cooked, but Pliny discusses cabbage almost exclusively as a medicinal plant, to be applied to the exterior of the body in plasters and poultices, and internally as soothing concoctions poured into orifices, or ingested to fight a litany of internal upsets. Both Cato and Pliny lavish more attention on cabbage (brassica/κράμβη) than on any other vegetable from the kitchen garden.
Present-day botanists still consider the plant family Brassicaceae to include some of the world's most economically important dietary crops for humans, especially the members of the genera Brassica oleracea L. (“cole crops”): broccoli, brussels sprouts, cabbage, cauliflower, kales, kohlrabi, and other cultivated modulations of the same plant.Footnote 5 L. Maggioni notes: “Coles are not mentioned in the Bible, they are not included among the vegetables of Babylonian gardens and of the Assyrian feasts and they are not identifiable in Egyptian lists of vegetables.” But, as a papyrologist, I must add that κράμβη (cabbage) has, to date, been found some 75 times in Greek papyri from Hellenistic, Roman, and Byzantine Egypt, one example being as early as the mid-3rd c. BCE, and another as late as a century after the fall of Alexandria in 641 CE, by which point the Greek language had begun to be replaced by Arabic.Footnote 6 In common with other vegetables, κράμβη was often tied in bundles for transport and cooking; Cato himself tied smooth leaves of cabbage together in bundles when boiling them (conligare, Cat. Agr. 156.2; κράμβης δέσμη [“bunch of cabbage leaves”], O.Did. 344.6). “Stalks of cabbage” are also mentioned (κράμβης καυλοί, BGU 4.1120.11).
Two papyri are of special interest here. The first is P.Cair.Zen.1.59129.19‒20 (March 22, 256 BCE), a letter from Zenon to Panacestor. The latter lived beside the Nile, closer to Alexandria than was Zenon, who resided in Philadelpheia, a farming village upcountry in the Fayum. Zenon writes “send us some cabbage” (κράμβη), implying, I think, that cabbage had recently been introduced into Egypt by Greeks, but was only gradually garnering the stable place in the Egyptian diet that it would occupy in later centuries. The other papyrus is BGU 4.1118.12, a lease of a garden. The text in line 12 has been translated by P. van Minnen to read, “800 cabbage heads.”Footnote 7 Maggioni is also relevant here:
The words for “stem,” καυλός and caulis are used to mean the entire cole plant, since the IV and I centuries BCE, respectively in Greece and in Italy … the word caulis took over and became predominant after the I century CE, replacing brassica almost entirely. Caulis remained in use, with little variation, in European languages, even after the plant started to differentiate into many forms, where the stem was no longer always the most evident anatomical element.Footnote 8
Cabbage leaves and cabbage stalks remain more frequent in papyri and ostraca than the cephalic cabbages so familiar to us. A Nile fisherman named Peteouchos, from the Arsinoite nome in the 2nd c. CE, bore the nickname “Κράμβη” (BGU 1.277.5). In common with this “Cabbage-head,” the 800 “heads” referred to above in Alexandria during the reign of Augustus assure us that cephalic cabbage heads were not unknown in the Greek and Roman world, despite the greater attention paid to the leaves and stalks.
In the tradition of Theophrastus, Cato spoke of three varieties of cabbage (brassica) known to him. Earlier I discussed his boiling bunches of the smooth-leaved variety, yet he had highest praise for the curly-leaved, for “no other variety approaches it in medicinal value.” The implication is that the uses and recipes that follow in Agr. 157.3‒11 are all compounded from the curly-leaved variety, when available. We do not know for certain what Cato's curly-leaved cabbage looked like, but it did not resemble the cephalic varieties we eat, both raw and cooked. Maggioni displays recent photographic images of Brassica oleracea from northern Spain and the Italian peninsula, and these well resemble the image of κράμβη ἥμɛρος from the Vienna Dioscorides (Fig. 1).Footnote 9 Modern kale, popular today both raw in salads and cooked as a side vegetable, certainly takes us closer to Cato and his acephalic, panacean cabbage (brassica).
Codex Vindobonensis Medicus Graecus 1, fol. 182v, from Dioscorides, De materia medica: ΚΡΑΜΒΗ ΗΜΕΡΟC/κράμβη ἥμɛρος. Gartenkohl (Brassica oleracea). (Reproduced from Gerstinger Reference Gerstinger1970 with permission from ADEVA; photographic image by R. E. Geiger.)
Final thoughts
It is difficult to tell tales of Roman phenomena without bumping up against Greek antecedents. Describing Roman medicine and its attendant practices has always been more difficult than describing those of the Greco-Roman medicine that followed and expanded, from the 2nd c. BCE to the end of Antiquity and beyond. Old Roman medicine was ultimately a forgotten loser in the competition with Greek medical systems and its flood of practitioners, though bits and pieces of the old survived, especially in the writings of the early authors. The Elder Cato championed Roman medicine even as Greek medical practices were beginning to have greater impact on the city. Two centuries later, Horace flippantly took note of how attractive Greek things had become to his fellow Romans (“Graecia capta …,” Ep. 2.1.156‒57). He neglected, however, to dig more deeply into Roman habits of borrowing, for more often than not Romans revised what they borrowed so as to align the borrowed practice more closely with their own preferences. Cato's views were important to the Elder Pliny, and to others who made a show of avoiding dependency on Greeks.
The medicine D. chooses to explicate is at issue, since her project was to explicate Roman medicine. Difficult though it be, I would have been happier if she had included additional medical details from relevant authors to report on, such as the doctor in Menaechmi 889‒964 who interrogates his patient with silly questions about the latter's daily habits; more on foodstuffs consumed by Romans in the 2nd c. BCE from the many other Plautine cooks, in addition to the one in the Pseudolus (116); and food from the sea, for example, as discussed by the fishermen in Rudens 290‒305 and Gripus the fisherman in Acts 4 and 5 of the same comedy. My preference would be for a closer look at specific recipes and procedures in Cato's De agricultura: for example, a procedure for healing fractures with a poultice of softened cabbage (brassica) (157.4), in contrast to the 5th/4th-c. BCE Hippocratic procedure that called for resetting the broken bone, especially a large one, prior to the application of poultices (Art. 1‒2). This Greek procedure, violently painful as the bone is being reset into something resembling its proper position, brought a potential of greater mobility in future for the damaged limb, for hopefully the leg or arm might function again, even if it were never “as good as new.”
There is ample room, then, for other volumes that not only recognize and explore how Greek practices and practitioners gradually integrated themselves into the social fabric of traditional Roman medicine, but also look closely at those medical prescriptions and procedures that remained in use during the Later Republic, and into the Early Empire, as fewer Roman patients voiced a preference for old ways or shied away from the more extravagant and expensive suggestions being proffered by all the immigrant physicians among them.
