A few introductory words. When examining the position of physicians in ancient society, a fundamental fact must be taken into account. Unlike in medieval and modern times, doctors did not form a homogeneous profession. In Greece and Rome, anyone could call himself a doctor and practice medicine. In other words, the state or public sector did not usually direct or control either medical training or the licence to practise medicine. The scale of those who styled themselves health care professionals, ranged surely from quacks to physicians with scientific training, the latter being always in the minority, especially in the Roman world.

Owing to the wide range of intellectual, social and juristic origins of men who called themselves doctors in ancient society, the importance of medical schools in the Roman world should also be put in its correct perspective. Is it really necessary even to speculate about a ‘medical school’ at Salerno in Roman times; should we not rather refer simply to a single Salernitan doctor recorded in the inscription we will deal with in a little while? The question arises, what do we mean by a ‘school of medicine’? The criterion should at least be an establishment of organized medical teaching. The presence of physicians in a given place does not necessarily mean that teaching was provided there, and geographical unity is a tenuous reason for the establishment of a school. This is especially true for a town like Salerno where the evidence shrinks away to one epigraphically attested doctor and an ambiguous passage of Horace. Thus, the question ‘Was there a school of medicine at Salerno in Roman times’ is in some ways a pseudo-problem. However, it might be interesting to have a closer look at both pieces of evidence and also at the evidence coming from other towns in Southern Italy.

Let us begin with Horace, Epistles Book I, Epistle 15, addressed to Numonius Vala who belonged to a family of standing in the region of Salernum and Velia. This Vala was perhaps identical with Q. Numonius Vala, patronus coloniae of Paestum, known from a local inscription. The poet enquires how suitable his homeland would be for a convalescent, playing artfully with a great complexity of syntax. In the first long parenthesis, it is for medical reasons that Horace thinks of visiting Lucania (including Salerno) and abandoning the luxuries of Baiae:

I give the passage in a masterly English version by Colin Macleod:

This epistle is an object lesson in the doctrine represented by Aristippus (a Greek philosopher from the Socratic circle, represented as a champion of hedonism) whose natural follower Horace had declared himself to be at the outset of the collection of the Epistles. He usually takes a winter break on the coast, or in the warm South, but uncertain health and doctor's orders (and what a doctor! the imperial physician no less) demand a change in habit and Horace is not one to stick doggedly to a simple regime. Baiae was famous for its gay life, and Horace blandly pretends he must avoid it merely because its springs are not indicated for his condition. He prefers the region of Velia and Salernum, as advised by Antonius Musa, the famous physician who brought cold-water therapy into fashion by curing Augustus with it in 23 BC. Horace at once reveals, by his choice of doctor, that he is used to a good style of life; he also puns on the Muse whose commands the poet obeys.

Now, Velia, Salernum and Baiae were spas whose greatest period of activity was in the early empire, and it is quite probable that in all these centres doctors practised medicine in the service of the visitors (as was also the case in many tourist centres in Greece), even if we do not know of any certain case of medici at Baiae.¹ But whereas the existence of doctors in such places is quite probable, one hears of no formal medical training establishment in these villages. And there is absolutely no link between Antonius Musa and these centres, as is often assumed in the local historiography. Therefore, what Horace says simply shows that the region of Velia and Salerno had become a popular spa for Romans in the early empire. His choice does not fall upon that region because of supposed schools of medicine that could offer him therapy, but because he wants to spend the winter in a town where he need not renounce the pleasures of life.

The inscription from Salerno was found some 60 years ago. It is certainly of local provenance.² The text runs as follows:

This is the funerary inscription of a medicus clinicus from the first century AD. Diogenes was a physician who tended patients in bed, as the term clinicus shows (by the way, this term appears quite rarely in ancient Latin texts, a couple of times in inscriptions, then used playfully in the epigrams of Martial, and lastly in non-medical Christian writers, but never in ancient Latin medical treatises; one thus wonders how technical the term was in classical Latin); in medieval Latin it means ‘bed-ridden patients’.³ Diogenes’ name form gives an almost certain hint as to his origin: he is a Roman citizen, but his patronymic shows that his father was a peregrinus, a free man without Roman citizenship and that he (or at least his father) possibly originated from the Greek East. If his father had also been a Roman citizen, his name should run not Diogenis filius ‘son of Diogenes’, but Tiberi filius ‘son of Tiberius’. Our doctor seems to have received his citizenship under Claudius or Nero (if not under Augustus). I would opt for the first alternative, including on the grounds of the letter forms and the wording. In the Greek East, innumerable Tiberii Claudii from Claudian or post-Claudian time are known who belonged to the tribus Quirina. This Diogenes seems to be one of them. It would, however, be possible, even if less probable, that Diogenes had received his citizenship from Tiberius, during his, that is Tiberius’, stay in the East, before Augustus adopted him in AD 4, when he still bore the gentile name Claudius – after the adoption, Tiberius became a Iulius. For the latter alternative, we have an interesting piece of evidence which came to light in 1940, an inscription from Rome which runs as follows:⁴

All previous editors think that the man called Germanicus in the text should be the emperor Claudius, but for many reasons it is preferable to identify him rather with Germanicus (I mean the man we are used to calling Germanicus, that is to say the son of Drusus the Elder and Antonia the Younger), as I have tried to show elsewhere.Reference Solin⁵ Melito would have been of eastern origin, have received citizenship from Tiberius during his stay in the East, and after that become the personal physician of Germanicus; the latter would have brought him to Rome.

The last advocate of the idea of a Salernitan school of medicine, Vittorio Bracco, the meritorious editor of the inscriptions of Roman Salerno in the series Inscriptiones Italiae of 1981, not only saw in this inscription a clear proof for the existence of such a school, but he also detected other epigraphic traces of that supposed school. However, they are all dubious.

(1) An inscription of which only the consular date is preserved:⁶

that is to say something, a dedication or a honorary inscription or the like was set up in AD 21, during the fourth consulate of Tiberius and the second consulate of Drusus the Younger. With the best will in the world, I can't see how this inscription could have something to do with a local medical school.

(2) An honorary inscription to Germanicus:

To connect this inscription with a Salernitan school of medicine is speculation of the highest degree.

I would now like to touch upon the question of the origins of the medical school of Salerno, a problem that has exercised the talents of many distinguished medical historians, a question Vivian Nutton has dealt with in two articles that appeared in 1970 and 1971.Reference Nutton⁷ Thus, there is no need for a reappraisal of the whole question, and I shall make only a few remarks, above all concerning the Roman period. An old and discredited theory has been resurrected in the second half of the past century, and a direct link was discovered between medieval Salerno and early Greek medicine through the existence of a medical college at Velia, which was transferred with its learning and institutions intact to Salerno. The classical heritage of Salerno has once again become something more than vague ideas; it is the continuation of a tradition of doctrine and organization going back to the Romans and Greeks, even back to the age of Hippocrates himself. The new evidence is derived from archaeology, epigraphy and numismatics, each of which has its own limitations and difficulties, but also its strength in offering very interesting new materials. The starting point for my reflections is the small town of Velia which lies some 80 km south along the coast from Salerno. It was originally the Greek Elea, which in the classical period became an important cultural centre with the great philosopher Parmenides as founder of the Eleatic school. The excavations at the site of Velia have produced many interesting finds, not least among them a building containing several statues with important inscriptions. On the base of male statues or herms, we read a few inscriptions of the following type:⁸

The inscriptions were engraved perhaps around AD 40, but the persons recorded in them belong to much older periods.

I cannot touch upon many interesting details contained in the new documentation and refer to the previous discussion. I only state that these finds have led some ardent local historians to proclaim the existence of a medical school at the site.Reference Cantalupo⁹ For them, the presence of doctors at Velia confirmed the well-known stories of its success as a healing spa: not only Horace, but also Aemilius Paullus and Cicero, all came to take the cure at its waters (but note that there is no evidence of a sojourn of Musa at Velia or even Salerno). It is, however, open to doubt whether this association of persons at Velia is a medical school in the strict sense of the word. Note also that the doctors attested in the new inscriptions lived generations if not centuries before AD 40 and that Velia at that time was only a little almost unpopulated village. Single doctors occupied with therapy in popular spas cannot prove the existence of a school of medicine. No better is the state of affairs when examining the links between Velia and Salerno, both earlier and later. Only the most ardent champion would claim that the origin of Ti. Claudius Diogenes was Velia, when he very probably was of Eastern Greek origin, as I tried to show earlier, nor can the specialty he professes, that of clinical doctor, be brought into line with the balnear therapy of Velia (but at Salerno, a much bigger city in the early imperial period many kinds of doctors were needed). A critical reappraisal of all available historical, archaeological, epigraphic and numismatic material does not support the existence of a school of medicine at Velia or at Roman Salerno. There would thus be no direct links to the medieval school of Salerno.

But could we perhaps identify other medical centres of Roman Southern Italy that could come into question as possible predecessors of the Salerno school and thus have contributed to its rise? For this purpose, let us conclude with a brief survey of what we know about doctors and medicine in Italy south of Rome.

I begin by presenting to you a few new inscriptions of physicians I have found during my epigraphic fieldwork in Southern Latium and Campania.

(1) From Puteoli, with Capua the most important town of South Italy, where three doctors are previously attested epigraphically:¹⁰

Pausanias was very probably a slave from the first century AD, a simple medicus. There is no real chance to understand Medicus as an ethnikon (Pausanias would thus have been born in Media), it remains a purely theoretical possibility. As Pausanias bears the mere title medicus, he might have been an ordinary general practitioner.

(2) This text enriches the not insignificant corpus of inscriptions of physicians in Capua; previously we knew of some four medici.¹¹

This is from the first century AD. Nothing certain can be said of his origin; he could be an ex peregrinus from the Greek East, but likewise a freedman or descendent of a freedman. Like Pausanias, he might have been a merely general practitioner.

(3) From Abellinum, we have the first mention of a doctor in this Hirpinian town:¹²

We meet in this town, some half century before the Lombard occupation, an archiater. As is known, the use of this title had many different meanings in the administrative terminology, and it was enlarged in late antiquity also to mean an esteemed doctor in general, but I would think that our Marcellinus acted as a municipal officer of health at Abellinum.

(4) from Aeclanum between Abellinum and Beneventum:Reference Solin and Kajava¹³

Worth noting are, in addition to the social standing of this libertine family, the names of the two doctors, Soterichus and Herophilus; both can be characterized as so-called nomina artis. Soterichus is an onomastic derivative from Soter, saviour, but special interest is attached to Herophilus whose bearer might have been given it on the model of the great Alexandrinian doctor Herophilus. We know from Rome of a veterinarian namesake, but his case is a little bit obscure. That of our man, a simple doctor and an Augustalis, a priest of the cult of Augustus, is however clear and shows that also in more remote towns in Roman Italy, such name customs were not unknown. As I have dealt with this question regarding the nomina artis within the medical profession elsewhere,¹⁴ I will not amplify the topic here.

The earlier known documentation has provided us with doctors from many other centres of South Italy, for example from Naples, Puteoli, Beneventum, Venusia, Venafrum, Aquinum, Setia, Velitrae, even from the neighbourhood of Salerno, from Pertosa in the territory of the Roman Volcei where an interesting and often misunderstood bilingual testimony has come to light; unfortunately, I cannot deal with it more closely here.¹⁵ Of these cities, I would like to draw special attention to Beneventum. We know of many doctors there from the first century BC to the third century AD. Note that in the early second century, Beneventum had a collegium medicorum which received bequests from satisfied patients (CIL IX 1618)¹⁶ and a century later, in 231 AD, we meet there a specially proved civic practitioner or archiater, who was a Roman knight and father of a mayor of the town (CIL IX 1655).¹⁷ It is difficult to say whether some form of medical instruction was imparted within that collegium medicorum, but comparative evidence from Greek and also Western centres could suggest it; in the lack of clear proofs, it might however be better to see in such a collegium a sort of guild or even some sort of ‘trade union’. And note that this collegium of doctors is mentioned together with a group of freedmen. From the seventh to the ninth centuries, Beneventum either ruled or maintained contact with Salerno, and one of its kings, Arechis, made Salerno his seat of government. Paul the Deacon praised him in his epitaph for his knowledge of phisis and because he adorned his country with learning, ramparts and palaces. Note also that Salerno was in the Middle Ages the harbour of Beneventum. Medicine could have reached Salerno by this route, or also from the Greek or rather (in that time) half-Greek city of Naples which controlled Salerno in AD 638 and where several doctors lived in the seventh and eighth centuries. But there are also other possibilities to explain the routes of influence. Be this as it may, a direct and unbroken chain of medical learning and institutions from Velia to Salerno is unproven and highly improbable, as is also the existence of a medical school at Salerno at Roman times. As to Velia, one has to take into account that, in spite of its site as a resort and spa, it was in Roman times, even if nominally a municipium, only a little village where one would not seek a centre of medical teaching.