Xenophobia comes from Xenophon

Zosimus, doctor in Obernburg

Doctors and medicine in the Roman Empire
If you open the telephone book for Obernburg under the keyword "Doctors", you will find eighteen entries - many general practitioners, but also specialists from ophthalmologists to pediatricians to dentists. Should this phone book fall into the hands of archaeologists of the future in 2000 years, they will get a very informative insight into medicine and medicine of the beginning of the 21st century.
But who would have thought that, thanks to an "entry" on two stones, we would also know something about a doctor in the Roman town of Obernburg? By an astonishing coincidence we are actually able to know the name of a man who practiced in the Roman fort Obernburg almost 2000 years ago - in an Obernburg, which is probably a rather wild outpost of Roman civilization in the Germania inhabited by barbarian tribes. Two consecration altars with inscriptions give us testimony of the life and work of this doctor. These stone witnesses of the past speak on the one hand of the camp commandant Lucius Petronius Florentinus and on the other hand of the man to whom he owed his life and health: of Zosimus, the military doctor of the Aquitaine equestrian cohort stationed in Obernburg at the time.

Both stones were found in the area of ​​the Roman Obernburg. One is now a copy in the small inner courtyard of the Roman Museum (original in the Stiftsmuseum, Aschaffenburg), the other was built in the house at Römerstrasse 41 and can be read there.

Doctor 2000 years ago - what was that like? What injuries and illnesses did a Roman military doctor deal with? What healing methods were available to him? What were the chances of actually healing the patient? Were there any specializations like today? And last but not least: What was his position in society like?

The social position of the Roman doctors
In our modern world, the doctor enjoys great social esteem. We even joke about the "demigod in white". The study of medicine is so popular that today, despite the hard selection of applicants, one has to struggle with a medical glut. How was it in Roman times?

The name of the Roman camp doctor can give us an initial answer. At first glance, it seems to be a typical three-part Roman name: Marcus Rubrius Zosimus. That sounds very similar to "Caius Iulius Caesar": first name (noun), gender name and surname. But the last part of the name, Zosimus, is telltale. One of the first things a Latin student learns is that there are certain letters in Latin. For example the "W" - we write "wine", but the word goes back to the Latin word "vinum" written with "v" ("in vino veritas" - there is truth in wine). The "k" does not appear in the language of the Romans, apart from a few remains: The chancellor goes back to a Latin "cancellarius" (= head).

Another of these letters that do not exist in Latin is the "Z" - we speak of "circus", but the word comes from the Latin "circus", which is written with a "C". Then how can the Roman camp doctor be called "Zosimus" with "Z"? On closer inspection, the word root does not remind us of any other Roman name or word, but it makes us think of things and technical terms such as "zoo" or "herpes zoster" (technical term for painful shingles), which are of Greek origin. And indeed: Zosimus is a Greek name, the ending of which was Latinized to - us. Originally the man was called Zosimos. The other two parts of the name, on the other hand, are really Roman.

That can only mean one thing: the first Obernburg doctor was of Greek origin and possibly had the freedom, but certainly only received the full name and Roman citizenship retrospectively. At the end of the inscription he calls home the city of Ostia, which served as the port of Rome. Mind you: Zosimus had his "home" in Ostia, but he does not say that he was a citizen of Ostia or that he was born there. A plausible explanation would be that he or even his father, as a Greek or even as a Greek slave, had learned the trade of the doctor in Ostia and was then released.

From many other sources, for example from a Cologne inscription (CIL XIII 8349; there a doctor expressly calls himself "libertus", ie "released") we know that the medical trade was often carried out by slaves or freedmen even in the 2nd century AD mostly of Greek origin was exercised. Even the personal physician of the emperors Tiberius, Caligula and Claudius was a Greek who later acquired Roman citizenship. Like that of our Zosimus, his name also consists of two Latin and one Greek components, in which we take the original Greek personal name: Caius Stertinius Xenophon.

The medical profession and medicine were so thoroughly Greek that it is not surprising that our word "doctor" goes back to a Greek root, namely "iatros" or "archiatros" (doctor / community doctor).

The imperial personal physician Xenophon had become extremely rich in Rome through his art. But despite his 30 million sesterces, Xenophon was far more respected in his homeland, the Greek island of Kos, than in Rome: while a memorial was erected there and coins were minted with his image, doctors were primarily a target of ridicule in Rome during the imperial era . Only a few years after the reign of the three emperors, whom the doctor Xenophon served, the poet Martial set himself the goal of denouncing the vices of his time ("dicere de vitiis" = to speak about the vices), of course without exposing certain individuals ( "parcere personis" = to spare people). And no other professional group is so much the target of his biting ridicule as doctors in particular:

Martial calls them "stulti" (fools; II, 40) because they cannot see through imaginary patients. From a doctor with - how could it be otherwise? - According to the Greek name, he even reports that he stole a valuable drinking cup from his patient. Greed is then joined by insolence, because caught in the act, the thieving doctor shifts the blame on to the sick person: Why did the sick person really want to drink something (IX, 96)? How much, or rather how little Martial thought of the abilities of the Greek doctors, is expressed in several epigrams, all of which are built according to the same scheme:

  • "Nuper erat medicus, nunc est vispillo Diaulus.
  • Quod vispillo facit, fecerat et medicus "(I, 47)
  • The other day he was a doctor, now he is a gravedigger, the Diaulus.
  • What he does as a gravedigger, he had also done as a doctor. "
  • (namely bringing people underground, adds the writer)

Another epigram tells of an ophthalmologist who, as a gladiator, is now doing what he used to do - namely gouge out eyes and thus possibly kill them, the reader must conclude (VIII, 74).
In general, the idea that doctors are just greedy and kill patients with their (sham) art seems to have been widespread. Martial's most sarcastic doctor poem tells of the sudden and inexplicable death that a perfectly healthy man had found in his sleep. Martial concludes that he must have dreamed of the (Greek!) Doctor Hermocrates (VI, 53).

The older Pliny also shares this deep skepticism towards doctors (Nat. Hist. 29,8,11) - it is repulsive for a real Roman to ask for money for saving human life. The greed for money is what all medical luminaries have in common. Every Greek doctor wants to invent a new method, less to help his patients than to enrich himself with them.

In this context Pliny also mentions the "tombstone of an unfortunate man", on which one can read that he was "killed by the many doctors" (29:11). Pliny himself is not against medicine, but he is against doctors. In his opinion, self-medication is recommended.

So in these testimonies we grasp the most important difference with regard to the social position of the doctor. Although the reputation of doctors improved over the centuries, they could only dream of the reputation of their modern colleagues. In ancient Rome, doctors were far from being respected members of high society. You saw craftsmen in them, not much different from e.g. cooks. Doctors were highly specialized slaves, which is why one paid for them - as well as for cooks, by the way - often horrendously high purchase sums. The word "family doctor" goes back to this time and literally meant the doctor who, like a house garden or a front door or the doorman, was a slave to the inventory of the house.

Real education was not seen in medical studies. The arts worthy of a free man ("septem artes liberales") include not only philosophy and grammar but also mathematics, but not medicine. In addition, doctors were usually foreigners. And xenophobia is really not a modern phenomenon, as evidenced by the words of ancient Cato about the first Greek doctors who practiced in Rome:

"Iurarunt inter se barbaros necare omnis medicina, sed hoc ipsum mercede facient, ut fides iis sit et facile disperdant." Translated, this means: They (= the Greek doctors) have sworn among themselves to kill all barbarians (= the Romans) with their medicine, but they will even do that for payment, so that they are trusted and they can easily ruin you can".

Cato sums up the prejudices against the Greek doctors clearly: greed for money, arrogance and hatred of the Romans, whom they call barbarians. The word "barbarian" is of Greek origin and originally means "those who speak blah blah", i.e. people who do not speak Greek and who are therefore not understood. In this sense, the Romans are also "barbarians" for the Greeks.

Cato's fears apparently shared many of his fellow Roman citizens. They gave Archagatos, one of the first Greek doctors practicing in Rome, the nickname "carnifex" (butcher). In order not to have to rely on Greek doctors, Cato gives his son various "home recipes" that are supposed to cure all kinds of diseases. His cabbage soup is famous and notorious, which - consumed in abundance on an empty stomach - is said to induce healthy vomiting and purging in case of internal complaints:

    The patient will "spit out so much bile and phlegm on this drink that he will be surprised himself where so much comes from." (De agricultura, 156, 4)

Under Caesar, who otherwise showed himself to be a scientifically enlightened man (just think of his calendar reform), the Greek doctors were granted citizenship. From then on the social position of doctors naturally rose, but the rather modest equipment of the doctors' houses found in Pompeii shows that even capable doctors were not exactly among the wealthiest citizens of the country town.

A good hundred years after Martial ridiculed the doctors, Zosimus lived and worked in Obernburg. A third stone, which bears the name of the Prefect Florentinus, leads to this dating. With a high degree of probability, it can be determined from the reign of Emperor Commodus (180 - 192 AD)

What was the image of the doctor when Zosimus was practicing?
Does the altar found in Obernburg tell us directly or indirectly something about the position of the military doctor Zosimus? The inscription tells of a recovery. Zosimus, the doctor, thanks various gods for the health or salvation ("pro salute" - salus, salutis means health as well as recovery and salvation) of the camp commandant Florentinus. The standard formula V.S.L.M. in the last line (votum solvit libens laetus merito - he kept his vow, gladly, gladly and how he owed it) reveals the following:

The illness of the Prefect Florentinus had worried Zosimus. Apparently he couldn't afford to kill the patient. Although military doctors had only low officer rank - mostly they were ranked centurions - or even belonged only to the crews, Zosimus had promised the gods an altar for the recovery of his superior - by no means cheap in relation to his pay!

While one often hears complaints from patients today that doctors treat them "from above" and with too much self-confidence, it was apparently exactly the other way around at the time: the doctor was above all insecure, anxious, and seeking help. In contrast, it is not surprising that the patient himself had a consecration altar set. After all, it was about his life and his Health, and for all we know, he should have been far better off financially than his doctor. Significantly, the remainder of the Florentine stone walled in in Obernburg's most beautiful half-timbered house (in the former "Via Principalis", today Römerstrasse) suggests that the doctor's altar was no smaller than that of his high-ranking patient.

All of this shows how insecure the position and reputation of the military doctor must have been. We can assume that Zosimus would have had to fear serious losses in reputation if the prefect had died. There was a tendency to blame the doctors. The already mentioned satirist Martial speaks of a sick person who immediately messes with his doctors because they don't heal him quickly enough.

So Zosimus sets an altar and thanks the gods, whom he had asked for the prefect's recovery. With this, Zosimus is moving far away from the cliché widespread in Rome that doctors are only after money. But which gods had he begged?

The first he names Apollo. This is above all the leader of the muses and thus the god of the fine arts. But he was also venerated in Rome as Apollo medicus (medicus = doctor). After a plague epidemic, a temple was built for him in Rome very early on, long before the arrival of the Greek doctors.
Then follows the name of the god Aesculap, who as Asklepios was responsible for the healing arts in Greece, was greatly venerated in Epidaurus and whose cult had come to Rome with the Greek doctors. His first temple in Rome was not built until 150 years after that of Apollo. We still know this god in the modern symbol of the doctor: a staff around which an Aesculapian snake winds.
Zosimus, the doctor of Greek origin in the Roman service, first turned to the more "Roman" of the two gods responsible for the art of healing. By having the roman Thanks to Healing God, he shows that despite his Greek origins, he is primarily committed to Rome.
Next follows the deity "salus", under which one must see the Roman translation for the Greek "Hygieia", personification of health. Their naming is understandable as well. By the way, our term hygiene goes back to Hygieia.

Why does Zosimus end up calling it "Fortuna", happiness personified? Of course, health is one of the positive gifts that Fortuna carries in her horn of plenty. But that's not all. Happiness plays a particularly important role for doctors, as we know from the famous doctor Celsus (1st year AD), because one remedy can help in one case, but not in another. His writings must have been known to Zosimus. It is therefore completely logical that Zosimus had also recently asked Fortuna for help in the convalescence of the commander. His long list gives the impression that he was desperate and very insecure and in order not to forget a possibly useful deity, he turns to everyone who could be helpful in some way for healing and recovery. And of course he has to mention all of them by name on the consecration stone, which he commissioned after the prefect's happy recovery.

The first line of the inscription is a curiosity. As already said, it is a consecration stone, an altar and typical for such inscriptions is the initial formula I-O-M: Iovi Optimo Maximo - to Jupiter, the greatest and best (consecrated). In our case, this typically Roman consecration formula was added later, because it is located outside the field prepared for the inscription and is also smaller (but normally the IOM is larger!) Than the rest of the text. Should the Greek Zosimus, in all his excitement about the unexpected healing, have completely forgotten how to start a Roman altarpiece and only have the formula added afterwards? That the local stonemason might have forgotten them is possible, but less likely, because the stonemasons work according to patterns and would therefore rather make the most absurd spelling mistakes than forget such a standard formula.

But what deities did the sick prefect himself invoke? His inscription is much shorter and he thanks only one god: Jupiter, the greatest and best. That seems Roman and also much calmer, more composed than the reaction of the doctor, who had asked all possible gods for help as a precaution.And perhaps this inscription also explains the subsequent addition of the "IOM" on the stone set by Zosimus: Perhaps one wanted to identify the two stones as belonging together in this way. Although the Florentine stone does not give the reason for the vow, it is rightly assumed in the literature that it is the same thing that the Zosimus stone mentions: the setting of such a stone was something special and rare and came about in the One and the same man hardly lives more than once.

But what were the typical diseases and problems a military doctor had to deal with?
What kind of illness could the Commander Florentinus have been? Of course, after almost 2000 years, we will not find out the suffering of Florentine. But a compilation of what was already possible back then and what the ancient doctors had problems with can give us a picture of Zosimus' everyday practice.

Naturally, a military doctor primarily had to deal with wounds caused by combat. The camp doctor was therefore primarily a surgeon, had to remove bullets with probes, amputate limbs, and treat cuts and stab wounds. This is how surgery came about and was originally there to treat war injuries. The camp in Obernburg was an outpost and wounds in combat are therefore always conceivable; perhaps also in connection with the second marcomannary war (178-180).

The first concern with an arrow wound was to pull out the foreign body. In order not to cause further damage to the tissue (because, ingeniously, the arrows not only had barbs but also broke off easily), the so-called "Spoon of Diocles" was used and pushed through the wound canal towards the foreign body. The instrument had a small hole that was used to anchor the arrowhead. Its sharp sides were held in place by grooves, so that wounds could not be worse when pulled out.

In contrast to their modern colleagues, however, the ancient doctors did not have two invaluable tools at their disposal: They could not or only inadequately anesthetize and there was no antiseptic wound care. Penicillin and antibiotics are also only achievements of the 20th century. How could you care for a wounded man under such circumstances? When the wound was first treated, the injured person was unconscious, if the doctor was lucky. This condition could be prolonged by elevating the upper body, but always with the risk of causing a life-threatening drop in blood pressure. It is no coincidence that a relief on Trajan's Column shows how sitting upright Wounded are cared for. If the injured person was conscious, he had to endure the pain essentially, as the legendary hero and forefather of the Romans, Aeneas, on a Pompeian wall painting - a doctor treats a wound on his leg and only the posture of Aeneas' son shows the pain with which he is that was connected.

Bleeding could be stopped with the cautery, a very thin iron instrument that was heated and used to burn the wound. A saying by Hippocrates suggests that bleeding was not only stopped by burning out, but that the instrument was also used to treat inflammation: "What medicine cannot heal, iron heals; what iron cannot heal, fire heals; but what the fire cannot heal, that must be considered incurable. "

The sword could make very long cuts that were already sewn back then to improve healing. Different types of sutures were known. The wound had to be cleaned well beforehand. Even so, the wound naturally always became infected. At best, it festered, which was interpreted as a drainage of the bad body fluids, and then healed. Ancient doctors were powerless against blood poisoning.

It is therefore conceivable that the camp prefect had suffered from a wound, that it had been critical of him and that the doctor had therefore begged all the gods for their help.

An infectious disease is just as conceivable. Infections of the eyes were very common, which is why ophthalmologists (next to the "chirurgus", originally surgeon) were one of the first specializations in ancient medicine. The adjective "lippus" appears quite often in Roman literature; B. in the Augustan poet Horace and the above-mentioned Martial. The translation is "watery eyes" and means someone whose eye is leaking and oozing due to an inflammation of the eye. "Lippitudo" (watery eyesight) is the Roman word for eye disease par excellence. Attempts were made to heal these with all kinds of ointments. Good ointments were spread all over the Roman world; they were called "Kollyrien" after the shape of their packaging and the survival of the word z.b. in Italian ("collirio" = eye drops) proves how widespread eye ointments and therefore eye diseases must have been. Roman doctors were also able to successfully stab the star.

On the other hand, you were powerless against coughing. An epigram of the Martial about a terribly ugly rich lady who was nevertheless coveted for marriage shows that this was not taken to mean a harmless cold, but tuberculosis. Its only appeal is that it coughs - and can therefore soon be inherited:

    Quid ergo in illa petitur et placet? Chick.
    So what is it that attracts and likes about her? She coughs. (Book 1, 10)

Roman doctors have also performed real operations. In principle, Roman scalpels did not look any different from their modern version, except that the blade was removable. We also know of trepanations, i.e. openings of the skull in order to e.g. Remove bone fragments. Sometimes an amputation was necessary, which of course was always life-threatening.

Furthermore, rotten teeth were extracted with the dental forceps.

The removal of bladder stones was considered to be the most dangerous operation in ancient Rome. Catheters were used to allow urine to drain when the urethra was blocked. Before that, of course, people tried to stimulate the flow of urine with medication. The old Cato already writes about the ailment and recommends a variant of his cabbage soup as a remedy and adds that this medicine must be taken daily: "cotidie id facito!". The operation of stone cutting is mentioned by various ancient doctors. It was evidently very dangerous and extremely painful, so that several people were needed to hold the patient. Perhaps this is why this treatment is mentioned far more often than the statistical incidence of bladder stones would suggest. Such a risky operation would also have been conceivable for our Prefect Florentinus.

What medicines did a Roman doctor have at his disposal?
Back then - as has become fashionable again today - people believed in the healing power of gemstones. In his monumental work "De rerum natura" (natural history), Pliny devoted several books to medicine and mentions, among other things, the power of amber, which is said to be able to heal goiter. In addition, one knew about the power of certain plants. As a young man, Pliny himself had access to the famous herb garden of Antonius Castor, who, thanks to his plant medicine, reached a very old age in excellent health. In his natural history, already mentioned, Pliny mentions an abundance of herbal ingredients and also gives us the recipe for the famous "Theriak", a kind of panacea made from opium, valerian, myrrh and other ingredients. Incidentally, the Emperor Marcus Aurelius, who presumably suffered from stomach cancer, tried to cure himself with him before succumbing to his ailment in Vienna. In soil samples from the legionary camp of Neuss, henbane, which was used to numb pain and a kind of primitive anesthetic, and centaury, which was used to treat wounds, could be detected. The ancient herbal medicines lived on in the monasteries, where an extract from the work of Pliny, the "medicina Plinii", was eagerly used.

Whatever Florentinus suffered from, healing was much more a matter of luck than it is today. "He who heals is right" is a saying that was coined in antiquity and is still used by doctors today. Fortuna, happiness, was balanced by Zosimus and Florentinus: the patient survived and recovered, the doctor was relieved of serious worries and his already uncertain reputation was saved for the time being.

Margit Kuhn

Marion Giebel, meeting point Tusculum, Reclam 1995 (there p. 163-180 about Pliny the Elder)
Hartmut Matthäus, the doctor in Roman times. Part I, (publication by the Limesmuseum Aalen), Winnenden 1987
ders., The doctor in Roman times, medical instruments and medicines, (publication of the Limesmuseum Aalen), Winnenden 1989