Medicine, Murder and Mouse Droppings - by Ruth Downie

If I’d known that my three chapters for that “start a novel” competition would turn into a whole series of murder mysteries, I’d never have based them on a Roman army medic. All I was looking for at the time was a character who was in a quandary, plus the suggestion of a story to follow.

There wasn’t a story, of course - which was something I had to confess when an agent got in touch and asked to see the rest of the manuscript. What I didn’t dare tell her was that I didn’t know enough about Roman army medics to write one.

Fortunately, plenty of ancient medical textbooks survive and there are modern scholars who know how to interpret them. You’ll find some of them listed at the end of this post. Meanwhile, here are ten of the fun facts that have kept me entertained over the years while I’ve tried to find G Petreius Ruso, Medicus, credible things to do.

1) Buyer beware! Ancient medical practice had no quality control. Much as anyone today can call themselves a ‘therapist’, anyone in the classical world could call themselves a doctor.

2) When only the best will do:  Xenophon, doctor to the emperor Claudius, earned a vast salary. However, demonstrating that you don’t always get what you pay for, Xenophon was said to have finished Claudius off by sticking a poisoned feather down his throat, faking an attempt to save the emperor from the poisoned mushrooms he’d been fed at dinner.

3) “Only a doctor can kill a man with impunity.” Pliny the Elder was not a fan of the medical profession. Not only were doctors dangerous foreign* charlatans who conspired to murder the population of Rome, but they also expected to get paid for doing it.
*Doctors were often Greek.

4) Human arteries were full of air, or possibly milk, and one day somebody would devise a way to prove it. (To be fair, not everybody believed this. We only know about it because the multi-talented Galen took time to pour scorn on his deluded competitors. According to him, his own public lectures on anatomy - complete with live animal dissections - filled the crowds with wonder and his rivals with envy.)

5) This is going to hurt you more than it hurts me. With no microscopes, scans or x-rays, and with human dissection not allowed, the best place for a doctor to learn about anatomy was somewhere with a handy supply of injured patients - like a gladiator school, or the Army.

6) Practice makes perfect: Some of the surgery on offer was top-class. Field hospitals in the first world war were still using amputation techniques that would have been used in the Roman army, and for the bold and the desperate, it was even possible to have successful cataract surgery. 

7) Maybe it’s the bad air. The causes of disease were largely unknown. Bacteria and viruses were still undiscovered, which perhaps explains a whole slew of remedies using animal waste, including lizard dung to make ladies’ complexions glow, and wild boar dung - smeared on fresh, if necessary - to treat injured chariot drivers. The emperor Nero, who fancied himself as a charioteer, was said to prefer his boar dung dried, powdered, and drunk with water.

Still, looking on the bright side - if you were unlucky enough to have a mouse infestation and a bald patch, and on top of all that you found that your wine had gone off, you could grind the mouse-droppings into the vinegar to make a hair-restorer. 

Wormwood - just the thing to get rid of clothes moths and mosquitoes and stop mice eating your scrolls. Also used as a purgative and diuretic, it was said to prevent nausea and to cure sore throats, eye troubles and prurulent ears. Boiled up with lentils, it was (allegedly) ideal for fattening up sheep.

8) Remember to pack the medicine: Drugs derived from plants, animals and minerals were widely used and common medicines like opium were very well understood. In the absence of inoculations, travellers might ask to be prescribed a theriac - a complicated mixture of dozens of tonics and antidotes that would protect them against foreign diseases and poisons.   

9) Where doctors failed, the gods could succeed: here’s the cast of a plaque set up by a grateful worshipper who had his deafness cured at the temple in Epidauros.

10) And finally: The weak (who include “a large proportion of townspeople and almost all those fond of letters”) need to take good care of themselves. In particular, if last night’s meal has not been fully digested, the weak person should stay in bed “and neither work, take exercise nor attend to business.”

 As a townsperson who is fond of letters, this is the only piece of ancient medical advice that I can fully recommend.

For more rounded and reliable information, try:

Roman Medicine - Audrey Cruse

Doctors and Diseases in the Roman Empire - Ralph Jackson

Ancient Medicine -Vivian Nutton (not a light read, but an excellent in-depth study)

The free Futurelearn course on Health and Wellbeing in the Ancient World, offered by the Open University.
Anything by Professor John Scarborough

 On the subject of women practising medicine - here's the delightful tale of “Agnodike, the Flashing Midwife”, being discussed by Professor Helen King of the Open University.

Click here to visit an earlier blog post on the theory of the Wandering Womb

I'd like to thank the re-enactors whose collections are displayed in my photos above but I can't remember where I took all of them - if you recognise your kit please let me know! 

Ruth Downie writes a series of mysteries featuring Roman military medic Ruso and his British partner Tilla - find out more at www.ruthdownie.com.

The Secret Garden: Ancient World Contraception by Elisabeth Storrs

Etruscan woman holding a pomegranate

Childbirth is dangerous. The Western world often forgets this. The advances made in medicine and mothercraft to improve the mortality rates of both mother and babies have been remarkable but are now taken for granted. So too effective forms of contraception. Many forget that the development of the ‘Pill’ only occurred in the 1960s. And it can be argued that the introduction of reliable oral contraceptives gave impetus to the feminist movement as women were at last given the opportunity to plan their pregnancies as well as their careers.

Women of the ancient world did not have access to such sophisticated medicine; instead they relied on more humble ways to prevent falling pregnant. I was absorbed when researching the methods used in classical Greece, Rome and Etruria when writing my Tales of Ancient Rome series.

One of my protagonists is a young, innocent Roman girl who is married to an Etruscan man to seal a truce between two warring cities. She discovers her husband’s society offers independence, education and sexual freedom to women. Such freedoms, however, do not excuse her from the duty of bearing children.  In her quest to delay this destiny she learns that there were certain plants that offered a chance to avoid falling with child including a delicious fruit grown in her garden, and a mysterious plant from a distant land.

           

Prosperpine by Dante Gabriel Rosetti

Pomegranates were associated with the myth of Persephone (Roman Proserpina) and the vegetation cycle. Persephone was the child of Zeus, king of the gods, and Demeter, goddess of the harvest. When Hades, god of the Underworld, abducted Demeter’s daughter, the deity was so grief stricken she rendered the earth barren. Faced with a desolate world, the other gods pleaded for Zeus to intervene. He demanded Hades release Persephone whom he’d instructed not to eat while in the Underworld. Hades grudgingly agreed but before the maiden left his realm she ate some forbidden pomegranate seeds. For her disobedience, Persephone was ordered to return to live with Hades for three months of the year. And so, during winter, Demeter refused anything to grow until her daughter was once again returned in the spring.

           

In various ancient cultures, the pomegranate was seen as a symbol of fecundity. An Etruscan bride would offer a pomegranate to her groom during the wedding ceremony. However, the fruit was also considered useful for regulating menstrual flow. Accordingly the fruit was seen as holding the secret to both fertility and sterility.

           

Ancient physicians such as Hippocrates, Soranus and Dioscorides prescribed the seeds and rind of the pomegranate to prevent conception but details of the preparation or the quantities used are unknown. There is mention of the fruit being eaten while some sources state that the seed pulp was used on pessaries.

           

Did pomegranates work? Studies conducted during the 1970s and 80s on rats and guinea pigs revealed reduced fertility in females that had been fed the fruit. Furthermore, scientists discovered the pulp around the seed was most effective compared to the roots or the flesh. Accordingly, there may have been some efficacy to using pomegranate pulp in pessary form as was described in ancient sources although extrapolating the results of tests conducted on rats to human reproduction can be tricky.

Using pomegranates may have been haphazard as a means of prevention but there was another plant that clearly was considered as a viable contraceptive. The Romans called it ‘silphium’ while the Greeks knew it as ‘silphion’. 

Modern botanists have identified silphium as a member of the giant fennel (Ferula) family based on ancient descriptions, and pictures on coins and pottery. The plant was rare, growing in the dry climate of Cyrenaica in northern Africa (modern Libya). The pungent resin from silphium's stems and roots was known as laserpicium and was used as an additive which gave food a rich distinctive taste. It was also used to treat coughs, sore throats and fevers. Perfume was distilled from its blooms.

The crop became the main commodity of Cyrene (Shahhat, Libya) a city colonized by the Greeks in C7th BCE. These colonists had reluctantly migrated from the island of Thera, having been forced to draw lots. According to Theophrastus, a pupil of Aristotle, the settlers discovered the silphium plant which made them rich and their city famous. Demand across the ancient world for the plant bumped up its price leading the playwright Aristophanes to write in The Knights: “Don’t you remember when a stalk of silphium sold so cheap?”

           

Silphium stalk on Cyrene coin

The wealth brought from exporting silphium led Cyrene to recognize the importance of its prize export by stamping its coins with the distinctive symbol of the plant in a similar manner to Athens’ use of an owl. The design of one series of four drachma coins depicts a woman touching the plant with one hand while pointing to her womb with the other. Interestingly, there is also speculation as to a connection between the contours of silphium seeds and the traditional heart shape as silver coins from Cyrene from C6–5th BCE bear a similar design. The coat of arms of Italian Libya also bore an image of the plant indicating the importance of its history to the region even as recently as 1947.

           

There is a reference to the plant’s resin being applied to pessaries but silphium could also be taken orally. Soranus recommended women take about a chick pea’s size of silphium juice dissolved in water once a month. It is clear that he also considered it had abortive effects, as did Dioscorides.

           

The Roman poet, Catullus, advised his lover, Lesbia, in Carmen 7, that they could share as many kisses as there are grains of sand on the shores of ‘silphium producing Cyrene’ as follows:

You ask, my Lesbia, how many of your kisses
are enough and more than enough for me.
As big a number as the Libyan grains of sand
that lie at silphium producing Cyrene
between the oracle of Sultry Jupiter
and the sacred tomb of old Battus;
Or as many stars that see the secret love affairs of men,
when the night is silent.
So many kisses are enough
and more than enough for mad Catullus to kiss you,
these kisses which neither the inquisitive are able to count
nor an evil tongue bewitch.

           

Heart shaped silphium seed - Cyrene coin

Catullus’ endorsement of the plant to his lover was an assurance that their lovemaking could continue as long as silphium was obtainable. Unfortunately, at the time of the poet’s death in 54 BCE  stocks of the plant were dwindling with the Roman historian, Pliny the Elder, remarking during Nero’s reign in 37-68 CE “only a single stalk has been found there within our memory”. In effect, the plant was considered worth its weight in silver denarii or even gold. With its scarcity, a lucrative black market thrived.

           

Ultimately silphium became extinct. Various theories include demand outstripping supply, or simply over-farming by the Romans after they gained governorship over the Greeks. However, Theophrastus wrote that silphium was peculiar in that it couldn’t be cultivated and only grew in a narrow band of land along dry mountainsides facing the Mediterranean Sea. Repeated attempts to farm the plant proved futile; instead it was harvested from the wild under strict rules. It has now been posited that the plant was either a hybrid with unpredictable generational outcomes, or similar to wild huckleberries. This fruit is native to the mountain slopes, forests and lake basins of North America. The berries are sensitive to soil chemistry so when grown from seed, bear no fruit.

           

Was silphium effective? It’s difficult to say when scientists possess no specimens upon which to test. However, another member of the fennel family, asafoetida, exists and can be successfully cultivated. It is used today to give Worcestershire sauce its characteristic flavour. Early testing of asafoetida and other Ferula species on rats proved notable anti-fertility effects. In 1963, it was established that asafoetida was effective as a contraceptive for humans. Given this, the popularity of silphium as a drug of choice in the ancient world can be given credence.

           

There was a veritable pharmacopia of other herbs and plants used by women of the ancient world: Queen Anne’s Lace (wild carrot), rue, myrrh, juniper and pennyroyal to name a few. Unfortunately most of these are also poisonous when taken in incorrect dosages.

           

Despite the folklore and science surrounding all these natural remedies, it is a sobering fact that the average life expectancy of females in the Iron Age was approximately 27-30 years. We will never know how many women avoided an unwanted pregnancy through use of herb, fruit or plant, nor how many mothers and children perished due to the use of toxic abortifacients. And even those who welcomed a baby quickening within them weren’t guaranteed a long life - the mortality rate for both maternal and infant deaths in childbirth was incredibly high. 

Elisabeth Storrs is the author of the A Tale of Ancient Rome series. Her latest release, is Fables & Lies: A World War II Novel about stolen Trojan treasure and the Aryan Myth. She is also the founder of the Historical Novel Society Australasia and the ARA Historical Novel Prize. Learn more at www.elisabethstorrs.com. 

Images are courtesy of the MET project, Wikimedia Commons and

Expedition Magazine Vol. 34, Nos. 1-2, 1992. "The Coins from the Sanctuary of Demeter and Persephone." by T. V. Buttrey .

The Wandering Womb - by Ruth Downie

Women! Are you suffering from choking, collapse, suffocation, seizures and the inability to speak? Has your doctor ruled out all the usual causes? Have you considered that your womb may have gone wandering in search of moisture?

This may come as a surprise to anyone trained in anatomy (or indeed anyone at all in the 21st century) but it would have been a sensible question in the ancient world. Opinion was divided even then, but a substantial number of doctors believed that the womb was not firmly attached to its moorings. It was thus free to roam about the body causing trouble. 

The doctors of the time were a fiercely competitive bunch who did their best without the aid of microscopes, x-rays or very much sense of scientific method. They were, however, keen observers, and they were confident that neither asthma, epilepsy nor anything else they could name explained the problem afflicting some of their women patients. It became known as hysterical suffocation (from ‘hystera’, a Greek word for ‘uterus’).

Luckily there was a relatively safe and straightforward remedy. Wombs were said to be very sensitive to odour. They could be lured by sweet smells and repelled by foul ones. (Smells that they disliked included charred deers’ horn, burned hair or rags, and squashed bed bugs.) Apply the right smells at the right ends of the suffering woman, said the theory, and her troubles would subside as her womb slunk back home. 

Models of wombs presented to the gods in the hope of healing.

If the smells didn’t work there were other options. Few of them can be recommended for trying at home, or indeed anywhere else. Doctor Mantias prescribed drinks of beaver secretions and bitumen in wine, plus flute music and drumming (presumably performed to, not by, the patient). Doctor Asclepiades suggested tight bandaging just below the ribs, making the woman sneeze, shouting at her and blowing vinegar into her nose. If that failed, her helpers could try pouring cold water over her head. 

Soranus, a specialist whose book on gynaecology still survives, was scathing. “For the uterus,” he declared, “does not issue forth like a wild animal from the lair, delighted by fragrant odours and fleeing bad odours.” He warns that trying to straighten out a woman’s internal tangles by using smith’s bellows to force in air – a ghastly suggestion that seems to have had a long, if surely unhappy, history – would only do more damage. As for the therapeutic effects of loud noises and the prescribed crashing of metal plates – “even many healthy persons have been given headaches by such sounds”. He agreed that the womb was the source of the trouble, but that rather than trespassing in unauthorised places, it was suffering from inflammation. 

While Soranus and his fellow-medics disagreed on the causes and treatment of hysterical suffocation, they didn’t question its existence. The usual view of modern commentators is that they were describing some sort of stress-related symptoms that we would name and treat very differently today.

Before we feel too superior in our modern knowledge, though, it’s worth remembering that when my grandparents were young, smoking was considered to be a harmless way to relax. And by the time surgeons decided that routinely removing parts of healthy five-year-olds wasn’t such a great idea, my innocent tonsils were long gone. Who knows what twenty-first century beliefs future generations will look back on with alarm and incredulity?

Hopefully many sufferers were offered the sensible and restrained treatment recommended by Soranus, who suggested laying the afflicted woman down in a warm, bright room, placing warm compresses on her, gently straightening the constricted limbs and washing her face with a sponge. Given such treatment, we can only hope that she would feel well cared-for and that her womb, wherever it had gone, would find its own way home.

Ruth writes a series of mysteries featuring Roman military medic Ruso and his British partner Tilla - find out more at www.ruthdownie.com.