So i've been working on a Alt history Rome setting and started doing some research into roman medicine in order to deal with the medicine skill. One piece of info realy startled me: the Romans had bronze catheters. I always wondered what they did for urinary retention in the ancient world, and guess i kind of assumed people simply endured bladder rupture. So at least they had a solution, even if it sounds terribly painful.

Anyone know where i can get more information on ancient medical practices?

The Hippocratic Writings might be a good place to start:
http://classics.mit.edu/Browse/browse-Hippocrates.html

For a good start, look up Hippocrates, Celsus and Galen.

Hippocrates is of course the big name of ancient Greek medicine and was required reading of every Roman doctor. Famous for his "Aphorisms", a collection of sayings and axioms based on clinical observations (not a few of which hold true to this very day).

Celsus wasn't a doctor actually, but that didn't stop him from writing one of the most voluminous and encyclopedic medical texts of Antiquity.

Galen, who would go on to be revered as the ultimate dogmatic source of medical knowledge for much of the Middle Ages, IIRC actually held an appointment as surgeon to the Colosseum's gladiators.

Generally speaking, ancient and medieval doctors had a decent working knowledge of simple surgical procedures such as incision and drainage of abscesses, splinting fractures, dressing (though not necessarily suturing) skin and soft tissue wounds, limb amputations, and excising some tumors (breast, skin, soft tissue). The very boldest would perform crude procedures to trephine skulls, extract or break urinary calculi inside the bladder, or caesarian delivery (mostly postmortem, i.e. immediately after a pregnant woman died, as allegedly was the case with Julius Caesar and St. Raymond Nonnatus; c-section in living women was anathema)

They were rather fond of cauterization, using hot irons to burn wounds and even tumors "clean", which BTW is just as painful but less effective than it sounds.

They had no antibiotics, but that doesn't mean that bacterial infections were universally lethal. Galen, and IIRC Hippocrates as well, went so far as to state that suppuration (the production of pus) was a normal and healthy stage of wound healing (a claim which saw challenge as early as 5th Century AD, with Theodoric of Cervia, but wasn't really debunked until the late 19th Century).

Humoral theory dates back to Hippocrates and again, wouldn't be replaced by a working knowledge of human pathology until the late 18th Century with Morgagni in Italy. Every disease was the result of "imbalances" with the four "humors" (black bile, yellow bile, blood and "phlegm"). Remedies would restablish the balance by "purging" the body of excess fluids; e.g. leeching or cutting veins to drain blood, vomit-inducing herbal remedies to purge excess bile, and of course, enemas. Lots of enemas. :eek:

For starters, this is a decent link:http://www.historylearningsite.co.uk/medicine_in_ancient_rome.htm

I'll try and post some more when I have the time.

There is a scene in I Claudius wher Claudius consults a Greek doctor that shows the difference in approach between the two cultures.

I'd point out that there was also a tremendous amount of reliance on both herbalism and magic for health-care assistance.

The former was often remarkably effective. The latter, not as often, but hey if its a fantasy campaign...

RPGPundit

Quote from: RPGPundit;471141I'd point out that there was also a tremendous amount of reliance on both herbalism and magic for health-care assistance.

The former was often remarkably effective. The latter, not as often, but hey if its a fantasy campaign...

RPGPundit

I am going to take a bit of an I, Claudius approach, where superstitions from the period have some effect. So curse tablets work, divining the will of the gods through augury can work, astrology yields some useful info and magic may have some health benefit. Still it will be pretty low magic as far as things go.

I don't have an herbalism component but should probably include one. There is a Poisoning skill, so maybe I can make it a component of that.

Quote from: Ian Warner;470986There is a scene in I Claudius wher Claudius consults a Greek doctor that shows the difference in approach between the two cultures.

That was a pretty good scene. The doctor who "believes in brine".

Quote from: The Butcher;470984For a good start, look up Hippocrates, Celsus and Galen.

Hippocrates is of course the big name of ancient Greek medicine and was required reading of every Roman doctor. Famous for his "Aphorisms", a collection of sayings and axioms based on clinical observations (not a few of which hold true to this very day).

Celsus wasn't a doctor actually, but that didn't stop him from writing one of the most voluminous and encyclopedic medical texts of Antiquity.

Galen, who would go on to be revered as the ultimate dogmatic source of medical knowledge for much of the Middle Ages, IIRC actually held an appointment as surgeon to the Colosseum's gladiators.

Generally speaking, ancient and medieval doctors had a decent working knowledge of simple surgical procedures such as incision and drainage of abscesses, splinting fractures, dressing (though not necessarily suturing) skin and soft tissue wounds, limb amputations, and excising some tumors (breast, skin, soft tissue). The very boldest would perform crude procedures to trephine skulls, extract or break urinary calculi inside the bladder, or caesarian delivery (mostly postmortem, i.e. immediately after a pregnant woman died, as allegedly was the case with Julius Caesar and St. Raymond Nonnatus; c-section in living women was anathema)

They were rather fond of cauterization, using hot irons to burn wounds and even tumors "clean", which BTW is just as painful but less effective than it sounds.

They had no antibiotics, but that doesn't mean that bacterial infections were universally lethal. Galen, and IIRC Hippocrates as well, went so far as to state that suppuration (the production of pus) was a normal and healthy stage of wound healing (a claim which saw challenge as early as 5th Century AD, with Theodoric of Cervia, but wasn't really debunked until the late 19th Century).

Humoral theory dates back to Hippocrates and again, wouldn't be replaced by a working knowledge of human pathology until the late 18th Century with Morgagni in Italy. Every disease was the result of "imbalances" with the four "humors" (black bile, yellow bile, blood and "phlegm"). Remedies would restablish the balance by "purging" the body of excess fluids; e.g. leeching or cutting veins to drain blood, vomit-inducing herbal remedies to purge excess bile, and of course, enemas. Lots of enemas. :eek:

For starters, this is a decent link:http://www.historylearningsite.co.uk/medicine_in_ancient_rome.htm

I'll try and post some more when I have the time.

Thanks for the thorough listing there. Just out of curiosity how effective were they in treating abcesses. Was an abcess in the digestive system pretty much a death sentence at the time?

Quote from: BedrockBrendan;471146Thanks for the thorough listing there. Just out of curiosity how effective were they in treating abcesses. Was an abcess in the digestive system pretty much a death sentence at the time?

For the most part, yes, since surgical intervention inside the abdomen was a definite no-no back then (without aseptic technique, it almost aways ended with peritonitis and death). Unless the patient was lucky enough to have an abcess in the vicinity of the abdominal wall, which would be usually synonymous with an inflamed and/or obstructed hollow viscus (appendix, colon, gallbladder, etc.) perforating and being tamponaded by the abdominal wall (anterior usually, but sometimes even in the posterior/lumbar region).

In this case, there would be pain, redness, warmth and swelling visible on the affected site, which a few bold souls would incise and drain like an ordinary abcess. If the patient wasn't already dying of sepsis, odds are that the abcess being drained, and the viscus remaining perforated (with a certain debit of secretion, e.g. feces or bile, coming out through the incision eve after the pus was drained and the inflammatory process resolved), you'd have granulation and epithelization around the incision, forming an epithelized traject around the incision; a fistula. The patient would most likely have to live with a messy, stinky fistula for the rest of his days (though spontaneous healing of fistulas isn't unheard of... I've had some peculiar cases myself, even in this day and age).

This is an exceptional outcome, but entirely within the realm of possibility. Generally speaking, if you had an abcess inside your belly before the days of asepsis and anesthesia, you were fucked. Hell, even today you're still kind of fucked; intra-abdominal sepsis still carries a high enough mortality in our days of asepsis and anesthesia and antibiotics and ICUs.

Thanks for the info butcher. Answers many of my questions. I myself have been dealing with abcesses and a fistula since january and am thankful I live in the 20th century. Any vague notion i may have had before that living in a simpler age would be better than our hectic modern world has been thorougly smashed. Though as you say, sepsis is still a serious concern today.

Quote from: BedrockBrendan;471144I don't have an herbalism component but should probably include one.

Hopefully, if you google Herbalism - WFRP, you should find a document i did for that game which'll give you some real-world herbalism goodness.