Medical Practices in Roman Spain: Identity through Medical Instruments
Patricia Baker, University of Kent, Canterbury
Fig 1. A surgeon treating a thigh wound. From the original fresco found at Pompeii. Wellcome Images Collection number M0008724. Wellcome Library, London, Copyrighted work available under Creative Commons by-nc 2.0 UK: England & Wales
In his Natural History, Pliny the Elder (25. 85) stated that the Cantabri, an indigenous group of people who lived in the Roman province of Hispania Tarraconensis, devised an elixir consisting of one-hundred herbs that they drank to maintain their health. Pliny’s story is one of a rare few comments in ancient literature that refers to localised traditions of medical practices in the Roman provinces. His statement was the initiating factor in undertaking a pilot study that asked how the native populations of the three provinces of Roman Spain responded to the introduction of Graeco-Roman medical philosophies and practices in contrast to their own healing traditions after the incorporation of Hispania into the empire (1st century BC). This paper gives a short overview of my preliminary findings and explains why it is necessary to consider provincial medical practices in historical examinations of Roman medicine from an archaeological perspective.
Since the Roman empire covered a vast geographical area, it has been easier for scholars to subsume the unique medical customs of different societies living within it under an over-generalised notion of Roman identity, which has led to postulations that medical practices were, for the most part, homogeneous. This idea has mainly developed from archaeological examinations of the remains of medical tools found in the provinces (Allason-Jones1999; Breitwieser 1998; Künzl 1996). Since there is little literary material for the provinces, scholars of medical texts have rarely contributed to this aspect of medical history. It is the archaeological evidence that provides the most information about medical practices in areas beyond Italy and the eastern Mediterranean, places where the medical texts were written.
Based on the premise that Roman-style medical instruments appear in the archaeological record after Roman occupation, archaeologists and medical historians have theorised that Graeco-Roman medical traditions were fully adopted into these different societies. Yet, this idea is in contrast to the textual exegeses that have shown that even amongst Greek and Roman medical writers there were many disagreements about how the body functioned, the nature of disease and appropriate treatments (King 2001). Since medical philosophies varied amongst these writers it is difficult to provide a precise definition of Greek or Roman medicine, therefore triggering the question, “if there were no ‘standard’ practices in Greece and Rome, what type of medical philosophies were those living in the provinces adopting?”
In order to examine provincial medicine a study of all the regions would be a near impossible undertaking, but focusing on a particular areas sheds light onto certain provincial practices and allows for easier comparisons with other provinces to be made in future research. Spain was mainly chosen because it has been overlooked outside Spanish scholarship. More focus has been given to instruments in Roman Britain, Gaul and Germany. Nonetheless, Spanish archaeologists have written reports on the medical tools found in Spain, and like those examined in the northwestern provinces, they were not only compared to objects from Italy, but the archaeologists determined the function of the tools by comparing them with extant medical literature (e.g. Borobia 1988).
The appearance of instruments does not automatically imply the same uses and adoption of practices, particularly when there were many societies living within the empire that would have had their own beliefs about the body and treatments. Medical anthropological studies demonstrate that medical practices are closely linked to a society’s philosophies and they are not easily dispensed with for new and seemingly more advanced practices (Kleinman 1980). Thus, this project seeks to rectify the limitations of earlier studies with a critical re-evaluation of the medical instruments that considers their design and archaeological context with a focus on Hispania.
Between 2008 and 2009 I undertook a pilot study that examined the published medical tools from Tarraconensis, Baetica and Lusitania. The instruments dated from the late first century BC to the fourth century AD. They were collated and studied according to type, archaeological context, design and associated artefacts. The remains were examined via critical and contextual archaeological methodologies rather than comparisons to medical literature. When the ancient writers mention medical tools they tend not to provide a physical description of them; they sometimes mention instruments that archaeologists have yet to identify and they mention varying uses for them, problems archaeologists rarely consider. These differences in tool functions are similar to the variations in descriptions of bodily functions and the nature of disease.
Fig 2. Map of the archaeological sites in the three provinces of Hispania that have published medical instruments.
Having chosen to re-evaluate medical instruments in Spain, the immediate outcome of the examination shows that Roman occupation helped facilitate the inculcation of medical instruments since a total of 19 published sites had the remains of medical tools: the province of Baetica had six, Tarraconensis 11 and Lusitania two (Fig. 2). The total number of identifiable instruments is 298 with 122 in Baetica, 131 in Tarraconensis and 45 in Lusitania. Overall the instruments are common types found throughout the empire: scalpels, forceps, spoon and spatula probes and ligulae, objects used to clean the ears. However, some interesting patterns emerged in the study that demonstrated Spain was not fully adopting ‘Roman’ practices.
A number of instruments, particularly the scalpels, have unusual designs, in comparison to those found in Italy and the published instruments in other provinces. Throughout the empire, scalpels are commonly found with rectangular handles (Fig. 2). In Spain eight out of 20 were not of this type: three had octagonal handles: one was found at Gerona: (Oliva Pratt 1949), one was from Mérida (Sáenz de Buruaga and García de Soto 1946) and a third was from Palencia (Molina 1981). One hexagonal handle was found at Ercávica (Fuentes Domínquez 1987). Another found at Zaragoza had a head thought to be Hercules on the handle itself rather than above the handle, which is a rare design found at Pompeii (Oritz Palomar 1998). Three at La Cañada Honda were decorated with silver inlay (Hibbs 1991: 129). Other types of instruments also showed design differences. Although rare outside Gaul, three oculist stamps, objects used to mark eye medicines, were found in Hispania. One from Caceres near Mérida was hexagonal, unlike their ubiquitously square and rectangular shapes (Floriano, A. C. 1940/41: 430-1). A spoon probe with a hook rather than the standard olivary end came from Ampurias (Oliva Prat 1945: 56) and a decorated ligula which has two “arms” protruding diagonally from the main handle of the object was also noted at Gerona (Oliva Prat 1949: 190).
Fig 3a. Oculist's Stamp, Roman, in the Guildhall Museum. Wellcome Images Collection number L0000813. Wellcome Library, London, Copyrighted work available under Creative Commons by-nc 2.0 UK: England & Wales
Fig 3b. Oculist stamp from Caceres. After Floriano 1941, 146. Drawing by Lloyd Bosworth.
These unusual instruments, although not great in number, are more concentrated in a particular area than noted with other provinces, the only notable exception being the preponderance of oculist stamps in Gaul (Voinot 1999). Preliminary suggestions for this are that the population of Hispania was not fully taking on new medical practices; rather they were adapting their medical tools to designs suited to local preference for a specific style or craftsmanship, which were either familiar to them, and/or were deemed appropriate to their healing practices. Such a suggestion for the maintenance of localised traditions finds support in the unusual design of instruments found at Stanway, Essex, Britain, a rare set of medical objects from the early occupation of Roman Britain (Jackson 1997).
Not only are localised practices suggested by the unique design of some instruments, but the archaeological context of the medical tools is most indicative of the continuation of regional traditions. Noting where objects were discarded, as archaeologists and anthropologists have demonstrated in numerous studies, shows that social beliefs can be found in the treatment of objects, beliefs that are often not recorded in writing. The treatment of medical instruments can elucidate conceptions of social taboos and attitudes towards disease and objects associated with the body and the ill (Baker 2004).
Thirteen of the 19 Spanish sites were properly recorded and ten of those had instruments found in burials. Some sites had high numbers of instruments, such as Ampurias with 58 and La Cañada Honda with 55. It was uncommon to find personal objects in Roman burials in Italy, which tend to have two artefacts: lamps and coins, thought necessary for the journey to the underworld. Spanish Iron Age burials did, however, contain grave offerings, indicating that the practices were maintained into the Roman period, but with the native population now offering Roman-style objects.
Thus, from the treatment and the design of instruments, it seems as if those in Spain were not fully adopting Roman objects, but making them conform to their own designs and practices, some of which might have carried over from earlier periods. This preliminary research is now being taken further with examinations of healing sanctuaries dedicated to syncretic deities, such as the god Salus Umeritana. Inscriptions mentioning doctors will also be examined to see if the evidence further suggests a meshing of Roman and indigenous practices, which is indicated by the published remains of medical tools.
'Thanks goes to the British Academy for a Small Grant to undertake preliminary library research.
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