Outlines of Greek and Roman Medicine Part 10

A smaller suite of bathing apartments adjoining the men's establishment was for the use of women.

The most important baths formed only a part of the great establishments called _thermae_. Adjoining the baths of the thermae were a gymnasium for sports and exercises, a library for the studious, lounging places for the idle, halls for poets and philosophers, in which they declaimed and lectured, museums of art, and sometimes shady groves. These complete establishments were first erected by Marcus Agrippa in the time of Augustus. Succeeding emperors vied with each other in providing magnificent thermae, and the ruins of the Baths of Caracalla remain in a wonderful state of preservation to this day. The building of these baths began in A.D. 216. The structure, 1,050 ft. long and 1,390 ft. broad, was on a scale of almost incredible magnificence. Priceless statues and rare objects of art have been unearthed from the ruins. In recent years excavations have revealed a complicated system of subterranean corridors and galleries which existed for the purpose of carrying leaden water-pipes to the baths, and providing a pa.s.sage-way for the host of slaves who acted as bath-attendants. The great buildings were well lit by windows in the walls of the courtyards, and these openings also allowed for ventilation. A great stadium and beautiful gardens adjoined the Baths of Caracalla. In the north-west section of these baths Alessio Valle has very recently discovered the remains of a great public library. When Caracalla pillaged Alexandria he probably carried off many of the books from the famous library there to enrich his baths. The ruins of the library in the Baths of Caracalla reveal circular tiers of galleries for the display of ma.n.u.scripts and papyri. There were 500 rooms round these baths. The great hall had a ceiling made in one span, and the roof was an early example of reinforced concrete, for it was made of concrete in which bronze bars were laid. The lead for the water-pipes was probably brought from Cornwall.

The Thermae of Diocletian could accommodate 3,200 bathers. Its tepidarium was 300 ft. long by nearly 100 ft. wide, "vaulted in three bays with simple quadripart.i.te groining, which springs from eight monolithic columns of Egyptian granite about 50 ft. high and 5 ft. in diameter"

(Middleton).

From the medical point of view, these great bathing inst.i.tutions were capable of being used for the treatment of various diseases, and for physical culture. No doubt, they were extensively employed for these purposes and with good results, but their legitimate use became increasingly limited, and abuse of them was a prime factor in promoting national decay. To show to what an extent luxurious bathing was carried in some instances, it is interesting to read that baths were taken sometimes in warm perfumes, in saffron oil, and that the voluptuous Poppaea soothed her skin in baths of milk drawn from a herd of 500 she-a.s.ses.

FOOTNOTES:

[41] Od. viii, 249.

CHAPTER XIII.

SANITATION.

Water-supply--Its extent--The Aqueducts--Distribution in city--Drainage--Disposal of the Dead--Cremation and Burial--Catacombs--Public Health Regulations.

THE WATER-SUPPLY.

In ancient Greece, the cities were supplied with water from springs over which beautiful fountains were erected. The Greek aqueducts were not on the same grand scale as the Roman, but were usually rectangular channels cut in the rock, or made of pipes or masonry. Great care was taken in the supervision of these public works.

The first Roman aqueduct, according to Frontinus, dates from 312 B.C.

Pliny wrote of the Claudian aqueduct: "But if anyone will carefully calculate the quant.i.ty of the public supply of water, for baths, reservoirs, houses, trenches, gardens and suburban villas, and, along the distance which it traverses, the arches built, the mountains perforated, the valleys levelled, he will confess that there never was anything more wonderful in the whole world."

Frontinus, who was controller of the aqueducts in the time of Nerva and of Trajan, describes nine aqueducts, of which four belonged to the days of the Republic, and five to the reigns of Augustus and Claudius.

"The total water-supply of Rome has been estimated at 332,306,624 gallons a day, or, taking the population at a million, 332 gallons a head. Forty gallons a day is now considered sufficient."[42]

The ancient Aqua Virgo at the present day supplies the magnificent Fontana di Trevi, and the glorious fountains in the Piazzo di Spagna and the Piazzo Navona.

The Romans not only provided great aqueducts for the Imperial City, but also built them throughout various parts of the Empire. In Rome, the aqueducts were built to supply both the low and the high levels of the city. The reason why the Romans did not build underground aqueducts, as is done at the present day, has been variously explained. Perhaps they did not fully understand that water will find its own level over a great distance. They also would have found great difficulty in overcoming the high pressure of the water.

In their conduits they built shafts at frequent intervals designed to relieve the pressure of compressed air in the pipes. The water from the neighbourhood of Rome rapidly encrusted channels and pipes with calcareous deposits. Probably the great advantage of accessibility to leaks and defects gained by building unenclosed aqueducts appealed strongly to the ancient Romans. They did not fully understand the technical difficulties involved in the "hydraulic mean gradient." No machinery was used to pump the water or raise it to an artificial level.

A strip of land 15 ft. wide was left on either side of the aqueducts, and this land was defined at intervals by boundary stones. No trees were grown near the aqueduct, to avoid the risk of injuring the foundations, and any breach of the rules for the preservation of the aqueducts was severely punished by fines.

Vitruvius gives rules for testing the water, and points out that water led through earthen pipes is more wholesome than water coming from leaden ones. He states that the "fall" of an aqueduct should be not less than 1 in 200. A circuit was often made to prevent the too rapid flow of the water, and intermediate reservoirs were constructed to avoid a shortage of water in the case of a broken main. Reservoirs were also used for irrigation.

The water from the aqueduct was received at the walls of the city in a great reservoir called _castellum aquarum_, externally a beautiful building and internally a vast chamber lined with hard cement and covered with a vaulted roof supported on pillars. The water flowed thence into three smaller reservoirs, the middle one filled by the overflow of the two outer ones. The outer reservoirs supplied the public baths and private houses, while the middle one supplied the public ponds and fountains, so that, in the event of a shortage of water, the first supply to fail was the least important. The amount of water provided for private use could be checked, for purposes of revenue, by means of this arrangement.

At first the aqueducts were not connected with private houses, but, later, private persons were allowed to buy the water which escaped from leaks in the aqueducts. Next, private connections were made with the public mains, and, finally, reservoirs were built at the expense of adjoining households, but these reservoirs, although built with private money, were considered part of the public property. Water rights were renewed with each change of occupant. The water-supply to a house was measured by the size of the pipe through which it pa.s.sed at the in-flow and at the out-flow of the reservoir.

The _curatores aquarum_ had very responsible duties. Under their orders, in the time of Trajan, were 460 slaves who were subdivided into various cla.s.ses, each of which had its own particular duties to perform in connection with the maintenance and control of the water-supply. A supply of pure water and proper drainage are of first importance in sanitation, and it is evident that the Romans understood these matters well.

DRAINAGE.

The drains of Athens, built of brick and stone and provided with air-shafts, ran into a basin from which pipes carried the sewage beneath the surrounding plain which it helped to fertilize.

The chief drain of Rome was the Cloaca Maxima, and there was a great network of smaller drains. The privy in private houses was usually situated near the kitchen, and a common drain from the kitchen and the privy discharged into the public cloaca. A pipe opened just above the floor of the closet to supply water for flushing. Ruins of very small rooms have been discovered in the Via Sacra of the Roman Forum, and it has puzzled archaeologists to discover their use, but they are thought to have been sanitary closets. The sewers of Rome drained into the Tiber.

DISPOSAL OF THE DEAD.

Both in Greece and Rome earth-burial and cremation were employed for the disposal of the dead. Near the Temple of Faustina in the Roman Forum, under the Via Sacra, have been found the graves of some of the dwellers of the hills before Romulus founded the city. In Rome, burial within the city was forbidden from the time of the Twelve Tables. Exceptions were made in the case of emperors, vestal virgins, and famous men, such as those who had been honoured with triumphs. The large cemetery for the poor lay on the east side of the city and the tombs of the rich were along the roadsides. The remains of some of these can now be seen along the Appian Way. One of these tombs is the Tomb of the Scipios, which, as Byron wrote, "contains no ashes now." Near the Tomb of the Scipios can be seen a door with high steps which leads to the _columbaria_. These are little rooms provided with pigeon-holes for the reception of the ashes of the freedmen of notabilities. Inscriptions show that some of these freedmen were physicians, and others musicians and silversmiths.

The shops of the perfumers stood in a part of the Forum on the Via Sacra. Perfumes were much used at incinerations to disguise the smell of decomposition before the fires were kindled. The Christians opposed cremation and favoured earth burial, and in time the business of the perfume-sellers failed, and Constantine bought their shops.

The _Catacombs_ were used almost entirely by the Christians. If all the pa.s.sages of the Catacombs could be placed in line, it is said that they would extend the whole length of Italy. They were hewn out of volcanic soil very well suited for the purpose, and were probably extensions, in the first place, of quarries made for the purpose of obtaining building cement. They were used by the Christians, not only for the religious rite of burial, but also as secluded meeting places. The bodies were laid in _loculi_, sometimes in two or three tiers, the loculi being filled in with earth and stone.

Many of our public health regulations had their counterpart in ancient times, for instance, any factory or workshop in Rome which created a public nuisance had to be removed outside the city. The _spoliarium_ of the Coliseum was an ancient morgue.

A detached building or room, _valetudinarium_, was provided in large houses for sick slaves. This was for the purpose of preventing infection as well as for convenient attendance on the sick.

FOOTNOTES:

[42] "Dict. of Gr. and Rom. Antiq.," Smith, vol. i, p. 150, _to which the author is indebted for much of the information herein supplied_.

APPENDIX.

FEES IN ANCIENT TIMES.

The professional incomes of doctors in ancient Greece and Rome varied greatly as at the present day. A few were paid very large fees, but the rank and file did not make more money than was equal to keeping them in decency.

Seleucus paid Erasistratus about 20,000 for curing his son Antiochus.

Herodotus mentions that the aeginetans (532 B.C.) paid Democedes, from the public treasury, 304 a year; the Athenians afterwards paid him 406 a year, and at Samos he received 422 yearly. Pliny says that Albutius, Arruntius, Calpeta.n.u.s, Ca.s.sius and Rubrius each made close upon 2,000 a year, and that Quintus Stertinius favoured the Emperor by accepting about 4,000 a year when he could have made more in private practice.

The surgeon Alcon made a fortune of nearly 100,000 by a few years'

practice in Gaul. Pliny states that Manlius Cornutus paid his doctor 2,000 for curing him of a skin disease, and Galen's fee for curing the wife of a consul was about 400 of our money.