HISTORY OF UROLOGY

What did the Romans ever do for us?

n this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, Ihosted on the BAUS website (www. baus.org.uk). Previously in this column, I told you about the Saxons and how they treated some urological diseases (Urology News 2013;17(5):22). Since then I have become aware of even earlier urological activity in Britain. The Romans first came to Britain

with an expeditionary force under the Figure 1: Highly stylised bronze Roman Phallic amulet. British c.C3rd AD. command of Julius Caesar in 55 BC; they didn’t stay long. They came again however in AD43 during the reign of often have Greek names. Much healing Claudius and Britannia became part of took place in the home, the master or the Roman Empire until AD410. mistress of the household taking the The Romans brought doctors with part of family healer. them, often Greeks, and the medicine Many herbal remedies were used in of was heavily influenced by the Roman times. doctrines of Ancient Greece. There were (c40-90 AD) was a Greek botanist, four main medical schools of thought. pharmacologist and physician who The Dogmatics tried to balance a practised in Rome at the time of Nero. patient’s four humours (blood, phlegm, Dioscorides wrote a five-volume yellow bile and black bile); for example, encyclopaedia, , listing if they felt the patient had too much over 600 herbal cures. It was used blood they would bleed them, too much extensively by doctors for 1500 years. Figure 2: Roman Bronze Phallic amulet with phimosis. phlegm, they would warm them to try Ancient cesspits are often a useful Eastern European. c.C3rd AD. and dry them out. The Pneumatists archaeological source and one on the tried to balance the patient’s pneuma or Antonine wall (it’s further north than life spirit using environmental factors Hadrian’s) in Scotland has revealed such as clean water, fresh air and baths. faecal material containing both celery The Empiracists used careful clinical seeds and . Celery was a well-

observation to make a diagnosis and described diuretic, used for urinary Figure 3: Roman ‘S’ shaped male catheter (Modern based management on “whatever disorders. One wonders if this poor reproduction). worked last time in that situation”, Roman was suffering from bladder hence the name. The Methodists stones and had taken opium for the pain specific problems like infertility, sexual followed the works of Asclepiades and celery to help him void more easily or penile diseases. The bronze phallus in and used a combination of food, (complete speculation of course!!). Figure 1 was found in Britain, it probably wine, massage, exercise and bathing Religion and faith played a major part dates from the second or third Century (unsurprisingly, this was the most in Roman healing. Although Aesclepius AD. The one in Figure 2 appears to have popular!). was the major Roman God of healing, a phimosis, perhaps the wearer was There were different types of Apollo was also worshipped in Britain hoping for a divine cure to avoid the healers in the Roman Empire, with as were some older Celtic Gods such as surgeon’s knife? some being attached to the army. Sulis and Brigantia. Votive (small models was certainly carried out The Medicus Ordinarius probably had of diseased body parts) were given to in Roman Britain. was a rank equivalent to a Centurian. A the gods in the hope the giver would be of course known to Greco-Roman valetudarium or military hospital has healed. Often they were thrown into doctors; the procedure was carefully been identified at Housesteads Fort near sacred pools or springs. Bronze amulets described by Aulus Cornelius Celsus Hadrian’s Wall. There must have been were also worn often in the shape of (c25 – c50 BC). Celsus was a Roman civilian doctors and itinerant healers. phalluses. It is unclear if these were encyclopaedist rather than a doctor The few identifiable British medics for general good luck or good health or but he is famous for his well-known

urology news | MAY/JUNE 2016 | VOL 20 NO 4 | www.urologynews.uk.com HISTORY OF UROLOGY

“Certain Roman medical a blade to make the initial lithotomy * I am very grateful to Dr Ralph Jackson incision (like a modern disposable FSA, Senior Curator at The British Museum instruments have been scalpel blade). for putting me straight on this point. Some surgical instruments have excavated that appear been excavated in Britain at the forts at Housesteads and Corbridge. to be urological.” Previous Urology News historical articles Although there are hooks, scoops and can now be read online in The Museum one artefact has been named a bladder of Urology, BAUS. sound, no urological instruments have convincingly been found (as yet!) in the UK.* It is not clear if lithotomy was carried out in Roman Britain by specialised medical book, De Medicina. This was a ‘lithotomists” or stone cutters or by primary source on diet, and doctors who specialised in surgery, or surgery for centuries and is one of the if doctors were expected to be both best sources of medical knowledge physician and surgeon. Remember in the Roman world. His description warned his colleagues to of ancient lithotomy has led to it leave stone cutting to specialists! It is being called the Celsian method of certain that urological conditions would cutting for the stone. Certain Roman have presented to healers in Britannia. medical instruments have been Some would have been treated by diet, excavated that appear to be urological. fluids and other conservative measures, Jonathan Charles Bronze catheters for males were some medically with herbs and some Goddard, S shaped (Figure 3) whilst female Curator of the The Museum surgically; sound familiar? catheters were shorter. Hooks and of Urology, BAUS; Next time, I will explore the history scoops with roughened surfaces have Consultant Urological of something we find difficult to treat in been identified; these are typical of Surgeon, Leicester General modern urology clinics to see how our Hospital, UK lithotomy scoops, to pull out bladder forebears tackled it; chronic bladder E: jonathan.goddard@ stones. Some have a groove on the uhl-tr.nhs.uk pain. other end, which may have contained

urology news | MAY/JUNE 2016 | VOL 20 NO 4 | www.urologynews.uk.com