Medicine and the Roman army: a further reconsideration.

PROFESSOR John Scarborough in a recent article in this journal has discussed the relationship between doctors and the Roman army, but his methods and his conclusion, which may seem to some to compel assent, demand a cautious and thorough examination before being accepted.' As Sigerist saw, it is necessary to exclude modern preconceptions and to avoid the obfuscation of an account by the introduction of evidence from different periods and cultural contexts. Roman military medicine extends over many centuries, from Polybius writing in the second century B.C. to Paulus of Aegina and Alexander of Tralles in the sixth century A.D., and the army of the empire differs in organization, composition and purpose from that of the Republic. Thus an investigation of Roman military medicine must take care not to introduce terms and evidence that are chronologically insecure and it must consider the medical services of the army within the context of the army and secondly within that of Roman medicine as a whole. A full and detailed exposition of all the evidence would consume much space, but there are objections to and clarifications of Scarborough's article that can be made briefly and without producing those arguments that require broad discussion or that have implications for more than the study of ancient medicine. This article, therefore, sets out destructive arguments rather than constructive proposals, although some idea may be gained of the direction in which further research is needed or in which I hope to develop some of my suggestions. I begin with a summary of Scarborough's conclusions, which are complicated and somewhat difficult to follow. The republican evidence attests the presence of private doctors in the army, brought by the general and by those who could afford them, and there was no corps of doctors but only 'a kind of de facto medical service of soldier-medici'.2 Under the empire the need for medical care was filled by having the wounded cared for on the field and the sick and severely wounded placed in valetudinaria.3 Trained physicians were rare and the sick were treated by medici, soldiers in the ranks specially detailed for the post who gathered their craft within the legion. Military medicine was confined to wound surgery and could be easily learned by such men.4 There is an 'unofficial basis' admitted in many cases, and, as