Ancient Greek & Roman Medicine (Radio Edit)

Summary

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You're Dead to Me – Ancient Greek & Roman Medicine (Radio Edit)

Host: Greg Jenner
Guests: Professor Christy Upson-Saia (Religious Studies, Occidental College), Stu Goldsmith (Comedian)
Release Date: January 14, 2023
Podcast: BBC Radio 4, You’re Dead to Me

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Episode Overview

This lively and insightful episode of "You're Dead to Me" explores the world of medicine in Ancient Greece and Rome. Host Greg Jenner is joined by historian Prof. Christy Upson-Saia and comedian Stu Goldsmith to unpick just how the Greeks and Romans understood and treated illness, blending gory medical details with humor and critical historical context. The episode covers the prevalence and causes of illness, the interplay between religion and medicine, the famous Four Humours theory, ancient cures (including bizarre treatments like beaver glands), women's roles in medicine, and the shift to hospitals with the rise of Christianity.

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Key Discussion Points & Insights

1. Illness as the Ancient Norm

• Constant Ill Health: Prof. Upson-Saia sets the scene by clarifying that there was a "norm" of being unwell in the ancient world.
  • Quote (Prof. Upson-Saia, 03:45): "When we read Greek and Roman sources, we get the picture that at any given time, nearly everyone had some sort of illness, injury or impairment... People were unwell most of the time, and health was a state they only fleetingly experienced."
• Roman letters (Fronto) often detail fevers, chronic pain, and household sickness.
• Urban Environments: Dense living, poor sanitation, stagnant water — prime environments for infectious diseases.
  • Quote (Prof. Upson-Saia, 05:03): "...air pollution from smoke, from fires, from cooking, or from oil lamps, and even from fecal matter..."

2. Religion and Healing: Asclepius & Incubation

• Healing Temples: Worshippers brought anatomical "votives" (clay models of ailing body parts) to Asclepius temples.
• Dream healing practice called incubation: spend the night in the temple, hope for a healing dream or a dream prescribing a treatment.
  • Quote (Prof. Upson-Saia, 07:11): "Either the God would treat them within the dream and they would wake up healed, or they would receive a dream in which the God prescribed a treatment plan..."
• Temples often incorporated pharmacies, where prescribed treatments from dreams could be purchased.
  • Quote (Prof. Upson-Saia, 08:44): "At the Asclepian temple in Pergamum... it’s lined with these shops or stalls... some of them were pharmacists... they were in cahoots with the priests."

3. The Rise of Professional Medicine

• Hippocrates of Kos: Advocated for natural explanations of illness, shifting away from divine blame.
  • Practiced diagnosis and prognosis, and sampled patients’ bodily fluids to diagnose illness.
  • Quote (Greg Jenner, 09:45): "He drank people's urine, he tasted their earwax and their mucus and nasal phlegm..."
• Resistance: Folk were suspicious of medicine overtaking religion; doctors often blended both.
  • Quote (Prof. Upson-Saia, 10:20): "The other approach is just to fold medicine and religion together... the gods were the ones who showed them the remedies."
• By 46 BCE, Julius Caesar offered Roman citizenship to foreign doctors, signifying growing societal value.

4. The Four Humours & Theories of Disease

• The Four Humours: Blood, phlegm, black bile, yellow bile. Health meant balance; disease, imbalance.
  • Quote (Prof. Upson-Saia, 11:19): "Ancient folks thought that the body was made up of four different: blood, phlegm, black bile and yellow bile."
• Treating Imbalance: Eg. For an excess of phlegm (cold, wet), prescribe hot, dry things: spices, garlic, exercise.
  • Quote (Prof. Upson-Saia, 12:00): "Phlegm is the cold and wet humor... prescribe treatments that counteract those qualities."
• Alternative Theories: Asclepiades argued for an atomistic model — health depended on free movement of body’s 'atoms.'

5. Ancient Cures: Bizarre and Botanical

• Bizarre Treatments: All of the following were genuinely prescribed:
  • Hold a puppy to ailing organs to suck out disease
  • Eat injured human earwax for stings
  • Drink gladiator blood for epilepsy
  • Zap migraines with electric eels or torpedo fish
  • Quote (Greg Jenner, 15:06): "We've screwed you here because they're all true."
• Pharmacology: Plant-based cures were widespread, with over 700 listed in Roman texts. But the Greek word pharmakon meant both "remedy" and "poison" — expertise was essential.
  • Quote (Prof. Upson-Saia, 15:33): "Both drug and poison."
• Drug Trade: Pharmacologists operated in bustling marketplace stalls.

6. Medical Professionalism, Training & Gender

• Medical Training: No official licenses; reputation and word of mouth ruled. Many doctors, including enslaved Greeks, migrated to Rome. Some doctors (e.g. city physicians) had retainers paid by city councils (17:22).
• Surgery: High risk; surgeons were often located near cemeteries.
  • Quote (Prof. Upson-Saia, 18:18): "Most of the time, physicians tried to avoid cutting open their patients. So surgeons were the professional class... it was incredibly risky..."
• Women in Medicine: Women served not just as midwives, but as physicians with classical recognition.
  • Quote (Prof. Upson-Saia, 19:05): "There was a professional class of women healers, healthcare professionals, that were often called midwives or obstetricians... the titles start to be called physicians [using same terms as men]."

7. Women's Health and the Wandering Womb

• Humoral Differences: Men were "hot and dry", women "wet and cold."
• Wandering Womb: Some believed the uterus could "wander" if deprived of moisture, causing illness.
  • Treatments: Sex to "moisten" the womb, or olfactory lures like aromatic herbs placed below, and foul-smelling substances or fumes above to scare it into place.
  • Beaver Bum (Castoreum): Used as a disgusting-tasting encouragement for womb cure; also a source for vanilla flavor!
    • Quote (Prof. Upson-Saia, 22:27): "You would either have the woman inhale foul smelling things... or force her to ingest disgusting drinks like castoreum, which is a substance extracted from beavers. And fun fact, also used in modern vanilla flavorings."

8. Pain Relief & Hospitals

• Painkillers: Mandrake, henbane, opium were known, but rarely anesthetized fully — restraint was common.
• Rise of Hospitals: With Christianity (and Jewish tradition), healthcare shifted from private to communal, charitable institutions — the origins of the hospital as we know it.

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Memorable Quotes & Moments

• Stu Goldsmith (04:26): “The idea that the normal state was to be ill means that everybody who created anything... they were writing that stuff whilst weeping and bleeding and pussy and stinking.”
• Greg Jenner (14:04): "Hold a puppy close to that part of their body and the puppy will suck out the disease..." (On bizarre ancient cures)
• Stu Goldsmith (15:08): “Ah, yeah. Okay. Even the puppy.”
• Prof. Upson-Saia (19:05): "...over 50 attestations of women physicians, many of whom rose to prominence..."
• Greg Jenner (23:33): "We've got no real mention here of painkillers or anesthetics. Do we think they had any?"
• Prof. Upson-Saia (25:25 – Nuance Window): "Studying the past is an occasion to practice becoming comfortable with diversity and difference. And this is a skill that is directly transferable to the clinical context... what experts now call culturally competent healthcare."

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Important Timestamps

• 03:45 – Normalcy of illness in ancient societies
• 05:29 – Urban living and sanitation issues
• 06:49 – Asclepius temples and dream healing
• 09:45 – Hippocrates, bodily fluids as diagnostic tools
• 11:19 – The Four Humours explained
• 13:05 – Medical debate: Galen vs. Asclepiades (atom theory)
• 14:04 – Quizzing ancient cures (puppies, earwax, eels)
• 15:26 – Pharmacology and the dual nature of drugs
• 16:32 – Medical training and the lack of regulation
• 17:57 – City physicians and Pompeii’s surgeon
• 19:05 – Women as physicians
• 20:46 – The wandering womb & beaver bums (castoreum)
• 23:33 – Painkillers and surgery
• 24:12 – Rise of Christian hospitals
• 25:25 – Nuance Window: Why study ancient medicine?
• 27:32 – Culturally competent healthcare, persuasion in medicine

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Conclusion

This episode captures the surprises and strangeness of ancient healthcare, illustrating how ordinary people navigated disease, how healing straddled the religious and scientific, and how both men and women contributed to medical knowledge. The conversation is anchored by poignant moments and zany ancient cures (from puppies to beaver glands), while Prof. Upson-Saia’s "Nuance Window" (25:25) draws lessons on empathy, critical thinking, and cultural competence for modern medicine. Whether you’re a history fan, a medical professional, or just fascinated by the weirdness of the past, this is an illuminating listen.

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Transcript

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[Professor Christy Upson Sawyer]

BBC Sounds Music Radio.

[Greg Jenner]

Podcasts hello and welcome to youo're Dead to Me, the comedy podcast that takes history seriously. My name is Greg Jenner. I'm a public historian, author and broadc and on this podcast we treat you with a soothing sou of two parts book learning and one part chuckles. Because laughter is the best medicine. And today we are grabbing our scalpel and forceps to journey back to ancient Greece and Rome to learn all about medicine in the classical world and to help me diagnose fact from fiction. I'm joined by two very special guests in History Corner. She's professor of Religious Studies at Occidental College in LA and is an expert in religions of the late ancient Mediterranean world. But more importantly, she's co writing a fascinating new book on ancient medicine is Professor Christy Upson Sawyer. Hello Christy, thank you for coming.

[Professor Christy Upson Sawyer]

Hi. Thanks for having me. Lovely to be here.

[Greg Jenner]

And in Comedy Corner he's a stand up comedian, the host of one of my all time favorite podcasts, the Comedian's Comedian as well as other podcasts. And of course you'll remember him from other episodes of youf're Dead to Me, Blackbeard the Pirate, Jack Shepard and fandom. It's Stu Goldsmith. Hi, Stu. How are you?

[Stu Goldsmith]

I'm fantastic. And that's the only time I've ever been described as a returning hero. And I would like to preserve this moment in amber for the rest of my life.

[Greg Jenner]

This time, we're taking you back to the ancient world and to ancient medicine. And is this something that you know anything about? Have you done anything like this at school?

[Stu Goldsmith]

I don't think so. I did a bit of Latin at school, and I seem to remember that their medicine was all about scraping, mostly scraping and poking. I'm also kind of on tenterhooks, hoping that there isn't going to be anything quite so visually arresting.

[Greg Jenner]

I'm afraid we might have to disappoint you on that, because we do have some pretty arresting things coming up.

[Stu Goldsmith]

Eyes down. Let's get scraping.

[Greg Jenner]

So, what do you know? This is where I have a go at guessing what you might know about today's subject. And I'm gonna guess you know what medicine is, but would you know what to expect if we dumped you in ancient Rome or ancient Greece and said, eat this. Oh, no, you've got a dodgy tummy. Sorry. And would you know what the four humors are? They sound like a Motown group. Sadly, they weren't. You might know the Hippocratic oath to do no harm, not least because it appears quite often in TV shows like Grey's Anatomy and Scrubs and Outlander and Star Trek, even. But what else is there to know? And more importantly, what are vanilla cupcakes and beaver bums have to do with medicine? Let's find out, shall we? Professor Christie, is it fair to say that this is a world in which illness is the norm?

[Professor Christy Upson Sawyer]

Yeah, absolutely. When we read Greek and Roman sources, we get the picture that at any given time, nearly everyone had some sort of illness, injury or impairment. And my favorite illustration of this comes from the letters of the Roman orator Fronto, the bulk of which are comprised of his and his friends complaining about their aches and pains. Fronto mentions his own chronic knee pain flaring up all the time, and he talks about bouts of fever and diarrhea, a bite from a scorpion who's hiding in his bed, a stiff neck. He's worried about his mother, who's getting sick and his wife, who's about to give birth. People were unwell most of the time, and health was a state they only fleetingly experienced.

[Stu Goldsmith]

The idea that the normal state was to be ill means that everybody who created anything that we think about and Respect from your Socrates to your other people, names like that, they were writing that stuff whilst weeping and bleeding and pussy and stinking. The gentleman who jumped out of the bath, whose name escapes me, Archimedes, but the eureka guy, he jumped out of the bath, and it might well have been a bath of his own pus. This is not a thing that I.

[Greg Jenner]

Like to think about. Roman society in particular, enormously urban for the major cities. But there are also reasons people are ill all the time. These illnesses are caused by things.

[Stu Goldsmith]

Yeah.

[Professor Christy Upson Sawyer]

So they're living in these really close quarters, which, as you can imagine, contagious diseases would have spread quickly in these living conditions. And. Yeah, air pollution from smoke, from fires, from cooking, or from oil lamps, and even from fecal matter in chamber pots that people kept in their homes. And so, you know, when we've exhumed human remains from the time, we find diseases of the lung that are similar to those found in coal miners today.

[Greg Jenner]

As well as the occupancy problem of dense cities, we also have the kind of sanitation problem. I mean, obviously the Romans are amazing for bringing water into the cities with aqueducts, but there would be some pretty unclean water that people would be bathing in, wouldn't they, Christy?

[Professor Christy Upson Sawyer]

Yeah. Aqueducts were, in fact, pretty remarkable. They had settlement ponds and channels that purified the water as it was routed into the cities. But once the water arrived into the cities, it was stored in cisterns, so it sat stagnant. And as we know, these are the ideal conditions for waterborne bacteria and for the breeding of insects that transmitted diseases like mosquitoes. And there also wasn't waste removal, so people just threw their rubbish in the streets and it piled, and as it sat there, it rotted. And this was another place in which insects and vermin that transmitted diseases flourished.

[Stu Goldsmith]

The idea that Roman civilization was so advanced. Oh, we have the finest stuff incoming. Then when it gets here, it sits around, we throw it out the window. Look, we're only in charge of the first half of the job.

[Greg Jenner]

Let's talk about the religious aspect, then. Let's start with ancient Greece, and we're talking perhaps two and a half thousand years ago. And the God in charge of healthcare is called Asclepius, and he has daughters. How do you go to a temple dedicated to him? And what's the process of getting better?

[Professor Christy Upson Sawyer]

So Asclepius was the God you wanted to go to if you were sick. And like you said, his daughter Hygiea and Panichea were also goddesses at these temples. You would bring Them gifts you would bring prayers and petitions you would bring anatomical votives. They were clay or stone objects in the shape of the body part that they wanted the God or goddess to heal.

[Stu Goldsmith]

So if I've got a dodgy knee, I'm going to make a little clay knee and I'm going to take it and place it in the temple, as if to sort of highlight the bit of me that there's an issue with.

[Professor Christy Upson Sawyer]

Yeah, we mostly have a lot of eyes and ears and internal organs, wombs. But the signature practice at Asclepian temples was the healing ritual called incubation. So incubation required a sick person to sleep in a special sanctuary where they hope to have one of two kinds of dreams. Either the God would treat them within the dream and they would wake up healed, or they would receive a dream in which the God prescribed a treatment plan that upon waking, they would follow with the help of the priests.

[Stu Goldsmith]

I love your use of the phrase a treatment plan. I have incubated and I have dreamt a treatment plan which is six of these four times a day.

[Greg Jenner]

You wake up in the morning and you're not better. Does that mean the gods have failed you?

[Professor Christy Upson Sawyer]

No, it means you have to go and do some work. So usually the priest would help you procure the drugs that were prescribed in the dream. So sometimes the treatment plan involved bathing in hot pools or cold pools, sometimes exercise was prescribed.

[Stu Goldsmith]

I mean, it really was a treatment plan, wasn't it?

[Professor Christy Upson Sawyer]

That's incredible.

[Stu Goldsmith]

Yes, that they should. So presumably, if you're the doctor or the kind of the pharmacist people come along and they're going to dream and then you're going to sell them the stuff afterwards, as they're falling asleep, do you whisper, oh, go to Salvio's Pharmacy, it's the best one. And in the hope that they dream about gold pellets, which. Oh, I've got a couple of those I can rustle up.

[Professor Christy Upson Sawyer]

You're not far off, Stu. Actually, at the Asclepian temple in Pergamum in modern day Turkey, when you enter into the temple, it's lined with these shops or stalls, and we know that some of them were pharmacists. And so it's pretty clear that they were in cahoots with the priests.

[Stu Goldsmith]

I may not know much about medicine, but I admire a hustle when I see one.

[Greg Jenner]

But at the same time as we have those priests and those temples, we also get the rise of professional medicine. And the most important in the Greek world is probably hippocrates of Kos, born around two and a half thousand years ago. He invents the concept of diagnosis and of prognosis, of saying, I know what's wrong with you and I know what's coming next. But what was sort of slightly gross about it is that some of his techniques, Christy, were. I mean, he drank people's urine, he tasted their earwax and their mucus and nasal phlegm and all sorts of things. And he was like, I think it might be scurvy.

[Stu Goldsmith]

They can taste what's wrong with you.

[Professor Christy Upson Sawyer]

He and other medical writers introduced a pretty significant paradigm shift in that he thought that sickness could be explained entirely in terms of changes in the body, not the gods. And medical writers like him set out to diagnose what exactly it was that was going wrong inside of a patient's body by looking at these signs, or what we would today call symptoms.

[Greg Jenner]

There was resistance to these new ideas. The Greeks in particular looked at these professional doctors and went, what's that? No, I'm sticking with my gods, thanks very much.

[Stu Goldsmith]

How did they overcome that?

[Professor Christy Upson Sawyer]

It took a lot of persuasion. So we have early Hippocratic writings. The Art of Medicine is one of my favorite texts, and it's just a litany of criticisms and skepticism about the new science and responding to them one by one. But the other approach is just to fold medicine and religion together. The doctors would appeal to the gods for help. They would say that the gods were the ones who showed them the remedies.

[Stu Goldsmith]

We've got some aspirin, and don't worry. Do you want the blessed aspirin or the unblessed aspirin? Great.

[Greg Jenner]

Although there was stubborn resistance, gradually doctors do sort of gain a bit more prominence. And by 46 BCE, Julius Caesar conferred Roman citizenship automatically on all foreign doctors. But, Stu, I'm gonna ask you about what you think the four humours might have been.

[Stu Goldsmith]

Four humours, I guess, are gonna be slapstick prop gags, one liners and shaggy dog stories. I want to say bilge, but I think I'm conflating bile. And Flem Christie, do you want to.

[Greg Jenner]

Put him out of his misery?

[Professor Christy Upson Sawyer]

Yeah. So ancient folks thought that the body was made up of four different blood phlegm, black bile and yellow bile. So two different kinds of bile.

[Greg Jenner]

There is this idea that these four humors, if they get out of balance, can tip you towards a certain mood and also, of course, into bad health. So that then brings us to the theory of opposites, which is also something we get from Hippocrates but also then later on, it's popularized by Galen, who's a very famous doctor in the Roman world. And the theory of opposites, Christie, is that you're kind of trying to tip the other way. If you've gone one way too far, you're like, oh, no, back the other way. So how would that work? If Stu had a nasty head cold and a bit of mucus and a bit of phlegm, and he was a bit under the weather?

[Professor Christy Upson Sawyer]

The ancient physician would say phlegm is the problematic humor, and there's an overabundance of that humor. And they thought that all of the humors had certain qualities on the spectrum of being hot or cold or moist and dry. Phlegm is the cold and wet humor. And so in order to restore balance, we need to prescribe treatments that counteract those qualities. And so this could be done in lots of different ways with food that's hot or dry, so spices, garlic, fermented foods and drinks. Or you could send your patient to a hot, dry climate, or you could prescribe an exercise regimen that would heat and dry them out and so on and so on.

[Stu Goldsmith]

The look on my face there was, because I was sure you were going to say it's the opposite. So if he's phlegmy, we've got to make him drink some black bile.

[Greg Jenner]

We've mentioned Galen there, and he's a huge name because not only does he write a huge amount of stuff, we have so many of his books, but he also treats gladiators and Roman emperors. Does that mean, therefore, that he is the authority? You cannot argue with him. Or was there still debate about medicine and how best to treat people?

[Professor Christy Upson Sawyer]

There were multiple schools of thought in the ancient world about what caused illness. And view of another physician who was working in Rome about the same time as Galen, Asclepiades became very popular. And he believed that the body was made up of atoms, and that illness was caused by the atoms not being able to move freely and regularly throughout the body, especially when the body's pores or channels were too constricted or. Or were too loose.

[Greg Jenner]

Sounds like an X, man. Just like your atoms are too loose, you need to tie it up.

[Professor Christy Upson Sawyer]

Whether he's right or not, I want his treatment. So his treatment was massage, loosen the body, exercise. Right. Move your body.

[Greg Jenner]

His motto was swiftly, safely and pleasantly.

[Stu Goldsmith]

That's virgin trains, isn't it?

[Greg Jenner]

It does sound like a kind of, yeah, we'll get you there. We'll get you there safely. Very little.

[Stu Goldsmith]

Yeah, but if the alternative is you get a poking and a scraping and a bunch of bile in your eye. Probably a certain amount of success with that.

[Greg Jenner]

We've heard quite a lot about systemic thinking about the body. Let's hear now about some actual cures. Stu, I'm gonna read you four possible cures. Which of the four is the real one? Number one, if an organ hurts, hold a puppy close to that part of their body and the puppy will suck out the disease and the pain with its mouth. If you've been bitten or stung by a snake or a scorpion, you need to eat some human earwax, preferably from someone injured. Number three, if you've got epilepsy, then you just need to drink some gladiator blood. Simple. Or number four, have you got a headache or a migraine? Then you need to zap yourself with an electric eel or a torpedo fish.

[Stu Goldsmith]

I'm not having the puppy one. That's nonsense. So electric eel for headaches, that could work, isn't it, in a kind of an electroconvulsive kind of. Certainly. It'd take your mind off the headache. Epilepsy. Would they have diagnosed epilepsy? I don't know about that one. And what was the other one bitten by?

[Greg Jenner]

A scorpion or a snake? Eat human earwax from someone who's been injured.

[Stu Goldsmith]

I can't believe I'm saying this, but it has the ring of truth. I think I'm gonna go electric eel. I think that one's real to a certain extent.

[Greg Jenner]

We've screwed you here because they're all true.

[Stu Goldsmith]

Ah, yeah, okay. Even the puppy.

[Greg Jenner]

Puppy is true. It's really fun. The other thing that was more widely available and probably more sensible than electrocuting yourself with an eel would have been pharmacology. Plant based cures, of which we have over 700 in later Roman texts.

[Professor Christy Upson Sawyer]

Right.

[Greg Jenner]

But there were still problems in this because the word pharmacon, from where we get the word pharmacy, meant in Greek.

[Professor Christy Upson Sawyer]

Both drug and poison.

[Stu Goldsmith]

Oh, that's handy.

[Professor Christy Upson Sawyer]

Yeah, yeah. So plants, particularly subspecies of the same plant, one of them could heal you and the other one could kill you. And so, so you did not want to just take drugs from anyone off the side of the street. You wanted to get your drugs from an expert. We have a thriving drug trade in the ancient world as well, with pharmacologists setting up shops and stalls in local marketplaces.

[Greg Jenner]

So pharmacology and of course also diet was also really important too, wasn't it? We know that professional doctors are giving dietary advice. They're saying eat this, don't eat that, exercise. But in terms of the spread of medicine through the Roman world, we do know that eventually, you know, we've heard Julius Caesar in 46 BCE gives natural citizenship to all foreign doctors, which means presumably doctors are starting to come in. And some of these doctors are enslaved people. They're going to be ancient Greeks who've been conquered by the Romans and enslaved and brought in because they're educated.

[Professor Christy Upson Sawyer]

Yeah. So most physicians would have been trained by being an apprentice. And if you could afford it, you might travel to one of the big cities like Athens or Alexandria or Smyrna, where there were medical centers, and there they could hear lectures from prominent medical thinkers or they could sharpen their anatomical knowledge by looking at full sets of human bones. There was no centralized medical association that issued medical licenses. You could just lie if you wanted to. Patients really had to rely on word of mouth, reputation.

[Greg Jenner]

There presumably would have been some doctors who. Galen, for example, he worked in Rome. Right. But most other doctors are probably. They may be on the road a bit.

[Professor Christy Upson Sawyer]

Yeah. If you're not doing well in a city, if you're killing a lot of your patients, you're going to want to get out of town as soon as possible. Right.

[Stu Goldsmith]

Always been my rule.

[Professor Christy Upson Sawyer]

But also doctors, even those who are quite good, they need to find enough clients to make a living. There's a small subset of physicians who stayed in place, and these were known as city physicians. These were folks who earned a widespread reputation for success or who had impressed a particularly wealthy, influential client in town. And so these cities, these city councils, would pay city physicians a retainer fee simply to keep them in town so that they were available when needed. The patients would still pay the physician fees for services. So this was the gig he wanted.

[Greg Jenner]

At Pompeii, which I'm sure you've heard of, there was a surgeon working in the town, except he was right on the edge of the town, next to the exit road. Basically, it was the last stop before the cemetery. So you kind of went to him and if he didn't cure you, next stop, Morgsville. I mean, Christie. He was a surgeon. Presumably he was going to be doing kind of emergency work perhaps.

[Professor Christy Upson Sawyer]

So surgeons were a slightly different class than physicians. Most of the time, physicians tried to avoid cutting open their patients. So surgeons were the professional class, the tradesmen who did this kind of work. And it was incredibly risky, mostly because of the high rates of infection and the necropoli. The cemeteries were directly outside of the gates of cities. So he was set up as close as you could be to the cemetery.

[Stu Goldsmith]

Yes. Ideally up a hill, at the foot of which was the cemetery. And then when things went wrong, you.

[Greg Jenner]

Could just pull a lever and then just slide out. We've been talking about men so far, Christy, but actually we do know of women in the ancient world who were not just midwives, not just sort of, you know, folk healers were trained physicians who were well respected.

[Professor Christy Upson Sawyer]

Yeah. So early on in medicine, there was a professional class of women healers, healthcare professionals, that were often called midwives or obstetricians, Though there's some indication that these women were general practitioners who treated a wider array of illnesses beyond just pregnancy and childbirth. And from the Hellenistic period onward, the titles start to catch up with the work that they're doing. They start to be called physicians. So etrine in Greek and medica and Latin, these are the exact same terms that get attributed to men physicians. And we have over 50 attestations of women physicians, many of whom rose to prominence, including Antiochus of Tlas, which is a city in modern day Turkey. She was elected by the city council as the city physician. So she must have had some chops to get that job. And her work gained renown even outside the city. Asclepiades, who we were talking about a moment ago, and Galen both cite her.

[Greg Jenner]

Remedies, as well as lots of evidence for women working in healthcare and medicine. We also now should talk, really about women's health and in terms of the way in which women were treated as patients. And humoral theory said that men were hot and dry and women were wet and cold. We now have to get on to the somewhat strange concept of the wandering womb. The idea here is that women's bodies are different to men's in very profound ways. There is a Greek physician called Aretaeus who argues the womb is a separate animal living inside a human, and that it is sort of parasitic and it needs moisture, and if things dry up, it will go looking for moisture.

[Professor Christy Upson Sawyer]

So medical writers thought that because women were colder than men, they didn't possess the heat necessary to digest food. So women accumulated their partially digested food as thick menstrual blood. And once a month, this is month in Latin is menses. It required this enormous effort to push this thick menstrual blood out of the body. But this overheated the womb. So the womb became dry and hot. It's now parched because it's lost all of its moisture. And so the reasoning is that it's wandering around the body looking for moisture to soak up from nearby organs. And one of the remedies for menstrual problem or the wandering womb was to have sex.

[Greg Jenner]

Now, Stu, we have promised you beaver bums, so now it's time for beaver bum updates.

[Stu Goldsmith]

Oh, God, is it finally time? Come on then, hit me.

[Greg Jenner]

I would like you to guess how else apart from recommending that a woman have sex, how else might the wandering womb be lured back into place?

[Stu Goldsmith]

And this is something to do with beaver bums. I have got. I feel like I'm having a breakdown. Are we going to introduce something into the lady in order that the womb be charmed back down to its correct place?

[Greg Jenner]

Bang on.

[Stu Goldsmith]

Christ. Why'd you do this to me?

[Greg Jenner]

There's another method as well, which is not just lure down with charming, but also scare down with something nasty from the top.

[Stu Goldsmith]

Oh, it's shouting at the top of the head. Get back down there, you womb.

[Professor Christy Upson Sawyer]

Even more disgusting.

[Greg Jenner]

Yeah.

[Stu Goldsmith]

Oh, God.

[Greg Jenner]

Can we now have our beaver bum update? And also just a sort of general guide to how was this done? What nice smelling things are we talking?

[Professor Christy Upson Sawyer]

As you mentioned, Greg, medical writers like Areteus thought about the womb as a little animal that was receptive to pleasant things and repulsed from unpleasant things. And so you would put sweet smelling fumigations underneath the vagina like cardamom, cumin, anise, fennel. And here's the less exciting part. You would either have the woman inhale foul smelling things like smoke from a burning goat, or force her to ingest disgusting drinks like castoreum, which is a substance extracted from beavers. And fun fact, also used in modern vanilla flavorings.

[Stu Goldsmith]

Oh my God. Castoreum. This is shellac and beetles all over again. Castoreum is disgusting beaver bum gland produce and it's made in vanilla.

[Greg Jenner]

It's added to vanilla products, I think. Yeah, it's.

[Stu Goldsmith]

So if it's. If it's not beaver bummy enough, chuck a bit of custodian in it.

[Greg Jenner]

Christy, we've got no real mention here of painkillers or anesthetics. Do we think they had any?

[Professor Christy Upson Sawyer]

Yeah, they certainly knew about painkillers, so they knew about mandrake, henbane and especially opium. But it doesn't seem like pain relievers were always available or that they managed to dull all of the pain. Our medical sources talk about using apprentices and even pulling in family and friends to hold down a patient who's writhing and wriggling in pain.

[Greg Jenner]

It's a part of the training to be aroma surgeon was presumably to just Ignore the screaming. So just a final thought really. When we get the rise of Christianity and you know, which of course starts as a Jewish faith, this is where we start to see a slight change in healthcare. Because it becomes charitable and we get hospitals, right?

[Professor Christy Upson Sawyer]

Exactly. For most of antiquity, healthcare was a private issue. It was left to families to treat themselves or to find money to hire physicians. But with the rise of Christianity, we start to see this shift and rooted largely in Jewish traditions, Jewish values of hospitality for the vulnerable and the needy. And Christians adopt these values and create charities like food doles, alms for the poor, and eventually, by the 4th century CE, full blown hospitality complexes. This is where we get our term hospital. These hospitals that were connected to monasteries were places where all sorts of vulnerable people could get help, including the sick. And this was revolutionary because it was the first time that the masses had access to free inpatient healthcare under the supervision of medical professionals.

[Greg Jenner]

The Nuance Window. It's now time for my favorite part of the show, which is called the Nuance window, which is this is where we, Stu and I have a little. A little, well, I suppose a convalescence perhaps. And we allow our expert, Professor Christie, to tell us what we need to know about this subject. So without much further ado, the Nuance Window.

[Professor Christy Upson Sawyer]

So, as we've seen today, it's really fun to talk about ancient medicine. But my students who are aspiring healthcare professionals always ask me, is there anything useful to studying the past? Ancient theories are outdated. Many of these ancient treatments are downright horrific. So is there anything they can take, take to make them better physicians? And I have a few responses for them. So first, I think it's important just to get a sense of where medical ideas and values and institutions came from. So we've talked about the oath hospitals, also just basic scientific method. Second, studying medicine from other time periods and contexts can unstick us from routine ways of thinking and attune us to aspects of medicine that we tend to pay less attention to. So, for example, today medical students are laser focused on science classes, and that seems to be the only thing they care about. But when we read ancient sources together, it reveals far more humanistic perspectives, including patients, fears, anxieties, reluctance to follow instructions, as well as physicians struggling with particularly thorny diagnoses. And these are issues that have not gone away. So studying medicine in another context can broaden our perspective to a wider array of issues and resensitize us to neglected aspects of health care. And third, and finally, studying history generally puts us in contact with a plurality of people, many of whom seem quite strange to us. And our goal as historians is to try to understand unfamiliar views and practices and to see them as reasonable given their context. So studying the past is an occasion to practice becoming comfortable with diversity and difference. And this is a skill that is directly transferable to the clinical context where physicians encounter people with many different worldviews, priorities, values. And the best physicians are those who meet their patients where they're at and work with them as partners, what experts now call culturally competent healthcare.

[Greg Jenner]

Amazing. Thank you so much.

[Stu Goldsmith]

I love the idea of you say culturally competent meeting people where they're at. I mean, I suppose that must be harder and harder with things like the anti vax movement, that people are going to need vaccinated and if you meet them where they're at, they're not going to get vaccinated. So I suppose that's going to be increasingly important, isn't it?

[Professor Christy Upson Sawyer]

And it's a problem that ancient physicians dealt with too. You had to convince them, you had to persuade them. And so those kinds of rhetorical strategies might come in handy today too.

[Greg Jenner]

Absolutely. And on that note, I'm afraid that is all we have time for today. A huge thank you to our guests. In History Corner, the outstanding professor Christy Upson Sire from Occidental College in la, and in Comedy Corner, the stupendous Stu Goldsmith. And to you, lovely listener, join me next time as we promenade through the past with a brand new double act. But for now, I've got a bit of a headache, so I'm off to go and lick a torpedo fish.

[Stu Goldsmith]

Bye.

[Jonathan Myerson]

My name is Jonathan Myerson, and two years ago we produced Nuremberg, a dramatized reconstruction of the trial of the major Nazi war criminals. Their crimes were indisputable, but one mystery remained. How did this group of unremarkable men come to rule all of Germany? Our new podcast, the Road to Power, unravels this improbable story in 16 episodes. Starring Tom Mothersdale, Derek Jacoby, Alexander Vlahos, Toby Stevens and Laura Donnelly. It remains a lesson for us all. Listen, wherever you get your podcasts.