Tuesday, 1 January 2013

Is there another doctor in the house



Even though most modern medical practices have developed in historic isolation to that of the classical era, it appears that the final outcome generally needs the same strategy. The Greeks and Romans were putting badly broken limbs into traction two thousand years before modern medicine returned to the same method for restoring fractured bones to their proper length. Likewise putting broken limbs into casts - made from bandages soaked in egg whites rather than plaster - dates back to the Egyptians at least 5000-years ago. But bones are bones, right? What about actual surgery? Well, we know that Roman law required at least one surgical procedure to be procured on a regular basis. Since the early 6th-Century BC, the Lex Regia (the Regal Law) required any pregnant woman who died prior to birth to have her unborn child removed. This on many occasions would have produced a successful delivery. However while it is accepted that this is the origin for the Caesarian Birth, the presumed outcome for Roman mothers was pretty negative...but remember, until this last century, childbirth was still one of the main causes of death for women. 

So this is the big question - were Roman surgeons capable of replicating modern Caesarian births where both mother and child are expected to have survive? The first successful modern Caesarian birth did not occur until 1881, however the conditions in which it occurred were little different to those that would have presented themselves two thousand years earlier - that is, it occurred in a private residence, it was completed with minimal anaesthetic and with only the most basic wound and instrument sterilisation. What's more, two years before this historic birth, Ugandan villagers were observed completing successful Caesarian sections in even more basic conditions. So, all in all, there doesn't seem a lot standing in the way of ancient surgeons being able to do the same. Remember, with a fairly regular attendance to pregnant women who had died for any number of reasons, a Roman surgeon would have been familiar with the abdominal region, including where they should make incisions and what they would encounter beneath.

A Roman era 'dialator'
But just to add a little twist of evidence to the story, we may have an example of a successful Caesarian birth right under our noses...the namesake. The story goes that the Caesarian birth is named after Julius Caesar - Pliny actually attributes the name to an earlier much less famous ancestor 'who was cut from the womb', and the question of Julius Caesar being born in such a manner is usually dismissed since his mother, Aurelia, lived to old age. Of course this could be a classic case of ignoring the trees for the forest. Perhaps her survival to old age should not be used as a denial of the legend but proof of it. Face it, Roman women would have been just as keen to live as anyone today, so I am pretty sure that one way or another surgeons of the era would have been very interested in the rewards - particularly the financial ones - if they could keep mothers alive too. After all, they were certainly equipped with tools and fundamental standards to do so...so maybe they did.