The Romans had a good knowledge of medicine, and likely used Galens and Celsus texts to train their doctors. There were doctors in Britain, but they varied from highly competent, legitimate practitioners, to exploitative quacks. They were all probably quite expensive. Most tombstones dedicated to doctors have been found near the forts, showing that the majority of their patients were soldiers.
By examining skeletons, it seems that public health was not as good as one might expect. In Cirencester, most of the remains are of people who did not live longer than 45 years, and this was one of the longer-lived areas. All the evidence we have suggests that a person of 45, who, to us, would be middle-aged, would have been considered old in Roman Britain. At Dorchester-on-Thames, only half the men and a third of the women even lived to be as old as forty. At Ilchester, the average life-expectancy for men was 40 years, 36 years for women. Worse than that, at Lankhills cemetery in Winchester, only just over a fifth of the skeletons belonged to people who had lived to be older than thirty. At Vindolanda the average age of death for women was as low as 28. The stress of pregnancy and childbirth, and complications such as eclampsia and puerperal fever, are probably the reasons why women died younger than men.
In Cirencester, excavators estimated that 80 per cent of the adults suffered from osteoarthritis. At Dorchester-on-Thames, almost all of the skeletons examined in a fifth-century cemetery showed osteoarthritis in the spines. All over Britain, many skeletons show evidence of damaged joints or broken bones. Some of these might have been caused by accidents during a day of backbreaking work - someone might hit himself with a hammer, or have a mishap with the plough. Some of the bones seem to have been broken deliberately, by punching or with a weapon. A male skeleton at Cirencester showed sixteen broken ribs - perhaps a slave beaten by his master. In addition, quarrels may have broken out between colleagues during a stressful days work.
Another cause of illness must have been the public baths. The baths certainly had their place in a healthy lifestyle, by encouraging people to socialize, exercise and keep clean, but there were disadvantages. For one thing, even though the Romans were careful about their water supply, and knew that polluted water spread disease, they had no concept of germs or viruses. As far as they were concerned, if water looked clear and tasted fresh, then it was clean. The trachoma virus, which was carried by flies, often affected peoples eyes. At Wroxeter votive offerings of over thirty eyes made of wallplaster, and one pair of sheet-gold eyes, were apparently left by sufferers in search of a cure. The drinking water was not safe either: latrines sent their sewage untreated into the rivers.
Many people resorted to folk remedies. An amphora fragment was found at the fort at Carpow, which showed that soldiers imported wine mixed with horehound to cure their coughs. Soldiers had a daily ration of garlic for general health. Henbane might have been used as a painkiller. Plantain was a treatment for dysentery, and an amphora from Caerleon bore the word amine, a wine imported from Italy to cure both diarrhoea and colds. Elecampane helped digestion, and celery could be used as a diuretic. Fenugreek was used to treat pneumonia. Fennel was supposed to calm the nerves, and mustard had many uses - the writer Pliny listed forty different types of mustard remedies. Rosemary was often used, and sage was considered a sacred herb with powerful healing properties.
Doctors might use honey to stop the bleeding from a cut, and to keep the wound clear. A tree resin found in the Near East, called opobalsamum, was used as a balm for eyes, for wounds, even for arthritis. Another kind of ointment was found on basketwork in the Bartlow Hills. It was probably made out of myrrh or frankincense. In Bath and Lydney, oculist stamps have been found. These were small four-sided tablets with inscriptions carved backwards on the surface. The stamp would be pressed onto a cake of ointment or a pot of eye salve. The ointment might be of vinegar, as recommended by Valerius Amandus as a treatment for running eyes; of poppy, as Attius prescribed at Cirencester; or of frankincense, which Tiberius Claudius prescribed for all eye troubles. At Bath T. Julianus recommended quince salve not only for clearing the vision, but for any or all medical conditions.
The largest hospital in Britain was at Housesteads. At the centre was a courtyard, perhaps used for growing herbs. The hospital had ten wards, a latrine, a washroom, and an operating theatre.
There are no surviving examples of a full set of medical instruments in Britain, although some have been found in Germany and Italy. Medical instruments have sometimes been found in graves. We do have things like scalpels, probes, knives and spatulas. These instruments were usually made of bronze, which was hard-wearing. The probes were used to examine wounds, and forceps, like tweezers, plucked out debris. A speculum was used for internal examinations. A cupping vessel held blood which would be let deliberately to allow disease to drain out with it. The spatulas were for mixing and applying ointments.
A saw with very fine teeth would be used to cut through bone during amputations. There are examples of hooks for holding incisions open during operations. A skull in York gives proof that the person was trepanned - an operation which involved drilling holes in the head. Of course, all these operations were carried out without anaesthetic: doctors were trained to carry on regardless of any noise their patient was making.
However skilled doctors might have been, they did not have the advantages we have. Appendicitis was always fatal, because there was no such thing as a routine operation. Surgery was always a ghastly, frightening, agonizing ordeal. There were no antibiotics, so whatever other useful drugs were around, many diseases that are easily cured today were fatal then. There were no inoculations either. In cemeteries at Cirencester and Vindolanda, there are many bodies of people who died of spinal tuberculosis and polio. It is no wonder that people relied as much on folk remedies, prayer and superstition as they did on medical science.