The transformation of the Roman world under Augustus (ruled 31 BC to AD 14), the heir of Julius Caesar, was not just a political transition from Republic to Empire, from the effective rule of the Senate and people of Rome to an autocracy hiding behind traditional terminology. It was also a social and geographical revolution as Roman imperial power was extended to the Rhine, the Danube and the Euphrates. Whether in N. Italy, Gaul or Asia Minor, local elites were assimilated, in a variety of ways, into the wider system of Roman government and Roman culture. The city of Rome itself was changed almost beyond recognition as marble public buildings replaced brick and apartment blocks took over from cottages. The population of the city grew enormously, and the city’s boundaries had to be extended with all due religious pomp and ceremony. Amid this flood of immigrants (a veritable river Orontes, sneered one satirist) came Greek doctors, from Thebes (whether the town in Boeotia or Egypt is not clear), from Nicaea, Laodicea, Smyrna and other less prestigious towns all over the eastern Mediterranean.1 They sought fame and fortune in the metropolis, in Italy, in the more Romanised provinces of the West and, in a few cases, even on the very fringes of the Western Empire.2 The passage of Greek medicine into the Roman world was now so complete, with the same theories and often the same medicaments circulating in Latin as well as in Greek, that one can now truly begin to talk of Roman medicine as something that could be found across the Empire without any distinction of language. At the very apex of the ambitions of medical practitioners was now the imperial household, the emperor, his family, their friends, advisers and, particularly in the first century AD, the ex-slaves (or freedmen) who acted as imperial secretaries. Becoming the personal physician to one of these grandees was, as will be shown later, a sure path to wealth and influence, for one’s family as well as oneself. But even the suggestion of imperial approval could be used to promote a theory or vindicate a novel drug. Paccius Antiochus, on his deathbed c.AD 30, described his wonderful painkilling remedy in a letter to the Emperor Tiberius, who then arranged for it to be available in public libraries for all to read.3 A generation later, Thessalus of Tralles addressed a somewhat boastful

letter to the Emperor Nero, denouncing the harmful precepts of Hippocrates and proclaiming the virtues of his newly created medical sect.4 How these imperial connections might work in practice and how the expansion of the Roman Empire had an impact on medicine are neatly illustrated by the career and writings of a Latin writer on pharmacology, Scribonius Largus. Largus dedicated his Drug Recipes to one of the most powerful of the imperial freedmen, C. Julius Callistus, in late 47 or early 48.5 Although he was probably not one of the emperor’s own physicians, Largus had good court connections – he gives details of the favourite dentifrices of Augustus’ sister Octavia and the Empress Messalina, as well as drugs used by Augustus himself, Tiberius and the mother and grandmother of the Emperor Claudius – and in 43 he participated in Claudius’ British expedition.6 He describes a herb he had found near Luni in Etruria while waiting to embark with the emperor’s household troops. Whether he was there as an army doctor on a short service contract or was brought along as the private physician of a general or leading courtier is unclear.7 His links seem strongest with Sicily. Largus refers in passing to an exotic remedy against snakebite carried by Sicilian huntsmen, and to the rare pointed trefoil growing there. He records a recipe against rabies presented to the town of Centuripae by his own teacher, a celebrated local physician. He himself was less than convinced of its value in rabies, but reports that he had used it effectively against other bites and stings.8 As an educated Sicilian, he would have been bilingual in Latin and Greek. As well as his Latin drug book, and the, now lost, Latin medical books once presented on his behalf to the emperor by Callistus, some of his prescriptions survive in Greek, preserved among Galen’s quotations from other Greek pharmacologists of the late first century. Whether these once formed part of a work written in Greek by Largus or had been translated from the Latin is disputed, but, whatever their origin, these recipes show the ease with which Latin and Greek information could now be interchanged.9 Largus’ unpretentious book is full of interest. Its 271 Recipes are divided into three main sections. The first and largest group (1-162) is organised according to diseases, going from head to toe, from headache and epilepsy to gout; then follow thirty-seven antidotes against poisons, bites and stings; and the book concludes with plasters, dressings and soothing salves – the typical drugs used by surgeons.10 Largus mentions 249 vegetable, forty-five mineral and thirty-six animal substances, drawn from the Mediterranean region or imported from further east or from Africa via Alexandria.11 They range from the humble carrot to the exotic aloe, from fenugreek to ginger, from butter to the electric ray or torpedo fish, recommended for constant headache (perhaps migraine), since the continuous application of electric shocks would dull and ultimately remove the pain. A similar treatment, allowing the fish to attack the patient’s feet and shins as he paddled in the sea until the painful area became numb, is claimed to have cured an official at the court of the Emperor Tiberius of pains in the legs.12