When Galen encountered peasants from rural regions of the Roman Empire, he considered much of what he saw to be foreign. Although he sometimes prescribed different treatments for peasants than he did for urban dwellers, Galen remained committed to Hippocratic ethics, and his recommendations were guided by this academic medical philosophy. From his rural patients’ perspective, however, academic medicine was radically different from their own approach to healing. In such communities, folk remedies were more common. In addition to academic, religious, and magical medicines, Roman folk remedies continued to play a role in the healing culture of the second century CE.
In rural communities it was traditionally seen as the responsibility of the owner of the farm or estate, as head of the extended household or pater familias, to deliver medical care. Providing medical treatment for one’s family was as much a part of life as farming and animal keeping. When a peasant in an isolated region became ill or sustained an injury, no doctors or healers of any kind may have been nearby. Roman folk medicine was primarily a combination of magic and botanical lore, sometimes documented in farm manuals and almanac-style records. This kind of healing was informed by a magically inflected world view, and an offense to the gods was frequently understood as the cause of disease or misfortune. Greek academic medicine, with its humoral understanding of the body, likely seemed as alien to the peasants as the peasants seemed to Galen.
Modern medical anthropologists have tried to imagine the encounter between Greek doctors and Roman patients. These scholars caution that casting the meeting as a simple confrontation between Greek intellectual theory and folksy Roman superstition is likely an oversimplification. Even though a full, 360-degree view is unattainable, a hypothetical scenario illuminates the complex cultural constructions of illness and medicine: if a Roman peasant was accustomed to treating a dislocated joint by chanting and ritually waving a split and rejoined reed, then a Greek doctor’s physical manipulations to reset the ball in its socket by forceful adjustment would seem violent and incomprehensible. Although the Greek treatment may have been successful, there was no immediate way for a peasant to make sense of how or why it worked. Time and urbanization eventually led to greater integration between the different medical systems, but the underlying belief systems persisted and syncretized in different ways in various contexts.