The Etruscans, an ancient people, inhabited the Italian peninsula from early in the 9th century B.C. down to just before the Christian era. They have long occupied a special place in the eyes of Western man. They evoked descriptions from the great writers of Rome, heirs of their legacy. Livy, Virgil and Cicero among others describe the exploits, ritual and magic of the Etruscans. For almost two thousand years the secret of their existence was virtually lost. In the past one hundred ad fifty years historians and archaeologists have verified the truth as noted in the writings of Virgil and Livy. The power of the Roman Empire in its pervasive history obscured this advanced civilization hidden in the Etruscan hills. In the past few decades, archaeology has exposed a prosperous and advanced civilization well established in a loose federation of city-states by the 6th century B.C. when Rome was an insignificant village of mud and waddle huts on the hills overlooking the banks of the Tiber River. This century of discovery has revealed an immense number of artifacts in every form of the plastic arts, and they fill museums and private collections around the world. Patient scholarship has yet to unveil the exact origin of the Tuscan inhabitants and what language they spoke.
Our knowledge of the medicine of these early Italian peninsula inhabitants is as shrouded in mystery as their origins, but certain facts are known. These must be interpreted in the light of Greek influence on the Etruscans. 3,81,93,95,100. This is clearly seen in their art and mythology. The routes are difficult to discern, but clearly have an Oriental character. The mythology is founded on a divine and infernal trinity with parallels in the Cretan and Mycenaean myths and different from the Greco-Sicily civilization. Greek influence in Etruscan art and the adoption of the Greek alphabet between 600 B.C. and 500 B.C. is evident. Greek mythology is commonly portrayed on Etruscan Vessels and other art objects. We can safely assume Greek medical Concepts made their way to Etruria at the same time.4
The Etruscan dynasty of Tarquin kings who controlled the Roman hills overlooking the Tiber recognized this as a strategic stronghold. They took these small villages and developed them with a program of civic and religious buildings and created the city of Rome during the years 616 to 510 B.C. the Romans in the centuries that followed continued to use and import Etruscan architects and engineers. There knowledge of agriculture, metal working and many of her social and religious institutions formed the foundation of the Roman Empire and we shall see that Etruscan science; namely, dentistry, medicine, and astronomy, profoundly influenced Rome. By the 1st century B.C. the Etruscans were thoroughly defeated and widespread confiscation of their property by the Romans. They disappeared as an ethnic group and their language is no longer understood.
The Etruscans to the ancients and moderns seemed to have little in common with their neighbors and the question of origin is raised. The ancients accepted the account of the great Greek historian, Herodotus. The Greeks called the Etruscans the Tyrrhenians and Herodotus tells us of the saga of migration from the land of Lydia in the East on the plain of Asia Minor. In the reign of Atys a great famine occurred in Lydia. After eighteen years of living in privation the king divided his people in two groups. King Atys remained home, but he put his son, Tyrrhenos, at the head of the group forced to leave. They sailed for Smyrna and following the coastland they reached the land of the Umbrians. Here they founded towns and took the name of their leader calling themselves Tyrrhenians. The Romans called them Tusci or Etruscii (hence the modern words Tuscany, the region in Italy, and Etruscans, the people.) 113 The Tyrrhenian Sea whose shores held some of the Etruscan towns retains the Greek word. According to the Greek legend this was late in the 13th century B.C. and Herodotus was writing in the mid-5th century B.C. Thus at the time of Augustus the Greek theoretician, Dionysius of Halicarnassus, who lived in Rome argued the Etruscans were indigenous to the Italian peninsula and not natives of Lydia. His argument hinged on the fact the Lydian language, gods and laws were different form t he Etruscans. Thus the two opposing views argued ever since by scholars and various disciplines. In the 18th century Nicolas Freret and other scholars argued the Etruscans arrived in Italy as part of the Indo-European invaders that came in waves from the north after 2000 B.C.
In 1885 a 7th century B.C. stele was found on the island of Lemnos inscribed in the Etruscan language. Other inscriptions have been found on the island. This island is on the route from Lydia to Etruria and is used as evidence to enhance the eastern theory of Etruscan origin.
All butt focuses on the origin of the Etruscans in an attempt to explain the roots of Roman medicine. He stresses the amalgamation of three distinct peoples making up the population of central Italy at the time of the emerging Roman Empire. These were the Lydian immigrants, the indigenous population and the Northern invaders into the Italian peninsula. The omens and auguries of the Etruscans who came to dominant this area before the Romans persisted into the roman civilization. He feels Roman affinity for superstition and rituals are entrenched as it were in folklore and fold medicine with the worship of Chthonic deities who came from the amalgamation of the indigenous small, dark skinned inhabitants of the peninsula with the lighter skinned, blonder Northern invaders and the Oriental Lydian. The CIBA Foundation, a division of the CIBA Pharmaceutical Company, organized a scientific symposium to try to answer from medico biological view Etruscan origins. Barnicot and Brothwell examined the physical measurements of skulls of Etruscan origin and other ancient peoples. They compiled several charts using data from many publications. Population sample differed very little from the Etruscan measurements. Theses included Roman, Sicilian, Greek, Cretan, and Egyptian among others. Brothwell noted 4 percent carious teeth in Etruscan skulls similar to the figure reported for ancient Roman and Egyptian material.104
Resorption of the tooth sockets indicative of periodontal disease was seen in 50 percent of the skulls and 33 percent showed hypoplasia of the dental enamel. They also found no difference of Etruscan skulls with modern Italians from Tuscany. 61
Morganti in the same symposium discusses blood samples in Tuscany. There is not enough data on blood group distribution to draw any conclusion either positive or negative to throw light on the genetic influence by Etruscans on the mode4rn population. 62 Siniscalco et al showed how thalassemia, the genetic disorder of the hemoglobin molecule, could affect standard anthropologic measurements. Since tahlassemia is present in the Mediterranean Basin interpretation of the standard anthropometric measurements must be cautiously interpreted.64
Paris et al studied the serum haptoglobin types in Italian populations and was unable to arrive at any distinct population types in Tuscany. 63 all attempts to study blood groups including ABO, Rh factor, fetal hemoglobin and sickle cell hemoglobin in an attempt to genetically identify the Etruscans as a separate group came to no avail. It was noted by all that to harvest blood for ABO, Rh, fetal and sickle cell studies bones from the pelvis and femur were needed. Few of these bones are left for analysis, and fewer yet can carefully be identified as truly Etruscan. However, laboratory studies are possible on the marrow of these bones and an occasional mandible is suitable. A plea was made for the careful analysis and preservation of the long bones including the pelvis.
The deciphering of the Etruscan language has occupied linguists and philologists for centuries. 55,105 Long before the end of the Roman Empire the ability to read the Etruscan language was lost. About 13000 inscriptions hav3e been found and catalogued, but nine tenths are funerary and contain only the name of the deceased, his parentage and the age at death. Reading these words is easy since the Greek alphabet is used. Only ten inscriptions of any length have been found. An engraved tile discovered at Capua and another on a cippus found near Perugia consists of a hundred words.9 A mummy found in Alexandria dating from the 2nd century B.C. has handwritten on the mummy’s lined shroud 1500 words, but only 500 are different from one another. A few Etruscan words are found borrowed from other known languages, but what are needed are longer bilingual inscriptions similar to the gold tablets found in 1964 at Pyrgia the harbor for Caera. Thirty Latin-Etruscan bilingual inscriptions have been found but, unfortunately, are not as helpful as the Rosetta Stone was in deciphering Egyptian hieroglyphics since the translations of the Latin and the Etruscan are not word for word. The Etruscans simply adopted the Greek alphabet to their spoken language. The Greeks were close by just south of Latium in the colonies of Cumae and Pithekoussai (Ischia) near modern day Naples. The final translation of the language will only come about by studying the language in historical context and this will require more excavations and scholarship. The Etruscan language is not related to the group of Indo-European languages spoken by other people inhabiting the Italian peninsula from the late Iron Age (Villanovan) to the beginning of the Roman Empire in the 5th century B.C. The only word in our modern scientific vocabulary of Etruscan origin is Atrium. Atrium began as athre, the Etruscan word for a building; the Romans changed the spelling to atrium and gave to the atrium a specific architectural function. Vitruvius, our great source of Etruscan architectural knowledge, describes Etruscan houses as having an external portico and an internal court of atrium. This was the prototype for Roman architecture. We must rely on Vitruvius’ description, Etruscan rock cut tombs and temples have long since disappeared since they were built primarily of wood with tile roofs. Now only stone foundations and floors littered with shards of roof tiles give testimony to their buildings. The word atrium is used to describe parts of the anatomy of several different organs, but of course, the upper chambers of the heart are the most common use for this word and as a cardiologist of the most interest to me.
Several writers as enjoying a great medical reputation record the Etruscans in antiquity. (3) Theophrastus (5,9) in The History of Plants (IX, 15) cites Aeschylus’ elegies that mention Etruria as rich in medicine. He tells of the “Tyrrhenian stock, a nation that makes drugs”.
In Hesiod’s Theogony (22) the sons of Circe, Agrius, Latinus and Telegonus, become Etruscan Rulers and are experts in medicine. (3,51)
The Etruscan knowledge of medicine is recognized by Diodorus V, 379, in a very brief comment when discussing the achievements of the Etruscans in general. (9,24)
Martinanus Capella, the late 4th century to early 5th century A.D. north African prose and poetry writer, in his book De Arte Geometrica part of De Nuptiis Philogiae Et Mercurii composed of nine books discusses Etruscan physicians and says Etruria is famous for the origin of remedies. (9,117,121)
Etruscan medicine also is mentioned in the Tarquin region legends.(4)
Pliny in Natural History Book VII-2 says the Marsi, a race descending form Circe whose sons were Etruscan Princes, possess a poison as a protection against snakes. The snakes flee when touched with saliva and, if it gets inside their throats, they die. The saliva of a fasting person is said to be very potent.(52)
Varro in De Re Rustica I.II, 27, discusses the treatment of pain in the feet in magical terms. The incantation is addressed to Tarquenna the mythical founder of Tarquinii the ecclesiastical metropolis of Eturia. (17)
Pliny the younger in a letter to a friend, Domitius Apollinaris, mentions a febrile illness that may be malaria (miasma) that occurred in Etruria. (51,112)
In Livy (book VII, II, 2-7) the Romans used an old Etruscan custom of making a banquet to the gods associated with singing and dancing to mitigate an epidemic. (110) Also in Livy (book VII, III, 1-5) the act of driving a nail into a temple wall to purge men’s bodies of disease is described. (111) The Etruscans are known for various rites associated with the liver, but also the leaden tablets of devotions found at Volterra and Monte Pitto. These along with the leaden relic of Magliano in the Florence Museum contain magic formulae against disease. (3,68,69) These formula are both apotropaic (to ward off illness and deprecatory (disapproving/protesting/apologetic). It is most important to realize magic, medicine and religion were all mixed in early civilizations. We cannot think in terms of clinical and scientific medicine in the 19th century. No distinction between natural and supernatural was present in the minds of primitive peoples. Early medicine was wider in scope that mere doctoring. Magic was the route to good fortune and priests were of greater stature than herbalists and moralists. If the supposition that Roman folk medicine has roots in Etruscan fold medicine is true, we can postulate the Etruscan doctors were lay people rather than professional as we now envision the doctor or even a priest since it seems most Roman physicians were laymen and not priests.
The household was the basic building bloc of the roman state. These units were animated and governed by the husband and wife. Form the earliest of times their union was solemnly bound by the confarreatio, or eating of the wedding cake. This rite was both a private and personalized act, but a public ritual rite as well. We know from Etruscan art the husband and wife feasted together and on their sarcophagi are often portrayed laying side by side. Did the Roman custom of the husband and wife jointly representing the family come from the Etruscans? If so, we might predict that Etruscan medicine was built around the concept of pater-familiaris. Although males and females were both identified with the family the mane function of pater-reigned supreme. One of his functions as pater-familiaris was as a physician to his family, slaves, general health and sanitary officer and chief veterinarian. This system of folk medicine can in no way be considered scientific, but was based on myth, magic and folklore. Treatment consisted of simples and spices mixed into a complex of herbal concoctions. The temptation to use these facts to extrapolate backward to the Etruscans is tempting, but there is absolutely not solid evidence to solidify this position. Allbutt stresses Roman folk medicine was not simply pharmacy but involved magic and ritual in part imported form the East that he feels was passed through the Etruscans if their origin from Lydia is valid. This was most obvious in the Etruscan augury and haruspicy. The Etruscan rites of driving a nail in the wall to ward off disease is recorded in Livy (VII 2-3) ad used by the Romans.(111)\
Astrology is of Eastern origin and impacted directly and indirectly in medicine. We know from Celsus astrology was not introduced in part to Roman life by the Etruscans, but most of the influence came from the many Oriental cults and philosophies that poured into Rome from the east. We have no historical evidence of detailed Etruscan astrology however and this is a speculative thought. The Greek cult of Asclepius, the most ancient and powerful of deities, came to Rome with all of his medical power including the temple cult in the early 3rd century B.C. (34) An in-d3epth discussion of Asclepius is beyond this paper because the transfer to Rome was by Hellenistic Greeks and Etruria. How Asclepius effected the Etruscans is unknown. The Etruscans surely did not escape this important segment of Greek culture, but the historical record is barren and archaeology has yet to provide any clues. What other philosophical concepts will help us understand Etruscan medicine? The roman theory of Genius for med and its equivalent Iuno for women is said to be of Etruscan origin. Horace says in Epistles II, 2,187, Genius is part of each individual (his double) that came into being with each individual and guides his dest8iny and presumably his health. This is the only justification for mentioning this concept of Roman religion in this paper. (86)
The concept of Genius is also mentioned by Vitruvious, but here the concept seeps to have a meaning closer to our contemporary definition of the word implying high intelligence with creativity. (87) Before settling in a new area the Romans examined the livers of the local animals. If the organ was diseased, it meant the area was unhealthy. The animal was probably also sacrificed to ascertain if the Genius of the local deity looked favorably on the new building site. In this indirect way the Etruscan concept of Genius permeated the public health concepts of Rome. (33, 56)
Observing the Liver
This brings us to making a few observations on the art of observing the viscera, especially the liver called extispicium. In divination this is of great importance. The term haruspex of divination of the liver comes from the Chaldean word for liver, har. The Hittites who controlled Syria and Mesopotamia in the 2nd half of the 2nd millennium B.C transmitted this concept. Clay models of livers with cuneiform inscription are from Chaldea and the Hittite capital of Bogaz-Kevi. These are considered the inspiration or the famous bronze liver of Piacenza of the 3rd century B.C. (22,40,31,65,78) This is a templum or temple in the form of a sheep’s liver divided into sectors each with the name of the divinity. This artifact was used as a teaching tool for the art of haruspex. Each sector corresponds to a region in heaven inhabited by the divinity named. The liver is also divided into parts similar to the celestial temple. A pars familiares and pars hostilis corresponds to the right and left of the observer. The fissum is an incision limiting the parts. There is a captus jecinoris or protuberance as seen in sheep and cattle livers. The fibrae are the borders of the liver. Each part apparently had its own special function, but little is known of this. The historical relationship between the Etruscan liver and those found in Asia Minor has been the subject of much debate. Giuseppe Furlani discussed this subject in depth at the First International Etruscan Congress (1929) in Florence. Furlani concludes we cannot with those founding Asia Minor, but some relationship surely seems to be present especially if the Oriental origin of the Etruscans is believed. (25,28)
The liver is used for divination because the ancients considered this organ the seat of the soul. The liver, not the heart, was considered the central vital organ even among the Greeks, Romans and Hebrews in early period of these cultures. The Babylonian priests studied in detail the anatomy of the liver. Several writers have discussed these anatomic details including Jastrow, Korte and Thulin. The Etruscans as noted in Greek and Roman writings used a similar system of studying the liver for divination. The bronze liver of Piacenza is direct evidence of Etruscan involvement but no historical documents survived. The markings on the liver are similar to the Babylonian livers and it is difficult not to definitely link the two but, as discussed above, this cannot be said with certainty. The Romans took their system from the Etruscans as Cicero mentions (De Divinatione, I, ii, 3.). (74) In fact, until late in the Roman Empire augers were imported from Etruria. Greek hepatoscopy is assumed to be a direct connection with Babylonian and not as a result of cross-fertilization with the Etruscans. (27)
When it became important what the gods had in mind for an individual or for a city or country, divination to the liver of a sacrificial animal was employed. Invariably the animal used was a sheep. Why this animal was chosen is not explained. When the invoked god accepts the animal offered to him, the two are assimilated. The soul of the god and the soul of the animal are as one and thus, if you know one, you know the other. Thus, if you can read the liver you can enter the mind of the god. Since the gods control the future the divination can thus predict the future. I dwell on this point because in liver divination, which dates to the earliest human historical records of 3000 B.C., we see the beginning of anatomic study. The Etruscans system of divination was highly developed leading Bouche-Leclercq to say “the study of the liver is the highest art.” The Piacenza liver like the clay model of a liver in the British Museum from the Hammurabi period of about 2000 B.C. seemed to by training models, perhaps for novices studying for the priesthood. (29,30) Further proof of the importance of the Etruscan augury is seen in the augur portrayed on the mirror as originally presented in Korte’s publication. Tabanelli has extensively surveyed ancient Roman writings for references to Etruscan divination practices. An outline of these citations is included if the reader is desirous of further analysis of this subject.
Cicero: De Divinatione I, 13,16,32,42,53,58,118
II, 12,13,15,16,26,28 (88)
Tacitus: History II, (89)
Pliny the Elder: Natural History XI, 190 (90)
Celsus: De Medicina Lib. IV, Chp. 1
Tibullus: Elegie I, 8,3
III, Ch. 4, V. 5
Pausanias: IV, 2, 5
Ovid: Fasti IV, 907, 935
Metamorphosis XV, 790,794
Fronto, Marcus Cornelius: Ad Vsrum II, 8
Seurvio: Georgiche I, 120
Properzio: Carmi IV, I 104
Pliny The Younger: Epistle II, 20
Lucian: Phantalla I, 622
De Bello Civili I, 584
Pharsalia I, 626, 622
Plutarch: Alexander, 73
Cimone, 18, 15
Sulla XXVII, 6
Arian: Anabasis VII, 18,2
Livy: Story of Rome VII-X, 1
Valeria Massimo: Factorum A-C
Dictorum Mirabilium I-VI, 9
Seneca Oedipus, 357, 359, 360, 362
Euripides, Le Feni Cie, V. 1255
Etruscan mirrors and vases are a major source of knowledge about Etruscan religion and thought, including medicine.(22) The mirrors are a polished bronze with artwork etched on the obverse side from the polished surface. They include female aphrodisiac demons with the appearance of winged women. These figures protected women in labor. A mirror form Palestrina in the British Museum shows tow figures, Ecthanova and Tharn, assisting at the birth of Minerva from the heads of Tinia. The Eilecthya is the goddess of birth and considered originally of Minoan origin. Her name has been identified with Hera, Artemis and the Roman Lucina. (21) she is represented with the right hand raised and open. To close the fingers meant arresting the birth. She as a beneficent goddess acts as a guardian by blessing the birth process by symbol8ic gesture or lying on of the right hand. The left hand apparently is not used and implies a sinister meaning or ill omen.
A recent study of Etruscan skulls compared with modern skulls showed no significant difference in skull size with particular reference to the mandibular shape and size. (35)
This is further confirmation following CIBA’s study previously mentioned.
Other pathologic conditions include thalassemia. The origin of thalassemia has been debated. Where and when in the medite4rranean basin did this disease of the hemoglobin molecule arise? Quarneti studied the skull from Spina, a Greco-Etruscan city of the 3rd century B.C., and found radiographic evidence of osteoporosis compatible with thalassemia. Of 30 skulls examined, 7 presented with generalized osteoporosis. Three of these with osteoporosis most localized in the diplopic layer of the cranium and two with the findings concentrated in the frontal area. The x-ray findings are pathognomonic for thalassemia. (39)
Other pathology portrayed in Etruscan art includes obesity.(51) Although an argument can be made obesity is not truly a disease state, it is often associated as a risk factor in many illnesses and is included for completeness sake. Examples of obesity are most noted on the lids of sarcophagi and are found in museums in Florence, Chiusi, Orvieto, Tarquinia, Volterra and Villia Giula in Rome among others. Ascites has been suggested as the cause of the Protuberant abdomen in these figures. This seems unreasonable since the person portrayed is generally robust and not sickly in appearance.
A freso from the Francois Tomb at Vulci and currently found at the Museo Torlonia in Rome shows an achrondroplastic dwarf.
A bronze mirror now in the museum Nazionale di Tarquinia showed a bizarre figure with a head out of proportion to the torso and extremities. This possibly represents the congenital defect of macrocephalus.
Another bronze mirror also in the museum in Tarquinia shows a kyphotic and possibly scoliotic male in the kneeling position with disproportionally short legs. Is this congenital kyphoscoliosis or the result of childhood rickets? A penile erection is also noted.
Did the ancient artist portray these pathologic figures for a specific reason or was he simply portraying in his art his observances of nature? We might debate this endlessly, but the author feels there is no evidence form what is known of Etruscan religion and philosophy to build a case for either view and is content to simply to record these observations.
The Etruscan artist drew the external anatomy quite well. They were strongly influenced by Greek art. (51,83) Etruscan sculpture and painting demonstrates a precise knowledge of the musculature of the thorax, abdomen and extremities. Etruscan votive offerings representing various parts of the human body, including limbs and viscera, are known. These ex-votos express the gratitude of the cured to the divinity and sanctuary where the cure occurred. They do not appear to represent specific pathologic entities but clearly show the Etruscan knew gross anatomy. (3,8) The models are realistic representations of the organs and sections of the body with proper orientation obviously produced form direct observation of sacrificial animals and possibly cadavers. (79,76,80,96,97,102,103115,116) These anatomic models have been found in various sites and now primarily rest in museum collections. These figures are made of gold, silver, copper, bronze, wood, terra-cotta, sandstone and marble. The majority is terra-cotta. They represent the body organs of man both internal and external. An area of the body, such as the thorax or abdomen, is presented with individual organs or in some cases all of the major organs reproduced. Ostensibly the organ in contention is depicted in detail with the remainder of the sculptured anatomy roughed in. (37)
Votive offerings do at times represent pathologic conditions. (50) From my research the exact origin and dates of this type of artifact is not accurately dated. (85,107) (See Pages 58-67 in Lanciani) The author believes most, if not all, of these ex-votos reveling pathologic conditions are of Roman origin, but this cannot be categorically stated and will require much more research. A sampling of the pathologic conditions encountered includes phimosis, double orifice cervix, rheumatic deformities, spinomegaly, and skin disease, tumor of the orbit of the eye and breast cancer.
Ducati believes the Etruscans practiced surgery and medical skills broadened to include hospitals. (4) Other writers including Castiglioni and Tabanelli echo these sentiments, but there is precious little evidence on which to base these beliefs. Certainly some form of surgery was performed, but the level of sophistication is unknown. The Roman and Greek writers discuss Etruscan knowledge of medicine and pharmacy but on the most general of terms. They are reporting several centuries later what has been passed down through the years with few specifics. Warfare and injury involving fractures must have created in all organized societies some empirical forms of therapy to stop hemorrhage and stabilize a fracture. There is no direct evidence surgical the Etruscans organized therapy in a professional way. Furthermore, the surgical instruments founding Etruscan museums are not proven to be of Etruscan invention of manufacture. The consensus is that they are of Greek inspiration. This same argument seemed valid for surgical instruments found at Pompeii similar to Etruscan instruments, which seemingly copy Greek instruments. Tabanelli gives a detailed accounting of the Italian museums containing surgical instruments. This includes: Museo Etrusco Guarnacci Di Volterra, Museo Etrusco Di Chuisi, Museo Etrusco Romano di Perugia Archeological del Museo Tell’Apera del Dumo di Orvieto, Museo Civico Della Fondazione Faina di Orvieto, Museo Nazionale Etrusco di Villa Guila in Roma. The instruments represented are said to include forceps, probes, spatulas, trephines, speculums, spoons, cauteries and ligature devices. (51,23)
The Sign of the Horn
The British Journal of Plastic Surgery published in 1980 is a fascinating paper on the horn sign. (10) In many of the cinerary urns of the Etruscan city of Volterra, found in the Guarnacci Museum, is found an unusual anatomic deformity. The index finger and little finger are fully extended; the middle and ring fingers are partially or completely flexed. (70) The aristocratic and wealthy Etruscan families keep the decedents ashes in these urns after cremation. The urn consisted of a box and lid. The sides of the box are carved with scenes of daily life or mythology. The lids usually portrayed the decedent lying on the left side in a semi-recumbent position. Wealthy Etruscans used this position during their banquets. The left hand is often holding an unusual cup or bowl called a patera unbilicata. This bowl was held with the middle and fourth fingers in a hole in the bottom or unbilicata. In many such lids the person is not holding a patera but the fingers are in a flexed position. Even thought the funerary urns were massed produced the face is often considered a portrait of the dead person with the details added at the time of death. This mass production theory might account for so many urns with hands in the horn position. However, why was it used in the first place and why did this practice continue for some 300 years? This must have a socially acceptable explanation. The frequent explanation given of this configuration of fingers is an apotropaic gesture. This term is derived from the Greek to turn away and is thus a gesture to ward off evil spirits. Perhaps this deformity has another explanation. The patera was used for pouring libations during sacrificial rites and for drinking. (12) The patera was also used to hold food and the Etruscans “were mighty eaters” as described by Diodorus Siculus. (13) The meals of the aristocracy were long affairs and eating was so important to Etruscans, woman were allowed to take part I the banquets. Is this then an acquired deformity? If the middle and ring fingers were kept in the umbilicus of the patera several hours a day for many, years, one could speculate the flexor muscle bellies to these fingers might develop a functional hypertrophy and so produce an acquired flexion deformity. Children and slaves are never depicted as having this deformity. The former are too young and the latter are not allowed to use the patera.
We tend to think of the Romans as the great innovators of large public health projects. (22,8) This includes traditionally the aqueducts, sewer projects and burial of the dead outside the city walls. But the evidence is accumulating that the Etruscans were the teachers of the Romans in several areas and exceeded the Greeks. (3,109) The Etruscans excavated the vast galleries and subterranean tunnels in the soft tufa stone in the cities and in the countryside. (8,9,66) They cut through entire mountains draining lakes and rivers. The tunnels are still functional. These projects draining swampy low-lying coastal land were performed to control malaria. The exact dates are unknown, but the malaria mosquito wiped out entire populations in ancient Latium. Latium is that part of Italy containing Rome and her environs. Pliny about 300 years later says 53 populations in ancient Latium vanished without a trace. (3,5,71) H.M.S. Jones mentions the contemporary Greek references to malaria in Magna Graexia adjacent to and south of the Etrurian city-states. (33) These epidemics must have been proportional to the plague epidemics of the Middle Ages to be remembered and recorded so many years later. (6) In Neolithic times malaria apparently was not a problem. The early inhabitants were farmers. Only toward the end of the Etruscan period, 2nd and 3rd century B.C., did epidemics appear. The Etruscans understood the importance of draining the swamps. The original Etruscan cities were along the coast. Was it malaria that drove the Etruscans inland and is this why they built their towns and cities on the tops of the hills? The traditional argument given is defensive, but defense against what? Invading neighbors or the malaria mosquito? (60,106)
The early kings of Rome were Etruscans. Tarquinuis Priscus, a legendary Etruscan king of early Rome, built the Cloaca Maxima. We are used to believing this was the world’s greatest ancient sewer. The Romans did indeed turn this into a receptacle to drain the sewers of Rome when the aqueducts were constructed however, several centuries before Tarquinuis Priscus built this structure to drain the swamps around Rome in an attempt to prevent malaria. (84)
Potable water was provided to the inhabitants of the Etruscan city of Marzabotto by conduits dug through the tufa. Also at this site sewer pipes were found.
So before the great Roman engineering feats of building aqueducts systems for which they are so justly famous, their forbearers in the Italian peninsula were draining swamps with fast galleries and tunnels leading to the sea; bringing potable water to their cities and providing for a water-driven sewage system.
The thermal waters of Etruria are famous and were incorporated by the Romans. (3,99, 120) One might argue the famous roman baths grew out of this tradition.
Aqua Populonia (Etruria Populuna) – Probably the bath of Caldana near Campliglia Marittima (Anonymous Ravenian) Anonino Raventrate_ IV, 3c) (4)
Vetonlunia _Hot water baths (Le Caldane, known by early writers as Aquae Calidae ad Vetolonius of Pliny) Pliny- Natural History II, 227) (4,19,91)
Aquae Apollinares- A Roman term (Baths of Vicarello) and Etruscan site as well on the shores of Lake Bracciano. This is near Vicarello and Veii noted in the Travels of Antonio as the Baths of Stigliano. A collection of Etruscan and Roman coins was found here in 1852. In 1878 Dennis found them displayed in the Kirchner Museum contained in the larger Collegio Romano in Rome. (18) The Aquac Passerianae in Eturia where were also the Aqua Apollinares now Bagni di Vicarello as noted in Martial (Book) VI, P. XLII (in the footnotes of Dennis Volume I, Chapter XIV, page 157, says Martial’s description not possible and this must be the Baths of Serapis [see page 34 of these notes]).
Cervetri (Caere) Spas- Probably the baths of Sasso near Cerveteri (Strabo, Geographia V, ii, 3) (114) are of Etruscan origin and frequented by the Romans.
Rutilio Bamaziono (the Rutilo I, v 249)- The Tauro Spas or the baths of the Terrata near Civitavecchia celebrated for the prominent crowds found there and dedicated to Apollo and to the nymphs near Lake Bracciano. (4,18,19)
Linco River- Mentioned by Linconfrone, Da Calcide in his Greek tragedy Cassandra (Alessandra, v 1246) as existing in Etruria and rich in hot springs has been identified with the Cornia River flowing in the Cecina Valley between Campiglia and Massa. This is perhaps the Thermae of Pomarance known in ancient times as Aquae Volaterranae.(51)
Baths of Ferrata (Bagni di Ferrata) or Aquae (Thermae) Tauri of Pliny in the mountains three miles from Civita Vecchia (Centumecllae) says Rutilius (I, 249) (18,19)
Baths of Volterra are stated to be Etruscan, but Dennis saw only opus in certain brickwork. They are situated on the out side of the city just outside the San Felice gate. (19)
The Baths of Roselle- approximately four miles from Grosetto and near Moscana Hill is found the site of ancient Roselle on a smaller hill in the shape of a truncated cone. (19)
Baths of the Queen (Bagni della Regina)- The baths are entered through a large clef in the rock. Within the cave is the bath with seats cut from the living rock. Virgil’s Grotto of Nymphs is postulated as the site, but this is not at all certain and there is no direct evidence of Etruscan use (Virgil: Aenid I, 167; Repetti III, p. 679). (19)
Saturnia- Bagno Secco (Dry Bath)- Dennis doubts this actually is a true bath. It is a square forty-nine foot concrete enclosure of two courses each two feet in height. The concrete blocks are twenty feet in length. Sulfur Baths of Saturnia- Found three miles form the ancient city. The spring falls in a cascade encrusting the cliffs with a colored deposit at least as described by Dennis in 1878. (19)
The Baths of San Casciano found at Chuisi and also known as the Fontes Clusini (Horace. Epistle I, XV, v 9). The remains are of ancient date and very possibly Etruscan. (19,4,92)
Baths of Serapis (Bagni Delle Serpi) or locally called La Lettghetta or the warming pan. Also known as the Waters of Passeris noted by Martial (VI, 42) and Peutinger Table. This is identified with either the hot springs near Bacucco or the Dantean Bulicame. (4, 19) (See page 3 Aquae of Apollinares.)
Saint Ippolito- A small town halfway between Viterbo and Vetralla reveals remains of ancient baths and a Roman aqueduct as mentioned in Dennis. Apparently no other references to this site. (19)
Bagno Viquoni (see Jane’s References)-
Scribonio Largo records in 1528 a hot springs 50 miles from Rome belonging to a magistrate, Milone Brocchio, and near Viterbo(51).
In the tombs of Tarquinia, Capodimonte on Lake Bolsena and Civita Castellana were found teeth with gold wire some specimens are preserved in the museum at Corneto. This same method of treating the teeth was used in Roman times as well. Gold dentures are found in Roman tombs. The laws of the Twelve Tables, the important Roman document defining Roman laws and procedures, forbade placing gold in tombs except in the teeth of the deceased. The laws date from 450 B.C. And long before Archagathus, a Greek and the first surgeon, appeared in Rome in 218 B.C. The evidence suggests false teeth and prosthesis to hold natural teeth were used in Eturia. The Roman writers Celsus, Pliny and Martial discuss various aspects of dentistry. This includes extractions and fracture dislocations of the jaw. Exact knowledge of Etruscan dentistry is lacking except for the gold prosthesis and extrapolation backward from our knowledge of the Romans is pure conjecture. The Etruscan pure gold dental bands for fastening loose teeth and replacing lost ones indicate remarkable progress form appliances founding Egypt and Phoenicia. Skilled artisans and goldsmiths rather than a person we would consider a professional dentist probably did this work. There is no Latin word for dentist. They used gold bands to make a dental bridge or into a prosthesis when teeth were missing. They used carved teeth riveted to the gold band. The Etruscans also made the earliest gold crowns. A dental appliance with a crown soldered to a gold band forming the abutment of a dental bridge. This technique was apparently lost for over 2000 years when at the end of the 16th century the crown next appears in the dental literature.(7)
The relationship between the Etruscans and the Greeks we have discussed before. Greek medicine must have permeated Etruscan culture so we might assume the Etruscans were aware of the Hippocratic treatment of a dislocated mandible. Hippocrates in the 5th century B.C. used the same method described in Edwin Smith Papyrus of 1000-1500 years earlier. The Greeks of the 5th century B.C. also wrote of toothache, tooth extractions, dentition and oral hygiene but, if the Etruscans knew or used this, is again purely speculative. (94,98,101)
Guerini’s chapter on Etruscan dentistry argues the Etruscans learned the art of dentistry directly form the Egyptians and Phoenicians. He feels Etruscan seamen and merchants must have visited Memphis I Egypt, Tyer and Sidon in Phoenicia and Phoenician navigators also visited Etruria. The Oriental motif in Etruscan art is given as evidence of this.(14) this argument originally presented in Deneffee’s monograph of 1899. (67) The Egyptian and Phoenician civilizations clearly predate the Etruscan, but the route to Etruria is speculative. However, Etruscan workmanship exceeded in all respects their predecessors. Cremation was in general use early in Etruscan history, but by the 6th and 5th centuries B.C. in Southern Etruria inhumation and cremation are practiced side by side and examples are found in the same tomb. Various appliances are found. (122, 123) These include crowns, bridges, supports of gold wire and gold bands. The religious laws held that the dead were sacred and forbade the use of a dead man’s tooth for use in prosthesis. Ox and calf teeth were used as artificial teeth. For details of the various types of appliances the reader is referred to the detailed description of the appliance in the chapter on Etruscan dentistry in Guerini’s monograph. The thick band of pure gold in some appliances was surely designed for the wearer to show off and perhaps was a status symbol.
Walsh carries the discussion of Etruscan dentistry even further. His chapter, How Old the New, points out the often forgotten fact that man is continually reinventing and rediscovering techniques used in the past and forgotten for centuries. He uses Etruscan dental skills to make his point. (15) Walsh accepts Guerini’s contention that Et4uscan trading with Phoenicia and Egypt were the source of their inspiration. He properly noted the paucity of Egyptian prosthesis; a point omitted by Guerini and stresses that great skill of Phoenician artisans as well especially those from the city-state, Sidon. Only a single Phoenician prosthesis survives in and upper jaw of a female with two canines and four incisors united with gold wire. This was found by Dr. Gaillardot, a fellow excavator of Renan, who presents a drawing of this in his “ Mission de Phoenicia”.(16) But this exceeds in skill any Egyptian appliances. All are exceeded by the Etruscan workmanship.
The Decemviri or the ten magistrates that headed the commission for drawing up the laws of the Twelve Tables were not written later than 450 B.C. Since gold was in short supply in ancient Rome only gold in the teeth could be buried with the corpse. There has been some discussion that the reference to gold referring to fixing artificial teeth, but Geist-Jacobi (108) as quoted by Guerini in his History of Dentistry supports the idea this includes gold wire to support lose teeth.
Cato the Elder gives us a glimpse into Etruscan medical therapeutics. (21) This energetic roman of old Sabine stock has left us with considerable knowledge of early Roman medicine. Here is the personification of the peterfamiliaris. He practiced a home art not yet differentiated by society into a separate field of knowledge. Cato used cabbage (Olus or Brassica) mixed with wine and other herbals in many of his prescriptions. The cabbage was a remedy known long before Cato ad used by the Sicilian Greeks and Etruscans. All attempts to study Etruscan herbals have essentially ended in failure. The precise identification of plants is difficult and usage even more obscure. (72, 77) Only a few vague references are available in the Greek and roman literature. Tabanilli has ably summarized these and others are included in the section of this monograph under ancient references. Prescriptions or recipes for Roman fold medicine abound. Cato in his works mentioned twelve prescriptions; Celsus mentions eight, Scribonius Larguos in the 1st century A.D. 271 prescriptions (compositions) and Pliny the Elder who describes even more with a total of more that 1000 herbs, shrubs and trees and 100 parts of various animals and birds with medicinal properties.
Original sources of all of these mentioned above are unknown. To suggest at least some of these are Etruscan in origin seems reasonable without verification and so the subject must stand as regards Etruscan fold medicine and pharmacy unless other sources are forthcoming and this seems quite unlikely.
A remarkable story and a valuable footnote on Etruscan occult remedies deserve mention at this time. A remarkable American, Charles Godfrey Leland, lived in Florence the second half of the 19th century. Leland was born in Philadelphia and began his adult life as a journalist. Folklore was the passion of his life and he produced important works on the Algonquin Indians in America and the gypsies in Eastern Europe. His most important work, however, was his research on Etruscan magic and occult remedies. This work was collaboration with a gypsy sorceress, Maggdellina, who related her secrets for him and gathered from the Etruscan countryside a wealth of information including stories, incantations, chants and other magic remedies. This was done in the latter part of his life when Leland was too ill for trips to the countryside himself. In 1849 Jacob Grimm reprinted a book written by Marcellus Burdegalensis, a court physician to Emperor Honorius in the 4th century A.D. of 100 magical cures used by the rural fold in Northern Italy in his time. Many of these were ancient at the time of Marcellus and, like most roman magic, were Etruscan in origin. Leland found fifty of the hundred magical cures still being practiced in Northern Italy. The collected tales and antidotes of Leland were studies and he found them similar to what he read in Virgil, Pliny, Cato, Varro and other Roan writers. He was convinced the peasantry of Tuscany had lived with little change since prehistoric times. That is the same magic was transmitted thought Etruscan rule, Roman rule and Christian rule without march change. This primitive shamanism or rudanimism (i.e. the worship of spirits) was coupled with a system of sorcery. These people believed every plant, stone and rock has its own spirit. In Leland’s book are cures for headaches and diseases of the eyes, throat, feet and intestines among others. If Leland’s hypothesis is true, this is the only window through which we have a glimpse of Etruscan medicine and pharmacy.
G.Bilancioni in a paper published in 1928 discusses the cure of a laryngeal condition as described in an inscription of 68 Etruscan words found on a stone in 1882 near Magliano (Grossetto). This has been dated to the 8th century B.C. and would qualify as the oldest prescription founding Europe. (118)
S. Baglioni in a review of the history of the enema includes a vase, possibly Etruscan bucchero. The inferior drawing shows a bearded male wearing a toga-like garment (? physician) about to insert into the rectum of a nude, kneeling woman the tip of an apparatus that could only be a clister. (119)