There are days when researching subjects for Commonplace Fun Facts has us reading inspiring stories of heroism. Sometimes we are privy to the thought-provoking journals of some of history’s greatest minds. There are those glorious hours of imagining the workings of a chocolate factory.
And then there are days like this, where we are wading through one of the most unpleasant and uncomfortable treatises in Western literature. Today’s task in becoming a well-read person of culture introduces us to one of the oldest pieces of medical literature, authored by the Father of Medicine. We refer, of course, to everyone’s favorite breakfast-table reading material, Hippocrates’ classic treatise, On Hemorrhoids.
Hippocrates of Kos (c. 460 – c. 370 BC), is considered the Father of Medicine. His method of clinical observation, systemized categorization of diseases, and use of prognosis established medicine as a distinct science. The Hippocratic Oath, taken by physicians before they begin practicing, is named in his honor. The most famous line from the Oath, “First, do no harm,” originally appeared as, “Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free.”
The definition of “harm” and “abusing the bodies” means something different to physicians than it might mean to you. This certainly seems to be the case when reading about the way Hippocrates got to the bottom of things when dealing with hemorrhoids.
He wrote the inspiring treatise in 400 B.C. You can read an English translation of it here. Before you dive into it, here’s a word of warning: at times, it reads more like a script for a Halloween horror movie than a medical textbook.
Consider, for example, a few of Hippocrates’ favorite ways of putting people’s hemorrhoid problems behind them:
I recommend seven or eight small pieces of iron to be prepared, a fathom in size, in thickness like a thick specillum [surgical probe], and bent at the extremity, and a broad piece should be on the extremity, like a small obolus [a Greek coin weighing one gram]…. Having laid [the patient] on his back, and placed a pillow below the breech, force out the anus as much as possible with the fingers, and make the irons red-hot, and burn the pile until it be dried up, and so as that no part may be left behind. And burn so as to leave none of the hemorrhoids unburnt, for you should burn them all up… When the cautery is applied, the patient’s head and hands should be held so that he may not stir, but he himself should cry out… When you have performed the burning, boil lentils and tares, finely triturated in water, and apply as a cataplasm for five or six days. But on the seventh, cut a soft sponge into a very slender slice, its width should be about six inches square. Then a thin smooth piece of cloth, of the same size as the sponge, is to be smeared with honey and applied; and with the index finger of the left hand the middle of the sponge is to be pushed as far up as possible; and afterward wool is to be placed upon the sponge so that it may remain in the anus. And having girded the patient about the loins and fastened a shawl to the girdle, bring up this band from behind between the legs and attach it to the girdle at the navel. Then let the medicine which I formerly said is calculated to render the skin thick and strong, be bound on. These things should be kept on for not less than twenty days.
If this method doesn’t do the trick, Hippocrates recommends another treatment:
Having placed the man over two round stones upon his knees, examine, for you will find the parts near the anus between the buttocks inflated, and blood proceeding from within. If, then, the [afflicted area], bring it away with the finger, for there is no more difficulty in this than in skinning a sheep, to pass the finger between the hide and the flesh. And this should be accomplished without the patient’s knowledge, while he is kept in conversation.
“This should be accomplished without the patient’s knowledge, while he is kept in conversation”? One can’t help but wonder how effective this approach was. Could this really be done “without the patient’s knowledge”?
We also suspect this is where the practice started of physicians and dentists offering the blatantly-fraudulent promise, “This won’t hurt a bit,” or “You’ll feel a wee bit of pressure,” or “You might experience a bit of ‘discomfort.'”
Another method of curing hemorrhoids:-You must prepare a cautery like the arundo phragmites [a common reed that grows in the wetlands], and an iron that exactly fits is to be adapted to it; then the tube being introduced into the anus, the iron, red hot, is to be passed down it, and frequently drawn out, so that the part may bear the more heat, and no sore may result from the heating, and the dried veins may heal up… The hemorrhoid will separate under the use of these medicines, like a piece of burnt hide.
Fascination with the treatment of the derriere was not limited to Hippocrates. Some 600 years after the Father of Medicine dealt with the issue, another medical great offered his two cents. Galen, (A.D. 129-216), achieved historical immortality for his contributions to surgery, medicine, and logic. He applied his expertise to the problem of “melancholy” and concluded that the hind end, rather than the heart, was the cause. He wrote, “The opening of the hemorrhoids is the surest remedy [to melancholy].”
Since the classic definition of melancholy is “a pensive sadness without any obvious cause,” Galen’s approach might actually have some value. Applying Hippocrates’ method for dealing with hemorrhoids may not do anything about changing a person’s sadness, but it would at least provide an obvious cause for the downcast mood.