Hippocrates did WHAT to treat hemorrhoids?

Did you know that more than half of all people will experience hemorrhoids at least once in their life? While hemorrhoids are a problem no one looks forward to, if you ever find yourself dealing with that annoying condition, be VERY glad you don’t live in ancient Greece with the famous Hippocrates (aka the “father of modern medicine”) as your doctor .

The famous physician traveled widely and may have even written down many of his thoughts and practices (although many Greeks studied and wrote under him on the basis of his teachings, it is likely that there are multiple authors of the works commonly referred to as the “Hippocratic collection”. “). What he is best known for by far is the still-used “Hippocratic Oath” taken by modern physicians around the world to this day. What’s ironic is that the oath says “do no harm” – which is why it may be surprising to find that if you went to a Hippocratic doctor in ancient Greece, they would treat your hemorrhoids by literally sending heated iron surgical instruments to you. bring derriere!

Greek doctor and patient, plaster cast in WHMM (Wellcome Collection/ CC BY 4.0)

Greek doctor and patient, plaster cast in WHMM (Wellcome Collection/ CC BY 4.0

The Hippocratic Procedure to Treat Hemorrhoids

The specific words of the 400 BC. Treatise “About Hemorrhoids” will detail how best to carry out this procedure. It says that “seven or eight” iron surgical instruments with a coin-sized piece on the end must be “prepared” – meaning they must be made red hot. Then the patient must be held with the arms restrained while the hemorrhoids are literally “burnt until the pile has dried, so that no part is left behind”. Interestingly, the work specifically encouraged the patient not to be gagged and encouraged to yell, as yelling “push the anus out” and make it easier to access and burn more hemorrhoids!

Surgical instruments, 5th century BC, Greece.  Reconstruction based on descriptions within the Hippocratic corpus.  Technology Museum of Thessaloniki.  (Gts-tg/CC BY-SA 4.0)

Surgical instruments, 5th century BC, Greece. Reconstruction based on descriptions within the Hippocratic corpus. Technology Museum of Thessaloniki. (Gts-tg/ CC BY-SA 4.0

At least when the procedure was completed, there were processes in place to treat the (possibly now quite more serious) wounds on the person’s back. After surgery, a classic soothing paste made from the medicinal staples (?) lentils and chickpeas was applied, and a bandage was placed around the person’s diaphragm to keep it in place for several days. After the lentil and chickpea bandage was removed, honey was applied to a new bandage and inserted into the person’s anus.

Now, how the person relieved themselves that week, or how they could possibly do it with any semblance of hygiene… is best not to think about. Especially when you consider that ancient Greeks tended to use actual shards of pottery instead of toilet paper after they became “#2”. I can think of few worse things than having to literally scrape excrement from recent burns… but I think these ancient Greeks were a different race. Unfortunately, that habit of using pottery shards as tp is a major reason why hemorrhoids were so common among the ancient Greeks.

Ancient Greek pottery from Cycladic workshop, find from burial site north of Paroikia, painted shard, 700 – 600 BC.  Archaeological Museum of Paros.  Zde/CC BY-SA 4.0

Ancient Greek pottery from Cycladic workshop, find from burial site north of Paroikia, painted shard, 700 – 600 BC. Archaeological Museum of Paros. Zth/ CC BY-SA 4.0

Other Ancient Hemorrhoid Treatments

This “burn them straight to hell!” technique seems to have been limited to the Greeks, although other possible solutions (essentially ALL preferred) were also written by the Hippocratic authors as well as other ancient societies. For example, the ancient Egyptians had several recipes for medicinal pastes that could be applied to the affected areas.

Interestingly, another strategy used by Romans, Indians and Arabs involved “ligation”. Ligation, or literally cutting off the blood supply to an area, was used by each of these cultures and also appears in some of the Hippocratic writings. The Greeks wrote of using wool or thread to tie off the hemorrhoid tightly, cutting off blood flow to it, so that over time it would shrivel and fall off, either by itself or by “excision” – the cut off. This technique has stood the test of time and is one of many methods still used, although doctors now use a rubber band instead of a version of thread to tie off the hemorrhoid.

11th century English miniature.  On the right side is surgery to remove hemorrhoids.  On the left, a patient with gout is treated with cuts and burns of the feet.  (Public domain)

11th century English miniature. On the right side is surgery to remove hemorrhoids. On the left, a patient with gout is treated with cuts and burns of the feet. † public domain

Hemorrhoid burns aside, Hippocrates has made some positive contributions to today’s healthcare

Of all the possible solutions, the Hippocratic red hot iron burn is definitely the worst. However, Hippocrates gave the world a whole new perspective on health and even terms like symptom, diagnosis, therapy, trauma and sepsis. He is credited with being the first to accurately diagnose epilepsy and discover that it was caused by a problem in the brain, thus proving that the brain actually controlled the body.

He also mentioned many diseases that we still refer to today by the same terms, such as cancer, diabetes, arthritis, coma, and paralysis. He even learned how to diagnose and treat a lung infection known as empyema, a potentially fatal condition that today requires a CT scan and X-ray for diagnosis.

Given Hippocrates’ numerous notable achievements in multiple medical disciplines before the invention of nearly all modern diagnostic tools, we may be able to give him a break for making the wrong decision about one particular condition. Also, when you consider that it’s always best to look on the bright side, and since almost everyone will deal with hemorrhoids at some point in their lives… side!

Top image: 13th century depiction of a hemorrhoid surgery. Source: The British Library / Public domain

By Brendan Beatty

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