19 November 2012

Medicine: The Roman Army

The Ancient Romans based their medical knowledge on that of the Greeks, enhancing it over time with their own folklore and innovations. Like other cultures, their pharmacology was based on herbalism; and while it contained a hefty dose of woo-woo, many staples of the Roman first aid kit were scientifically sound. A great example is Pliny the Elder's Naturalis Historiae, a massive encyclopedia of facts, hearsay, myth, and superstition. Pliny was an officer in the Roman army during his youth, so it's not a stretch to speculate this collection of "remedies" was influenced by what he learned in the field; from his writings (and those of physicians like Galen of Pergamon), and from the records and artifacts left by the legions, we can put together a pretty good picture of how Roman army doctors dealt with the aftermath of battle.

Roman surgical tools from Pompeii
Legion medics employed a variety of surgical tools including scalpels, forceps, clamps, tweezers, and saws. What made this hardware slightly less terrifying was how it was treated; Roman doctors kept their own personal kits, and took pride in keeping their collection clean, up to date, and in good condition. They were skilled in setting bones, correcting dislocations, and sewing lacerations, and they knew enough about the circulatory and muscular systems to repair pretty hardcore damage — so except for the most catastrophic wounds, legionaries were not automatically doomed to bleed out or face amputation. As for pain management, they had nothing to rival today's anesthesia, but strong opiates did a lot to dull the senses — you would be awake for your surgery, but hopefully so strung out that you wouldn't care.

But after bones were splinted and stitches tied off, the real trick was preventing infection. Luckily the Romans practiced excellent hygiene, and the army was no exception. Surgeons knew dirty tools caused festering, and they boiled everything before each use; they also boiled the cloth used for bandages and the twine used for sutures. They knew the benefits of rinsing wounds with alcohol or vinegar, and of keeping hands and clothing relatively clean. As for post-triage care, their use of herbalism proved to be less woo-woo and more science, as modern medicine has since discovered. The following five ingredients were some of the most important in Roman field medicine, and while they don't exactly replace soap and penicillin, all five have been proven at least moderately effective.

Honey was often used as the base for poultices and dressings, both for its consistency and because it was known to ward off infection and speed up healing. Honey inhibits the growth of bacteria: when applied to a wound, it creates a slow release of hydrogen peroxide, keeping the area clean.

Calendula arvensis, the pot marigold
Crushed garlic was used in poultices or for scrubbing down sick-rooms; as you can imagine, the result was rather fragrant. If the patient could bear it, they would indeed benefit from garlic’s antibiotic properties. It was used as an antiseptic as recently as WWII.

The bark of the willow tree is high in salicylic acid, the main component of aspirin. It was prized by many cultures as an antiseptic, analgesic, and anti-inflammatory, and could be administered in several forms: infused in wine, steeped as a tea, or ground for poultices.

Calendula — the garden marigold — was a mainstay of the Roman medicine cabinet. The flowers were used in poultices and taken as tea to prevent and break fevers. Calendula is mildly anti-biotic and high in flavonols and saponins. It is widely used today in lotions and skin products.

Achillea millefolium, common yarrow
The Romans called yarrow achillea in honor of Achilles, who was said to have required his soldiers to carry yarrow on their person at all times. Its main function was to arrest bleeding; it could also be used to dull pain and break fevers. Yarrow is high in salicylic acid and anti-inflammatory compounds.

The Roman battlefield was as much a scene of horror and agony as any other throughout time; wounds were just as ghastly, risk of infection just as dangerous. But with hygienic practices like cremation of the dead, latrines to prevent dysentery, and sound medical techniques to prevent and treat infection, the Roman legions maintained a state of health and sanitation not found in other military forces. In the ancient world, that advantage alone could make all the difference.

Heather Domin is the author of The Soldier of Raetia, set in Augustan Rome; and Allegiance, set in 1922 Dublin. She is currently working on the The Heir of Fortune, sequel to The Soldier of Raetia, and in the meantime enjoys puttering around with her herb garden, which may or may not contain woo-woo elements.