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
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

GARLIC
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.

WILLOW
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
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

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.

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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.

Maladies & Treatments: Writing with Folk Cures

By Anna C. Bowling

Growing up as the child of older (both were over forty when they adopted me; the photo is of me, at three, on the blacktop where I skinned pretty much everything) first generation American parents must have hardwired me for unusual historicals right from the start. Many of the treatments for the minor childhood illnesses or injuries I had in the 1960s/70s were as likely to come from the traditions my mothers and aunts, one of whom who worked as a nurse, learned from their mother, who learned them from her mother back in Italy in the early 20th century.

As a child, I'd often wondered what my mother grew that patch of mint for (aside from the delightful smell) but when puberty hit, I found out it was a natural remedy for menstrual cramps. By then we had moved away from the house with the fresh mint in the garden, so it had to come from a store, but it still worked, and the mint tea also worked to help with nausea.

Sore throats were as likely to be treated with licorice as commercial medications, which may be why I still like licorice today, and I will long remember the discussion my parents had when my father wanted to give me a hot toddy (mostly rum) to help ease the discomfort of a bad case of chicken pox when I was ten. They left it up to me, and I declined.

One of my strongest memories of my mother's Aunt Anna, who I only knew as an elderly woman who spoke a fast stream of Italian was the time when I'd talked a neighbor child into splitting a bar of Ex-Lax (to be fair, I was five and the grownups had described it to me as chocolate.) Being sorely lacking in my Italian, I can't vouch for anything said that day, but Aunt Anna refused to let my mother take me to the doctor, instead pounding an endless supply of ice with a hammer and pouring it down my throat before depositing me in the bathroom with even more tall glasses of ice. When I asked my mother to translate, she said this was Aunt Anna’s treatment for loose bowels, something she learned back in Italy.

Since I survived and turned out okay, my foremothers must have been on to something, so when characters in my historicals now have the need for doctoring, I turn to the state of the art medical care of their time. Often, such as in colonial settlements, the most advanced medical treatments meant calling in whoever had dealt with the illness or injury before. If the need was something the person hadn't encountered before, common sense was often the best guess.

In my colonial historical romance, MY OUTCAST HEART, the hero, Dalby, suffers third degree burns to one hand. Today, witnesses would call 911 and paramedics would rush him to the burn unit, where trained professionals would examine him and use a variety of treatments and procedures to find out how bad the damage was, how much mobility he might be able to retain and even address cosmetic repair. In 1720, Dalby was lucky this occurred in winter, so heroine Tabetha can drag him outside and stick his hand in a snowbank. The cold would help, but the "everybody knows" medicine of the time--likely coating the burn in butter or bear grease--we now know would have the exact opposite effect.

Looking at the folk medicine of the times I write about, and consulting with several friends who work in the medical field of today as well as visiting living history museums lets my characters have the best--or worst--of both worlds, depending on what the story needs. Good thing a great read is excellent medicine in any time.

Historical Medicines

I suffer from migraines, very bad, very life-interrupting ones. I'm on medication, I meditate, exercise, drink lots of tea, actually cut back on my chocolate consumption (let me tell you, no easy feat), have certain scents to help with the pain (lavender), use eye packs in hot and cold for some small amount of help, and I've completely stopped eating rye bread based on one particularly debilitating migraine. (I never did figure out if it was the rye or just a bad day, but would you want to experiment with something like that?) I'm seriously worried about my liver, I take so many pain medications, and I drink enough water to fill the Atlantic at least once a year.

One thing I've never had done, and will fatally maim the first person to try it on me, is trepanation. You know, where they drill a hole in your head!

Celsus (215-300 AD) correctly described typical migraine triggers: "drinking wine, or crudity (dyspepsia), or cold, or heat of fire, or the sun." He forgot to add drops in barometer. Yup, a rainstorm'll get you every time.

Abulcasis (Abu El Quasim) (936-1013 AD)suggested putting a hot iron to the head or inserting garlic into an incision made in the temple. Please see my reactiuon to trepanation.

Ebn Sina (Avicenna) (980-1037) described migraines in his textbook El Qanoon fel Teb as "...small movements, drinking and eating, and sounds provoke the pain...the patient cannot tolerate the sound of speaking and light. He would like to rest in darkness alone." Yes please, this is perfect. Darkness and QUIET!

Abu Bakr Mohamed Ibn Zakariya Râzi (864-930 AD) noted the association of headache with different events in the lives of women, "...And such a headache may be observed after delivery and abortion or during menopause and dysmenorrhea." Er...no.

I take wonderful pain medication for this. Lovely knocks me out so I-can't-feel-a-thing drugs. Thank you modern science!

But medicine then still has a basis in today's world. I drink tea (nasty awful stuff I wouldn't wish on my worst enemny...wait, let me think. Yes, yes I would.) that has ginger, willowbark, and white-something in it. No, not white bark, that's licorice. And herbal Chinese tea that's even nastier. But hey, it works.

What ailemnts have your characters encountered? What did you use to treat them?

A History of Migranes
Avicenna
Al-Razi
Choler
Another Migraine History