Combat Wounds

[Pertinax]

The very period that fascinates so many Romanists (Fall of the Republic and the subsequent conflict) is the one which lead to great advances in military medicine.Given the clash of Legions and the efficiency of these men in combat, the infliction of wounds and deadly injuries was greatly multiplied amongst the soldiery. Augustus realised that combat medicine and medical attention generally were key strategies in keeping armies well, in good morale and efficient. The establishment of thorough Doctor's training for military and civil use dates from this time.The lowliness of "physical" doctoring as a slaves task (versus a good bedside manner and counselling role of a freeborn doctor) is pushed aside to deliver effective care and combat worthiness of the soldiery.

 

Once again I note that acetum was used as a first wound cleansing medium, actually more effective than Lister's carbolic wash two millenia later-and probably like many things Roman not truly surpassed to this day( British hospitals are presently very concerned to find that soap is actually more effective than the liquid handwashes used by staff in preference to it as they panic about MRSA infections in dirty hospitals).

 

I was hoping to put a medical thread in to hold the " roman herbal" gallery in context

Edited July 9, 2006 by Pertinax

[FLavius Valerius Constantinus]

Just to add a little info on the military aspect:

 

In the legion, every castrum (fort) had something called a valetudinarium( meaning house of the surgeon; hospistal). This was where all the wounded were brought immediately after battle.

In another aspect, there was a longstanding tradition since the Republic that every general have his own real qualified and top-of-the-line physician who stayed with him everywhere he went, even into battle.

But here's the most important thing about legionary medicus. For common legionaries, the medicus who cared for them were actually their own fellow soldiers. In the legion, you were considered a medicus if were good at attending and healing the wounded soldiers, not much experience needed. It was these medicus whom the common soldiers valued so much and with lots of compassion. For example, when a medicus died, often his comrades of the unit( cohort etc...) would pay respects to him by contributing him a monument with inscriptions of his role in the field. But, the job of medicus to the legionaire himself was a second priority, the job of being a ruthless soldier was the main one. By the time of the Gallic campaigns, Caesar recognized the importance of medicus, thus he created a special staff of them, but rules still applied.

In the legion there were three specified types of medicus:

medicus ordinarius--> obviously he tended his own unit

medicus cohors---> he attended the cohort

medicus legionis (not sure which case)---> attended everyone.

Edited November 27, 2005 by FLavius Valerius Constantinus

[Pertinax]

This ties in with the ubiquity of medical equipment finds in and around major Roman sites, and as ive remarked elsewhere this shows that one must be very careful in attempting to define a particular site or building as a dedicated valetudinarium. Stoves for the preparation of medicines seem to have been commonplace as well I would add.

A snippet which comes from Cruse's book shows that wine and/ or acetum was oftn the medium for medication-the presence of wine amphora with "horehound" annotation showed someone was treating chesty coughs in the wet hinterlands of Britannia.

[Pertinax]

This thread now ties quite well with the Gallery of medical plants posted and the review of Cruse's book on the sites lead page.

 

check yarrow herb and henbane in particular

Edited December 11, 2005 by Pertinax

[Pertinax]

If members wish to see a hint of combat realism please go here:

 

http://www.unrv.com/forum/index.php?automo...;blogid=19&

 

and check the gallery entries regarding wounds.

[caldrail]

Medical care was a definite perk of service in the legions, and its peculiar that soldiers often livd longer than civilians. There are even reports of centurions still serving in their eighties. It made sense to a military society like Rome to keep their soldiers fit and healthy. In fact, modern medicine is based on the work of Galen, who tended gladiators for wounds early in his career. Some of their medicine is quite sophisticated, and they had a range of utensils that are similar to those in use to this day.

 

As an aside, they tended not to sew wounds, but preferred staples made of silver which has good properties for this sort of thing. These would be snipped in half and removed when the wound heals.

 

Bandages have been found at Vindolanda. Although the colour is lost (they're now a sort of muddy black) they would have have been an off-white colour like today.

[Pertinax]

I have some more images showing the Surgeon at work

 

http://www.unrv.com/forum/index.php?act=mo...=si&img=910

 

here he extracts a sling round from the thigh of a wounded man.

 

Also we see the design of the arrow extraction pliers: the soldiery were trained not to attempt to pull out any arrows but to leave a reasonable length of snapped shaft in the wound so the angle of inclination could be seen by the surgeon , and he could follow into the wound with the pliers.

 

http://www.unrv.com/forum/index.php?act=mo...=si&img=911

 

As an aside to Caldrail's post the logic regarding non-suturing was that any necrotic matter would be more easily drained away from an unsealed wound, and contemporary conventional wisdom has now gone full circle to suggesting a moist natural scab (kept clear of flies) is the best wound dressing available.Galen noted that the "true " use of medicine ansd medicinal skill was in the treatment of soldier's wounds.

[Lex]

I wonder quite how advanced their knowledge was of treating problems like torn tendons, ligaments and tendonitis and other overuse injuries which I think would have occurred after a long battle or rigorous training. I once read somewhere that for torn tendons, they would stick a piece of steel covered with sulphur (I

[Lost_Warrior]

I'm sure they knew how to fix dislocations (they'd have to have), and I'm fairly certain that Romans had chiropractors (after a fashion) so I'm sure they were in the army as well. (it doesn't take a "rocket scientist" to crack a back or set a broken bone...with some instruction even a child can set a broken bone)

 

Sulphur is a great antibiotic.

 

[edit]

 

I'd imagine injured muscles, ligaments, and tendons were common in training and battle. I'd imagine too, that stress fractures were common, especially in the feet ("march fracture")

Edited July 14, 2006 by Lost_Warrior

[Lex]

Good point about the stress fractures Lost Warrior.

 

Other injuries which come to mind, which I'm sure must have been possible from the impact of shield upon shield would be rotator-cuff injuries in the shoulder. Just imagine the sheer force of two opposing armies smashing into each other. I think that there would be a considerable amount of injuries that would have to be dealt with even after a successful battle, since the strains on the body must have been immense.

 

I'm wondering, if a Roman soldier sustained an injury while he was in formation would it have been possible for him to safely withdraw from his position to seek medical attention and then have a soldier behind him replace him? Or could this cause a break in the line? Would the soldier be allowed to abandon his position? I think it would be possible if the formation wasn't too tight. Or did they constantly rotate their positions anyway since it would be so difficult to have the stamina to fight for extended periods?

 

Does anyone know the procedure or policy with regards to injured troops in the frontline of the battle? Were they expected to literally 'fight to the death' holding their position no matter what their physical condition was? Or were they allowed to move to the back of the lines to get medical attention, or would this cause confusion?

Edited July 14, 2006 by Lex

[Pertinax]

Lex's post raises some very interesting questions.Some considerable time ago I had the loan of a work on the evolution of combat medicine, in an act of witlesness I failed to note its title and author , but the gist of the observation as regards Rome was as follows:(here we speak of the period from the rule of Augustus onward) regarding retrival of casualties , a key Roman policy was to "recycle" trained men, the economic and practical value of keeping troops fit and healthy , and returning seasoned and capable men to the foray was in itself a tactical victory over those who fought in a manner more appropriate to an "honour" culture.

 

As a corollary of this the rapid removal of casualties from a combat area is vital, modern casevac is predicated on speed as a key factor in trauma survivability.

 

By good fortune I will , I hope, be seeing my friend Oannes the Medicus of LEG II AVG this weekend and I will ask him as regards the sulphuring of wounds, certainly the correct disposition of limbs and musculature after treatment of a fracture wound was given proper consideration, limbs were "stretched" to correct lengths after deep dressings were applied to allow muscle and bone to re-grow.

 

http://www.unrv.com/forum/index.php?act=mo...=si&img=916

 

This illustrates the "repaired" and stretched deep leg wound.

[caldrail]

Good point about the stress fractures Lost Warrior.

 

Other injuries which come to mind, which I'm sure must have been possible from the impact of shield upon shield would be rotator-cuff injuries in the shoulder. Just imagine the sheer force of two opposing armies smashing into each other. I think that there would be a considerable amount of injuries that would have to be dealt with even after a successful battle, since the strains on the body must have been immense.

 

I'm wondering, if a Roman soldier sustained an injury while he was in formation would it have been possible for him to safely withdraw from his position to seek medical attention and then have a soldier behind him replace him? Or could this cause a break in the line? Would the soldier be allowed to abandon his position? I think it would be possible if the formation wasn't too tight. Or did they constantly rotate their positions anyway since it would be so difficult to have the stamina to fight for extended periods?

 

Does anyone know the procedure or policy with regards to injured troops in the frontline of the battle? Were they expected to literally 'fight to the death' holding their position no matter what their physical condition was? Or were they allowed to move to the back of the lines to get medical attention, or would this cause confusion?

 

In combat things were happening fast. An injured man would automatically tend to fall back or fall over unless he was in a killing rage. If he couldn't fight, it was likely he would die very soon courtesy of an enemy strike. To some extent, his mates in the line would attempt to cover him or replace him in the line, but thats difficult to do with barbarians hacking at you right left and center. Once injured, survival would be down to circumstance. Were your forces advancing? If so you'd be left there while they carried on. Rotation of men during the fight isn't so easy although fresh men behind you would fill the gap very quickly. Roman troops weren't expected to fight to the death as such, but many soldiers would regard that as their duty. To do less was a sign of weakness or cowardice. Mind you, you would see weak or cowardly legionaries from time to time - every army has its quota of them. In the event, fighting to the death might not be a matter of choice.

 

Medical attention was received after the battle, not during. They didn't have medics on call like you would today.

[Pertinax]

Yes we must be clear that medical work was after the event, I did not want to imply retrival during combat, but that it was considered only good housekeeping to re-cycle those who had been trained and were experienced.

We have discussed "rotation" elsewhere and I think the consensus is that it would be rather difficult as a planned activity in the most unplanned and unpredictable of circumstances.

 

We have also discussed suicide as an honourable death in certain military contexts (Jewish Revolt in particular), so the mindset of the Roman soldier might be somewhat out of step as regards those with a Judaeo-Christian moral background.

[caldrail]

Its not just the moral background. The ancient world was a violent place. Warfare is a human extension of our social animal heritage and in military societies we quickly become used to it. Even those with a Judaeo-Christian moral background in those days were likely to accept violence as part of their lives (I know quite a few didn't, but then these were the same maverick reformer characters that we still see today). Lets remember that the defenders of Masada were a cult of assassins. The mindset of the average roman soldier probably isn't too removed from modern soldiers. I would say they were less restrained, less honest, but would smile knowlingly at the discipline and physical effort required.

[Pertinax]

I add this post as a "possible" scenario , rather than something evidential. One of the interesting snippets that has come out of the commentary extras on HBO Rome is as regards the fight scene in episode 1 ( meant to be a holding action near Alesia). The historical advisor to the production unit posits the idea that Republican soldiers held the scabbard strap ( across the body) of the man in front of them as a means of casualty retrieval. If the man in front was hit ,you hauled him back and stepped forward. Difficult in a scrap id say , and does the casualty get trodden on by his pals? Thought id mention this as the fight scene is well choreographed but that might be the most appropriate word for the action sequence.