Battlefield Surgery

Doctors performed bloody operations in emergency battlefield conditions to try to save soldiers’ lives; missiles caused the deepest wounds and the most painful operations, as Celsus describes (On Medicine 7.5). Extracting arrows was excruciating if the point at the end of the shaft lodged in a bone. Given that arrowheads often had pointed barbs, pulling an arrow backward out of a wound tore muscle and blood vessels. Therefore, it could be less dangerous to push the arrow all the way through and out the other side. Surgeons used a Y-shaped metal instrument to spread the edges of the wound to make the push or pull easier. If the arrow had to be pulled out backward, then the surgeon could use an instrument called the “spoon of Diocles” after its inventor. This was a smooth metal piece with a small hole at the front end to snag the tip of the arrow and then pull it backward; the sides were turned inward to protect surrounding flesh as the arrow was extracted. If the arrow tip was stuck in a bone, then the doctor could place small reeds around the shaft to smooth its exit and drill holes in the bone around the impact point, to prevent splintering of the bone, which made healing especially difficult. How the patients withstood what must have been the agonizing pain and blood loss of these operations is hard to imagine. If they survived the operation, then infection became a dangerous hazard. It is remarkable that Alexander lived despite often being seriously wounded. Plutarch lists eleven separate injuries that he suffered from arrows, swords, clubs, and rocks (Moralia 327 A-B = On the Fortune of Alexander).