One instance is referred to in history, in which an Egyptian king, when thrown from his horse in battle, wounded and speechless from injury of the head, had his skull trepanned by his surgeons. I allude to Ptolemy Philometor, who defeated Alexander Balas, the pretender to the throne of Syria, in the year B.C. 146. According to Livy, the victor himself died after the battle during the attempts of his surgeons to relieve him. “Ptolemaeus, in caput graviter vulneratus, inter curationem, dum ossa medici terebrare contendunt, exspiravit.”—(Epit. lib. lii.)
Nor is the old classical literature of Greece without reference to surgical services tendered to the soldier in war. Homer describes the double character of army surgeons and warriors as combined in the persons of Podalirius and Machaon.[378] And when the latter is wounded, he puts into the mouth of Idomeneus the well-known expression (Iliad, lib. xi. v. 514), that the medical man is to the army more valuable than many warriors; knowing as he does how to excise arrows, and to apply soothing medications:—
Ιητρος γαρ ανηρ πολλῶν ἀνταξιος ἀλλων,
Ιους τ' ἐκταμνειν, επι τ' ηπια φαρμακα πασσειν.
In the course of the Iliad, the surgical treatment followed in individual cases among the disabled Greek warriors is sometimes minutely entered upon; and thus the different modes of operation by which the transfixing arrow, dart, and lance, were, in those early days of surgical science, removed from the bodies of the wounded, may be sometimes gathered from Homer’s lucid and minute descriptions. He mentions three different methods, at least, by which war-weapons were extracted—viz., first, by evulsion, or traction of the weapon backwards, as in the case of Menelaus (Iliad, lib. iv. 214); secondly, by protrusion, or pushing of the instrument forward, as in the case of Diomede (v. 112); and, thirdly, by enlarging the wound, and cutting out the weapon, as was the practice of Patroclus in the case of Eurypylus (xi. 843). I am not aware that Homer ever individualises any internal medical treatment except once (xi. 638), when he mentions a mixture of Pramnian wine, cheese, and flour, as having been administered by the nursing hand of Hecamede to the wounded Machaon,[379] ere she prepared the warm bath for him and washed away the clotted blood (xiv. 7).
The author of the ancient Greek treatise Περὶ, an essay usually included in the works of Hippocrates, explicitly advises the young physician to attach himself for a time to some army, in order to learn the best methods of extracting war-weapons, and to acquire practical skill in the treatment of accidents.[380]
Xenophon alludes in various parts of his works to physicians or surgeons connected with the Greek armies. In describing the laws of the Lacedemonians, as instituted in the earliest ages of Greek history by Lycurgus, he incidentally mentions that physicians were attached to the Spartan army. For in the arrangements previously laid down for the troops before a battle, it was ordered that there should be placed behind the station occupied by the King several officials, and among others, the soothsayers or priests, the physicians, the minstrels, the leaders of the army, and any persons who were voluntarily present in the expedition (καὶ μάντεις, καὶ ἰατροὶ, καὶ αὐληταὶ, οἱ τοῦ στρατοῦ ἄρχοντες, καὶ ἐθελούσιοι ἠν τινες πατρῶσιν).
Again, in his celebrated account of the retreat of the ten thousand Greeks, Xenophon states that at the conclusion of the fifth day of their march, and after considerable skirmishing with the troops of Tissaphernes, “they appointed eight physicians, for there were many persons wounded.”[381]—(Anabasis, lib. iii. c. 4, § 30.)
Lastly, in his semi-historical or political romance—the Cyropædia (lib. i. 6, § 15), Xenophon makes his young royal hero, Cyrus, the founder of the Persian monarchy, speak, among other matters, of the importance of medical officers being attached to armies. “With respect to health” (says Cyrus), “having heard and observed that cities that wish health choose physicians, and that commanders, for the sake of their soldiers, take physicians; so, when I was placed in this command, I immediately attended to this point; and I believe that I have men with me that are very skilful in the art of physic.” In the same work Xenophon subsequently describes Cyrus as commending to the professional services and care of his medical officers the Chaldeans who had been wounded and captured in fight with him.—(Instit. Cyri, lib. iii. c. 2, § 12.)