Few individual instances are recorded in Greek history of surgical aid being afforded on the field of battle. One of the most interesting examples is that mentioned by Quintus Curtius in reference to Alexander the Great at the taking of the capital of the Oxydraceæ, or Mallians. The Macedonian King, who had leaped down, almost alone, within the walls of the fortress, was struck with a long arrow (duorum cubitorum sagitta), which entered the right side of the thorax (per thoracem paulum super latus dextrum infigeretur). The wound produced great hæmorrhage and faintness. Alexander was carried on his shield to his tent; and the shaft of the arrow being cut off and his cuirass removed, it was discovered that the head of the arrow was barbed, and could not, consequently, be removed without the artificial dilatation of the wound and imminent danger from increased bleeding; for the large weapon was fixed in its situation, and seemed to have penetrated into the internal viscera (quippe ingens telum adactum erat, et penetrasse in viscera videbatur). At Alexander’s request, the surgeon Critobulus undertook the extraction, enlarged the wound, and removed the arrow-head, which, according to Plutarch, was “three fingers broad and four long.” Great hæmorrhage (ingens vis sanguinis) attended the operation; death-like insensibility supervened; and, when the flow of blood continued in despite of the medicaments (medicamenta) applied, a cry and wail was set up by those around, that the king was dead. At last, however, the hæmorrhage stopped, under the state of syncope. That very syncope, observes Arrian, saved his life; and Alexander gradually recovered. But every modern surgeon must admire the boldness, not less than the expertness, of Critobulus, when he reflects for a moment on the fearful peril attendant on such an operation, performed on so august a patient —and at a time, too, when surgical science as yet possessed no certain means of restraining surgical hæmorrhage.[382]
In the earlier periods of Roman history and Roman warfare, the treatment of the military sick and wounded was, in all probability, trusted to the casual care of some fellow-soldiers whose tastes and inclinations had led them to pay more than usual care to the rude surgery which existed at the time.[383] As early, however, as the commencement of the Christian era, we find Celsus laying down distinct, and in many instances very excellent and practical precepts for the extraction of war-weapons from the bodies of the wounded[384]—as of arrows, spears, leaden bullets (glandes plumbeæ), etc.
Occasionally the weapons used in ancient war seem to have been forged for the special purpose of rendering their extraction by the surgeon a matter of difficulty and danger. At least we find Paulus Ægineta complaining that some of them have “their barbs diverging in opposite directions, like the forked lightning, in order that, whether pulled or pushed, they may fasten in the parts.”[385]
Still, let me repeat, neither in Celsus nor in Paulus Ægineta, nor, indeed, in any other ancient medical work, have we, as far as I know, any allusion to the circumstance of surgeons or physicians being regularly appointed as army medical officers in the Roman army, for the purpose of superintending the treatment of the wounded, or—what is of still greater importance—in order to take professional care of the soldiers disabled by sickness and disease, and whose number in warfare is generally very much greater than the number of those that are disabled in fight.
Modern military experience has, in many instances, proved the high importance of the services and superintendence of a medical military staff; and not so much in reference to the care of individual cases, and the cure of the wounded, as in reference to the general health and consequent general strength and success of whole armies. In fact, in war the devastations produced by sickness and disease have often been found greatly more formidable and fatal than any devastations produced by the sword; fevers, dysenteries, and other distempers of the camp, have carried off far more soldiers than the ball or bayonet; malarious and morbific agency has sometimes terminated a campaign as effectually as the highest military strategy; and armies have occasionally, in later times, been as completely destroyed by the indirect ravages of disease as by the direct effects of battle.
Nor was the experience of the Roman armies in this respect different from our own. When the Emperor Septimius Severus determined to subdue the whole of Scotland, he about the year 208 led, according to Herodian and Dion Cassius,[386] an army of not less than 80,000 men across the Forth, marched them north, apparently as far as the Moray Firth, and thence returned to York. But though in this course the Roman Emperor nowhere met the enemy in open fight, he is stated to have lost, in this single campaign, not less than 50,000 of his troops. The marshes, fens, woods, etc., of Caledonia were far more destructive to the Roman invaders, than were the spears, long swords (ingentes gladii) and scythed chariots (corvini) of its painted, and almost naked, warriors.[387]
We know, from the oft-repeated anecdote regarding Arcagathus, as told by Pliny, that in the early days of republican Rome the practice of medicine was not encouraged among the inhabitants of the Eternal City. But, in the later periods of the empire, Rome abounded with native and foreign physicians; and, when we find the Roman people exalted in so many branches of art and knowledge, we could not but expect that common experience, and results like that of Severus, would have suggested to them the propriety of increasing the strength and success of their armies, by having medical men to watch over the health of the soldiers that were fighting in so many different regions around the Roman standards.
Some modern discoveries in Great Britain and elsewhere show that such a conjecture is not at variance with truth, and that the Roman armies were provided, at all events in the time of the Empire, with a medical staff.
Housesteads, in Northumberland (the ancient Borcovicus), formed one of the principal stations on the great defensive wall which the Emperor Hadrian reared, in the second century, from the Tyne to the Solway. Many Roman remains have been found at Housesteads.[388] Thirty years ago the embellished monumental tablet, represented in the accompanying plate, Fig. 1, was discovered among these remains. This tablet was, according to the inscription upon it, raised by the first Tungrian cohort to the memory of their MEDICUS ORDINARIUS.[389] The plate represents this interesting relic, which is preserved in the Newcastle Museum. The inscription upon the tablet reads as follows, in its contracted and in its extended forms:—