What was the ancient understanding of battle-wound infections?

Long before the discovery of germs, the ancients probably noticed that after a battle in which a lot of people had suffered wounds, those wounds would often lead to infection and sickness, possibly death.

What connection, if any, did they draw between the wounds, and illness? Was there a concept of “battle fever” or “battle illness?”

I’m sure they could see the results of infection, even if they didn’t know the cause.

Infected wounds are easy to spot, and the pain, fever, swelling, and pus are pretty obvious.

I’m sure people were well aware that breaking the skin meant a strong risk of infection - war wound or plain scrape. The bigger, deeper the wound, the bigger the infection. Wounds in some areas (i.e. intestines) would be seen as riskier than others. In a world chronically short of running water and soap, there was probably not a lot more to observe about this except that contact with stinky and gross stuff was far more risky than not contacting it.

FOr sicknesses, there was already a fairly common theory of “bad air”.

Right, but before the concept of bacteria/germs, what did they think was going on?

I guess earlier attempts of explanation would have involved humoral imbalance, planetary influences, sorcery, or some combination of those. Semmelweis famously proposed “cadaverous poisoning” as the cause of the closely related childbed fever (he was on the right track; but was largely ridiculed or ignored, precisely because he couldn’t provide a credible mechanism).

I would imagine most people didn’t think anything more fundamental than simple cause and effect was going on. If you stub your toe, it hurts. That’s all there is to it. If you cut your skin, it bleeds, and then the wound turns red and painful. That’s just the way things work. Looking for an underlying mechanism is a type of thinking that most people just didn’t engage in.

Even though many people did try to theorize about the cause of disease and infections, we simply lacked the ability to verify anything until the development of technology which could directly observe the cause. The idea of germs had existed for a long time before it was actually proven. In fact, the idea was viewed with a deep suspicion by the scientific and medical establishment, and for good (scientific) reasons. It was a theory that asked a lot of questions but couldn’t provide answers.

To give an extreme example of how wrong medicine was, consider that during the (American) Civil War, many if not most doctors believed that infection was actually a sign of healing - which isn’t totally wrong, either. Unfortunately, doctors couldn’t have done too much about in any case.

As far as it goes, over the centuries various armies did come up with half-decent treatments for battlefield injury, including good but basic ways to prevent infection. Note that many of the treatments we have today would have actually been pretty risky. Just try finding a clean source of water in the dust and mud after a battle.

The idea of bacteria/germs preceded the idea of bacterial infection.

Bacteria were observed when good microscopes were developed. It wasn’t clear where they came from, or what they were doing. Prior to the acceptence of the “Germ Theory” of infection, the alternative theory of ‘spontaneous generation’ was widely believed.

In the ‘spontaneous generation’ theory, Bacteria were the result of infection, not the cause. Wound infection and decay was a result of Humoral inbalance, bad air (miasma), or even as a result of exposure to the weapon itself (a kind of “Zymotic disease” theory of wounding that you will notice in reading “Lord of the Rings”).

Why would they have associated this with battles, particularly? They would have observed exactly the same thing with wounds resulting from, e.g. agricultural accidents.

The Edwin Smith Papyrus which is from nearly 5000 years ago describes injuries and treatments for various injuries.

The Ancient Egyptians were pretty good at treating wounds.

They knew that dirt caused infection or at least led to it. The problem is that until germ theory of disease was developed, it was not totally clear scientifically that infection was necessarily due to dirt, lots of times “clean” envirmoments also caused infection.

To take an example, look at the 1854 Broad Street Cholera Outbreak. John Snow (not that one) from taking patient histories concluded that everyone who fell ill had taken water from one pump. The authorities humoured him and closed said pump and the rates of infection dropped.

The problem? Dr Snow had no reason except anecdotal as to why the pump’s water caused the outbreak. The tests that were done on the water showed it to be clean. And this was smack in the middle of the Industrial Revolution, not the StoneAge. The problem was that the Germ theory of disease was not known at the time and they simply had no way of knowing why the water which appeared to be clean was causing illness.

ETA:UDS battles would consistently provide a fresh source of wounded men to observe, as opposed to the occasional accident.

One thing I read was that the arrival of gunpowder weapons greatly increased the types, complexity and infectionability of wounds. While stab and slash wounds are not exactly good for you, at least Doctors knew how to treat them. With gunpowder weapons… yeah all bets are off.

What makes you think ancients didn’t have soap?

Of course they had soap. Just not a lot of it, and not a lot of public restrooms supplied with free soap, nor running water… personal hygiene was not the greatest in a world where every bucket of water had to be hauled from a well nearby (well, we hope it was not too far) Soap had to be made with fat and ashes, usually, meaning someone had to go out and collect wood; then boil down the concoction… We’ve forgotten how much industrial production and automation has saved us from drudgery. For less than half an hour’s wages I can buy over a dozen bars of soap at Costco; whereas the equivalent in the middle ages involved some very expensive inputs and a day of hard work.

I recall a quite from some late medieval noble who mentioned that the Romans had built extensive baths and sewage systems whenever they built a town, since they were concerned about the diseases caused by “bad air” that came from poor sanitation. He goes on to say “but we know now they were mistaken.”

The Arabs invented soap in the first or second century.

Sure, but battle was on a wider scale. “We just had 20,000 men wounded - and it looks like, several weeks later, fully half of them have succumbed to some mystery post-wound syndrome.”

They would have had to notice that something was killing the men that could not be accounted for by way of explanation of immediate injury - i.e., the men weren’t bleeding to death, and the infection death took place a comparatively long time after the wound was inflicted.

The meaning of “contagious” has changed. It used to mean that you got sick by some unknown kind of association: like associating with contagious people, or plants, or air, or geography, or battlefields, or engaging in contagious activities, like fighting, or agriculture.

I personally can’t easily tell the difference between a yeast/fungal/bacterial/viral infection, though I believe that a difference exists. In older theories of disease, they sometimes made a distinction between battlefield disease and agricultural disease, even though the symptoms seemed similar, the theory indeicated that there must be a difference.


OK, what exactly are you defining as “ancient”
here? Because publicbath-houses with running water are *exactly *what many of them did have. Granted, for cultural reasons the Romans and Greeks used oil+*strigil *rather than soap, but they *had *soap - just used it as hair pomade, and to clean wool.

No, it can be made with vegetable oil, too.

…because Lord knows, they weren’t burning wood for other purposes that generated masses of ashes as a byproduct…

We’ve also forgotten that mass production is not a modern invention. Ancients did it too, for some products (I’m not saying soap was definitely one of those) - amphorae, fish sauce, fibulae, armour - the Romans were very good at mass production, in fact.

No, they didn’t. The oldest recipe for a soap is from 2200 BC Babylon.

Infected wounds are pretty easy to see. One of the things people learned quite early was how to amputate, to do it when limbs got to look and smell a certain way, and that if you got the same in the torso you were SOL. They also knew that limb wounds were generally less likely to go bad than the dreaded abdominal wounds.

Someone once asked me how come Spain doesn’t have much of an archery tradition. My answer (which was only half a joke) was “because our most famous archer is the Moor who killed El Cid, and he wasn’t even aiming”. Abdominal wound.

Babylonians had soap. Gauls too. It wasn’t invented by the Arabs.

Some cultures stressed hygiene. The Romans had public baths, public fountains, running water wherever they could. The Jews in ancient Israel were obsessed with ritual cleansing. Mohammed made several-times-daily cleaning a part of the religion.

Other cultures… not so much.

Doctors knew about techniques to prevent infection in wounds, even if they didn’t know why they worked.

In 1403 the Prince of Wales, the future King Henry V, was struck in the face by an arrow at the Battle of Shrewsbury. The arrow struck his cheekbone, on the left side of his nose. It penetrated about 6 inches deep, and the point lodged in the bone at base of his skull.

Being royalty, he got the best available treatment. The physician and surgeon John Bradmore was sent for from London, and took charge of dealing with wound. Bradmore later wrote a detailed account of his successful treatment.

The techniques he used for preventing infection included:

[li]Honey: raw honey has excellent anti-bacterial qualities and has been used in wounds for thousands of years. [/li][li]Alcohol: once the arrowhead had been extracted (a whole story in itself), he used a syringe filled with a dilute solution of white wine to wash out the wound. This would have washed out any foreign particles remaining, and the alcohol would have sterilized it. [/li][li]He packed the wound with the medieval equivalent of cotton wool, steeped in an ointment of which the active ingredient was a small quantity of oil of turpentine. This would also have had strong anti-bacterial qualities.[/li][/ul]
Henry recovered fully, and years later went on to become king, and win the battle of Agincourt, etc.