The historian Procopius relates some unusual combat injuries of the Gothic War, which took place from 535 to 554 A.D. as part of the emperor Justinian’s attempt to bring back the Italic peninsula and its environs back into the Roman fold. A few incidents stand out as worth of relation here. In our modern age of firearms and high-velocity projectile weapons, we forget that battlefield wounds from swords, javelins, and spears had their own bizarre qualities.
In the spring of 537, Justinian’s general Belisarius sent his commanders Martinus and Valerianus to a place called the Plain of Nero near Terracina, which is about 75 kilometers southwest of Rome. The Roman forces engaged the Gothic occupiers at close quarters:
But as they continued, they began at last to be filled with rage against each other. The battle then settled down to a fierce struggle in which many of the best men on both sides fell, and support came up for each of the two armies, from the city and the camps. When they mixed with the fighters the struggle became still greater. The shouting that filled the city and the camps terrified the combatants. But finally the Romans by their valor forced back the enemy and routed them.
In this action Koutilas [one of Belisarius’s men] was struck in the middle of the head by a javelin, but he kept on pursuing the enemy with the javelin still embedded in his head. After the rout was finished, he rode into the city about sunset with the other survivors, the javelin still in his head waving around, an extraordinary sight.
In the same encounter Arzes, one of Belisarius’s guardsmen, was hit by one of the Gothic archers between the nose and the right eye. The point of the arrow penetrated as far as the neck behind, but it did not show through, and the rest of the shaft projected from his face and shook as he rode. When the Romans saw him and Koutilas they marveled greatly that both men continued to ride, paying no heed to their wounds. Such, then, was the course of events there.[Wars VI.2. Trans. by A. Kaldellis]
But removing such projectiles from the body was never an easy matter. When foreign objects enter the body, the tissues can “close” around it, forming a seal; trying to remove the object is a matter of great surgical skill. If it is done in too much haste, the patient can experience massive blood loss and trauma.
What could be done about the wounds of these fighters. Procopius relates:
When all had returned to the city, they attended to the wounded men. In the case of Arzes, although the physicians wished to draw the weapon from his face, they were for some time reluctant to do so, not so much on account of the eye, which they supposed could not possibly be saved, but for fear that, by cutting the membranes and tissues that are very numerous in that region, they might cause the death of one of the best men of Belisarius’s household.
But afterward one of the physicians, Theoktistos by name, pressed on the back of his neck and asked whether he felt mush pain. When the man said that he did feel pain, he said, “Then you yourself will be saved and your sight will not be impaired.” He made this declaration because he inferred that the barb of the weapon had penetrated to a point not far below the skin. So he cut off the part of the shaft that showed outside and threw it away, and cutting open the skin at the back of the head, at the place where the man felt the most pain, he easily drew out the barb, which with its three sharp points now stuck out behind and brought with it the remaining part of the weapon. [Wars VI.2.25]
But things did not go as well for Koutilas, who had the javelin embedded in his head. The surgeon who was caring for him drew the weapon out of his head, perhaps unwisely; when this happened, Koutilas fainted. The membranes began to be inflamed, and he died of acute phrenitis soon afterward. Another hero, a soldier named Bochas, also died of his wounds that day. He had been hit in the breastplate with about ten enemy spears, but had stood firm. But a slashing sword wound to the thigh that severed his muscles there ultimately led to his death.
Another notable incident is recounted several pages later. This is something that Procopius, who was present with the army, must have witnessed at first hand. A soldier named Traianos was struck in the face with an arrow “above the right eye, not far from the nose.” The iron point penetrated inside his head and disappeared inside his skull. The barb was long, but not securely fastened to the arrow’s shaft; this made the shaft drop to the ground almost immediately.
Traianos, however, paid no heed to this at all, but continued killing and pursuing the enemy. But in the fifth year after this, the tip of the iron barb of its own accord began to project visibly from his face. This was now the third year since it has been slowly but steadily coming out. It is to be expected, then, that the whole barb will eventually come out, although not for a long time. But it has not been an impediment to the man in any way. [Wars VI.5]
We can now understand why the Greek physician Galen spent so much time writing about treating inflammations and fevers. It seems that a foreign object entering the body is sometimes not the direct cause of death.
Rather, death comes from the collateral effects of such wounds, in the form of infections, fevers, and inflammations. Galen says the following with regard to such inflammations:
Therefore, in the case of a seething inflammation, it must be cooled to a degree that is appropriate to eradicate it altogether or to prevent it from increasing. And because too much heat excites pain and also draws something to the affected part, what happens is that the inflammation is increased by both of these factors…Therefore, since the whole principle of the treatment of inflammations lies in evacuating the excess blood of the inflamed part, this evacuation is thought of in a twofold way: the transfer of blood contained in what is inflamed to other parts, and the evacuation of the body externally…[Method of Medicine XIII.6. Trans. by I. Johnston]
Even today, we see these sorts of wounds. I remember a client who was a police officer told me about a crime victim he once witnessed. The man had been stabbed in the head with a knife and was able to speak and walk about normally with a knife in his head. But when the doctors tried to remove it, his head tissues became inflamed, and he died.
So much, then, for these matters.