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Updated 27 October 2015

A brief history of haemorrhoids

CyberShrink discusses how the affliction of ‘piles’ may have changed the course of history.

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In 2012 the top health topic searched for on Google was "haemorrhoids". Haemorrhoids are a very common and often painful affliction, but many people are so embarrassed by this problem that they would rather consult Google than discuss the problem with their doctor.  

A recent article on Health24 on the topic reminded me of other aspects of this topic. So, if you’re sitting comfortably (or not), here we go.

'Sieg Heils'

Haemorrhoids is one of the most embarrassing medical topics, which is strange, since previously taboo subjects like sexual matters are nowadays dealt with as a matter of course. Also curious is the fact that there are only a few euphemisms for haemorrhoids. One of them is “piles”, which is derived from the Medieval Latin word “pila”, meaning ball. (This is presumably also where the word “pill” comes from.) 

Read: Piles

Cockney rhyming slang, though, has been eloquent with terms for piles. Many date from World War II, like “Sieg Heils”, “Nuremberg Trials” and a number of others.

Though the Kardashian industry pumps out every possible boring detail about these inherently uninteresting people, their haemorrhoidal status is one detail I don’t think they’ve ever revealed or discussed.

Haemorrhoids have been around at least since man started walking upright, and has attracted an odd range of treatments, some highly unappealing.

The topic is discussed in an Egyptian papyrus dating back to 1700 BC, which recommends “an ointment of great protection”, consisting of ground acacia leaves, cooked, smeared on fine linen, and then placed on the appropriate area. The concoction promised “immediate” recovery. 

The Hippocratic teachings of 460 BC were surprisingly similar to the modern method of ligating piles with rubber bands “by transfixing them with a needle and tying them with very thick and woollen thread until they drop off”. Hippocrates suggested alternatives, including suppositories of goose grease, alum, and urine. Others were somewhat less gentle, including simply ripping off the polyps by hand, which Hippocrates said was “as easy as skinning a sheep”.  It was apparently best to do it without warning, while keeping the patient in conversation.

Read: Prednisolone and cinchocaine

Alternatively, one could use red-hot irons to burn them off, which had the added advantage of cauterizing the site to prevent bleeding. One should hold the patient’s head and hands, but encourage them to cry out – not that any encouragement would be needed! A dressing of boiled lentils was recommended.

Haemorrhoids are mentioned in the Bible, often with the old spelling “emerods”. Throughout history there is regular mention of surgical treatments and the problem of keeping the wounds clean.  In the Middle Ages they were called “Saint Fiacre’s curse”,  after a 6th century saint who developed them after working hard tilling the soil, becoming the patron saint of piles (and gardeners). The word “haemorrhoid” has been around since about 1400, derived from a Greek word for “liable to bleed”.

The 'mysterious plague of emerods'

There’s a Bible story in 1 Samuel about how the Philistines, who had been disrespectfully messing with the Ark of the Covenant, were punished by being smote with “emerods”.  Although the meaning seems clear, it is debated by Biblical scholars and translators regarding the precise meaning.

Some talk more vaguely of “tumours”, but in the words of the King James Bible (1 Samuel 5:9): “The hand of the Lord was against the city with a very great destruction: and he smote the men of the city, both small and great, and they had emerods in their secret parts.” A more modern version is more explicit, and “they broke out with haemorrhoids”.  This followed a plague of mice which had not been severe enough to cause despair.

Read: Pramoxine, bismuth subgallate, bismuth oxide, bismuth subiodide, resorcinol, Balcem Peru, benzoyl benzoate, zinc oxide & boric acid

Lacking modern ointments (and imagine the sand!) the despondent Philistines asked their priests how to end this affliction, and are told to give the Ark back to the Israelites, but to include a specific treasure: five golden mice, and five golden images of haemorrhoids: the Five Golden “emerods” of legend.  So they placed the Ark on a cart, along with the golden mice and haemorrhoids.    

In Deuteronomy Moses warned of the penalties and “smitings” that would befall those who ignored their God, including emerods, along with the “scab”, the itch “whereof thou canst not be healed”,  as well as “the botch of Egypt” (either peculiarly nasty boils, or possibly elephantiasis ).

Piles in history

Haemorrhoids have played more of a part in history that you might think. King Alfred the Great of Wessex (849 – 899) prayed to God to cause him to have a disease that would suppress lust, but allow him to continue to rule well, and soon after developed haemorrhoids. We need more politicians and rulers to follow his fine example.

The French Emperor Napoleon Bonaparte suffered badly from piles, and on the very day of the Battle of Waterloo, was badly distracted by pain from thrombosed piles, a factor that may have played a part in his defeat most historians ignore. Some say he was in so much pain he couldn’t even sit on his horse.  

Read: Haemorrhoids - graphic

The great African explorer David Livingstone suffered chronically from piles. At that time therapeutic bleeding was a popular, if misguided, practice, and he believed that the loss of blood from his bleeding piles actually helped him to recover his health from periods of exhaustion in the bush. He had previously refused to accept an operation, having known someone who had died after such an operation. Some have written that he died of bleeding piles, which seems unlikely, although, with chronic anaemia and malaria and disturbed blood clotting, it is conceivable.  The evidence, such as it is, points to the rupture of an enlarged spleen. 

Several American presidents suffered from piles, including Gerald Ford, Franklin Roosevelt and Jimmy Carter. Ditto for Ernest Hemingway, Marilyn Monroe and Elizabeth Taylor. Gorillas can also suffer from piles, and drummers in rock bands are said to be especially prone to this affliction.

A proletarian disease?

Someone whose highly influential but gloomy and angry political views were probably strongly influenced by his piles  is Karl Marx.  He suffered severely from piles and boils, and eventually had to read and write while standing up.  He once wrote to his pal Engels: “I hope the bourgeoisie will remember my carbuncles until their dying day.” He said he found consolation in suffering from such a proletarian disease. Combined with his boils, his piles are believed to have caused low self-esteem and a sense of alienation.

When in 1851 he met a police spy pretending to be a doctor, he promptly asked for medicines to reduce the pain of his haemorrhoids, explaining that this tortured him when he sat down.  He received drugs like opium and morphine from various sources (easily available in those days), and drank heavily. Nowadays he would be considered to be addicted to the opiates, as was his wife; and it is reported than an infant child of theirs died from opium poisoning from breast milk. He was desperate enough to try strange remedies such as wearing sticking plasters with finely ground beetles (Spanish Fly). This caused severe skin irritation, onto which he would then rub opium.  

Nowadays there are still countless people who suffer from haemorrhoids, but modern medicine and effective surgical procedures have made the affliction somewhat less of a burden. One can nevertheless not help but wonder if a number of modern political decisions weren’t made by politicians whose judgement was clouded by haemorrhoids.  

Read more:

Haemorrhoids   

How a doctor would diagnose and treat piles

How Anusol can relieve the pain of piles

Professor MA Simpson is Health24's CyberShrink. A South African psychiatrist, he qualified in medicine and in psychiatry in Britain. He has been a senior academic, researcher, and Professor in several countries. Read more of his columns.

 

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