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.
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.)
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
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
Read: Prednisolone and cinchocaine
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.
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
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
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.
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.