GLADIATORIAL MEDICINE

Treating Traumatic Wounds


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Gladiators represented a significant financial investment for their owners, so their medical care was a priority and often entrusted to a team of experienced physicians. Galen describes the arrangement in Pergamon:

“[The high priest] entrusted me with the treatment of all the wounded men who had fought duels in combats. Before my time, two or three of the Elder [physicians] were in charge.”

His monkey vivisection impressed the high priest, but Galen notes that his pharmacological innovations for treating wounds also attracted attention. He alone cared for Pergamon’s gladiators from 158 to 161 CE, and he boasted of excellent outcomes.

Rectangular gray slab with a bas relief of a man wearing a loincloth, arms extended on either side. A small dog and a large frond appear on the left. A Greek inscription has been carved below.

Gladiator relief. 2nd–3rd century CE. Stone. S 1/93, fig garden site, Ephesus, Turkey. Photo: OeAW-OeAI.

In aiming to put on a good show—keeping the threat of death ever present—gladiators frequently sustained serious traumatic wounds. Gashes to the front of the thigh were common, according to Galen, and gladiators were often hit on their hands and feet as well.

A thick, belt-like coil that seems to be made from a greenish-brown metal.

Thigh tourniquet. Roman, 199 BCE–500 CE. Bronze. Science Museum, London: Hamonic Collection, A63014. Photo: © The Board of Trustees of the Science Museum.

Galen treated wounds to the extremities with a self-devised remedy of oil with wine-soaked linen and damp sponges to keep the opening moist. The treatment predates germ theory, and he attributes its effectiveness to preventing the wounds from drying out, yet it is plausible that the ethanol and acidity of the wine had a protective, antimicrobial effect. For deeper lacerations across the thigh (gashes severing muscles), Galen sutured deep muscle layers together and even stripped tendons (likely removing the epitenon, the outer covering of a tendon) before stitching them together as well. For severed arteries and veins, Galen ligated (tied off) injured vessels to staunch the bleeding. And when he operated on the abdominal wounds of nearly disemboweled gladiators, Galen recommended full-thickness sutures rather than sewing in layers as he likely did with thigh wounds; doctors would approach suturing these kinds of injuries in a similar way today. He was critical of physicians who used plasters of wheat flour, oil, and water, or those who only sutured the upper layers of muscle or skin despite the presence of a deep, traverse gash. While many gladiators had died in previous years, Galen claims that he saved all the warriors in his care during his two years on the job.

Two figures take a fighting stance, while a third looks on. Hovering above are two colorful circles with target patterns in yellow, red, blue, white, and black. Isolated words appear in the background.

Mosaic detail depicting gladiatorial injury. Roman, 3rd century CE. Marble and limestone. Museo Arqueológico Nacional, Madrid: 3601. Photo: Adam Eastland / Alamy Stock Photo.

Yet this statement is contradicted by his numbers in other texts, where he notes that his team suffered two fatalities in his first year, but none in subsequent seasons. Whatever the actual numbers, there is little reason to doubt Galen’s accomplishment in the role: the fact that subsequent high priests continued his appointment for several years reveals that his skill was honored, likely because he saved more men than previous doctors.

However, there is no doubt that Galen witnessed fatalities. The impression of ever present death occurs when death is more likely to be possible. While wounds to the legs were frequently treatable, damage to the heart or head was often fatal. Galen’s own writings about traumatic wounds offer clues. He describes scenarios involving injuries to the heart: a perforated ventricle results in almost immediate exsanguination, while wounds to the cardiac muscle will lead to death later in the day or perhaps the following night. Archaeological evidence reveals the extent of the brutality of these games to us today.

A rectangular stone slab with two figures in bas relief. The figures, dressed in armor and helmets, are engaged in close combat. An inscription runs across a ledge at the top, while the bottom left corner is missing.

Relief showing combat between two gladiators. Roman, 3rd century CE. Marble, Ephesus, Turkey. Pergamon Museum. Photo: The Print Collector / Alamy Stock Photo.

Skeletons of gladiators from the cemetery of Ephesus show a range of traumatic head injuries frequently related to the types of armor and weapons.

A human skeleton lies horizontally among large blocks of grayish-tan stone. A red-and-white striped stick has been placed just above the skeleton; a chalkboard with writing rests on the ground below.

Gladiator grave. Unearthed in 1993. Ephesus, Turkey. Photo: OeAW-OeAI.

Scientists have found evidence of cranial wounds that may have healed, some that had likely been treated by physicians, and others that were deadly: strikes from combat, blows from the gladiator’s own helmet, punctures from swords and tridents, and lethal hammer hits.

Partial human skull with large holes in the cranium.

Top of a gladiator’s skull with injuries. 2nd–3rd century CE. Ephesus, Turkey. Photo: OeAW-OeAI.