Engines of Our Ingenuity

No. 1170:
THE IATROS

by John H. Lienhard

Click here for audio of Episode 1170.

Today, we visit a 2400-year-old clinic. The University of Houston's College of Engineering presents this series about the machines that make our civilization run, and the people whose ingenuity created them.

In his treatise on ancient healing, Guido Majno includes a chapter titled Iatros. That's the old Greek word for physician. It leads to modern words like pediatrics, the medical treatment of children. Medieval medical alchemists called their practice, iatrochemistry -- the chemistry of healing.

Majno takes us to an iatreion, an ancient Greek clinic. It was only for outpatients because hospitals had yet to be invented. Reading old works, like Hippocrates and Xenephon, along with the archeological record, he pieces together what might've gone on during a typical day in 400 BC. Ten patients come to his iatreion. Each is treated according to the practice of the day.

First, a carpenter with a slashed foot gushing blood: The doctor (the iatros) wraps the edges of the wound with a cold wet bandage. He wraps the man's head in a hot towel. That draws blood from the wound toward the head. When it keeps bleeding, he applies a tourniquet. The few Hippocratic doctors who used tourniquets knew the wrong rhythm of tightening and release could lead to gangrene. But tourniquets were tricky and they fell out of use. They didn't re-emerge as part of regular emergency procedure until the 1500s.

The next patient is a woman with a round ulcer on her ankle. The doctor widens the ulcer -- cuts it into a square shape. That's because wounds pull inward as they heal. A square wound first goes to a four-cornered star shape, then to an X shape. A circle has no corners from which to work inward. The iatros didn't have sutures. He had to help nature draw the wound closed.

An athlete shows up with a dislocated shoulder. The iatros lays him on the floor and puts a leather ball in his armpit. Then, lying on the floor, the iatros tugs on the arm while he holds the ball in place with his heel. That treatment is still done.

But not everything makes sense. When the iatros treated the carpenter with the cut foot, he also bled him. Still, that was no more senseless than procedures I've seen used, and then dropped, in my own lifetime. Some procedures are folly we've yet to recognize.

The last patient is a slave from Scythia. He strips off his shirt to reveal infected wounds from a recent whipping. The iatros cleans the back, cools the infection with a celery plaster, and applies a zinc ointment -- like ointments you might buy at the drugstore. Of course, healing will largely be done by the slave's own natural processes. But so too is most of our own healing.

Suppose you were taken back in time 2400 years to ancient Greece, and you were hurt while you were there. You could do worse than the local iatros. But then, as now, you'd be foolish if you didn't question all that was being done to you. That brings us to another word derived from the old Greek root. The word iatrogenics refers to a medical problem that is caused by medical treatments.

I'm John Lienhard at the University of Houston, where we're interested in the way inventive minds work.

(Theme music)


Majno, G., The Healing Hand: Man and Wound in the Ancient World. Cambridge, MA: Harvard University Press, 1975, Chapter 4, The Iatros.


The Engines of Our Ingenuity is Copyright © 1988-1997 by John H. Lienhard.

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