St. Fiacre? Patron Saint of Hemorrhoid Suffers
More than 10 million people in the United States suffer from hemorrhoids. Three out of four people in Minnesota will develop hemorrhoids at some time in their lives. In fact, the disease is so common that hemorrhoid sufferers have their own patron Saint, St. Fiacre.
Patron Saint of Hemorrhoid Sufferers
During the middle ages, an integral part of the therapy for certain ailments included prayer to “patron” saints for possible divine intervention. Through legends surrounding his life, St. Fiacre, a 7th century Irish monk, became the patron saint for hemorrhoid sufferers (and gardeners). During medieval times, hemorrhoids were known as St. Fiacre’s curse. St. Fiacre is also known as the patron saint of gardeners because he could farm all the land and manage to cultivate in a single day. As the legend goes, the saint was given a rather small shovel by his bishop and spent very long days spading his garden and developed a severe case of prolapsed hemorrhoids. Seeking a solution, he sat on a stone and prayed for help. The legend states he enjoyed a miraculous cure from the stone.
Did Bad Hemorrhoids Cause Napoleon to Lose at Waterloo?
A theory that has persisted is that Napoleon was suffering from a bad case of hemorrhoids at the time of the battle, and this delayed his opening assault on the morning of June 18, 1815. In fact, the theory is so popular that one author and historian wrote a book titled Napoleon’s Hemorrhoids: And Other Small Events That Changed History.
It was believed that, on last day of the battle of Waterloo he was unable to mount his horse, and his doctors accidentally overdosed him with laudanum. Researchers believe that it’s possible that’s what caused the fatal delay starting the battle, if Napoleon had begun the battle earlier, the Duke of Wellington would not have been able to join forces with Blucher and the battle most likely would have been lost.
Is this what really happened? Andrew Roberts, author of Napoleon & Wellington, says no (as does Waterloo expert Alisdair White).
Roberts said that Napoleon was indeed suffering from the affliction, which “had prolapsed and were strangulated outside the anus,” causing him great pain. (This information came from the emperor’s brother, Jerome, one of only three people aware of Napoleon’s condition; Jerome shared the story in 1860, shortly before his own death.)
Inflamed piles, however, cannot reasonably explain Napoleon’s failure to attack Wellington that morning. Roberts points out that Bonaparte was dressed and in saddle by 8 a.m. that morning.
He concludes that bad hemorrhoids and other medical conditions known to afflict Napoleon–cystitis, exhaustion, and constipation–are explanations employed by Napoleon apologists largely as a device to sustain the Corsican’s myth of invulnerability.
Hemorrhoid Treatment on the Road
I have an interesting story that happened while I visited China many years ago. I was invited to give a lecture on office procedures as a guest professor in Zhejiang University, China. After the academic exchange, I had a few days to myself, so I went to visit an old friend of mine (let’s call him Dave). We decided to go visit a new resort town a few hours away from the city. As we were talking in the hotel, he was looking a bit shifty on the couch, as if he was very uncomfortable. After spending an unbelievable amount of time in the bathroom, I asked him if he was having a problem, and he said he had a lot of pain going to the bathroom because of his hemorrhoids. Thankfully, this being an area of my specialty, I was able to diagnose him with having a thrombosed hemorrhoid that needed immediate treatment. I told him that a thrombosed external hemorrhoid is the common complication of hemorrhoids. If the blood clots, the hemorrhoid develops localized bulging and becomes extremely painful, especially when going to the bathroom.
Dave said he would go to the hospital, but he hesitated to go because of inconvenient medical care in China. He didn’t trust the doctors in the local small hospital, and he was indecisive in choosing a larger hospital. I told him that I had fixed countless thrombosed hemorrhoids, and that if I had the tools I needed, I could fix it for him in a flash. I went to a local hospital in the town and identified myself, the medical staff believed that I was a general surgeon at Shanghai Medical University twenty years ago and that currently I practice in the US. I asked if I could get the necessary gear to do the procedure. Amazingly, the staff in the local hospital were very helpful and generous, and I managed to return with latex gloves, a scalpel, syringes, a pack of gauze, and a bottle of Lidocaine. I got him down on the bed and we did the procedure right there in the hotel.
The procedure took only a few minutes. I gave 0.5 cc Lidociaine to numb the top of the thrombosed hemorrhoid, then sliced open the hemorrhoid with a scalpel and removed the clotted blood with a cotton-tipped applicator. Once the clot was gone, I cleaned up the area by packing large amounts of gauze. The relief was immediate and other than a little bleeding for a day or so, the problem was gone. I told Dave if he had the chance to visit Minneapolis, I can do IRC treatments to treat the root cause of problem – internal hemorrhoids.
The Treatment of Hemorrhoids in the Ancient and Modern Times
Hemorrhoids, a condition that involves swelling of veins in the rectum, has been a nuisance since the dawn of man. Accounts of hemorrhoids date back to the earliest of civilizations, including the Egyptians, the Greeks, the Romans.
Ancient Egyptian documents direct caregivers to apply an ointment made from ground acacia tree for an unnamed, but painful perianal disease that is most likely hemorrhoids. The word haemorrhoid has Greek roots haema (blood), and rhoos, coined by Hippocrates in 460 BC. Hippocrates provides some of the earliest recorded methods of surgical procedures. Hippocrates describes a ligation procedure which involved tying thick woolen thread around the hemorrhoid to cut off the blood supply. Later writings also describe excision of hemorrhoids. Romans, too, had a fairly good concept of hemorrhoids, and books describe their own ligation and excision techniques. The same is true in Arab and Indian societies.
During the Middle Ages, these procedures were often performed by literal barbers. At the time it was common for barbers to perform surgical procedures; physicians often thought themselves to be above performing surgery. Barbers often had various tools essential to their trade that doubled as makeshift surgical equipment. For a 350 year period surgery was largely done by the same person that cut your hair! Science and surgery met once again in the during the renaissance, where documents indicated the usage of ligation using needle and thread followed by excision.
Indeed, ligation was the preferred way of operating on hemorrhoids. It was simple to do, and required readily available material. Even today, ligation is an incredibly common procedures, offered by many clinics, including One Stop. Rubber band ligation, the modern version of the procedure, is not too different from ancient ones. The procedure involves inserting an anoscope into the anus, grasping the hemorrhoid, then attaching a rubber band tightly around the base of the hemorrhoid The hemorrhoid shrivels up an falls off in about a week.
Now a days, ligation is just one of multiple options, and is chosen depending on how advanced the hemorrhoids are. Infrared Coagulation Therapy, or IRC, is a procedure that has gained popularity for small to medium sized hemorrhoids. The device is inserted through anoscope, and will then apply infrared light directly to the hemorrhoid, which causes clotting and scar tissue. Scarring will cause the hemorrhoid to shrink. Rubber band ligation is slightly more painful, but IRC has slightly higher chances of relapse. Ultimately, they are similar in effectiveness.
Major Moments in Hemorrhoids History
Hemorrhoids have been an issue for people for as long as people have existed, and it’s fascinating to see its presence so universally throughout history. Remember- everyone gets hemorrhoids. Don’t be afraid to have them checked out by your doctor.
Hemorrhoids have plagued humans for thousands of years, with the earliest known mention of its symptoms dating back to roughly ~2250 BC in the kingdom of Babylon in the Code of King Hammurabi. Fast forward to 1700 BC in Egypt, and we stumble upon the first-ever recorded case of hemorrhoids, which also happened to highlight an important topical wound ointment.
The first use of the word “haemorrhoids” in the English language occurred in 1398. The term derived from the Old French word “emorroides,” taken from Latin derivative “hæmorrhoida-ae,” which in turn originated from the Greek word for “haimorrhois.”
Below is a timeline of key events in the history of hemorrhoid development:
Hemorrhoid History: A Timeline
~2250 BC: Babylon Code of King Hammurabi described the symptoms of hemorrhoids
1700 BC: Egyptian papyrus pronounced a topical astringent lotion
1552 BC: Egyptian medical record detailed remedies for hemorrhoids
1046 BC: Old Testament, 1 Samuel 5:9 Philistines punished with “emerods”, and in 1 Samuel 5:12 People who moved the Ark to Ekron were punished with “emerods”
460–375 BC: Hippocratic Treatises described hemorrhoid treatment by cautery and excision, and first recorded use of speculum to inspect the rectum (endoscopy)
25 BC–AD 50: Celsus describes Pile ligation
41–68: Roman physician Dioscorides defined Aloe Vera use for easing hemorrhoids
130–200: Roman Emperor Marcus Aurelius’s physician Galen pronounced hemorrhoids treatment ointment containing laxatives and leeches. He also explained thread use to tie off piles causing them to shrivel up
4th–5th Century: Indian Susruta Samhita text defined clamp and cautery use
5th–10th Century: Arab physician El-Zahrawy defined cautery irons use, whilst Byzantine physicians ligated with thread on the hemorrhoid base, before amputating
1307–1370: John of Ardene’s exposition transcribed hemorrhoids and fistula treatment, and enemas use
1806: Modern era of endoscopy was piloted by Bozzini with his aluminum tube to expose the genitourinary tract
1835: St.Marks Hospital London was founded by Frederick Salmon providing modern hemorrhoids and fistula treatment
1849: Introduction of anal dilation for hemorrhoids treatment
1935: St.Marks Hospital further developed excision and ligation methods at the hands of ETC Milligan and C Naughton Morgan – nowadays defined as the gold inhemorrhoidectomy standard
1952: Modification to the Milligan-Morgan procedure introduced by Ferguson
1955: A.G. Parks’ developed his closed method surgical treatment the hemorrhoidectomy
1963: J Barron developed an out-patient rubber band procedure to tie hemorrhoids
1970: Development of cryotheraphy, diathermy, infrared coagulation and laser cauteries
1975: PH Lord developed his anal dilation hemorrhoid treatment method, whilst WHF Thompson postulated that hemorrhoids developed from anal cushions that are part of the normal anatomical structures
1997: Italian A Longo introduced his stapled hemorrhoidectomy procedure for prolapsed hemorrhoids
Due to lack of studies and documentation on hemorrhoids, as well as lack of patients seeking medical assistance, the exact prevalence of hemorrhoids is unknown. However, it’s estimated that roughly half of Americans develop hemorrhoids by age 50, with roughly five percent of the US population affected.
The outlook for hemorrhoid treatment and rehabilitation is generally positive. While some individuals suffer from flare-ups and recurring hemorrhoids, only a small portion of patients require surgery.