Piles (Haemorrhoids) Treatment by Burning Metallic Rod: The Brutal History Before Modern Surgery

How were piles treated before modern surgery? For over two thousand years, one of the most common answers was a burning metallic rod, pressed directly onto the swollen tissue until it was destroyed. This wasn't a rare or fringe method either. Piles (haemorrhoids) treatment by burning with a metallic rod, known medically as cauterisation, was standard practice across ancient Greece, Rome, medieval Europe, and beyond. 

Who First Documented Piles Treatment by Burning Metallic Rod?

Piles Treatment by Burning Metallic Rod

image credit: Google Gemini AI

The practice traces back to Hippocrates, writing around 400 BC. In his treatise On Haemorrhoids, he instructed that "seven or eight" iron surgical tools with a coin-sized end should be heated red hot, then used to burn the piles "until the pile is dried up, so that no part may be left behind," according to Ancient Origins. Patients were restrained and specifically encouraged to yell during the procedure, since it was believed shouting would push the anus outward and make the burning easier to perform.

Was This Method Used Beyond Ancient Greece?

Yes, and it spread widely. According to WhiteCoatRecall, Roman physicians continued referencing cauterisation alongside ligation techniques, and the Susruta Samhita, an Indian medical text from the 4th to 5th century AD, also documented the use of clamp and cautery to remove haemorrhoids and control bleeding, according to Procedure Clinic. The practice persisted through the medieval period too, with 15th-century German woodcuts depicting surgeons cauterising patients using red-hot coals and iron tools, as documented by ScienceNordic.

Why Was Burning Metallic Rod Treatment Considered Standard Care?

Without anaesthesia, antiseptics, or a real understanding of infection, cauterisation was viewed as an effective way to destroy diseased tissue and stop bleeding in one step. According to LA Colon, Hippocrates himself actually preferred a different method for less severe cases, ligating haemorrhoids with a needle and thick woollen thread, reserving the hot iron specifically for more serious presentations. Even so, cauterisation remained a go-to option across cultures for centuries.

When Did Piles Treatment by Burning Metallic Rod Finally Decline?

Progress was remarkably slow. According to a historical review in Frontiers in Surgery, little advanced in haemorrhoid treatment throughout the Middle Ages up until the 18th century, with high mortality rates and frequent complications discouraging surgery altogether, partly because operations were often carried out by barber surgeons rather than trained physicians.Real change only began in the 19th century, with safer techniques like sclerotherapy emerging in 1869, according to Hemovel.

Conclusion

Piles (haemorrhoids) treatment by burning with a metallic rod wasn't a one-off historical oddity. It was the dominant treatment approach for roughly two thousand years, from ancient Greece through to the eve of modern surgery. It's a genuinely useful reminder of how recent safe, effective haemorrhoid treatment actually is, and how much medicine has advanced in a relatively short window of history.

Thumbnail image credit: Google Gemini AI