OUR SURGICAL HERITAGE
Chest Trauma During the Battle of Troy:
Ancient Warfare and Chest Trauma
Gil Hauer Santos, MD
Department of Thoracic Surgery, Albert Einstein College of Medicine, New York, New York
The Iliad is the story of the events related to the siege and
battle of Troy presenting an unsurpassed view of the
strengths and weaknesses of its main characters. And
what a revelation it is to see that the human element that
ignites and sustains the flames of war did not change
through the centuries and was 3,000 years ago the same as
it is today! An added source of fascination in Homer’s
I n The Iliad, that fountainhead of Western literature,
Homer describes the events related to the battle of
Troy and its disastrous aftermath. All that enormous
suffering and bloodshed was incurred to bring back a
woman, Helen, who had departed with her lover, Paris,
to a far away land. An expedition made up by her
husband Menelaus, his brother Agamemnon, friends,
and allies was assembled in a loose association to go to
Troy, punish the Trojans, and bring Helen back to
Greece.
Throughout the narrative, Homer gives a majestic and
unmatched view of the human condition. Those who are
fortunate enough to read this book are filled with awe
and profound admiration for the genius of the one who
laid the foundations of Western thinking.
Of special interest for surgeons is the description of 130
injuries occurring during the combats, and we are
amazed by Homer’s meticulous account of the wounds
inflicted to the combatants in that historic and allegory-
laden war.
To go from Greece to Troy across the Aegean Sea, the
Homeric boats were equipped with a single midship sail
and built with decks at the prow and the stern with a
single layer of rowers in between. They had no under-
deck and the sailors alternated rowing with sleeping on
the deck. Rowers and wind moved the craft away from
Greece towards the city of Troy. A large flotilla carried
100,000 warriors, most distinguished among them Odys-
seus, Agamemnon, and Achilles. Most of the warriors
were also rowers who alternated at the oars.
On arriving at the proximity of Troy, they camped
outside the city walls and on the beaches, staying close to
their boats. For 10 years, they attempted to break through
the defenses of the city of Priam, until discouraged and
exhausted from the long time already passed and their
losses in battle, they decided on a stratagem to get inside
Address reprint requests to Dr Santos, Jacobi Hospital, Room 610, Pelham
Parkway and Eastchester Rd, Bronx, NY 10461.
© 2000 by The Society of Thoracic Surgeons
Published by Elsevier Science Inc
work is his peculiar description of the injuries suffered
by the combatants. That, as well as the presence of
physicians in the battlefield, is of special interest for us
surgeons.
(Ann Thorac Surg 2000;69:1285–7)
© 2000 by The Society of Thoracic Surgeons
the walls of the well-defended city, as later described by
Homer in The Odyssey.
One hundred and thirty battle wounds are described in
The Iliad, of which, 26 (20%) were in the chest. Other
anatomical areas with a large incidence of wounds were
the head with 22, the abdomen with 23, and the neck with
19. Only one wound was described in a foot.
For weapons, the combatants used spears, swords,
arrows, and stones, protecting themselves with helmets
and shields made of leather, wood, and bronze. In a
typical clash, the chiefs rode chariots pulled by two
horses, while their men ran close to them. Frequently,
during the heat of battle, the chiefs were dragged out of
their chariots and had to face the other combatants on the
same footing.
Apparently, horseback fighting was still an unknown
art, possibly because stirrups, which permitted the rider
to stay in a steady position to keep his balance and use
his weapons, had not yet been invented. The first known
rigid stirrups were found in China dating from the fourth
century AD. In the Western world, stirrups were found in
Avar tombs in Hungary dating from the seventh century
AD. It is possible that Avar and other nomadic tribes
brought stirrups from the East across the steppes of
northern Asia. It was with the help of the cavalry pro-
vided with stirrups that Charles Martel, chief of the
Franks and grandfather of Charlemagne, consolidated
his kingdom, defeating the Moslems at a battle near
Poitiers in the year 732.
Looking at the weapons used, we read that 72 of 130
wounds described at the battle of Troy, were produced by
a spear, some of them specifically described as bronze-
tipped spears. Bronze spearheads like the ones described
have been recovered on archaeological excavations, no-
tably by Schliemann late in the nineteenth century on
excavations conducted by him at the hill of Hissarlik,
where ancient Troy is supposed to have stood. Those
bronze spearheads measured an average of 65 cm and
were likely used as part of a thrusting spear. Its size and
weight would have made it difficult to use them as a
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1286 SURGICAL HERITAGE SANTOS
CHEST TRAUMA DURING BATTLE OF TROY
Fig 1. Possible route of Greek forces to Troy.
throwing weapon, yet in several instances they are de-
scribed as being thrown against the enemy.
Fifty-eight injuries were caused by weapons other than
spears. Of those, 12 were inflicted by swords. These were
short swords made to be used in close combat. Arrows
were responsible for nine other injuries. In nine other
instances, wounds were caused by hurled large stones
found in abundance where the battle took place. Most of
the head injuries were produced by those heavy stones.
We find four victims of an initial injury by spear followed
by a blow with a sword, and one victim of a combined
stone and sword attack. One combatant died as a result of
a hand-to-hand fight, while for 22 injured fighters, there
is no mention of the weapon used.
Of the 26 chest wounds, the majority, that is 20, were
produced by spears. Two chest injuries were inflicted by
Fig 2. Plate dated to 7th century BC showing Menelaus and Hector
fighting over fallen Trojan.
Ann Thorac Surg
2000;69:1285–7
Fig 3. Chariot drawn by two horses as described in the Iliad.
arrows, one was made by a combination of spear and
sword, while in three cases there is no mention of the
weapon that was used.
Most of the injuries are succinctly described by naming
the weapon and the anatomical area afflicted, but in some
cases, a more elaborate description is made, as with the
description of the charge of Patroclus against Sarpedon:
“The spear sped not from his hand in vain, for he hit
Sarpedon just where the diaphragm bounds the ever-
beating heart. He fell like some oak or silver poplar or tall
pine to which woodmen have laid their axes upon the
mountain to make timber for ship building. Even so did
he lie stretched at full length in front of his chariot and
horses moaning and clutching at the blood stained dust.
Death closed his eyes as he spoke. Patroclus planted his
heel on his breast and drew the spear from his body,
whereon the diaphragm came along with it and he drew
out both spear point and Sarpedon’s soul at the same
time.”
In the same way, the vivid description of Alcathous’s
death has some poignant graphic details:
“Idomeneus struck him with a spear in the middle of his
chest. The coat of mail that had hitherto protected his
body was now broken and rang harshly as the spear tore
through it. He fell heavily to the ground, and the spear
stuck to his heart which still beat, and made the butt-end
of the spear quiver till dread Ares put an end to his life.”
Peirous wounded by Thoas was hit in two areas:
“Thoas struck him in the chest near the nipple, and the
point fixed itself in his lungs. Thoas came close up to him,
pulled the spear out of his chest and then drawing his
sword, smote him in the middle of the belly so that he
died.”
A more straightforward encounter was the one when:
“King Agamemnon knocked mighty Odius from his
Ann Thorac Surg
2000;69:1285–7
Fig 4. Greek weapons from 1500 to 1200 BC found in different
Greek locations. The spearheads were excavated at the Troy site and
are as long as 65 cm.
chariot. The spear of Agamemnon caught him on the
broad of his back, just as was turning in flight; it struck
him between the shoulders and went right through his
chest, and his armour rang round him as he fell heavily to
the ground.”
Two physicians attended the Greek forces in battle.
One of them was Podalirius and the other Machaon.
When Machaon was wounded by Alexandrus with an
arrow on his right shoulder, Idomeneus said to Nestor:
“Mount your chariot at once and take Machaon with you
and drive your horses to the ships as fast as you can. A
physician is worth more than several other men put
together, for he can cut out arrows and spread healing
SURGICAL HERITAGE SANTOS 1287
CHEST TRAUMA DURING BATTLE OF TROY
herbs.” However, when soon after Eurypylus was
wounded with an arrow in the thigh, he asked help from
one of his companions: “Noble Patroclus . . . save me and
take me to my ship, cut out the arrow from my thigh,
wash the black blood from off it with warm water and lay
upon it those gracious herbs . . . for of the physicians
Podalirius and Machaon, I hear that the one is lying
wounded in his tent and is himself in need of healing,
while the other is fighting the Trojans upon the plain.
Patroclus clasped him round the middle and led him into
the tent, and a servant, when he saw him, spread bullock-
skins on the ground for him to lay on. He laid him at full
length and cut out the sharp arrow from his thigh; he
washed the black blood from the wound with warm
water, he then crushed a bitter herb, rubbing it between
his hands, and spread it upon the wound; this was a
virtuous herb which killed all pain, so the wound pres-
ently dried and the blood left off flowing.”
Serious injuries bringing suffering and death resulted
from this conflict. Yet as a sad part of the human
condition, bloody episodes continue, with no interrup-
tion, to punctuate our history from distant past to present
days, and it always appears that through the centuries no
lesson has yet been learned because war continues to be
a way to solve disputes among nations. Weapons are
getting more formidable and the damage produced by
them on the fragile human body equally more
horrendous.
Surgeons continue to be dedicated to preserve and
restore the integrity of the delicate human body not only
by confronting diseases but also repairing injuries caused
by civilian and war trauma.
An extra role for the surgeon should certainly include
his or her participation as an active voice in the world-
wide dialogue searching for a future of peace when
disputes will be decided at the negotiating table instead
of the battlefield.
References
1. Homer. The Iliad (translated by Samuel Butler). New York:
Simon and Schuster, 1969.
2. Warry J. Warfare in the classical world. New York: St. Mar-
tin’s Press, 1980.
3. MacKay-Smith A, Drue Sedow JR, Ryder T, eds. Man and the
horse. New York: Simon and Schuster, 1984.
4. Spaulding OL, Nickerson H, Wright JW. A study of military
methods from the earliest times. Richmond, VA: Garrett and
Massie, 1937.