Good morning. Have a seat.

Oh, I see. Well, maybe grab that throw pillow in the corner there and give it a try.

Ah, very well. Hemorrhoids. Yes, I understand, and empathize. Well of course I can deal with those for you. However, before we begin, I must ask – did you happen to change insurance providers recently? I only ask so that I can check to make sure a newer procedure is covered under your health plan. Trust me, it’s worth your while. The older one is not especially preferable, in my professional opinion…

THE RED-HOT POKER AND ITS SOFT HEALING TOUCH?

What are the positives of this treatment?

Hemorrhoids – more specifically, inflamed hemorrhoids – have afflicted humanity since time immemorial. There are written accounts from all manner of ancient civilizations describing hemorrhoids, including from ancient Mesopotamia, India, China, Egypt, Greece, and Rome.

Hemorrhoids were treated with all varieties of methods – and in Greek, Roman, and Medieval European tradition, these methods typically related to the “four humors” theory of Hippocratic medicine which was the standard for almost two millennia. For those unfamiliar, all illness exists due to various imbalances between the four humors – bodily fluids – of the human body, specifically, blood, phlegm, yellow bile, and black bile. According to humorist medical theory, hemorrhoids were thus caused by “a stagnation of blood, phlegm and black bile in the blood vessels of the anus”. Not only this, but any bleeding was actually a benefit, when in small, controllable amounts because it would restore balance to the humors. Some accounts referred to blood vessels in the anus as “golden veins”. It was even compared by some physicians of old to female menstrual cycles.

Before speaking of the most widely-used treatment method, it’s important to note that many others were considered and used; even as late as the mid-19th century, European physicians were trying to use bloodletting (on different body parts) as a method for curing hemorrhoids. Others placed leeches in and around the anus to try and consume blood and stop the bleeding… and further still, cupping was also tried on some patients’ anal and genital regions.

Since none of those prior-mentioned treatments had much effect, we’ll focus on the method that most would say is the most permanent way of curing hemorrhoids – using a red-hot poker to cauterize the inflammation and bleeding.

Even as far back as the 12th century, we have records of Medieval European doctors using a heated metal rod to burn away their patients’ hemorrhoids. We have artwork documenting the entire thing. St. Fiacre, the patron saint of gardeners, is supposed to have to developed hemorrhoids for some reason, and as such, pulled double duty as patron saint for hemorrhoid patients. If you suffered from hemorrhoids, you probably hadn’t properly venerated the saint… and needed “seven or eight small pieces of iron” heated nice and hot and inserted into your anal cavity. Success!

Cauterization has been known to humanity for thousands of years, and its usage has been documented all over the world across all manners of societies ancient and modern, including in ancient Greece and Egypt, Persia, Arabia, China, and in indigenous peoples in the Americas. In addition to hemorrhoids, cauterization was used to treat dog bites, tooth extraction, mental illness, and, most importantly, to stop the bleeding after major procedures after amputations. Because it’s a versatile treatment, it remains somewhat common even today.

What are the negatives of this treatment?

Well… When cauterizing hemorrhoids, pain and suffering was extremely common, and sometimes the burns would cause abscesses that could be fatal if they got infected. So perhaps maybe we can’t call it success.

Additionally, there is a widespread perception that cauterization (at least when used in other methods) is useful at preventing infection due to rapid closing of wounds, but new knowledge suggests that it actually greatly increases the risk of infection due to tissue damage and death at the point of the wound, and that the (temporarily) elevated temperatures of the wound could prove to be a suitable breeding ground for bacteria and other parasites.

What are some real-life examples of this treatment? 

It is still possible to get hemorrhoids cauterized even today – though fortunately, surgeons no longer use red-hot pokers to do the job, which is probably just as well.

There are other procedures where cauterization is more common today; in particular, severe nosebleeds, especially in children, may see cauterization as the appropriate tool for the job in order to stop the problem permanently. I myself actually once cauterized Chargers RB Ryan Mathews’ nose to stop his nosebleeds. 100% true story.

Some surgeons even use cauterization as a tool for circumcision. Not surprisingly, there have been several lawsuits involved with mishaps regarding this procedure.

How can we improve this treatment for the future?

Upgrading from the red-hot poker to an electric wand helped tremendously to improve the accuracy of cauterization as a treatment method, but I think in future, we surgeons will be able to take it one step further; I see a future where we won’t even need surgical implements at all to burn wounds shut… we’ll all just be able to throw lightning bolts with our own brains.

Additionally, if you’re too spooked to have these cauterized, we could also try some small rubber bands or some sclerotherapy, using some salt injections to collapse the veins and coagulate the blood a little bit.

Thank you for your visit today. I have to get to my next patient. Say, before you leave… do you hear the faint sound of drumming somewhere off in the distance? Or is that just me?

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Information for this article taken from here, here, here, here, here, here, here, here, here, here, here, here, here, here, and here.