War trauma in Homer’s Iliad: a trauma registry perspective

PURPOSE: Homer’s Iliad reports detailed descriptions of war traumas, with precise anatomical references, so that the Iliad can be considered the first trauma registry. We aimed to analyse the Iliad from the perspective of a modern trauma registry: that is, to find historical and local prognostic factors through the epidemiological study of the reported traumas. METHODS: Two different editions of Homer’s Iliad—one in English and one in Italian—were thoroughly studied and epidemiological data were statistically analysed. RESULTS: 148 reports of human traumas were analysed. The majority of traumas (73.6%) involved Trojan warriors, with spears being the most frequent wounding agent (71%). Overall mortality was 84.5% and was higher in the Trojan field (90.8% vs 61.5%). Despite the high mortality, median New Injury Severity Score (NISS) was low, probably due to high prevalence of penetrating mono-systemic trauma. Median NISS was higher in the Trojan group. Compared to the Achaeans, the Trojans had more torso injuries, whereas Achaeans had more injuries to limbs and superficial tissues. However, in both fields, head and neck were more frequently injured. CONCLUSIONS: Homer’s Iliad gives us an interesting insight into war traumas during the siege of Troy. The reported higher mortality within the Trojan army can be explained not only by poetic reasons but also by different military skills.