Write about what you know - that is the old piece of wisdom handed on to all budding writers. I am a doctor and have pretty well followed that advice throughout my writing career and find that it works for me. I don’t mean that I only write about medicine and doctors. Apart from my medical and non-fiction writing I write fiction in four genres, but in them all I introduce some medicine or surgery into the tale. It gives me an opportunity to give my stories some authenticity and credibility in telling what diagnoses and treatments a doctor might give, or what injuries would be plausible.
When the Western Fictioneers started a blog I volunteered to write a monthly post on 19th century medicine and surgery. The aim was to tell my fellow western writers about medical and surgical practice and provide information that they could use in their own novels and short stories when a character was shot, wounded or injured. Another aim was to show what things were not plausible, perhaps because certain instruments had not been invented, or because medical discoveries had yet to be made. In a nutshell, how to avoid medical anachronsms in their fiction.
It has given me much pleasure to help my fellow writers with aspects of medical practice that they needed to include. There are all sorts of questions that crop up when we as writers put our characters into those tight corners. For example, you may want to know how to dig out a bullet or an arrow, or how to deliver a baby. And just why is the husband always sent off to boil some water, or why do you wait expectantly for that slapping noise in the other room before a newborn baby cries.
It was suggested to me that these posts should be collected as a reference book for writers of historical and western fiction. It was a suggestion that I could not refuse and I hope that the book may prove useful to my fellow authors.
“Bleed, blister and purge.”
Those words just about sum up the practice of medicine in the early 19th century.
The Doctor’s Bag is a compilation of posts on the medicine and surgery of yesteryear, written by western writer Clay More (under whose hat can be found his alter ego Dr Keith Souter, a medical doctor for almost forty years). The posts show the state of medicine and surgery in the 19th century, by delving into the doctor’s bag to look at what instruments, medicines and techniques were available back then.
In this book you will find information not readily available to writers and readers of historical fiction. You will find out exactly how a doctor would dig out a bullet or arrow, set a broken leg, perform an amputation, or deliver a baby. You will also find out about famous surgeons like Dr George Goodfellow, the surgeon to the Gunfighters as well as learn about snake-oil salesmen, phrenologists and some of the more exotic diseases that folk were subject to.
DIG IT OUT, DOC!
Part 1 ARROWS
Out on the frontier a doctor would have to be prepared to deliver babies, splint and fix broken bones, and dig out arrows and bullets. Tough work, if you then had to go and play poker and drink a little whiskey.
In many a western a doctor is either called upon to dig out a bullet or arrow. He usually does so with some ease, depositing the missile in a tin bowl with a resounding clunk, a wipe of his brow and the message that “he’ll be all right now, once I patch up the wound.”
But of course, in real life things are not quite as simple, so in this post I’m going to look at digging out arrows. In a later post we’ll talk about digging out bullets.
Dig it out, Doc!
One of the best sources of information about arrow wounds in the modern era comes from a paper by Dr Joseph H Bill, an MD and Assistant Surgeon, published in the American Journal of the Medical Sciences, published in 1862. He wrote this paper from his own experience as a surgeon on the frontier. He was a Lieutenant Colonel in the US Army.
He begins by describing how arrows are made, which is really crucial to the understanding of the problems involved with arrow wounds. Basically, the arrow has a shaft and a head. The shaft would vary in size from two to three feet, generally being made from dogwood. The head would be inserted into a slit and lashed to the shaft. The head would be made of iron, glass, obsidian or flint. It would vary in size from half an inch to two and a half inches in length, and about half an inch to three-quarters of an inch in width at the base.
The lashing was done with tendons, which were tied tightly and allowed to dry to tighten them further. This is also of importance to our understanding, because once an arrow penetrates the body the tissue fluids and blood would cause the lashing tendon to swell and come loose. Any attempt to pull the arrow out, as people were wont to do, would simply cause the shaft to come out, leaving the potentially lethal arrow-head inside the body.
Doctor Bill describes the relative frequency of arrow wounds. Wounds to the upper limbs were the commonest, because you could see an arrow coming and attempt to fend it off, only to sustain a wound, probably hitting and lodging in bone. Then came abdominal wounds, then chest, then lower limbs, then head, and lastly neck. Multiple arrow wounds were common, since a bowman could fire off six arrows per minute and once a person was hit once, they would be easy targets for the second and third.
Native American arrows
The first thing to be assessed in Doctor Bill’s view was the depth of the arrow. He suggested that the length of the arrow shaft should be measured, so that this measurement could be deducted from the total length of the arrow. Navajo and Utah arrows were made to two and a half feet. Apache, Comanche, Arrapahoe, Cheyenne, Kiowa and Pawnee arrows were made to two feet and three-quarters.
Treatment of arrow wounds
In the initial examination of the wound, with the arrow in situ, he would firstly assess whether the arrowhead was lodged in bone or not. To do this he would…..
Well, I’m sure you get the drift.
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