It’s Ask-A-Wench time! We’ve chosen a question from reader Kantu Malhotra, who mentioned (a while back -- OK, so we're not that prompt) that she rather liked a “little tidbit (in the newsletter) about Roquefort cheese” -- a reference to local sheepherders applying stinky, moldy cheese to wounds to prevent gangrene—a practice that eventually led to the discovery of penicillin. “Cool to have a story woven around medical facts of the time,” Kantu told us.
The Wenches agree—it’s really interesting to weave historical medical tidbits into our stories, and we’ve each done that to some degree or another. It might be an injured hero or heroine, or a trained or natural healer; sometimes it’s just a flesh wound ... or something minor that comes in handy for the story. We’re all careful to match the treatment to its historical context. Here are some examples of Wenchly doses of medicine:
Illnesses and injuries have come up several times in my books, but in most cases they're pretty straightforward things - broken ankle, fevers, that kind of thing. I have a couple of doctor friends who I run things past, although they're not experts on the historical methods of treatment. I generally ask what could happen if there was no treatment, and would aspirin or poultices or whatever help? And they usually say "Maybe, it depends..." Sometimes I just say something like, "I need a disease that could look fatal but which could be healed without modern medicine."
Many of the recognised medical treatments of the time ranged from harmless to the downright dangerous, but some modern-day readers bring a modern day sensibility to their fiction. I've had a reader criticise my heroine (in The Perfect Kiss) for overruling a doctor and sacking him because all he ever did was bleed the patient who was getting weaker and weaker. My heroine brought in a local wise woman/healer, and the man got better. The reader scoffed at this -- first at the arrogant heroine who "knew better than a doctor", secondly at the ability of the wise woman to "magically" heal him with poultices and chicken soup. Actually the disease, the symptoms and the wise woman's treatment had all come from a doctor friend of mine.
I have historical household management books that contain loads of advice on how to treat various ailments. Some would horrify us. The eye cure, for instance that calls for powdered white of hen's dung to be blown into the patient's eyes, recipes that use "oil of worms" as an ingredient, or the blood of a hare, or dried snail-shells and bees baked in an oven, and white lead -- all sorts of concoctions, and impossible claims that they will cure all kinds of disease. I love these books, with their recipes headed 'An excellent vomit' or 'An infallible cure for the bite of a mad dog' and 'The Tar Pills for a Cough' -- they contained actual tar.
But I generally have my characters employ historical treatments that people today can understand and appreciate -- willow-bark tea for instance, which was the raw source of aspirin, and had been used for centuries as a folk treatment. Cinchona bark, a natural source of what we now call quinine, has medicinal properties that were known in Europe as far back as the 16th century. I have my people use herbal unguents containing herbs that have recognized healing qualities. And being a beekeeper, I know about the healing powers and antibacterial qualities of natural honey—people in history didn't understand the science of it, but they knew it worked.
I do seem to injure my characters a lot, especially my heroes. No wonder my husband says I don't want to meet any of them on a dark night! I think it's because if they're going to be active and brave there have to be consequences sometimes or where are the risks?
In my first medieval, Lord of My Heart, I had the heroine skillfully tending Aimery's wound -- a classic bonding moment, as we all know -- and stitching it. I learned years later that that could well have killed him. Before antibiotics people were more intent on keeping wounds open to keep track of and fight infection than stitching them up to minimize scarring.
In The Rogue's Return, set in the relative wilderness of Upper Canada, Jancy uses her gypsy knowledge to fight Simon's infected wound with maggots. This definitely works and is still used today. The right maggots will eat corrupted flesh but leave the sound flesh intact to heal. I know, however, that the wrong maggots would eat anything. I sort of mused aloud about how she'd find the right sort and my husband said, "Ask an angler." I soon had all the information and knew that one old way of fishing was to hang a rabbit or such over a stream. The maggots fell out and attracted the fish, which the person fishingust scooped up. People who wanted to fish with a line would cultivate maggots in rotting meat. Therefore I knew how Jancy would get plenty of the right sort, and Simon's arm was saved.
Having no medical expertise whatsoever, (not to speak of being incredibly squeamish about needles and blood . . .suffice it to say I once fainted before my doc could even give me a shot) I tend to avoid any detailed descriptions of medical procedures. When my heroes or heroines get hurt, they tend to say, “Oh, it’s just a scratch” and then someone sprinkles basilicum powder on the wound.
That said, in To Sin With A Scoundrel, my heroine was a scientist with a specialty in chemistry, and I have her make a discovery about mold and the healing process (using artistic license to play with the idea of penicillin.) I did some basic research, but didn’t get too detailed about the science as it wasn’t critical to the story. Laudenum, which was so prevalent in Regency times, does interest me, and I’ve toyed with using addiction as a plot point, but as yet haven’t found the right storyline.
I have to admit that I seldom include much historical medical detail in my books. I belong to a family with more than its fair share of medical professionals and yet I am quite a squeamish person when it comes to the debates they all have around the dinner table! Medicine in history is not a subject I've researched very much and I think one of the reasons I don't tend to include it is fear of making a huge error. I got caught out once in one of my books, Lord Greville's Captive, when the heroine was in a coma for quite a long time and a reader wrote to me to point out that it seemed unlike she would have survived with the treatment that was available in the seventeenth century. Absolutely. Other than a hero with a gunshot wound in one of my early books, The Larkswood Legacy, I can't think of any other times I've damaged my characters physically!
On the other hand, I do tend to give them much more mental anguish. The heroine of my next book, The Lady and the Laird, has post traumatic stress after a terrifying childhood experience. I researched PTS very thoroughly in terms of the understanding of it available at the time and found it a fascinating topic. But that's a different AAW!
Like Nicola, I'm squeamish about maiming my
characters. That could be because I know just enough to be dangerous about the
medical profession of the time and can't imagine how anyone survived. So if I'm
going to wound anyone, it will be in books like the Mystic Isle books where
they had Healers on hand to ease the process with magic. Devil's Lady has a heroine suffering malnutrition
and exposure, does that count? And I guess a magically induced coma from my
next Jamie Quaid, Damn Him to
Hell, probably isn't even accurate in today's terms, much less
So nope, research has never led me to use cheese to heal what ails my characters!
Having a weakness for healers and medical situations, I’ve included several in my books. I find this stuff so interesting to research -- and very handy for creating dramatic situations that can affect, define or develop the characters and story. In my first book, The Black Thorne’s Rose, the heroine, practicing her archery skills, accidentally shoots the hero in the thigh—she's a lousy shot, and he's in the wrong place at the wrong time. She cracks off the arrowshaft and later removes the bolt. He’s not real pleased, as you can imagine.
The medieval hero of The Angel Knight has a natural healing ability--and the heroine, imprisoned in an iron cage by the king, is dying. She gets better just by being around the hero--that pesky healing thing he's trying to hide--and I was careful to make sure her symptoms and the medieval remedies were appropriate for the time. The sequel, Lady Miracle, (recently converted to ebook) is my most medically detailed book. The heroine—sister of the Angel Knight--has the same gift, but she is also a trained physician. That was possible, just, because I sent her (in backstory) to Italy.
During the medieval era, women were rarely allowed to practice medicine as physicians—except in Italy. So she was educated in Bologna--the most advanced medicine was practiced in the Arab world then, and the Italian schools were paying close attention, even bringing Arabian physicians into their universities. The heroine’s first husband was an elderly Arabian physician, and she learned well. Once back home in Scotland, she has little chance to use what she knows, and doesn't dare admit her healing gift for fear of heresy. But when the hero, a Highlander and field surgeon desperate to save his ailing niece, comes looking for the lady physician, she finally gets to follow her training as well as her heart.
I got to play with all sorts of conditions and medical treatments—battle wounds (wine poured over an open wound, cautery, and silk thread with steel needles were all in use then), toothache, childbirth, neonatal medicine, polio and physical therapy, even astrology and medicine, were all part of the story. This book was a research challenge, but it was fascinating and fun to write about medieval medicine, all wrapped into a Scottish historical romance.
Mary Jo Putney
I adore damaging my characters! My very first book, The Diabolical Baron, had a hero, Richard Davenport, who was left with permanent leg damage from a Waterloo wound. The first book where I did period medical research was my next Regency The Would-Be Widow, now available in a historical version as the The Bargain. The hero, David Lancaster, was mostly paralyzed and dying from wounds suffered at Waterloo. (He and the hero of the first book were friends and brother officers.)
I was inspired by reading accounts of the battle, including one man who was on the operating table paralyzed from the waist down. The surgeon removed a piece of shrapnel in the spine that had been blocking the nerves, and the patient promptly got up and ran out of the room. In David’s case, I added over-medication with laudanum, which killed his appetite so he was fading toward death. Just to top it off, after his miraculous surgery, I gave Dave an opium addiction to kick. It isn’t easy to be one of my heroes.
David was operated on by a Scottish surgeon and physician called Ian Kinlock, who had an experimental turn of mind and had learned how to use a primitive antibiotic in the moldy bread that he’d gotten from a Polish sailor. Ian fed it regularly, rather like yeast, so it would keep producing the substance that reduced inflammation rates. As part of the same research, I read of people who would keep a chunk of bread up in the rafters getting moldy, and they’d use a slice for poultices to treat wounds.
Probably the most research I’ve done was to figure out how to do a primitive blood transfusion for Shattered Rainbows. My hero, Lord Michael Kenyon, was another Waterloo casualty. (What can I say? The battle is so very convenient.) He’d bled out and was close to death when the heroine, a battlefield nurse, suggested to the surgeon, Ian Kinlock (he’s handy, too <G>), that they could try a blood transfusion from her to Michael. Ian wasn’t keen, but admitted there wasn’t much to lose. Goose quills were used to transfer the blood, which naturally saved Michael’s life. Talk about romantic! Catherine couldn't reveal her love because she was married, but she literally gave him the blood from her veins.
This was pre-internet, so I had to do a lot of digging, include a visit to the Maryland Med Chi library. I described the technique to a hematologist and a vascular surgeon, both of whom were horrified by the very thought. But there were some recorded occasions when such transfusions worked, presumably when the blood types were compatible and no killer infections set in.
One of the nice things about playing God in our books is that we can always make the medical treatments turn out right.
My heroine Annique in The Spymaster's Lady does take a bullet out of young Adrian. True, It was a fairly shallow bullet wound, but then, my heroine was blind. Blind, you say. How did that go? you say.
I got into this taking of bullets out of chests because I wanted my Annique to
do something competent and heroine-oic. In the back of my mind there was
the memory of how surgeons operate by touch. Operate 'blind' as it
were. Interns practice operations on plastic models of body parts, putting
their hands inside a sack so they have to work only by touch. That levels
the playing field a bit for a blind woman.
The process of taking a bullet out of somebody hasn't changed all that much in two hundred years. In 1802, a surgeon might use a scalpel to open a crusted entry wound and forceps to collect the bullet and pluck it forth. Lead shot, the simple medical instrumentation, and the arrangement of muscle and bone are all pretty much the same after two centuries. Technique? A modern surgeon, with an array of antibiotics at hand, might cut a new pathway to the bullet. A Regency period surgeon would be apt to use the preexisting entry to avoid 'enlarging the wound' as they would have called it. That's what I have Annique do.
My characters are on the run. It's emergency surgery with no anesthetic--not that there were any great ones around at the time. Opium and brandy were about it, and a couple strong friends to hold the patient down. Speed, as you might imagine, is of the essence if you're poking at the innards of somebody awake and kicking. In my bullet-removal scene we do a brief excursion into a sort of hypnosis. It's plausible my characters would have been familiar with this concept. It had been kicking around Europe, more or less disrespectable, for most of the eighteenth century.
Afterwards, my French heroine left the entry hole bandaged but open to drain, following the best French battlefield practice of the time.
So the weaving of medical history into our historical fiction is important to all of us -- and we've each done our best to make it original, accurate, authentic and interesting!
What about you all -- do you enjoy reading about historical medicine? And do you prefer more or less detail about the squicky bits?
And congratulations to Kantu, who wins a book because we chose her question!
Remember -- if you ask a question of the Wenches and if we choose your question as the basis of a blog, you win a book! Easy and fun. So ask away!