Proper bandage for an arrow wound?

bylinebree · Dec 18, 2006

OK, so my hero took an arrow in the shoulder just under the right clavicle, it nicked the bone and did a bunch of damage (as you can imagine).

I have the Healer binding his arm, bent naturally, across his chest -- the binding wraps around his chest to keep him from moving it, similar to what they did when my son broke his clavicle.

The setting is a sort of alternative early medieval european, the healing arts are fairly progressive for their "time."

Is this bandaging close to correct, all you trained Medical Marvels?

Chumplet · Dec 18, 2006

I would think a compress with some kind of healing herb should be held against the wound with the bandaging, but what do I know....

BTW, we had a limited edition print (huge) of your avatar in our recent Santa Fund auction.

From an untrained Medical Idiot

bylinebree · Dec 18, 2006

I love that picture! Don't recall who did it or when, but it just "spoke" to me.

Years ago, a sort-of besotted friend of mine gave me a small engraving of a knight kneeling before a golden haired maiden. He told me it was the way he thought of me, and I kept that pic for a very long time -- then gave it to charity, fool that I am. I've never found the pic again, but my avatar is based on the one closest I've found to that pic.

Hope the art raised a bunch of money for your Santa Fund.

Chumplet · Dec 18, 2006

It was huge, with a lovely gold frame. It raised over a hundred dollars. There was another one that was obviously from Dragonriders of Pern.

Tiger · Dec 18, 2006

Looks like a Brothers Hildebrandt painting.

GPatten · Dec 19, 2006

They may want to stitch it, and they may want to singe the wound with a hot poker. They may want to do both.

Histry Nerd · Dec 19, 2006

Bree, I'm not a doctor. I don't even play one on TV. But I do know a little bit about patching combat injuries.

Immobilizing the shoulder, as you have done, is an important piece of it. But you'll also have to patch the wound. Remember most war arrows are barbed to a greater or lesser extent, so extracting it probably caused more damage than getting hit in the first place did. A couple of options on the extraction:

--You can have a surgeon or healer cut it free, then stitch the wound closed or cauterize it, then put a bandage over it. This is the least damaging of your options.
--You can have somebody push it through, break off the barbed head and pull it out. Now you have two relatively neat wounds. There are two risks here, though: you could push it through an artery (the brachial artery runs through that area on its way to the arm) or you could push it into the scapula, just making the wound deeper and making one of the other methods necessary.
--You can have somebody jerk it out. Any half-competent healer will choose this as the last resort, because the arrow will do a lot more damage coming out than it did going in. And depending on the tech level of your world and how the head is affixed to the shaft, just pulling it out could cause the head to break off and remain in the wound. Oops.

Whichever method you choose, you'll need to bandage the wound(s) and immobilize the shoulder to maximize healing.

HN

sharra · Dec 19, 2006

Cupping spoons were usually used to extract arrow heads; these were inserted into the wound and closed around the head to minimise tissue damage when it was extracted - they came in a variety of sizes, as well. Google spoon of Diocles to find hits on the earliest of these.
The wound would have been rinsed, either with a herbal tincture (St John's wort/echinacea or something similar) or with diluted alchohol or witchazel (if it is undiluted alchohol, your MC is going to scream like a 6 year old.)
Stitches could have been tried - a lot of battlefield physician used horsehair (easy access to horses) or flax/linen strands to close the wound. Keep in mind if the wound is too deep; you'll have sever muscle damage unless your surgeon is a prodigy - even when they stitched muscle and ligament; the damage was usually permanent & the risk of infection huge.
Honey would probably have been smeared over the wound (natural antiseptic & anasthetic) followed by a herbal poltice - there is a huge variety of plants you can use seperately or combine for this; everything from liquorice root to angelica. Google healing herbs for this one - it'll give you a good idea of the stock out there, and you could base plants in your world on these.

Julie Worth · Dec 19, 2006

“...doubts the importance of the "spoon of Diocles" described by Celsus; she outlines the methods of withdrawing the missile from the side it entered (ephelkysmos) or pushing it through the other side (diôsmos)” --from a review of The Treatment of War Wounds in Graeco-Roman Antiquity

sharra · Dec 19, 2006

That's the puppy. I've read references to it being used in ancient Egypt, as well as China & Japan - I'm sure they had different names for it though. Sounds more painful than getting the initial wound..

Akuma · Dec 19, 2006

Do what I do. Make things easy with "Presto! Healing Magic!"

:tongue

Little Red Barn · Dec 19, 2006

sharra said:
Cupping spoons were usually used to extract arrow heads; these were inserted into the wound and closed around the head to minimise tissue damage when it was extracted - they came in a variety of sizes, as well. Google spoon of Diocles to find hits on the earliest of these.
The wound would have been rinsed, either with a herbal tincture (St John's wort/echinacea or something similar) or with diluted alchohol or witchazel (if it is undiluted alchohol, your MC is going to scream like a 6 year old.)
Stitches could have been tried - a lot of battlefield physician used horsehair (easy access to horses) or flax/linen strands to close the wound. Keep in mind if the wound is too deep; you'll have sever muscle damage unless your surgeon is a prodigy - even when they stitched muscle and ligament; the damage was usually permanent & the risk of infection huge.
Honey would probably have been smeared over the wound (natural antiseptic & anasthetic) followed by a herbal poltice - there is a huge variety of plants you can use seperately or combine for this; everything from liquorice root to angelica. Google healing herbs for this one - it'll give you a good idea of the stock out there, and you could base plants in your world on these.

sharra, I loved this info, thanks for sharing.

Kentuk · Dec 19, 2006

Until the issue of bleeding is resolved the healer immobilizes the whole patient, immobilizing the arm would indicate a minimal wound.
The hot poker is pure desperation. Burns are very prone to infection. I doubt it would stop bleeding in most cases.
In WWII they learned not to close wounds prematurely, not closing wounds kept the infection rate down allowed for cleaning the wound and allowed for second tries at surgury. Perhaps your healer has an unusual way of keeping the wound clean and a nice safe drug to immobilize the patient for a few days.

sharra · Dec 20, 2006

no probs. PS - if there is a problem with infection, you could have healers use maggots. There are varieties that feed on living flesh (not good) and those that only feed on necrotic/decaying tissue.
Mild hypnotism could also be used for pain & calming a patient - "mesmerism" became known because of Joseph Mesmer, but alternative healers & druids have used relaxation & hypnotic techniques for centuries.

greglondon · Dec 20, 2006

sucking chest wound? Ouch.

sharra · Dec 21, 2006

nasty, right? Could actually work really well if you want a very dark touch - have it happen to a lesser character - surgeon using the wrong type of maggot. Ugg.
On that cheery, note, have a great season folks. I'll be galloping around Glasgow for the next couple of weeks, so won't be on the boards..

:partyguy:

bylinebree · Dec 22, 2006

Such great input...thanks

Sorry I haven't replied sooner to your good ideas and info. Been sick and snowed-in here, with too many teens wanting to monopolize the internet!

I didn't go into the cleaning and such of the wound here in my question, as I felt pretty sound on that aspect of it after researching ancient medicine. Never heard of the "cupping spoons" though, thanks!

The arrow head broke off in his wound, so they used a metal probe to get it out without causing so much rip-and-tear damage internally. Then it was cleaned out with alcohol-based stuff and packed with a substance called 'luminaria', a seaweed saturated with herbal tinctures and honey to avoid infection. Pressure was applied to slow the bleeding, but thanks for the note about the brachial artery; I think the arrow conveniently missed it though, as my poor Hero suffers plenty from his other, more serious (!) wound -- from a first arrow that pierced him front to back, just under his liver!

They do immobilize him with an opium-based med, mixed with other botanicals. There was a nifty item called a "Soporific sponge" that was soaked with powerful stuff and held to the patient's nostrils until he conked out. This was used for surgery, for ex.

Yes, to the WWII reference about leaving wounds open! Thanks.
It took medicine quite a while to "get enlightened" again, as ancient wound-treating techniques actually were fairly sound, given their lack of modern antibiotics etc. This was sort of forgotten in the Middle-Ages up to the Civil War period even, thus the terrible mortality rates they saw as a part of this ignorance.

My Healers do leave the wound open until they are sure it's draining well and clean, before stitching it up.

No cautery here, yuck. My people are archaic, but not barbarians!

Oh, and sorry -- no maggots, either, at least not this time

Gracias, all.

bylinebree · Dec 22, 2006

Akuma said:
Do what I do. Make things easy with "Presto! Healing Magic!"

Wouldn't it be great to be able to heal people that way in reality??

I think so. Or maybe that would make life too easy, taking away all the strength we can gain by all that suffering & striving to get well, eh?

Not to forget the compassion we gain by being sick occasionally ourselves, lest we forget how it feels. Or all that character gained from tending to the unwell among us... (wry smile here)

MattW · Dec 22, 2006

I always have a problem with the ease of magical healing - takes away responsibility from the author for hurting people, and seems a rather difficult task for the healer to accomplish.

Think about all of the healing and mending that needs to take place, the reconnecting of severed tissues and nerves, bones knit slowly, blood loss needs replacing, and the mental shock of a wound is rarely addressed.

Just my mini-rant on a peripheral topic to this one.

bylinebree · Dec 22, 2006

Good rant re: magical healing

No, I think those are good points, at least the second part of your comment that I understand.

I don't understand what you mean by the "responsibility of the author for hurting someone"? Explain, plz?

I did read a more realistic (if that term could be used) description of magical healing this past year. The healer visualized in more detail the blood, muscle, tissue and such in stages as he healed the wound. It made more sense as to "how" such powers might work.

(Or was I watching Sci-Fi? Hmm. )

But addressing the mental trauma, now that's another thing.
What do you mean by "mental shock," so I don't just assume?

Dixie · Dec 31, 2006

OK, so my hero took an arrow in the shoulder just under the right clavicle, it nicked the bone and did a bunch of damage (as you can imagine).

I have the Healer binding his arm, bent naturally, across his chest -- the binding wraps around his chest to keep him from moving it, similar to what they did when my son broke his clavicle.

The setting is a sort of alternative early medieval european, the healing arts are fairly progressive for their "time."

Is this bandaging close to correct, all you trained Medical Marvels?

First you would try to put the arm in the anatomically correct position. Then you treat this as an impaled object type of wound. I would not try to remove the arrowhead from the wound (that is if its still in there). Id stabilize the arrowhead with some gauze, then place a 4x4 over it then add another layer of gauze for compression and tape it off.

If it nicked an artery Id be applying pressure to the would on the side closest to the neck. Id also wrap around under the shoulder if that was possible to help keep the bandage in place - then bandage the arm in place next to the chest (again in anatomica position) by wrapping a wrap around the opposite side of the chest and around the arm 2-3 times, just to help the overall area stable to prevent further damage.

I hope that helps.

Cav Guy · Jan 2, 2007

This also brings up some interesting questions about the arrow and arrowhead itself. Some cultures used wrapping on the shaft of the arrow that would more or less dissolve once it hit someone, making sure that the arrowhead did remain in the wound. Also, is it a metal point or stone? If it's metal, there's a chance that it would bend once it hit bone, making it even harder to pull out (this became quite common in the later Frontier period as tribes began using metal instead of stone to make arrowheads).

bylinebree · Jan 3, 2007

The arrowhead is metal, probably either iron or bronze. Did they make then of bronze? I hadn't gotten that detailed.

No, the shaft doesn't dissolve - it's of wood, painted but not wrapped with anything.

truelyana · Jan 3, 2007

bylinebree said:
Wouldn't it be great to be able to heal people that way in reality??

I think so. Or maybe that would make life too easy, taking away all the strength we can gain by all that suffering & striving to get well, eh?

Not to forget the compassion we gain by being sick occasionally ourselves, lest we forget how it feels. Or all that character gained from tending to the unwell among us... (wry smile here)

You can heal people in any reality you wish to participate in

bylinebree · Jan 3, 2007

(blushing hotly)
Ok, I don't even know my own book!! Awhile ago, I had changed the shoulder wound from being caused by an arrow to a sword wound, sheesh -- and forgot my own editing. My MC was badly injured first by an arrow, so I changed his second 'ouch' to a sword-wound just for variety (and to show him being all heroic and stuff, swinging a sword around even though he's barely hanging onto his horse)

This is sad, sad, sad.

Proof that I do need to return in earnest to my poor abandoned novel, still awaiting the final edit of the last few chaps!

And get more of a social life, as well :tongue

Proper bandage for an arrow wound?

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