Punctured lung: treatment / recovery...

Mr Flibble · May 26, 2008

..in say the 1500's

If there was a small puncture ( not life threatening but enough so there was some blood on the lips and impaired function) what would have been the treatment ( if any different from now. I've tried to look, --for a small one there doesn't seem to be much treatment) and what would be the recovery time?

Any ideas?

slcboston · May 26, 2008

Not having had the pleasure myself, but a friend of mine ....

oh, wait. That was a collapsed lung. (He continued playing the trumpet through the rest of the concert before going to the doctor to find out what he had...)

I'm not sure about a punctured lung. That's usually pretty bad, isn't it? It doesn't seem like the kind of thing you'd just "get better" from...

Mr Flibble · May 26, 2008

I'm not sure about a punctured lung. That's usually pretty bad, isn't it? It doesn't seem like the kind of thing you'd just "get better" from..

Well I've had cracked ribs and they just send you home. I've not known anyone with a punctured lung to ask, although if it's small ( what I'm after) they apparantly just x-ray you a lot and keep an eye on you. I just want to know if that's true, and how long till you can do stuff.

waylander · May 26, 2008

It rather depends on where you are. At that time the best medics were probably in the Ottoman Empire or China.

In England: "Leeches, Lord Blackadder"

ColoradoGuy · May 26, 2008

A punctured lung that would give blood on the lips would cause the lung to collapse (pneumothorax). The treatement of this is a chest tube (tube thoracostomy) to suck the air from the space between the lung and the chest wall (pleural space), restoring the normal negative pressure there and re-expanding the lung. They couldn't do this in the 1500s. Still, lung collapse, depending upon the circumstances, was a survivable injury, although a pretty serious one. If that's your scenario, it would make the person quite short of breath and probably a bit blue around the lips at least.

Mr Flibble · May 27, 2008

right, thanks guys

Tsu Dho Nimh · May 27, 2008

IdiotsRUs said:
..in say the 1500's

If there was a small puncture ( not life threatening but enough so there was some blood on the lips and impaired function) what would have been the treatment ( if any different from now. I've tried to look, --for a small one there doesn't seem to be much treatment) and what would be the recovery time?

Any ideas?

Straight from the medieval first aid manual ... wash the wound with wine and olive oil or turpentine (antibacterial phenolic compounds), cover the wound with an occlusive dressing (something to stop air leaks, often a linen patch with a wax and herb mix smeared on it - a plaster) and keep them inactive while it heals. You can administer some herbs: oregano, thyme, basil, and barberry were all used. Their aromatic antibacterial compounds are excreted into the lungs - helps prevent infeciton.

Recovery time is a couple of weeks - you need good scar tissue so they don't pop a leak. It can be longer if your plot needs it - they will hurt and be short of breath until any air is reabsorbed, muscled heal.

Mr Flibble · May 27, 2008

Tsu, that is exactly what I was after, have a free hug.

wickeddj · May 27, 2008

Don't forget the nifty crackly feeling to the skin right around the hole, like rice crispies, called subcutaneous emphysema (in case you want to research the term, though it obviously wasn't around at the time) caused by air trapped under the skin.

Mr Flibble · May 27, 2008

Thanks. Yuk.

Just one thing I suddenly thought of though.

cover the wound with an occlusive dressing (something to stop air leaks, often a linen patch with a wax and herb mix smeared on it - a plaster)

What if there is no external hole -- the broken rib has punctured the lung, not the skin. Would the treatment be any different? ( and I assume no rice crispies either).

Horseshoes · May 27, 2008

You can still get the sub-q air w/out a skin puncture. The air came from the lungs, not the external environmental air beside the chest.

A completely occusive dressing can help the vic develop a tension pneumo, which will kill him. Stick it down on three of the four sides, so air can evac from the pleural space and the lung can re-inflate.

murmel · May 27, 2008

They would have done this 1500? When did they know more about it? Interesting discussion, thanks!

Tsu Dho Nimh · May 28, 2008

IdiotsRUs said:
Thanks. Yuk.
Just one thing I suddenly thought of though.

What if there is no external hole -- the broken rib has punctured the lung, not the skin. Would the treatment be any different? ( and I assume no rice crispies either).

If there was no external hole, it would be bandages to immobilize the ribs for comfort, and bed rest. There were herbs for "breathing easier", the same aromatics as listed above.

These injuries were really common: get kicked by a horse, gored/butted by an ox, whacked with a club or sword ... they led a rough life.

***************
Murmel -
I have medical texts all the way back to Celsus, and they are extremely close to current practices if you disregard the changes in materials available. Celcus describes a method of splinting a broken arm that doesn't vary from what I do every winter. The French army surgeon, Ambrois Pare, was treating open fractures, skull fractures, sucking chest wounds, and other nasties with an astounding survival rate.

BarbaraKE · May 28, 2008

If there's no puncture, we're talking about blunt force trauma (i.e. kicked by horse instead of being cut by a sword). The ribs are very good at doing their job, i.e. protecting the heart and lungs since they are somewhat flexible.

It sounds like your character is hit/kicked by something hard enough to actually break the rib *and* drive the broken ends into the lung. That's going to be quite serious with more symptoms than just 'blood around the mouth' and 'shortness of breath'.

If that's all your character needs, I would think about having him be hit hard enough to bruise the chest badly/crack a rib (hurts to breath, shortness of breath) and hit his face/bite his tongue as he falls down (blood around mouth).

This also has the advantage that he could force himself to breath deeply (in order to run from bull or whatever). Of course, breathing deeply would hurt like the devil but he could do it if necessary

Mr Flibble · May 28, 2008

If there was no external hole, it would be bandages to immobilize the ribs for comfort, and bed rest. There were herbs for "breathing easier", the same aromatics as listed above.

Thanks.

BarbaraKE said:
If there's no puncture, we're talking about blunt force trauma (i.e. kicked by horse instead of being cut by a sword). The ribs are very good at doing their job, i.e. protecting the heart and lungs since they are somewhat flexible.

It sounds like your character is hit/kicked by something hard enough to actually break the rib *and* drive the broken ends into the lung. That's going to be quite serious with more symptoms than just 'blood around the mouth' and 'shortness of breath'.

Yup, and bugger.

If that's all your character needs, I would think about having him be hit hard enough to bruise the chest badly/crack a rib (hurts to breath, shortness of breath) and hit his face/bite his tongue as he falls down (blood around mouth).

ooh, good. That'll do. They can use the hobnail boots to kick his ribs and then his face.

This also has the advantage that he could force himself to breath deeply (in order to run from bull or whatever). Of course, breathing deeply would hurt like the devil but he could do it if necessary

Exactly what I needed! Excellent. You are evil and I love you.

Mind you, he's gonna get the punctured lung right at the end ( another whack to the same spot on the weakened ribs and pop!), when I need him seriously screwed with.

Thank you all.

BarbaraKE · May 28, 2008

IdiotsRUs said:
Exactly what I needed! Excellent. You are evil and I love you.

Gosh, never thought I'd feel so complimented by being called 'evil'.

Glad I could help.

Punctured lung: treatment / recovery...

Mr Flibble

They've been very bad, Mr Flibble

slcboston

Pasture-ized

Mr Flibble

They've been very bad, Mr Flibble

waylander

Who's going for a beer?

ColoradoGuy

I've seen worse.

Mr Flibble

They've been very bad, Mr Flibble

Tsu Dho Nimh

Mr Flibble

They've been very bad, Mr Flibble

wickeddj

Wicked is as wicked does

Mr Flibble

They've been very bad, Mr Flibble

Horseshoes

lisapreston.com

murmel

Tsu Dho Nimh

BarbaraKE

Mr Flibble

They've been very bad, Mr Flibble

BarbaraKE