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katiemac
05-30-2005, 09:11 PM
I've done quite a bit of research already myself and written in a scene where one of my characters is shot in the shoulder. My characters don't have access to modern medical technology, as this is a more Industrial Revolution era. Anyway, the character is sent to a doctor and everything is taken care of there. Later, it gets infected.

Now I'm thinking my facts aren't straight, and I was hoping someone here could answer a few questions, or know any helpful books or websites.

1. What would be the procedure the doctor uses to remove the bullet?
2. If it were to get infected, are there any 'homeopathic' remedies used to cure?
3. Could the infection reasonably be caused by a piece of the bullet unremoved? How difficult would it be for character to recover, if the piece were removed?

Thanks in advance, everyone. I'm actually considering cutting this whole scenario because it's not serving the purpose it used to. If it makes any sort of difference, the make of gun would be very similar to .38 Colt 6-shot revolver.

Fern
05-30-2005, 09:49 PM
Reminds me of scenes on tv & also in books where the patient was given laudanum (sp?) or else gotten very drunk before the doctor dug the bullet out with a knife. Others had to hold them down. I'd be more apt to believe the infection was caused from the doctor having not disinfected his hands, etc. before doing surgery. Seems the bullet would come out in one piece.

I read once where doctors ground their fingernails in sand to keep them short so perhaps you could have a doctor who wasn't careful about keeping his nails clean. Of course, they wouldn't have used gloves then.

Home remedies would have involved a poultice of some kind. Might try the FoxFire books if they are available at your library. If I'm not mistaken, those had old time remedies in them.

Julie Worth
05-30-2005, 10:11 PM
...as this is a more Industrial Revolution era....If it makes any sort of difference, the make of gun would be very similar to .38 Colt 6-shot revolver.

Just be sure it's been invented.

dblteam
05-30-2005, 10:24 PM
If this is pre-antibiotics, you might do some research into maggots. They're very effective in eating away gangrenous/infected flesh and are, in fact, seeing a revival in modern medicine.

Valerie

katiemac
05-30-2005, 10:34 PM
Maggots! Blegh. I don't think I have the stomach to do that -- even if it is to my characters. Poor characters. I beat them around so much already.

Fern, thanks. I wrote the scene the way you mentioned -- digging the bullet out with a knife. (Ow.) I didn't think about getting him drunk first. Poor guy.

As for the gun, it's been researched. (Actually, katdad helped me out quite a bit there.) I'm not following our own industrial revolution to the T, so the gun isn't exactly the Colt, I just figured having a real historic example might be helpful.

I'd still be interested in hearing any other thoughts, but now I'm off to do a little more research...

Julie Worth
05-30-2005, 10:44 PM
The infection is most likely to be caused by digging in there to get it out. I've never understood why 19th century folks put up with all that pain, having a barber fish around in there, since metallic lead is not that dangerous.

MadScientistMatt
06-01-2005, 06:19 PM
One other note of interest:


If it were to get infected, are there any 'homeopathic' remedies used to cure?

If your story predates the Industrial Revolution by a good bit, chances are there would not be any homeopathy either. It appears that the first article making any reference to this idea appeared in 1796, and this practice was not described in books until the early 19th century. About the same time the Luddites started smashing knitting frames, in fact. So if this is set in the real world before the Industrial Revolution, folk remedies would not be called homeopathy. You may wish to take a look at this essay by Oliver Wendell Holmes (http://www.quackwatch.org/01QuackeryRelatedTopics/holmes.html) for an example of comments on the history of homeopathy from not too long after the practice originated. It is hosted on a site that opposes homeopathy, but from what I understand the history part presented is fairly accurate.

Doctors would have their own remedies, however. Exactly what they tried would vary depending on the location. For example, many American settlers used willow bark to treat fever. But like modern asprin, this should not be given to anyone who is bleeding. They might try using a mercury compound. Or they may try some sort of patent elixer with dozens of ingredients. They may try cauterizing the wound with a hot iron, like the scene in Braveheart.

The doctor might use a tweezers or similar tool instead of a knife.

Andrew Jameson
06-01-2005, 10:54 PM
Here's an interesting article (http://www.healthtouch.com/bin/EContent_HT/cnoteShowLfts.asp?fname=00733&title=SOFT+TISSUE+FOREIGN+BODY+&cid=HTHLTH&print=yes) on modern treating of foreign things, like bullets, in your body. Of special note: 1) "If an object is very deep, it may cause more damage to remove it than to leave it there" and 2) "Some foreign objects may have passed through clothing before entering your skin. For example, stepping on a nail may cause it to pass through your sock before entering your foot. This may have caused small threads or bits of clothing to be pushed under your skin. Bits of clothing in a wound increases your risk of getting an infection." Perhaps you could use that as an underlying idea.

I suspect that when you say "homeopathy," which is pure bunkum, you might really mean "naturopathy," which at least has some underlying basis, yes? I would suspect that herbal remedies, some effective, some not so much, were used pretty extensively in the West right through the first part of this century.

[Wow. I just realized I used the word "underlying" twice in two paragraphs. Terrible.]

BradyH1861
06-02-2005, 07:13 AM
If this is Civil War or post Civil War, please read the following....otherwise, disregard.

The type of pistol you mentioned fired a round lead ball. In order to remove it, the doctor would use a bullet clamp to pull it out. It sort of looked like a large pair of tweezers, with ridges on the clamps. They would also have used retractors to pull the skin back to allow them to access the bullet. The real risk for infection would come from a piece of cloth from the patient's shirt getting caught in the wound.

I'm sorry that the above is rather brief. I actually have a Civil War era surgical kit with retractors, saws, etc. If you want to see what the specific pieces of equipment look like, I'd be happy to send you some pictures.

Brady H.

Sunrise2Fantasy
06-02-2005, 08:20 AM
1. What would be the procedure the doctor uses to remove the bullet?

Don't take my word 1oo%, but I remember reading in 5th grade, a war book, about a chick who disguised herself as a dude to get in the war. It showed her in the hospital bed, and she used some type of metal thing to get the bullet out of her...I'm not quite sure what the doctors would use, and depending on your age of technology, watch M*A*S*H its a show about the vietnam war and these medical doctors. That might give you some insight.

2. If it were to get infected, are there any 'homeopathic' remedies used to cure?

You'd have to look that up. As far as I know, in my religion, Wicca, we use herbal remedies for medicines. Of course, depending on the type of story you're writing, you could make up a cure. For example...a lab we did in science once, we were studying a made up plant that they said helped cancer- Botona Curus. So it could be something simple like that. But remember if your going to do something along herbal remedies keep it simple. Marines and such have to now and then survive out in the wild for periods of time, so many had to learn how to tend to wounds. Maybe you can research books or online about some information on that.

3. Could the infection reasonably be caused by a piece of the bullet unremoved? How difficult would it be for character to recover, if the piece were removed?

It could be caused my an unmoved piece of bullet...again depending on the age of your story, many MANY bullets were and still are made of a heavy lead substance that is pretty much poisonous...as far as I know...You ever see the patriot? In that movie a ton of soldiers got infected by lead poisoning of bullets. Plus it could block out arteries or veins or disrupt something in the body, and having metal inside you like that could lead to a possible infection. Depending on how long it was in there and how bad the infection is is how long it will take for the character to recover. Depending on the kind of infection, while they recover, they might not be able to do a lot of activities.

Again, dont rely on me totally, as far as I know what I've told you is half true or less. My dad was in the Marines, so I've learned a little, but never much about guns, except what I'm learning now. I know a little bit about infections and stuff from a lot of things, but maybe not enough. I hope this helps.

Liam Jackson
06-02-2005, 09:11 AM
<<<This may have caused small threads or bits of clothing to be pushed under your skin. Bits of clothing in a wound increases your risk of getting an infection." Perhaps you could use that as an underlying idea.>>>

Dead on. Slowing moving, ball-shaped ammo was/is notorious for carrying lead fragments/shavings, cloth, skin, hair and grit into the wound channel. The general methodology for extracting ball ammo in a field enviornment hasn't changed a great deal. (by field, I mean a battlefield) Today's instruments, of course, are far superior. However, the protocol has changed a great deal.

Then: Remove the object, ASAP. Warriors and field surgeons of two centuries ago had decent, general knowledge regarding infection cause and effect. Use a long metal probe to determine exact location of the projectile. Incise the entry wound, spread the wound if it's in an area conducive to the procedure, irrigate, and remove with long, narrow extraction tool (bullet clamp). Irrigate with water, sterilze with "spirits", (isopropyl alcohol wasn't always available) stitch up, (A no-no in today's combat arenas) and cover with clean linen (relative to the enviroment) or use ball ammo patches (small squares of dry, clean cloth used to seat the ball in the muzzleloading weapon.)

Now: Protocol depends on location/severity of the wound, availability of combat medic, time/distance to triage unit. Prevailing attitude is DON'T EXTRACT IN THE FIELD unless the circumstanses are highly peculiar.

NOTE: Not sure of the time frame or level of industrialization you're aiming for (did I miss that in a previous post?), so your mileage may vary with the information above. Okay, a bad pun. So shoot me.
'Nite all.

Kathie Freeman
06-02-2005, 09:34 PM
The phrase "shot in the shoulder" is rather vague. Was it from the front or the back, at what level and from what distance? Movies notwithstanding, a bullet, any kind of bullet, rarely travels a straight path. My husband was shot in the shoulder a few years ago, and it passed downward through his lung and ended up in his back about an inch from the spine. Your surgeon had better know where it is before he starts cutting. However, I do agree that any infection would probably not come from the retained fragment, as it would likely have been "sterilized" in firing. And while doctors in the Civil war era may have know theoretically about pathogens, there was little time or equipment to pratice it under battlefield conditions. Until the advent of penicilllin, more war deaths were caused by infection than by the original wound.
Kathie

katiemac
06-02-2005, 09:53 PM
I just wanted to thank all of you again for your responses -- this is actually extremely helpful. There's plenty of information here, and for a scene that's only going to be a page or so, I have a wealth here to work with. I'll have to take some time and go through each of your responses more carefully, but I sincerely appreciate all the help so far.

Liam Jackson
06-03-2005, 12:56 PM
I think we've properly exhausted this subject. :)