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Sirena of Glamis
12-24-2013, 01:14 PM
There are two parts to this post so I'll try to make it short and to the point. Here's the scenario:
The story is set in a sort of medieval world. The heroine's home is attacked and set on fire. She gets caught in the blaze and suffers severe burns across her left shoulder, arm, back, that general area. What I'm wondering is:


What type of treatment would she need? What type of treatment could she receive in a medieval style world?
What sort of scars would she have? What might they look like, feel like?
How long would it take for the burns to heal? How long would the burns still pain her? Could they hinder her movement?
What other injuries might she receive from the fire? (Damage to her lungs from the smoke? I don't know. *shrugs*)

The second part of this is still very fuzzy: what I was hoping for was your typical scenario where she bumps her head or something and hey-presto, total amnesia! However, I know after doing some research that real amnesia doesn't actually work that way. What I'm aiming for is what you typically see in fiction where she can't recall anything before a certain point (the fire) but she can still remember basic skills (talking, walking, etc.), she can still create new memories, and she can retrieve her old memories when exposed to certain stimulus (a familiar song, for example). So my question is:


Is there a type of amnesia that actually works like this, or is similar to it? How similar? What other affects might there be?
How do people in real life get amnesia? How do they recover from it?

Annnd that's the gist of it. This is a high fantasy story, so I am willing to play with reality a little bit if need be, but I would like to keep it as realistic/plausible as possible. Thanks so much for your time, guys!

StormChord
12-24-2013, 05:15 PM
Okay, so for the burn treatment: She'd need a salve on her wounds and a compressive bandage over it. Also, raw onions cut and put over the burn would have been used to keep her from blistering too much. These were fairly well-known treatments in medieval times - although they also used boiling oil on gunpowder wounds, so maybe their medical expertise should be called into question.

If there's magic in your world, you could also have some kind of magical salve with unspecified ingredients. It's up to you.

Third-degree burns take longer than three weeks to heal. Burns worse than that never heal without skin grafts.

Burn scars are notoriously gross. The skin on her arm, shoulder and back will be pink, shiny, and look somewhat veined. You know what, just google this one. I'm not gonna describe it in that much detail, I just ate breakfast. :P

Smoke inhalation would be a problem, but she'd get over it fairly quickly. Her eyes might be somewhat damaged by the smoke.

As for the amnesia thing, what you're looking for is "Retrograde Amnesia", which is the inability to recall anything before a certain date. It generally results from brain damage, but can also be caused by severe mental trauma - this variant is called "Psychogenic Amnesia".

But amnesia is one of those things where you can take all the writing liberties you want, since a lot of it isn't totally understood anyway. If you want to do realistic amnesia, that's cool, but if you want to do fantasyland amnesia, that's also totally fine. No-one will hold it against you.

One last thing. I got most of this from the magic of Google - on basic principle, I'd suggest checking there before asking here. :)

ECathers
12-24-2013, 09:01 PM
Some herbs/preparations that can help the burns:

First, cold water too cool/clean the burns. Take care not to pop any blisters as that leaves the patient open to infection.

Chamomile tea compress (cold) or chamomile oil - antibacterial anti-inflamatory antiseptic, heals skin. Drinking the tea will also aid sleep.

Lavender oil - anti-bacterial, anti microbial, pain killer, stops wounds from itching, lessens scarring and will also help the patient sleep.

Calendula - encourages collagen production (helps new skin and connective tissue grow) astringent and anti-inflammatory properties, anti-bacterial, anti-viral and anti-fungal.

Plantain - anti-inflammatory, promotes healing of injuries

Goldenseal - anti-microbial, anti-bacterial, anti-fungal, anti-inflammatory, antiseptic, helps the immune system, heals wounds

Comfrey - (especially the roots) heals skin wounds & burns, bones, cartiliage, promotes cell growth, anti-inflammatory - external use only

Honey - antibiotic, anti-viral, anti-inflammatory, cell regenerator

Note that 3rd degree burns often burn nerves as well, so there may be no pain. Are these 2nd or 3rd degree burns?

Also, with her wounds so near her head, it's likely that her hair may be at least partially burned and that she might have lesser burns on her head.

Sirena of Glamis
12-25-2013, 03:24 AM
Thanks so much, both of you. This is exactly the information I need. Super helpful!


One last thing. I got most of this from the magic of Google - on basic principle, I'd suggest checking there before asking here. :)

Thanks for the note (laughs) I have done research on this before, but info on the internet can be sketchy. Hence why I'm asking real people. Still, thanks very much for your time!


Note that 3rd degree burns often burn nerves as well, so there may be no pain. Are these 2nd or 3rd degree burns

No pain at all? Interesting. My original thought was 3rd degree, but I might play around with it and make them 2nd. How would the nerve damage affect her?

asroc
12-25-2013, 06:33 AM
Do not put foodstuffs of any kind on a burn, ever. Especially if it's anything worse than a first-degree burn (a first-degree burn means the skin is red and hurts but is not actually broken. If there are blisters and any kind of moistness it's a second-degree burn at least.) The only thing that should go on second-degree burns and up is clean cool (not cold) water, running if possible. Keep it under there for ten to fifteen minutes, then dress with a clean, moist dressing. Do not put pressure on the burn.
Topical antibiotics and other ointments are pretty much pointless. Even the hospital stuff has little to no effect, no homemade salve is going to do any good. I've had plenty of patients who made their burns a lot worse with their home remedies.

A burn like you're describing would require rapid transport to a burn center in the modern world. Large burns cause hypovolemic shock and are very prone to infection (hence no food and no ointments). They require oxygen, IV fluids and antibiotics and often skin grafts, so they're not really treatable without modern medicine.

There will definitely be pain. Third-degree burns don't hurt, but they're surrounded by second-degree burns, which are excruciating.

Smoke inhalation is not something you get over fairly quickly. Smoke is toxic and she'll have inhaled hot air, doing potentially serious damage to her airway including the lungs. Effectively all our burn patients need supplemental oxygen, and many have to be incubated (while conscious.) Smoke inhalation kills.

Sirena of Glamis
12-25-2013, 10:33 AM
A burn like you're describing would require rapid transport to a burn center in the modern world. Large burns cause hypovolemic shock and are very prone to infection (hence no food and no ointments). They require oxygen, IV fluids and antibiotics and often skin grafts, so they're not really treatable without modern medicine.
So in a medieval setting, there's really nothing you can do for a burn other than put it in cool water and wrap it up in a bandage. No salves or ointments. That's very good to know, thanks :) So all the aforementioned salves and oils would do more harm than good, correct?


Smoke inhalation is not something you get over fairly quickly. Smoke is toxic and she'll have inhaled hot air, doing potentially serious damage to her airway including the lungs. Effectively all our burn patients need supplemental oxygen, and many have to be incubated (while conscious.) Smoke inhalation kills.
I was wondering about that, actually, because I know when someone is caught in a fire, they'll sooner die from smoke inhalation than from the fire itself. So my heroine is pretty much screwed, since there is no modern medicine like ours in her world. I may have to do some tweaking...

Follow-up question: ECathers mentioned nerve damage. I read once that it can take something like 6-9 months for a nerve to regenerate from a torn branch in the neck to the end of the arm. Given the injuries I described, how long might it take for my heroine to recover from the nerve damage? And out of curiosity, how would nerve damage in her shoulder affect her hand? (Assuming her hand only received very minor burns) Would it affect her dexterity in that hand?

Okay, now I'm thinking I should lower the severity of her burns... Or maybe I'll just wing it and go with a magical solution. Still, it's good to know real world applications to problems like these, even if they can't be used in this particular novel...

MDSchafer
12-25-2013, 07:45 PM
So in a medieval setting, there's really nothing you can do for a burn other than put it in cool water and wrap it up in a bandage. No salves or ointments. That's very good to know, thanks :) So all the aforementioned salves and oils would do more harm than good, correct?


I was wondering about that, actually, because I know when someone is caught in a fire, they'll sooner die from smoke inhalation than from the fire itself. So my heroine is pretty much screwed, since there is no modern medicine like ours in her world. I may have to do some tweaking...

Follow-up question: ECathers mentioned nerve damage. I read once that it can take something like 6-9 months for a nerve to regenerate from a torn branch in the neck to the end of the arm. Given the injuries I described, how long might it take for my heroine to recover from the nerve damage? And out of curiosity, how would nerve damage in her shoulder affect her hand? (Assuming her hand only received very minor burns) Would it affect her dexterity in that hand?

Okay, now I'm thinking I should lower the severity of her burns... Or maybe I'll just wing it and go with a magical solution. Still, it's good to know real world applications to problems like these, even if they can't be used in this particular novel...

Medieavil medicine was pretty bad for the most part. Google King George III and medical treatment. It's some pretty horrific stuff and they were trying to help him, and he was supposedly getting the best treatment available.

Probably the best case scenario you could likely have someone do is Urtica urens. It's called dwarf nettles and is commonly available in North America and Europe. Basically you use it like tea leaves and dilute it down to like a 1 to 10 proportion. It only works with first and second degree burns. Even then, as I understand it, it only helps with the side effects which will keep the blister intact longer.

Orianna2000
12-25-2013, 08:46 PM
Infection is your worst enemy. Before antibiotics, they used garlic, honey, and wine to treat wounds, since these have antibacterial properties. But serious burns? Depending on how large the burns are, your character is pretty much screwed. She might very well die, and if not, will have major scarring and nerve damage. And nerve damage can HURT. If the nerves are completely gone, you can have phantom pain, and if they're still intact but injured, you can have lots of pain.

I sliced a nerve in my pinkie finger when I accidentally cut myself with a paring knife. It was a small, shallow cut, didn't need stitches or treatment, but it sliced through the nerve. After that, anytime I bumped that part of my finger, or if it got squeezed in a handshake, or whatever, the most excruciating pain shot through my hand. We're talking hold your breath, double-over, and try not to faint pain. Gradually, the nerve damage spread through the entire nerve cluster, encompassing two fingers, and the slightest bump would set the whole thing off. After about fifteen or twenty years, it inexplicably started to heal. Now it takes quite a bit of pressure to set off the pain. (Makes me glad I didn't agree to the surgery to remove the nerve, which would have left my fingers numb.)

Regarding burns, my grandfather (a pilot) was in a plane crash and suffered severe burns to 60 percent of his body, back in the 1980s. He died after a month and a half in the burn center. That was with antibiotics and special treatments. Without them? Your character doesn't stand a chance, unless the affected area is relatively small and she somehow manages to avoid infection.