An arrow in the gut?

I was researching gunshot wounds in the abdominal area, and came across this discussion from a 1903 issue of JAMA. It's talking about bullet wounds specifically, but a lot of the same issues should apply.

According to that, there's a huge difference between the mortality of wounds to the stomach and intestines depending on whether they're full or empty when the patient gets shot. Full=contents emptying into stomach cavity and almost immediate, often fatal, infection. Empty means the patient can be operated on even many hours later, and still live. Apparently, a perforated stomach (if empty when shot) will even heal on its own without surgical intervention.

Lots of fascinating detail at the link. You would have to think about how an arrow wound might differ from a bullet wound, but arrowheads come in a variety of shapes and sizes so you could probably craft a likely scenario where the wound is or isn't survivable as you please.

I don't know exactly but 15 hours might be enough to empty, depending upon what he is in the habit of eating. Maybe a dietary person can help here.

Scott Kaelen said:

ETA: My story is epic fantasy, so it's setting is similar to middle Iron Age.

In the early chapters of my story, a character who might seem to be shaping up to become a major character gets an arrow fired into his midriff. He then, along with two companions, fights off the attackers.

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Battles are chaotic and fast-moving places. Maybe your guy gets gut-shot by an arrow but it's not a tv-friendly big wooden shaft sticking cartoonishl out of his belly, giving plenty of time for one last heroic speech. Instead, it's off to the side and penetrates the tough leather armor and rough-hewn shirt he's wearing to jam into the thick muscles of his oblique abdominals.

He's got an arrow in him, it's going to hurt but won't kill him outright and given how any reasonable fighter is going to be dodging and twisting and moving, a glancing shot like that is lucky to stick at all. Of course, trying to do anything with a big chunk of wood in you is going to be pretty tricky but I'm sure you can write around that.

Later, they'll try and pull or cut the arrow out and maybe bleed the wound a bit. Maybe slap some honey or other gross poultice on there that the local shaman/medicine man recommends. Lots of prayers happen and then he dies like a dog from the gross infected wound full of septic fibers from his shirt as well as general iron age uncleanliness.

If the arrow sticks in too far and penetrates into the abdominal cavity right away you're going to have an immediately fatal situation due to massive sepsis and gross stick-in-the-guts syndrome.

For a modern equivalent go talk to some bow hunters and ask them about bringing down deer. Sometimes you get lucky and they bleed a lot and drop in a few minutes. Other times you have a long long hike ahead of you trailing a wounded animal. Grim stuff.

I would say it depends on where the person is hit. If hit in the stomach, you can have stomach acid coming out and causing damage. If the bowel is hit, infection is likely due to the contents spilling out. The size of the wound and depth plays a part too, being how much it'll bleed. Any organs that get shredded or hit can change the outlook, but if you get to a hospital soon enough, you can be safe from some pretty gnarly wounds, too. So if you want the character to die, you could make them die. If you want to live, then they can live. It's all in how you make it get them.

http://www.ehistory.freeservers.com/vol2/Arrow Wounds.htm

According to that doctor, and what I've picked up about gut wounds, his chances are pretty low. If you really want him shot in the torso and living, glancing blows will be far better than anything else. Maybe the arrow gets stuck in his clothing and keeps tearing and damaging the skin and upper fat and muscle layers, and he gets a surface infection after a few days. Those can be dealt with, and anyone looking would be going, "Holy shit, he's been shot in the stomach and he's still fighting!"

Infection can happen in any wound, and can be massively serious--in the sort of era you're talking about (pre-antibiotic, pre-knowledge of basic antiseptic procedures), it's incredibly likely. Look up sepsis (blood poisoning). You can shoot him anywhere you like. Hell, you can have him nick himself shaving.

Stomach still seems about perfect for what you want. The wound itself would potentially be survivable without surgery, but like any wound could easily infect--especially if the person who treated him didn't wash their hands before stitching up the hole or slapping on a poultice. Or take another peek at the link I gave you in my first post--the same article discusses chest wounds, which might give you another option.

But really, if all you need is an infection, anywhere is going to work.

I haven't seen this brought up, but if you get shot with an arrow anywhere in your body you are going to bleed. If this is as far back as you say, surgical techniques are non existant and the person will most likely bleed out because there is no way to stitch up the internal wounds. I doubt seriously that they would live long enough to get an infection if they take an arrow in the torso. Moving around during battle is just going to make this worse as every move the person makes the arrow head is just making more internal cuts.

What you need is an arrow to an extremity, ie... arm, leg.

Scott Kaelen said:

I'm leaning towards the torso being just too fatal for a non-antiseptic, non-antibiotic era. Although... I do have a get-out clause with it being fantasy. Also, 'luck' plays a subtle part throughout the story, so would it be possible for an arrow to enter the abdomen but miss all vital organs and intestinal tract completely?

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It *might* be possible, but it's really gonna bend the reader's suspensions of disbelief quite a bit, if not break it entirely.

The "common knowledge" is that a gut wound before antiboitics was always fatal. That may not be 100% true, but it's what a lot of people believe and expect, and it your going to go away from that you should have a good reason.

I'd give him a leg or thigh wound, personally. that will limit his mobility nicely and require time to heal, but doesn't have the problems associate with a gut or abdomen wound, both in terms of real world infection issues and organ damage issues and in terms of "what people expect" in terms of story.

EDIT: With a leg or thigh wound I'd also include the hip/pelvis as a possibility.

My advice: Kill him off. That helps the reader get the idea that "no one is safe," which you can use to your advantage later.

This is getting past answering a specific question though so I'll just leave that there and stop now.

Getting an arrow in the leg sounds pretty likely in the heat of battle. He's not likely to have strong enough armor there (leather or otherwise) and it's a big meaty muscle that can still half function if you get something stuck in it. It hurts, as soon as the adrenaline wears off he's likely to just collapse for a while till he gets it treated and it can develop into a fatal or non-fatal septic wound at your discretion.

It's reasonable that he gets an infection and it lays him low. The gods alone can tell whether he will live or die based on their whims. If you want him to live then his body will fight off the infection eventually. He'll have a high fever and be totally out of his head and on total bedrest during this time. He better have a loving family or a rich patron that needs him around because he'll need frequent care. Coming out of it he'll probably have a fairly gnarly scar at the point of entry, a bit of a limp till the muscle heals and a healthy hatred for archers.

It *can* be a crippling injury but doesn't have to be if the wound is fairly shallow. A deep puncture wound is most likely to go septic and kill him dead of blood poisoning or gangrene - take your pick.

Medically, with the latest and greatest in Iron Age tech he has a pretty minimal chance of coming out of it. People were getting stabbed by those damn iron swords and spears in that era and the doctors/medicine men and women would have had an array of gross-smelling roots and poultices and icky things to slather on there because their grandpappy once did that and the Chief's son lived so clearly this treatment plus the will of the gods will let your dude live.

Don't bother with amputation stuff, he'd just die from that. It wasn't till the Civil War that amputation was a reasonable gamble.

Alexander the Great survived, barely, an arrow through the lung in one of his battles in India, but it was touch-and-go for some time and had a lasting impact on his health.

There's an interesting book about arrows and arrow wounds that may have good information for you: "The Lightning Stick: Arrows, Wounds and Indian Legends" by H. Henrietta Stockel.

Have fun maiming your character!

Gut shot by an arrow = Dead man.