Wounded at War

In my new research project I have been reading a lot of surgical treatises. Many popular accounts of early modern surgery focus on the idea that before the advent of anaesthesia and antiseptics the majority of surgical patients experienced exquisite torture, particularly in something like an amputation, and subsequently died from shock or infection. While true in some cases, Mary Lindemann has argued this rather bleak view of surgical practice is not entirely substantiated by the available evidence.1 She emphasises that many surgeons knowing these risks and dangers did not undertake surgical interventions lightly, and they almost never interfered with the cavity of the chest and abdomen.2 Lindemann also points out that many surgeons had acquired substantial amounts of theoretical knowledge and hands-on  training.3 Indeed in the 17th century many surgeons produced written treatises to demonstrate that they possessed the theoretical medical knowledge physicians claimed as their own.

In many cases surgeons acquired this hands-on knowledge on the battlefield. During the late fifteenth and early sixteenth centuries new weapons, particularly firearms, were introduced that required developments in battlefield surgery.

This battlefield knowledge is evident in many of the treatises produced by surgeons in the 16th and 17th centuries. The preface to Richard Wiseman’s treatise on wounds declared ‘I do pretend to have spent my time in Armies, Navies, and Cities, not in Universities‘.4 Ambrose Paré’s treatise on the same topic also revealed his background in military medicine: The Method of Curing Wounds made by gun-shot also by arrows and darts.

In his book on curing wounds Wiseman revealed that it was not only soldiers who were endangered by these new weapons. He included one story of an unfortunate bystander shot through the jaw at close range:

‘at our entring into Worcester, when the King came out of Scotland with an Army of that valiant People, a Townsman was shot. A Pistol fired by the Cheek, shot him through his lower Jaw and Tongue, and out by the contrary Cheek’.5

The first surgeon to undertake the cure of this injury believed that it had gangrened because of its black colour and so did not engage in the appropriate treatment. Conversely Wiseman, well versed in military medicine, knew that the ‘Wound was burnt by the flame, the very powder sticking in some parts of the Cheek’ and cured the injury.6 Wiseman, in this case, noted that for those who did not have experience  gained in war gunshot wounds could pose a particular challenge, ‘It is this ugly aspect that puts the inconsiderate Chirurgeon out of his Method, and so makes Gun-shot more difficult to cure’.7 Wiseman continued in his treatise to explain how gunshot wounds had severe consequences including haemorrhaging and, if the bullet wasn’t properly extracted, inflammation. Numerous surgical treatises discussed the difficulties of curing  gunshot wounds, including John Browne’s A Compleat discourse of wounds which included illustrations of surgeons in action on the battlefield.

Although not a new operation, these texts also suggest that gunshot wound patients were likely to face the terror of amputation. John Moyle’s Abstractum Chirurgiae Marinae, Or An abstract of Sea Chirurgery, explained the need for naval surgeons to be decisive and confident even in the face of the ‘sad schreeking’ of the patient:

‘By this time I’le suppose the fight is be|gun, and your Ship is ingaged, and wounded men begin to be brought down: And first one, who to save his Life, must have his Limbs amputated. You see part of the Limb carried away by the Shot; as the Hand from the Arm, the Foot from the Leg, or else the Bones so shattered, that should you leave it on, there were no hopes of healing it, nor of saving the mans life. This indicates amputation, and it is speedily to be done, for ’tis no time now for you to pause upon it; your main design is to save the mans life’.8

Guns and new artillery weapons were not the only hazard to health for those serving in the military. Wounds could also be caused by swords, daggers and (the newer) bayonets. Raymund Minderer’s Dutch treatise, translated into English, explained that wounds of all kinds, including those caused by bullets, affected a ‘very great number of men’.9 Thus learning to staunch blood was one of the most important elements of a surgeon’s training. Minderer offered numerous remedies to stop blood loss including the following,

‘Among the chief Astringents, is Frog-spawn; which therefore you are, when `tis in season, to make good provision of, for the whole year … This Spawn stauncheth bleeding, with a good bandage.’10

There were also much more (perhaps) mundane dangers. Minderer cautioned that because of the need to sleep outside and their irregular diet soldiers were likely to develop fevers, agues and bubos.11 Poor diet was also linked to other unsavoury medical problems ‘In Wars and Camps, Blood and other Fluxes [diarrhoea] are very frequent, caused by an irregular and ill dyet’.12 Thankfully this could be cured with oak leaves, or pear rind, and mace boiled in wine or wit crayfish boiled in vinegar, with the scales beaten to a powder, taken in red wine or broth.13

The life of a soldier as presented in surgical treatises appears to have frequently involved illness, disease and injury. Yet military, and although not explored particularly here naval, engagements not only caused great suffering and pain but advanced medical practice and physicians and surgeons fought to find new ways to save their patients.

For a more in depth and comprehensive look at the innovations of battlefield surgery and the use of boiled puppies to cure gun shot wounds head on over to Samantha Sandassie’s Panacea blog.

______________________

1. Mary Lindmann, Medicine and Society in early modern Europe (Cambridge, 2010) ,p. 266.

2. Ibid, p. 266.

3. Ibid.

4.Richard Wiseman,  A Treatise of Wounds (London, 1672).

5. Ibid, p. 3.

6. Ibid. p. 3-4.

7. Ibid, p. 4.

8.  John Moyle, Abstractum chirurgiae marinae., or, An abstract of sea chirurgery: designed for the use of such chirurgeons who desire to serve at sea (London, 1686), pp. 25, 23.

9. Raymund Minderer, Medicina militaris, or, A body of military medicines experimented (London, 1674), p. 109.

10. Ibid, pp. 120-1

11, pp.18-9.

12. Ibid, pp. 74-5.

13. Ibid, p. 76.