1. ghostkisses

    ghostkisses Member

    Joined:
    Sep 10, 2017
    Messages:
    29
    Likes Received:
    28
    Location:
    Somewhere, that's for sure.

    Medieval amputation methods and preventing blood loss (help)

    Discussion in 'Research' started by ghostkisses, Jun 25, 2019.

    Okay.

    I have a character, he needs half of his arm removed. He will not accept cauterization to help with the blood loss, and magic is also a no go. To use any of those methods on him would be instant betrayal to him.

    So... First things first. What's the ideal instrument to remove the arm with? I want something that would take it clean off, but I'm not sure if the bone requires some sawing to get through. I just want it off in one swipe. Secondly, what kind of surface would this be done upon? Like.. Would a stone table suffice?

    Then..

    Sterilization. I presume they should wash this instrument in something to avoid infection, so maybe some type of alcohol, but which one? Should he drink some alcohol as well beforehand to help the pain?

    And then he's going to need something to bite down on so he doesn't accidentally bite off his tongue, so, would a belt suffice?

    Then preventing blood loss. So, since cauterization and... Well anything with burning is off the table, I'm assuming applying pressure and a tourniquet would be an idea. Would another belt tightened a whole lot around the area do? And should they apply the tourniquet before or after the amputation?

    Should he do anything else for the tourniquet? Like, are we applying cloth and pressing it against him as well for pressure.. And what about sterilizing the wound, are we applying alcohol to that too?

    And what of preventing shock.. I don't think I want the procedure performed whilst he's unconscious, but I don't know if that increases or decreases his chances of shock, and how I'd avoid shock overall. Then infection is a thing, how to stop that?

    Would there be any mixtures he might drink besides the alcohol to help with the pain, like herbs or something, and then, would he use poultices on the amputated arm or would that just worsen chances of infection because open wound, like, when should that be applied if at all, and what kind of stuff would we find in this poultice?

    And then.. Day to day upkeep of the amputated arm, and recovery. What should he do, and how long would the initial recovery be, you think?

    Lastly, could an unqualified person (supervised and with the guidance of physicians at the ready) perform this amputation for him? His girlfriend is going to do the amputation, she is a warrior, but no physician.

    Supplies wise he has a lot because he is wealthy, he's not out in the middle of nowhere he's at his home and he has proper physicians around him. So that's not an issue.

    Thanks.
     
  2. jannert

    jannert Who? Whooo? Staff Supporter Contributor

    Joined:
    Mar 7, 2013
    Messages:
    14,576
    Likes Received:
    16,189
    Location:
    Scotland
    Here's a good place to start. There seems to be a lot online about this kind of procedure, done under primitive circumstances. http://www.medievalists.net/2014/10/surgery-14th-century/

    Of course most physicians would not be aware of how to prevent infection. In fact, I believe some of them thought that if the wound got infected, that was good. Pus was good, etc. (urgh...)
     
    Rosacrvx and Andrew Alvarez like this.
  3. ghostkisses

    ghostkisses Member

    Joined:
    Sep 10, 2017
    Messages:
    29
    Likes Received:
    28
    Location:
    Somewhere, that's for sure.
    I'm willing to take some diversions away from the fact since this is a medieval fantasy so I have the liberty there for that, but, mainly I want the procedure to be realistic but not necessarily completely time accurate as I do want him to have decent treatment against infection, but not so far-fetched that I get historians coming at me with pitchforks, so yeah?

    The link helps though I'm not sure of the bit where they mention using a hot iron or gold cautery, because he would like.. Never trust anyone again if they approached him with burning stuff.
     
    jannert likes this.
  4. jannert

    jannert Who? Whooo? Staff Supporter Contributor

    Joined:
    Mar 7, 2013
    Messages:
    14,576
    Likes Received:
    16,189
    Location:
    Scotland
    Just keep doing research, and it will give you ideas. If this is fantasy, all the better, because you can pick and choose what bits you can include in your story.
     
  5. big soft moose

    big soft moose The Moderating Moose Staff Supporter Contributor Community Volunteer

    Joined:
    Aug 1, 2016
    Messages:
    13,264
    Likes Received:
    15,318
    Location:
    East devon/somerset border
    tourniquet and spirits to disinfect the wound, bind it up with a poultice of herbs ... (in reality hes going to die without cauterization, but in your world may be the herbs have haemostatic properties or something)

    ETA in some situation hot tar was used to cauterize wounds - its not literally burning like fire so would that be acceptable to your patient?
     
    jannert and Andrew Alvarez like this.
  6. Andrew Alvarez

    Andrew Alvarez Senior Member

    Joined:
    Mar 6, 2018
    Messages:
    334
    Likes Received:
    250
    Location:
    South America
    Unfortunately, without any means of quickly seal open arteries in aseptic way, death was guaranteed. There's a limit in how a tourniquet can help, since itself involves dieing tissue. Even slave's punitive amputations were sealed with red hot iron or deep frying the limb for that reason. Most probably, the surgeon would knock his patient off with alcohol or drugs and cauterize anyway... not that he could oppose that much resistance, anyway.
     
    jannert likes this.
  7. ghostkisses

    ghostkisses Member

    Joined:
    Sep 10, 2017
    Messages:
    29
    Likes Received:
    28
    Location:
    Somewhere, that's for sure.
    ...Oof. I have to make him suffer, don't I? So, magic's still off the table, but I'm leaning towards cauterization now because okay he has third degree burns from a past experience which is why he would be reluctant with that but... His past experience revolved more around people trying to "help" him without his permission and that's where it kind of went haywire, so because the amputation is his decision, maybe he would (very, very, very) reluctantly allow for cauterization because... His problem was more with having magic used on him without him allowing for it. And he does have a very persuasive girlfriend, so... Maybe she could convince him.

    So... Aww. Noo. I want to say "I don't want him to suffer" but then... Well ya heard some of his backstory. I gave him all the suffering. He needs a hug. Ohh no..
     
    jannert likes this.
  8. Andrew Alvarez

    Andrew Alvarez Senior Member

    Joined:
    Mar 6, 2018
    Messages:
    334
    Likes Received:
    250
    Location:
    South America
    That sounds like a great 'turning point' sort of event for character development! It would be great to know how it goes at the end and what elements prevailed on his psyche... or hit him with a board to the head and make him deal with a new involuntary trauma. The options are great in any case!
     
    jannert likes this.
  9. Homer Potvin

    Homer Potvin The bastards hung me in the spring of '25.... Contributor

    Joined:
    Jan 8, 2017
    Messages:
    5,154
    Likes Received:
    9,245
    Location:
    Rhode Island
    Yeah, having a limb lopped off definitely alters one's trajectory in life.
     
    Cave Troll likes this.
  10. Selbbin

    Selbbin I hate you Contributor

    Joined:
    Oct 16, 2012
    Messages:
    3,700
    Likes Received:
    2,373
    Location:
    Australia
    A saw, a suture and something to bind the wound to stop blood loss would be enough. Cleaned in alcohol to stop infection although they may not have known this depending on your world rules. Cauterizing was not always used for something so radical.

    From: https://www.ipfh.org/media-press/features/amputation-through-the-ages-a-time-honored-way-to-save-lives


    In 1st century AD Rome, an encyclopedist and philosopher named Aulus Cornelius Celsus wrote of circular surgical amputation, ligation of blood vessels, creating a flap of skin to cover the stump and packing the wound with lint soaked in vinegar. Surgical instruments used for amputation as early as 79 AD have been found in Pompeii. Albucasis was an Arab physician, also of the 1st century AD. He applied tourniquets to both sides of the amputation site to cause tension in the soft tissue, which was protected from saw injury with linen dressings. Albucasis also developed the “double suture” (suturing successive layers of tissue) procedure, which is still used today.

    Amputation surgery continued to evolve until the early Middle Ages. Unfortunately, a decree from the Catholic Church between 1130 and 1247 prohibited surgeons from causing bleeding. To fill the obvious need for surgery, the procedure was taken over by “barber surgeons,” who had only dexterity and skill with a shaving razor. Surgical skills degenerated, and because Europe was made up of isolated kingdoms, there were few surgical innovations until the 14th century.
     
    Last edited: Jun 26, 2019
    jannert likes this.
  11. Hammer

    Hammer Contributor Contributor

    Joined:
    Oct 28, 2018
    Messages:
    964
    Likes Received:
    1,975
    Location:
    UK
    Well, he could try keeping it on ice, but I don't think it will recover...



    I have an C18th vetinary book somewhere, there is already some good info on here, I will try to dig the book out and find out what they did to animals (if trying to save them)
     
  12. badgerjelly

    badgerjelly Contributor Contributor

    Joined:
    Aug 10, 2013
    Messages:
    1,406
    Likes Received:
    810
    Location:
    Earth
    I thought shock would be the biggest issue? Knock him out, chop it off, sort out the arteries and then sew the patches of skin over - ample use of alcohol to keep the thing clean too wouldn’t hurt. Or watch the movie ‘48 hours’ and just go that route - cut off blood flow to prevent pain and then hack it off.

    If you wish to practice on someone you can use me ... if you can hunt me down ;)

    Anyway, I’d be interested to hear what you come up with if you have the time to share? Thanks
     

Share This Page