Medicine at sea

[Sjöröveren]

I considered the use of seawater as well, for cleaning/flushing out wounds if nothing else. I seem to recall having heard somewhere that, depending on where or perhaps where that seawater came from, it could be chock full of pretty nasty infectious agents. Purely anecdotal, though, old-wife tale sort of thing.

And considering the sea-borne cloud of filth that would surround a becalmed ship, it would probably be a really bad idea in that situation.

But it's one of those things that got into my head, so I discounted the use of seawater without really considering it. If it is, in fact, true, then a minor abrasion would probably be fine, but a deep wound opening up muscle and/or veins/arteries would be a bad idea to expose to it.

Basically, I just don't know. Very possibly better than nothing at all, though.

And some interesting stuff in the other posted info there, Jenny.

Just remembered another common topical antiseptic. "Blue ointment" was basically mercury mixed with lard. Apparently the mecury reacted with the fat to create a deep royal blue color, hence the name. It was a very common treatment, and I've seen it listed often in ship's surgeon's stores. It was applied in a generous layer on flannel, which was then secured over the wound. I'm sure the lard did more good than the mercury, as an effective barrier to air and moisture. We certainly have better treatments now, but it wasn't that long ago that fats were used routinely in home remedies - maybe still are in many places. Whenever I burned myself when I was a kid, my mom put butter or Crisco on it.

[Sjöröveren]

Didn't they find them in food stores, sometimes, along with the weevils? And even if they do turn into flies, the flies will lay eggs that turn into maggots. It's a vicious cycle. Still, imagine having to pick through your food to find maggots to put on your wounds...

Most of the meat onboard was either dried, pickled or on-the-hoof. So I'm guessing the numbers of carnivorous insects were fairly low compared to the ones feeding on bread, flour and other plant materials. So lots of weevils, not so many flies. Just a guess, though.

[blackjohn]

You mean the olde ways, like flushing wounds with fresh urine or letting maggots clean them out by eating the dead flesh? 

I've heard of urine being used, but don't know much about it. Same with maggots. I know more about the contemporary uses of medicinal maggots than historical. I gotta research those two more....

In my spare time the other day I researched maggots a bit. That research was showing a trend towards maggots not being used during the 17th/18th centuries.

[Story]

You mean the olde ways, like flushing wounds with fresh urine or letting maggots clean them out by eating the dead flesh? 

I've heard of urine being used, but don't know much about it. Same with maggots. I know more about the contemporary uses of medicinal maggots than historical. I gotta research those two more....

In my spare time the other day I researched maggots a bit. That research was showing a trend towards maggots not being used during the 17th/18th centuries.

History of Maggot Therapy

References to the use of maggot therapy in ancient times

The primitive, carrion-breeding habit of blowflies has been known and recorded for centuries. A very early reference can be found in the Hortus Sanitatus, one of the earliest European medical texts, published at Mainz in 1491. Fewer historical references are available on the habits of parasitic species that cause myiasis although some references do exist. In the Bible, Job (Job 7:5) complained `My body is clothed with worms and scabs, my skin is broken and festering'.

*

Maggots in military conflicts

The opportunistic infestation of wounds, particularly those sustained in battle, has similarly been observed throughout the centuries. Ambroise Paré (1509-1590), Chief Surgeon to Charles IX and Henri III, recorded that in the battle of St. Quentin (1557) maggots frequently infested suppurating wounds4.

Napoleon's Surgeon in Chief, Baron Dominic Larrey, quoted by Goldstein4 reported that when maggots developed in battle injuries, they prevented the development of infection and accelerated healing. `These insects, so far from being injurious to their wounds, promoted rather their cicatrization by cutting short the process of nature and causing the separation of cellular eschars which they devoured. These larvae are indeed greedy only after putrefying substances and never touched the parts endowed with life'. There is no evidence, however, that Larrey deliberately introduced maggots into his patients' wounds.

During the American Civil War, a Confederate medical officer Joseph Jones, quoted by Chernin5 noted the beneficial effects of wound myiasis as follows; `I have frequently seen neglected wounds filled with maggots, as far as my experience extends, these worms only destroy dead tissues, and do not injure specifically the well parts. I have heard surgeons affirm that a gangrenous wound which has been thoroughly cleansed by maggots heals more rapidly than if it had been left to itself.'

According to Baer6 and McLellan7 the Confederate surgeon J. Zacharias, may have been the first western physician to intentionally introduce maggots into wounds for the purpose of cleaning or debriding the wound. Baer quotes Zacharias as stating: `During my service in the hospital in Danville, Virginia, I first used maggots to remove the decayed tissue in hospital gangrene and with eminent satisfaction. In a single day would clean a wound much better than any agents we had at our command.... I am sure I saved many lives by their use, escaped septicaemia, and had rapid recoveries'

A fascinating review of the early history of maggots in wound care was published in 1932 by Goldstein8.

http://www.larve.com/maggot_manual/docs/history.html

[blackjohn]

That's one of the sites I saw. Notice the big gap between the 1500s and the Age of Napoleon. I'm pretty sure I found another site that pointed to this gap and concluded they weren't in use during that time. Of course, it could be that they weren't in use in some regions, but were in others, etc.

[Zephaniah W Nash]

" Exactly! How many of you here have butchered a pig? Prepared the body of a family member for burial? Performed a bloodletting on a child, spouse or horse? Assisted in the delivery of a child, or calf/colt, etc.?"

All of the above, apart from preparing the body of a family member for burial. Although I've dug a couple of graves -- picked up a little extra cash from a local cemetary.

Okay, bragging aside...

blackjohn; I'd be as curious to see the documentation saying specifically that maggots were not used in the appropriate time frame. I'm starting to become a bit leery of the tendency of some historians I've read to declare that if they cannot find a specific mention of some practice or other in a particular time frame, that it necessarily did not happen at that time.

It seems to me that if something was common practice right up until the specific time in question, and common immediately afterwards, that we should probably infer it carried on throughout -- unless we have specific documentation that it did not. May not apply to this specific subject, just a general view I've been developing...

[blackjohn]

blackjohn; I'd be as curious to see the documentation saying specifically that maggots were not used in the appropriate time frame. I'm starting to become a bit leery of the tendency of some historians I've read to declare that if they cannot find a specific mention of some practice or other in a particular time frame, that it necessarily did not happen at that time.

Yeah, I agree that one must be careful, in either direction. One shouldn't assume a lack of evidence that creates a gap in the use of something means it went out of style. But one also shouldn't assume that is remained in style either. Applying Occam's Razor doesn't really work here either, I'm afraid, because which is the most likely explanation? I tend to lean toward the side of not. Ymmv, which is cool. Bottom line, I'll try to locate that source, and each can interpret it to their liking.

:)

[blackjohn]

I found the citation. It's really an offhand type of thing...

http://www.livescience.com/humanbiology/05...19_maggots.html

"The treatments were back in vogue during the Middle Ages, and again in the 1800s." One could read that as, "yeah, they practiced it, but not much" or "it wasn't practiced." Just for fun, I'll keep looking around.

While looking, I did come across this interesting site... sick RevWar soldiers... fun stuff! Not water, not our era, but still fun! (especially since I just got a flu shot!)

http://www.mnwelldir.org/docs/history/history02.htm

[blackjohn]

I just searched through some online texts, no luck with maggots yets.

http://history.amedd.army.mil/booksdocs/mi...frameindex.html

http://history.amedd.army.mil/booksdocs/re...frameindex.html

More from wiki...

http://en.wikipedia.org/wiki/Maggot_therapy

If anyone is interested, try searching "maggot debridement." (Reading this stuff reminds me of the time I was making maps for the US Army Center of Military History's Medical Corps in the European Theater in WWII book.)

And yes, I'm eating lunch while researching maggot therapy.

http://ecam.oxfordjournals.org/cgi/reprint/3/2/223.pdf

[Sjöröveren]

" Exactly! How many of you here have butchered a pig? Prepared the body of a family member for burial? Performed a bloodletting on a child, spouse or horse? Assisted in the delivery of a child, or calf/colt, etc.?"

All of the above, apart from preparing the body of a family member for burial.  Although I've dug a couple of graves -- picked up a little extra cash from a local cemetary.

out -- unless we have specific documentation that it did not.  May not apply to this specific subject, just a general view I've been developing...

This is why I love people like us! I throw out a comment like this and all kinds of hands go up. I should have said "How many of them have butchered a pig?"

[blackjohn]

It occurs to me that the "correct" answer probably is contained in John Woodall's book The Surgeon's Mate. Sadly, it seems it is still unavailable as an e-text.

[Red Cat Jenny]

Sjöröveren

Again thanks for the input. You have a wealth of knowledge it seems on the subject.

Interesting that "The New World" of the un developed frontier would seem so polluted (Guess I watched too many Westerns with sparkling streams and the like LOL)

Seriously.. I did put more thought to it than that. I lived for 5 years 1/2 block from the beach in an area where the wind blew so constantly off the Ocean you noticed the few times it stopped (yet the local idiots still wont put up windmills so we can stop paying for so much electric) Anyway I had to hose off my porch sidewalk and furniture every couple of days because of the sand buildup. Damn I miss that house..anyway there were no trees and no indstry in the area. I felt very healthy and my allergies even ceased. When I moved back to the 'burbs' I was shocked that I could "smell the place" soil, bug spray, mold, exhaust. In a word it was a wakeup call to what you were breathing in nowadays. This got me thinking about the more pristine condition very early America might have held. I know the cities in the beginning were fetid and disgusting due to no health code and industry. I was thinking more on the lined of sitting on a windy prairie with the nearest pollution being a cow chip or two.

--

On the reference to herbal - I use this term as reference against what we state today as pharmaceutical. Most of which is derived from natural materials anyway. I'm not up on "herbals" at all. I take Bayer! haha

Still perhaps I should have been clearer in stating plant/root/animal based remedies instead of "herbal"

--

Ick fator? Yes (By the way guys, I never slaughtered a pig, but some of the multinational peolple I work with had a rousing albeit disgusting conversation in grand detail about watching relatives slaughter farm animals "back home" when they were young. )A first hand account was enough. I feel like I've been there. But one mans icky brutality is anothers normal way of life, just have to be open minded.

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I had read about cauterising in stories but wondered if it were true. It seemed to make sense as we still cauterize (on a small scale) in medicine today.

--

No worries if you were cranky, we all have those days A toast to the knowledge here glad we started this thread!

[Zephaniah W Nash]

I've heard more of cauterization for wounds in later time periods, and even then only as an emergency treatment -- definitely not the first choice, but better than letting someone bleed out.

I've even seen some anecdotal accounts of people slapping a hot gun barrel onto a wound to cauterize the wound, but that one seems pretty farfetched to me, particularly in the days of muzzleloaders. You'd have to be reloading allfired fast to ever get a barrel hot enough to cauterize flesh.

And as far as butchering animals, I'm a life-long hunter -- and not for trophies. If I kill something, somebody is a-gonna eat it. Mostly deer, but there's other tasty critters out there, too. We had a major run of feral hogs throughout the local cattle country last year (and a bit this year). Wild pigs will completely destroy pastureland, and you don't know a good porkchop or ham 'til you've eaten one that isn't pumped full of all the stuff the corporate pig farms do to the meat.

In fact, we gave away many, many pounds of the meat to a friend of the family who has an allergy to penicillin -- which left him out of eating most commercially produced pork products.

[Brit.Privateer]

that reference to using a firearm barrel to cauterize wounds reminds me of a scene from one of the worst pirate movies ever made, "Blackbeard the Pirate" with Robert Newton as Blackbeard. In one scene, to get someone to talk, they heated up a barrel of a pistol in a fire, and where going to use it, until another event interrupted (won't go into it). While this is a reasonable idea, but even the guys in the movie made a good point saying "that ruins a good pistol." For pirates, I see pistols used for cauterizing as not likely.

[Dorian Lasseter]

Well... I'm gonna disagree with you lads on this one... I've been reenacting for many years... I own a Brown Bess (75 Cal Musket), And during heavy firings, the barrel will heat up very hot... I have burned myself once or twice, not a superficial thing, I've had blisters from it. So.... Technically you could cauterize a wound with a hot musket barrel...

I will agree, However, that it probably wasn't done. Usually you would cauterize a wound with a knife...

And, to add something else, there's something I've always heard that it's best to sew up a wound in it's own fresh blood.... If that makes sense...

[Black Syren]

Ok Two question..But first..About the blood Mr. Lasseter I too had heard that, since the flesh blood would insure there would be no infection.

As to my Question..I read somewhere that if you needed stitching it was safest to sew with your own hair as the thread..And that if you had a freely bleeding wound if you could find a spiderweb and it was free of debris you could use that to staunch blood flow..Anyone else heard this?

[mrwill]

Brethren,

I have done considerable research on medical practices of this period. I have found out that as far as to cauterize wounds goes only the most unskilled and uneducated would have used this as a method of stopping the flow of blood. In 1545 Pare' published his magnum opus on surgery which clearly stated that to cauterize was counter productive in that it cause excessive pain, retarded healing and caused what could be called collateral damage to surrounding tissue. Doctors would still cauterize was but only in limited situations such as the when it was desirable for the destruction of tissue, when blood flow could not be stopped by ligature, pressure or styptic or any other way. Cauterizatrion was also used to cause irritation or therapeutic blisters to the skin of the patient.

That is not to say that some jack leg professing some medical knowledge wouldn't use cauterize, just not a professional.

Yrs.

M. Williams Esq.

Late Surgeon to his Majesty’s Provincial Forces.

[Red Cat Jenny]

The spider web thing as far as I know is correct, it assists to help clotting"

Some notes I found..

---

There is a large body of folklore concerning the antibiotic, wound-healing, and clot-inducing activity of spider silk. However, much of that lore has not been seriously tested."

The lore dates to the first century A.D. when spider webs were prized as wound dressings. They even found a place in Shakespeare's Midsummer Night's Dream: "I shall desire you of more acquaintance, good master cobweb," the character "Bottom" said. "If I cut my finger, I shall make bold of you."

The scanty scientific evidence is tantalizing, Lewis notes. He cites, for instance, animal studies concluding that spider silks do not induce an immune response -- which causes rejection of implants.

It dates back toAD

[Black Syren]

Thank you Jenny..I always found that intresting..Anything on using the persons own hair to sew them up?

[Zephaniah W Nash]

It seems to me that the spider webs, if nothing else, could just serve as a plug of sorts, no too different that stuffing cloth into a wound to stop bleeding.

Not horribly hygenic, of course, but it might do in a pinch. If there are other, actual medicinal properties that actually do aid in clotting apart from the plugging factor, this is the first I've heard of it -- and it is somewhat interesting.

And Dorian, with the hot musket barrel, I've done the same with other barrels, but it's always been my understanding to actually cauterize a wound, the weapon would have to be red-hot. Heat enough to just blister (as if that isn't hot in and of itself ) supposedly just wasn't hot enough.

Having accidentally grabbed the wrong end of a branding iron once, there is a bit of difference there. Ouch.

But at any rate, it looks like that particular method of treatment wasn't used all that much.

I've never heard of the idea that one's own hair would be the best for stitching up a wound, but the idea seems sound, from a holistic point of view, at least, even if there's nothing valid behind it. I mean, it would just make sense that something from one's own body would be best, wouldn't it...? Of course, considering the state of cleanliness of that hair might make all the difference...

[Black Syren]

Well actually from what I remember I read, I was thinking of the cleanliness of the hair myself..But it said that your own hair was more sterile to use than anything else..*Shrugs* Again i do not know how true that is and Wish I could find where I read it but so far no luck..

[Sjöröveren]

Regarding cobwebs, I have used this remedy with great success on myself a number of times. It will staunch the bleeding of a superficial cut almost immediately. Of course, a superficial cut will usually stop bleeding on its own in under a minute, so the cobweb itself probably doesn't do much. I also assigned the benefit not to the spider silk, but to the dust collected on the silk -- remember, it's cobwebs, not fresh spider silk that's supposed to be the remedy. All that dust makes it act much like lint, which was almost always used on cuts and incisions.

Regarding hair as sutures, I have never personally read anything about human hair being used, one's own or someone else's. I do know that the Southern doctors during the Civil War used boiled horse hair for sutures when silk was unavailable. They boiled it to make it more pliable, with the unknown benefit of killing germs.

[Story]

*Ahem*

From the "Wreck of Blackbeard's Ship Found " thread:

The team has found cannons, a bell, lead shot of all sizes, gold dust, pewter cups and medical devices, like a urethral syringe used to treat syphilis with mercury.

"A saying at the time was 'a night with Venus and a month with mercury.' And mercury doesn't even cure you," lead archeologist Chris Southerly said in an interview.

Mercury was also a violent purgative, and used by English doctorsin the treatment of Yellow Fever. Apparently, the French eschewed that approach.

Mercury would have been available, casked, as the Spanish used it as part of the silver refining process.

[Misson]

I just happened to find this and Sjöröveren's comments are very interesting and agree with things I have read. Also, I have read that use of leeches was on the wane during period. Of course, like everyone else, I am not sure where I read that. I do believe John Kirkup talks about the lack of leech-oriented instruments in his book The Evolution of Surgical Instruments; An Illustrated History from Ancient Time to the Twentieth Century during period, but I didn't write it down (what "isn't" didn't seem interesting) and don't have the book. I know the medical books at the time often recommended against cauterizing as they were concerned for the comfort of the patient.

If it was out of fashion, leeching did increase in popularity in the late 18th century. From Kirkup,

“Leeching was an alternative to venesection and generally safer for children and the very ill, although blood oozing due to the anticoagulant effect of leech bites were often difficult to stop. Their application reached a zenith in Europe during the 1830s when demand outstripped the supply of leeches available. Thereafter leeching declined in parallel with venesection, although leeches are still occasionally used by some British plastic surgeons for aspirating fluid collections beneath skin grafts.” (Kirkup, p. 407)

And another example from the late 18th century:

“After treatment, patients were removed from the cockpit to the adjacent gun room or the berth deck for observation, and the slightly wounded were ordered back to duty. If there was fever after surgery, [Edward] Cutbush [(1735-1790), Surgeon for the U.S. Navy] recommended a low diet and repeated bleedings as necessary. He believed that animal food was the best sustenance after wounding. Leeches were attached to the wound edges to reduce the swelling.

Tetanus (lockjaw) was the most feared complication, according to Cutbush, and always resulted in death. The titanic symptoms of stiffness, facial grimacing, rigidity of the spine, and distortion of the limbs were palliated with calomel, opium and cold baths…Cutbush’s treatments were those used by the British.” (Zachary Friedenberg, Medicine Under Sail, p. 125)

[Misson]

:angry:

And here it is in a nutshell, from the mouth of the common seaman (Edward Barlow - actually a bit uncommon as he wrote and drew and worked/lived as a seaman for 43 years...but you get the point):

“[1672] So we steering our course through that narrow channel [near the island of ‘Pulocandore’(?) in the East Indies], we had several of our men sick of the ‘fflukes’ [flux], and I myself being very bad; the sea being an uncomfortable and bad place for sick men, and many are the miseries that poor seamen endure at sea when they are sick, having small means to comfort themselves with, for there they cannot run and fetch what meat and drink they think will do them good. There they want both fresh meat and drink of all sorts, with both fruits and roots, which the sick on land do not lack to give themselves comfort with, and we having no other thing to eat and drink, to restore health, and comfort ourselves with, unless we can eat a piece of hard biscuit cake, or a piece of old salt beef or pork, and maybe both stinking and rotten, having lain in pickle one year or two and nothing to drink but a little fresh water, many times both stinking and dirty, and yet cannot get half enough of it.

And the surgeons and doctors of physic in ships many times are very careless of a poor man in his sickness, their common phrase being to come to him and take him by the hand when they hear that he hath been sick two or three days, thinking that is soon enough, and feeling his pulses when he is half dead, asking when he was at stool, and how he feels himself, and how he has slept, and then giving him some of their medicines upon the point of a knife, which doeth as much good to him as a blow upon the pate with a stick.” (Barlow, p. 214)

Note: Barlow, for all his splendid prose, is a bit of a whiner. I am actually growing a bit weary of the term "poor seaman" which I swear he uses every five or ten pages. He's pretty adamant in advising young men not to chose the sea as their vocation, but he was similarly shrill and negative about bartending and linen whitening, each of which he tried before going to sea. Still, this is one of the best period narratives I've come across yet.