The Best Medicine: How the Historical Healing Arts are Vital to Building Your World
To create a vivid and authentic world in your historical novel, you need to have a basic knowledge of the medical technology—or lack thereof—that would have impacted your characters in huge ways.
- We don’t have reliable statistics, but a good estimate for women dying in childbirth before the turn of the twentieth century is around one in ten. Same for kids not making it through birth alive.
- Something like 30-50% of kids never made it to the age of ten.
- If you got a minor cut, it could get infected, gangrenous, and kill you in the most horribly, slow and painful way as it boiled your organs and turned your skin black.
- That annual winter cold could become pneumonia and kill even the healthiest teenager.
- With no tooth brushes or dental floss, teeth were pretty bad. Until the 19th century, the dentist was a big burly guy with a pair of plyers. There were no pain killers for tooth extractions until the 1840s.
- If you badly broke a leg or arm, they would amputate, without anesthesia, and if that didn’t kill you, an infection could.
- From the medieval era up into the early nineteenth century, doctors bled patients to “balance their humors.” Bleeding killed almost the entire French royal family during a measles epidemic in 1712. In 1799 George Washington’s doctors killed him by removing 40% of his blood in a few hours in a misguided effort to cure his cold.
- Ironically, the poorer classes—who couldn’t afford to be bled to death—often survived illnesses better than the rich and noble. And the poor—who were more physically active, drank very little wine, and ate more vegetables—were often healthier than the rich who sat around drunk, eating meat with rich sauces, and not knowing a thing about blood pressure, diabetes, or cholesterol. Many of these noble souls keeled over at banquets at the age of forty-five or fifty, dead from “an apoplexy.”
- Until the mid-nineteenth century, people understood that illnesses could be contagious but didn’t have a clue why. Blissfully unaware of viruses and bacteria, they thought bad air caused plague and other infectious diseases.
- Many illnesses were spread by the doctors themselves. Doctors went from one patient to the next, using the same infected instruments and bloody, gross hands, spreading whatever one person had to everyone else they touched. Loads of women (including two of Henry VIII’s wives) gave birth successfully, only to die of “childbirth fever” a few days later.
Two major medical breakthroughs reshaped the world:
- Anesthesia: While various forms of poppy juice and opium were used to knock patients out in the ancient world, most people relied on getting drunk or being strapped to a table so the doctor could perform the surgery. Mercifully, chloroform came into use in the 1850s.
- Even after the invention of anesthesia, many successful surgeries resulted in dead patients—from infection. Antibiotics came into use in the 1940s.
So sprinkle some bad teeth, scars, difficult childbirths, and mysterious illnesses among your characters (without overdoing it—you don’t want to gross out your readers.) And make sure to fully research the medical lore of your era for unique tidbits to enrich your novel’s authentic feel.
For instance, I discovered that through the 18th century whenever a member of the Spanish royal family was gravely ill, their servants would put entire corpses of saints in bed with them. I’m not sure how often that worked, but I do know one thing: if waking up from a fever with corpses in your bed didn’t kill you, nothing would.
Next Week: Getting around in your historical novel; horses, boats, and really bad roads
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