Author Question: Treatment of Burns circa 1807

Michelle G asks:

I'm working on a historical (surprise, surprise) 1807, to be exact, in England, and wondered if you could give me a little medical advice? I've burnt the leg of one of my characters, a little boy, like 9, and I want him up and about in 3 weeks or so, but he can use a crutch. What would that leg look like? How much pain? How would he react that first week? I don't want to overdo it, nor do I want to gloss over it either. What's your .02?

Here's what happened to him...

“Thomas leaned over the hearth to scoop a ladle of stew from the pot. He moved too fast, with too much force. The hook broke. The pot fell into the flames. Coals shot out, catching the fabric of his trousers. He tried to whack it out, brave boy, but ended up fanning it larger. He ran. I stopped him. I thought he was…” She gulped back the lump in her throat. “I thought he was dead.”

Jordyn Says:

This sounds like a pretty significant burn-- his pants catching on fire. Easily partial thickness and could even be full thickness in some places. Have you considered just having the pot of stew fall on him-- maybe with bare legs? This would be more partial thickness and could more likely heal in your time frame.

Full thickness burns are problematic because they usually require grafting so back then treatment was likely very limited. We also do fluid resuscitation for significant burns and if both of his legs were this severely burned-- he'd need quite a bit of fluid, and again, I'm not sure this would be available during your time period.

So, I might try to back down the injury to second degree burns. Those should heal up pretty nicely in your three week time frame. Second degree or partial thickness would include skin blistering and peeling, big concern for infection (intact skin is your largest protector against infection) and dehydration initially because burns also leak a lot of fluid. He could probably walk with crutches. It's not really a muscle injury (it would be if you go with full thickness burns-- like his pants catching of fire) so he should be able to walk.

Pain is going to be a big issue. Burns are very painful. So, he's going to need something.

Here is a very interesting link that has tons of information on the evolution of burn surgery. It will give you some treatment options for your time period. 

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Keep up with the exploits of Michelle Griep at Writer Off the Leash, Facebook, Twitter, and Pinterest. You can check out her latest novel,  A Heart Deceived, at David C. Cook as well as Amazon, Barnes & Noble, and ChristianBook.  

Author Question: Civil War Dead House

I'm so pleased to be hosting author Jocelyn Green this week. She e-mailed me a feasibility question and I managed to rope her into writing a few posts about the medical aspects of the Civil War!

I know...I'm a tricky girl.

Jocelyn has graciously agreed to give away a signed copy of her novel Wedded to War. Just leave a comment in the comments section that includes your e-mail address on any of her posts this week and you'll be eligible to win-- though you must live in the USA. Drawing will be Saturday, September 1, 2012 at midnight. Winner announced here on Sunday, Sept 2, 2012!

Now, let's get on to some exciting stuff!

Jocelyn Asks:

Hi Jordyn: I’m a Civil War novelist and working on my second book in the Heroines Behind the Lines series right now. (My first, Wedded to War, is about pioneering nurses for the Union Army and just released July 1 from River North, an imprint of Moody.) I’ve got a couple questions for you!
1) I read an account by Capt. O.H. Miller of the 59th GA which said he was basically called a lost cause (after an injury at Gettysburg) and “They ordered me to the dead-house where I remained fifteen days.” My question to you is: HOW in the world would he have been able to survive that? Can we believe his first-person statement? I did read in another book an account of a soldier who was left in a field for three days surviving by eating the maggots out of his puddle of blood. (I’m so sorry, that’s gross.) So, I suppose if Capt. Miller was in a dead-house, there would have been plenty of maggots to eat. What do you think? Any insights on this? It seems unbelievable, but I WANT to believe it because I want to use it in my novel!

2) I need one of my main characters to suffer from temporary amnesia from an injury at Gettysburg. What kind of a wound would produce this? I want him to regain his memory in about a month’s time (two weeks minimum).

Jordyn Says:

Hmmm.... okay question #1. Being in the dead house for just over two weeks. According to my research, the dead house is the morgue so there wouldn’t be any provision of food and water. The problem will be this... does he have access to water? If he has something to drink it's probably reasonable to say he could have survived but with NOTHING to drink-- dehydration will kill you in a few days-- around one to three depending on the elements your body is in. So, if you want to use this in your ms—you’ll need to at least have him drinking something. But, he can't just be lying there without fluids for 15 days and not die. I do find that particularly unbelievable.

Here's a previous post that discusses aspects of dehydration.

Regarding question #2-- what type of injury will produce amnesia? Really any type of head injury can produce amnesia so you could have some writerly leeway here.

A fall from a height, blunt force trauma to the head, gunshot wound to the head (though this is hard to survive in today's medical climate so would be probably lethal during civil war times.)

Here's a previous post about amnesia.

I found a few resources that were particularly interesting for my inner medical nerd.

1. This one dealt with treatment of the dead. Very interesting insight here particularly concerning how dog tags for soldiers likely came about. http://www.deathreference.com/Ce-Da/Civil-War-U-S.html

2. Photos of Lincoln General Hospital—A Civil War Hospital. http://southcarolinaavenue.webs.com/civilwarhospital.htm

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A former military wife, Jocelyn Green authored, along with contributing writers, the award-winning Faith Deployed: Daily Encouragement for Military Wives and Faith Deployed . . . Again. Jocelyn also co-authored Stories of Faith and Couragefrom the Home Front, which inspired her first novel: Wedded to War. She loves Mexican food, Broadway musicals, Toblerone chocolate bars, the color red, and reading on her patio. Jocelyn lives with her husband Rob and two small children in Cedar Falls, Iowa.

Connect with Jocelyn: www.jocelyngreen.com, www.heroinesbehindthelines.com, www.facebook.com/jocelyngreenauthor

Historical Overview of 19th Century Medicine

I ran across these guest posts by Eleanor Sullivan over at The Writer's Forensic Blog which were excellent and a good resource for the historical authors that follow here. They are must read as I learned a lot of fascinating facts.

To supplement, I thought I'd add a few words to her list of terms that were used then and what they mean. These are referenced from Frontier Medicine by David Dary which is another excellent resource.

Acute Indigestion: listed as a cause of death. Probably a heart attack. This is interesting as in modern medicine, women can present quite differently from their male counterparts when they are suffering from heart attack. One of these symptoms can be indigestion.

Bad Blood: syphilis

Barber's Itch: infection of the hair follicles of the face.

Black Fever: Rocky Mountain spotted fever.

Camp Colic: appendicitis

Domestic Illness: polite label for mental breakdown, depression, or the aftereffects of a stroke where a person was housebound and in need of regular nursing.

Dry Bellyache: lead poisoning

Grip/Gripe: influenza

Quinsy: tonsillitis

Scrivener's Palsy: writer's cramp

For an outstanding generalized overview of 19th century medicine, check out these links to Eleanor's Guest Posts:

1. http://writersforensicsblog.wordpress.com/2011/10/09/guest-blogger-eleanor-sullivan-19th-century-medicine-part-1/

2. http://writersforensicsblog.wordpress.com/?s=Eleanor+Sullivan