You Might Be Better Off Dead...

Vikings for all occasions, no leach too fat

Manaraefan Herred

Dark Age Combat Medicine

By

Bohn (Bones) Aelfricsson

Considering how long it takes people to die after battle injuries, here's a few thoughts on why, if we were really living circa 9001000 AD, you might prefer to be among the slain.

One other thing anaesthetics were available during the period (though decidedly dangerous to use) but there simply wouldn't be the time, the manpower or the supplies to use them widely after a battle...

If you were lucky, or if your injuries were too severe to be cauterised, you might get sewn back together. Silk was the suturing material of choice, as it dissolves relatively cleanly into the body as the injury heals. Once the silk ran out, horsehair was also used, though it was more likely to infect or to tear the skin around the stitches, and of course needed removing after the injury was healed. Suturing was most commonly recommended for injuries to the abdominal wall, especially "if a man's guts be out".

Since gut wounds, though painful, typically take a long time to kill, a primitive form of triage came into operation here. Victims of this kind of injury would be fed an onion-based porridge or broth and left to digest their meal. If, after an hour or so, the smell of onions issued from the wound, it was an indication that the intestines had been perforated and the victim would therefore die of peritonitis or septicaemia. If there was no smell, the surgeon would wet his hand in fresh milk, still warm from the cow, re-insert any protruding intestines, and sew the patient back up. Silk sutures are actually specified for this kind of surgery. The milk, being still warm, should in theory not have had time to become contaminated by bacteria (and don't forget that no-one was drinking pasteurised milk, so they were pretty immune to the normal bacteria from the cow) and would prevent the intestines from forming adhesions. Adhesions, where sections of gut stick together, are still a problem after abdominal surgery, to the point that they may require further surgery to remove the affected section of gut!

Broken bones could be set, using splints and bandages or even an early version of a plaster cast. By dipping bandages in a mixture of egg whites and wine (well beaten together), the bandages stiffen as they dry, forming a more or less rigid cast. The drying process takes some hours, but seems to be quicker if the egg whites are beaten really thoroughly. Broken ribs were more of a problem, just as they are today. For a start, it is not possible to immobilise a rib unless you want to stop the patient from breathing properly until it has healed. Having said that, a claw bar - a device rather like the back end of a hammer -could be used to lever cracked ribs back into position (I have one of these handy implements, if anyone wants a demo!)

As every good Viking knows, with shields to protect the body while fighting in shield wall, the head and legs tend to bear the brunt of battle injuries. Skull fractures, particularly those in which bone became depressed into the cranial cavity, seem to have been fairly common, if the frequency of remedies to treat them is any guide. Minor fractures might simply be poultice and left to heal as best they could. If the doctor had the skill and the specialist instruments, flakes of bone might be chiselled out and any depressed bone levered back into place. Equally, a small hole might be drilled out using a trepan (or trephine, if you prefer), to relieve pressure, provide access for leverage or to remove a flaky or damaged section of bone. More drastic (and less successful) is the following set of instructions, again, for a caved-in skull fracture: lay the man out on the ground and pound two stakes into the ground, just above his shoulders. Then lay a board across the soles of his feet and hit the board with a sledgehammer. One assumes that the shock-wave from the hammer blow was supposed to pop the caved in skull back into place!

An episode from Grettir's Saga suggests that surgeons of the period might even have been able to perform successful amputation, with prosthetic limbs available afterwards. According to the story, a warrior called Onund suffered a severe leg injury during ship-to-ship fighting. Despite his injury, he propped himself up and carried on fighting. Afterwards, the relevant portion of his leg was amputated and for the rest of his life, Onund used a wooden leg, which earned him the name of Onund Treefoot. While Saga evidence must be taken with a large pinch of salt, being part fantasy and in any case written after the historical period in question, the story does tend to suggest that such things might have been possible. Certainly amputation was practised surgeons were advised to cut into the healthy flesh when gangrenous limbs needed removing. Prosthetics? Who knows?

Comments on this site should be sent to Roger Barry

Finally, though I have used the term "surgeon" throughout this article, since it refers more to surgery than to what might be considered general practice. The Saxons used the term laece to refer to their doctors. We usually translate this as "leech" and tend to assume that it refers to the use of little water-dwelling blood-sucking critters for the purpose of bleeding patients. In fact, at least according to Stephen Pollington, the derivation of the term suggests that it has more to do with shamanic practices and making sacrifices to the gods for good health, than to any association with leeches.

Bohn (Bones) Aelfricsson, who is not a doctor in real life, so don't come to me unless you want Dark Age treatment, okay?

Perhaps surprisingly, armies did take what might be termed combat medics with them, though one of the Saxon kings sent out a call through his army for "men with soft hands" to supplement the medical team, presumably to act as orderlies or the equivalent of nurses. These surgeons might be in the employ of those men leading the armies, or drawn from the local area. Inevitably, the first (and best) treatment would be received by the most valuable warriors lords and the hearth troop while Saxon fyrdsmen would be right at the end of the waiting list.

The vast majority of minor (i.e. not life-threatening) wounds would simply be cauterised closed and a poultice bandaged on top. Common poultices included mashed leek or lily bulb, which rapidly remove the heat from the cauterisation burns and also significantly reduce scarring. Also useful was a plantain, comfrey and honey mixture, which contains antiseptic, antibiotic and wound healing agents. This is not to say that all poultices were effective or even safe. Hemlock is NOT a good idea, even applied externally, let alone on a wound where it will probably get into the bloodstream.