Trible (tamtrible) wrote in little_details,

Low-tech surgery with modern knowledge

Really not sure how to search this one.
Setting is Unspecified Fantasy, general tech level's about Renaissance, give or take, but medical knowledge is at least roughly modern, at least re: basics like sepsis, shock, anatomy, etc.
Either direct answers/commentary, or resources/search terms, would be helpful.

Our Heroine (who has magic) is describing to her apprentice (who does not) how she should go about a C-section, should she ever have to perform one. Some of what she's saying is also General Advice For Surgery. Anything you'd add to or leave out of the following description? Anything I got wrong? Et cetera. Things in [brackets] are, of course, my notes/additions/questions, not what Our Heroine is saying. I won't necessarily include all this in the story, I just want to make sure that... what I do include makes sense, in context, and is as technically correct as practical.

Dose the patient with [weight-appropriate dose of] poppy wine [basically, laudanum], and wait until she's asleep.

Clean *everything*. Boil what you can, and clean the rest with [I need something appropriately antiseptic here. Would they have distilled alcohol in any real quantity? If so, is there any reason they *wouldn't* use it for this, medically? If not, what would be the best available antiseptic solution? Wine? Lavender water? Strong soap? Or would the best thing just be boiled and cooled water?].

Use the sharpest knife you can--obsidian or flint is usually best if you have it, as long as you won't be working near bone, otherwise just sharpen your best small steel knife as well as you can--the sharper the knife, the less damage you'll do. Make sure you have all the supplies you need before you start, and make sure *everything* is clean, including your patient and your hands.

Cut the patient thus. There will usually be a little blood, but if you cut any major blood vessels, be sure to clamp them off [would there be something tech-level-appropriate to use as surgical clamps? Or would one's assistant(s) have to tie things off with thread or something?].

Cut here, lift there, take the baby out thus. Be sure to take out the placenta, as well. Let someone *else* take the baby, you need to focus on the mother.

Line the edges of the cut up, and sew them together with your sharpest needle and boiled silk thread. Use small, neat stitches, but don't take too long about it. [What should she do about any blood vessels she had to clamp? Sew them back together, or what?] You might want to practice on a fresh pig carcass, at slaughtering time. Sew up each layer you cut separately [is that how you do it? I'm Not A Doctor...].

Afterwards, make sure the patient *stays in bed* until the wound has had plenty of time to heal, a week at a minimum. The patient may need smaller doses of poppy wine for a few days, for the pain. Clean the wound regularly with [aforementioned antiseptic, or something milder/cheaper] until it heals. If the wound shows the slightest signs of going bad, dose the patient with bread mold [and/or other antibiotics? Anything topical that should be used, or just a systemic?]. Make sure someone else is on hand to take care of the baby, the mother can nurse the child, but *nothing* else.

So. Anything major I missed/got horribly wrong/included that I shouldn't have? If it's relevant, this is the village healer, not a city doctor or whatever, so things like cross-contamination between patients is not much of a concern.
Tags: ~medicine: historical
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