18th Century Medicine, 19th Century Medicine, Akria Kurosawa, al-Zahrawi, Arab Medicine, arrows, Black Plague, Boromir, Charles Dickens, Elrond, Frodo, gask mask, Greco-Roman, Hans Janssen, Henry V, London, Louis Pasteur, malaria, miasma, Micrographia, Morgul Knife, Our Mutual Friend, Prince Hal, Robert Hooke, Sir Joseph Lister, Thames, The Lord of the Rings, Throne of Blood, Tolkien, Toshiro Mifune, Victorian disease, Zacharias Janssen
Welcome, as always, dear readers.
Not long ago, we had a posting about Frodo’s wound from a Morgul-knife and the extraction of an arrow from the skull of Prince Hal, the future Henry V.
This, in turn, has led us to think about the kinds of wounds we see among the major characters of The Lord of the Rings and their cures—and about their creator.
The first one wounded is, of course, Frodo. In his case, it’s not so much the original knife wound, but the aftermath—the point of the blade which, as Gandalf describes it, “was deeply buried, and it was working inwards.” (The Fellowship of the Ring, Book Two, Chapter 1, “Many Meetings”). This, then, was no ordinary fighting knife, but the equivalent of the injection of a kind of poison or even parasite—“They tried to pierce your heart with a Morgul-knife which remains in the wound.”
Treatment was surgical—“Then Elrond removed a splinter…”—just as in the case of the young Prince Hal. We have no idea what else Elrond might have done, but, in Hal’s case, the surgeon was extremely careful to prevent infection. Any good medieval doctor would have been well aware of the danger and would have recognized the symptoms, but, once infection would have set in, would have been at a loss as to how to prevent the consequences. If a limb had been affected, he would have amputated, hoping to have pinched off the infection.
As Hal’s was a head wound, well, all the doctor could have done was what he did—keep the wound clean until the healing was clearly going well.
The difficulty was, medieval doctors could be aware of infection and could even try various methods to prevent it, but they had no accurate idea of what it was and where it came from. In their world, infection was either a mystery (possibly divinely inflicted) or, in the case of infectious disease, caused by something which they called miasma, an ancient Greek word which means, in fact, “pollution” (often “ritual pollution”).
This miasma was believed to be caused by rotting matter and was to be found in the air—and, in a world of open sewers in towns,
the “bad air” (where the word “malaria” comes from), would have been everywhere, especially when plague hit and burial services were quickly overwhelmed.
Part of the problem lay in the reliance upon ancient, outdated medical ideas, derived from Greco-Roman sources. Part, however, lay with the lack of tools available.
The medieval doctor had only his naked eyes with which to observe and to diagnose illness. The microscope was the invention of two Dutchmen, father and son Zacharias and Hans Janssen, in the 1590s.
Just seeing what’s there wasn’t enough, however, although what could be seen was absolutely amazing to people who had no idea what existed in worlds beyond this one. In 1665, the English polymath, Robert Hooke (1635-1703), published Micrographia, with a series of engravings of things seen under magnification which must have astounded people.
Just look at this flea, for example.
Ironically, in the gut of this flea could be the bacterium Yersinia Pestis,
which is the basis of black plague—but everyone in 1665 knew that the plague was caused by miasma—which was still the theory for infectious diseases in Victorian days, as this cartoon shows. (Death is here depicted as one of the scavengers of the river, major characters in Charles Dickens’ last completed novel, Our Mutual Friend, 1864-65.)
The Thames, was filled with sewage, chemicals, refuse, dead animals, the overflow of cattle markets, and anything else horrible one might imagine. Of course it stank—in the summer of 1858 in fact, the smell was so overpowering that Parliament adjourned and fled its handsome and nearly-new home. One imagines that this was as much in fear of what that smell might portend as disgust at the odor.
It was only in the mid-19th century that the work of scientists like Louis Pasteur (1822-1895)
began the process of retiring the miasma theory in favor of the theory still used in the early 21st century, the germ theory. This was not an overnight process: the medical profession was very cautious and some members clung to outdated beliefs long after they could see that the efforts of forward-looking surgeons like Sir Joseph Lister (1827-1912) drastically cut the number of deaths directly related to the dangers of surgery before his changes.
Lister believed that, by sterilizing the operating room and the instruments with carbolic acid (we would call it “phenol”, a petroleum derivative), as well as aggressive handwashing and careful and frequent cleansing of wounds, lives could be saved—and they were.
That Prince Hal’s surgeon, lacking knowledge of germs, could still be as energetic as he was in keeping Hal’s horrible wound clean, must be remembered when we imagine that medieval doctors were nothing more than ignorant charlatans. Some, at least, were observant and creative, even as they struggled to save their patients from dangers understood from their outcome, rather than from their origins.
(And so, if you remember that the medieval medical community believed that “bad air” carried disease, that crow-like mask which can be seen on late illustrations of “plague doctors” isn’t silly: the “beak”, packed with what they believed were “healthy” herbs, was meant to act as a filter against that air.
In fact, that idea wasn’t so far from the idea of World War One gas masks, which also carried a filter to cleanse the air of the poisonous gases—real ones, this time—with which both sides sometimes tried to flood the enemy’s trenches.)
Prince Hal’s arrow reminds us of the second wounding in The Lord of the Rings, this one fatal: Boromir.
Unlike Prince Hal, there was no possibility of extraction: Boromir had been hit multiple times: “…Aragorn saw that he was pierced with many black-feathered arrows.” (The Two Towers,, Book One, Chapter 1, “The Departure of Boromir”) And Ted Nasmith’s illustration tells it all—just look how pale Boromir is—he’s dying from blood loss.
[This always reminds us of the death of Toshiro Mifune as the Macbeth figure in Kurosawa’s wonderful 1957 film, Throne of Blood.)
As in the case of infection, only so much could be done for the sufferer in the medieval world. Arrows could be extracted, but, if they were barbed,
they caused more damage coming out than going in—although a brilliant Arab doctor, whom we’ve mentioned before, al-Zahrawi, had invented an “arrow spoon” for this very problem. (We once saw this demonstrated, but we currently have no illustration, unfortunately. In the near future, however, we’re going to have a feature on JRRT’s Haradrim/Corsairs of Umbar vs actual medieval Arabic culture, where we’ll include discussion of the brilliant intellectual life of the Arabic world from Spain to the Middle East.)
After Boromir’s death, our next injury would be not a physical, but a psychological (or magical?) one. Pippin, peeping into a palantir, has had an encounter with Sauron and it hasn’t been a pleasant one:
“Then suddenly he seemed to see me, and he laughed at me. It was cruel. It was like being stabbed with knives….Then he gloated over me. I felt I was falling to pieces.” (The Two Towers, Book Three, Chapter 11, “The Palantir”)
In response, Gandalf commands Pippin to look at him:
“Pippin looked up straight into his eyes. The wizard held his gaze for a moment in silence. Then his face grew gentler, and the shadow of a smile appeared. He laid his hand softly on Pippin’s head. ‘All right!’ he said. ‘Say no more! You have taken no harm.’ ”
Pippin has escaped, then, though Gandalf has said that it was a close call: “You have been saved, and all your friends too, mainly by good fortune, as it is called.”
Our next injury—that of Faramir—won’t be so easy… But that’s for next time!
Thanks, as always, for reading—in “Healings.2”, we’ll look at other wounds in The Lord of the Rings, then move on to another war and one of its millions of victims…