These posts brought to you by the recurrence of the search term “boiling wine” bringing people to my little rant on the use of same on wounds in GRRM’s A Song of Ice and Fire series.
Magical healing aside, basic sanitation is the one thing that will most increase your characters’ chances of survival when they’re injured. Stitches are helpful. So are herbs. Splints are important for broken bones. But if that cut gets infected, abscesses, and gangrene sets in, all the willow bark tea in the world isn’t going to save you.
In real-world history, the importance of keeping wounds clean was not fully realized until only a few hundred years ago. Why your fantasy world’s physicians know they need to do this is up to you. I’m going to look at how to do it in a world without industrialized chemical analysis and synthesis.
Gargling saltwater for a sore throat and old recipes for toothpaste made of salt and baking soda (more on that later) work because salt does kill microbes when it’s concentrated enough. This is why pickling and salting work as food preservatives.
Brine recipes call for anywhere from a half cup to a cup of salt per gallon of water, which would be 3 – 6% salt by volume. Seawater tends to be more like 3 – 4%.
Depending on where your characters are, seawater could be easy to get and a reasonable thing to wash a wound with — if the seawater has been filtered and hopefully boiled as well. It does contain microbes that are acclimated to salty water, after all.
Brine prepared from salt and boiled water is a viable option if your characters have access to economically priced salt. Or maybe it’s a rare and expensive way to treat wounds, reserved only for those who can afford it. Either way, I recommend Mark Kurlansky’s Salt as an excellent overview of salt production over the course of history.
Given a supply of fairly pure salt, why not just pack the wound with salt? Yes, that’s been done in the past. Especially with abscesses, it seems. The packing needs to be changed a few times a day, and after the salt’s done its job the wound will need to be closed by whatever method and given a chance to heal. You don’t actually want to make jerky out of your character.
You know it better as baking soda. Combined with salt and a little water, baking soda makes for a nasty-tasting toothpaste but it’ll kill those germs and even bleach your teeth a little.
Naturally occurring bicarbonate is one of several compounds found in natron, which the Egyptians used for cleaning, an antiseptic, and to preserve mummies. Natron is mined from natural deposits, which can be found in a variety of places — not just deserts. Perhaps this would be a viable industry for your fantasy kingdom on top of its medical uses.
Baking soda mouthwash recipes range up to 25% concentration but tend to fall more around a teaspoon per half pint of water which would be… 4%? As with salt above, your healers could use either a brine to wash wounds or pack the wound directly with natron — bearing in mind that we don’t want to mummify the characters just yet. Natron is a drying agent, which means it draws out moisture from the tissues. This makes the tissues less hospitable to bacteria… and life in general.
Stay tuned for the more accurate use of alcohol (not by boiling wine, for crying out loud) and an antiseptic wild card.