This is a very medically oriented thread. I have a character with a shattered hip or a similar leg injury. It's an old wound but it's left him with a hobble and a permanent use of a walking cane.
Recently I asked myself if it would make sense for him to use pain killers. Since that seems to make sense, I was wondering what kind of side effects such addiction would cause. Would the painkiller gradually stop working? That would mean he would have to resort to stronger painkillers.
This is all in a semi medieval society so if you made any research on the matter I would be happy if you shared your knowledge but pretty much any period and location would do. I know opium was used but that's pretty much it. George R R Martin keeps using 'milk of the poppy' but I think that's pretty much the same. Morphine? Does heroine dull the pain? I know it was used in medicine a while ago until the bad effects were discovered. Anything else? Let's make it a contest!
[ August 02, 2012, 07:26 PM: Message edited by: MartinV ]
Posted by extrinsic (Member # 8019) on :
Western Old World laudanam, poppy, late middle ages. Paregoric, poppy, early colonial era. Though henbane, datura, mandrake, cannabis, and cedar, and cyperus species were also used for early anesthetics. Alcohol too.
Apothecaries blended a proprietary selection for pain relief.
Betel in the Far East, and cannabis, henbane, datura, mandrake, and cyperus species, and the poppy later.
Coca in the New World southern nations, and henbane, datura, mandrake, and other cyperus species like juniper.
[ August 03, 2012, 07:03 PM: Message edited by: extrinsic ]
Posted by rcmann (Member # 9757) on :
Depends on level of education in the society and location. Even as late as early twentieth century rural america, poor people were making do without real medicine. FOr pain they either toughed it out, brewed willow bark tea, or drank whiskey.
Posted by History (Member # 9213) on :
If your setting is historical earth, then Opium and its derivatives are what historical has been used since prehistoric times. How far back in history you go may determine what you choose (e.g. laudanum, an alchohol based tincture of opium, was not discovered until the 17th century; and morphine and codeine not until the 19th).
GRRM is wise in merely selecting "milk of the poppy" for his semi-medieval setting. However, the world wherein Westeros resides is not a historical earth. He could have invented a drug with the properties he desired and named it himself.
Side effects of opiates include euphoria, sedation, constipation, respiratory depression, tremors, and (off course) physical dependence.
Best of luck.
Respectfully, Dr. Bob
Posted by rcmann (Member # 9757) on :
Reiterate, willow bark tea = aspirin.
Posted by extrinsic (Member # 8019) on :
Hercule's Club leaf, Xanthophyllum clava-herculis also has a pain relieving effect like willow bark and was used by Native Nations within its Southeastern U.S. range. The leaves have a citrus-like flavor and an instantaneous tingly numbing effect in the mouth. I tried it on an open wound. It burned. After a few doses, a headache also went away.
Posted by skadder (Member # 6757) on :
You could always use some kind of self-hypnosis--chanting or meditation--or acupuncture.
Also bear in mind the placebo effect can help with pain--someone may believe anything the are told to do actually helps with the pain.
Posted by rcmann (Member # 9757) on :
Sex helps too.
Posted by extrinsic (Member # 8019) on :
A homeopathic remedy for osteoarthritis recommends rubbing wormwood Artemisia absinthium oil tincture on affected joints. Also for lumbago and other muscle pains.
Posted by MattLeo (Member # 9331) on :
My dad, who passed away some thirty years ago, used to take tiger bone wine for his joint pain. That' s not an herbalist's poetical name, its rice wine in which the bones of an actual tiger have been steeped. It's highly illegal and consquently fabulously expensive now, but back in the 70s you could get it at the herbalist's The price was steep, but it wasn't ten dollars a milliliter like now.
The way he used it was he poured a teaapoon or so in a saucer, and massaged his elbow with that as he drank shots. It didn't cure his bursitis, but I'm sure it helped the pain.
A traditional treatment doesn't necessarily work like it's supposed to, or even work at all, although some like willow bark have a scientific basis. I'm sure anyone in chronic pain would avail himself of whatever remedies were available to him, effective or not.
Posted by BoldWriter (Member # 9899) on :
I'm not sure it makes sense for someone in that era to be using pain killers, assuming he is of middle or lower class. I'm not sure what the story is about, but for my two cents, I would say that the most commonly used method of pain relief in those times would be alchohol. Cheap, easy to make, endless source material, endless vareity.
I would say other methods might be used by the higher classes of people, as apothecaries kept thier formulas very secret. It makes sense that even the knowledge of what substances can be used to relieve pain would be closely guarded.
Just another way to look at things.
Posted by Pyre Dynasty (Member # 1947) on :
Don't underestimate the placebo effect. There were plenty of things people did back then that have been proven scientifically wrong, but were used for centuries. (Sorry my mind is tired right now so I can't think of any.) Look up old wives tales, or go talk some old ladies in your neighborhood.
Posted by MattLeo (Member # 9331) on :
quote:Originally posted by BoldWriter: I'm not sure it makes sense for someone in that era to be using pain killers, assuming he is of middle or lower classs.
I don’t think that model extends to medieval times. Prosperous burghers might have more access to learned physicians than all but the greatest barons, but those scholars would consult your horoscope to determine how often to bleed you. You might be better off with your peasant granny's willow bark tea.
Also, if I recall, learned physicians would have lower class tradesman assistants whi did the actual hands on work -- at least in cities blessed with a university. Your treatment outcome probably depended a great deal on their practical experience.
Posted by rcmann (Member # 9757) on :
Seems to me 'taking the waters' was a popular healing option in fairly recent times. Don't know if it was practiced in the middle ages or not. But many places in the middle ages were visited by pilgrims in hopes of miracle cures, so maybe some places were believed to have waters with healing properties? Some of them might even have helped. Especially when a person's pain had an environmental cause, rather then being due to damage or infection. Like noise causing headaches. Or humidity, or cold causing joint aches. Changing to a more pleasant environment might very well help, even if the patient didn't know why.
Since you guy has an old hip injury, hot soak pools might very well be a way to help him. Or a sauna maybe?
Posted by extrinsic (Member # 8019) on :
Pain and illness throughout the medieval ages was generally considered God given and to be borne stoicly if not celebrated as a gift. Treatment was often considered specifically within the church purview. Treatment by healers using herbal and root cures and incantations outside church auspices led to accusations and punishments for practicing witchcraft.
Pennances were paid for spiritual healing, both through charitable acts and through prayer. Pilgrimages to holy shrines were also common for paying pennance and healing. Elaborate promotion of shrines often included the unique if imagined healing powers of the locale, be it taking waters at a natural hot bath, bathing in mud or mineral waters, taking salt air, cold climes, warm climes, dry climes, wet climes, or unhealthy climes, a saintly personage living or dead, sacred relics, and just plain anywhere a nearby abbey had monks versed in faith healing and needed a calling and wanted a revenue source. Besides the Crusades, pilgrimages and war were about the only reasons for travelling away from a home region during the age, which led to founding the hospitality industry through church practices.
Posted by mikerancourt (Member # 9890) on :
Sorry for being weeks late! From hip and femur-fracture experience, I'd like to chime in with some (obvious) character quirks:
He'd squirm after sitting still for several minutes or his hip would stiffen. Any extended dialogue would literally irritate the hell out of him. He would probably gently stretch in his morning routine to retain what little mobility he had left.
His old wound would occasionally flare up and get very tender, even decades later. Any pressure around that area would hurt like a sonuvagun. Rcmann pointed out sex. If your MC is in the throes of passion with a wily barmaid and she muckles on to his sides...that would be sweet.
And about opium pain management (if you're leaning toward it): it never outright stopped my pain; it lowered the intensity and muddled the pain messages. The shock-inducing spikes became barely-manageable waves.
I definitely experienced the euphoria, sedation, and ESPECIALLY constipation Dr. Bob mentioned.
+1 for hot springs for your setting. Hot showers help me relax and loosen my hip.
If you snap his femur too, you could make really awful Middle-Ages traction machine. Cast his entire leg from the hip down. Lay him horizontally, wrap his knee with rope, string the rope to a pulley, and throw ten pounds of weight on that sucker. It will slowly pull the broken femur apart, allowing the bones to fuse and knit at the break.
A hip injury is life-changing. It is certainly something your character will have a vivid memory about if he was conscious. He will definitely remember the recovery.
Hope this helps!
Posted by kmsf (Member # 9905) on :
Typically a person using a narcotic pain-killer (which alcohol can be considered) will develop a tolerance. More will be required to acheive the same effect. With alcohol eventually the reverse occurs as the liver becomes damaged - less is required to cause drunkeness. This can occur long before jaundice sets in. As with all addictions, the initial phase is pleasurable and often gives the sense one has actually acquired control over previously insurmountable difficulties. The chains aren't felt until they're too strong to break. References regarding withdrawal should be easy to find. Withdrawal, especially from alcohol, can be especially dangerous.
Posted by MartinV (Member # 5512) on :
I was avoiding the use of alcohol for personal reasons. The post-WWII generation in my country was very pro-alcohol which includes my parents. They're not exactly alcoholics but they drink far too much of it to my standards. My own generation is also very generous with it, at least the peope I went to high school with. I don't touch the stuff and never did but it did left some quite unpleasant memories.
I do like the idea of my character resorting to alcohol because he doesn't have the money to afford the good stuff. Will make the research. Thanks for the pointers.
Posted by jawood (Member # 9907) on :
Anyone who lives with chronic pain long enough develops tricks to work through it. My mom lives with chronic nerve pain, and while she does have to rely on pain killers to dull the pain a lot of the time, she has learned to ignore the pain when it's most inconvenient. It never fully goes away.
The best thing to remember about pain is that it's the body telling you to slow down and take care of yourself. Taking painkillers of any kind or ignoring it can worsen your condition over time.
Posted by MartinV (Member # 5512) on :
That sounds perfect for my character. I was thinking he could use the costly drugs for social occasions and resort to the cheap ones for the regular ones. He would have good and bad days and since his job means being nervous a lot it would mean the days off would be better than those off.
Posted by skadder (Member # 6757) on :
quote:With alcohol eventually the reverse occurs as the liver becomes damaged - less is required to cause drunkeness.
Just an added detail:
Any significant damage to the functioning of the liver--from alcohol or another cause--can slow down the breakdown of any other drug that is metabolised by liver enzymes. This means that the drug (or, as correctly pointed out, alcohol) will remain in the blood stream for longer--therefore the effect last longer.