Sounds like heresy I know, but hear me out...

..and Doc Rocket, now yer in Comanche country you need to listen up.....

This from an ER guy who walked the walk and talked the talk....

http://allthingsliberty.com/2013/05/battle-wounds-never-pull-an-arrow-out-of-a-body/

Battle Wounds: Never Pull an Arrow Out of a Body.

Dr Joseph Howland Bill was originally from Philadelphia and attended Jefferson Medical College. After graduation he joined the U.S. Army, was commissioned 1st Lieutenant, and in 1860 was assigned to Fort Defiance, New Mexico. There he wrote his 22-page essay, “Notes on Arrow Wounds,” published in the American Journal of Medical Sciences, 1862....

Bill states arrows inflict wounds “with a fatality greater than that produced by any other weapons — particularly when surgical assistance cannot be obtained.”[3] Bill understood the importance of recording his observations for the Army and future settlers as well as documenting his experiences and findings, from both living and dead arrow wound victims, for history and medicine....

...when the arrow penetrated the body the arrowhead would loosen from its contact with blood and other bodily fluids. Dr. Bill explains the worst thing a friend could do was to try to remove the arrow by pulling on the shaft, which would cause the arrowhead to be left behind forcing the doctor to search for the projectile...

The problems came from the nature of arrow warfare and the shape and texture of the projectile. Dr. Bill estimates an “expert bowman can easily discharge six arrows per minute.”[8] In one of Dr. Bill’s cases three soldiers suffered a total of 42 arrow wounds between them. Although this number of wounds was extreme, Bill states he rarely saw someone with a single arrow wound.[9]

Further complicating the multiple wounds was that each arrowhead had to be removed. Unlike a gunshot wound, the arrowhead must be located and extracted. Arrowheads were rough and sharp. No tissue around the arrowhead could heal and in the body’s attempt to rid itself of the foreign object infection would rage forming an abscess. Every time the victim moved the arrowhead’s rough edges would inflame and aggravate the injury and eventually lead to a fatal infection or amputation...

In contrast a.... bullet did not have the sharp edges and could become encysted in tissue or encased in bone and safely remain in the body. The importance of removal is clear in Dr. Bill’s instructions: “We might as well cut the patient’s limb up until we do find the arrow-head.”[11]

Now the gravity of a friend’s attempt to pull the arrow from a wounded comrade becomes apparent. If the shaft was left in place, Dr. Bill’s treatment was to make an incision to enlarge the entry wound and slide a finger down the shaft to feel the depth of the wound and determine if the arrowhead is lodged in bone.[12] Without the shaft in place the doctor was forced to search for the arrow by making a larger incision, probing through tissue, causing more trauma, and taking more time. It was much easier for the doctor and patient if the shaft was left intact until a doctor could remove the head and shaft as one piece. Further, there was always the danger that the arrowhead could not be found leaving the “angular and jagged head… buried in bone to kill – for so it surely will.”[13] If, however, the arrowhead is removed properly, the wound was likely to heal naturally.[14]




Next up: "Anesthesia: Is it worth the trouble?"


Birdwatcher

"Anesthesia: Is it worth the trouble?"

I'm going to vote yes.

Amnesia....

Good grief. I'm even sober and fouled that up.

Agreed!!

McMurtry's incidents were largely based on others described in southwestern literature and lore, some of which were accurate and others of which were simply legends. He does manage to make most of them believable in the context of his story.

Ouch

I once got a piece of glass maybe 1/8" x 1/2" stuck in my foot. It was in such a position that I just could not contort myself to reach it very well, so after trying for a day I gave up & went to the doc, who found it and fished it out in a couple minutes. Considering how bad it hurt and how bad it had me spun up, I don't especially want to think about getting shot by an arrow

it would be even more interesting to know how the indians themselves treated arrow wounds. The chances of a doctor being right there would be slim, I'm thinking. Maybe there was a doctor in an army outfit, but settlers and others darn sure would not have had access to trained help.

He is a story teller who doesn't worry too much about accuracy on the small details. He had Woodrow shooting bandits and Indians with his Winchester in the 1850s in one of his books I read.

Somewhere there must be a good compilation of Indian doctoring techniques. I'm recalling that in the mid-Eighteenth Century, the polyglot Indian town of Onoquaga, on the southern fringe of Iroquoia near the present NY/Pa state line, was a place where White folks would travel considerable distances to be doctored, tho presumably using the Indian's accumulated knowledge of botanical pharmacology rather than the immediate treatment of wounds.

Of seriously wounded Comanches, Smithwick had this to say....

http://www.lsjunction.com/olbooks/smithwic/otd8.htm

That was the only Indian I ever knew that I shot down, and, after a long experience with them and their success at getting away wounded, I am not at all sure that that fellow would not have survived my shot, so I can't say positively that I ever did kill a man, not even an Indian.

The best account we have though of surviving serious wounds in the prehistoric era is Kennewick man, who apparently lived for more than twenty years with a stone spear point embedded in his femur, and who had survived broken ribs and two skull fractures.

I never knew before reading thins how much we owe to those eight scientists who put their careers on the line to get access to this skeleton. The ignorant opposition of the tribes was understandable given abuses in the past, but the actions of the Corps of Engineers in first obliterating the discovery site, and then fighting access to the bones is inexcusable. Even refusing to allow a chip of that spearpoint to be collected to determine geographic origin, which would tell us where this guy spent his teenage years

http://www.smithsonianmag.com/histo...mail&spMailingID=21363381&page=2


There’s a wonderful term used by anthropologists: “osteobiography,” the “biography of the bones.” Kennewick Man’s osteobiography tells a tale of an eventful life, which a newer radiocarbon analysis puts at having taken place 8,900 to 9,000 years ago. He was a stocky, muscular man about 5 feet 7 inches tall, weighing about 160 pounds. He was right-handed. His age at death was around 40.

Anthropologists can tell from looking at bones what muscles a person used most, because muscle attachments leave marks in the bones: The more stressed the muscle, the more pronounced the mark. For example, Kennewick Man’s right arm and shoulder look a lot like a baseball pitcher’s. He spent a lot of time throwing something with his right hand, elbow bent—no doubt a spear. Kennewick Man once threw so hard, Owsley says, he fractured his glenoid rim—the socket of his shoulder joint. This is the kind of injury that puts a baseball pitcher out of action, and it would have made throwing painful. His left leg was stronger than his right, also a characteristic of right-handed pitchers, who arrest their forward momentum with their left leg. His hands and forearms indicate he often pinched his fingers and thumb together while tightly gripping a small object; presumably, then, he knapped his own spearpoints.

Kennewick Man spent a lot of time holding something in front of him while forcibly raising and lowering it; the researchers theorize he was hurling a spear downward into the water, as seal hunters do. His leg bones suggest he often waded in shallow rapids, and he had bone growths consistent with “surfer’s ear,” caused by frequent immersion in cold water. His knee joints suggest he often squatted on his heels. I like to think he might have been a storyteller, enthralling his audience with tales of far-flung travels.

Many years before Kennewick Man’s death, a heavy blow to his chest broke six ribs. Because he used his right hand to throw spears, five broken ribs on his right side never knitted together. This man was one tough dude.

The scientists also found two small depression fractures on his cranium, one on his forehead and the other farther back. These dents occur on about half of all ancient American skulls; what caused them is a mystery. They may have come from fights involving rock throwing, or possibly accidents involving the whirling of a bola. This ancient weapon consisted of two or more stones connected by a cord, which were whirled above the head and thrown at birds to entangle them. If you don’t swing a bola just right, the stones can whip around and smack you. Perhaps a youthful Kennewick Man learned how to toss a bola the hard way.

The most intriguing injury is the spearpoint buried in his hip. He was lucky: The spear, apparently thrown from a distance, barely missed the abdominal cavity, which would have caused a fatal wound. It struck him at a downward arc of 29 degrees. Given the bone growth around the embedded point, the injury occurred when he was between 15 and 20 years old, and he probably would not have survived if he had been left alone; the researchers conclude that Kennewick Man must have been with people who cared about him enough to feed and nurse him back to health. The injury healed well and any limp disappeared over time, as evidenced by the symmetry of his gluteal muscle attachments.

Birdwatcher

I seem to remember some of the Sacketts, probably Tell, pushing arrows on through instead of pulling them out. Of course this was in a book that was fiction. miles

Interesting taht the protocol today is NEVER remove an impaled object, stabilize and transport... leave it to the folks with more medical training than I have.

The other thing is not healing over an arrow head.... deer have cartilage formed around modern heads often enough these days that they are found and reported.

It may not be possible in certain areas of the body but evidently it is in others.

The interesting part of this is that even in the day, they were trying to figure out best practices.

I've had to cut exactly three fishooks out of my hands, and I can tell you that I don't want an arrow stuck in me.

Familiar with two archaeological sites that produced human skeletal remains with projections associated withthe remains. One was site at Rices Crossing Texas. Female had atlatl dart embedded in back of skull, entry thru eye socket. Other was a mass grave (5) in area of Breckenridge Tx. Perdiz arrow point embedded in back of hip of one of the males. All native remains.

I have seen a fewe Iroqouis and Ottowa war points. Backswept as in barbed. No pulling THOSE out. Push through sometimes maybe, but no "pulling it out".

Texas found arrow points

Abu al-Qasim al-Zahrawi, lived in present-day Spain in the 11th Century, "the father of modern surgery", inventor of 200 surgical instruments.

http://en.wikipedia.org/wiki/Abu_al-Qasim_al-Zahrawi

Including the arrow spoon, used to extract 'em. State of the art through the Middle Ages.

Makes sense, interesting little piece.

I'm not sure the good Doctor was correct in the above passage, as your excerpt about Kennesaw Man hints. Arrowhead fragments are indeed found in anthropological specimens, suggesting that a permanently imbedded foreign body was NOT necessarily a fatal problem. Infection/abscess were possibilities, but not firm probabilities, from what I've read.

Doctors in Western movies are always seen removing bullets, which is based to some degree on standard medical practice in the 19th century. In point of fact, removal of bullets and other penetrating foreign bodies was and is largely unnecessary. If you could push the arrowhead/shaft through and out the far side, this was probably the best surgical treatment. Using an "arrow spoon" would also be feasible, although I don't know if they were in common usage.

Bottom line, though, I'd rather have a GSW than an arrow, knife, or sword wound, if I had to have one or t'other.

I was thinking about animals and their ability to survive seemingly huge infections and/or injuries. I'll bet you that your average Stone Age guy was closer to an animal in that regard than he was to us. While we are probably a lot stronger with regard to having immunities to certain diseases and the like, we probably aren't nearly as hardy in general and with common bacteria and organisms found in natural environments.

Also, until quite recently, anyone with a broken bone, penetrating wound or infection would lay around for several weeks going "Oh SH*T that hurts! Oh, HOLY F***ING CRAP THAT HURTS!!!" "Ow! Ow! Ow! Jesus H. (or prophet or deity of choice) that hurts!" "Oh God or Gods! Make it stop hurting!!!"

Not much else they could do.





That's a little exaggerated, they did have opium or various herbal remedies. The Medicine Man would say, "chew some willow bark and call me in the morning." But mostly, they suffered a lot.

Ol' Jim Bridger carried a 3" iron arrow point in his back
for 3yrs before he ran into Marcus Whitman. Dr. said the
point bent when it hit bone and was hard to remove with
the "cartilagi-nous (sic) growth around it".Just sayin'.

When my wife, Crystal, was a teen-age bride (married to her first husband), Pete went out one morning to do some disking. He took along his Ruger Single Six which he kept in a holster wired to the steering column of the tractor. At some point, the pistol fell out and Pete bent over to try and catch it. When the pistol hit the floor, it fired, sending a .22 slug into his upper chest below the collar bone. Crystal drove him into Lordsburg to the only clinic which was operated by an old country doctor whom everyone called Doc Baxter.

Doc Baxter took him into the exam room and Crystal sat anxiously out in the waiting room. After a bit, Doc Baxter stuck his head out and said, "Hon, come on in here." Pete was lying there with a perfect little round .22 caliber hole in his chest. Doc Baxter said, "Hon, see this hole here?" and Crystal nodded her head. He said, "See how he isn't breathing in and out of it?" Crystal nodded again, and he said, "That's a good thing. We'll give him a tetanus shot and you can take him home." She was a bit flabbergasted and said, "Aren't you going take the bullet out?" Doc Baxter replied, "Oh, hell no, Hon. We'd have to make a way bigger hole to get it out. He'll be fine."

Crystal was still somewhat apprehensive, so the next day she insisted that they drive 140 miles to Las Cruces and see her old family doctor. He examined Pete and asked her, "Who treated him yesterday?" When she told him, he exclaimed, "Oh, Old Doc Baxter. He's treated more gunshot wounds than any of us here in Las Cruces will ever see. I'm sure that Pete will be fine."

Turns out Homer (the Ancient Greek, not the Simpson) was all about describing injuries and their outcomes more'n 3,000 years ago. Clearly him and his audience were familiar with edged weapons and the consequences thereof.

The Ancient Greeks and Trojans were spear throwing fools but every once in a while someone gets stuck with an arrow, like the guy who was shot in buttock while running away and gets stuck through the bladder. That guy dies pretty quick so it must have nicked an artery.

One guy elsewhere fatally hit by an arrow in the neck at the base of the jaw, dropped right away.

This guy stuck through the shoulder plate of his armor does have someone pull the arrow out, but it was probably shallow as he's back in action right away...

http://www.poetryintranslation.com/PITBR/Greek/Iliad5.htm

when glorious Pandarus, Lycaon’s son, saw Diomedes rage across the plain, routing the army ahead, he swiftly bent his curved bow, and aimed at him, striking him firmly, as he ran, on the right shoulder-plate of his cuirass, so the sharp arrow pierced clean through, and the armour ran with blood...

...the swift shaft failed to down Diomedes, who drew back to the shadow of his chariot, where he called to Sthenelus, Capaneus’ son: ‘Quick, my lad, down here, and pull this bitter dart from my flesh.’

Leaping from the chariot, as he spoke, Sthenelus touched ground beside him and pulled the sharp arrow from his shoulder, so the blood soaked through the woven tunic.


Ten guys killed outright with arrows by one guy, the two hits we get descriptions of both quick kills in the chest. The archer in turn felled with a rock, by the shoulder where the collarbone meets the neck "a fatal spot"...

I have worked with all my might and never rested, from the moment we drove them back towards Ilium. I have watched and waited, killing them with my bow. Eight long-headed arrows I have let fly, and each has found its mark in the body of some young warrior. But here is the mad dog I cannot reach.’

With this he shot another arrow from the bow, aiming for Hector, eager to strike him. Hector he missed, but struck peerless Gorgythion in the chest, Priam’s mighty son, born of lovely Castianeira of Aesyme, goddess-like in form, whom Priam once married. His head, weighed down by the helmet, fell to one side, like a garden poppy heavy with seed and spring rain.

Then Teucer fired again at Hector, eager once more to strike him, but again he missed, Apollo making his arrow swerve. Yet he struck Archeptolemus, Hector’s brave charioteer, on the chest by the nipple. He fell from the chariot, forcing the galloping horses to swerve, his strength faded, and his spirit was loosed.

Hector’s mind was darkened by dreadful sorrow for his comrade’s death. Yet he left him there, despite his grief, and called Cebriones his brother, who was nearby, to take the reins, and he instantly obeyed. Hector himself leapt from his shining chariot with a dreadful cry, and grasping a rock in his hand ran at Teucer, his heart urging him on to the kill. Now Teucer had drawn a sharp bolt from his quiver, and laid it to the string but, as he drew, Hector of the gleaming helm struck him with the jagged stone by the shoulder where the collarbone joins the neck and chest, a fatal spot. It caught Teucer as he aimed in his eagerness, breaking the string. The hand and wrist were numbed; he sank to his knees, and remained there the bow falling from his hand.

A guy struck by an arrow in the thigh and taken out of the fight.

When noble Eurypylus, Euaemon’s son, saw Ajax fending off showers of missiles, he ran to support him, and hurling his gleaming spear struck a general, Apisaon, Phausius’ son, in the liver under the midriff, bringing him down. Then standing over him he started to strip the armour from his body. But Paris, seeing him, quickly fired his bow, and his arrow struck Eurypylus in the right thigh.

Hampered by the broken shaft, Eurypylus cheated death by taking cover among his comrades... ...the Greeks gathered round the wounded Eurypylus, crouched behind sloping shields, with outstretched lances.

...and the aftermath...

Patroclus... ...met Eurypylus, Zeus-born son of Euaemon, limping from the field with an arrow-wound in the thigh. Sweat was pouring from his head and shoulders, and dark blood ran from the vicious wound, but his mind was still clear....

...he put his arm round the warrior’s waist, and helped him to his hut. When Eurypylus’ squire saw them, he spread ox-hides on the floor, and Patroclus lowered the wounded man to the ground, and cut the sharp arrow-head from his thigh. Next he washed the dark blood from the place with warm water, and rubbing a bitter pain-killing herb between his hands sprinkled it on the flesh to numb the agony. Then the blood began to clot, and ceased to flow.

And finally, a guy struck all the way through the foot "pulls the arrow out" presumably forwards, but is taken out of the fight by the pain.

Diomedes was still busy stripping brave Agastrophus of his shining breastplate, the shield from his shoulder, and his heavy helmet, when Paris drew back the string and let fly. The shaft did not leave his bow in vain, striking Diomedes on the flat of his right foot, passing clean through and fixing itself in the earth....

....Odysseus the spearman stepped up to give him cover. Then Diomedes sat to the rear and agony shot through him, as he pulled the arrowhead from his foot. Mounting his chariot then, in pain, he ordered his charioteer to head for the hollow ships.

Still looking for a reference to "pushing the arrow on through".

Birdwatcher

You may have to look at surgical texts to find one.

FWIW, the most commonly used modern ER method for removing fishhooks from people is to "push it on through", cut off the barb, and then pull the body of the hook back out. Alternatively with some hooks that have barbs on the shaft of the hook you cut off the eye and push the hook through. These techniques are described in multiple surgical texts. Nobody seems to know how the technique was invented, or where, or when, but it seems to be an ancient method.

(Myself, I pull most fishhooks straight out with forceps and a quick, sharp tug. Works great, causes less tissue damage, doesn't require anesthetic, and has less risk of infection. It's a surprisingly recently developed technique, actually. Most people still use the "push-through" method.)

I am aware of similar techniques being used for other penetrating foreign bodies, although these days most larger FB's are taken to the OR for removal.

In the days prior to anesthetic and antibiotics, particularly if a bone was fractured, amputation of the limb was the treatment of choice.

High School buddy of mine accidentally shot me in the leg with his .22 rifle once while we were out shooting rabbits at night. We were both about 17 at the time. The bullet barely missed my femoral artery and exited my leg with out striking any bone. Yes it hurt, but did not bleed all that much. Just a entrance and exit hole on either side of that leg.

Went to my old family doctor, and he had the nurse clean it out with what looked like a big ass pipe cleaner or brush, with lots of alcohol / iodine. That hurt a hell of a lot worse than the actual gunshot did. I was just damn glad he wasn't shooting Stinger's

Tooth absesses/ infections took extremely high toll from much archaeological evidence.

My son had a fairly large hook removed from his thumb by a nurse at an ER. The nurse slid a hypodermic needle down along the curve of the hook and put the hole in the needle on the barb of the hook. She pressed down the eye of the hook and held the needle on the barb, while I just slid the hook back out by pulling on a thread that was looped in the curve of the hook. She made it look easy as could be. It seemed a lot less traumatic to my son than trying to force the point on through or yanking the hook out backwards against the barb. It didn't take any time to heal and according to my son, never got very sore.

I used a pair of vice grips and a good pull on this one back in the spring. The end of the hook was against the bone so it couldn't be pushed through. Minor consumption of alcohol was used to dull the pain...if needed again the RX will be changed to include major consumption.

As I remember the movie Lonesome Dove, the arrow in Gus was pushed on thru by the other guy, not pulled out.

Medical history is full of poor of even stupid medical practices by todays standard. That doesn't mean it wasn't done with good intentions.

The way I recall it, Gus had two arrows in his left leg. Pea Eye, following Gus's direction, first tried to pull it out, it wouldn't go, so he pushed it on through.

The second arrow was stuck in the bone.

Birdwatcher

You are correct, Birdy. If I've watched that Movie once, I bet I've seen it at least 50 times. It's one of my favorites, of what I call the "modern" Westerns.