Warning! This Post Contains Graphic Content!!!
OK, to me the graphic content in this post isn’t as bad as in my first post on the topic, but it still has some so I thought I’d repeat the warning. I have a more serious purpose with this post than discussing a wound which would leave you unfit for anything other than the lead if Jethro Tull dusted off one of their songs to make a new music video.
In reading Lisi Oliver’s The Body Legal in Barbarian Law I was struck by her mention of several instances where a value is placed on injuries which at one time I would have considered to be pretty much an automatic death sentence before modern medicine, particularly without the availability of antibiotics to counter sepsis. Evidently, as a value which is less than a person’s full wergild is assigned to these injuries, people could sometimes recover from them. I thought I’d take a post to discuss this in a bit more detail.
Before I get started, for those of you less familiar with Germanic (sorry Goffart!) law codes, I want to give a very brief explanation of the concept of wergild. Every person in a given Germanic society is assigned a value. This value is usually equal to the amount a murderer would be required to pay the victim’s family to avoid possible repercussions, or from being “handed over” to the family. These are interesting in and of themselves as they help indicate how valuable that society considered members of a certain social class to be, as well as revealing what skills/abilities/characteristics were important. For example, in Frankish society a free woman of childbearing age had a wergild of 600, the same as that of a nobleman and three times that of a normal freeman, indicating the value of the ability to produce children. Penalties for lesser crimes are sometimes set at a percentage of wergild. For example, among the Alamanni, if someone is killed by a dog then the owner of the dog owes half the man’s wergild (though there is an interesting clause in this case requiring the dog to be hung over its owner’s door until it rots away and the owner must enter and leave his home only through that door until decomposition is complete). However sometimes the price for these penalties is a flat value. Returning to the Alamanni, if someone causes a woman to abort, he or she owes 12 solidi if the child is male, 24 if it is female. 1
This type of system has often been characterized as primitive. To me the civil court system, at least in the US, functions very similarly. In an early medieval case an assessment was made of a person’s value, how much the injury or death was worth and a punitive penalty was sometimes assigned. Items such as potential earning ability, impacts on quality of life, cost of medical care, etc., were factored in. The conflict may have been settled out of court by agreement of the two parties but if they chose the judicial route there were fairly strict criteria for selecting a judge and witness testimony was highly valued. I don’t see a lot of difference between these medieval cases and a modern lawsuit (once you accept the lack of scientific evidence available back then).
I had always been of the opinion that certain injuries from those days would have been pretty much a death sentence. After all, while they had some pretty solid herbal remedies, they didn’t have antibiotics and while they had knowledge of the general concept that clean was better than dirty for injuries, they had no concept of germs. It’s apparent that simple injuries, amputations, or even abdominal wounds which didn’t damage internal organs could be recovered from. The assignment of penalties to these wounds, at rates below full wergild, indicates that survival could be expected.
There are certain wounds I would have considered extremely serious but sometimes survivable. Among these would have been non-penetrating trauma which caused serious internal injuries and wounds which penetrated the peritoneum but did not damage internal organs. Interestingly, the former receives almost no mention in the law codes. There’s nothing pointing to, say, coughing blood because a rib punctures a lung, urinating blood because kidneys are damaged (this is particularly surprising to me because of how common it should have been) or excreting blood due to lower GI injuries. Apparently, if there weren’t visible, external signs of injury, it didn’t matter. Wounds to the abdomen do receive mention in many of the codes. The Franks have some provisions discussing if the wound doesn’t heal but continuously seeps. 2
There are some wounds mentioned by the law codes which I would have expected survival from to be extremely rare, nearly nonexistent. Two of these involve the abdomen. In one, the abdomen is cut so the internal organs spill out and must be replaced. Now folks back then had a pretty decent knowledge of anatomy and they would certainly have known to clean things up before stuffing everything back in but I would still expect this sort of injury to introduce foreign matter into the body cavity, something I understand to be pretty much a death sentence. A related wound is one to the abdomen which also damages the intestines so that excrement comes out. Again, this is contamination with foreign matter, in this case material which is loaded with bacteria. A medieval surgeon would have had the choice of sewing up the intestines with stitches which couldn’t be removed or tucking the excrement-leaking intestines back in. I probably need to read Galen or Hippocrates but I can’t imagine they’d leave the body open while the intestines healed and wait until then to close the wound. These two types of wounds are such that I would have expected near certain death, however values at less than full wergild were assessed for them, so evidently they were survivable at least some of the time. 3
The other wound category involves those to the head. And not just a head wound but those which expose the brain. Again, there are two categories. In one the brain is simply exposed. I can see how this might be survived though I’d expect this to be rare. The other involves a head injury such that the brain protrudes out of the skull. This is another I’d expect to be almost always fatal, but it is dealt with in the law codes so evidently the medievals had ways of treating it. In fact, in the Alamannic code this is portrayed as relatively common, “If, however, the brain protrudes from the wound, as often happens, so that a physician mends (the skull) with medication or silk and afterwards (the patient) recovers, and this is proved to be true, let him (the giver of the blow) compensate with forty solidi.” 4
Clearly I’m underestimating either; the ability of the body to fight off infection caused by exposure to or introduction of foreign materials or; the ability of medievals to treat such injuries. Or both. I don’t have a ton of medieval medical manuals and this isn’t something I’ve read a lot on. Thanks to Stephen Pollington(2008) I do have a few Anglo-Saxon sources. Bald’s Leechbook includes a treatment for wounds of the head where the bones are broken. The Leechbook also contains instructions for “… if one’s bowels be out …” but I suspect this refers to a prolapse. Examples of trepanation known through archaeological finds are fairly numerous so they were willing to drill holes in someone’s head if necessary. 5
Herbal remedies were also available. The Old English Herbarium suggests that, “If a man’s head be broken …” the patient should drink a concoction made of bishopswort and hot beer. Drink enough of it and I bet you would feel better. 6
This is something I need to read more on and it appears that early medieval medicine is more sophisticated than I have given it credit for. I suspect a reading of Galen and Hippocrates would be useful. I’m not sure how available these would have been to early medieval doctors however Galen’s Therapeutics to Glaucon, Hippocrates Aphorisms and a text, The Wisdom of the Art of Medicine were, among others, in circulation. I also want to get a copy of the Frisian laws. According to Oliver, they were very concerned with specifics of anatomy.
Once again, even after all the reading I’ve done, I’ve come across something which surprised me. This is really cool, happens fairly often, and if it ever stops happening I have a feeling I’ll have to find a new hobby. Of course it also leaves me with the sense of how much I don’t know but that’s OK too.
The following abbreviations will be used to identify law codes in the notes:
PLA – Pactus Legis Alamannorum
LLA – Alamannic Laws from the Lantfridana Manuscripts
BL – Bavarian Laws (from the Ingolstadt Manuscript)
PLS – Pactus Legis Salicae (Salic Law)
LSK – Lex Salica Karolina (Charlemagne’s update to the Salic Law)
1 For being killed by a dog, see LLA, XCVI.3. For abortion, LLA, LXXXVIII.1. I should also mention that when an offender was handed over to the victim’s family, general opinion is that this would usually be to serve the family as a slave until it is judged that the debt is paid, not to be killed. See Oliver(2011) pp 49-51 for a discussion of this. One of the main points of the wergild system was to reduce violence by providing non-violent means of compensation. I doubt they would have legalized turning someone over to be tortured and/or killed which would only serve to continue the violence/retribution cycle.
2 Oliver (2011), p 59 in discussing a poisoning case, “The resulting harm, in any case, would have damaged the internal organs which (except in Frisia) were not protected by law.” For non-healing abdominal wounds see PLS, XVII.7, LSK, XV.6.
3 Oliver (2011), p 129, “Frisia includes a fine for causing the intestines to spill out such that they have to be replaced.” The Alamans, LLA, LVII.57, include a fine for, “If, however, he mutilates the intestines so that the excrement comes out, let him compensate with forty solidi.”
4 LLA, LVII.7. The Alamans, LLA, LVII.6 also include compensation of 12 solidi where, “… the brain appears and a physician can touch it with a feather or a cloth …”. This is the most specific account but the Bavarians, Frisians and Franks all include compensation for injuries in which the brain is exposed. In addition to those quoted see Oliver(2011), p 86 referencing the Frisians and; BL, IV.6, V.5 and VI.5; PLS, XVII.4 and XVII.5; LSK, XV.4; PLA, I.1. Another interesting aspect to head injuries which I’m not going to cover here is that of compensation being established by determining if a piece of bone broken off was large enough to hear it strike a shield when you threw it.
5 Bald’s Leechbook, III.33 for the head and III.73 for bowels.
6 Old English Herbarium, 1.Bishopwort/Betonica.
Drew, Katherine Fischer, trans., The Laws of the Salian Franks. Philadelphia: University of Pennsylvania Press (1991). ISBN: 978-0-8122-1322-5.
Oliver, Lisi, The Body Legal in Barbarian Law. Toronto: University of Toronto Press (2011). ISBN: 978-0-8020-9706-4.
Pollington, Stephen, Leechcraft: Early English Charms, Plant Lore, and Healing. Hereward: Anglo-Saxon Books (2008). ISBN: 978-1-898281-47-4.
Rivers, Theodore John, trans., Laws of the Alamans and Bavarians. Philadelphia: University of Pennsylvania Press (1977). ISBN: 0-8122-7731-7.
Wallis, Faith, ed., Medieval Medicine: A Reader. Toronto: University of Toronto Press (2010). ISBN: 978-1-4426-0103-1.