Arrow wounds: an interesting footnote

Arrow wounds are not common. In my long stint in the Government hospitals of West Bengal, I can remember one patient with an arrow embedded in his neck. He was admitted in the Casualty Block of the Medical College Hospitals where a general surgeon referred the patient to me because the arrow head was lying very close to the carotid artery in the neck. We explored the wound and managed to remove the arrow head from its precarious position. The patient recovered and went home in one piece.
He was from the tribal belt of western West Bengal where bows and arrows are still a way of life among the Santals and other tribal groups who make up the mosaic of
peoples who try to cling onto the way of life that their forefathers had made their own. Of course in recent times carrying bows and arrows is more a statement rather than an actual weapon, but sometimes they a`re used in anger and result in the sort of wound that we had seen.
I was reminded of this tribal lad when reading about Dr Joseph Howland Bill an American surgeon, who in 1862 wrote a definitive review on the treatment of arrow wounds. Bill had been educated in the Jefferson Medical College in Philadelphia and joined the army. He was posted in the forward areas where the colonizers were encroaching on tribal lands and the Indian tribes were making a desperate but doomed attempt to protect the lands of their fathers from the advancing hordes.
His paper was entitled “Notes on arrow wounds” and he published it in the American Journal of Medical Sciences in 1862. In this treatise, Bill pointed out that arrows were still very versatile weapons even in an age when firearms had come to the fore. An arrow wound tended to incapacitate the stricken man who was unable to fight on until the arrow was removed. Also the arrow head was not hot and therefore sterile when it entered the body. This meant that it was necessary to remove it, failing which it left a festering sore that drained pus and the patient often died of septicaemia as a result of the infection entering the bloodstream. This was of crucial importance in the preantibiotic era when there was no effective means of treating infections.
Indian tribes also sometimes used poison to make these weapons even more effective. Apparently rattlesnakes were induced to bite the liver of an animal and this was then buried for several days. When dug up, the spoilt liver, now seeped in rattlesnake poison was now a deadly weapon. He laid down the principle that still holds: never break off the shaft from the arrow. As anybody who has searched a wound for a foreign body will testify, finding a foreign body without a guide to it is very difficult even today when using imaging during the surgery. Before these aids were available, it could be impossible to find the arrowhead and the surgery could damage more tissue than the actual war wound itself!
Bill had designed several forceps to extract the arrowheads from inaccessible positions. He had patients who needed a burr hole in the skull because of an arrow wound in the head, but he was most wary of chest and abdominal wounds. These, in his experience very often were fatal, mostly because they produced infections because of intestinal perforations that were essentially untreatable in those days.
I wonder if British doctors in India used his observations n their work here? I am sure that there must have been large numbers of arrow wounds to deal with during their tenure here. Also when the colonial adventure spread to the Malayan peninsula I suppose the local tribes must have fought back principally with this silent weapon which could be deadly when used by experienced archers.
His treatise is now forgotten but it was a definitive document in his times. Just as all the reviews of CABGs will become historical curiosities if somebody comes up with a drug to reverse atherosclerotic changes in the blood vessels. It is interesting to read history; it teaches you that nothing really is permanent. .


Anonymous said…
文王廷 said…
Anonymous said…
Anonymous said…
When are you writing your next piece
college board said…
Having read this material, I have learned for myself a lot of the new. Big Thanks
You know, arrow poisons are used to poison arrow heads or darts for the purposes of hunting. They have been used by hunter-gatherer peoples worldwide and are still in use in areas of South America, Africa and Asia.
Wishes: all information must be stored in the form of pages, and individual leadership, the book should be kept and be available for download in a convenient form, in a separate archive file
Nice story, I read it twice, very very good.

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