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Fantasy Writers

Research of less-than-desirable topics (wounds, wound complications, etc.)

Viewing 15 posts - 106 through 120 (of 124 total)
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  • #126180
    Rose
    @rose-colored-fancy

    Hi everyone!

    I venture into this topic because I need some advice on a fictional poison I’m working out.

    Here’s all the information I’ve been able to gather:

    It’s distilled from a flower, and the distillation is of a very high concentration. The flower itself, if ingested, is mildly toxic, but won’t cause much more symptoms than a bad stomach flu.

    It’s administered by smearing it on a knife/arrowhead/ cutty thing and cutting someone so the poison enters the bloodstream.

    It’s supposed to be quite stealthy, so it would look as though the victim simply fell ill and died. One of the main symptoms of the poison is hallucinations, so it’s fairly plausible that everyone would think the victim was hallucinating the assassin in the first place.

    The poison is fairly slow working, about a week before the victim dies. (I need this for plot reasons XD)

    I’ve figured out that the poison is most likely a neurotoxin since the symptoms are paralysis, confusion, disorientation, and hallucinations. The paralysis and hallucinations are necessary for plot reasons, the other symptoms can be changed around a bit.

    The character (No spoilers XD) gets a fairly large, deep cut on his right forearm with a poisoned knife.

    Now, what I really wanted to know:

    Is an antidote possible for neurotoxicity of this sort? (I hope so, I need that for the plot XD)

    Would there be permanent effects of the poison, even after an antidote is administered? Such as paralysis or partial vision loss? (of neurological origin)

    How long after the poison is administered would the first symptoms appear? 10, 15 minutes?

    I had an idea that the antidote could possibly be from the same plant, but from the root instead of the flower. Basically, that the root is also ‘poisonous’ but it has opposite symptoms, so it would treat the symptoms enough that recovery is possible. Is that possible?

    Would there be any symptoms like heightened pulse/blood pressure?

    Would the victim get a fever from trying to work through the poison? I suppose infection of the wound is possible, but I think that might be overdoing it a bit.

    Would the poison still have a smell? The flower has a rather strong smell, so I suppose it would. (Minor detail, but I still want to know XD)

    Would the symptoms gradually get worse as time continues? (I think so, but just checking)

    Is there anything I’ve overlooked?

    For context, the story is set in a fantasy world without magic. The medicine is approximately on the level of the North-African and Middle-eastern medieval period.

    Thanks!

     

    "Stories are light. Light is precious in a world so dark." The Tale of Despereaux

    #126266
    Livi Ryddle
    @anne_the_noob14

    @rose-colored-fancy

    I can’t answer this as well as @the-inkspiller probably could, but here are my two cents:

    Antidote question: In all honesty, I have no idea. That is a question for Jonathan. But also… it’s your book, so if you need an antidote then I’d say go for it.

    Permanent effects… You mentioned that the symptoms were paralysis, confusion, disorientation, and hallucination… So the poison messes with your brain. I’d think that could leave permanent issues, yeah. Again, though, I defer to Jonathan. (Pfft, I’m a dummy. Read through that again… You said it’s a neurotoxin. Nervous system is affected. So yeah, no duh that it affects brain XD)

    ANYWAYS

    Length of time before symptoms appear… I’d say depends on: A) the concentration level of the poison, B) how much of it actually entered the bloodstream, and C) how active the affected person is after being poisoned. (Like, if they go do a bunch of jumping jacks, that would probably carry the poison through their system faster.)

    Antidote from same plant: My immediate reaction to that is one of skepticism. I’m not sure how the flower and the root can be opposite and cancel the other out. But I don’t think it’s totally outside the realm of possibility. (I’m also not a botanist. 😛 )

    Symptoms like heightened pulse / blood pressure? I’d say yes, most definitely. But ask the Spiller of Ink.

    Fever from working through poison? Again, I think so. And yeah, I think wound infection wouldn’t necessarily be a direct effect of the poison. If the wound itself is left untreated, then yeah, infection would likely ensue. But just from the poison? Eh.

    Symptoms getting worse: Honestly I’m not sure. That’s probably up to you. I’ve read a series before where someone was poisoned, and, as time went on, the person seemed to be getting better. Like, they weren’t tossing and turning in their sleep as much, they were lucid for most of the time, etc. But really, they were getting worse. The better they seemed to be, the worse they actually were. (So like, the symptoms themselves could maybe be getting “better”, but the condition of the person actually worsens.) If that makes sense at all. But anyways, point is, I think you could do whichever and be cool.

    Hopefully that helps!

    “Enough! Be quiet! I can’t hear myself think! I can’t hear my teeth chatter!"

    #126287
    Rose
    @rose-colored-fancy

    @anne_the_noob14

    Thank you for the help!

    Antidote from same plant: My immediate reaction to that is one of skepticism. I’m not sure how the flower and the root can be opposite and cancel the other out. But I don’t think it’s totally outside the realm of possibility. (I’m also not a botanist.   )

    I’m going to put some more research into that! Thanks for pointing out that it seems unrealistic, I was thinking that myself XD

     

    "Stories are light. Light is precious in a world so dark." The Tale of Despereaux

    #126290
    Livi Ryddle
    @anne_the_noob14

    @rose-colored-fancy

    Of course! And lemme know if you find anything useful… I could use it for one of my own fictional poison plants XD

    “Enough! Be quiet! I can’t hear myself think! I can’t hear my teeth chatter!"

    #126378
    Rose
    @rose-colored-fancy

    @anne_the_noob14

    Okay, did some more research! Here’s the new plan!

    I haven’t found a single instance of a plant being its own antidote, so I changed it a bit. It’s fairly common for poisonous plants and antidotes to be close together. Jewelweed and poison ivy, or stinging nettle and plantain.

    So, I’m going to use that so my characters can figure out what the antidote is. (Possibly with the help of a talking raven. Don’t ask XD) One of my characters has considerable knowledge of herbs and plants, so she can figure it out, and it’ll make it so they have to work a little harder for the solution.

    Hope you can use this bit of research for your writing 😉

    "Stories are light. Light is precious in a world so dark." The Tale of Despereaux

    #126382
    The Inkspiller
    @the-inkspiller

    @rose-colored-fancy

    Sorry I took so long to make a reply. Life has been crazy, and sadly this response will be a bit less exhaustive than I’d like. Thankfully, Ms. Ryddle here has also chimed in with her own good sense and research, to which I shall add with my own obscure knowledge of how people die. 😛

    Poisons have a huuuuuge variety of mechanisms of action by which they kill you. However, as far as natural poisons go,  whether animal or plant, there are two general ways:

    1) Neurotoxin – most common to animal venom (i.e., snakes and spiders), but there’s a couple plants with neurotoxic effects – many of which are also used for medicinal purposes (just not in lethal doses). Both drugs and poisons in this category affect nerve transmissions and muscle contractions, and therefore most prominently the muscles of the heart and lungs. And when these stop working, you die. 

    Like, now.

    The main takeaway (and unfortunately for realism) is that direct neurotoxins usually kill you within minutes or hours, before there’s time to diagnose the unknown poison and administer the antidote. However, if you know the poison (e.g., water hemlock [treated with charcoal]) then these agents can often be treated with an antidote to reverse their effects before the patient bites it.

    Examples include aconite (from monkshood/Wolfbane), botulinum (botox), belladonna, tetrodotoxin, and strychnine, among many, many others.

    2) Shock – this is a broad category, but this includes classic substances like Spanish Fly, cyanide, ricin, arsenic, antimony – notice the heavy metals on the list? These substances don’t have a direct effect on the nervous system, but cause the breakdown of other body systems which are rather critical to sustained life. Everything I just mentioned except cyanide directly attacks the GI system, causing irritation – a medical euphemism for causing your intestinal lining to split open and bleed into your abdominal cavity. The “shock” part is a bit of a mess; in some poisons, it comes from huge losses of circulating blood volume. In others, such as cyanide, it is because the body is dying on a cellular level due to lack of energy (as cyanide paralyzes the mitochondria, preventing your cells from making the energy they need to live).

    These poisons often kill somewhat slower, but that is not always the case – and even so, you’re looking at a difference more of a few hours instead of a few minutes, or potentially a day. It is also important to note that there’s significant overlap between these two mechanisms of action, and most poisons work in both ways to some degree.

    The main causes of a long, slow death are a combination of low dose / low concentration and old age – OR low dose and constant administration.

    Not because old age allows you to survive poison better, but because with old age, the person cannot survive the lesser damage caused by a more moderate dose, and ends up dying not directly of the poison, but of complications from the poison.

    As for the latter, that is the sort of assassination technique one might use when trying to dispatch someone without it being known that they were poisoned. Even in the medieval period, it was pretty easy to tell the difference between poison and disease (unless you waited for the person to get sick of some regular cold before slipping them some good ole “herbal tea”). The most reliable poisons killed you far too quickly, and so it would be immediately known that an assassination attempt had been made once the victim (or their cupbearer) bought the farm (not that this was much consolation to the victim, but it would make it hard for the assassin or their employer to make good on the murder – at least if the murdered was reasonably popular.)

    The more subtle way would be to poison the victim gradually with small doses of mild poison to cause general illness and sickliness over a period of weeks or months. The doses wouldn’t necessarily have to be constant or regular, just every few days, randomized so that the victim doesn’t know what’s making them sick, and therefore is more likely to believe that he just caught the plague or something. You could even use very, very dilute arsenic exposure over a long period to cause jaundice and rashes, which would lead to most people assuming it to be a health condition rather than a poison – especially if your victim is particularly fat (jaundice, gout, and obesity go hand in hand).

     

    Just some ideas. When my exams are over I can come back and answer again in greater, more thoroughly researched detail.

     

    Non nobis Domine, sed nomini, Tuo da gloriam.

    #126383
    Skylarynn
    @skylarynn

    @the-inkspiller

    Did you see my questions?

    “So how would a medieval skin graft work out?  I ask because previously Brendin had been burned badly enough to need one and a very well trained University surgeon was on hand to treat him.

    Also might mandrake root have been used as an anesthetic? You’d mentioned something like that earlier, I think.”

    • This reply was modified 3 weeks, 2 days ago by Skylarynn.
    • This reply was modified 3 weeks, 2 days ago by Skylarynn.

    "Remember, you go nowhere by accident. Wherever you go, God is sending you." - Rev. Peter R. Hale

    #126385
    The Inkspiller
    @the-inkspiller

    Fun little fact, cyanide isn’t just produced for killing people. Apart from cyanide derivatives used in the manufacture of plastics, one of its primary economic purposes is actually the processing of silver and gold ore, as it is one of the few substances capable of dissolving those minerals selectively.

    Seems almost poetic. One of the most fatal substances ever discovered is also used to produce wealth.

    Non nobis Domine, sed nomini, Tuo da gloriam.

    #126390
    Rose
    @rose-colored-fancy

    @the-inkspiller

    Thank you so much for your reply! It’s extremely helpful and points out the weak points in my idea.

    My biggest issue is that I need some sort of slow-working poison so the characters can get to a specific place and back for the antidote.

    I was planning for the victim to have some permanent damage from the poison, specifically, paralysis of his right hand. That correlates to the symptoms of a neurotoxin, but that acts quickly, especially in doses that only require it to be administered once.

    The barest minimum of the stuff I need for the plot is the permanent paralysis, and that it works slowly.

    Hmmm…. maybe I could somehow make it possible that the assassin administers lower doses over a longer period of time…. Hmm, I’ll be thinking about this!

    Fun little fact, cyanide isn’t just produced for killing people. Apart from cyanide derivatives used in the manufacture of plastics, one of its primary economic purposes is actually the processing of silver and gold ore, as it is one of the few substances capable of dissolving those minerals selectively.

    Seems almost poetic. One of the most fatal substances ever discovered is also used to produce wealth.

    Oooh, I didn’t know that! That’s the coolest thing!

    Thank you so much for the help! I hope you have the best of success with your exams!

    "Stories are light. Light is precious in a world so dark." The Tale of Despereaux

    #126397
    The Inkspiller
    @the-inkspiller

    @skylarynn

    Ah, my mistake! I didn’t see the second follow up question. Or maybe I did and I just forgot about it. Thank you for asking again!

    A warning in advance – this is some gruesome material. In a nominally related tangent, the Russian word for hospital, Больница (Ballnitza) literally means “house of pain.”

    Regarding medieval skin grafts… the bulk of the information we have available regards rhinoplasty, or nose jobs. Not for vanity, no – until the invention of antibiotics, syphilis was the bane of those who couldn’t keep it in their pants, or who made a living of getting in others’. One of the long term consequences of syphilis are its characteristic sores, blisters, and massive disfigurement – one of the most prominent and inevitable symptoms being the infamous “saddle nose” in which the bridge of the nose necrotized and rotted away, leaving you with a bad case of Voldemort face. Those who could afford it would pay for surgery by a (hopefully) competent surgeon, for which there were two methods: the Italian method, perfected by Gaspare Tagliacozzi in the mid-late 1500s (he died in 1599, and his technique fell out of use with him), and the Indian (Hindu) Method, brought to Europe during Antiquity (Rome), and practiced since 600 BC.

    The Indian Method consisted of slicing free a full-thickness section of skin from the forehead, twisting it down and around where the nose used to be, and shaping it into a new nose around a wax mold (which you would obviously remove once the nose was fastened in place). It would take 14 days for the graft to take, and then another 25 days or so for full healing (including the donor site). It worked remarkably well – if neither donor site nor your new nose got infected, you would heal with an at least passably human nose, although you would have a strange unpigmented triangle on your forehead where your new nose came from (mixture of new skin and scar tissue – tends not to come with melanin). Infection rates also seem to have been pretty low (granted, being rich enough to afford a surgeon also usually means you’re generally cleaner), although some surgeons were dogged by graft rejections – which stemmed from the bad practice of taking skin grafts from other people, which does not work even today. Short of being identical twins, only autografts work.

    Then there’s the Italian Method. Tagliacozzi (who was pretty much the only practitioner of it, even in his own time) would do the same as the Indian method, except the skin flap was taken from the upper arm, which would then have to be belted to your face for the 14 day grafting period, at which point he would sever the graft from the arm and then keep you on bed rest for another 25 days to 5 months. This was understandably uncomfortable, and carried a high risk of permanent contractures in the affected arm – meaning it could be permanently locked in a bent shape, unable to extend or contract. This, understandably, sucked. Nonetheless, he boasted that his method made noses better than the originals (and had little to say about contractures), but few surgeons kept up his technique after his death. Yet his motto lives on in the hearts of plastic surgeon around the world:

    “We restore, rebuild, and make whole those parts which nature hath given, but which fortune has taken away. Not so much that it may delight the eye, but that it might buoy up the spirit, and help the mind of the afflicted.”

     

    However, as wholesome as the mantra is, it was also not uncommon for persons of wealth to seek replacements of their nose not by grafts, but by prosthesis. Tycho Brahe, the boisterous astronomer of the 16th century, had a nose made of silver (though it may actually have been copper) after he lost his nose in a duel. Conveniently enough, both copper and silver not only look fly as heck, but they’re naturally antimicrobial – greatly reducing the likelihood of infection. The medievals may not have understood why exactly copper and silver were good for prosthetics and medical operations in general, but they knew that it worked and that was good enough.

     

    Now. Applying this to other body parts:

    The reason why these skin grafts kept the skin attached to the donor site until the graft healed was because they did not have the means to keep skin alive after it was separated from the body. Without at least some functional epithelial tissue to provide circulation, a graft would die before it could grow new granulation tissue to adhere to the new attachment site. Large burns across the body necessitating graft(s) might well be a death sentence regardless of the surgeon’s skill; there’s just not enough skin left. A crafty (read: desperate) surgeon might be able to literally stretch skin grafts to make them work, but there’s no guarantee that will work, and it may just destroy the graft; the equivalent modern technique is a heck of a lot more complicated.

    One of the biggest related complications to burn injuries and skin grafts (and anything that requires bed rest) is pressure injuries; a patient who sits still without moving for more than a couple days is at a high risk of developing sores on bony prominences like the hip and sacrum (your tailbone) that squish your muscle / skin against whatever surface you’re laying on. If it goes on long enough, tissue will ulcerate, die, and rot away. This only gets worse with sacral injuries, as that is very close to your poopy hole – and bed rest also often means uncontrolled poo. Poo + open tissue = massive infection = death by poo. Poo itself can also rot away your skin – though not directly because of the poo, but just because moisture is a breeding ground for bacteria and fungus which then eat the skin, and the poo happens to provide lots of nutritious organic matter for micro-organisms to proliferate on.

    Someone who has full body burns is going to have a rough time of lying still enough to heal and moving about enough to ward off pressure injuries. The standard medical prescription these days is to rotate the patient every 2 hours (whether we do it or the patient does, doesn’t matter). I am not sure if medieval medical literature recorded this practice, but the patient would have eventually gotten uncomfortable sitting in the same position for hours on end, while any sort of open wound would not have been sat upon – it’s common sense. It hurts a lot, why would you sit on it?

     

    And yes, mandrake root was historically used as an anesthetic, and widely so. It doesn’t reduce pain, it just knocks you out. Or causes wild hallucinations. Or death. A note from the poison post above – a number of neurotoxic substances were also historically used as medicines, in addition to their more homicidal applications – to variable effect.

    One of the unfair advantages of the East was their access to opium – from which we derive modern morphine (and also heroin, which is not as helpful). Although highly addictive, it is a powerful painkiller, and while very much still capable of killing you, significantly less likely to do so by accident.

    Non nobis Domine, sed nomini, Tuo da gloriam.

    #126398
    The Inkspiller
    @the-inkspiller

    On a side note, the history of prosthetics is rather fascinating. Apart from the silver/copper noses of above, some ancient prosthetics could get pretty creative. The most stunning example was the “Iron Fist” of the German knight Gotz von Berlichingen (who formed the loose basis for a really gritty, awesome medieval fantasy anime), who lived a long life (he died at 82) of mercenary adventures and derring-do, generally being a nuisance to his neighbors, and being one of the most quotable men of his period (he invented the phrase “you can kiss my butt.” This was after having his right arm blown off when he was only 24. Too hardcore to let a little dismemberment get in the way of his quest for glory and booty, he had two iron hands commissioned with the expertise of a saddlemaker, a blacksmith, and a clockmaker. The end result was a fully articulated iron hand that could be flexed with the free hand and locked in place such that it could hold a sword. In fact, Gotz became rather famous for his “iron grip” – it’s rather hard to disarm a man whose hand is made of iron. Though he was rather more famous for being a pillock and a stubborn chucklenut who did whatever he wanted, picked fights with dukes, caroused with his fellow mercenary celebrities Georg von Frundsberg and Franz von Sickingen (who later testified for their homie in court), and was repeatedly outlawed by his emperor for sundry acts such as pillaging imperial trade caravans, kidnapping a count, leading a peasant rebellion (Peasant rebellion of 1525 – Luther’s era), and only finally absolved in order to serve the emperor against the Ottoman Empire.

     

    I really like this dude. He’s kind of inspirational.

    Non nobis Domine, sed nomini, Tuo da gloriam.

    #126529
    Rose
    @rose-colored-fancy

    @the-inkspiller

    I heard about him! Reportedly, his iron hand was so well made that he could hold a quill with it. One thing’s for sure, he left an interesting legacy. XD

    I’ve been thinking about the dilemma of the poison, and I might have a solution, but I have no idea if it’s feasible in any way, shape, or form.

    Here’s the idea. The first dose of poison was administered by a cut with a poisoned knife. This means the poison was delivered directly to the bloodstream, so it would work fairly quickly. But, if the concentration was too low to be lethal, I think you’d get some pretty nasty symptoms, but they’d get better within a few days if the dosage was fairly low. As far as I can guess, correct me if I’m wrong.

    Now, what if the assassin administered another dose of the poison before the other had entirely worked out? This could be done multiple times, and so the poison would eventually accumulate. The biggest question is whether it would accumulate.

    By my guess, the symptoms would either get progressively worse, or the victim would become weaker, but he’d die either way, in the end.

    Next question, would it be effective to administer the poison to the cut?

    A way I thought of administering the poison was via bandages that were soaked in a dilution of the poison and then left to dry. The solvent will evaporate, but I think the toxic chemical might not. If this applied to the cut, I think the poison would be absorbed into the cut, and from there into the bloodstream.

    I’ve actually never heard or read of this, so I have no idea if it’s feasible.

    The one issue I have with this is that the cut will close within a few hours. It’s deep, but one of the characters will stitch it, so it should close.

    Would there need to be some sort of chemical added to the poison to keep the cut from closing?

    The assassin has no way to reach the food or water supply, so I can’t see any other way how this would work. I can definitely get the bandages to the other characters without it looking suspicious, though.

    In this case, it isn’t really a priority that it looks like a disease. The victim already knows he’s been poisoned, so that doesn’t matter.

    I’d love to hear anyone’s thoughts or suggestions on this!

    "Stories are light. Light is precious in a world so dark." The Tale of Despereaux

    #128034
    Livi Ryddle
    @anne_the_noob14

    @rose-colored-fancy

    I have a talking owl, so don’t worry – I’m not judging a talking raven 😛


    @the-inkspiller

    Water hemlock treated with charcoal! I am pleased with myself. I actually knew that bit of info already 😀 I read a book once, where a girl found water hemlock, didn’t know what it was (thought it was a turnip or something) and was chopping it up for soup. She gave some bites of it to some kids, and they got sick. Then were given charcoal. Point is, I am happy I recalled that random piece of trivia.

    • This reply was modified 1 week, 3 days ago by Livi Ryddle.

    “Enough! Be quiet! I can’t hear myself think! I can’t hear my teeth chatter!"

    #128446
    Crazywriter
    @crazywriter

    This forum caught my eye. Gore! Haha just my thing.

     

    Has anyone researched Japanese tortures during ww2? If not, don’t. Just ask me. I’ll be much less gory

    #128468
    The Inkspiller
    @the-inkspiller

    @crazywriter

    I have. It’s part of my cultural heritage. And – without meaning any rude contrariness – as tragic and revolting as it is, it is a subject very much worth studying and researching in its full detail. There is a reason why the issue of Japanese remilitarization is an issue for every Asian country in the Pacific; the atrocities of the War in the Pacific are branded into the cultural memories of every nation which suffered Japanese occupation. We’ve gotten over it in recent years inasmuch as we know that today’s generation are not responsible for the crimes of their forefathers, but unlike Germany, Japan has never really been forced to acknowledge their war crimes in a similar fashion – being overshadowed by suffering the first and only nuclear weapons used in anger.

    Non nobis Domine, sed nomini, Tuo da gloriam.

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