One of the difficulties of surgery, even today, is keeping the patient’s body temperature at a safe level. Core temperatures can drop quite dramatically when a large incision has been made, and although it is theoretically possible to keep the patient warm by making the operating theatre hotter, in practice this makes conditions intolerable for the surgeons and other theatre staff. So patients are sometimes mildly hypothermic when they leave theatre, and have to be warmed using electric blankets, or by slightly heating the gases and intravenous fluids administered to them. An alternative – and rather disgusting – method of preventing surgical hypothermia was outlined in The Medico-Chirurgical Review of 1823:
A soldier in the 1st regiment of Curassiers, 29 years of age, received a blow, by the kick of a horse, on the epigastrium, 18th October last, which felled him to the ground, whence he could not rise. He was bled instanter, and conveyed to the military hospital of the guards, where Baron Larrey found him motionless, pale, skin cold, eyes fixed, breathing feeble and slow, pulse scarcely perceptible.
Dominique-Jean Larrey, Surgeon-in-chief to Napoleon’s armies, was one of the great medics of the nineteenth century: pioneer of battlefield medicine, inventor of the ambulance, and a fearless and innovative operator.
The epigastrium was so tender that the least pressure there caused the patient to utter groans. He otherwise spoke not. There was no appearance of injury on the part. Six cupping-glasses (cum ferro) were applied to the epigastrium and vicinity. The application was very painful, but gave some relief to the patient, who opened his eyes, and expressed by interrupted words a sense of bitterness.
Cupping, a procedure still used today by some alternative therapists, involves placing glass cups from which air has been evacuated on the skin, to promote blood flow to the affected area. In cupping cum ferro, a scarificator is first used to open small blood vessels so that the suction inside the cup draws out a quantity of blood.
This operation finished, Baron Larrey caused a sheep to be instantly pithed, and the skin, torn reeking from the body, to be enveloped round that of the patient. Round this hide again were thrown warmed blankets, in order that the temperature might be kept elevated tor some time. In this situation the man remained two hours, at the expiration of which time things were greatly altered for the better. The coldness of the surface was gone—some colour returned to the face—and the patient could give an account of the accident. Nevertheless he passed a very bad night, continually complaining.
Well, he had a lot to complain about, what with being wrapped in a reeking sheepskin newly flayed from the living animal. He remained ill for some weeks, but was well enough to be returned to active service in early December.
Duponchal thinks that this patient would certainly have been lost had it not been for the extraordinary measure put in force by Baron Larrey, as above related. This was the third successful employment of the same measure by the Baron, at the Military Hospital. The application of a recently excoriated sheep’s hide is directed by Ambrose Paré, as the last resource in violent contusions, and where life is menaced by the first effects of the shock.
Baron Larrey, in the first volume of his Memoirs and Campaigns, reports the instance of some sailors who were shipwrecked on the coast of Labrador, and picked up on the beach by the Esquimaux Indians, almost dead with cold, and exhausted with fatigue. These hospitable creatures placed the sailors on dried skins, chafed their bodies and limbs with hot aromatic liquors, and then enveloped them in the freshly excoriated hides of animals which they killed for the purpose. The inhabitants of Upper Egypt also are acquainted with this remedy. In violent, but very circumscribed contusions, they eviscerate a dove or other bird, and apply it warm to the part— but, where the contusion is extensive, they surround the body of the patient with the hide of a sheep just stripped from the body of the animal. In the memorable Russian Campaign, it is said that the most effectual mode of preventing the complete congelation [freezing] of a limb, was to fold it in the skin of an animal just killed—or even to plunge the member into the reeking entrails of a horse.
And let us not forget Luke Skywalker surviving a cold night on Hoth by sleeping inside the abdomen of a tauntaun. An example which our nineteenth-century medic inexplicably omits.
We are disposed to agree with the author of the paper before us, that there is something more congenial in a warm, and we might say half-alive substance of this kind, than in any unorganized medium through which a similar degree of temperature could be kept to the part or whole of a human body. Our author proposes the application in question, in cases of repelled eruption, and to a limb after the operation for aneurism. To these propositions we can have no objection.
I can think of a few.