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Piracy when it counts: a surgical operation adapted to save a future king

By on September 20, 2021 0


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When we imagine the medieval world, it conjures up images of darkness, deprivation and disease that we find it hard to imagine from our sanitized point of view. The 1400s, and indeed all of history before the introduction of antibiotics in the 1940s, was a time when the slightest scratch acquired in the affairs of daily life could lead to infection ending in slow and painful death. . Add to that the challenges of war, where violent men wielding sharps on a dirty battlefield, and it’s a miracle people survived.

But then like today, some people are luckier than others, and surviving what even today would likely be a fatal injury was not unheard of, as one boy discovered. sixteen years in 1403. It did not hurt that he was the son of the King of England, and when he received an arrow in the face in battle, everything would be done to save the prince and heir to the throne. It also helped that he was fortunate enough to have a surgeon with the imagination to solve the problem and the skills to build a tool to help.

The prince

Henry of Monmouth, after he became king in 1413. The artist wisely chose not to include his severe scar. Source: National Portrait Gallery, public domain.

Henri de Monmouth, the future Henry V, was born in 1389 in Wales. His father, Henry Bolingbroke, was the cousin of the current king, Richard II, whom he deposed and imprisoned in 1399. Calling himself Henry IV, this placed his son Henry, now Prince of Wales, in the line of succession in as heir apparent. As such, great efforts were made to prepare him for future royalty, including extensive military training.

Prince Henry’s training was quickly put to the test at the Battle of Shrewsbury, where King Henry’s men clashed with the rebel forces of Lord Henry “Hotspur” Percy. The battle marked the first time that English archers have faced each other. The English longbow was a terribly powerful weapon, with a draw of 90 to 100 pounds or more; longbows found aboard the wreck of King Henry VIII’s flagship Marie rose have been shown to have pulling weights of up to 160 pounds. Such a bow would require amazing upper body strength to shoot properly, so much so that the skeletons of English archers show considerable overdevelopment of the bones of the left arm and wrist, as well as the fingers of the right hand.

Tear

An English longbow of the time was typically around six feet long, although this varied depending on the archer’s stature. Arrows typically had thick stems of poplar, ash, beech, or hazel about 32 to 36 inches long, flanked with goose feathers. Trees could be fitted with a variety of arrowheads, each specializing in different needs. But the most common warhead at the time was the bodkin point.

A bodkin stitch was designed to defeat plate armor. Reports vary on its effectiveness, and modern tests are somewhat equivocal. But the shape of the head, with its square section and sharp edges, was clearly designed to cut through sheet metal. Like most mass-produced metal objects at the time, bodkin points were made of wrought iron. Even with hardening and tempering this would have left the tip too soft to penetrate the sheet steel armor which was becoming more common, but there are historical accounts of “steel” bodkin tips, which may mean that they have been case hardened. This would have been done by wrapping a number of points in charcoal and heating them in a forge to cement the metal.

The arrowheads of the time were forged with sockets, which allowed them to be mounted at the end of a shaft. The methods of attaching the head to the rod varied; some were glued with skin glue, some were pinned with tiny nails, and others were simply frictionally inserted into the sockets. The latter seems to have been the case at least with the arrow that found Prince Henry, a fluke that will ultimately save his life.

The battle

The Battle of Shrewsbury took place on July 21, 1403. Shortly before dusk, King Henry gave the order to attack Percy’s forces, and the battle began. Prince Henry, protected by plate armor and leading his men on the left flank, advanced towards the rebel line. The young prince lifted the visor of his helmet to get a better view of the battlefield, and as luck would have it, an arrow hit him in the face. The tip of the cord sunk into his left cheek, under his eye, and right next to his nose. Miraculously, the arrow came to rest with about six inches of the stem sunk into the prince’s face; given the power of a longbow fired at close range – easily enough to directly pierce a human skull – it’s likely that the arrow that found Henry was deflected by a shield or someone else’s armor , expending the majority of its kinetic energy in the process.

Despite the excruciating injury, Prince Henry refused to leave the battlefield and continued to fight for three more hours, until Henry Percy suffered an injury ironically similar to that of Prince Henry; when Percy raised his visor for a breath of fresh air, an arrow, this time unhindered in its flight, found his mouth gaping and killed him. It was only then that Prince Henry left the battlefield to travel to nearby Kenilworth Castle, in an effort to save his life.

The injury

The fact that the prince wasn’t shot instantly was an incredible stroke of luck. The base of the skull is rich in major blood vessels that supply the brain, important cranial nerves that control basic bodily functions, and the top of the spinal cord, where it exits the skull via the foramen magnum. That the tip of the cord had threaded its way through all of these vital structures and lodged itself in the thick, hard bone at the base of the skull, and done so little damage that the prince was able to keep fighting, was simply miraculous.

The royal surgeons, however, knew that the arrow had to be removed. The common practice at the time was to push the arrow in the direction it was going, but being lodged in Henry’s skull, the only option was to remove it. When surgeons tried this, however, the rod broke free from the tip of the arrow. It is not clear if the rod broke or if it broke free from the bodkin socket, but in any case it left the arrowhead lodged in the prince’s skull at the end. from a deep and inaccessible wound.

The surgeon

At this point, surgeon John Bradmore was sent for. At that time, being a surgeon did not have the same social cachet as it does today. Surgery was more of a trade than a profession, and surgeons often performed several different trades in addition to restoring bones, amputating limbs, and pricking boils. Bradmore’s other trade was metallurgist, a trade term that refers to the ability to do finer work than a blacksmith would normally turn to. This was quite common for surgeons of the day, who often maintained a lucrative sideline by making and selling surgical tools of their own design.

Prince Henry’s early examinations of Bradmore, which he recorded in a treatise called the Philomene, consisted in probing the wound to discover its depth and its course. He reports using the pith of elderberry branches as a probe, wrapped in linen and soaked in rose honey – a natural antiseptic. Once the position of the bodkin was determined, Bradmore proceeded to enlarge the wound with a series of larger diameter probes. It was a necessary but agonizing process; entry wounds often close very tightly after the projectile has passed, and Bradmore knew he would need room to work.

During this slow expansion process, Bradmore designed a special set of clamps. In the Philomene, he described it as “[L]small, small and hollow pliers, and with the width of an arrow. A screw went through the middle of the clamp, the ends of which were well rounded on both inside and outside, and even the end of the screw, which had entered in the middle, was generally well rounded in the path of a screw, so that it adheres better and more strongly. This is its form.

A modern recreation of Bradmore's surgical forceps.
Bradmore’s pliers, recreated from his description in the Philomena by historic metallurgist Hector Cole. Source: 2019 Armor of the Abbey, photo JA.

Modern recreations of pliers require some imagination on the part of the blacksmith, as Bradmore’s description and drawings are somewhat at odds with each other. It could be that the pliers were mainly used to guide the central screw through the remains of the tree; or, if the shaft had pulled out cleanly from the bodkin socket, the clamps could have been forced out into the walls of the socket by the screw.

Either way, Bradmore was able to grab the bodice and, with a little rocking back and forth, pulled it off the prince. He filled the wound with white wine, applied a poultice of white bread, flour, barley, honey and turpentine, and cared for the prince until he was healed.

Long live the king

There is no doubt that Bradmore saved the life of the future king; a foreign body left in a deep wound would at least result in sepsis, or, if the arrow had carried the anaerobic soil bacteria Clostridium tetani in the wound, a fatal tetanus infection.

For his efforts, Bradmore received a nice pension for the rest of his life, which unfortunately was only nine years old. King Henry IV outlived the man who saved his one-year-old son, leaving the scarred but courageous young Prince Henry to ascend the throne in 1413, and ultimately win the historic Battle of Agincourt. But none of this would have happened without the luck of a prince and the hacking skills of his surgeon.

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