Creating Authentic Details: Medicine

by Pamela Taylor
published in Reading

Full disclosure: the impetus for this article came from my own writing. I was having fun because I was finally getting to use Bald’s eyesalve in my story – though I’m not so sure the character was enjoying it quite as much as I was. 

Bald’s eyesalve (from a 10th-century medical text) is made of equal parts of garlic and another allium (think leeks or onions) finely chopped and ground in a mortar for two minutes then mixed in a brass vessel with wine and cow bile, stored in a cool cellar for nine days, and finally strained through a cloth before being administered to a patient. 

It first came to my attention from a report by the BBC on research at the University of Nottingham that had shown the stuff could kill MRSA (the antibiotic-resistant staph infection that gets into hospitals and is often fatal). Another study at the National Institutes of Health has reaffirmed that the mixture does, indeed, have antibacterial properties.

Writing the passage reminded me that medicine, like food, is one of those details that need to be correct for the time and place of our stories.

Whose medicine?

Humans have been devising remedies for what ails us since long before we could write them down, but medicine isn’t just a universal thing that sprang from a single source. Western medicine evolved from the traditions of Galen and Hippocrates into today’s medical-industrial complex (to borrow a phrase from Eisenhower). 

Eastern medicine arose from different beliefs and theories. Arab physicians were among the most advanced of their day, and many of their skills and remedies became incorporated into the medical practices of the cultures they touched during the peak of their empire. And we mustn’t forget the medicine of the indigenous peoples of the Americas, Australia and New Zealand, and remote parts of human habitation.

And when?

My story is set in the fourteenth century, so Bald’s eyesalve would be a well-known remedy at the time. But let’s think about some other remedies and where they fit on the human timeline.

Most of us might not remember a time when penicillin wasn’t part of the physician’s arsenal against infection. That particular remedy, however, has only recently made the cut for something that could be included in historical fiction (if you subscribe to the conventional definition that the events of the story had to occur at least fifty years in the past). Even though Alexander Fleming proved its antibacterial efficacy in 1928, it wasn’t until 1942 that it was commercially produced – and even then, the world’s entire supply of penicillin was enough for only ten patients. Production ramped up during World War II, but it wasn’t until after the war that the remedy was widely available for the average patient.

Vaccines are an entirely different story. We tend to think of them as very modern inventions, perhaps because of the recent controversy over disproven side effects. But they’re much, much older. Today, we don’t give smallpox a second thought, but it was once as feared and as deadly as the plague. 

As early as the 10th century, the Chinese had a method of preventing smallpox that involved blowing powdered smallpox material into a person’s nose. This idea came into Western medicine as a result of European exploration in the Far East. In 1796, Edward Jenner proved that inoculation with cowpox was effective in preventing the contraction of smallpox, thus launching the development of ways to prevent deadly diseases rather than simply hoping to cure them.

The germ theory of disease was proposed by Arab physicians as early as the 11th century but didn’t definitively displace the miasma (bad air) theory until the work of Louis Pasteur and Robert Koch in the late 19th century.

It wasn’t until the 1870s when Joseph Lister began developing techniques for sanitation and antiseptics that significant advances occurred in preventing the transmission of disease from one patient to another by the very doctors who were trying to provide care. So if your story is set before Lister’s time, disinfecting medical instruments between patients would have been highly unlikely. Even hand-washing when caring for patients didn’t really become a standard practice until Florence Nightingale introduced it during the Crimean War in the mid-1850s.

And what about the physicians and others providing care? Even the ancient Greeks recognized that infections could be contracted by those in the presence of sick people. (This likely contributed to the miasma theory of disease.) But it wasn’t until the late Middle Ages that the notion of PPE began to emerge with the idea of wearing a mask when tending very ill people. This culminated in the 17th-century plague doctor’s “uniform,” which may have offered some protection, though the breathing holes in the long snout of the mask might not have been the most well-thought-out part of the gear.

Getting things right for your narrative

This article is little more than a set of thought-starters for things you might need to pay attention to if the characters in your story find themselves in need of medical attention. My objective was to identify a few milestones to help guide any specific research you might need to undertake to be sure your details fit your setting and period.

And to end with a bit of fun

A shout-out to Karen Brooks for a social media post that led me to a fun little book entitled Revolting Remedies from the Middle Ages. It’s published by the Bodleian Library of Oxford University and is a compilation by Daniel Wakelin and 7 students from his Master’s-level course on “handling and reading manuscripts from the seventh to the sixteenth centuries.” In the Introduction, Wakelin says the intent of the compilation was not to choose remedies that were representative of an era, but to pick those that struck him and his students as “funny or freaky in some way.” The following are excerpts from the book:

“FOR A ZITTY FACE

Take urine eight days old and heat it over the fire; wash your face with it morning and night.”

“FOR FEVER CHILLS

Take three drops of milk from a woman who is breastfeeding a baby boy, and put it inside a soft-boiled hen’s egg, and let the sick man snack on that for this disease.”


Pamela Taylor’s inspiration for her first book turned out to be that final straw that pushed her to leave the corporate world behind for the world of words and imagination. Now an author and an editor, she loves helping others polish their stories almost as much as she enjoys writing her own. She’s a member of the DFW Writers Workshop and the Editorial Freelancers Association and is in her fourth year on the judges panel for the Ink & Insights Contest. You can learn more about her books at secondsonchronicles.com, and about her editing services at editing4you.com

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