A detailed example of good low tech surgery

[Polydamas]

Originally Posted by sir_pudding

I'm not sure if the procedure described actually qualifies as TL 4 or less. I realize that Unganda probably wasn't TL5 in 1879 overall, but this procedure seems to have most of the features of late TL5 (or even early TL6, though without anesthesia) surgery...

Medicine, especially learned medicine, really doesn't show consistent progress before 1900. I don't know whether this is because proving things without scholarly communications and statistics is hard, or because taboos often interfered with effective research.

[The Colonel]

Originally Posted by Agemegos

My mother had a Caesarian in 1949 followed by vaginal deliveries in 1951, 1953, 1954, 1957, and 1964. It wasn't even considered especially remarkable.

I'm amazed, I was still hearing doctors citing "once a caesar, always a caesar" in the 1990s - still, there's no arguing with facts*.

Originally Posted by Polydamas

Medicine, especially learned medicine, really doesn't show consistent progress before 1900. I don't know whether this is because proving things without scholarly communications and statistics is hard, or because taboos often interfered with effective research.

There may also be the issue of the number of cases - modern public health services (or other high volume systems) put vast numbers of patients past each doctor, probably far more than a pre-modern practioner would ever see, and generate a great deal of data in a wide range of fields. That data is also better processed and shared now that there are widespread medical journals and textbooks - such things seem to have started in the C18-19, but not really flourished until the C20. I seem to recall that the Royal Navy made some quite significant advances in limited fields based on treating large numbers of seamen for the same range of problems, but generally you might well expect any given physician or surgeon not to see many conditions more than once or twice in a lifetime. Also, I seem to recall that the Navy started off with trouble disseminating their findings - and that's an organisation whose medical professionals work for it and are under military discipline. I'm told you can still attract a large crowd in a modern hospital if you present with something rare, simply so that all the doctors present can actually see it in real life.

*Granted we are on the internet, but even so...

[Flyndaran]

Originally Posted by sir_pudding

I think it's highly unlikely that she misremembered the dates of Brett's and siblings births, or that the first was a C-section. These things tend to be the sort of details people retain. Presumably the dates were celebrated annually...

Don't be silly. I meant that she may have misremembered the doctor downplaying the risk of later vaginal births, not that she misremembered having children.

But Agemegos clarified that such misrememberings are highly unlikely.

[sir_pudding]

Originally Posted by Polydamas

Medicine, especially learned medicine, really doesn't show consistent progress before 1900. I don't know whether this is because proving things without scholarly communications and statistics is hard, or because taboos often interfered with effective research.

The procedure described used sterilization and steel sutures, both of which seem to be fairly late TL5. Also 1879 is only one year short of TL6 anyway. How backwards do you reckon Uganda was?

[Polydamas]

Originally Posted by sir_pudding

The procedure described used sterilization and steel sutures, both of which seem to be fairly late TL5. Also 1879 is only one year short of TL6 anyway. How backwards do you reckon Uganda was?

I reckon that it was peasant-and-village Iron Age with black powder and some cloth and tools from foreign factories. But plenty of Hellenistic and Roman surgeons used pins to close wounds and used boiling, wine, or vinegar to sterilize tools and incisions.

Edit: Here is a link for ancient antisepsis, and one for Romans using fibulae to close wounds (although I would recommend that one takes most of Gabriel's writing with a pinch of salt).

[tantric]

wow - this the Kitara Kingdom. Iron age - never invented the wheel, the plow, written language, nada. really, it's neolithic but with iron tools. VERY low tech. TL3? The point is that for some reason, at that time, some form of antisepsis was understood, plus a very practiced surgical team.

These same people purify themselves by smearing themselves with the chyme from a goat's stomach

[Polydamas]

Originally Posted by tantric

wow - this the Kitara Kingdom. Iron age - never invented the wheel, the plow, written language, nada. really, it's neolithic but with iron tools. VERY low tech. TL3? The point is that for some reason, at that time, some form of antisepsis was understood, plus a very practiced surgical team.

That sounds a lot like many societies in Europe in the first millennium BCE or CE, and I'd be happy to call all of those Iron Age. Trying to be more precise and comparative is beyond the scope of a thread.

Wiki claims that there was at least one large kingdom and one city with tens of thousands of residents in Uganda at this time, and those are pretty sophisticated.

Originally Posted by tantric

These same people purify themselves by smearing themselves with the chyme from a goat's stomach

And a browse through Quackwatch will bring up plenty of people who do things equally strange in countries with "evidence-based medicine" today. But in 1879, I think that many European surgeons could have learned from the Ugandans.

Homer's Greeks had a pretty simple technology too, but they had some idea about washing wounds with wine and binding them with honey, and some men were known for skill in treating wounds and preparing drugs.

[tantric]

Originally Posted by Polydamas

That sounds a lot like many societies in Europe in the first millennium BCE or CE, and I'd be happy to call all of those Iron Age. Trying to be more precise and comparative is beyond the scope of a thread.

Wiki claims that there was at least one large kingdom and one city with tens of thousands of residents in Uganda at this time, and those are pretty sophisticated.


And a browse through Quackwatch will bring up plenty of people who do things equally strange in countries with "evidence-based medicine" today. But in 1879, I think that many European surgeons could have learned from the Ugandans.

Homer's Greeks had a pretty simple technology too, but they had some idea about washing wounds with wine and binding them with honey, and some men were known for skill in treating wounds and preparing drugs.

yes, buGanda at the time was sophisticated...compared to the rest of Africa. It was closest to a Greek polis that had conquered other polises.

[Polydamas]

Originally Posted by tantric

yes, buGanda at the time was sophisticated...compared to the rest of Africa. It was closest to a Greek polis that had conquered other polises.

Still, the basic patterns that before the 20th century later medicine is not always more effective than earlier, and that before the 20th century scholarly medicine was not always more effective than folk medicine, are common. Medical knowledge seems surprisingly "fragile" and improvements were often lost or discarded or just ignored because they came from the wrong sort of person.

[tantric]

More true than you know - all of this was lost. I also found an early ethnography that tells of a village in East Africa where the people kept ostriches as pets - meaning possible domestication, but when rinderpest swept through the area and all the livestock died, everything else got eaten.

Another weird bit - I'm fairly convinced East Africans invented drinking straws, I have another ethnography that tells of the 'peculiar habit of drinking their beer through hollow reeds...."