Treatment and infection of gunshot wounds (Sengoku Japan)
Hi, everyone. I need help with a scenario that's so specific I'm not having much luck googling it because of the whole historical aspect (I keep coming up with present-day resources while searching for the medical stuff, and only technical information while searching for the firearms. Search terms have included things like "16th century firearms", "arquebus", "tanegashima", "gunshot wounds treatment/infection" which turns up modern resources that assume the use of antibiotics even if I add "history" to the query as well, "sepsis/septic shock", and possibly a few others, finding mostly general information. I've also checked the tags that seemed relevant in this comm, but the situations described there were all significantly different).
Setting: Japan, 1600 CE (just after the Battle of Sekigahara)
Scenario: I have a 60-year-old man who gets shot somewhere on the torso during the battle. (He was previously quite physically fit, and distinguished himself as one of the officers who fought fiercely till the end on the losing side.) The injury does not kill him then and there, but he is said to have died about a month later in consequence. My fic is set in this time window. It starts a day after the battle with the wounded character collapsing from exhaustion, having tried to get farther away from the battlefield and lie low. He is found by a monk who attempts (the key word here: attempts) to nurse him back to health. At this point, the injury has had all sorts of ill-advised stuff rubbed into it, ranging from bits of the projectile to dirty clothing to mud.
#1
Obviously, I'm going for infection as the eventual cause of death, possibly coupled with lead poisoning from the projectile (unless the latter would have been too slow to matter in a few weeks). The problem is that, reading the general resources on gunshot wounds and infections before antibiotics, I'm beginning to find it unlikely he'd even survive for as long as a month. I am open to shortening the timeline of the fic somewhat (since the history I'm working with is half the stuff of legend anyway when it comes to this guy, and the portrayal I'm using is already fictionalized), but I do need him to be alive and coherent long enough to be able to carry on several conversations with the POV character, the monk trying to heal him. (Varying degrees of coherence are, of course, expected.)
So, what's the best guess for an infection that turns out to be fatal, but not immediately? One option I've come up with is to give him a fairly superficial injury (thus not hitting any major internal organs, and the projectile had lost speed) from a shot that was fired at a distance and shattered on impact, creating a non-lethal but highly contaminated wound. How fast would the infection progress in this scenario? Would there be a brief period of "getting better" as the wound itself healed, only to be followed by a worsening state overall as the infection began to spread? Or would it just be a steady downhill ride until (presumably untreatable) septic shock set in? What kinds of symptoms would be realistic to show that his condition is getting worse than it should be for still making a recovery? And is this idea even plausible, or does it require tons of artistic licence and I should look for something different to bring about the end result?
Another alternative would be to "just" give him a graze, but I'm not sure if that can get as messy/dangerous.
#2, less important to the story:
One more question (not so crucial since I can tweak the POV not to mention the specifics, but additional detail would be nice all the same) - would the monk attempt to sterilize or manually clean the wound at all while first tending to it? The one moderately useful article I found with "gun wounds treatment history" on google only dealt with Western medicine and mentioned cauterizing wounds by pouring "seething oil" into them, which may well not have been the done thing in Sengoku Japan. Herbal medicine seems to be the most likely method for a Buddhist monk to use, but would he do anything else as well? I'd just like to have something to illustrate that the monk isn't incompetent, it's simply that the infection is worse than can be managed without antibiotics. (That said, all this is still a secondary concern in comparison to question #1.)
Thanks in advance for any help!
Setting: Japan, 1600 CE (just after the Battle of Sekigahara)
Scenario: I have a 60-year-old man who gets shot somewhere on the torso during the battle. (He was previously quite physically fit, and distinguished himself as one of the officers who fought fiercely till the end on the losing side.) The injury does not kill him then and there, but he is said to have died about a month later in consequence. My fic is set in this time window. It starts a day after the battle with the wounded character collapsing from exhaustion, having tried to get farther away from the battlefield and lie low. He is found by a monk who attempts (the key word here: attempts) to nurse him back to health. At this point, the injury has had all sorts of ill-advised stuff rubbed into it, ranging from bits of the projectile to dirty clothing to mud.
#1
Obviously, I'm going for infection as the eventual cause of death, possibly coupled with lead poisoning from the projectile (unless the latter would have been too slow to matter in a few weeks). The problem is that, reading the general resources on gunshot wounds and infections before antibiotics, I'm beginning to find it unlikely he'd even survive for as long as a month. I am open to shortening the timeline of the fic somewhat (since the history I'm working with is half the stuff of legend anyway when it comes to this guy, and the portrayal I'm using is already fictionalized), but I do need him to be alive and coherent long enough to be able to carry on several conversations with the POV character, the monk trying to heal him. (Varying degrees of coherence are, of course, expected.)
So, what's the best guess for an infection that turns out to be fatal, but not immediately? One option I've come up with is to give him a fairly superficial injury (thus not hitting any major internal organs, and the projectile had lost speed) from a shot that was fired at a distance and shattered on impact, creating a non-lethal but highly contaminated wound. How fast would the infection progress in this scenario? Would there be a brief period of "getting better" as the wound itself healed, only to be followed by a worsening state overall as the infection began to spread? Or would it just be a steady downhill ride until (presumably untreatable) septic shock set in? What kinds of symptoms would be realistic to show that his condition is getting worse than it should be for still making a recovery? And is this idea even plausible, or does it require tons of artistic licence and I should look for something different to bring about the end result?
Another alternative would be to "just" give him a graze, but I'm not sure if that can get as messy/dangerous.
#2, less important to the story:
One more question (not so crucial since I can tweak the POV not to mention the specifics, but additional detail would be nice all the same) - would the monk attempt to sterilize or manually clean the wound at all while first tending to it? The one moderately useful article I found with "gun wounds treatment history" on google only dealt with Western medicine and mentioned cauterizing wounds by pouring "seething oil" into them, which may well not have been the done thing in Sengoku Japan. Herbal medicine seems to be the most likely method for a Buddhist monk to use, but would he do anything else as well? I'd just like to have something to illustrate that the monk isn't incompetent, it's simply that the infection is worse than can be managed without antibiotics. (That said, all this is still a secondary concern in comparison to question #1.)
Thanks in advance for any help!