Movies and tv-series often show the removal of arrows as an extremely unsophisticated and brutal procedure in which the wounded man has to bite on a piece of wood, and is held down by several of his comrades, while a more or less qualified surgeon tears the arrow out of the wound.
However in reality the removal of an arrow, especially in the case that the arrowhead had separated from the shaft and had gotten lost in the wound, was an extremely sophisticated procedure for which very delicate instruments were designed and used. So in the following, I would like to dissolve a few of the myths that many of us believe when it comes to the treatment of arrow wounds and medical knowledge in the Middle Ages in General.
Arrows with Bodkin points were carefully pulled out and sophisticated tools like the Bradmore screw were used to remove arrowheads from wounds with as little damage to the surrounding tissue as possible. Mixtures of honey and alder flower, but also special types of mold that were grown on mixtures of sheep excrements and honey and that produced penicillin were used to prevent and combat infected wounds in the Middle Ages.
Let`s take a closer look!
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The medieval knowledge of the human body
The most important precondition for any successful medical procedure is a solid knowledge of the human body. And when it comes to removing arrows then especially a solid knowledge about the positions of the important blood vessels is needed.
The medieval knowledge of the human anatomy & its sources
It is here where he already encounter the first myth about medical knowledge and capabilities in the Middle Ages.
But the stereotype that people in the Middle Ages didn`t have a clue about human anatomy can easily be invalidated by referring to one of the most important medical manuals of the Late Middle Ages, the „Feldbuch der Wundartzney“ (=the fieldbook of surgery) that was written in 1517 by the German army surgeon Hans von Gersdorff.
Hans von Gersdorff claims that he had learned his craft during the Burgundian Wars (1474-1477), which makes his book one of the best sources of information about Late Medieval medical knowledge.
Unfortunately, the book is not available in any other language than old German. But the depictions are still extremely interesting. So if you want to check it out you can find it here* on Amazon at a reasonable price.
There are 2 depictions right at the beginning of the book, one showing the human skeleton with all the names for the bones and joints, the second showing the location of all the major blood vessels and the inner organs. By the way, the book also differentiates between arteries and veins. Although the book wrongly claims that the arteries were the blood vessels that transported the blood while the veins transported air.
The reason for that can be found in the fact that when a corpse was dissected a couple of days after the death the blood in the arteries was usually clotted while the veins were empty.
And that brings us right to the next myth. And that is the myth that the church did not allow corpses to be dissected in the Middle Ages.
Did the church really prohibit the dissection of corpses in the Middle Ages?
While reading the last paragraph you might have asked yourself where the medieval doctors and surgeons got their knowledge of the human body from. Well, most got it from books like the mentioned „Feldbuch der Wundartzney“ (=the fieldbook of surgery). But where did the author get its information from?
Most of the medical knowledge of the Middle Ages was not new but was just recovered from ancient Greek and Roman knowledge that had been lost during the Fall of the Western Roman Empire. However, that knowledge survived in the Eastern part that would become Muslim during the Middle Ages. Through interactions like the crusades but also more peaceful interactions that ancient knowledge was brought back to Western Europe.
Are you interested in how that knowledge was brought back to Western Europe, why the Christian Norman rulers of Sicily gained their nickname the „baptized caliphs“, and what innovations apart from ancient medieval knowledge were brought back to Western Europe? Then I would like to recommend you my article here.
The books in which the ancient Greek and Roman knowledge was preserved and transported back to Western Europe were written in Arabian, so they first had to be translated. But there was another way of gaining knowledge about the human anatomy.
And that was the dissection of corpses. Now there is the myth that the church prohibited dissections. But that is not true.
When medieval doctors started studying they received the lower ordinations which prohibited them from performing a dissection. But they did not prevent them from attending a dissection. So several doctors would watch a medieval dissection (and learn about the anatomy without getting in contact with blood) while surgeons performed the dissection.
By the way. That differentiation into observing and performing medical procedures did also extend to the treatment of wounded soldiers.
While a medieval doctor would only observe and examine the wounded man the actual surgical operation was performed by a surgeon.
Another interesting fact about these two sources of knowledge about human anatomy, the ancient Greek and Roman books and the dissection of bodies, is that their information sometimes differed. So when a medieval doctor who had read the ancient Greek books about human anatomy was observing a dissection and one of the organs was at a different place than the place that the Greek book claimed it would be, then the body that was dissected was seen as an abnormality.
But why am I telling you all of that?
Well, that was a very long way of trying to emphasize that medieval doctors and surgeons knew pretty well where the major blood vessels were that mustn`t be injured during an operation.
And that finally brings us to the question of how arrows were removed in the Middle Ages.
How were arrows removed in the Middle Ages?
There were countless types of arrowheads that all had different usages in the Middle Ages. But for the sake of simplicity I will focus on the so-called Bodkin-points since these were not only able to piece through armor but also much easier to manufacture than – for example – barbed arrowheads. Because of that Bodkin-points were used extensively throughout the Middle Ages.
But when we look at how arrow wounds were treated we basically have to differentiate between wounds in which the arrow was still in one piece and wounds where the arrow shaft and the arrow had separated.
Let`s start out with the easier case.
Removing an entire arrow from a wound
So how did the removal of an arrow with a Bodkins-point work when the arrowhead had not separated from the shaft?
As long as the arrowhead remained connected to the arrow shaft the removal was relatively easy and done by carefully pulling the entire arrow out of the arm or leg of the wounded soldier.
The practice of pushing an arrow through the limb instead of pulling it out was not really done in the case of Bodkin points since they did not have barbs on them that could inflict major damage to the tissue when they were just pulled out with no kind of preparation. By pushing an arrow with a Bodkin point through the limb the surgeon would have just increased the size of the wound and would have taken the risk of damaging a bigger blood vessel.
So getting the wounded soldier into the position in which he had been hit with the arrow and then carefully pulling the arrow out worked fine as long as the arrowhead did not separate from the shaft.
Removing an arrowhead that had separated from the shaft
So now we have looked at how entire arrows were removed from a wound. But what happened when an arrowhead separated from the shaft while the surgeon tried to remove the arrow?
Unfortunately, many arrowheads were only loosely fastened to the arrow shaft. Oftentimes the arrow shaft was just pushed into the socket tang of the arrowhead and not additionally glued on with glue made from animal hides.
By the way, the same glue was also used to make medieval shields extremely resilient to blows and hits. Here you can find out more about how medieval shields were built.
When the arrowhead had separated from the shaft inside of the wound then the entire procedure of removing the arrowhead became a lot more challenging and demanding. Tongs were used to get a stuck arrowhead that had separated from the arrow shaft and that could sit deep within the limb out of a wound. Once again the „Feldbuch der Wundartzney“ gives us some insight into how these tongs were used and which tongs were preferred for that kind of job.
The „Feldbuch der Wundartzney“ differentiated between tongs that are well suited and tongs that are less suited for removing a lost arrowhead from a wound. The less suited tongs are regular tongs that gripped the outside of the arrowhead. And while these tongues were much easier to build they also extended the wound channel and damaged additional tissue.
The better-suited tongs worked differently.
Tongs that were seen as ideal for the removal of arrowheads from wounds could be opened by turning a screw. So the tongs were inserted into the wound channel and into the socket tang of the arrowhead. Then the screw was turned, the tongs opened up, and gripped the arrowhead from the inside. As a result, the arrowhead could be removed without any additional damage to the tissue around the wound channel.
The following video should give you a good visualization of how the so-called Bradmore screw worked.
As long as the arrow wounds were situated at the limbs they could be treated pretty well. Only when an arrow had hit the torso did things start to look very different since operations on an open thorax were just not possible during the Middle Ages. So as soon as the lungs were damaged the surgeons were pretty helpless, although some wounded soldiers (for example Alexander the Great, more on him here) were able to survive an arrow to the lung.
However, a wound from an arrow could be treated much better than a wound from a bullet from one of the early firearms. The advantage of a wound from an arrow was that the arrow usually went right through clothes and flesh and – contrary to a bullet from early firearms – didn`t rip apart the tissue but also didn`t bring pieces of the clothes into the wound.
That made treating the wound after the arrow was removed much easier and reduced the risk of infection and death for the wounded soldiers.
But when firearms slowly replaced the bows on the medieval battlefields, more on the 5 reasons for that in my article here, the medical professionals had to adapt to the new type of wounds.
It wasn`t until the 1940s that Penicillin was developed as an effective way to treat wound infections. Until then wound infections remained the main cause of death of soldiers in all wars.
So let`s now look at how infection of the wound was prevented (or combatted) after the arrow was removed.
How were infections prevented & combatted in the Middle Ages?
The danger of wound infections but also potential treatments had already been known in Antiquity. So to prevent infections wounds were washed out with alcohol during the Middle Ages. But sometimes that just wasn`t enough and a wound got infected.
In that case, other tricks had to be used.
In the Middle Ages, doctors used special types of mold that were cultivated on a special culture medium consisting of honey and sheep excrements and put onto wounds to combat infections. These special molds did produce a substance that would later be known as Penicillin!
However, it is obviously better to prevent an infection instead of trying to combat it. And medieval doctors also had a couple of tricks up their sleeves when it came to preventing wounds from getting infected.
One example of such a trick can be found in the year 1403 when an English surgeon called John Bradmore (the inventor of the already mentioned Bradmore srew) operated an arrowhead out of the face of the Prince of Wales, the future king Henry V.
The English surgeon John Bradmore, the inventor of the Bradmore srew, used a mixture of alder flower and honey as well as bandages that he soaked in honey to successfully prevent infections after he had treated the – at that time – 16-year-old future king Henry V who had been hit in the face by an arrow in the battle of Shrewsbury in 1403.
After removing the arrowhead (that had separated from the arrow shaft) with the Bradmore screw John Bradmore used bandages soaked in honey (honey is supposedly antiseptic and antibacterial) to prevent the wounds of the – at that point of time – 16 years old prince of Wales from getting infected.
However, all these treatments would no longer be effective when bows and arrows were slowly but steadily replaced by early firearms during the Late Middle Ages and the early modern period. But the reasons why these firearms replaced bows even though bows were superior in a one-on-one comparison are a story for another time.
If you are interested in these 5 reasons why firearms almost completely replaced bows on the Western European battlefields then I would like to recommend you my article here.
Take care of yourself because you deserve it. You really do.
Until next time
Malte Prietzel: Krieg im Mittelalter (Darmstadt 2006).
Richard Wadge: Arrowstorm: The world of the archer in the hundred years war (Gloucestershire 2007).
Please note that everything mentioned in this article is for entertainment purposes only and must not be seen as any sort of medical advice!