Thursday, November 1, 2018

Contraceptives in the Old West.

Writing romance in the old west is certainly not for the faint of heart, but as I dive back into the third story in my McCades of Cheyenne Series, I keep coming across the same dilemma—what was done for contraception back then? I mean a toss a hero and heroine together and well, even if not married things can get out of hand and I have to wonder if readers are wondering too about pregnancy even if the couple doesn’t discuss it.

As I writes these stories, I keep writing around the idea of just how women in the day kept from becoming pregnant. Hey, if I hurry and marry off the couple then it’s not really a big deal, but what about if the marriage might be a ways off in the story? So…I started doing a bit of research to answer my own questions and thought I could share this with some of the other writers who might be asking themselves the same questions.

Caution: PG-13 if you continue to read.  

Childbirth in the late 1800’s was a gamble for any woman given the complications and out west the lack of facilities of physicians made even a normal birth a huge risk for a woman. Birth control as a whole wasn’t widely accepted and should a woman birth a viable child, it might be she had a house full of children due to the lack of contraceptive ideas. The 1800’s was full of restrictions and law but held some of the highest abortion rates of any of the recent centuries, but women and even men weren’t beyond trying a variety of methods to keep from producing a child or more children.

Various methods of contraception in the Old West:

1-Abstinance-Providing a woman could convince her husband to stay out of her bed or possibly visit the local brothel instead.

2-Withdrawal-Which meant a man had to have the ability to hold off on the end result and had to have the ability to remove himself from the woman before his big finale. The problem here was the “guppies” at least a few escaped prior that same big finale and women often found this method failed them.

3-Sponges and douching-Sponges soaked in lemon juice were at times effective, as the acidity immobilized the “guppies” and the sponge blocked the path into he cervix. And lemons were not widely available and so woman might opt for Quinine which was proven to have little effectiveness when used with a sponge. There were also the women who opted for a variety of chemicals who caused them more harm than good and often ended in pregnancy anyway. Douching with various liquids and herbs might or might not work but often caused hard to sensitive tissues. Douching syringes were sold for the purpose and often with chemical like sulphates or Zinc or Iron to kill the “guppies”.

4-Cervical Caps were customized from a variety of items including beeswax and were easily replaced by the same wax that families used to make their candles, but without customized fits for security, the “guppies” found a way in more times than not. Some cervical caps were made of items such as wood and later rubber

5-Condoms did exist though as in modern day, men of the old west didn’t much prefer them, nor were they easily available or reliable. First condoms were made of sheep or pig intestine which could cost around one dollar each and men were often said to wash them out for re-use but of course each use lessened the security of leaks. And by the 1840’s rubber version became available, though failure rates were still in excess of 10%. Prostitutes were the first to readily use condoms to prevent pregnancy and disease, but it took a bit longer for married couples to venture into methods as such. Added to newer variety of rubber condoms was lemon juice, sulfur, zinc and a variety of other concoctions which didn’t lower the risk of pregnancy much more than the 10% of condoms alone and added to that was the costs and availability to a cowboy seeking a little pleasure from his women or wife.

6-Chemical or mechanical abortion. With little medical care, shortage of physicians and lack of resources, women did opt to “rid” themselves of unwanted pregnancies. A variety of harsh chemicals might terminate a pregnancy but often put a woman herself at risk. Toxic drugs such as Ergot and Quinine in large doses could terminate a pregnancy but also left the woman, if she lived with harmful effects from damage to the kidneys to excessive bleeding, anemia and potential death. With mechanical intervention the risks of bleeding and infection were extremely high and many women died. Women also wore tighter and tighter corsets, starved themselves, and caused themselves deliberate injury in order to end an unwanted pregnancy and it wasn’t until the 1850’s that anti-abortion protests began and 1870 when the act was banned by law.

7-Rhythm Method-Women who knew their bodies well, figured out their fertile and non-fertile days but this method of contraception was often not so reliable, given today we know that the “guppies” can live up to five or six days in the vagina and still manage to travel

Contraception was a bit different where Indian’s of various tribes were concerned. Because the Indian’s were nomads living off the land and often moving, children were spaced out for 3 to 5 years, given a mother could not travel and nurse more than one child with two small children.  Indian women often nursed a child for 3 to 4 years and during that time period was often abstinence and this was tolerated by the men, with most families consisting of no more than 3 to 5 children when compared to pioneer/western white families with twelve or more children.

Native American’s often utilized various herbs and plants to prevent pregnancy and it’s suggested some of these herbs work in this day and time:

1-Saskatoon Serviceberry

2-Indian Paintbrush-liquid concoction prevented pregnancy

3-White Turtlehead-Leave boiled for tea prevented pregnancy

4-One-Seed Juniper-Tea of leaves or tea of the berries drank every morning for 3 days prevented conception

5-Western StoneSeed-boiled roots, pounded and soaked in water and then consumed daily for 6 months would prevent pregnancy for good.

6-Bitter Cherry-dried wood form the plant was soaked in hot water and the water consumed to prevent pregnancy.

7-False Hellebore-Tea made from the root was consumed to prevent pregnancy

 
I couldn’t find much as far as rating all these plants in their effectiveness, but my guess is even today not one method of birth control is truly 100% effective…there is always that .00999% waiting to happen. Careful Cowboy….tread lightly. 

Monday, October 8, 2018

All But the Fall give away Oct. 15th! Pre-order now!




See below in order to win!!!


Kiss Your Cowboy Small Scrapbook up for grabs! Just comment here that you have pre-ordered my new release ALL BUT THE FALL and you will be in the drawing held this Sunday evening around 7pm! (Only 1 winner)

The print book will show up soon so stay tuned!











Monday, October 1, 2018

Medical Injuries then and now

WARNING GRAPHIC PHOTOS



Emergencies and First Care:
I have chosen some emergencies that might come up in some of your stories-historically or current. I hope a bit of this helps-for the sake of time I abbreviated each to a few sentences. No Matter what the injury, do not forget to check in contemporary stories to--Check A, B, C’s—Airway, breathing and circulation first. For the correct steps to CPR, take a look at the American Heart Association website for examples. Or take an official Healthcare Provider CPR course which costs around $60.00 and it will go into great detail about what is done in a lot of situations from heart attack to stroke. This type of course is for Healthcare providers of course but even the simpler courses with entities like Red Cross can be very beneficial in saving lives. RN’s most often complete a course in ACLS-Advanced Cardiac Life Support, which is an intensive course on reading heart rhythms and treating or shocking as necessary. Now, none of this existed in our historical stories so no one will be trying CPR for the most part.



SHOCK---Call 9-1-1. Lay the Person Down. Elevate the person's feet about 12 inches unless head, neck, or back is injured or you suspect broken hip or leg bones. Shock, which may cause any of the following symptoms: Confusion, Clammy Skin, Dizziness, Low blood pressure, Paleness, Rapid pulse, Shortness of breath Call 911.
Historically, most physicians knew to lay a person down and keep them warm.

ALLERGIC REACTIONS: Difficulty breathing-wheezing-tightness in the throat-hoarseness-trouble Speaking-swollen lips, tongue, or throat-Nausea, abdominal pain, or vomiting-Fast heartbeat or pulse-anxiety or dizziness-Loss of consciousness. This very serious condition was probably not corrected historically and it was a gamble whether or not the patient would live or not.
 
ANAPHYLAXIS-A medical crisis that can end in death if not reversed. (Same as Allergic reaction though this severe reaction often ends in death even today.

ANIMAL BITES: (Mammals) Stop Bleeding. Clean and Protect. Get medical help immediately for any animal bite that is more than a superficial scratch or if the animal was a wild animal or stray, regardless of the severity of the injury. Rabies can be an issue but historically that was called Hydrophobia as those afflicted seemed to have a fear of water and succumbed to a very horrible death.

ASTHMA ATTACKS: Symptoms of acute attack include difficulty talking or walking because of shortness of breath or lips or fingernails turning blue. Sit the person upright, loosen tight clothing. If the person has asthma medication, such as an inhaler, assist in using it. Monitor the Person Until Help Arrives.

Inhaler to open airway-Historically herbs were used and even chloroform to relax the bronchioles.

FRACTURES AND DISLOCATONS-Stop Bleeding if skin is broken as in a open fracture. Splint the Area. Reduce Swelling. Apply ice pack/elevate. Call (9-1-1) RICE-Rest, ICE, Compress (Wrap) and Elevate.

Protrusion of a fractured rib. Today a patient may be given a support binder but historically the patients were wrapped tight which the doctors of that day and time didn't know caused pneumonia because the patient couldn't breathe deep to clear secretions.



Dislocated Shoulder is usually obvious and can be put back in place but is very painful for several weeks later. Old West Docs would have just held this patient down and pulled and pushed the arm back into place likely without pain medication or maybe with a big shot of whiskey.



This is an open fracture of the Leg bone protruding at the ankle. Today this patient would get surgery and pins and maybe external traction. Historically, this person might in fact die due to infection and if they did survive it would be after months of bedrest and then one leg would have likely been shorter than the other. Now and historically this person would probably carry a limp.

This is a fracture of both bones in the lower arm. These bones need set. Today that might mean surgery or a conscious sedation where the bones could be manipulated back in place. Historically the Physician would have pulled hard to set the bone and hope for the best in healing which may do well or may have left a deformity and lack of usefulness to the limb. No one back them worried of nerve damage in fractures and there were times full loss of mobility of a limb happened.






VEHICLE ACCIDENTS-Spinal & Head InjuriesShock, concussion, fractures…Head and Spinal injuries: Cervical fx: 3,4,5 the patient will need airway support. Cervical fx: 5 through back no trouble breathing, but the level of injury tells what the patient is able to move or do. Writer Tips:Remember spinal injuries can result in permanent paralysis. Head injuries can take months to heal and often change a person personality. (Not an issue prior to vehicles, but wagon accidents, falls from animals or buildings could have happened historically resulting in trauma that needed treatment.





COLLAPSED LUNGS--Broken ribs—would be wrapped tightly in historical times but these days it’s best to let the patient be able to take deeper breaths or pneumonia can happen. A word about chest tubes-used to remove fluid, blood or air from the lining around the lungs. This is to allow the lungs to re-inflate. For historicals most likely the patient would have been on bedrest and had a difficult time breathing and many would have died.


This modern patient likely suffered a trauma from the look of the bruises on the chest and the result was a collapsed lung on the left side. The chest tub in inserted and stitched into place to allow the draining of blood or air so the lung can refill. Again historically this was a very grave condition.

FALLS-- result in a few things: Back, Pelvic and leg fractures-often open (Bones sticking out). The biggest thing in a bad fall is aortic dissection (rupture of the aortic artery-usually lethal) & Head or Neck injuries. Blunt force trauma can rupture the spleen etc. Falls in historical times just meant hauling the injured person to bed and nursing them from there and often times death was the result from unknown bleeding  and later infection.

FIGHTS- Broken hand and fingers-boxer fracture. Broken noses, black eyes, cuts and bruises. Broken ribs, jaws, head injuries. Treatment for breaks and bruises--RICE-Rest, Ice, Compress, Elevate, Pain Meds. Historically it was known that ice decreased pain and swelling.

FIRST DEGREE BURNS: First layer of skin-blister or surface burn. Stop Burning Immediately. Medicate.

SECOND DEGREE BURNS: Into the second layer of skin. Cool Burn. Immerse in cool water for 10 or 15 minutes. Protect Burn. Prevent Shock.

THIRD DEGREE BURNS: Call 911-Into the Muscle and to the bones the burn is so deep. Protect the Burn. Separate burned toes and fingers with dry, sterile dressings. Do not soak burn in water or apply ointments or butter, which can cause infection. Prevent Shock.


Severe burns today can end in death due to closing of the airway and loss of tissue fluids. Sometimes patient do well the first 24 hours and then die later of organ failure from the trauma. Historically, burn victims might take days to die but there was little done for them but to try to clean and keep clean bandages in place. Infection is an issue now and in the old days.

CONCUSION: Anyone with a suspected concussion should be seen by a doctor. Nausea, dizziness, memory loss, headache, confusion concentration problems, issues with light or sound, irritable, aggressive, anxious, insomnia, vomiting. Symptoms will likely improve in 7 to 10 days. Historically, physicians could do very little to know if there was a bleed inside the brain. Cold therapy is done today and the value of  ice was known in history as well. A concussion is basically the brain sloshing around in the head and causing swelling and injury, sometimes mild and sometimes enough to cause a bleed in various areas of the brain.





FROSTBITE--Do not use direct heat from heating pads, radiator, or fires. Do not rub or massage the skin or break blisters. Bandage the Area: Loosely apply dry, sterile dressings. Put gauze or clean cotton balls between fingers or toes to keep them separated. SEEK MEDICAL HELP! Historically it was thought that rubbing the limbs helped but today we know if can casue more damage.

HEAT STROKE--Call 911. Heat stroke is a medical emergency. Seek immediate emergency care. Lower Body Temperature Quickly While Waiting for Emergency Services to Arrive. Get the person into air conditioning, out of the sun, Spray with cool water, or ice packs to the armpits, neck, and groin. Fan air across the person to increase cooling. Might respond and be able to drink.

HEAT EXHAUSTION-Severe reaction to the heat-call 911! Will be less likely to respond.


For heat injury in historical times fluids or ice would have been used to help but either one of these can be very deadly even today.
 
POISONING-Call 911 if the person: Has collapsed, Has stopped breathing or is having trouble breathing, Is having seizures or convulsions, Is unconscious or not alert. Call Poison Control if: Call the poison control center (9-1-1 operators will connect you) if the person has done any of these things and is alert: Swallowed too much medicine or the wrong kind, Inhaled poison, Gotten poison on the skin or in the eye, Swallowed a household product or other chemical.


SEIZURES- need emergency care unless you know the person has a history of seizures and can be treated for a brief seizure at home. Prevent Choking, Loosen clothing around the person's neck, Roll the person on his or her side to keep the airway open, Don't put anything into the person's mouth. Protect From Injury: Move sharp objects, such as glassware or furniture, away from the person. Ask bystanders to give the person room. Do not restrain or hold down the person. Stay with the person until emergency help arrives.

SMOKE INHALTION-Call 9-1-1 if: Is unconscious, Is dizzy or confused, Has chest pain-tightness, Is coughing-choking violently, Has wheezing-shortness of breath, Has ash or smoke around mouth and nose, Has burns inside mouth, throat, and nose, Has swollen airways, Has black or gray saliva, Is nauseated or vomiting, Is hoarse, Has double or blurry vision, Has numbness or tingling in his or her extremities. Damage from toxin inhalation may not show up for hours and can worsen quickly.
Smoke damage to Trachea.




Sometimes it isn't the fire that kills a person, it can be the smoke. Initially a smoke inhalation victim might they are fine only to have their airway close off later on. These patient need quick ventilation and a tube to keep their airway open. Historically, many of those involved in fire died right away or suffered death in the first few days.


SNAKEBITE--Move the person beyond striking distance of the snake. Have the person lie down with wound below the heart. Keep the person still to keep venom from spreading. Cover the wound with loose, sterile bandage. Do not: Cut a bite wound or Attempt to suck out venom—unless you are writing in the old west, but do apply tourniquet, ice, or water, do not give the person alcohol or caffeinated drink.



Copperhead-Tissue Poison-Toxic (A cobra is Neuro-Toxic.)



Tissue and vessels are affected and destroyed by the snake's poison. Today Ante venom helps but often people still have horrible tissue loss and some die. Historically this might mean the loss of the limb or death. Treatment would have meant  ice and keeping the site clean and at times sucking the poison out of the wound. The issue with that is it often killed the one sucking the poison. Makes for a bad story.

GUNSHOT WOUNDS- are unpredictable puncture wounds that cause major tissue damage. Three factors work together to determine the severity of a gunshot wound. Location of the injury--Size of the projectile--Speed of the projectile. Changing the speed of the bullet makes the most difference to the amount of damage done. Basically, bigger guns make bigger holes. Surviving a gunshot wound depends greatly on how quickly a victim gets to medical help Know the type of bullets used: Jacket-shrapnel Hollow Points- Shock waves Slugs-shotgun Buck Shot-Spray.



Gunshot Wound. While it look small bullets can rip up the insides of the victim as it ricochets around the body. Some bullets do worse damage than others. The main issue is stopping blood loss and repairing organ damage. Historically those who were "gut shot" were sure to die and were often not given much care. Some suffered for days or weeks before dying a horrible death to blood loss, infection and fever.

STABBINGS-Treat as a puncture wound. Injury or death of often related to the amount of blood loss or major organs punctured.
Knife wound

Knife wound. Today and historically the issue is bleeding to death and or organ damage which historically might not have been able to be repaired.


MEDICATIONS…Look up medications related to treating an illness or injury prior to writing about it. There are a tone of medication and medical websites for researching. Call local pharmacists and they are usually happy to answer questions about drugs and drug therapies. With HIPAA laws (Confidentiality of patients and information) the way they are it is difficult to tour a hospital or like facility but they will often take calls and send out pamplets or information. For medication information there are a ton of websites, but I prefer to use a PDR-Physician’s Desk Reference. But like any book (Except ours—ha ha) They outdate, so when looking at drugs research what is new on the market.

About the Hospital—Code for emergencies vary and are not the same from hospital to hospital. A code Blue in one facility might mean something else in another. Respiratory arrest means that breathing has stopped but a Cardiac Arrest means the heart has stopped.


As you write your contemporary and historical stories, make sure to do your research. And I added the graphic pictures so writers will remember if one of these things happens to your character they are not up and making love the next day. You gotta give them care and time to heal.


Give me some comments on what you'd like to know about medical conditions or other things nurse related and I will see what I can come up with. Hpe these last few posts will help you with your writing.