Chapter 13

Devnum

Hywel was leaning over a patient, looking at the bandage. It hadn’t been an overly serious wound, but one he’d offered to treat in order to test out some methods the Consul had given them for different wound types. This one had been a man who’d gotten a bad burn while working in one of the local factories. The issue with burns was that they could fester and sickness would set in, and the larger the burn, the more chances of sickness.

The Consul had explained that this was, again, an infection caused by bacteria. Hywel had spent his life treating illnesses in the villages of Caledonia, learning the trade from his grandfather, who had been a healer in his own village. Back then, sickness was just a way of life. Sometimes the gods allowed you to recover and sometimes they didn’t. The fevers that came, if you survived them, were a test by the gods to show your strength.

And then the Romans came, or at least their Consul, as he’d later learned that was who all the Roman innovations originated from and showed him that much of what he’d learned was not true. Some was, of course. Bones should still be set, rest for sickness was best, but those were in the minority.

The Romans had taught him much, but by far the biggest was learning that so much of their ills were caused by a variety of these tiny creatures, which the Consul called bacteria and viruses. It seemed unbelievable that all of these problems were related, but everything he’d seen since he was told about it said the Consul was right.

“Sir!” called one of his assistants, bursting through the door. “We’ve got an urgent case coming in. Wagon accident, crushed arm. It ... it’s bad.”

Hywel knew why that was important. That was one of the injuries they’d discussed for testing amputations. It had been weeks and none of the injuries on their list had showed up. The more Hywel had studied for the procedure, the more nervous he’d gotten. He’d seen men get cut before, trying to remove foreign objects or cut off mostly severed limbs, and in most cases, the patient had died. Those who hadn’t had been blessed by the gods, and it had been a close thing.

Even understanding the errors they made that ended with those results didn’t remove his nerves. But this was what he’d been waiting for.

“You two,” he said to two of his assistants who’d been reviewing patients with him. “Prepare the operations room. Boil more water and ready the instruments.”

His team hurried away to carry out his orders. They had yet to use the room the Consul had given them designs for and had called an operations room. Completely marble, with a drain in the floor at the center of the floor, to let out the water. In the center of the room was a solid steel table, polished and smooth with no channels or divots where blood and other biological material could settle and fester.

The Consul had been insistent that the room be cleaned down with caustic acid and boiling water prior to use, after use, and daily to keep the surfaces clean and free of germs ... as he called them.

His assistants had left to do exactly that, in fact.

Hywel’s thoughts were interrupted as the patient was brought in on a stretcher. The man’s arm was a mangled mess, crushed beyond recognition and partially hanging loose. Thankfully, one of the stretcher bearers was one of the praetorians who’d undergone some of the rudimentary first aid training they’d started providing, which included how and when to apply tourniquets. One had been applied here, and early enough that the man was pale, but not bled out, which could happen with wounds like this.

“Take him to the operating room,” Hywel ordered. “Prepare a saline drip and time it for four hours, remove his soiled clothing, and clean him.”

Besides the sterilization methods, another universal practice the Consul had given them was the use of infusions to help keep patients from bleeding out. The easiest was a saltwater solution that Sorantius’s chemists had begun producing that matched the salt levels found in human sweat and tears. According to the Consul, the increased fluids helped the body produce blood on its own and was a major help for both injuries and situations where a patient had lost a lot of fluids, and just drinking them would not add it to the body fast enough.

It wasn’t something easily done without direct medical supervision, since the Consul had been very specific that too much would cause a kind of flooding in the body that could strangle the patient’s organs. Although, as with all of his explanations, he’d then said that was an adequate but wholly inaccurate description, which Hywel found somewhat disconcerting.

There was, apparently, an additional step that could be taken where a family member could be used to transfer their own blood into the patient’s body, although the steps required to do this were complicated. Apparently, not all blood was the same, and different people had different blood. Worse, it wasn’t even evident what made one person have one kind and another a different kind. People in the same family could be different and there could be a match with complete strangers.

That, however, was important and the Consul had given them a test that included a foot-pedal powered spinning machine that would separate out the donor blood into a clear liquid and a thick, more solid one. They could then test a sample against similarly prepared blood from the patient. The Consul had said that if coagulation was seen, it meant the blood was incompatible, and if you put incompatible blood into a patient, it could cause them infection and often death.

There were apparently other issues. Some people could have conditions where their blood would be damaged and others would have infections in their blood, both of which could pass those problems on to the patient.