A Pox on Your Story: Tips for Using Medical History in Your Novel

#HNS2023 Conference Preview by Georgie Blalock

The mid 19th century was an amazing time in the history and development of medicine. Quacks and snake oil men were replaced by respected practitioners who finally had effective tools, medicine and knowledge to fight illness and disease. Many of today’s practices have their roots in the discoveries of the late 19th and early 20th century, and many of the techniques, ideas and tools developed then are familiar to us today. As a result, writing medical scenes set in the late 19th century until World War II is easier than writing medical scenes set in older eras. However, it can still be a challenge to balance historical facts with reader expectations and the needs of the story.

Below are 3 tips for incorporating historic medical practices into your stories.

Tip 1: Connect the Dots

For centuries, the causes of infection and disease were as unfamiliar as the empty spaces on a map. However, people of the past did draw certain conclusions from experience, such as smallpox survivors gaining lifelong immunity and quarantine halting the spread of certain diseases.

If your story needs a more modern medical concept such as washing your hands before mucking around in wounds, look for a period appropriate way to justify it. For example, germ theory and hygienic practices weren’t accepted until the late 1800s. However, people in the past did make some connections between cleanliness and a decrease in infection. The Royal Navy attempted to keep their sailors and ships clean to stop fevers, and producers of milk and cheese understood that the dairy house must be clean to prevent dairy products from spoiling. Having characters recognize a link between cleanliness and a lack of infection isn’t outside the realm of possibility.

Tip 2: Research

Medical breakthroughs often happened long before their widespread implementation. If you need to use a medical practice that wasn’t in common use during your time period, search for prior mentions or theories about it. For example, people used nitrous oxide in the early 19th century to get high. It wasn’t used in surgery until the 1840s, but many people suggested that use long before it was officially adopted. If you can find evidence of something happening much earlier, you can find a way to craft it into your story.

The location of your story also impacts the techniques available to you. The closer a person was to the major medical centers in London, Edinburgh, and America, the more likely they were to benefit from the latest medical advances. The uneven spread of information allows writers to be creative with their use of medical history.  

Tip 3: Make It Up with the Flavor of the Era

If you take artistic license and invent treatments or drugs for your stories, create ones that have the flavor of the era. For example, if a character needs pain relief, consider writing about an opiate based concoction. If you need to treat illness, consider an herbal remedy. A large number of medicines were available in the past. Most were useless, but some contained effective ingredients such as foxglove (digitalis). Giving your made up medicines the flare of the era will help you strike a balance between reader expectation and historical accuracy.

I hope these tips help you craft realistic medical scenes for your novels. If you want to learn more about the history of anesthesia and pain relief and ways to use it in your stories, look for my workshop Potions, Pills and Poppies: How to Heal Your Characters or Put Them Out of Their Misery at #HNS2023. I look forward to seeing you there!


Georgie Blalock 
is a history and movie buff who loves combining her different passions through historical fiction, and a healthy dose of period piece films. When not writing, she can be found prowling the non-fiction history section of the library or the British film listings on Netflix or in the dojo training for her next karate black belt rank. She writes historical women’s fiction for William Morrow and her novels include The Other Windsor Girl, The Last Debutantes and An Indiscreet Princess.

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