# Physical/medical effects of medieval torture



## Panda (Feb 19, 2015)

I have a major character in my story who ends up being tortured and thrown in a prison cell in a dungeon, and eventually rescued. The torture will most likely be "off-screen" (not really a fan of graphic torture scenes), but I realize that torture, particularly traditional medieval torture (the rack, thumbscrews, etc) would have profound effects on the character, both physically and psychologically, and I need to account for that.

I've been reading up on PTSD, and I think I have a handle on how to write the character in that regard, although of course I'd appreciate any advice. What I'm really worried about is realistically portraying the physical and medical effects. I've read a bit about torture but I can't seem to find much about what happens to victims who aren't killed. With the rack, for example: would your arms and legs become unusable? Could someone relocate the joints, so that they'd heal and you could walk again? Is it just the shoulders and hips that are damaged, or would your back break as well? 

At least a week is going to pass before my character is rescued (I need to figure out how long it would take her rescuer to find out where she is). After that, she needs to be smuggled out of the prison and transported to the nearest town, where she'll be brought to a healer. Healing magic exists but isn't very effective; having a healing spell cast on you would make your broken leg heal somewhat faster than normal, but you aren't going to immediately jump up and dance, and if the leg wasn't set correctly then you'll end up with a crooked leg. Aside from magic, medicine is your typical medieval fantasy stuff: healers know how to set bones, use herbs, etc.

So, how do I do this without killing her in the process? It's okay if she ends up with permanent physical impairments (although I'd prefer for her to eventually have at least some mobility; I have a feeling GRRM isn't renting Hodor out to other fantasy characters ). I need the damage to be severe enough that there's some suspense as to whether she'll survive, but not so severe that her survival is unrealistic. I'd also prefer for the torture to be non-magical and, since I'm not going to be portraying it directly, conventional. (e.g. I'm not going to invent a Rube Goldberg machine where the character is stabbed by a dagger attached to a hamster wheel every time the antagonist farts. Let's stick to the rack and thumbscrews.)

Any advice is appreciated. Thank you. Also, anyone who can help me with this will be rewarded with the rights to my patented Fart-Powered Hamster Wheel of Doom.


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## Tom (Feb 19, 2015)

Oh, nasty. Luckily, I have had a few characters tortured, so I've done some research into the sorts of things that might happen to them, and the affects of those things.

If she was beaten at all or otherwise cut, she'll have open wounds. In a dungeon environment, those will fester and go septic. That will lead to necrosis (tissue death) and blood poisoning. She will certainly have some bad scarring, and may even lose digits or use of a limb if the damage from infection is severe enough.

As for the rack, speaking as someone who's had a shoulder and several fingers dislocated, it is very, very painful. There's lots of swelling in the joint and it takes _months_ to regain full mobility. The rack will also give her back problems, since it involves stretching the spine. It probably won't break her back (the spine tends to snap from blunt impact, not stretching), but it will damage the tissue that connects the vertebrae to the disks. That could lead to ruptured or slipped discs, and the stretching will also tear the muscles that anchor to the spine, weakening her back. 

Plus, with hips, you've got to remember that the hip is a deep-seated joint, nestled in a "pocket" of dense, tightly wrapped muscles and ligaments (which is why hip dislocations are somewhat rare, as opposed to the shoulder, which has a much weaker seat). Tearing the joint out of its socket is also going to tear the muscles and ligaments that bind it in, possibly resulting in permanent tissue damage. This'll keep her from walking for about six months to a year, and even after that she might remain partially crippled.

She might also get injuries just from being in the dungeon itself. Her eyes, mouth, and nose might become infected (bacteria thrive in warm, moist conditions of any orifice lined with mucous membranes), leading to open sores in and around the mouth and inflammation and possible blindness in the eyes. Her fingernails and toenails might become infected as well and slough off, exposing the tissue beneath to damage as well. The dirty, damp dungeon air might also give her a respiratory infection--a hacking cough, burning sensation in the lungs, etc. The fleas and lice will give her scabs and sores that will fester as well. The poor food will cause her to lose weight and become malnourished; if the water's dirty, it might give her dysentry or many other manner of nasty water-borne illnesses. 

Eesh. Your heroine might be in pretty bad shape when she comes out of her ordeal. I hope that magical healer is good.


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## Panda (Feb 19, 2015)

I... I think I might throw this story out and write about cute little bunny rabbits instead.

In all seriousness, though, thank you.


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## Tom (Feb 19, 2015)

Sorry; I write dark fantasy, and have a penchant for incorporating as much realism into situations as I can. It leads to some unpleasant elements. 

But you're welcome. Have fun with those bunnies, but be careful. I hear they sometimes bite.


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## CupofJoe (Feb 20, 2015)

Tom Nimenai said:


> But you're welcome. Have fun with those bunnies, but be careful. I hear they sometimes bite.





> Bunnies aren't just cute like everybody supposes!
> They've got them hoppy legs and twitchy little noses!
> And what's with all the carrots?
> What do they need such good eyesight for anyway?
> ...


_Anyanka "Anya" Christina Emmanuella Jenkins_

[Somebody had to do it...]


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## Russ (Feb 20, 2015)

Magic aside that kind of torture is going to leave permanent physical impairments in all of the affected body parts.  Lots of burning used in that kind of torture as well.  Think arthritis from all the injuries as well.

On the question of PTSD in your character let me sound a note of caution.  PTSD is a very modern phenomena, and it is a real stretch to apply modern pysch ideas to characters from very different times and cultures.  There was a school of historians who tried this for a while, but eventually the research just trashed it.

Characters from vastly different times and cultures should have vastly different pyschology than people from NYC, and will react very differently to things like torture.

There is a very good book on this problem called Shrinking History IIRC.

Good luck with the scene.


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## CupofJoe (Feb 20, 2015)

I can only partially agree with Russ.
While PTSD is a recent concept, its affects and effects have been know for hundreds if not thousands of years.
It may have been called Lack of Moral Fibre, Cowardice, Shell-shock, or the Indian Mutiny Stare, but it can be seen in writing going back to Herodotus and probably before...
I saw this article only a few days ago... Post-traumatic stress 'evident in 1300BC'
How we describe and interpret things may change but I don't think our underlying psychology hasn't... that much...


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## X Equestris (Feb 20, 2015)

Russ said:


> Magic aside that kind of torture is going to leave permanent physical impairments in all of the affected body parts.  Lots of burning used in that kind of torture as well.  Think arthritis from all the injuries as well.
> 
> On the question of PTSD in your character let me sound a note of caution.  PTSD is a very modern phenomena, and it is a real stretch to apply modern pysch ideas to characters from very different times and cultures.  There was a school of historians who tried this for a while, but eventually the research just trashed it.
> 
> ...



It may be a recent term, but the phenomenon is not.


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## Russ (Feb 20, 2015)

CupofJoe said:


> I can only partially agree with Russ.
> While PTSD is a recent concept, its affects and effects have been know for hundreds if not thousands of years.
> It may have been called Lack of Moral Fibre, Cowardice, Shell-shock, or the Indian Mutiny Stare, but it can be seen in writing going back to Herodotus and probably before...
> I saw this article only a few days ago... Post-traumatic stress 'evident in 1300BC'
> How we describe and interpret things may change but I don't think our underlying psychology hasn't... that much...



I am going to half agree with you.

The link you posted is exactly the kind of very bad work that has been pretty much rejected by the serious historical community.

To suggest that people seeing "ghosts" means you diagnose a historical person with PTSD is far too much a stretch.

Many people try to link diseases as far back as they can to give them legitimacy, but if you think about it from a scientific perspective, one mention of a person losing their eyesight, or seeing ghosts of the dead does not PTSD make.  You see it as well in the CFS field where one well known Toronto researcher suggested that stories of people in the late 1800's being tired and lethargic for a long period means that CFS was around back then.  Nobody takes that seriously any more.

Where I really have to disagree is the suggestion that our underlying psychology hasn't changed.  There is almost no doubt that it has.  It is so shaped by environment, what our parents do etc, if psychology is valid, then it must be very different now than it was even 100 years ago, let alone 3000 years ago.

I would agree that combat or pain or fear of death likely have had some significant impact on people throughout recorded history, but I would suggest that believing that the medieval person or the ancient person responded to that stimuli in anything much like the way we do now is not supported by either scientific reasoning or modern historical approaches.  That is really just us applying our biases to people very much unlike us.


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## Panda (Feb 20, 2015)

CupofJoe said:


> _Anyanka "Anya" Christina Emmanuella Jenkins_
> 
> [Somebody had to do it...]



Hey, the whole reason she got tortured in the first place is because her response to being questioned about a secret was "I'll never tell!" 



Russ said:


> Magic aside that kind of torture is going to leave permanent physical impairments in all of the affected body parts.  Lots of burning used in that kind of torture as well.  Think arthritis from all the injuries as well.
> 
> On the question of PTSD in your character let me sound a note of caution.  PTSD is a very modern phenomena, and it is a real stretch to apply modern pysch ideas to characters from very different times and cultures.  There was a school of historians who tried this for a while, but eventually the research just trashed it.
> 
> ...



Thanks, I will check out Shrinking History. I find it a bit hard to believe that PTSD is a recent disorder, however (although I say this as someone who's neither a psychologist nor a historian). Becoming traumatized is a pretty fundamental part of the human psyche, isn't it? I wouldn't find it hard to believe that some aspects of our psychology are the result of our modern environment. (For example, I've heard that attention spans were much longer before the invention of TV and the internet.) Extreme anxiety as a reaction to memories of horrific suffering seems like it should be a basic, primitive thing, though.

And even if PTSD somehow didn't exist in the Middle Ages, I still think it's worth considering in the context of a fantasy character. I care about limiting the amount of anachronism in terms of things like technology for the sake of simplicity and making the world feel consistent, but I'm not trying to write historical fiction and I'd rather the reader see my characters as people they can relate to than historical specimens. My character isn't going to go to a psychiatrist and receive a diagnosis, she isn't going to go to therapy or take psychiatric medications, but she is going to exhibit some of the symptoms associated with being traumatized because I can't imagine a human being who _wouldn't_ be traumatized in that scenario.

I don't mean to make this post even more long-winded than it already is, but I guess I should mention that part of my motivation for trying to write a novel is that, while I love fantasy stories, there are certain tropes that annoy me, and I want to play around with them and see what happens if I put my own spin on them. (Although it's still meant to be a serious story, not a satire.) And one of the things that annoys me, that comes up in many fantasy stories, is the dramatic torture scene that leaves no permanent mark on the hero once they escape. (Or if it does leave a mark, it's something cool instead of disabling.) So that's why I'm so worried about getting this right.


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## Nimue (Feb 20, 2015)

Yeah, I'd have to weigh in on the side that traumatization isn't a modern phenomenon.  The basic symptoms of PTSD are nightmares, flashbacks, and having extreme reactions to things that are connected to the event--which I think could have easily been conceptualized or attributed differently throughout history.  It's an evolutionary fear response taken to the extreme, and fear and aversion have always been with us.

I do have to wonder if PTSD is more common now not because it's been invented by our culture somehow, but simply because everyday life is a lot less traumatic than it was a thousand years ago, which makes those events worse in comparison.

(I was a Psychology major, but it's almost cliche that that means zilch, so I will gladly admit that these are my own unsupported opinions.)

Anyhow, kudos to you, Panda, for delving into this.  There are so many torture scenes in books and movies where the hero or the damsel gets away without a scratch--if they've been jailed and tortured for months, maybe they're hungry and have some whip scars, of course.

Incidentally, I did read somewhere that the elaborate "medieval torture chamber" was mostly invented by later, more imaginative centuries.  If a feudal henchman really wants to torture someone, it's probably not going to be with an Iron Maiden (not even a thing in the Middle Ages), it's going to be through good old-fashioned cutting fingers off and pulling teeth out.  Maybe stacking some stones on top of them.  It's a lot less expensive in terms of equipment costs.


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## CupofJoe (Feb 21, 2015)

Russ said:


> That is really just us applying our biases to people very much unlike us.


But that is my point... They were fundamentally like us.
They ran away from things they fears and threw themselves in front of those they loved to protect them.
Its the nature-nurture debate... neither extreme position is correct. 
That said all I am trying to say is that if you stress someone for long enough, hard enough, badly enough... It will have a lasting psychological affect. How that affect become an effect, will change with place, time, culture, society, people and lots of other variables.


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## Panda (Feb 21, 2015)

Nimue said:


> I do have to wonder if PTSD is more common now not because it's been invented by our culture somehow, but simply because everyday life is a lot less traumatic than it was a thousand years ago, which makes those events worse in comparison.



This sounds plausible.



> (I was a Psychology major, but it's almost cliche that that means zilch, so I will gladly admit that these are my own unsupported opinions.)



I was a Computer Science major, so you're still more qualified than I am. 



> Anyhow, kudos to you, Panda, for delving into this.  There are so many torture scenes in books and movies where the hero or the damsel gets away without a scratch--if they've been jailed and tortured for months, maybe they're hungry and have some whip scars, of course.



Don't forget cool psychic powers, scars that look badass and not ugly, and a strong resolve to get revenge instead of having a panic attack every time they think of their enemy.



> Incidentally, I did read somewhere that the elaborate "medieval torture chamber" was mostly invented by later, more imaginative centuries.  If a feudal henchman really wants to torture someone, it's probably not going to be with an Iron Maiden (not even a thing in the Middle Ages), it's going to be through good old-fashioned cutting fingers off and pulling teeth out.  Maybe stacking some stones on top of them.  It's a lot less expensive in terms of equipment costs.



I've been reading a lot about the Middle Ages lately, and it's sort of astounding how much of our perception of it is the result of imaginative Victorians. Iron maidens were never used, chastity belts weren't real (not that that's surprising; consider the hygiene implications  ), dual-wielding swords was never seriously used (it was a stunt some fencers would do to look cool, but was never used in battle), and I saw one HEMA video on youtube that claimed the way quarterstaffs are wielded was made up by Victorians (supposedly real quarterstaffs were wielded like spears, rather than held in the middle).

Since I'm trying to write fantasy instead of historical fiction, I'm not concerned about historical accuracy so much as being believable. If something ends up in my story that didn't exist in the Middle Ages, that's fine. (Hell, I can think of dozens of things in the story that wouldn't work in historical fiction. Gender equality, openly gay characters, the fact that _magic exists_....) I just want to avoid things that don't make logical sense (magic aside), like a character walking away from torture unscathed or a weapon being wielded in a physically impossible way.


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## X Equestris (Feb 21, 2015)

Panda said:


> Since I'm trying to write fantasy instead of historical fiction, I'm not concerned about historical accuracy so much as being believable. If something ends up in my story that didn't exist in the Middle Ages, that's fine. (Hell, I can think of dozens of things in the story that wouldn't work in historical fiction. Gender equality, openly gay characters, the fact that _magic exists_....) I just want to avoid things that don't make logical sense (magic aside), like a character walking away from torture unscathed or a weapon being wielded in a physically impossible way.



While gender equality and open homosexuality might not have existed in some parts of the world during the Middle Ages, they aren't a huge stretch, as there were ancient and medieval societies that had those things.  I agree that issues like the improper use of a weapon are worse.  Unless I were writing something intended to be a commentary on the Middle Ages, I wouldn't concern myself with having the society be an exact copy of Medieval Europe or something.


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## Russ (Feb 22, 2015)

CupofJoe said:


> But that is my point... They were fundamentally like us.
> They ran away from things they fears and threw themselves in front of those they loved to protect them.
> Its the nature-nurture debate... neither extreme position is correct.
> That said all I am trying to say is that if you stress someone for long enough, hard enough, badly enough... It will have a lasting psychological affect. How that affect become an effect, will change with place, time, culture, society, people and lots of other variables.



This I agree with you on.

But I don't think that the effect would look much like PTSD in a modern soldier or car crash victim.

Let me make a rough analogy for you.  If I study fatal car accidents on the autobahn to discover how they happen and what impact they have, I can't apply my conclusions to two dead guys on horses found side by side 3000 years ago.  The whole context and environment is different.

I do think that as writers we should write about the deeper impacts of events such as torture on our characters, but I think we cheat ourselves and our readers if we simply try and import modern ideas into alien cultures.  That is easy, but not as rewarding, and unless the theme of your book is really a parable of a modern issue (which is a totally different thing, if your book is really about PTSD and you are using a fantasy story to make a point about that issue) you are cheating the reader out of something that could be very unique to your world, and educational and boundary pushing for him/her.

I argue something similar in my chapter in this excellent textbook on the craft for writing:

Many Genres, One Craft: Lessons in Writing Popular Fiction: Michael A. Arnzen, Heidi Ruby Miller: 9780938467083: Books - Amazon.ca

For a writer I don't think there are too many hard and fast rules, but it is something to think about.  I know as a reader it irks me when characters in far flung cultures act like people I would run into at Tim Horton's.


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## Panda (Feb 26, 2015)

I realize it's a matter of opinion but, personally, I prefer characters whom I can relate to, regardless of cultural background. (Even if they're from some weird culture where they shop at "Amazon.ca" instead of "Amazon.com" and eat at a place called "Tim Horton's". ) Like I said earlier in the thread, this is fantasy, not historical fiction. I care about getting physical details correct and being consistent in the way I depict the story's setting, but I'd rather the reader identify with the characters than see them as alien.

Incidentally, it looks like I have a new book on writing in my kindle library.  I'll let you know what I think of your chapter.


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## Russ (Feb 27, 2015)

it's a fine line to walk, giving the reader characters they can identify with, versus giving the readers something alien enough to reflect a different world and allow for escapism and expansion of the imagination.  But that is the fun of writing, having to make those tough calls.

I didn't enough know it was out an an e-book!  Enjoy.


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## psychotick (Feb 27, 2015)

Hi,

To weigh in a little on the PTSD, you've got to consider two things. First the psychology of the human animal hasn't much changed in thousands of years. We've become more adanced and learned a little more pride, but essentially we are the same. But what has changed is the environment in which people are raised. So what this means is that people will react to traumatic events / fear and pain etc in much the same way that they do today. But what is understood as a traumatic event or something to be fearful of, has changed markedly.

Put simply, today we have things like the shell shock of WWI etc leading to the modern concept of PTSD. And we are here talking about an over reaction to something that is considered horrific. And it is horrific - by our standards. We simply aren't exposed to gross violence in our daily lives. But, and this is important, when we consider much older times what we now consider horrific, wasn't so horrific back then. It wasn't even completely out of the ordinary. People died younger, and they often died in what we would now regard as horrific ways, and so what we now regard as horrific they would have instead viewed as bad but not completely out of the ordinary.

To put this into further perspective, consider a future time period from now when life spans are vastly increased and disease and suffering are unknown. People die today at say a good age of ninety and they suffer certain maladies such as measles etc. For us this is just life. It's bad, but not horrific. But now consider the people of that future society reacting to someone dying at say ninety or developing measles. For them it may well be horrific. Something they have never witnessed before. Something that frightens them. And for them it may become a cause of PTSD.

In essence we cannot as 21st century people put ourselves in the foot wraps of middle ages people, and expect to simply understand them or what they would feel about any particular event. Our world view, our understanding of what is normal and abnormal, of what is right and wrong has changed too much.

So yeah I would expect anyone who has been tortured in any age to experience some psychological distress, and that may well include PTSD type symptoms. It is in the end simply an overreaction to enduring trauma that they cannot deal with. But I would also expect them to understand with and cope with the experience vastly differently depending on the culture / age in which they live.

Cheers, Greg.


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## Panda (Feb 27, 2015)

I had no idea I would be opening such a can of worms by mentioning PTSD in my post. :confused2: I should probably clarify the fact that I'm not making her PTSD symptoms a major focus of the story; it's just a detail I figured would influence the character's behavior in the chapters after the torture scene. She's not a POV character, so I'm not going to analyze her thought process or anything like that.


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## Tom (Feb 27, 2015)

We're always up for a good debate, it seems.


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## Russ (Feb 28, 2015)

I always enjoy hearing other people's ideas and testing mine.


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## Panda (Mar 3, 2015)

Back to the original topic:

Tom (or anyone else), are there any books/websites/etc you'd recommend where I could learn more about how to write my character's injuries realistically?


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## Tom (Mar 3, 2015)

I don't know...I usually use my human bio textbook for references, as well as a friend who's an EMT/volunteer firefighter. If you have a friend who works as an EMT, as a nurse, or in the ER, you could consult them.


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## SeverinR (Apr 1, 2015)

Had a very long post on several issues in this, but it took so long to write, it logged me out.
When I logged in, of course what I wrote was gone.

The one thing I hate about this site, it logs you out to soon.


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