Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Fractures

Episode Date: April 30, 2018

This week on Sawbones: Bones! We know, we thought it was weird it took us this long too. It's like ... right there in the title, you know? Anyway: BONES! Music: "Medicines" by The Taxpayers

Saabones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, not a sense, the escalant macaque for the mouth. Wow! Hello everybody, welcome to Saul Bones, Meryl Tour of Miscite Adided medicine. I'm your co-host Justin McElroy and I'm Sydney McElroy

I said I just What do you want to do a show about this week? Why you just dive right in there, aren't you? That's me all business. It's ready to go. Ty list. We're going and it out to great Wolf Lodge I want to get my magic quest on and I want to wrap this up Well, we don't want to shortchange our audience. While we're doing a great job in keeping it the regular episode length. I thought this week, last week we did something that was a little controversial, or at least I thought it was going to be controversial. Yeah, we covered GMO and I expected

an onslaught of very angry emails. And I have to say that really didn't happen. No, no. A few haters. A few, but the positive, not I don't want to say like people really liked our episode. I'm really spreading. No, I'm saying the positive feedback on GMO and the ideas of it and the understanding of it far outweighed the misunderstanding. Yeah. I was very heartening, honestly. Yeah. So it made me think that maybe there isn't, while there are people who are still, I think,

receiving misinformation, the majority of people maybe aren't. I don't know. Good. So thank you for all your feedback. And, yes, I'd like to make, how much never make corrections? I know. I saw a few tweets about this.

I misspoke. I said that there are people who live on 8,000 calories a day. When I want to sleep. That's a lot of calories. I'm at 800. I just was, I was talking quickly. I was getting impassioned. And I misspoke. And that's it. I was getting impassioned and I

Misspoke and that's it. I got no other excuse. I just Misspoke I didn't catch it Justin didn't catch it, but it's 800 I caught it But I just didn't want you to be embarrassed So why didn't you edit it out and let me put out on the internet? Why didn't you fix it? I didn't actually notice that would have been I do know the difference. I would like to point that out. Between 800 and 8,000 calories. Well, I know that it's physicians notoriously don't get a ton of nutrition. Education, but I know that one, like that one, I got. Isn't there something that like, technically, when we say calories, we mean cake house?

Yes. So your technically, maybe you're technically right. No, we mean cake-house. Yes. So your technically, maybe you're technically right. No, I still think I'm... Okay, well, I'll... Well. If you do this, come on, there might be something you can thread here. No, I just misspoke. Okay.

I'm in 800 and I said 8,000. There you go. Sorry. But we're going to talk about fractures this week. Okay. I'm just diving right into that. Go for it. There's, thank you, Jen about fractures this week. Okay, I'm just diving right into that. Go for it. There's thank you, Jen, for recommending this topic.

And I'm sure other people have recommended it throughout the years, but Jen, Sinacidema, very recently recommending it. So, you get the credit. When I say fractures, I'm assuming Justin, you know what I mean? Yes, when your bones break. There you go. When your bones get a break in them.

When they get a break in them. Well, break, I think implies completely broken. And a fracture doesn't have to be completely broken, right? Right, yeah, there are different kinds of fractures. You get a crack in your bone, which doesn't necessarily mean the bone is broken per se. I mean, it is like all the way through. Like all the way through.

I mean, the bone is broken. Yeah, yeah, yeah, yeah, yeah, but you know what I mean? We're getting into semantics. There are different kinds of fractures for sure. There are simple fractures where there's just, it's just broken. It's under the skin, it's in one place. It's just broken in there.

There's compound fractures, which we could also say open fractures, meaning that something's poking through the skin. That's bad. That's very bad. I've never seen one of those when I feel like I would throw up. I have. I did not throw up, but it is bad.

It is scary to see. It's scary looking, and then they're much more serious. Your fracture could be displaced or not. Do you know what that means? Displaced. Kind of makes sense. Like bone goes in a weird place. If you think a fracture, like if you imagine one long bone

and there's just a crack drawn through the middle of it, that fracture would be not displaced. The bones are all where they're supposed to be. There's just a break in them. Versus the bone is broken and it has moved out of position. Okay. So the ends are not opposing each other the way they should be. Got it. And obviously if it's not in place, you have to place it. Right? That's part of the management. Sounds so bad. Yeah.

I've never read about it. You know that? I don't know if that's the topic for discussion, but I don't know. Well, I have an either. Well, look at us. There you go. Good stock. Good stock or reason.

And then there are indestructible children or children who have, let's call them indoor lifestyle. Maybe. I played outside a lot. I played a lot of sports. I just, hearty bones. Hearty bones. I don't know, lucky.

And then there are different kinds of, the way that the bone can be broken. You know, it can be broken across, transverse, it can be broken up and down, like a linear fracture, maybe like a spiral kind of spiraling down fracture. Oh, that's pretty. There are green stick fractures,

which are just kind of like broken on the edge a little bit. That's the kind of fracture my sister had when she was younger. Oh, oh yeah, yeah, I'm the trampoline. Yes. Both my sister's on the trampoline. Hey everybody. Don't get trampolines.

Don't get trampolines. Both my sister's on trampolines. They're fine now. Don't get trampolines. Don't get trampolines. Both my sisters on trampolines. They're fine now. Don't get trampolines. Don't get trampolines now. Okay. Now, fractures are kind of interesting because we have a long history of trying to treat them because they're a very obvious malignant.

I want to talk about trampolines again for a second in terms of medical history. I think trampol's represent the triumph of humans in medicine, or more accurately a hubris that we developed. Like we were like, oh, we've got this. Let's spice it up. Like we've got everything figured out.

Let's see what kind of shenanigans we can get into. They really are pretty dangerous. I mean, you won't find a lot of pediatricians and family doctors, like people who take care of kids, who would recommend having one or using one. And don't add us and say they're regular, a relatively safe, like, I check the sample size, two out of three kids, break bones in family.

That's very true. One in arm, one in ankle, that even with the nets, even with the big net around them now. Yeah, we didn't have those when we were kids. No, we we went wrong. Just fell off the trampoline. No, so trampolines are pretty dangerous. I'll just say we we don't have one. We'll leave it at that. Yeah. The treatment of fractures has been described as far back as the Edward Smith papyrus from ancient Egypt because people have broken bones as long as people have had bones. And it's very obvious when you break a bone. Pretty, I mean, usually there can be kind of hidden occult fractures that aren't immediately

recognizable, but if you break a long bone in your leg or arm, you know pretty quickly because it hurts, and then it looks weird. And so people have been trying to fix it for a long time. The, I don't know if this is a good or bad thing, positive slash negative. We do a funny show about medical history, so it's kind of a negative for us, but it's positive for humans.

We figured out pretty quickly some some effective methods. So it works. Did we treat fractures? So there's a lot of history that isn't particularly. Well, it's one of the few things where just let it alone, right? Like it'll actually, like where they must have tied it all up and said, well, I may have hoped that fixes itself because we have no idea. Then it did. And then it did. And it's very true. That's, I mean, more or less we have understood the idea of reduction of a fracture,

which means putting it back in place since the ancient Egyptians. So same thing with a dislocation of something pops out of joint. We've understood kind of how to relocate it for a really long time. With fractures, people will look at an arm and it's hanging at a funny angle.

And so they'll kind of pull on it to try to realign it, which is the basic idea of reducing or replacing a displaced fracture. Does that make sense? Yeah. Be sure to episode this week, huh? That's it. Well, no, I still found some wild stuff in there. Okay. So basically in ancient Egypt, you would just kind of pull on the limb until the bones slide back into place. Yes, that's going to be painful. And then you would apply bandages and honey because as we have talked about on the show before, the Egyptians were all about honey, which is helpful in some cases. If you actually had like an open fracture, honey is probably not enough there for you.

Because like I said, open fractures are a big deal. It's the infection. And that's... I'll go ahead and cover that. If you have a bone poking through the skin, the bone is now exposed to the world of infection that is out there, and that's bad. You don't want to get infected bones. Those are serious infections that are hard to treat even today.

And as you can imagine, prior to antibiotics, we're almost impossible to treat. So an open fracture is a huge deal, and it was a much bigger deal back in the day. That's a bummer. The honey is a bummer, because it's like, well, my arms are good now. Also, there's ants all over it, so that's not good. You could get away with simple bandages and ointments were applied if it was a closed fracture, meaning

that nothing was poking through the skin. They did recognize after a while that if you did have bone poking through, there really weren't a lot of recommendations, which was just kind of an acceptance that this is not going to go well. I mean, they knew that at least that the severity of an open fracture was, most people didn't make it. Nowadays, we do know how to treat them. They are a big deal, but we know how to treat them. I wanna reassure people. Hypocrites had pretty similar advice. He also advised reducing it first.

And there are a lot of, if you look back through medical literature, you can find a lot of really elaborate drawings, like diagrams of devices to reduce fractures of like ways to like haul somebody up by the arm to replace a humorous where it needs to be. And they look strange and like that can't be right, but I mean the principle of them isn't wrong in a lot of the cases. So it's not that off base. It's just kind of a wild contraption to build, to replace an arm. But you would reduce it and then you would bandage it with this

mixture of some kind of fat and some kind of waxy substance. So any kind of animal fat or oil and then wax, bees, wax would work. And you would mix it together and it made serrate. And you would bandage it with that bandage is soaked in that sort of like a cast. It's hard to need a cast. Yeah, kind of like a cast. Exactly. You would change this daily and then after about a week you would apply some splints to hold it in place.

The idea was that you didn't want to apply splints right away because there was going to be a lot of swelling and you didn't want to squish everything together too much initially. You wanted to kind of let that die down and then apply this plant, which isn't a bad idea either. And then because it was hypocrite, he also had very strict diet requirements for healing from a fraction. Everything, hypocrite came down to diet.

Really? Yeah, he was, he was very big on food, it's medicine. Yeah. Which again, these aren't wild recommendations. Now you are not going to have better ones back there. No, that are Tylenol. Yeah. Which again, these aren't wild recommendations now. You are not gonna have everyone's back there. That or Tylenol? No. You're not gonna heal a fracture with diet alone,

but eating a healthy diet is never a bad idea. And pretty much as we move into like the Roman period, you get the same kind of advice from physicians like Celsius. They just trade in wine for serrate, which isn't as effective in making a cast-like structure. Yeah. See how it downgrade? Yeah.

Just, you know, rubins in their wine, I guess. Now plenty of the elder, and I guess if all of medical opinion was going in one direction, like, oh, your bones broke and we think. So all you have to do is, you know, wrap it in some bandages and keep it in place and then it'll heal on its own. Plenty had to get in there and say, well, that seems boring. I need to say something different. But it makes up a bit.

So from his natural history, chapter 65, here's what Plenty has to say on broken bones. For broken bones, a sovereign remedy is the ashes of the jawbone of a wild boar or swine, boiled bacon, too, tied around the broken bone, unites it with marvelous rapidity. Now, if that was any fracture but your rib, that would work. Now, let's say it was your ribs. If it was your ribs, he had a different recipe for fractures of the ribs, goat's dung, applied an old wine, is extolled as the grand remedy being possessed in a high degree of

apparent extractive and healing properties. Extolled as the grand remedy. Extolled as the grand remedy. Just lay it on a little thick, planning for something you just kind of pull out your hindered there, bud. So I like that. Everybody says this is good.

I don't know. Everybody's pretty much getting it right. And then plenty's like, nah, I got, I got a whole other idea here. You may wonder to how exactly did people diagnose a fracture. I thought I'd mention this. It is mentioned throughout many different ancient medical texts that you could feel crepidus of the bones and that's kind of that sensation. We look for crepidus in different situations in medicine, but if you put your hand on something and you feel like that crackling and popping as the bones are moving

against each other, that's that's crepidus. You can also feel crepidus in like an arthritic joint. I'll just put my hand over a knee and have a patient bend their knee back and forth. And I can feel it popping and cracking underneath my hand. If there's trapped air, you can feel creptis. But anyway, they describe this all throughout. Just to hug your knuckles, right? Yeah. Now, usually when we get to the middle ages, I tell you that we forgot everything about

how to treat whatever we're managing. And it was all terrible. We actually didn't. There was a period of time where doctors didn't like to touch patients very much. We've talked about this a little bit before. Part of it was kind of a religious idea when physicians were closely tied to like monks and priests and things like that. Touching patients a lot was kind of taboo. And then there was also the fear of getting things like syphilis. Okay, yeah, that's legit. So there were-

Don't need to be religious for that. I mean, yeah. There was a time period where it wasn't forgotten, but touching your patient and resetting bones may not have been done as frequently. But we still, I found this great document, it was like a Dutch middle ages, it's from 1350, and they reenact these kind of cures and treatments so that they can see what it looked like.

And so I found this whole whole report on how they do this and images and all this kind of stuff. It was very cool, but they detailed how you would have treated a broken leg in 1350. So first of all, you have to feel the leg. Feel the leg, John. To figure out where it is. Like you just kind of squeeze along the leg

until it hurts, I guess. Gringa, okay, here's where it's broken. Um, and then you're going to set it. And the way that they would have set the bone or reduced the fracture, they would have one person like like the guy's laying on the ground. And this picture, it's like, it just happens to be a guy. Yeah. Be anybody. But just be a big guy. But, uh, but they've got one person behind him like with their arms wrapped around his chest, like pulling him backward, and then another person like pulling on his foot. So basically you and the master surgeon is going to kneel between the two people who are pulling on him and kind of hold the leg to try to

work the bones into place. I know. I know. And if you accidentally poke a bone through the skin, you just kind of massage it back down to where it goes. This is gonna be bad in the long run. I haven't so bad though. The one thing is it's so bad.

After you get that back into place, you're gonna take a bandage and you're gonna wet it with a white of an egg. That actually found that throughout different parts. Like there was some ancient Arabic medicine that with a white of an egg. That actually found that throughout different parts. Like there was some ancient Arabic medicine that suggested the white of an egg as kind of a hardening for the bandage. And you could mix it with milk or wine

or just water or whatever. And then you wrap that part of the leg with the bandage. And you wanna apply it pretty tightly and Then you splint it So they would have taken like seven splints for a broken leg and really wrap them all around You know, you would want them Spaced all around the leg and then just hold those with some cords and wrap it pretty tightly And they have specific things like they use like hollowed elder branches and things to keep so that the cords don wrap it pretty tightly. And they have specific things like they use

like hollowed elder branches and things to keep so that the cords don't wrap too tightly around the skin and all that. And then after that you just check it regularly, you reapply wax plaster as needed to hold everything in place. So again, we're kind of like cast. They often use something called black ointment. Black ointment or you also see it called black salve, which is a very similar thing. You said that in a way that you might have shared some familiarity within me. We've mentioned this before on the show. Oh yeah. I remember. In my clarity. For Cifalusis it was used a lot. We just tested this, you know exactly how much I retained. And it's around 75%. It's not bad, this is very good.

It had variable ingredients. You'd get different black ointments, depending on where you who made it. But it usually was some kind of mixture of herbs. There was some sort of tar oil or something, probably they gave it the appearance of, gave it made it black and then something like beeswax.

So it was like a thick ointment with herbs in it and you would apply it to the fracture and it was thought to be really good at drawing out bad stuff. Infection is what they were saying before they said infection or like tumors. You will see this, this is wild. I was, I was reading, trying to get a list of ingredients for black ointment. And as I said, it's hard because it was so variable. But you will find this marketed today.

Really? Yeah. That's weird. Yeah. And it's also marketed as like a- I said it's weird. Like I've been around earth for the past few years. It's not weird.

Of course. Let me try, let me do my answer again. Well, yeah, I said, obviously. And I would watch out for this because it is marketed as a cancer treatment. Yeah. And that's effective. No. No. Okay. But but back then it was used for everything and fractures in particular. And then basically you would tell your patient to take it easy for a while. You didn't want them up walking too fast because you wanted the bone to stay where it was supposed to be.

And then you would have them use things like crutches for a while to give it a rest. Hey, crutches? Yeah. Sure. That's not, that's not all right. I guess I'm going to think about it. I shouldn't be that surprised. Cough.

Fashion lives together. So again, none of this is particularly wild. Yeah, I'm doing a okay job. I guess there's only so much you can mess up. What about after a little later after the Middle Ages? Well, I'm gonna get into that Justin, but first let's head to the Billy department. Let's go.

The medicines, the medicines that ask you lift my God before the mouth. Besides what we've just learned, it's great for casts, apparently. So that's another thing you can use your wink one for. It's not. So let's move on from 1350, by the way, if you're interested in that, I did want to give you that because I pulled all that from the manuscripts of Brussels, Cambridge, Gint and London that were edited by EC Lerson in 1912.

In case you're interested in all of that. Pause the show. Pause the show after you've seen more. Treating a fracture. Reading about fracture treatment. In the 1400s in Anglo-Saxon England, I thought this was really interesting. I found a giant 30-page description of the treatment of fractures. People really love to write about this stuff.

I have a theory. It's because to get into orthopedics, it's a very competitive residency. You have to do research. I wonder if all these people are researching the history of fractures. That's my theory. I have no idea. Anyway, so inflicting a fracture on somebody was a serious crime in the 1400s. If you broke somebody's leg or arm, you had to pay. It's not about what you did. It's about the impact of your actions. Yes. That's fun. Yeah, because you could cause them obviously death if it was like an open fracture. Or they may be enabled to do whatever their job was previously or whatever after that,

because we didn't know how to set it properly. So an arm broken above the elbow incurred a penalty of 15 shillings. If you broke somebody's femur, it was twice that and 30 shillings. So there you go. There's the cost of breaking an arm or a leg. It's curious. So a shilling was worth 120th of a pound sterling. And this is in 1400. This is 1400, so in flip, you know, it's hard to figure out. But it's like 75 cents today.

Probably more. Probably more. I would think. No, no, 75 cents in those days. In what is this 14 hundred to my head? Yeah. Okay, Hold on. I can figure this out. Give me a second. Just let me Google for a second. While you're googling and entry that required crutches afterwards, might make you pay higher. Like if afterwards they, the person never regained the ability to walk without crutches, you might have to pay more money. Okay.

regain the ability to walk without crutches, you might have to pay more money. Okay. In general, breaking a leg was worse than breaking an arm for whatever reason that cost you more. So this inflation calculator only goes back to 19th century. So I don't think so. So we have no idea. Somebody's going to tell us. Somebody will, I trust our listeners. Somebody will know.

15 shillings in like the 1400s. Equals how much today? It goes how much today. You can stick with sterling. It's fine if it's still. We get I can put that into the air. I can handle. I can handle that if it's so.

It would be nice if you don't have to, you know what, if you're already doing it though, please do go to the extra step and convert that into USD for me. Thank you. The the basic principles at this point were not that different. Obviously, we haven't advanced that much in history. We've just kind of jumped countries. But I did find a lot of mentions of hot baths to relax muscles before you do the reduction,

which it's interesting. Like a hot bath could relax a muscle. If it's around a broken bone and there's inflammation, I don't know how much it would help, but it's not a broken bone and there's inflammation, I don't know how much it would help, but it's not a it's not a terrible idea Wow now there are I did find suggestions that the patient themselves try to stretch the limb out No, thank you. Um This is this is wild to me because one the pain alone I mean if you broke your femur, there's no way you're gonna be able to reduce that

Like they just do the pain. But then also, you had to be pretty strong to do this. I mean, to put all bones. Strong physically and like strong willed. Strong willed. Yes. Strong spirit. But also physically strong to pull a bone back into place.

And it'd be very hard to have the leverage to do that on your own limb. I think it would be a very difficult thing to do. So I can't imagine that worked very often. There were some specific recommendations for like, once you had, because I think that was just, well, we've reset everything. It's back in place.

We might as well throw some herbs and whatnot on it, because we do that for everything else. You want to justify the bill. Like I know you guys love doing that. So a couple different kind of exciting concoctions that I found. One was you take the root of the dragon plant, mix it with grease, and you make a poultice. I mean, it sounds impactful. The dragon plant certainly, like, give me some of that.

And you could especially do this if the wound was open and you thought there were little pieces of bone in there. So like a comminuted fracture with more that it broke into more than two pieces. Then the broken bones would kind of appear out of the body if you applied this poultice. But you should only gather this plant in July. Why is that? I don't know, because they said so. Okay, I'll take your word for it.

July is the month for dragon plant. There were also recommendations. You could lay bulls-dung, warm bulls-dung on the fracture. Okay. And all will be well after that. And that'll do it, huh? It will be well with him and so what they say. And for any fracture, you could take a dog's brain laid upon wool and bind that over the place where

the break occurred for 14 days, and then it will be healed. Okay. I wouldn't know, darling. But if you want to try and let us know, don don't this I want to get in this more extreme medicine sitting I don't want people I don't obtaining dogs brains please don't please don't do this. You have the dogs brains No, no Okay, don't we guess don't please don't please in general There's very little that we talk about on the show that we want you to do. Yeah.

I think it's just get vaccinated. Yeah. I don't think much else we want you to do. Go see your doctor and get vaccines. By the time of paray, and we talk a lot about Ambra paray on the show, it lived in the 1500s, revolutionized a lot of pre and post operative kind of care and surgery and equipment and all kinds of things. They're in raids after. No.

It seems so great. No. What are we going to call this? Like, everybody's marching to the line. There's musicians musicians. What's as great as this? What about Emma? Emma, I'm going to pray.

A parade. That's perfect. They just snuff the D in at the end for copyright reasons. Right. This is a stretch. This feels like I know as I'm saying it. This is wrong. I think our listeners know this is very, I mean, of course it's wrong, but I don't even think it's funny. That's my problem where I'm at. I'll say wrong things a little time, but I could at least land. By, by his time, the basic method of fracture management was already down.

And he summed it up. And since then, we kind of have been doing it the same way you restore the bandwidths play. Second, you contain it with some sort of, you know, splint cast, whatever you've got. And then you do things to prevent inflammation and infection and pain and whatnot. While they heal, take time to rehabilitate. And those are kind of the principles of fracture management that kind of stick around even today. Now I do want to take a little side note to discuss bone setters before we end this, before I get you to today. As long as people have been breaking bones, we need people who can set them.

And as I mentioned, reducing a fracture isn't necessarily easy. Right. You know, it's, I mean, you've got to be strong. And you wouldn't have always necessarily had a physician do it. Like I said, sometimes doctors didn't touch patients. And also, you needed somebody pretty strong physician do it. Like I said, sometimes doctors didn't touch patients. And also you needed somebody pretty strong to do it. So maybe the doctor wasn't necessarily strong enough. So they had like one burly person in the office

that just... No, you had bone setters. What? A bone setter may have been somebody with some sort of medical background. You know, certainly there were bone setters. I knew about to say bones. Forget what you have said. One of those. Um, like the in the in the uh, 16th century, you found a lot of like, um, monks and nuns who may be left religious orders who took their medical background with them, the training

they had and became things like bone centers. Um But you find bone setters in all cultures. They're actually still bone setters today. Really? Yeah, in some places. Traditional bone setters who do this kind of thing, who aren't necessarily what we think of as modern physicians or medical personnel. They just are very focused on this. Well, it's more knowledge that's been passed down through families.

Okay. You know, it's folk knowledge kind of thing. So, I wanted to talk about bone setters, not so much because that's, I mean, we figure somebody had to do this. But because of one that I discovered, her name was Sarah Mapp, but she was known as Crazy Sally. Okay. I don't, I think she gave herself that name. Nice. She was born in 1706 to a father that already worked as a bone setter. So her dad already had inherited this family tradition

of setting people's bones, right? Had this knowledge. He wasn't always around to set, I guess all the bones he needed to, maybe two people broke a bone at the same time. So it wasn't available. So Sarah started handling some cases for him. Okay. Stepping in and kind of inheriting the family business. Now, this would have been very strange at the time for a woman to be doing this. One, because it just wasn't, it was kind of unseemly. because it just wasn't, it was kind of unseemly. It was a big deal for women to be touching people and doing what a physician or medical person would do. And to, like I said, you had to be pretty strong to do this.

So it was usually done by blacksmiths. Like, yeah, like big burly people and here Sarah just kind of took on these cases and it turned out that she was really good at it. Nice. Actually probably better than her dad. Okay. So she took off and kind of started her own practice, which she called Cracked Sally, the one and only bone setter. Oh my God, that's so good. I love this person. She was very successful at it. She got one a lot of renown for being so good at setting bones.

And so she moved to Epsom. In Epsom, there was a lot of horse racing. There were a lot of rich people. A Epsom salts fame. Maybe. Probably. Probably. Probably.

Probably. So there were a lot of rich people and they liked to race horses. Some salts fame Maybe probably probably probably probably So there were a lot of rich people and they liked to race horses and this resulted in a lot of broken bones So her services were needed in Epsom so she moved there and started you know setting the bones of the rich and famous I love calling yourself the one and only something in days before Google because there is a chance that someone will be like She's the one. She's the only one. She's the one. Who you gonna get? Well, what do you think?

She's the only one. Look at her business card. Now, she was doing very well there, but there were a lot of places that wanted her services because she was becoming famous. And so she was thinking about leaving Epsom, and the people of Epsom were not thrilled with this. She was the one and only Booster.

She's the only one. Where they got you and only Bones. She's the only one where they got to do another one. She's the only one. So they actually started paying her to stay in town. Just don't leave. We will pay you 100 guineas a year just to stay here and fix Bones when we need you. They had her on retainer. Like a concierge physician.

That's concierge medicine. I love it. Thege physician. Okay. That's concierge medicine. I love it. They trip around town. Before it existed. Yeah. So she hung out in Epsom so that she could fix all of their bones. She obviously was making a good living. She would travel twice a week to London

and she worked ahead of the Grecian coffee house, fixing fractures, setting bones. What do you care? I mean, there's no rules you do to me or what? You're paying me to be there. And she was, like I said, she was doing very well for herself. So she had a very fine carriage. She had four horses and she would take this carriage back in fourth to London.

And she actually would decorate her carriage with crutches that she would get from people whose bones she supposedly fixed so well that they never needed their crutches again. Oh wow. So the crutches were like a trophy for her, so she would hang them, hang them from her fancy coach as she rode back and forth for one of his friends. She is my hero. She is remembered for this, but she was also remembered for being a little wild. Okay. She liked her drink.

Okay. And I don't know if this is true or not, maybe a powerful, but she used to get drunk and wander the countryside yelling profanity. Yes. But she is also remembered for being a woman in a male dominated profession that you had to be really tough and strong to do.

And she took it from her dad and took all his customers and went and did it. Now unfortunately, she is also remembered because she is pictured in William Hogarth, the company of undertaker's consultation of Quacks, a painting from 1736. The idea at the time was that a lot of people who practice medicine were quacks, which, I mean, that was 100% true. And so doctors and people like traditional bone setters alike were pictured in this

and a lot of other art and writings and plays and things from the time kind of saying, these people don't know what they're doing and they're just as likely to kill you as help you and you should stay away from them. And she, because of her notoriety, got memorialized as that as well. As a result, she kind of fell out of fame and favor

and ended up not doing as well in her later years. She was one of those who got really big, really fast, and then ended up dying penniless. You just can't pan away, can you see that? You just can't pan away. You always have to follow the person until the grave. What was it with you?

I'm just the pre-hat. You can't just celebrate every episode. It's like as they did this and they were crushing it and then well, they did die and they're dead. No, I think. I think. Dying panelists by the way. Great timing.

I'll say that. Who wants to die with pennies? No way. Burn them. The thing one, thing two. Just pan away. The camera is after follow them. The whole thing.

This is why I mentioned this is because with as we look back through the lens of history, it's hard to say, all the dead people, did she do a really good job or not. I don't know, we think so. Certainly a lot of people liked her. But as we've talked about on the show, just because people were very big fans of a treatment or thought it worked or a certain doctor doesn't necessarily mean they were Good at it. So I don't know was she amazing was she ahead of her time was she behind her time was she just Making money doing I say she was doing what comes naturally you know, you're like you're like

You're like both Adam ruins everything and you're like, both Adam Ruins, everything and everything. Like you introduce the thing and Dan Ruins. Just just trying to look at things. We were going to tag twos at this wall. You're like, well, one thing you can do, you can do. All I can say is I think that where I alive back in the 1730s in Epsom, I would probably have wanted to grab a drink with this lady. She sounds real good. That's what I would say. So now these days, do we have like radical lasers or pills to fix bones?

No. I mean, I feel like we kind of, like I said, these principles of fracture management aren't two different today. Obviously, we use an X-ray principles of fracture management aren't too different today. Obviously, we use an X-ray most of the time, or some sort of imaging. We don't just feel and say, I mean, although you can feel and tell if something's fractured sometimes, not always. We use imaging to make sure that we know where the fracture is, and depending on where it is and what kind it is, we may just, like I talked about, reduce it or put it in place, take

images to make sure it is in place, cast it, splint it, and then do rehabilitation, you know, to make sure that you build up the strength around it and everything heals like it's supposed to. Sometimes you need surgery if something is in multiple pieces or very displaced or just certain locations of fractures might necessitate that you go and put pins and plates and screws and things to hold the bones back together so that they'll heal appropriately because bones, if they're close enough, will heal. A callus forms, is what they call it, is the bones start rebuilding and healing. But if they're not in place, if they're kind of, you know, just a little bit diagonal or not where they should be. The limb or whatever is broken

will never function quite the same. So you want them to heal in place. So that's what a lot of it is. And then obviously, like I said, if there's an open fracture infection is a huge concern. So antibiotics would be part of that. And that would definitely be a surgical issue and blood loss and inflammation, everything else we manage, pain control, all the other things we do around that today. Let me ask you a question, Squid. Do you feel like maybe we rested on our laurels a little bit with this one? Like maybe we like figured it out early and then didn't spend a lot of energy and figured how to do it like better and faster and quicker.

Well, we do it pretty. I mean, what we're living in. We do find that. I can, what we're living in. We just find that we can't go into the doctor's office and then walk out the next day with a heel bone. Well, we're limited by the fact that bones take a while to heel. Now they do, because we haven't figured out

a better way of doing it is what I'm saying. Technology, nanobots, et cetera. To rebuild the bone. Nanobots. I think this is just my, this is personal opinion. This has nothing to do with research. We can fix anything. Bones are physical structures. Why can't we just fix them in their fix? Well, because again, it takes time for those cells to heal the bone and grow back together.

Is what I'm saying, like, or something? I know, but if we're going to put a lot of time and energy and research dollars into something, like a fracture will heal. And I think that if the worst that you got to do is wait a little bit. I don't think that's the end of the world. There are probably other areas where we could stress that. This isn't me. This is me being selfless. I've never broken about it.

And like, I might eventually, but probably not so far. It hasn't been issue for me. I'm worried about other people, not me. I think that is, I think if we know how to effectively manage fractures, eventually, but probably not. So far, it hasn't been an issue for me. I'm worried about other people, not me. I think that, I think if we know how to effectively manage fractures so that people survive and their bones work afterwards, I think we're both pretty darn good.

Fair enough. Hey, Sid, big news. We wrote a book. That's right. We're writing a book. We're almost done with the book. Pretty much done. We're pretty much done with the book.

We're just editing. Editing and I'm gonna start with the long side of this. Saw the book. We're pretty much done with the book. Just editing. Editing as far as alongside this. Sawbone's book. We're writing it. Taylor Smurl. You may know her as Sidney Sister, but she's also a very and co-host of Still Buffering. She's also of the aforementioned broken arm. Yeah. She's also an extremely talented artist. And she is doing the illustrations for this book. It's going to be, if you like the podcast, you're definitely going to enjoy the book. It's basically a lot of the same topics, but they're in book form and also we're rewriting

everything and it's new info and different jokes because it would be weird to do the same jokes over and over again. There's a lot of new stuff. It's a lot of new stuff and if somebody's not into our show, then this would be a great way to get them into it or just like as a gift. It's great for people who like like interesting like historical trivia or like gross stuff or anybody. Honestly, or maybe you think they should like it more, or they've never experienced it. Or maybe they hate it and you want to turn them around. Basically, just everybody needs this book. And if you get a bit.ly-word-flash-salboans-book, you can pre-order it off Amazon or make use of your

local bookstore. Your local indie go in there and demand it. Kick open the doors. Say give me this book. I need it. And like our show, it's curse free. Curse free. No swears. No swears. It's as family friendly as our show is. Yeah. Right. Some challenging ideas. Yes. The caveat. You decide what age your kid is ready for this. Yes. I told my kid about toxic mega colon and she's three. So you make up your mind though. I told Mike at about toxic mega colon and she's three. So you you make up your mind though. So bit.ly-forthslash-solvones-book. You can pre-order that now.

It comes out October 9th. God willing, the creep don't rise. It comes out October 9th. Yeah, well, well, do you want to tell everybody where we're going to be in a couple of weeks? Yes, we're going to be in Columbus at the Columbus podcast festival with still buffering and court appointed.

And many other shows, many other shows, those are just the ones that were related to that our family makes. That we're going to be performing on Saturday. You can get one ticket for Saturday gets you into all those shows or you can get a weekend ticket and see all the shows in the podcast. So I say all the shows, but some may be presented at the same time. But regardless, if you go to Columbus Podcast Festival dot com, you can get tickets right now. They're very reasonably priced. If memory serves, they are, they are like $20 for a single day and $40 for a weekend

pass. It's Thursday through Sunday, and we're performing on the Saturday again, May 12th. It is. I know it's Eurovision Day, I get it. I'm very upset about it too, but we'll figure it out together. Just record Eurovision.

Just record Eurovision from logo and watch it later. So please come out and see us at that. And I guess that, thanks for that. Tax bearish, let me just use the wrong medicines. This is the intro and outro of our program. And thank you to you for listening. We love you, buyer book, or you know what? Just keep being you, that's all I care about.

And that's gonna do it for, so until next week, my name is Justin McElroy. I'm Sydney McElroy. And as always, don't. Drill a hole in your head. I'm lost. I'm lost. I'm lost. I'm lost.

I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost.

I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. I'm lost. Alright!

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