In the cool of the evening of March 26th. 1199, forty-one year old Richard the Lionheart was before the walls of the besieged rebel castle of Chalus-Chabrol deep in the southern reaches of his empire, when a crossbow bolt flew from the fortress and lodged squarely in his shoulder. The shock was apparent yet he made barely a grunt lest his men realize the situation, become disheartened and desert their posts. Escorted covertly from the field of battle to his tent with only four of his closest compatriots privy to the king’s presence, his injury was kept closely guarded secret. Within his pavilion the king was stripped to the waist and laid on a cot. Richard withdrew the bolt only to have the wooden shaft snap in his hand leaving the arrowhead embedded deeply in the wound. To add insult to injury, he recognized it as being from his own arsenal and realized the quarrel head was probably barbed. Dusk had faded into night as a surgeon of sorts was summoned and in the darkness lit by flickering torchlight the delicate operation commenced. With the instruments available at the time, the surgeon cut into the flesh widening the gash in order to withdraw the bolt head. Whether doctor or butcher this was a formidable task, after all his patient was the king, the lesion severe but ultimately the operation botched. Without the benefit of anesthetic, agony ensued. Cauterization was employed in an attempt to stay the profuse flow of blood, searing flesh and vessels using a red hot poker plunged into the incision.
Bloodletting, a common feature of Medieval medicine with a belief in balancing the four humors of yellow bile, black bile, phlegm and blood - purported by Hippocrates some 1,600 years before - only served to weaken the king’s ability to stave off infection. Leeches were let loose on the incision to sup the excess blood. After a poultice was applied, little could be done but hope and pray as the best defense against certain death. Richard’s fate was ultimately in the hands of God.
In daylight the bandage was removed revealing inflamation of the flesh surrounding the wound. It had not taken long for nature to take its course. Pustulate sores exuding from the incision were the first signs of infection - but worst was to be. The operating instruments had not been sterilized so the wound turned septic. As time progressed blood poisoning contributed to his deteriorating condition turning flesh from red to brown to black; the onset of gangrene became apparent as infection spread unabated. Richard was well aware of the debilitating effects of gangrene. He had seen it many times after wounds received in battle and knew the only sure cure was amputation. In the case of an appendage - hand, foot, arm or leg - these could be successfully severed from the body but since the disease had spread from shoulder to chest, amputation was not an option. Such a wound was not necessarily fatal and under skilled supervision he could expect to recover but the bungled operation left a dire prognosis. Although pain ravaged his body his mind turned to the person he loved most: the Duchess.