A week or two ago, I put out some feelers about what my readers would like me to write about, and someone suggested writing about medical conditions in a historical context. This is something I’ve dealt with my entire writing career since my first book features an amputee main character and my latest series follows an autistic main character, and after eleven books, I have a bit of a process for researching medical conditions in a historical context. Before we get going, I will say that medical history is one of my special interests, so I tend to go down the rabbit hole because I enjoy learning about this kind of thing. Also, this research tactic is predicated on the idea that you already know what the condition you plan to use is and know at least a bit about it. If you don’t have that, start there first. If you know the condition you plan to use, onward to step one!
Step One: To Wikipedia!
Yes, yes, I know Wikipedia is not a source we can immediately trust, BUT it is AI-free, updated regularly, and linked to sources. What I like about Wikipedia for writing about diseases in a historical context is that Wikipedia often has a history section where articles from the Mayo Clinic do not. The point of researching is to find out when this condition was discovered, when it got its name, were there older treatments, etc. Step one is a cursory word and basic fact-finding mission. I would take notes about discovery, any antiquated names for it (ex. stroke being called apoplexy back in the day), antiquated cures (ex. drinking executed criminal blood for epilepsy), any past beliefs about how this condition occurred (anything regarding humors or pre-germ theory ideas). If you’re just using this for a side character or a passing sentence, you could just double check the info against the sources at the bottom of the Wikipedia article and move on.
Here is a link to a website with a bunch of antiquated names for diseases. Keep in mind that the time period the name was used is not listed, so make sure to research that. ALWAYS double check your sources/information. NEVER use AI. AI is wrecking the planet and is far less accurate than just using a basic search engine. Put in the effort to read and synthesize the information yourself.
Step Two: Research the Antiquated Name
Once we have the antiquated name for the condition, you will have an easier time finding how it was treated back in the day. My suggestion would be to try to find antiquated medical textbooks as a primary source. The National Library of Medicine has a database of old medical texts, and the Internet Archive as well as Project Guttenberg have a ton of scanned books you can look through. Once you go past the 1700s, things get a bit dicey in terms of medical knowledge as they tend to stray into alchemy and Ancient Greek beliefs in European texts on the body. Often, when researching a specific illness, you’ll find a handful of scientists or a single doctor who knew a lot about the specific condition, I suggest researching them as well because you will be able to trace back their sources and potentially find more information on how it was treated pre-modern medicine.
Aside: What if the Condition Wasn’t Known Back Then?
If there isn’t an antiquated name or mentions of the condition in a medical textbook, I’m going to assume the disease was unknown at the time your story takes place. In that case, I would suggest focusing on the symptoms and how to portray them in your story in such a way that a modern audience would recognize them. Keep in mind that even if the audience doesn’t know 100% what the condition is, they should recognize it as a medical condition and how that effects your character’s life.
While writing The Reanimator’s Heart, I debated using the word autism, even though it would anachronistic. I ultimately decided not to because Oliver wouldn’t know why he was different from neurotypical people and that would be part of his characterization. Autism wasn’t a recognized condition until the 1930s, and what we would recognize as severe or high support needs autism would have been classified as schizophrenia in the 1800s. Oliver wouldn’t have met that criteria, so it made more sense to just have him exist as someone with traits that a modern audience would recognize as autism.
In our modern world, we are quick to label things to make life easier and to clue the audience in faster, but it isn’t necessary. The vast majority of medical conditions we have now were lumped into “delicate constitutions,” “old age,” “queerness,” etc.
Step Three: Research Treatments
Now, that we know what we’re dealing with, we can now look up treatments. Those old medical books will come in handy again, and you should also look up antiquated folk medicine. If you’re writing in a time period like Ancient Greece or Rome, you have medical texts from those folks, but much like the Middle Ages or Enlightenment, there will be a lot of nonsense and magic wrapped up in the cures presented. Even with more modern eras, there will be a lot of cures that can also kill. Some will be quack medicine, others are just not great in terms of efficacy. Something I would like to stress to modern writers is that disability and death were the norm back before WWII and the invention of antibiotics. It was very common for people to get sick and never return to full health or to suffer with conditions for their whole life without much relief. More than likely, these characters will be coping as best they can, but they won’t be living at a modern “standard” of health. For my disabled readers of this post, many of you know that chronic illnesses mean always feeling off and never being at full health. When you are writing about sickness, injuries, or chronic conditions, you need to keep in mind the limits of medicine at the time you are writing within it.
Example: In Kinship and Kindness, Theo has epilepsy. When discussing his epilepsy in the story, the social/cultural context of epilepsy is brought up (saints, being possessed or divine punishment, being seen as lesser, etc.), and Theo also mentions going to a doctor in New Orleans who prescribed him bromide. Bromide was the standard treatment for epilepsy at the time and is still used today, but the dosage and purity wasn’t as well regulated, which means patients often had more negative side effects than they would today. Theo mentions how the bromide made him feel catatonic and awful to the point that he stopped taking it and tried to manage his stress (seizure trigger) instead.
Aside: Can We Finagle a Treatment?
Often, there isn’t a good treatment for a condition during the period in which the story is set, but we might be able to look at modern treatments and see if there is anything that might help that existed back then. For example, I have eczema, which means in the past I would have been a cracked and inflamed mess, but in the late 1890s, doctors realized coal tar helps treat eczema. The character might have had some interaction with the substance and then tried to mix it with animal fat or lotion to create a cream. Vaseline also came on the scene in the late 1800s, and that would also be used to help calm the itching and soreness. The character might also notice that when they interact with things that make their nose run, their eczema worsens (allergies weren’t a diagnosis until later). I would be cautious with creating treatments because you want to keep in mind that, like modern supplements, they can help lessen symptoms, but they aren’t curative or able to fully treat a condition.
Aside: What About Magic?
Magic and congenital conditions or neurodivergence is where things get dicey. It’s easy to veer into ableist territory when we magically cure things that are innate parts of the person. I think the best way to think about it is, would removing this thing change who the person is fundamentally? With autism and other flavors of neurodivergence, the community generally states they would rather be accepted than cured. This also goes for many parts of the disabled community. Treating symptoms that make life hard and creating a more inclusive world through world-building is better than eliminating disabled characters entirely. Do your due diligence in regards to ableism and disabled or neurodivergent representation (sensitivity readers can help).
Step Four: Time to Write
Now that you have done as much research as you can, it’s time to write this character. My main suggestion with this is to remember that the character is a person first. They are a person with a condition or disability, not a walking pile of symptoms. You should research what it’s like to live with the condition you’re writing about and keep the community’s experience at the forefront. People with disabilities and chronic conditions (or injuries) are still going about their lives, sometimes having jobs, loving their partners and/or families, and they have hopes, dreams, goals, feelings, etc. We certainly have times where our conditions are at the front of our minds more than other times, but we aren’t 24/7 hyperfocused on our symptoms because we live with it all the time. Your ableist leanings will show through if you haven’t worked through them yet, and while it is fine to explore a character’s internalized ableism or how they deal with ableism, we want it to be purposeful rather than something that snuck in because you have some ableist feelings about disabled or neurodivergent people. As always, do your homework and be respectful.
I hope this article helped you figure out how to research diseases and conditions while writing in the past. If there is anything you would like me to write about in the future, feel free to leave it in the comments.
Kara Jorgensen 