Q: In my story, set in 1908 in Toronto, a 35 year-old women who has been using corsets strenuously for many years (perhaps for 20) suffers the ill effects of the tight lacing common at that time. I want the effects to be sudden and dramatic, to threaten her within an inch of her life, or kill her. However the result, she is rushed to the hospital and doctors try to save her. In the weeks leading up to the emergency event where it is discovered that the effects of the corset on her skeleton and her organs is the cause of the medical crisis, her face is showing the effects of the impending crisis. When the emergency occurs, her dress is torn off and the medical effects, or at least their exterior consequences, are revealed. One of the problems may be that she tied the corset in such a way that it flattered her figure as much as possible (the ‘wasp waist’) but that had dire bodily effects.
Whitney Smith, London, England
www.whitneysmith.ca
A: Medical problems with corsets are exceedingly rare but there are a few things that could happen. If the corset was so tight that it fractured a rib, it could puncture and collapse a lung––we call this a pneumothorax. Though this is not typically lethal, in 1908 it very easily could have been. Now we treat these with chest tubes—plastic tubes inserted through the chest wall into the space between the lung and the chest wall. The tube is attached to a suction device and left in place for a few days until the lung heals and re-inflates. These weren’t available in 1908.
Also a tight corset can restrict breathing so that the person does not take a deep breath for extended periods of time. This can lead to areas where the lung tissue collapses––we call this atelectasis. This can serve as a location for pneumonia to develop, which could be lethal, particularly in 1908 as there were no antibiotics available to treat this.
The binding effect of the corset could also cause chronic gastroesophogeal reflux, where acids are constantly pushed up into the esophagus. This happens in people who overeat and go to bed and then wake up with heartburn. With a corset this external pressure will keep pressing on the stomach and pushing the undigested food and acids up in the esophagus. This can lead to esophagitis––an inflammation of the esophagus. This in turn can lead to bleeding, which could result in death.
If the corset was extremely tight and the victim moved in certain positions, she could damage internal organs such as the spleen, liver, or bowel. The spleen, which sits in the left upper part of the abdomen, is particularly vulnerable to this type of injury. It is often injured in motorcycle and bicycle accidents and could be injured by a corset if the victim bent over suddenly. A ruptured spleen, liver, or bowel often causes severe internal bleeding that can be deadly.
Corsets can also cause a reduction in blood return to the heart through the major veins of the abdomen and lead to dizziness and fainting. Here the victim could fall down stairs or strike her head on the floor or furniture, leading to death from bleeding into and around the brain.
Your lady could also survive any of these events. If she had a collapsed lung, it could heal itself and she could do fine. If she contracted pneumonia, she could survive even without antibiotics. If she had a bleed from esophagitis, the bleed itself could stop on its own and she could do fine. If she ruptured an internal organ, surgery could be performed to repair the injured organ or, in the case of a ruptured spleen, to remove the spleen––the spleen is almost never repaired but rather is removed when damaged. We do not need it to survive and it’s very difficult to repair. If she struck her head and suffered bleeding into or around her brain, she could be unconscious for a few hours or a few days and yet survive even though there was no real medical treatment at that time for this type of injury. With a bleed around the brain–called a subdural hematoma–the one technique your 1908 doctor could employ would be the placement of what we call Burr holes (trepanning). This is simply opening a hole in the skull with a drill or similar device, which allows the doctor to remove the clot and relieve the pressure that builds in the brain with this type of injury. If a secondary infection didn’t arise your young lady could survive even this event.
This should give you several options for your story.