Posted by Outlander Anatomist | Fun Facts

grume, blood clot, outlander

Starz episode 307, Creme De Menthe

Anatomy def: Grume is an archaic word for a mass of blood, as in blood clot. Clots form as a protective mechanism designed to staunch the flow of blood from breached vessels. Our modern equivalent term is hematoma.

Outlander def: In another “Claire, what-ha’-ye-done!!!” moment, our good doctor fells John Barton, Esq., by slashing his leg with her wee knife! Puir John trips, falls and strikes his head on the stone hearth.  Let this be fair warning to all excisemen – dinna mess with this Surgical – Sassenach – she is licensed to wield a blade!

Learn about grumes / hematomas in Anatomy Lesson #37, Mars and Scars.

Claire quickly diagnoses John’s injury as an epidural hematoma (epidural bleeding), a type of grume formed between skull and dura (outer covering of brain). Claire makes this diagnosis because:

  • The fall renders the bad-lad unconscious.
  • The left side of his head strikes the stone, imperiling the middle meningeal artery which supplies the dura.
  • Blood drains from John’s left ear, a symptom consistent of a epidural hematoma.

Imaging tests would confirm her diagnosis, but such tests lie 200 years in the far future, so Claire takes her best clinician’s 18th century shot.

Left untreated, a grume compresses delicate brain tissue and may result in fatality! Thus, we witness Claire’s urgency to obtain a trephine (skull drill) from the nearest barber surgeon (18th century Edinburgh likely had one on every street). Drill through the skull to drain the blood and relieve pressure on the brain.

Sadly, her valiant efforts fail: the taxman cometh, the taxman goeth! 😱

Read about blood clots in Herself’s terrific tome, Voyager (grumes appear in pretty much all of Diana’s books!):

Aye, it’s no more than a wee dunt,” he said, smiling up at me. There was a small gash at his hairline, where something like a pistol butt had caught him, but the blood had clotted already.

See Claire wield the wonderfully arcane trephine in Starz episode 307, Creme De Menthe!  Where in the world did Outlander special effects obtain that splendid drill? Fun, fun! Kudos to all!

A deeply grateful,

Outlander Anatomist