The Mortal Blow


Why does the victim die? This is where research into medical matters comes in. It’s not only a case of finding out how the death can occur. I have also to ensure that such a death could be recognised at the time of the setting of the story.

Thus you will see here, part of my notes copied from articles to show how a rib fracture could cause a man’s death. Also that this particular type of medical condition was known and could have been learned by Ottilia from her doctor brother, Patrick.

The other note concerns folding razors. I didn’t know when these were available, so these research notes were to discover whether the razor involved in this story would have been a folding one.

This sort of research is par for the course when I am working on a Lady Fan mystery.



Only Hippocrates had mentioned the association of chest wall injuries and haemoptysis as a result usually of rib fracture.

The importance of pneumothorax and haemothorax was realized in the 18th Century and many devices were devised to suck wounds out of the chest, sometimes using the mouth of a specialist to use his own inspiration to suck air or fluid from that of the injured.


An early description of traumatic pneumothorax secondary to rib fractures appears in Imperial Surgery by Turkish surgeon Şerafeddin Sabuncuoğlu (1385–1468), which also recommends a method of simple aspiration.[44]

Pneumothorax was described in 1803 by Jean Marc Gaspard Itard, a student of René Laennec, who provided an extensive description of the clinical picture in 1819.[45]

Gaspard’s work would have been known during late 1780s.

Tension pneumothorax is the progressive build-up of air within the pleural space, usually due to a lung laceration which allows air to escape into the pleural space but not to return. Positive pressure ventilation may exacerbate this ‘one-way-valve’ effect.

What are the signs and symptoms of pneumothorax?

  • chest pain that usually has a sudden onset.
  • The pain is sharp and may lead to feelings of tightness in the chest.
  • Shortness of breath,
  • rapid heart rate,
  • rapid breathing,
  • cough,
  • and fatigue are other symptoms of pneumothorax.

collapsed lung feels like a sharp, stabbing chest pain that worsens on breathing or with deep inspiration. This is referred to as “pleuritic” because it comes from irritation of nerve endings in the pleura (inner lining of the rib wall).

pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. … In a minority of cases the amount of air in the chest increases when a one-way valve is formed by an area of damaged tissue, leading to a tension pneumothorax.

A tension pneumothorax is when air builds up inside the chest. So much air builds up that one or both lungs may collapse. This causes serious breathing problems. … If it is not treated quickly, a tension pneumothorax will kill a person.

Spontaneous pneumothorax is regarded as a common and benign clinical entity, however, it can be lifethreatening if it progress to tension pneumothorax. While tension pneumothorax can develop abruptly, cardiovascular compromise progress more gradually due to the existence of a compensatory mechanism.


straight razor is a razor with a blade that can fold into its handle.[1][2] They are also called open razors and cut-throat razors.[3][4][5]

The predecessors of the modern straight razors include bronze razors, with cutting edges and fixed handles, produced by craftsmen from Ancient Egypt during the New Kingdom (1569 – 1081 BC). Solid gold and copper razors were also found in Ancient Egyptian tombs dating back to the 4th millennium BC.

The first steel-edged cutthroat razors were manufactured in Sheffield in 1680. By the late 1680s, early 1690s, razors with silver-covered handles along with other Sheffield-made products known as “Sheffield wares” were being exported to ports in the Gulf of Finland, approximately 1200 miles from Sheffield. From there, these goods were probably sent to Finland and even Russia. By 1740, Benjamin Huntsman was making straight razors complete with decorated handles and hollow-ground blades made from cast steel, using a process he invented. Huntsman’s process was adopted by the French sometime later, albeit reluctantly at first due to nationalist considerations. In England, razor manufacturers were even more reluctant than the French to adopt Huntsman’s steel-making process and only did so after they saw its success in France.

After their introduction in 1680, straight razors became the principal method of manual shaving for more than two hundred years, and remained in common use until the mid-20th century.[6] Straight razor production eventually fell behind that of the safety razor, which was introduced in late 19th century, and featured a disposable blade. Electric razors have also reduced the market share of the straight razors, especially since the 1950s.[5][7][6]

Folding razors similar to the type used on the victim