Q: I am about to start my next novel, which is set in the 16th century, and narrated by a young woman who was a dwarf. It is unknown what form of dwarfism she suffered from and her height was never recorded. She is sometimes described in the historical record as having a twisted spine or crooked back if that is relevant. She also died young, in her late 30s, possibly of what would today be called pneumonia. Could you tell me any common medical problems, including any gynecological ones if there are any, generally suffered by female dwarves?
Brandy Purdy, author of The Boleyn Wife and The Tudor Throne.
A: There are several types of dwarfism and you can read about them in Wikipedia or by Googling dwarfism. There are many medical problems associated with dwarfism. Most are musculoskeletal in origin and therefore your character could easily have scoliosis or some other spinal problem that could cause pain and interfere with mobility, sometimes to a significant degree. In addition, these individuals often have significant bowing of the legs and as a result can suffer hip and knee problems that require braces or walking assist devices such as canes. Now there are surgical procedures to help these problems, at least to some degree, but none of these were available in the 16th century. Nor were there any real pain medications. Your victim would simply have to suffer the discomfort and move around as best she could. It’s possible she could use canes or perhaps a rolling platform that she squatted on and propelled herself with her hands. Not sure if these were really available in the 16th century but I wouldn’t be surprised if someone didn’t come up with something like that, and, even if not, you could use it in your story.
Everything about dwarfs is small and therefore a lung infection such as bronchitis or pneumonia could be particularly treacherous. Smaller airways require less inflammation and swelling to cause serious breathing difficulties. In the 16th century there were no antibiotics and therefore no treatment. For this reason pneumonia carried a fairly high death rate in everyone. This would be particularly true in a dwarf.
Pregnancy would be a major issue in a female dwarf. Simply put, the child would grow normally but would do so inside a very small person. As the fetus grew there could be significant discomfort and it is possible she could even suffer uterine rupture and death. Of course if she carried the child to term and if delivery were attempted in the normal fashion, there could be what we call cranio-pelvic dissymmetry. This simply means that the infant’s head is too large to pass through the mother’s pelvic opening. When labor began, there would be great pain and the potential for both maternal and fetal death. This entire process could take many hours, even days, and the mother would begin to bleed and the potential for uterine rupture would be great. Such a rupture would be accompanied by severe pain and profuse bleeding. During all this, whether there was uterine rupture or not, the child would die. A C-section would have to be done to avoid these horrible complications and that was a risky undertaking in the 16th century.
So musculoskeletal problems would be the greatest difficulties your character would have but infectious processes and pregnancy could be deadly. And all of this does not begin to cover the psychological and social difficulties that these individuals had to endure, particularly in the 16th century when prejudices were strong and deep.