The Disease history book cont’d…

More fascinating notes from the book, Disease by Mary Dobson. (Part One of review is here.)

According to the author, the actual origin of the popular drink of gin-and-tonic actually got kickstarted with the disease malaria and its not-very-tasty medicine, quinine.

In the early days of the British Raj, there was a big public health problem with malaria, and quinine was a main staple of malaria prevention and treatment. Dobson reports that the British people would add quinine to Indian tonic water (to make it taste better?) and that led to the basis of a gin-and-tonic.

(Something similar happened in the States as well: during the U.S. Civil War, every Union soldier in the malarial zone was given a daily dose of quinine sulphate dissolved in whisky. Huh.)

Unrelated random fact: One famous smallpox survivor was Queen Elizabeth I who contracted the disease in 1592. Her penchant for wearing her face covered in white lead and vinegar is thought to have been her strategy to cover up her smallpox facial scars. They are also thought to have been the reason why she didn’t want to get married as she didn’t want to show anyone her scarred skin. (Poor thing.)

Stalin had smallpox as well, btw, but he had all his photos touched up to hide that. (Remind you of any other orange-colored world leader who would also probably do that?) President Lincoln survived the same disease. And so did Pocahantas (who died in 1616 on a visit to England, possibly of smallpox.)

Moving on to polio and its history of vaccination: I didn’t know this, but in 1955, Cutter Laboratories (a U.S. company and one manufacturer of the then-recently licensed Salk vaccine), distributed faulty serum. A total of 200,000 people were inoculated with this serum which then turned out to contain “virulent non-attenuated polio virus”. Seventy thousand people became ill; 200 children were left paralyzed and ten died. (I’m wondering if this is controversy is somehow related to the ferocious antivaxxers of today? Vaccinate your kids, folks.)

So, by now, you might have surmised that I may have enjoyed this gruesome but straightforward book. I really did (and so much so that I’m going to keep this copy to read at another time).

However, there was one (easily preventable) thing that kept popping up – poor production work with the graphics.

Whoever the poor soul was who added the graphic elements to one of the later proofs kept overlaying their image outlines so that the rest of the image field would cover up one end of some of the paragraphs which meant that there were whole sections of text where you had to sort of guess what it was trying to say.

I don’t want to seem too judge-y. It’s an easy thing to miss, in general, but proofreading/editing should have happened. I would have thought that if you had a well-written serious tome about public health hazards from the past, the least you could do would be to check for that novice error. (Maybe it was an intern. It’s intern season…) 😉

If I had been Dobson, I would have been disappointed in the final product (if she ever saw it): her research, her words, probably her collection of illustrations – and then there is that?

That aside, the book did have some lovely qualities: glossy pages, plenty of high-res graphics, loads of historical ephemera and lots of intriguing sidebars with fascinating bits and pieces about whatever disease was the topic for that section.

Ghoulish but fascinating. Highly recommended.

Just FYI: Other medical history (or medical-related) reads for JOMP include:

Disease: The Extraordinary Stories Behind History’s Deadliest Killers – Mary Dobson (2007)

Now, there is a dismal solitude… shops are shut… people rare, very few walk about… and there is a deep silence in almost every place. If any voice can be heard, it is the groans of the dying, and the funeral knell of them that are ready to be carried to their graves.

Thomas Vincent, describing the Great Plague of London, 1665-1666.

Seeing as we are in the midst of this current pandemic, what better time (thought I) than to read more about other diseases that have occurred throughout history. So, shopping my TBR shelves, I found this book…

This title was written by Mary Dobson, a medical historian who was director of the Wellcombe Unit for the History of Medicine and a Fellow of Green Templeton College, Oxford. (Thus, she knows her facts and there are a lot of them. She’s also, pleasingly, a very good writer.) 

As the book’s subtitle tells you, the contents cover health emergencies over the years, ranging from syphilis to schistosomiasis (due to parasitic worms in tropical aquatic snails) to SARS and bird flu. 

It was really interesting to read that Dobson, a scholar of medical history, also mentions the then-current widespread concern for another modern flu pandemic, perhaps from animal vectors (and this was when the book was published in 2007, 13 years ago).  And yet the Orange Goblin disbanded the U.S. Pandemic Taskforce last year since “we didn’t need it anymore.” <smh>

[Aside: I am so curious to read the not-yet-published NF account of this particular current-day pandemic. You know there are gonna be a few titles out there that will cover it.]

Back to the book: the chapters are divided into Bacterial Diseases, Parasitic Diseases, Viral Diseases and Lifestyle Diseases, and each chapter (and disease) goes into depth (including pretty detailed timelines) to cover the basic history of the topic for that section. It was absolutely fascinating for me.

Since I am a medical history nerd, I thought it might be best to approach this using bullet points. Here we go: 

  • Quarantines first started when the Black Death arrived at a Venetian colony called Ragusa. The inhabitants detained travelers from an infected nearby island for thirty days (or trente giorni). This time period proved not quite long enough so they increased the time period to forty days (or quaranti giorni) – thus, the word “quarantine”. Now you know… 😉 
  • Speaking of plague, you may remember that 17th-century physicians had the wearing-a-mask activity and social-distancing down to a science… They would also stuff herbs down the beak to help cover up the smell of rotting flesh. (See pic below.) Luckily, we don’t need that just yet. 🙂
  • Another word-related random fact: stethoscope. Invented in 1816 by French physician Réné Théophile Hyacinthe Laënnec (1781-1826), who had been embarrassed when treating a young overweight woman patient. He had wanted to listen to her heart but didn’t want to put his ear directly against her chest, so he rolled up a tube of newspaper and bingo – the start of a new medical instrument. (“Stethos” is Greek for “chest”, and “skopein” means “to look at”.) 
  • And OMG. I was thoroughly grossed out by the discussion of human worm infestations. One rather ethically-dubious experiment concerns two criminals who had been both condemned to death in the mid-19th-century. A researcher called Friedreich Küchenmeister fed the prisoners some pig meat with worm larvae inside it, and once the men had been put to death, scientists recovered adult tapeworms from their innards, one measuring 1.5m (or about 5ft) long. Euuugh.  (One good thing about worms: they have potential to treat human illness as a form of biotherapy, but you’d have to (heavily) sedate me long-term for that procedure if the worms are alive when they’re put in me.) 
  • The word “vaccination” originates from Latin “vacca” (which means the word for “cow”). Pasteur gave the procedure that name in honor of earlier researcher, Edward Jenner (1749-1823) who came up the idea of inoculating healthy people with cowpox to give them immunity to the more virulent and fatal smallpox, a big problem at the time. 
  • Speaking of smallpox, why is it called “small” pox? Possibly to differentiate it from syphilis, another disease with pustules and called the “great pox”. 

And there is more really interesting info, naturally, in this read but I don’t want to wear out my welcome with you. (You might not be quite so taken with medical history as I am!) 🙂

So – expect Part Two in an upcoming blog post, and in case you’re not sure, I really enjoyed this particular read! 

One of the 17th-century physicians wearing the plague-avoidance outfit of the time. Not such a far remove from the mask and glove requirements of the current day. 😉

A Book on Medical Discourses in Two Parts – Rebecca Crumpler, M.D. (1883)

My chief desire in presenting this book is to impress upon somebody’s mind the possibilities of prevention.

Traveling around the web, as one does, I came across an interesting nugget of American history when I met Rebecca Lee Crumpler who was the first African-American female physician in the U.S. when she graduated from the New England Female Medical College in 1860. (She was also the college’s only African-American graduate.)

Consider this statistic: there were only 54,543 physicians in the whole of the country in 1860. Only 300 of those physicians were women and Crumpler was the only African-American female physician. (And, in fact, as late as 1920, there were still only 65 African-American female docs in the entire country. I wonder what the stats are now…

(ETA: Only 4 percent of practicing physicians in 2016 are African-American, most graduating from HBSUs. Only 2 percent of nation’s physicians are female African-Americans. Female physicians now make up 34 percent of the whole physician population, but are still underpaid compared with men (64 cents for every dollar a man earns). Overall population of US (now) is 15 percent black (2013, US Census Bureau).)

Back to Crumpler: Crumpler was a remarkable woman and this is thought to be the very first medical text by any African-American author.

Imagine the U.S. as the country as it was then when Crumpler was getting her medical education as a “doctress” (as the title says). How very courageous and determined she was:

  • 1860 – Crumpler graduates from the medical college as a “doctress”.
  • 1863: US Emancipation Proclamation (meant that slaves were now free in the Southern/Confederate States).
  • 1865 – US 13th Amendment ended slavery in all states. Establishment of Freedman Bureau (agency to help millions of black slaves and poor whites in the South after Civil War.) (Actually, Crumpler and her hub moved to Virginia to work for the bureau and “more than 30,000 colored” after the war.)
  • 1868 – 14th Amendment secured American citizenship for African-Americans.
  • 1870 – 15th Amendment secured voting rights for African-Americans (on paper)

But obvs slavery still happening. (Look at Barracoon by Zora Neal Hurston (2018) which covers the life of Oluale Kossula who arrived in the U.S. from West Africa where he had been captured as part of the slave trade in 1860, same year as Crumpler is attending her first year at the medical college.)

Rebecca Lee Crumpler, doctress.

So, absolutely loads to think about with this nonfiction read, and that’s not even getting to the actual contents just yet!

Since this book is more of a how-to manual for the healthcare of people (not just African-Americans although they may well have been the main (and only audience for this text), I’ve put together a few notes on her healthcare guidance during this late Victorian period in case you’re curious. (Crumpler was also more than likely to only have been allowed access to care for the African-American populations as well…)

It’s in a bullet list since that seemed the easiest way to present such disparate info:

Baby health advice (under 5s):

One of the main baby healthcare advice chapters is titled this: Necessity of Agreeable and Soothing Surroundings. It’s meant to be in reference to infants but it certainly works for me as well. 🙂

All loud talking or laughing should be strictly prohibited. To insure this, no sly jokes should be indulged in by anyone present; for by so doing convulsions of an alarming nature may be brought on. “  (Chapter 5)

If the baby has a rattling or wheezing noise in its throat, Mrs. Crumpler recommends using a real feather (that has been wetted to tamp the down) to tickle the back of the tongue to make the child cough or gag… Don’t give the baby “soot tea”, by any means.

Saffron tea is really crocus tea?  And was popular for baby’s poop problems?

Don’t give infants a “little weak toddy” to “bring up wind and make them sleep”. It can cause intoxication and then a “fearful attack of purging”. Plus it may “inculcate a desire for tippling in many of our weak-minded youth”.

Later on: watch out if giving your baby any alcohol: it “tends to stunt the intellect and dwarf the stature of the youth of our land…”  

And no oysters for the young one: they are “most dangerous”. A broiled lamb chop of beef would be fine to give the baby though, as support for the diet of mother’s milk though. (They help to prevent “cholera of infants at the breast, especially in our crowded cities”.)

And too much soda (i.e. in making breads) makes your baby bald.

And don’t overfeed or do the “coarse habit of ‘stuffing’ babes, to avoid frequent feeding of them” – the habit needs to “vanish like dew before the noonday sun” …

Children who eat candy are also at risk of developing “dwarfed statures”… but kids will also be troubled with worms at the same time (due to the candy).

If your child is teething, “the greater mischief is done to the whole nervous system by the unnatural but ancient custom of pressing and rubbing gums – it is possible to trace the cause of insanity to this pernicious custom

Teething and not wearing shoes in puddles are believed to be a combo that directly cause lung fever (another name for pneumonia) in infants. If your child does get pneumonia, the best treatment is “patient watchfulness, pure air and absolute quiet”.

Apparently, babies have always been tough to get to sleep. “Many children screamed with fright at the noise created to get them to sleep”… What were the family doing to make the kids scream when they’re trying to get them to go to sleep? The mind boggles…

Once you do have your child sleeping, don’t let your baby sleep too long in soiled clothes: it can cause “soft bones, enlarged joints, inverted feet, flattened back-heads, sickening sores, dropsy, blindness or numerous ills”…

If you are a family of “moderate means” and you are not able to keep more than one fire going in your house during the cold season, taking a baby from a hot room to a colder one can cause frequent and severe colds… So, try to live with all your rooms on the same floor in your tenement to avoid (or mitigate) this problem and help the heat (from your one fire) spread throughout the house more evenly…

If your baby does has a lot of snot in his/her nose, try to unstop it with goose oil on a feather. But – be gentle. If you’re not careful, you can break the baby’s nose and that causes cancer. (What?)

Reading for kids is also dangerous:
Can you not cut short the certain destruction that awaits your sons and daughters, through the influence of impressions gained by the constant perusal of fictitious, and in many cases, corrupt library books?

For a breast-feeding mother:

If the mother’s nipple [for breastfeeding] is not prominent for the baby to suck, “a friendly adult or child could soon draw out the nipple by sucking so that the babe can get hold…” !!

(Just try not to do this when one’s mouth is full of snuff as it can cause other health problems (including “instant death”) for el bebe who breastfeeds immediately after this.)

If a new mom is waiting for her milk to “drop”, watch out: “diarrhea, convulsion, or even insanity may be brought on through the means of any excitement whatever” unless you’re careful… Diarrhea is also caused by “emptiness” in a baby (or a baby being hungry).

Don’t drink a glass of iced water when your baby is breastfeeding or this could happen: “the babe was seized with rigid convulsions and dropped from the breast” while the mother became “almost helpless with fright”…  But some quick-thinking from Mrs. Crumpler with a tub of hot water and some mustard managed to save the day… Phew.

Do try to avoid cholera if you can:

There was a whole chapter on the issue of child/infant starvation – it must have been a huge problem for the many poor families… Plus, failure-to-thrive (or malnourishment) was also seen as an early symptom of cholera in children (and cholera was one of the largest causes of infant mortality in those days)…

Cholera could also be caused by the mothers adding in a mixed or meat and veg diet too early after the birth of a child. (Poor mothers! They get blamed for everything!)

Cholera also increases the risk of having a “hair worm” which had been noticed to “infest the throat of some patients”. (Woah. What is that “hair worm” thing?)

And what is the cause of infantile cholera? No one really knows at that time, but Mrs. Crumpler swears that it’s not contagious but does offer this nugget: if you’re in a crowded space in the middle of a cholera epidemic, it’s best to leave if you can. Poverty, “wretchedness” and crime spread cholera.

And who’s responsible for all this?…

Places a heavy blame on mothers to “make a little sacrifice for the sake of equipping the mind” and look after their children better… Also, the child studying too hard can endanger your child’s health.

Mothers should learn more about health and prevention of illness, and get this: Crumpler, unsurprisingly, is pro-women’s vote. (But this wouldn’t happen until 1965!)

(But she does earnestly wish that mothers would try harder to not give their children to the alms houses… “Our women work hard, seemingly…” ooh. Them’s fighting words.)

Crumpler also strikes a critical note when she reports that women “appear to shrink from any responsibilities demanding patience and sacrifice”… Yikes.

She also blames the declining mortality in the “colored population of Boston” on “neglect to guard against the changes of the weather.’’

Advice for women’s health in general:

Exercising during your period will cause you to go barren, have ovarian inflammation, dropsy or consumption. (Periods also called “bringing on the turns”).

Monthly cramps are caused (and worsened by) having cold and/or wet feet (or even when sweeping the floor). Interestingly, another household task (sewing at a treadle sewing machine) also causes vaginal ulcers (mainly from getting frustrated with the machine itself). (This, although very serious stuff, cracked me up at the time since I remember frustrations when I was learning to use my mum’s treadle sewing machine. Not sure about the vaginal ulcers but definitely caused me some strife!)

Poverty, with chastity, is an enviable condition.

Menopause is worsened by drinking ice-water (which, in fact, could cause paralysis) and helped by “securing cheerful exercise for the mind, with an abundance of outdoor scenery”… Drinking more water just prolongs the hot flashes.

(But how best to control the size of your family (i.e. birth control)?: Mrs. Crumpler recommends that “if these little ones are given in quick succession, it is just as well to have and get through with it. Many are the women who have borne a dozen or more children into the world, and afterwards filled positions of trust and nobility…” Huh.

Colds are typically caused by northeast and easterly winds…

Beware of sudden changes in air, food or medicines (especially those that contract or depress muscles): “may cause suffocation and death at any moment.”

Tumors of all kinds are caused by fish, eggs, oysters, pork, gaseous vegetables, and anything that depresses or excites the mind. Also, gas and “loaded bowels”. Anointing the entire body with goose oil should help.

Brain fever was caused by “some irregularity, over-work or undue excitement” and effective treatment includes shaving your head sitting in a cool dark room and keeping wet cool material wrapped around your neck.

Fascinating stuff!

The Emperor of All Maladies – Siddhartha Mukherjee (2010)

Subtitle: A Biography of Cancer. 

I’d noticed that my recent reads were rather slacking on the diversity side of things, so wanting to address that along with maintaining with my push to read more TBR, this nonfiction read was put into the sights. Wow. Mukherjee can write (as evidenced by the oodles of literary prizes and recognitions that have been piled onto this book). 

Like many others, I’ve had a brush or two up against cancer and when a recent visit to my dermatologist led to a diagnosis of melanoma for a recalcitrant mole, I wanted to learn a bit more about this disease. What better way to do that than learn from the 2011 Pulitzer Prize for General Non-Fiction winner? 

Now, I must admit that this wasn’t the easiest read in the whole world – not because the idea of cancer is scary, but because I am not that well versed in molecular chemistry and there are quite a few chapters that talk about cancer cells and how they work. 

So there were some patches in this book that were a little above my paygrade and science knowledge, but Mukherjee does an excellent (and patient) job of explaining this really complex topic in a way that a non-science person can follow without too much trouble, and I would argue that this is what won him all the awards. 

He makes the world of cancer approachable for a lot of people, and when a life-threatening subject such as cancer enters a patient’s world, the more you can understand something, the less scary it will be. 

As the subtitle reports, this is a “biography” of cancer and Mukherjee has organized this massive subject into a logical and well-organized read. It’s a solid mix of personal (Mukherjee is a practicing oncologist) and the professional, and sources range from patients dealing with the diagnosis to researchers in labs across the world furthering their understanding of cancer, but however (and wherever) the author travels, he makes sure to include you as the reader and allows you to follow his trails. It’s a really impressive achievement to be able to reach both the science reader and the lay reader at the same time without alienating one or the other. 

At the end of this, I have to say that I have only admiration for all the players involved in this world: the cancer itself is an amazing disease – even more amazing once you learn how it adapts and reacts to any attempts to control it.

I was going to say that cancer is almost a living entity, but then thought about it again, and of course, it is a living entity (thus this book has the perfect subtitle: a biography). It’s adaptable, it’s ever-evolving, it learns from its environment… Is it curable? I don’t know if it is, but if anything, this read brings a renewed spotlight on the importance of cancer prevention. That’s where the focus will need to be for future generations. 

So, not the easiest read in the entire world, technically speaking, but a fantastic journey. 

For Her Own Good: Two Centuries of the Experts’ Advice to Women – Barbara Ehrenreich and Deidre English (1978/2005)

Continuing with my ongoing goal of reading from my own TBR (ha!), I pulled down this title. I’ve read Ehrenreich NF before (such as Nickel and Dimed: On (Not) Getting by in America [pre-blog]) so I knew to expect a well-written and pretty thoroughly researched non-fiction read from her (and the co-author), but what I was really impressed about was the breadth (and depth) of this look of women’s health (and the accompanying [mostly male] advisers. 

So – what is this book about? It’s an almost academic survey of how the health of women (and thus women themselves) have been on the receiving end of very questionable “scientific” advice over the years, and since it was a large overview of a long period of time, it was interesting to see the general patterns of the authoritarian (mostly male) through the years. 

For example, it’s pretty well known that the Victorian woman was treated as though she was an infantile imbecile by the males (and some females) in her life, but it was amusing to see how the advice from the “scientific experts” evolved from this to the Edwardian woman (who was told that her whole life was to produce children but then hand them over to a nanny or similar) to the next generation of women who were advised to treat their children via the whole “children should be seen but not heard” paradigm, to another stage when the foci of the family was to please the child first and foremost… and so it continues.

I am hoping that the most recent trend of viewing children as “equal” in power to (or sometimes with more power than) the parents will end soon, as I am seeing the result of that in some of the college students in my classroom at times. 

(The Helicopter parent has now been replaced by the Lawnmower parent, it seems. Lawnmower parents do more than the hovering of the Helicopter parent: the Lawnmower group actually leap into their adult child’s life and mow down any obstacles for their kid. Thus, the analogy of the Lawnmower… Of course, I’m not asserting that every parent does this, but it is common enough to be a “thing” in higher ed.) 

The “expert advice” for women has also evolved in tandem with the evolution and maturation of science as a discipline, since according to Ehrenreich, almost every piece of advice has been painted with the color (and authority) of science, whether it was crud or not. People followed what these “experts” recommended, regardless of how wacky the advice was. (This also follows with the notion that women were also infantile and did not have the wherewithal to make their own health decisions.) 

(Thinking about it, it’s a horrifyingly interesting exercise to see how this is playing out right now in some of the states and their recent (anti-)abortion laws. Women are still being told how to control their bodies by large legislative bodies of ill-informed men. Plus ca change…)

So, anyway, I really enjoyed this provocative (in terms of “thought-creating”) read, and if you’re interested in medicine, in women’s issues, in medical history… you’d enjoy this title. 

(Note though that this book was originally written in 1978, but the text has been updated in pieces. The updating is a little patchy in places, but overall, it’s a really interesting read as both a piece of history and an overview of social issues.) 

Words new to me…

Parlous: full of danger, precarious. (Also, in the olden days, it would mean excessive…) 

Anatomization: the process of cutting something natural apart to learn about its internal structure et al. Example: medical students will dissect a body in the morgue to learn more about how how everything is connected in the human.

Velocipedes: An early form of bicycle that is propelled by working pedals on cranks fitted to the front axle. (See pic below.)

Camera lucida: optical device that allowed surgeons to trace images projected onto a piece of paper and then “practice” their cutting skills using that. 

Pultaceous: having a soft consistency; pulpy.

Ragged Schools: 19th century charity schools in England around 1840s. Provided free education, along with a home, food etc., for those students who were too poor to pay. 

Hectic fever: this is a type of fever that sustains itself during a 24-hour period. 

Pyemia: another name for blood-poisoning (septicemia) caused by spread in blood stream of pus-forming bacteria released from an abscess. 

Erysipelas: a skin infection caused by Strep (typically). 

Hospitalism: the adverse effects of a prolonged stay in hospital. (Also called anaclitic depression). Common pediatric diagnosis in1950s for infants required to stay in hospital for long periods of time and due to their mental health (from loneliness, lack of human touch etc.) would waste away. 

Carious: decayed. 

Animalcule: old name for a microscopic animal. (Latin for “little animal”.) 

De novo: starting from the beginning of something.

Cicatrix: the remaining scar of a now-healed wound.

Antiseptic:from “anti” and “septic ” so material to prevent further infection leading to sepsis. Obvious to me now, but honestly, I hadn’t put that together before reading this. Duh, I know. 

Aleatory: depending on the throw of a dice; chance; random. 

Flaneur: a person who handles the art of strolling or sauntering. 

(Mostly taken from the title, The Butchering Art by Lindsey Fitzharris (2017).)

A velocipede in action. (Note pedals are on front wheel.)

The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine – Lindsey Fitzharris (2017)

“The ascendancy of knowledge over ignorance, and diligence over negligence, defined the profession’s future…”

If you are interested in Victorian times, in medical history, in social history, in well-told narratives… have I got the book for you. The Butchering Art by Lindsey Fitzharris ticks all the boxes for me with regard to having a great read: dry sense of humor, loads of facts, about a time period that I’m very interested in, and medicine? Yes please. 

I think that it’s quite amazing how fast (and how far) medicine (especially surgery) has come from its roots in Victorian science. In close to 150 years, we’ve completely reshaped the goals and methods of surgery, along with significantly reducing the death rates associated with that. When you keep in mind just how grubby surgery was, it’s an astonishing leap forward. 

So, always curious about the history of medicine, I was trawling my TBR shelves (go me!) and stumbled upon this title. Shortlisted for the 2018 Wellcome Book Prize along with other notable accolades, it was a brilliant read and one of those “read at the right time” situations for me. I loved it. 

So, what’s the book about? It’s revolves around Joseph Lister (1827-1912), a surgeon who introduced new principles of cleanliness (along with the germ theory) which went on to transform surgical practice and reduce post-operative mortality (or “ward fever”) deaths by huge numbers. Or, as the book says, the shift in medical procedure from antisepsis (germ killing) to asepsis (germ-free practices). It’s quite the story. 

Fitzharris reports that during this period of time, surgery was traumatic and risky. No anesthesia was available, surgeons’ cleanliness habits were anything but, and this was a time when most physicians believed that pus from a surgical incision was a “good thing” instead of an ominous onset of sepsis. In fact, surgeons were known as having a particular odor when they were working: “good old hospital stink” which was really the smell of rotting flesh and blood from their time in the operating theater. Crikey.

It was actually safer to have an operation at your own home (instead of in hospital) – hospitals had mortality rates that were three to five times higher. Curiously, Death was known at the time as Old Jacky, and some patients were said to be able to predict who would recover and who would die during surgery. Odds were that the patient would die… 

In fact, hospitals were such filthy places that many of them had a person who was charged with going around to rid the patient mattresses of lice. In fact, this person was more highly paid than surgeons, so that demonstrates how important hospitals viewed this lice person. 

Despite being such places of high mortality rates, there were a lot of hospital expansions and excitement about new techniques for surgeons at this time. The latest official medical text, The Art of Surgery, was in its ninth edition and was such a respected resource that a copy of it was given to every single doctor in the federal army during the U.S. Civil War. 

The medical field was still ignoring germ theory though, and so public health was still pretty terrible, particularly for those who were in poverty. The world’s first flushing toilet came about during Albert’s Great Exhibition, and more 800,000 people paid a penny to test these facilities out for themselves during their visit. 

(Interestingly (for me – maybe not for you!), this is where the English saying, “going to spend a penny” (for needing to go to the lavatory) arose. I remember my grandma frequently using this euphemism when I was growing up, and it was because in my childhood (1960s/1970s), the lavatories at the local park would have a locking mechanism so anyone in need would have to put a coin (usually a big penny) into the slot before it opened. I can only imagine how many wet pants this tradition caused British schoolchildren as they didn’t have a penny to use.) 

London, packed with all these thousands of visitors for the Great Exhibition, was not really equipped to deal with the teeming masses, and there was a time when the river Thames was called “The Great Stink” due to it smelling particularly badly due to the huge amount of human excrement that had piled up on the riverbanks. Yuck, but where else were people supposed to go? 

One of the old locks that used to guard the access to the public lavatories back in the 1960’s/1970s in England. No penny? No luck. 🙂

Back to Victorian medicine: Fitzharris uses a wide variety of sources for this history, including one called the Yearbook of Medicine, Surgery, and Their Allied Sciences, which gave the helpful statement: 

“The bandages and instruments which have been employed for gangrenous wounds ought not, if possible, to be employed a second time…” 

This was the world of medicine that Lister entered, after having given his first speech at his new job in LATIN because the establishment believed that that showed these men (of course) were of higher learning. (Imagine the reaction of today’s surgeons being told to do that…) 

(Non sequitur: Glasgow (in Scotland where Lister’s first job was) was actually growing in such numbers that people called it “the second City of the Empire” after London. Well, didn’t know that.)

I think it’s best to do bullet points from now on…:

  • Lister was extremely interested in the parallel work of Louis Pasteur and his research on fermentation and the decomposition of organic matter. Lister was convinced that it was linked with the health of surgical wounds, but no one else was ready to listen yet.. (Curiously, another doc, Thomas Spencer Wells, was also interested in Pasteur’s work. Wells happened to be the surgeon for Queen Victoria… I love these overlaps!)
  • There’s also a good link between Lister and Lord Brougham (who founded University College of London where my brother teaches). Lord Brougham was president of the both the university and the hospital, and Lister was trying to get a gig teaching there as a professor. Brougham is also the name for a type of carriage and was so named for this guy. (See here for more on Lord Brougham and his travelling mummified body.) After other doctors started to believe that Lister was onto something with his cleanliness theories, they began to be known as the “Listerians” and as they became more established in the medical world, they gradually started to spread the theory throughout the profession. 
  • Random trivia: it was around this time that more personal hygiene items started to come on to the market, including a mouth-wash called, wait for it, Listerine. Developed by an American in Philadelphia after he had listened to a speech by Lister as part of his professional medical society meeting…  It was marketed as a variety of things, including a treatment for dandruff, a floor cleaner, and notably, even a cure for gonorrhea. (I know. I’d never put this together with Lister either…)
  • All this was happening around the time of a big flu epidemic that occurred earlier than the most famous flu epidemic of 1918. This particular epidemic was in 1889-1890, and brought a doctor to the fore named Robert Wood Johnson, who, influenced by one of Lister’s talks, joined together with his two brothers to develop a company focused on developing sterile surgical dressings and sutures. The name of the company: Johnson & Johnson. Huh.
  • (And also, around this time, was the start of public health and John Snow mapping the outbreak of cholera… Well, I never. It’s fascinating how things overlap sometimes…)

And, really, the information goes on and on in one of the most interesting reads I’ve had this year. 

Honestly, if you’re looking for some great non-fiction about a field that still holds its importance today, Fitzharris is a great guide to show you the way of Victorian medicine. I loved it (in case you can’t tell). 

For some Victorian social history reads, you could try these: