July 20, 2010

Plague-Water

Ring-a-ring-a-roses
A pocketful of posies
Atishoo atishoo
We all fall down.

On Cheapside today, London reached a special pitch of airlessness and I was put in mind of the plague. Summer was the time to leave London, particularly after the Great Plague of 1665-6 and throughout the 18th century whilst there were outbreaks of 'plague' here and there, there was nothing to compare to the death toll of earlier decades.

The plague is a massive subject and impossible to deal with in one post, but two distinct and opposite images came to mind: Hannah Glasse's recipt for 'plague-water', a no-holds-barred treatment for the infected, and the curious case of Buckingham. Hannah's receipt involves 24 roots, 16 flowers and 13 seeds and 2 types of berries, plus copious boiling and 'stilling' in an alembic. This massive herbal overkill shows the desperation a carer might feel for a patient or family member with plague, willing to try anything and everything to save them (and there is no doubt that making up this receipt would have provided work for worried hands), and probably provided a sweet-smelling send off rather than a cure. A shortened version, boiled in vinegar and poured onto handkerchiefs was supposedly a preventative.

Buckingham is an altogether different matter, and at the other end of the care spectrum. Buckingham was one of the collectors of the deceased, working the streets with his 'dead cart'. During the Great Plague, as his cart clattered through the City he would cry, 'Faggots, faggots, five for sixpence, and take up a child by the leg'. His behaviour was too much to be endured, and he was arrested, 'whipt' and sent to gaol by Lord Craven for offending public sensibilities.

These examples are extremes and by the time Hannah's receipt was published plague was dying out, if not gone. There is now talk of genetic resistance amongst survivors (it is estimated just under a third of the infected survived) but no one really knows why. From the red ring of the first plague swellings, to Hannah and her predecessors' sweet pocketfuls of posies, to the feverish symptoms, to the unknown outcome after 'we all fall down', plague and all such other 'summer-fevers' were a dreaded annual occurence. Curious to think how diseases that were a deadly spectre on London's hot and airless streets are now little more than a jaunty (if slightly sinister) rhyme still sung by children in playgrounds, the meaning long forgotten.

March 20, 2010

A Morning Walk in the Metropolis

London is and always has been a tale of two cities: London and Westminster, the river and the shore, town and country, rich and poor. The contrasts can be remarkable. If Tiger Woods were to stand at the east end of pristine, polished Threadneedle Street where millions are traded every day and hit a golf towards Whitechapel, that ball would fly over at least one boarded-up pub, a handful of derelict buildings, a trendy club, local authority flats, 26 Big Issue sellers and some corner shops where all the biscuits are out of date.

Two hundred years ago, poverty and sickness were an ever-present spectre for many families and particularly the day-labourers, who supported wives and families from one sunrise to the next with the strength of their backs. They skirted the abyss, never more than a few days away from losing their footing. This morning I was flicking through a facsimile of an old miscellany from the British Library. Lots of it is random and undated, but one letter, originally submitted to the Gentleman's Magazine in 1780 really got under my skin. In December of 1780, Mr Lettsom left his front door with the intention of taking a morning walk. He was 'accosted' by a tall, thin man who was 'a picture of distress'. Lettsom enquired as to the man's situation and informed that the man's name was Foy, and that he had recently recovered from a sickness. He sought work, to support his family in Little Greenwich, Aldersgate Street.

Lettsom handed over some money, and Mr Foy burst into tears and went on to try and find work. Lettsom set out on his walk, but was troubled by the idea of the man and his family. His steps turned towards Aldersgate Street and without much trouble, he discovered Foy's 'miserable habitation': 'a little chamber furnished with one bedstead; an old box was the only article that answered the purpose of a chair'. However, it wasn't the furniture that shocked Lettsom, but the occupants: in the bed was a woman suffering from a putrid fever, her lips and gums black. At her feet was a girl of around five years old, naked apart from a poultice bound to the blisters on her back, held on by strings across her chest. Beneath the arm of the mother lay a naked boy of toddling age. On the floor was a girl of about twelve, covering herself with a petticoat, moaning that she would 'die of thirst'. All were fevered, apart from a four year old girl in a 'fragment of petticoat', who stood barefoot near them, providing water. The twelve year old, no doubt relieved to see another adult, begged Lettsom to look at 'her mother's side', where a huge 'mortification', or skin infection spread from her thigh to stomach, 'and nothing to stop its progress had been applied'.

Mr Lettsom 'procured medical assistance immediately' and paid a neighbour to nurse the family. Not long afterwards, he had 'the pleasure the conclude this relation of their unspeakable distress by communicating their total delivery from it'.

This is a tale of London itself, the ever-present gulf and how it is often breached by small acts of kindness rarely remembered. For Lettsom, the incident bore one crucial lesson and one that is a relevant today as it was in 1780:

I..experienced how greatly the sight of real misery exceeds the description of it.

February 12, 2010

Burking and Body-Snatching: The Deadly Side of Medicine in Georgian London

Some time ago I noted in a blog post about Bart's Hospital that the hospital's methods of obtaining bodies for anatomical study would bear further scrutiny, ideally as a PhD thesis (not by me, I hasten to add). Last weekend, an article appeared in the Guardian regarding Don Shelton's latest paper in the Journal of the Royal Society of Medicine, where he posits that surgeons William Hunter and William Smellie had women at their full-term of pregnancy murdered or 'burked' to provide bodies to further their obstetric studies. He's right in that the numbers don't add up, and that it is rare for a woman to die at full-term but without having begun labour, which seems to be their favoured choice of subject. However, whilst he has made a valuable study and some very salient points, I stall at his inference of murder. If you care what I think (and why should you?), this is why I don't agree.

There is no argument that both Smellie and Hunter were unscrupulous when it came to acquiring subjects for study, or for Hunter's medical 'museum' of freakery. Hunter in particular behaved appallingly over the corpses of various subjects he had his eye on, bribing family and friends to bring the body to him after the final illness, whatever the wishes of the person in question. Most famously, he paid the friends of Irish giant Charles Byrne five hundred pounds to supply him with Byrne's body, despite the fact that Byrne hated Hunter and specifically requested that he be buried at sea to avoid the anatomist's knife <this is an error on my part - it was actually John Hunter, William's younger brother who did this>. Being utterly ruthless and sanctioning murder are not the same. At one point, Hunter noted against Smellie's study of twins in utero that Dr MacKenzie, Smellie's assistant had procured and dissected the body without Smellie's knowledge 'was the cause of a separation between them, as the leading steps to such discovery could not be kept secret'. This indicated that the woman had been obtained by methods not sanctioned by Smellie and that he did not want to be associated with such methods. Hunter and Smellie were rivals medically, and both were aware that the whole business of procuring subjects would not bear scrutiny in polite society, but it doesn't mean they were turning a blind eye to the possible murdering of pregnant women.

Shelton examines the mechanisms of burial and arrives, quite rightly, at the conclusion that most 'resurrected' bodies were obtained from the poorhouses, either pre or post burial. He also asserts that people in a paupers' cemetery were placed in large pits and left uncovered until the pit was full. Nowhere in any of my studies have I found this to be true. Yes, destitute people were placed in communal graves in burial grounds throughout the city, but they were placed there with a bit of dignity and covered over with earth, even if others were later to be added to the grave. They were also prayed over by the incumbent. The pragmatism displayed by Georgian Londoners in the face of death and illness is not the same as being callous or unfeeling.

The rarity of death in women at full-term is a fact that cannot be argued with. However, in this we are largely influenced by modern statistics and the success of modern obstetric medicine, but pre-eclampsia is a dangerous condition still common now, affecting up to ten percent of pregnancies. Characterized by very high blood pressure, pain in the chest, damage to vital organs through raised blood protein levels, seizures and possible cerebral haemmorhages, there was no effective treatment for this condition in the 18thC. Sufferers describe the attendant pains of pre-eclampsia as unbearable, and medicate accordingly which may have resulted in overdose. If untreated, pre-eclampsia can prove fatal to both mother and child, and in Georgian London, would have meant many more mothers died when heavily pregnant, but without loss or damage to the body that would prevent an anatomist making a detailed study of the gravid uterus.

My last point is upon Shelton's light treatment of the 'resurrectionists'. Obtaining corpses for anatomical study wasn't an obvious career choice, granted. It would require a strong stomach, both morally and literally and a network of connections with like-minded individuals. Nevertheless, it was a job, perhaps coupled with another part-time occupation, but one taken seriously by those who engaged in it. They would know the poorhouses and those who supervised, they'd watch to see who came and went. Scoliotic, palsied, deformed or otherwise 'freakish' subjects were all required, as well as pregnant women. No doubt palms were heavily greased for word of a death. I don't believe for a moment that resurrectionists simply disinterred corpses 'randomly'. Most were probably never even buried. Vultures may be abhorrent creatures, but they let nature do the killing.

From the study of Smellie and Hunter's extant works, it appears they obtained 32 full term corpses in 13 years. I believe this number of women were available through natural death, but their bodies were obtained through fairly creepy and suspect supply chains, rather than murder. The woman pregnant with twins was clearly too much for MacKenzie to resist, and I am sure there were indeed murders associated with the study of anatomy, but I disagree with the condemnation of Smellie and Hunter as serial-killers and the sensationalism is both unpleasant and inaccurate. The inference that the men also worked on women rendered unconscious but still alive has no basis in fact whatsoever.<to further clarify this point: women were not 'anatomized' whilst still alive, although there are cases where C-sections were undertaken with little hope of the mother's survival. This does not make the operating doctor a monster.> Smellie and Hunter were at the top of the medical tree, doing valuable work. Associated with them were a large number of 'worker bees', from the artist Jan van Rymsdyk, who produced the astonishing images in the gallery to the poorhouse supervisor who shuffled the bodies out of the back door, to the grave-digger who after dark disinterred a body he had only just covered over. For my money, Rymsdyk is the scary one: he sat with these bodies for hours, studying them in minute detail and there is an adoring beauty to his renderings of these unfortunate women and their children: the sitting posture of the gravid woman, with her knees covered by a blanket, but her internal organs displayed by the neat flaying of the anatomist, and the baby curled snugly inside her, a stray wisp of its hair escaping the womb. There is a liveliness and humanity to the drawings that eludes the photographer's lens in post-mortem photography.

It is too easy to look back at history and attribute cruelty and inhumanity to people who lived in a time when death was a closer companion than it is now. As I hope this blog has shown, the 18thC is an interesting enough place to spend time even without sensationalism.

Click here to download:

Burking_and_Body-Snatching_The.zip (1749 KB)

November 3, 2009

John Keats: Apothecary, Surgeon's Pupil, Poet-

The airwaves are abuzz with Bright Star, Jane Campion's biopic of John Keats (1795-1821). Of all the Romantic poets he is the 'real' Londoner and as such I find his life interesting; more interesting than his poetry anyway.

John Keats' short and painful life began at the Hoop and Swan by Moorgate where he was the eldest of three boys and a girl. His father Thomas was a barman who came to manage or even own the pub (now Keats and the Globe for some reason, being nowhere near The Globe). When Keats was seven he was sent to a school in Enfield, North London. Nine months after he started at the school, John's father came to visit him and on the way home was thrown from his horse. Thomas Keats's skull was fractured and he died. John's mother, Frances, remarried almost instantly but it wasn't a success and she was forced to move in with her mother in north London. She died in March 1810, leaving her fourteen year old son in the charge of Thomas Hammond, an apothecary. He shared Hammond's lodgings, giving him a sense of continuity and an interest in medicine that would lead John to become a student at Guy's Hospital when he was 18. He would study there for 5 years, as a dresser (attending in theatre and dressing the patients' wounds after surgery). In 1816 Keats took his apothecary exams, and passed. He was an avid letter writer (although his handwriting was often more 'doctor' than 'poet'), rapidly developing a friendship with Leigh Hunt, Ben Haydon and others. He frequently left off 'spouting Shakespeare' to go and attend a surgery. In that year, Hunt helped him achieve publication with his first poem, and the following year, a collection of his poems were put before the public, to little success.

During a Scottish summer holiday in 1818 with his friend Charles Brown, Keats developed a cold so severe he could not continue and for the first time began to drop weight. When he came home, it was to the reality of his brother Tom's full-blown tuberculosis. Keats nursed Tom, but was probably succumbing to the early stages of TB himself. Their other brother George had left for America (although he would later return to borrow money from John, who was broke anyway and complained that 'He ought not to have asked,'). Tom died late in 1818 and by that time Keats had started his own slow decline. He had also started to take laudanum, claiming it eased the tightness in his chest, but it soon became a habit, and one he and Brown fell out over more than once. The two friends moved to Hampstead, where he met the elusive Miss Fanny Brawne, who would inspire so much of his work. Keats knew himself to be extreme in nature, and it is almost amusing he chose someone so practical and down-to-earth as Fanny to fall in love with. She was an incorrigible flirt and not just with John, which tore him up. He wrote her cruel and often spiteful notes, then others full of contrition. She seems to have taken them all in her stride and they developed a close relationship which would lead to an engagement. The convention of the day insisted John raise enough money to provide her with at least somewhere to live before they married, but he wished to devote himself to poetry, and so had to make some money out of writing. These hopes were almost dashed in 1819 with the publication of Endymion. It was savaged by the critics and Keats was heartbroken. Byron sniped at Keats as a 'Cockney' and a 'dirty little blackguard', but he was genuinely sorry for his fellow poet's mauling at the hands of the critics.

'Tis strange the mind, that very fiery particle,

Should let itself be snuffed out by an Article.

Keats' odd appearance was perhaps one of the factors that drove his unbalanced character. He was of short stature, perhaps no more than five feet tall, and delicately built. He was painfully aware of a mismatch between his mind and his body. He perceived himself as unattractive to women and regarded them with suspicion, perhaps always imagining them to be laughing behind their hands at him. Severn's appalling duck-faced, fuzzy-headed portrait remains one of the most popular images of John. Much better are the various sketches featured in the gallery, by various artists. His life mask shows a fine sensitive face with remarkable eyelashes and a beautiful, if slightly top-heavy mouth (emphasised in the silhouette). The touching image of him asleep as he was dying, also by Severn, conveys both the heartbreak of a friend, and the character of the patient.

Joseph Severn was to become Keats' greatest friend, and also his nursemaid, but through an odd series of events. Towards the end of winter in 1820, Keats returned from the City to Brown's house, thoroughly chilled. He was sent to bed by Brown, who brought him up a glass of spirits. Keats coughed once, but blood hit the sheet. He ordered Brown to bring him the candle in order to see the colour of the blood. His surgical training allowed him to recognize it as arterial blood, meaning his lungs were compromised. 'That drop of blood is my death warrant,' he told his friend. Later that night, he had his first serious lung haemorrhage, his mouth filling with blood. Brown later remembered the calm with which Keats wiped his chin and remarked, 'This is unfortunate.'

This period was one of his most productive, and with Leigh Hunt's support he began to think that it may be possible to support himself, and a wife through writing. John had run through three doctors, who seemed to have no idea what to do with him. He was bled, starved, fattened and opiated. He fretted for Fanny's company and began to suffer palpitations. Finally, the doctors recommended a warm climate. Joseph Severn, a promising young artist with an award for travel from the Royal Academy was singled out as a good friend for John, and he became a regular visitor, along with Coleridge. John was living with the Hunts, but found the noise and the children distressing. An odd incident drove all matters to a head: a letter from Fanny was opened by mistake. Keats had a tantrum then began to cry, walking the streets in a distracted state. He passed the house where his brother had died, then made his way to the Brawne house, where he collapsed. Mrs Brawne took him in and she and her daughter nursed John for a month. His lungs became more congested and he began to produce blood on a regular basis. Rome was settled upon as the place for him to convalesce, and Jospeh Severn as the companion. Fanny gave John paper that he might write to her and a large marble she used to cool her fingers when sewing. It would rarely leave his reach for the rest of his life.

John and Joseph Severn left England on the 17th of September 1820. As the distance from Fanny grew, John's spirits sank. Severn did not know how to help him, but listened when the poet talked. They employed an English doctor, who encouraged a robust diet and walking. When Keats continued to decline, the doctor confirmed what John already knew: that he was dying. Keats became set upon suicide by laudanum, determined not to suffer the loss of dignity his brother Tom had undergone. Severn confiscated Keats' supply of the drug and John punished him with descriptions of the incontinence, vomiting and raving that was to come. Severn was a stoic and ignored his friend, nursing him as his health plummeted early in 1821. Their friendship was a rare one. Keats became frightened of the dark, so Severn rigged up a system whereby one faltering candle would light the wick of the next, an invention Keats named 'the fairy lamplighter'. The sketch at the head of the gallery was drawn on 28th of January 1821 in the light of one of those candles.

Keats became resigned to his fate and encouraged Severn in his nursing: 'Now you must be firm for it will not last long.' A letter arrived from Fanny, but he would not open it, only asking for it to be placed in his coffin with his lock of her hair. On the 23rd of February, his lungs began 'to boil'. He asked Severn to lift him up and hold him, resolving to die easily, and soon. So he and Severn sat, hand in hand for the next seven hours, until John Keats died. The Police visited the house the following day (as was the law in Italy for consumptive deaths) and ordered all destroyed. Severn saved some things for himself, but Keats was buried in the Protestant cemetery as they had agreed. Severn wrote to Brown to tell him the news:

I am broken down from four nights' watching, and no sleep since, and my poor Keats gone. Three days since, the body was opened; the lungs were completely gone. The Doctors could not conceive by what means he had lived these two months. I followed his poor body to the grave on Monday...

The news took a month to reach London, where it was published in The Times on March 23rd, 1821.

At Rome on the 23rd of Feb., of a decline, John Keats, the poet, aged 25.

Click here to download:

John_Keats_Apothecary_Surgeons.zip (451 KB)

November 2, 2009

Th'Infernal Gout-

Gout is an extremely unpleasant disease, usually manifesting itself in the large joint of the big toe and causing agony to the sufferer. Too much uric acid in the blood causes urates (spiky little crystals of difficult-to-dislodge poison) to accumulate in the joints and mimics a painful arthritic attack. Over time, it can lead to large swellings on the joints which then break through the skin.

Uric acid is a byproduct of purine breakdown. Certain foods, such a lobster, crab, foie gras, champagne and port contain high levels of purine, leading gout to be termed the 'Rich Man's Disease'. Thomas Sydenham, the gifted doctor who introduced a holistic approach to English medicine recorded in his papers in 1683 that:

Gouty patients are, generally, either old men, or men who have so worn themselves out in youth as to have brought on a premature old age - of such dissolute habits none being more common than the premature and excessive indulgence in venery, and the like exhausting passions.

Of course, many other, more complex conditions were diagnosed as 'the gout'. The light diet and abstention from alcohol prescribed by Sydenham and his like-minded colleagues would have helped, but once got, gout is difficult to get rid of. Queen Anne, Isaac Newton and many others are famous sufferers. Samuel Johnson is also have thought to have suffered from gout, but let's be honest, there wasn't anything he didn't suffer from and it could have been any one of many underlying diseases, or simply degenerative arthritis. Gout is also a side effect of kidney failure and/or liver disease. It was likely that many deaths attributed to gout, including that of John Milton (8th Movember, 1674) were actually result of renal failure, with gout as the most obvious symptom. Dropsy, or grotesque swelling of the body, often accompanied gout-like pain.

All fortified wine was known to exacerbate gout, although there is always an opportunist ready to market their wares as 'medicinal'. One wine merchant sent a bottle of sherry to arch-snob Lord Chesterfield, with a note extolling the ability of his wine to 'cure the gout'. Lord Chesterfield, sharp as ever, replied:

Sir, I have tried your sherry and frankly prefer the gout.

October 30, 2009

Debunking Bedlam

On Wednesday I made a brief mention of the number of private Madhouses* in Hackney, Hoxton and Bethnal Green. I'll do a separate post on those another time, but today I just want to tackle the thorny subject of Bethlem Hospital (in its Georgian incarnation), and the treatment of the insane in Georgian London.

Bethlem Hospital, nicknamed Bedlam from its earliest times, is the oldest hospital in the world to deal specifically with mental disturbance. It has lived in four places since it took in its first mentally ill patients in 1357: in an old priory where Liverpool Street Station is now, Moorfields and Southwark and now Beckenham. I am most concerned with the Moorfields site, the first of three later purpose-built hospitals. Whilst the priory with its individual cells had originally been useful for confining inmates separately, it was over subscribed and in a poor state of repair. The new building, designed by Robert Hooke, was built at the Southern edge of Moorfields. It was a huge, grand building (that would later prove structurally unsound) and included the Caius Gabriel Cibber sculptures of 'Raving and Melancholy Madness' (now in the V&A). These sculptures signified the distinction made at the time between insanity (incurables) and depression (curables). Those born with severe mental deficiency, but largely passive natures were classed as idiots*. Samuel Johnson and Fanny Burney had a conversation about madness (mainly Johnson's fear of it) and how he believed it to come about through disconnected thinking, and how she believed it to be the result of a breakdown when life was very cruel and burdensome. 'Moral insanity' which one hears bandied about so much was a blanket term and it didn't mean 'you are a bad person and it has sent you mad', it means 'you have syphilis, or have lost your mind because of vile experiences as a street prostitute, or through drug abuse, and are therefore insane, and this is an acceptable euphemism'.

Very briefly, the care an afflicted person could expect to receive depended then, as now, on how much money they had. Bedlam was for poor people, which is why large numbers of official documents pertain to it. If you had a relative or spouse who became mentally ill, or was born an idiot (they managed to marry remarkably often if they had a large amount of land or money) you could have them nursed at home. If they became violent, you could have them cared for in an private madhouse. If you had nothing and were likely to end up on the street or in the workhouse, you went to Bedlam. The criminally insane such as Margaret Nicholson, who attempted to stab George IIIrd were also confined there. The engravings of the new hospital show it was built on no mean scale, and looks far more like a sanctuary than a prison. Hooke's plans show a distinct care for space, light and recreational areas for the patients.

From its opening in 1676, tours of the new building could be had for a penny a time. That people came and poked the insane with sticks is unlikely, but they did come to watch the 'ravers', particular favourites being the compulsive masturbators of both sexes. In no way do I condone making a spectacle of mental illness, but if asylums were open for visiting today people would go and gawp, so to condemn the Georgians as cruel is hypocritical considering the number of websites and magazines devoted to the bizarre and unfortunate of every kind. It should also be noted that one cannot take too much notice of Mr Hogarth's paintings and engravings on such subjects. He was a notorious joker (note how the Rake is depicted in the posture and appearance of Cibber's 'Raving Madness') In 1770, the visits were stopped, being considered inhumane.

In 1774 the Madhouses Act was passed in an attempt to improve the lot of those consigned to these institutions. It was largely unsuccessful, but excellent private houses did exist (and terrible ones, to be posted on some time in the near future), and the Monro family of doctors did take action to improve care at Bedlam in over a century of medical attendance there. Although many of their ideas were antiquated, they were concerned with exchanging shackles for straight-jackets, fitting cork or india-rubber flooring to cells, recreational activities, good diet and exercise for those who could take it. It is unclear how many patients were there at a time, but the numbers indicate above two hundred, plus around 80 criminally insane prisoners who were kept separately. Exceptionally violent or criminally insane patients were still kept fettered and in some cases wearing only blanket tunics and if they continued to soil bedding were given only straw to sleep upon. Almost every patient had a carer, but men were sometimes put in charge of female patients and there were accusations of abuse.

It cannot be assumed that everyone in Bedlam was an incoherent lunatic*. There were inmates who were both lucid and persuasive, such as James Tilly Matthews, admitted in 1797, who is believed to be the first fully documented case of paranoid schizophrenia. Tilly Matthews was a Welsh tea merchant who became obsessed with the idea that a gang of espionage 'experts' had set up a magnetic 'Air Loom' at London Wall, and were brainwashing the citizens of London, including major politicians. He spoke of threatening and harming these 'infected' persons. John Haslam, Bethlem's resident apothecary studied Tilly Matthews and made drawings of this loom (in the gallery). As a patient, Tilly Matthews was charming, but he was kept in an institution for the rest of his life.

In 1799, the building began to subside, and it was decided that it should be moved to Southwark. It took until 1815 to happen and the old hospital was demolished. With the turn of the 18th century, care for the mentally ill entered a new phase, much more like the care we see today and attitudes towards the afflicted changed rapidly. Bedlam is perhaps the worst example of early psychiatric care (we will never know the worst abuses in the private madhouses), and it was rapidly outpaced by the new-fangled St Luke's, under the charge of William Battie, which opened opposite it in 1751. However, it has retained its original purpose into the present day, and continues to provide care under very difficult circumstances.

*All these were the accepted terms in the period, although they are now antiquated and in many cases, inappropriate.

Click here to download:

Debunking_Bedlam.zip (1687 KB)

October 26, 2009

'Monstrous Twins-'

Physical abnormality is a difficult and emotive subject, and the late seventeenth century saw the emergence of the first glimmers of understanding about genetic disorders. There were many who still believe the sperm was delivered to the mother as a tiny homunculus, which she then nurtured and brought into the world. Any abnormalities were of course, the mother's fault.

There was a new school of thought: that material for a child was inherited from both parents. Such new ideas paved the way for new medical journals, and new ways of addressing patients. Emphasis was placed on the medical practitioner having seen and examined each case, and descriptions were more accurate than they had been before.

Of particular interest were conjoined and parasitic twins (a twin not fully formed and utterly dependent on the other, rather than 'Siamese' twins). Other than in the poorest countries of the modern world, every effort is made to separate or disengage twins joined at birth and efforts were made, even in the 17thC to separate twins who did not share organs, but the majority would struggle through life as they were. London appears to have drawn them in. The following note appears in the Statues on Slavery.

Sir Thomas Graham bought a monster in the Indies, which was a man of that country,

which had a perfect shape of a child growing out of his breast; as an excres-

ency, all but the head. This man he brought hither (i.e. to England) and

exposed to the sight of the people for profit.

In the same year, in Genoa, James Pero was born, displaying a similar parasitic twin called Matthew, which you can see in the gallery. He appeared on show in London in 1714, prompting Sir Hans Sloane to commission his portrait (now in the British Museum). Another witness to James Pero's show was James Paris du Plessis. Paris was not a physician (he was a servant and for some time worked for Samuel Pepys), but he was fascinated by medical anomalies, and by the end of his life had amassed a large library of associated matter. Written circa 1731, his History of Prodigies detailed the lusus naturae or natural freaks he had seen on his travels in service. There is no hint of kindness in his tales, but there is little of cruelty either, he is simply an observer, although on occasion he is rather more 'hands on' than perhaps he should've been: fascinated by the 'Yorkshire hermaphrodite' and noted 'its viril Herge did erect by Provocation'.

Every so often, something truly grotesque appears (don't read this if you have a delicate constitution):

December, 1748

Two months ago, J.H. a poor

woman belonging to this town,

was delivered of a monstrous child,

which, besides the usual form and parts

of a female, had adhering to, or rather

contained in it, as in its capsula, a rude

and imperfect substance, whose shape

is somewhat conical; at the birth it re-

sembled a large cyst, or bag, extending

itself from the fundament quite down

to the toes of the child; its size was e-

qual to that of a bullock's heart, was co-

ver'd with a thin membrane, in which

was contained a limpid fluid. A few

days after the birth, the membrane

burthing, discovered to view an irregular

mass of flesh, perfectly human, with a

smooth skin of a florid colour: In its

inside are solid substances, which feel

like bones; and on its external surface

are visible a distinct hand and foot; on

the former are five fingers and a thumb,

on the latter four toes, with the great

toe in the middle. There was no other

visible distinction of either parts or sex

in this substance, for part of it is still

lodg'd in the body of the child, and

possesses all that cavity form'd by the

ossa innominata (the pubic bone), reaching upwards half

the length of the spina dorsi (the spine), in order to

the lodgment of which, the rectum of

the child gives way, and discharges its

excrements very regularly at the left

groin. But the uncommon bulk, in

equality, and feel of the parts, I appre

hend there are distinct extremeties, and

a head still conceal'd from view; the

whole bulk, if extract'd, would be near

ly equal to that of the child---It re

ceives fluids, and increases in bulk, tho'

whether it enjoys an animal or vegeta

ble life is uncertain. I saw the child

yesterday, which feed heartily; many

hundreds beside myself have likewise

seen it; and 'tis allow'd to be one of of

the most surprising instances of the kind

ever seen of heard of.

Such phaenomena, as they are re-

markable displays of divine almighty

power, so they are undoubtedly visible

proofs of God's displeasure against sin,*

in that, contrary to the established laws

of nature, he sometimes permits such

uncommon lusus naturae (freaks of nature) to exist among

the human species; for in general har-

mony and proportion are the beauty of

his works.

* The parent of the child has been remarkably vile, and her offspring is spurious.

The freakishness of this entire entry is only compounded by the equal vileness of the 'constant reader' who submitted it.

October 23, 2009

Touching for the King's Evil-

Scrofula, or the King's Evil is a nasty and disfiguring disease caused by the rod-shaped bacteria you can see in the gallery. It can be a complication of tuberculosis, but in small children is usually a hideous lymphatic infection: the nodes of the neck and face swell and eventually the skin becomes attached to the swelling, hardens and bursts, causing an open wound or sinus.

To have a child suffering from scrofula must be very distressing. In 1702, Samuel Johnson's parents brought their son from Staffordshire to be touched by Queen Anne in the hopes of curing him. 'Touching for the King's Evil' was a tradition with its roots in the Middle Ages, when monarchs were deemed to be the chosen representative of God. Their touch was supposed magical and many children and adults were presented to Kings and Queens to be 'cured'. They came away with a 'touchpiece', a little metal token of the event (Samuel Johnson kept his about his person for the rest of his life).

The advertisement in the gallery, from the London Gazette of the 20th of April 1668, gives notice that Charles IInd will finish touching for the summer at the date printed. Although this might indicate Charles didn't want this duty to interfere with his summer plans (or be in a crowded room with the afflicted), it is estimated he 'touched' over 90,000 people for the Evil during his reign. He was well aware of the power of the ceremony, and how it was valued by the people who took part. Not everyone was convinced by the tradition though, and William IIIrd refused to 'touch', with one exception, when a man begged him. William laid his hand on the man's head saying, 'God give you better health and more sense.'

Queen Anne was by far the busiest monarch as far as touching was concerned, and she reinstated it as a ceremony immediately. Most monarchs laid their hand on the head of the afflicted and wished them better health (this touching of the forehead is all I can find in the early prints). Queen Anne apparently laid her bare hands on the sores themselves, making her fairly brave if you ask me. George Ist stopped the ceremony immediately, condemning it as superstitious and touching for the King's Evil ended in Britain (it continued in France until 1825).

Click here to download:

Touching_for_the_Kings_Evil-.zip (901 KB)

October 20, 2009

A Genuine Court-Plaister.

This little packet (16cm long) contains a Georgian sticking plaster, dating from around 1780. It was made from silk or cotton, isinglass (a sticky substance made from the swimbladders of fish, namely sturgeon) and glycerine. Supplied in various sizes, it could be used as a piece, or cut to fit the damaged area. It was then slightly moistened and applied and quite literally, stuck.

Survivals like this little packet, complete with its dried out plaister are very rare, and it is intriguing to see the form in which it would have been purchased originally. How it could have been 'faked', I have no idea, and presumably, the very fact it came from London rendered it superior to provincial sticking plasters.

October 15, 2009

The King's Physician, the Theatre Royal and London's first STD clinic-

Time for the 'human interest' story of the week: venereal disease. For the past twenty five years the world has been obsessed with HIV: a nasty disease, and a very clever one that gives you a decade of appearing normal and infecting other people before it kills you with the common cold. Syphilis or 'the pox'* was the big concern in Georgian London. It is a corkscrew-shaped bacteria, preferring a warm, damp environment such as the crotch. There are three stages of symptoms ranging from unthinkable sores in special locations, to white, fungal-type blooms, to the final stage where it corkscrews into your bones and brain, leaving you grossly deformed and insane. The first Britons to contract syphilis were the Crusaders but it became widespread when England's naval capability provided international 'travel'.

By the Elizabethan period syphilis was the new leprosy and by the end of her reign Elizabeth had put into place a system of local relief to help people disabled by the disease. Elizabeth's measures to care for the poor continued throughout the 17thC but as the population became increasingly urban, diseases began to concentrate upon the towns. Syphilis was no different. Of course, the natural reaction was to blame the whore you caught it from, which is a bit like putting your 'hand' in the fire and then blaming her because it's still hot. The law-makers of the time were aware of the women who ended up literally sitting in the streets after becoming so sick they could not support themselves by any means, but it was a thorny subject. Their solution was the 'foul' wards in hospitals, but it was unsatisfactory, both for patients and carers. Traditional remedies were the poisons arsenic and mercury, either applied directly to the affected parts, or administered in a manner of unappealing ways. No matter how unpleasant, these cures did not work, and only the natural remission of the disease between stages lead physicians to declare one third of their patients 'cur'd'.

William Bromfield was a doctor In Holborn. His father was a Doctor of Medicine at Oxford and his maternal grandfather had instructed Isaac Newton in anatomy and been William IIIrd's private physician. In 1744 he was elected Demonstrator of Anatomy at Barber-Surgeon's Hall (a better job than it sounds) and 1755, he became Vice-Surgeon to The Prince of Wales. In 1746, Bromfield began to rustle up a committee to raise money for a hospital concerned only with venereal disease, to be advised by doctors from St George's Hospital (where, co-incidentally, Bromfield had just been elected Surgeon). He was concerned at both the implications of housing the infected with other patients and the moral implications of housing prostitutes and men of 'low moral character' both with each other. Hospital boards had started putting patients of 'low character' in yellow outfits, giving rise to the name 'canaries' for those afflicted with venereal disease, but that was soon recognized as inhuman and stopped.

It is interesting to note that as early as the 17thC, a clear distinction was drawn between prostitutes and 'lewd women'. Historians often lump them together but prostitutes were recognized as a necessary part of society, and of male life. The average age of a first marriage during the 18thC remained fairly steady at around 26. If we take 16 as the beginning of sexual maturity that leaves a decade of abject frustration, or recourse to whores. It is likely all but the shyest or most devout men would've made some arrangement with one, or a few of London's estimated fifty thousand prostitutes.

Bromfield's charitable society was well-patronized, and on the 31st of January 1747, the original London Lock Hospital opened in the fine setting of Grosvenor Place near Hyde Park Corner (it is the building on the bottom left extreme of the map image, just behind what are now the gardens of Buckingham Palace). The engraving in the gallery is a bit hazy, but the large signs on the front read 'London Lock Hospital. Voluntary Contributions.' A Lock Hospital was the old name for a lazar house, thought to come from the French word for rags: loques, and soon there were more opening across London, utilizing old lazar and workhouses. Of course, you had to have a bit of God in your 'cure', so there was a zealot chaplain (Wesleyan Martin Madan), but the care given out was of a high standard, whilst all the time acknowledging that a true cure was not possible. Bromfield was nothing if not resourceful when it came to getting money out of his rich clients for his needy poor: he rehashed at least one old play, The City Match, by Jasper Maine and it was performed at the Theatre Royal in 1755 specifically to raise money for a separate hospital chapel (which gave its name to Chapel Street, SW1). William's brother Thomas was the 'visiting apothecary', charged with dispensing the drugs they did have available. They also established an 'asylum' in Knightsbridge for women who did not want to go back to prostitution.

Many people see Georgian London as a very inhospitable place to be poor or sick, and whilst there is some truth to this, it is necessary to see that the hospital was acutely aware that almost half the prostitutes they helped had been raised in local workhouses, and saw no alternative to their way of life. The London Lock Hospital was pioneering in providing healthcare and help for a hitherto marginalized section of society. The Hospital treated men as well, but it appears with rather less sympathy. Bromfield died in 1792, popular with his clients, but less so with the rest of the medical population, who weren't impressed with his championing of the venereally afflicted. His hospital and asylum eventually moved to the Harrow Road where they had better facilities, but by then it was the Victorian period and a solution to prostitution and its attendant problems had been found: Tasmania.

* The pox usually refers to syphilis, rather than smallpox.

Click here to download:

The_Kings_Physician_the_Theatr.zip (1294 KB)