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Posts Tagged ‘Regency medicine’

Oak cask for making vinegar. Image @Taste of Croatia

Vinegar has had a long and noble history of uses for mankind. Since ancient times it has been used as a preservative. Delicate fruits and berries were ripe for such a short season that vinegar, with its acetic acid content, was used to to preserve them. (Blackberry vinegar recipe)

Add sugar and water, to the mixture and one had created a tart and pleasing beverage. Mix it with alcohol, and this sweet concoction became a tasty mixer! Vinegar Cocktails Are Making the Rounds 

As vinegar is so necessary an article in a family, and one on which so great a profit is made, a barrel or two might always be kept preparing, according to what suited.” – A new system of domestic cookery: formed upon principles of economy, and adapted to the use of private families (Google eBook), Maria Eliza Ketelby Rundell, Printed by Norris & Sawyer, 1808.

18th century French faience oil and vinegar set

Vinegar is made from many sources: grapes, apples, sugar cane, or malted barley or oats.

In foods it is used for its antibacterial properties, as an acidity stabiliser, diluting colourings, as a flavouring agent and for inhibiting mould growth in bread. In brewing it is used to reduce excess losses of carbohydrate from the germinated barley and to compensate for production variations, so producing a consistent quality beer.

It can be found in beer, bread, cheese, chutney, horseradish cream, pickles, salad cream, brown sauce, fruit sauce, mint sauce and jelly and tinned baby food, sardines and tomatoes.” - La Leva di Archimede

George III condiment set, silver 1782 Sheffield

Herbs, fruits and spices have long been added to vinegar for flavor, and recipes for infused vinegars were handed down for generations. ‘Sugars of lead,’ a sweet tasting substance, was made by pouring vinegar over lead. This liquid would be used to sweeten harsh cider, but as every self-respecting 21st century reader knows, this substance was quite poisonous. One can only conclude that sugars of lead must have been quite deadly to Europeans addicted to drinking cider. – Enzyme facts, vinegar history 

Recipes for vinegar are found as early as the 17th century. In the Delightes for Ladies (1602), Sir Hugh Plats offers this recipe for distilling and purifying vinegar. Notice his caution of the use of lead.

How to distill wine vinegar or good Aligar that it may be both cleare and sharpe

I Know it is an usuall manner among the Novices of our time to put a quart or two of good vinegar into an ordinay leaden stil, and so to distill it as they doe all other waters. But this way I do utterly dislike, both for that heere is no separation made at all, and also because I feare that the Vinegar doth carry an ill touch with it, either fro the leaden botto or the pewter head or both. And therefore I could wish rather that the same were distilledin a large bodie of glasse with a head or receiver, the same beeing placed in sand or ashes. Note that the best part of the vinegar is the middle part that ariseth, for the first is fainte and phlegmatick, and the last will taste of adustion, because it groweth heavie toward the latter end, and must be urged up with a great fire, and therefore you must now and then taste of that which commeth both in the beginning & towardes the latter end, that you may receive the best by it selfe.

18th C. French vinaigrette bottle

Aromatic vinegar in the minds of 17th-19th century users had many medicinal purposes for preventing infections and megrims (headaches), reviving a fainting person, and covering bad odors. It was used to treat dropsy, croup, stomach aches, as well as sore throats. Vinegar teas were consumed by diabetics, and the liquid was used to heal wounds and fight infections. (Bragg, Health Information.) Vinegar was also a well-known cleaning agent and furniture polish, although it was not recommended for polishing marble, since the acid would eat into the smooth surface, leaving it pockmarked over time.

Vinegar was considered an indispensable item in the 18th century for arousing a fainting person or masking foul odors. When the sponge was soaked only in vinegar, its original use, it could help prevent the wearer from fainting. A person stepping outside a crowded London street might carry aromatic soaked sponges to hold close to the nose to mask the odor of raw sewage and rotting garbage.

19th c. Victorian silver vinaigrette

In the early 19th century, there wasn’t garbage men that carted away the trash. People threw the stuff out the window. Slop pails went out the window in the 18th century. And when you left your house, you would encounter odors that made you just choke. So they invented a device called the vinaigrette. And it was a box or a little trinket carried to revive oneself if one felt faint.

So now they can’t breathe, they go outside, they smell the rotten garbage and the sewage, and they think they’re going to faint. They opened up their vinaigrette, which they held in their hand, and inside is a gold-pierced grill with beautiful decoration. But underneath the grill is a sponge. They would soak that sponge in an aromatic solution, sort of a mixture of perfume and ammonia, like smelling salts.” - Barry Weber, Antiques Road Show 

Vinaigrette and train holder. Image @Antiques Road Show

That was the concept of the vinaigrette. But the other end of this, you seldom see these all together. This is called a train holder. And this is shaped like a shell. When you squeeze it, it opens. The train was the long part of the ball gown. And they didn’t want it to drag in the dirt and be soiled. So they would hook the train holder onto the edge of the train, and then they would hold the vinaigrette in their hand, and this kept the train from dragging behind them.” Barry Weber, Antiques Road Show 

Vinaigrettes were small decorative containers that held the vinegar-soaked sponges. The inside of the vinaigrette would be gilded to protect the silver from staining.

Used by both men and women, vinaigrettes were suspended from chatelaines, placed in pockets, hung from long chains, bracelets or finger rings. Often designed in the shape of a rectangular box, the more spectacular vinaigrettes took on the look of a vase of flowers, a purse, an urn, almost any contemporary theme. Made from multicolored gold or silver and sometimes silver-gilt, many were decorated with Italian mosaics, mother-of-pearl or other gem materials. – Antique Jewelry University

18th century French ladies carrying canes

The soaked sponges were also carried in a compartment in the head of walking canes.

…many ladies of the 18th and 19th centuries carried a “vinaigrette” cane to protect them from a variety of ailments. Throughout history, vinegar has been heralded for its medicinal qualities. A sponge soaked in the healing liquid was placed in a small container with holes in it on the handle of the cane. Should a lady’s tight corset cause her to faint or should she encounter someone with a dreaded illness, her vinaigrette tucked into her cane was close at hand to protect her.” – Collecting Antique Walking Sticks or Canes 

Vinaigrette, Nathaniel Mills. Image @Leopard Antiques

Often spices such as cinnamon, lavender, roses, or orange were added to sweeten the smell.

The vinaigrette was a most necessary adjunct to the toilette in the late eighteenth and early nineteenth centuries, when it was considered the correct thing for a lady to show symptoms of fainting on occasion. The little boxes with a grating inside—through which the essence contained in a saturated sponge could be inhaled— are of all sorts and conditions. Some are quite plain, others have delicately chased or monogrammed tops, or views engraved on the lids; others, again, are of fantastic shapes. The vinaigrette was the descendant of the old pomander, and the forerunner of the midVictorian smelling bottle; but whereas the vinaigrette is accessible to the most modest purse for a very small sum, the real old genuine pomander is very scarce indeed, and it means a lot of money to come by one at all. The pomander was round, and often of china, and contained a wonderfully strong-smelling ball, compounded of spices and pungent scents which could hardly fail to bring round the most upset of ladies. – Byways of Collecting, 1908, Ethel Deane, Pp 170-172.

The small containers known as vinaigrettes were actually an English invention. The French called them “boite de perfum”. They came in many shapes and sizes, and eventually became decorative items that lovers exchanged as tokens of affection. (Limoges Boxes: A Complete Guide)

The vapours from a vinaigrette caused the person to inhale sharply and then breathe more rapidly. Restoratives carried different names and were made from various recipes, not just with vinegar: In addition to vinaigrettes, there are smelling-salts, hartshorn, and Hungary water or lavender water. Ladies prone to fainting would also keep a bottle of laudanum nearby. Laudanum, a painkiller, was an alcoholic herbal preparation that containing approximately 10% powdered opium. Smelling-salts were an infusion made with ammonium carbonate and alcohol and scented with lemon or lavender oil. Hartshorn (aqueous ammonia)was made from carbonate of ammonia distilled from the shaved or powdered horns of a male deer. Hartshorn and smelling salts or sal volatile could be mixed with water and drunk as a restorative. Hungary water was a perfumed restorative made with distilled water and sweet-smelling herbs and flowers. This was dabbed on the skin of a person suffering from “nerves.”- Jennifer Kloester, Georgette Heyer’s Regency World, 157-58

Pauline Bonaparte transformed into a goddes of antiquity on her day couch. Neoclassical statue by Canova, 1805-1808, @ Borghese Gallery

And so we finally come to the fainting couch or a chaise longue, or a reclining chair with a long seat that supported the legs of the fainting person. These couches were placed in drawing rooms and dressing rooms, and were used for relaxation as well.

Early 19th century Recamier day bed. Image @Victoria & Albert Museum

This post will not go into the myriad reasons why women of this era fainted with such regularity. Tightly laced corsets certainly had something to do with the condition, but with so few rights and options open to them in their life’s choices, one cannot blame women of that time for reacting to the child-like treatment their husbands and fathers accorded them with fits, vapours, nerves, and fainting spells.

The Bennet family is well acquainted with Mrs. Bennet's nerves. Pride and Prejudice 1995

A character like Mrs. Bennet, who had her origins in Jane Austen’s real life observations, did not have many opportunities for maturing or turning into a well-educated and sensible woman. Mr. Bennet had given up on her and her childish behavior was enabled by her caring daughters and siblings.

Scene from 1995 Pride and Prejudice. Mrs. Bennet is overcome from the thought of Lydia's elopement. Note that she is not using the day bed but has a chair propped under her feet.

Vinegar had many other uses:

A recipe for black dye

Let one pound of chopped logwood remain all night in one gallon of vinegar. Then boil them, and put in a piece of copperas, as large as a hen’s egg. Wet the articles in warm water, and put them in the dye, boiling and stirring them for fifteen minutes. Dry them, then wet them in warm water, and dip them again. Repeat the process, till the articles are black enough. Wash them in suds, and rinse them till the water comes off clear. Iron nails, boiled in vinegar, make a black dye, which is good for restoring rusty black silks. – A Treatise on domestic economy for the use of young ladies at home and at school, by Catharine Esther Beecher, 1849, p. 299-303

For whitening scorched articles of  clothing

Scorched articles can often be whitened again by laying them in the sun wet with suds. Where this does not answer, put a pound of white soap in a gallon of milk and boil the article in it. Another method is to chop and extract the juice from two onions and boil this with half a pint of vinegar, an ounce of white soap, and two ounces of fuller’s earth. Spread this when cool on the scorched part, and when dry, wash it off in fair water. Mildew may be removed by dipping the article in sour buttermilk, laying it in the sun, and after it is white, rinsing it in fair water. Soap and chalk are also good, also soap and starch, adding half as much salt as there is starch, together with the juice of a lemon. Stains in linen can often be removed by rubbing on soft soap, then putting on a starch paste, and drying in the sun, renewing it several times. Wash off all the soap and starch in cold fair water. – A Treatise on domestic economy for the use of young ladies at home and at school, by Catharine Esther Beecher, 1849  p 296.

Reviving a person overcome with fumes:

In case of stupefaction from the fumes of charcoal or from entering a well, limekiln, or coal mine, expose the person to cold air; lying on his back, dash cold water on the head and breast, and rub the body with spirits of camphor vinegar or Cologne water. Apply mustard paste to the pit of the stomach, and use friction on the hands feet and whole length of the back bone. Give some acid drink, and when the person revives, place him in a warm bed in fresh air. Be prompt and persevering. – A Treatise on domestic economy for the use of young ladies at home and at school, by Catharine Esther Beecher, 1849 p. 243.

This late 19th century poem by Edith Willis Linn talks nostalgically about vinaigrettes as a thing of the past. At this time, lovers gave each other these small decorative items as tokens of affection:

AN OLD VINAIGRETTE – Poem by  Edith Willis Linn, C. W. Moulton, 1892.

LITTLE gleaming box of silver

Wrought in flowery design;

Drifted down the silent ages

To this humble hand of mine;

From the days of kingly France,

From the days of minuet dance,

From the days of stately graces,

Powdered hair and painted faces;

Bring a shining thread of story

To this all-prosaic hour;

From those castles proud and olden,

Those salons of wit and power.

You have known the love and woe

Of fair dames of long ago;

Round you like a love-tale wreathing

Is the perfume of their breathing.

Silent! Not a word to give me!

See, I raise your flowery lid;

Whisper in your heart my secret

Knowing you will keep it hid.

An Old Vinaigrette.

One more life now leaves its trace;

One more love has lent its grace;

Keep it sacred down the ages

On your shining silver pages.

Now my imprint I have given

Though you never bear my name:

Graven with your silver roses

Are all lives of praise or blame.

All things that we touch or wear

Must the spirit’s impress bear.

Every hand that ever won you

Left a fadeless mark upon you.

Love and hate and jealous passion,—

All I feel have been your own;

Shall my life not breathe about you

Purer love than you have known?

Nobler grows this life with years,

Grander grow earth’s hopes and fears;

May the traces of my living

Make this heirloom worthier giving.

Whence and Whither.

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It’s a truth universally acknowledged that after a bride and groom consummate the marriage the pitter patter of little feet will surely follow (and follow and follow and follow). Such was the case during Jane Austen’s day. Her mother bore eight children and luckily survived her ordeals. The wives of Jane’s brothers Edward and Frank did not, both dying in childbirth with their eleventh child. That these two women were able to survive so many pregnancies was a miracle in itself, given that the chance of a woman dying in childbirth at the time was 20%.

Queen Charlotte, King George IIIs consort, gave birth to 15 children in 21 years. The King and Queen are depicted with their 6 eldest.

Deborah Kaplan writes in Jane Austen Among Women:

“On the birth of his fourteenth child in 1817, Thomas Papillon received this advice within a letter of congratulations from his wife’s uncle, Sir Richard Hardinge: It is now recommended to you to deprive Yourself of the Power of Further Propagation. You have both done Well and Sufficiently.”

The fashionable mamma, or the convenience of modern dress, James Gillray

Abstinence was one method of birth control, as Sir Richard recommended. Breast feeding was another. If a mother breasfed her child for 3-4 years, the pregnancies would be naturally spaced inbetween periods of amenorrhea (the absence of menstruation). While breastfeeding regained some popularity during the Georgian and Regency eras, women did not feed their babies long enough to supress menstruation for very long and often handed them over to a wet nurse. Cassandra Austen farmed her children to a nurse in a nearby village after six to eight months, guaranteeing that her lactation would soon cease and that she would soon be fertile again. The common belief that having intercourse during lactation would in some way harm the mother and child did offer some added protection from pregnancy, but large families were still common.

Amanda Vickery shows a bachelor cadging food from an irritated married friend. The poor young man probably lived in a modest rented room.

Social customs also served to keep pregnancies down. Amanda Vickery mentioned in At Home with the Georgians that a bachelor needed to acquire a house and reliable income before he could seriously contemplate marriage. Such acquisitions took years to amass and would hold up the young man’s inevitable role as parent. Once the young man could afford to marry, however, his long period of delayed consummation with a chaste woman ended and he would waste no time in siring a legitimate child.

A woman’s chaste reputation owed much to the urgent necessity of her not getting pregnant before marriage. Conceiving a child out of wedlock turned a woman into a pariah. In medieval times a chastity belt guaranteed that no bride would enter her marriage bed sullied. Unfortunately, these contraptions came in only one size and were therefore extremely uncomfortable for the larger sized woman.(Johannah Cornblatt, Newsweek). Update: Information about chastity belts in medieval times is being debunked these days as a myth. See links in the comment section below.

James Gillray's priceless caricature.

Married couples anxious to reduce their number of offspring (or who had reached their limit of 10, 11, or 15) tried coitus interruptus and the rhythm method. Since the female fertility cycle was not fully understood until the early twentieth century, the latter form of birth control resembled a game of Russian Roulette more than family planning. Several religious institutions, the Catholic Church in particular, frowned upon a married couple attempting any form of birth control at all, but there was evidence that birth control was effectively practiced. “Some couples managed to delay the first conception within marriage and few babies were born in the months of July and August, when the heaviest harvest labor took place.”-History of Birth Control.

Condoms, which were made of linen soaked in a chemical solution or the lining of animal intestines, had been in use for centuries, but this method of birth control was linked to vice and was mostly practiced in houses of ill repute.

Casanova blowing up a condom with prostitutes looking on.

Giacomo Girolamo Casanova (1725-1798) was among the first to use condoms to prevent pregnancy. The famous womanizer called the condom an “English riding coat.” His memoirs also detail his attempt to use the empty rind of half a lemon as a primitive cervical cap. The engraving shows the Italian seducer blowing up a condom. The photo shows an early 19th-century contraceptive sheath made of animal gut and packaged in a paper envelope. - Newsweek

Condom made of animal gut with paper envelope. Image @Newsweek

One can imagine that such clumsy barriers to impregnation failed on too many occasions to count, although they did manage to prevent venereal disease.

Georgian caricatures made much sport of condoms. This one is entitled: "Quality control in a condom warehouse."

There were other means of pregnancy prevention. Aristotle recommended anointing the womb with olive oil. His other spermicides included cedar oil, lead ointment, or frankincense oil.

Pessaries, 1755. Image @The Global Library of Women's Medicine

“The pessary [mechanical tool or device used to block the cervix] was the most effective contraceptive device used in ancient times and numerous recipes for pessaries from ancient times are known. Ingredients for pessaries included: a base of crocodile dung (dung was frequently a base), a mixture of honey and natural sodium carbonate forming a kind of gum. All were of a consistency which would melt at body temperature and form an impenetrable covering of the cervix. The use of oil was also suggested by Aristotle and advocated as late as 1931 by birth control advocate Marie Stopes.” - History of Birth Control

Other societies had used methods of blocking sperm including plugs of cloth or grass in Africa, balls of bamboo tissue paper in Japan, wool by Islamic and Greek women, andlinen rags by Slavic women. Ancient Jews used a sea sponge wrapped in silk and attached to a string. – History of Birth Control.

Many young girls who had been seduced, engaged in pre-marital sex, or been raped would attempt not to get pregnant by any means. The unfortunate women who did were ostracised, much like Colonel Brandon’s young charge, Liza, who had been enticed by Willoughby in Sense and Sensibility to give up her virginity. These women were frantic to end their pregnancies rather than lose their standing in society or their livelihood, for no pregnant unmarried woman could work as a maid, shopgirl, or seamstress. They would try anything to end their pregnancies, including ingesting turpentine, castor oil, tansy tea, quinine water into which a rusty nail was soaked, horseradish, ginger, epsom salts, ammonia, mustard, gin with iron filings, rosemary, lavender, and opium. Severe exercise, heavy lifting, climbing trees, jumping, and shaking were also attempted, in most instances to no avail. – History of Birth Control

Tess of the D'Urberfield and her baby, Sorrow. Thomas Hardy wrote about the consequences of seduction. (Nastassia Kinski as Tess, 1980)

Infanticide has been practiced since the dawn of time, most famously with the Greeks, who left deformed babies to die outdoors. In Regency times, desperate women would leave their babies in the streets to die. Many left their infants at workhouses, a form of infanticide as the quote below attests, and a large number, too poor to support themselves and unable to work off their debts, wiled away their time in prison.

“When the poor stayed with their children in workhouses, the outcome was little better. Between 1728 and 1757, there were 468,081 christenings and 273,930 infant deaths in those younger than the age of 2 in London workhouses. Foundling hospitals and workhouses were institutionalized infanticide machines.” – Global Library of Women’s Medicine

Women at Bridewell Prison, 1808. Rowlandson and Pugin for Ackermann's Repository of Arts

Once children were born and the family was large, it was not unusual to farm out a few children, some to work in their childhood, as Charles Dickens did, and other to live with relatives, as was the case with Fanny Price, who lived with her aunt’s family in Mansfield Park and Edward Austen Knight, who was adopted by a rich, childless couple.

Early 20th century attitude towards an unwanted child. Image @Newsweek

It has been said that families had many children during the 18th and 19th centuries because of the high rate of infant mortality and the need for many helping hands on the farm. But as society became industrialized, large families became a hindrance. With many mouths to feed and limited resources (except in the case of the rich), it is no wonder that couples since time immemorial have searched for ways to limit the number of their offspring.  Update: As Nancy Mayer rightly pointed out in her comment, most women during the Georgian and Regency eras thought it their duty to bear their husbands children and oversee the family household. The matter of family planning might well have been influenced by women of a certain class who could not allow pregnancies to interfere with the rhythm of the work cycle, single women who were desperate to seek ways to end their pregnancies before their condition became obvious, and in houses of ill repute, where condoms would offer some protection against disease. Mistresses and prostitutes would find pregnancies to be more of a hindrance than help in their work. I have often wondered, for example, how Emma Hamilton managed to have so few children and yet enjoy the charms of so many men.

1920's Lysol Advertisement. Image @The Museum of Menstruation and Women's Health

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Caricatures from the late 18th- early 19th century always pique my interest. In this instance, Rowlandson’s apothecary (1801) is praying deeply. But what for? Skills to heal more efficiently and better, or for a slew of customers whose illnesses will help fill his coffers with lucre?

Knowing Rowlandson’s outrageous penchant for irony, I am willing to bet it is the latter. So I entered a few phrases into my trusty Google search bar and found this cached explanation of the prayer:

A prayer with a mischievous aim: This example is a sarcastic Apothecary’s Prayer, which was accompanied by a Thomas Rowlandson caricature. 12

“Oh mighty Esculapius! Hear a poor little man overwhelm’d with misfortunes, grant I beseech thee to send a few smart Fevers and some obstinate Catarrhs amongst us or thy humble supplicant must shut up shop…”

“and if it would please thee to throw in a few Cramps and Agues, it would greatly help thy miserable servant, for on the word of an apothecary, I have scarcely heard the music of Mortar these two month…”

“Physic those, I beseech thee, that will not encourage our profession, and blister their evil intentions, viz, such as their cursed new-invented waterproof…”

This was a weatherproof material which was expected to keep the wearer dry and hence free from colds and coughs and other diseases. – Wright, David. Some Prayers and Oaths from the History of Medicine, cached page.

The entire prayer:

O mighty Esculapius! hear a poor little man overwhelm’d with misfortunes, grant I beseech thee to send a few smart Fevers and some obstinate Catarrhs amongst us, or thy humble supplicant must shut up shop–and if it should please thee to throw in a few Cramps and Agues it would greatly help thy miserable servant, for on the word of an Apothecary I have scarcely heard the music of Mortar these two months.

Take notice also, I beseech thee, of the mournful situation of my neighbour, Crape the Undertaker, who suffers considerably by my want of practice, and loses many a job of my cutting out; enable him to bear his misfortunes with philosophy, and to look forward with new hope for the tolling of the bell.

Physic those, I beseech thee, that will not encourage our protection, and Blister their evil intentions, viz. such as their cursed new-invented waterproof; and may all the coats be eaten by the rats that are so made: But pour down the Balm of Gilead on the Overseers of the village, and all the Friends of Galen.

May it please thee to look over my book of bad debts with an eye of compassion, and increase my neighbours’ infirmities; give additional twinges to the Rector’s Gout, and our worthy Curate’s Rheumatism; but above all, I beseech thee to take under thy special the Lady of Squire Handy, for should the child prove an heir, and thy humble servant so fortunate as to bring the young gentleman handsomely into the world, it may be the means of raising me to the highest pinnacle of fortune.

I looked up the word Galen. He was the physician who succeeded Hippocrates and who described cancer as an excessive black bile.  Until the 17th century it was believe that the bile coursed throughout the entire body. Even if a tumor was removed, the black bile remained to create more tumors. Not a nice prayer, n’est-ce pas?

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Image Credit: Wellcome Library, London
An apothecary praying for a host of illnesses to descend on his customers so that he can make more money. Coloured etching by T. Rowlandson, 1801, after G.M. Woodward.
Coloured etching and text 1801 By: George Moutard Woodward after: Thomas Rowlandson
Published: R. Ackermann,[London] (101 Strand) :  30 July 1801
Printed: [E.] Spragg)(London :
Size: border 18.7 x 23 cm.
Collection: Iconographic Collections
Library reference no.: ICV No 11040
Full Bibliographic Record Link to Wellcome Library Catalogue

Copyrighted work available under Creative Commons by-nc 2.0 UK: England & Wales, see http://images.wellcome.ac.uk/indexplus/page/Prices.html
Previous Ref: D5459/2/146

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The Comforts of Bath, Thomas Rowlandson.

Almost everyone who visits my blog, Twitter account, and Facebook page knows I’ve broken my foot in two inconvenient places. Even with modern medical advances the most pleasant way to describe my experience is that it’s been a … pain. Literally and figuratively. This lover of walking 3-4 times a day with her dog has been sidelined. I’ve been sitting or lying down for a month, watching my bum grow two sizes. I’m a bit more mobile now and can hobble wearing an unwieldy boot.

How did people deal with this situation two-hundred years ago? I wondered as I stared at the ceiling with my foot propped up higher than my head. It certainly could not have been easy. Mrs. Mapp, or Crazy Sally, as she was known, was a famous London bone setter in the early 18th century. While she was unlucky in love, she made her fortune with her strength, boldness, and wonder-working cures.

Besides driving a profitable trade at home, she used to drive to town once a week in a coach and four and return again bearing away the crutches of her patients as trophies of honour. - Mrs. Mapp: The Bone-Setter, Book of Days, Robert Chamber, 1864

I doubt Mrs. Mapp would have bothered setting my foot. There was really nothing to manipulate. All it needed was rest and a good calcium-rich diet. How did people get round and about when they were hobbled in days of yore?

In my estimation, crutches resembled torture instruments more than helpmeets.

Beggar with one leg and a crutch. Image @Risky Regencies

This 1850 crutch is similar to the one depicted in the image above. It was not adjustable, and rags were wound around the top to make the crutch less painful. Even with ample padding on the modern crutch, my underarms became sore. I can only imagine how much discomfort the old models offered.

Wheelchair, Barry Lyndon

Wheelchairs were invented early in the history of mankind. In 530 B.C. a wheeled child’s bed made an appearance on a Greek vase, and in 525 A.D. a wheelchair was depicted on a Chinese print. By the 17th century, the patient’s comfort began to be taken into account.

Paralytic woman in wheelchair, 1821. Image @Museum of London

During the 18th century the Bath chair was born. Invented by John Dawson, the three-wheeled chairs remained popular all through the 19th century.

3-wheeled Bath chair. Image @BBC

This Rowlandson caricature depicts the ill visiting the Pump Room to take the waters. Note the sedan chair at left being carried inside the room, the man in the wheelchair, and the man walking with two canes.

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Copyright (c) Jane Austen’s World. In A Triple Tragedy: How Princess Charlotte’s Death in 1817 Changed Obstetrics, I discussed the two approaches to obstetrics in the early 19th century – the conservative approach, which meant no intervention, and the more radical intervention approach. I included no image of a physician examining a woman.

Morbid Anatomy, one of my new favorite sites, features three images of a physician examining a woman (circa 1800). These images came without attribution, but are interesting nevertheless. Click here to see them all.

Internal examination of a woman, circa 1800

In the early 1800’s there was also a growing number of formally trained doctors who took great pains to distinguish themselves from the host of lay practitioners. The most important real distinction was that the formally trained, or “regular” doctors as they called themselves, were male, usually middle class, and almost always more expensive than the lay competition. The “regulars'” practices were largely confined to middle and upper class people who could afford the prestige of being treated by a “gentleman” of their own class. By 1800, fashion even dictated that upper and middle class women employ male “regular” doctors for obstetrical care—a custom which plainer people regarded as grossly indecent.” – Witches, Midwives, and Nurses A History of Women Healers by Barbara Ehrenreich and Deirdre English

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The Comforts of Bath, Rowlandson

 

Had Margaret Dashwood fallen from a tree and broken her forearm, Mrs. Dashwood would have sent for the surgeon to set it. A broken bone presented a painful procedure in a time before anesthesia, but simple fractures of the arm were relatively easy to fix, even in the late 18th and early 19th centuries. In reaction to the injury, muscles contract and are stretched before the bone is set. Arm muscles do not offer undue resistance. Thus the bone of a forearm can be set without too much exertion on the part of the surgeon or bone setter. Once set and placed in a sling, the arm bone required time and rest for healing.

 

The Crofts in their gig, 1995 Persuasion

 

If Admiral Croft, a notoriously bad driver, had overset his vehicle and tossed poor Mrs. Croft to the ground, breaking her leg in two places, the situation would have been different. The size and strength of her leg muscles would have been so much stronger than Margaret’s arm muscles, and the exertion to set Mrs. Croft’s bone in place would have required more effort and required the work of at least two persons.

A fracture in Mrs. Croft’s lower leg would have been easier to remedy than a fracture of the thigh, in which large and strong muscles would experience a great degree of contraction and shortening. Considerable manipulation would have been required by several assistants to overcome strong thigh muscles and stretch them in order to place the bones in their natural position.

The simple position of the injured member sometimes suffices to overcome the contraction of the muscles and to restore the broken bone to something like its natural position. Yet, in most cases, it becomes necessary to employ additional means to accomplish this object by pulling the lower fragment away from the upper. This must be done with care and yet with considerable force.”- Home Medical Treatments

If, after the pulling and resetting, both limbs were the same length again, then the procedure was succesful, but this was not always the case. Soldiers on the battlefield whose bones shattered from canon and gun fire risked getting an infection. In such instances, surgeons often chose to amputate before the tissue became necrotic.

Bone Setters

As early as the 16th century, apprentice barber-surgeons were impressed in the army to treat soldiers, where they learned their trade by neccesity Generally, surgeons and bone setters learned how to set various kinds of fractures through apprenticeship.

“Bone setters included surgeons and barbers. the practice of bonesetting by both qualified and unqualified practitioners. (In using the term “unqualified,” we refer to those who take up the practice of healing without having had any formal training in the accepted medical procedures of the day.) –  Bonesetting, Chiropractic, and Cultism Chapter 1: The Origin and Course of Bonesetting ©1963, Samuel Homola, D.C.”

Not all bone setters were apprenticed to a medical person. If no surgeon or physician lived within the vicinity, the local blacksmith would set bones in humans and animals, for a fee, of course.

 

Sarah Mapp, 18th Century Bone Setter

 

Some bonesetters became celebrated for their dexterity. One such person in the early 18th century was Mrs Mapp, whose skill was legendary. A daughter of another famous bone setter, Polly Peachum (who married the Duke of Bolton), she was known as crazy Sally. Nevertheless, her “cures earned her upward of 100 guineas per year. Sally Mapp’s marriage was not as successful as her skills with bones. Her husband thrashed her several times before absconding with a majority of her earnings.

“Her bandages were neat, and her skill in reducing dislocations and in setting fractures was said to be wonderful. If it was known that she was going to the theatre, that was sufficient to fill the house. Her own estimate of herself is shown by an interesting incident. When passing through Kent street, she was taken for one of the King’s German mistresses, who was unpopular. A mob gathered and used threatening languages. Mrs Mapp thereupon put her head out of the window and cried, “Damn your bloods, don t you know me! I am Mrs Mapp, the bone setter,”and drove away amid the applause of the multitude.” – Boston Medical and Surgeon Journal

Not everyone was a fan. “Mr Percival Pott, the celebrated surgeon, who was her contemporary, spoke of her claims as the most extravagant assertions of an ignorant illiberal drunken female savage.”  – Boston Medical and Surgeon Journal

As the medical professions evolved, barber-surgeons, midwives, and professional bone setters like Mrs. Mapp, began to be replaced by trained male physicians and surgeons. During the 19th century, colorful characters like Mrs. Mapp, and midwives, who had widely practiced across all spectrum of classes, labored primarily for the poor and could barely scrape a decent living.

By the 1860’s, British physicians and surgeons were largely registered. A case against a Mr. A.E. Shakesby, bonesetter and osteopath was dismissed, for “osteopathy was not regulated, supervised, or recognized by any statute.” Mr. Shakesby had committed the cardinal sin of elevating his stature as bonesetter and describing himself as an osteopathic physician and surgeon. While his self-description amplified his profession of bonesetter, the grander sounding title did not go against the Medical Act of 1858, which required doctors to be registered in recognized fields. - Medico-Legal, 1932

Over the centuries, scientific inventions sped up a surgeon’s or bonesetter’s ability to help patients. As early as the 15th century, the printing press churned out medical manuals, in which medical procedures were standardized and disseminated over the world. In the late 17th century, traction was used to repair a broken bone, and in 1718, French surgeon, Jean Louis Petit, invented the tourniquet to control bleeding, a medical technique that was especially helpful during amputations.

Traction to repair a broken bone is seen here in “Armamentarium Chirurgiae”, by Ioannis Sculteti (1693), and the final illustration is by Laurence Heister in “A General System of Surgery” (1743). Note the numerous assistants required to restrain the patient in this pre-anesthetic era. – Collect Medical Antiques

Pain Control

Bone setting could be extremely painful, and pain was excrutiating during amputations. Before 1853, only a few substances were available to dull pain, but these efforts were generally unsuccessful and many surgeons relied on their patients to faint from pain as a method of relief. A person in shock would feel less pain and bleed less, for their lower blood pressure would reduce the flow of blood, in the case of a jagged bone.

Methods of pain control included: icing the limb, prescribing laudanum, drinking alcohol, and providing nerve compression or hypnosis. Icing the limb was problematic in that carting ice was a hugely expensive and laborious procedure, and storage through the warms months required ice houses and was available to only a few. (Storing Ice and Making Ice cream in Georgian England)

During the latter half of the 18th century and early 19th century, there were several missed opportunities for finding an effective anesthetic. In 1773, Joseph Priestley used nitrous oxide, a gas that was difficult to synthesize and store. Humphry Davy commented in 1800 that nitroous oxide transiently “relieved a severe headache, obliterated a minor headache, and briefly quenched an aggravating toothache.” No one seems to have taken that observation further. Humprhy Davy also realized that inhaling ether relieved pain, but remarkably, ether was considered a recreational drug during this period. In Britain and Ireland, when gin was taxed to the point where the poor found the cost prohibitive, they began to drink and ounce or two of ether instead. In America, students would hold nocturnal “ether frolics” by holding ethe-soaked towels to their faces.

By 1846, the situation had changed. Ether had made its appearance as a pain reliever, and chloroform was introduced for operations a year later. In 1853, Queen Victoira requested chloroform when giving birth to her eight child, and from then on it was accepted practice to offer pain relief to women in labor.

Sources

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