MEDICINE 100 YEARS AGO
Assoc. Prof. Warwick Carter
THE WAY WE WERE
"Hysteria generally occurs in females between the ages of 12 and 45"
So says a medical text book of 100 years ago. It goes on to say that "the present cruel method of bringing up young ladies favours the development of the disease by rendering the whole system delicate and nervous. They are deprived of sunlight, pure air, active labour and exercise. Hot rooms, crowding the intellect to the neglect of the body, solitary vice and novel reading are among the many causes of this disease".
Given the same circumstances today, most of us would probably be hysterical, and one's mind can barely grasp what solitary vices these young ladies nurtured!
100 years ago there were no antibiotics, no vaccinations against childhood diseases, no blood pressure treatments, no effective treatments of heart disease, cancer, peptic ulcers or even hysteria. Most medications were herbal concoctions,and certainly there were no synthetic medications. The doctors of this time often had little to offer except their time and compassion, and this they offered with the assistance of the knowledge available to them.
Sciagraphs (now known as X-rays) were just coming into regular use, although they were more a sideshow trick than a useful diagnostic tool.
Medical treatment was also expensive at 5 shillings (50 cents) a consultation when the average wage was £3 a week. By modern day standards that's about $60 a visit.
There were few specialists in those days. Most doctors were "Jacks of all trades", and performed their own surgery and obstetrics. Private hospitals were the norm, and some church run institutions were very good, but other privately run hospitals were little more than a few converted bedrooms at the back of an old house.
Treatments and attitudes have certainly changed over the years. It was considered proper that "married couples should adopt more generally the rule of sleeping in separate rooms. In this way, troublesome temptations are escaped, and a rational temperance would be practised without inconvenience".
Little was known about the method of spread or the cause of infections. It was considered that mumps was due to "a specific morbid miasma, generated during peculiar conditions of the atmosphere".
Infertility was considered to be caused by "failure of intercourse, the improper use of aphrodisiacs, masturbation and sexual excesses". Masturbation itself, or "self pollution" came in for considerable comment in old texts, and was thought to cause "epilepsy, softening of the brain, insanity and moral imbecility. The victim must be put in a straight jacket with his hands tied behind his back to prevent the inevitable consequences of speedy insanity and death".
The insane were incarcerated rapidly, often with minimal assessment, and even less treatment. A trip to the asylum to watch the insane at play was an amusing day's outing at the turn of the century.
Many methods of painless birth were espoused, including a tea brewed from the "blue cohosh" that "acts most satisfactorily, making the pains regular and effective, and making the doctor's attendance for less than 6 hours the rule".
Some of the more fascinating treatments found in old books include the "management of apparent death by lightening (sic) strike". "A bucket of cold water poured upon the head revives some, but if this fails a battery should be procured and a current of electricity should be passed from the base of the head down the spine to the extremities of the limbs". This is not quite as silly as it at first seems. If the battery was of sufficient power, it may have done the same job as electrocardioversion does today in restarting the heart.
Strokes, or apoplexy, were treated by "an injection of half a pint of soapsuds with half a teaspoon of salt and a teaspoon of cayenne pepper". It is assumed that an injection of this sort would be given into the rectum.
People throughout history have wanted to choose the sex of their children. There are some methods today that have a modicum of scientific rationale, but in 1890 the recommended method for having a male child was "the husband is to take substantial food, pass his time pleasantly in the gay society of men, read amusing books, take moderate exercise, and generally increase his sexual desires without cohabiting". During the same time the wife should "live sparingly, fatigue herself daily, take medicines to reduce sexual passion, and pass her time in the dry society of old women". The term "gay" has certainly changed in meaning since then!
Doctors were not totally ignorant 100 years ago. Many remedies were very effective, although their mechanism may not have been known. Scurvy was still a relatively common disease, particularly among the poorer classes whose diet may have been inadequate. Although it was not known that a lack of vitamin C was responsible, the treatment was "milk and lemon juice three times a day", both excellent sources of the missing vitamin.
But some things never seem to change. It was considered that "every healthy mother should nurse her offspring, as the mother's milk is a superb form of nutrient", and "tobacco is a poison and this weakening habit should be destroyed by a mouth wash of silver nitrate after each meal".
But don't laugh too much! What will doctors and patients think of current medical practice and procedures at the end of the twenty-first century?
EXTRACTS FROM MEDICAL TEXT BOOKS
FROM 1740 to 1900
1.
An intense itching of the nose is an invariable sign of worms.
2.
Severe manias should be treated by placing the feet in a bucket of leeches once a week.
3.
In marriage, a woman should subjugate herself to her husband.
4.
Diphtheria is endemic in all large cities, and becomes epidemic at times.
5.
When mercury is given in the proper dose, few medicines are better in effect.
6.
Apply locally chloroform liniment on hot flannel to cure muscular rheumatism.
7.
For dropsy (ascites : ed) of the abdomen, purge freely with concentrated salines and citrate of caffeine.
8.
After expulsion of the afterbirth, rub the inside of the uterus with ice and a sponge dipped in vinegar to prevent flooding.
9.
A hired wet nurse ought to be healthy, good tempered, careful, fond of children, cheerful, active and have a healthy child of her own.
10.
Love is a massive pleasure growing out of definite relations to persons or sentient creatures, and pointing to the embrace.
11.
Liquid air is useful in surgery, and a spray of it on a diseased part deadens the sensation like cocaine, and enables minor surgical procedures to be performed without pain, and even without an excessive outflow of blood.
12.
The oily skin of brunettes can be improved by rinsing the face in tincture of benzoin, which tends to close the large pores and whiten the skin.
13.
Consumption (TB :ed) may be treated by driving into the system - by means of static electricity. A sponge electrode, saturated with formaldehyde being applied externally over the location of the diseased tissue.
14.
The oil treatment, in connection with the use of a compress, will in almost every case result in a cure of appendicitis if applied in time.
15.
Incising the gums over the erupting tooth of an infant will guarantee great relief.
16.
Tonic cordial: Take a gallon jug, fill it half full with wild cherries, and then fill it up with Jamaican rum. Let it stand for a month or more. Take two tablespoons twice a day. Discontinue as early as possible so that there may be no development of an undue appetite for spirituous liquors.
17.
Hysteria generally occurs in females between the ages of 12 and 45.
18.
A competent physician should expect a fee of five shillings for his services, inclusive of pharmaceuticals.
19.
The modern sciagraph (x-ray : ed) is more a sideshow trick than a useful tool of medicine.
20.
Married couples should adopt more generally the rule of sleeping in separate rooms. In this way troublesome temptations are escaped and a rational temperance would be practised without inconvenience.
21.
Mumps is a specific morbid miasma, generated during peculiar conditions of the atmosphere.
22.
Infertility may be considered to be caused by failure of intercourse, the improper use of aphrodisiacs, masturbation and sexual excesses.
23.
Self-pollution (masturbation : ed) will cause epilepsy, softening of the brain, insanity and moral imbecility. The victim must be put in a straight-jacket with his hands tied behind to prevent the inevitable consequences of speedy insanity and death.
24.
A tea brewed from blue cohosh guarantees painless birth. It acts most satisfactorily, making the pains regular and effective, and making the doctor's attendance for less than six hours the rule.
25.
MANAGEMENT OF APPARENT DEATH BY LIGHTENING STRIKE>
A bucket of cold water poured upon the head revives some, but if this fails a battery should be procured and a current of electricity should be passed from the base of the head down the spine to the extremities of the limbs.
26.
Repeated apoplexy may be managed by the rectal injection of half a pint of soapsuds with half a teaspoon of salt and a teaspoon of cayenne pepper.
27.
For pregnancy to result in a male child -
"The husband is to take substantial food, pass his time pleasantly in the gay society of men, read amusing books, take moderate exercise, and generally increase his sexual desire without cohabiting. The wife should live sparingly, fatigue herself daily, take medications to reduce sexual passions, and pass her time in the dry society of old women".
28.
Scurvy cure is assured by the use of milk and lemon juice three times a day.
29.
Every healthy mother should nurse her offspring, as the mother's milk is a superb form of nutrient.
30.
Tobacco is a poison and this weakening habit should be destroyed by a mouth wash of silver nitrate after each meal.
31.
The present cruel method of bringing up young ladies favours the development of hysteria by rendering the whole system delicate and nervous. They are deprived of sunlight, pure air, active labour and exercise. Hot rooms, crowding the intellect to the neglect of the body, solitary vice and novel reading are amongst the many causes of this disease.
32.
Malaria : A state of the atmosphere or soil, or both, which, in certain localities, in the warm season, produces a fever more or less violent, according to the nature of the exposure.
33.
Apoplexy is most commonly found to accompany persons of a full habit of body, who have a short neck and a system disposed to a too copious sanguination.
34.
By means of the peristaltic motion, the chyle is driven into the orifices of the lacteal veins and assimilated into the blood.
35.
Smallpox, measles, croup, dysentery, scurvy, erysipelas and ague are zymotic diseases in that they are caused by the reception into the system of a poison, which is diffused through the frame, and operates upon it like a ferment or leaven.
36.
Ague is a periodical fever which occurs chiefly in situations where there are shallow, stagnant waters.
37.
Croton oil is so strong a purgative that half a drop will sometimes produce a powerful effect.
38.
In the seventy six great towns of England and Wales, there were during July, August and September of this year (1899), 14,306 infant deaths from diarrhoea.
39.
These new devices are called incubators. They have been responsible for saving the lives of many infants. They are made of iron and glass, and are divided into an upper and lower compartment. Several bottles of water are placed in the lower compartment, to be changed regularly, and the infant is placed in the upper compartment. (1892).
40.
Rooms in which patients with dysentery have been nursed should be cleaned by burning sulphur in them, and then washing them carefully with a solution of corrosive sublimate.
41.
Cyanotic attacks in infants are due to insufficient nourishment.
42.
Overfed infants suffer from indigestion and diarrhoea, and they very quickly lose weight. By careful dieting, their digestive tube can be restored to a healthy state, and they can gain weight.
43.
In the treatment of Addison's disease, decided advantage has followed the use of a combination of glycerine, in two drachm doses, with fifteen minims each of chloroform and tincture of chloride.
44.
Dementia is one of the common terminations of both mania and melancholia. Its outward signs are a vacant and puzzled look, a lack-lustre eye, a weak smile and a meaningless laugh.
45.
Our pay (as a naval surgeon in 1837) was six shillings a day, and one shilling and sixpence in lieu of provisions.
46.
Treat cholera with half a drachm of sulphate of zinc dissolved in warm water, or caromel and opium.
47.
I have seen (1847) some operations under ether inhalations, a new method of rendering patients insensible to pain. My professor opposes it in account of the delay and uncertainty of action.
48.
The penile sheath (condom) is to be condemned, for it prevents the seminal juices by the woman through the wall of her vagina. These seminal juices are essential for the good health of the woman. (Marie Stopes, 1921).
49.
Butchers are generally a healthy class of men because the atmosphere of the slaughterhouse, disgusting as it is to the nose, is highly beneficial to health.
50.
Some fevers, and all inflammations, call for the employment of blood letting. The results to all appearances are as marvellous as magic.
51.
In corpulency, auxiliary medicines such as freely evacuate the fluids whether by the bowels or skin, may occasionally be useful, but the only certain and permanent relief is to be sought in a right abstemiousness, and a strict and constant attention to diet and exercise.
52.
Individuals seized with a complete loss of voice will after the application of caffeine pepper to the throat, or strong gargles of port wine, receive speedy relief of their hoarseness.
53.
Sleeping after dinner is allowed to old people, but it should only be indulged in for a short time and in a sitting posture to prevent its being carried to any excess.
54.
Heartburn is eased by opening the bowels frequently after a dose of rhubarb and magnesia.
55.
In cold months, elderly people produce a kind of chronic cough or humoral asthma for which cigar smoking is beneficial.
56.
Pain of headache for which the pulse be quick, should be eased by loss of blood from the arm.
57.
If the inflammation of a whitlow (paronychia) is very great, three leaches may be applied and the patient may take a dose of opening medicine such as 15 grains of rhubarb powder and magnesia.
58.
The arteries on the inside of the stomach secrete from the blood a peculiar fluid called gastric juice which is highly antiseptic.
59.
Two grains of sulphate of quinine with six grains of powdered myrrh taken three times a day is an effective preservative against the contagion of cholera.
60.
Epileptic fits and other convulsive disorders may be bought on by extreme pain in the ear.
61.
Earache may proceed from a sudden suppression of perspiration, by worms on occasion being bred there, from the translation of diseased matter to the ear, or any hard body sticking in the ear.
62.
In the form of snuff, tobacco has not infrequently been found to produce indigestion.
63.
Any hard body sticking in the ear must be removed as soon as possible by taking snuff, or some strong stentutatory, to make the patient sneeze.
64.
If tobacco fumes are injected into the rectum, the patient shortly becomes comatose from the narcotic principle of the herb, and relief (of the strangulated hernia) will ensue.
65.
I have succeeded in relieving him of a malady that commenced when by accident he swallowed a tadpole as a small boy. Since then his stomach has been filled with frogs, which had been successively spawning ever since, and whose croaking is quite audible. (Letter to editor of medical journal, 1833).
66.
The brain is not the region where pain and happiness is felt, but it is the counting house of the stomach which is the region where happiness or misery is felt.
67.
Sydenham maintains that the antidote to excess body heat is cold, and the present practice of nursing a feverish patient in a room from which every breath of fresh air has been excluded and an open fire is maintained, is to be abhorred.
68.
Love, though at first but a moral malady, very frequently gives rise to organic diseases of the heart and lungs.
69.
The sister and nurse of Job's Ward, Guy;s Hospital (London), were themselves severely purged after massaging the abdomen of a patient confined in his bowels with croton oil.
70.
For cholera, a combination of cordial and purgative medicines is the only remedy at all worthy of confidence.
71.
In the mothers stomach food undergoes the complicated process of digestion, where it is converted into a type of white blood, from which the mothers milk is derived.
72.
Ear inflammation must be treated by a cooling regimen and opening medicines. Bleeding in the arm or jugular vein, or cupping in the neck, will be proper.
73.
Coffee, strongly brewed, is a most effective form of remedy for the distress of severe asthma.
74.
The local doctor treats diphtheria with doses of salts, senna and calomel. The hair is cut off and cold compresses are applied to the head.
75.
If a patient should suffer under the symptoms of apoplexy, he ought to take a brisk cathartic such as three or four doses of Epsom salts, and should carefully avoid all animal food.
76.
The application of a quantity of cobweb may be resorted to in stopping the bleeding of obstinate cuts.
77.
A draught of generous wine, or a dram of any spirituous liquor, will generally remove a hiccup.
78.
For quinsy about the throat and of the uvula, bleed immediately 8 ounces in the jugular vein and apply a blister to the neck.
79.
Trephining of the skull and replacement of the bone that is missing with a silver plate is sometimes useful in the cure of repeated headache.
80.
Wine is lauded as a panacea in red typhus, black plague, yellow fever and blue cholera.
81.
Eighteen drops of laudanum in strong coffee will prove serviceable for sick headache.
82.
ADVERTISEMENT FOR A NATUROPATHIC GUIDE BOOK
For those who can't afford to dye (sic) by the hands of a doctor, I recommend this treatise most heartily.
83.
Pleurisy has as its common consequence a violent cough. The physician must without loss of time take away ten ounces of blood and cause a vomit with 80 grains of ipecocanna (sic).
84.
A rupture is a common misfortune among children. Immediately apply a poultice of fresh cow dung and bind it on tight 'til the swelling disappears.
85.
For falling sickness (epilepsy) burn feathers often under the nose and four days after the full moon take a purge of Indian physick.
86.
Cholera is caused by a form of electricity. The spasmodic contractions of the body, the prickling sensations in the extremities, and the shocks of the body are the result of an unequal charge in the distribution of the blood.
87.
Inflammation in some textures of the human body is so obscure, the physician should never hesitate in the necessity of blood letting.
88.
In sheep, obstruction of the trachea will lead to death in three minutes. This may be reversed by placing a tube into the trachea and breathing forcibly into it. (1833).
89.
If a pin is swallowed and causes pain, administer four grains of tartar emetic dissolved in the warmed whites of six eggs. The coagulated mass and the pin will be bought up in three minutes.
90.
I am convinced of the efficacy of hydrocyanic acid in the relief of cholera. Its powers are far greater than prussic acid as it acts through the nervous system.
91.
Purgative medicines and extensive bleeding used freely will be found of eminent service in the management of falling sickness (epilepsy).
92.
Take of garlic two cloves; of gum ammoniac one drachm; blend them by bruising together, make them into two boluses with water and take one in the night and one in the morning whilst taking very strong made sassafras tea. This is found to banish rheumatism.
93.
In cases of fracture of the cranium, the patient must be copiously bled and large doses of some purgative medicine must be given.
94.
Modesty is a very frequently cause of constipation in women.
95.
When the torpor, congestion of brain and insensibility have occurred from an excessive use of opium ..... the patient is roused and restored by naked immersion in iced water.
96.
In the third stage of cholera, there is but little reason for hope, but I have found successful, the administration by a tube into the stomach, several gallons of cold water in two hours.
97.
Mathematical exercise of the mind is conducive to good health, the removal of listlessness and the retention of sanity.
98.
A person subject to epilepsy is often able to prevent a fit from coming on by tying a cord between the part where the preceding aura is first felt and the rest of the body.
99.
In some particular forms of disease in infants, champagne will prove itself to be of the greatest possible value. it is most efficacious when given ice cold in cases of obstinate vomiting.
100.
Uric acid plays a prominent part in the development of migraines, and excess is believed to give rise to an actual attack.
101.
It is a well ascertained fact that diabetes is far more common amongst educated people than amongst those whose mental powers are not so developed.
102.
Dissolve half a glass of isinglass in a pint of water, add half an ounce of sugar and half a pint of really good port wine. This will form a jelly ideal for inflammation of the throat.
103.
Flatulence proceeds from a neurosis of the stomach or bowels, in that the nerves of these localities are weak, disordered and not doing their work properly.
104.
It is considered that the regular monthly discharge of blood, occurring in women, wards off gout in the fairer gender.
105.
Dropsy (congestive heart failure) is a dire calamity that befalls ancient people sometimes by means of natural decay; and sometimes, those that are young, when they have made too bold with their constitution.
106.
Those who are liable to bleeding piles should avoid heating themselves with strong drink, nor must they fall into violent passions, either of love or anger.
107.
Common sore eyes may be cured by washing them with breast milk.
108.
Chronic constipation may be relieved by securing one pole of a galvanic battery to the nape of the neck, and the other to the lower part of the abdomen, and applying several shocks.
109.
To cure a hernia take a cup of hot coffee every 15 minutes. By the ninth cup the hernia should return of itself.
110.
TYPHOID FEVER
Treatment - Dose liberally with brandy and administer a bran bath every second day.
Bran Bath - Boil a bushel of bran, drain away water, spread on a sheet, lay patient naked in bran, sew up with another sheet, cover with blankets.
111.
To obtain recovery in cases of cancer, aconite (a potent poison) is recommended for persons of sanguine temperament; arsenic is better for bilious or melancholic temperament; and graphite for those of lean habit.
112.
If difficulty is encountered in fastening leeches to a patient, moisten the part with milk or a little blood.
113.
Premature decay in young married women may be prevented by dosing with a medicine containing cod liver oil and iodine of iron.
114.
If one should have the misfortune to be bit by a snake, let him kill the viper immediately, and apply its fat to the wound. This will sheath the poison, and give time for other remedies to expel it out of the blood.
115.
In case a film should grow over the sight of the eye, you may take it off by drying human dung in the sun, and having reduced it to a very fine powder, blow it thro' a quill two times a day into the eye.
116.
Women with immoderate flowing of their courses (menorrhagia) should rectally inject the decoction of comfry leaves, should govern their passions if they can; nor must their tongue be allowed to have too much motion.
117.
For a woman to escape the vapours, she must suffer none of the idle disturbances or disappointments of an empty world to prey upon her mind or ruffle her sweet temper. Let her use just exercise enough to give a gentle spring to her spirits without wasting them.
118.
Cigarettes give immediate relief in cases of Hay Fever, Chronic Bronchitis, Influenza, Cough and Shortness of Breath, and their daily use affects a complete cure.
119.
Exposure of the body for long periods to the heat of the sun is apt to result in more or less serious disturbances, such as congestions, brain haemorrhages, meningitis etc.
120.
As a remedy for many nervous diseases and for pain, the galvanic battery has come into quite general use. It is a clean, convenient and safe remedy. It is also economic, for the cost of an electrical machine is within the means of most every one, and it can be self operated.
121.
Typhus fever is excited by an unknown poison which is capable of being carried in the clothes. Bad food, impure air and overcrowding are predisposing factors.
122.
Dropsy (congestive heart failure) is a morbid collection of fluid in one or more of the serous cavities within the body or in the areolar tissue beneath the skin and in other situations. Great relief is sometimes obtained by multiple minute punctures of the lower limbs, through which the fluid drains in abundance.
123.
If menstruation is suppressed, leeches should be applied to the vaginal lips, pubis or inguinal regions, and the frequent use of hot pediluvia recommended.
124.
To alleviate the colic take a turf of green grass and lay it on the navel.
From 1797 Buchan's Domestic Medicine :-
The pleurisy may be occasioned by obstructed perspiration, cold northerly winds, drinking cold liquors when the body is hot, or sleeping without doors on the damp ground.
Nothing is more to be dreaded by a delicate person when on a visit than being laid in a bed which is kept on purpose for strangers. All the bad consequences from this quarter might easily be prevented in private families, by causing their servants to sleep in the spare beds, and resign them to strangers when they come.
Those who keep most within doors are most likely to catch cold.
Sitting in a warm room and drinking hot liquors until the pores are quite open, and immediately going into the cold air, is extremely dangerous.
The most general cause of fevers are infection, errors in diet, unwholesome air, violent emotions, excess of normal evacuations, or external injuries.
Purging medicines are useful and often necessary in intermittent fevers.
When a fever is attended with a violent pain in the side and a quick hard pulse, bleeding is necessary.
Consumption (TB) occurs in those confined in unwhoilesome air and those with violent passions, exertions or affections of the mind.
Living too much upon animal food without a proper mixture of vegetables, or eating flesh that has been kept too long, are likely to occasion a fever.
Such as wait upon the sick in infectious diseases should stuff their noses with tobacco to avoid great hazard.
The passion of anger ruffles the mind, distorts the countenance and occasions fevers, other diseases and sometimes even sudden death.
The prognosticating of a patient's fate is a vanity amongst physicians despite the inability to conceal this from the patient.
Many persons of a religious turn of mind behave as if they thought it a crime to be cheerful and encourage the development the development of the condition of religious melancholy.
When the faeces lie too long in the bowels they vitiate the humours, and when they are too soon discharged, the body is not sufficiently nourished.
The discharge of urine is lessened by a sedentary life, sleeping on beds that are too soft and warm, food of a dry quality and heating liquors such as red port.
Smallpox disease is so generally known that a minute description of it is unnecessary.
The patient with measles is often greatly relieved by vomiting, and when there is a tendency this way it ought to be promoted by drinking luke warm water.
Inflammation of the brain is often occasioned by night watching, expecially when joined with hard study.
Ophthalmia (eye inflammation) is often caused by the stoppage of customary evacuations.
Quinsy (tonsil abscess) is most fatal to young people of sanguine temperament.