Category: History of Medicine

Suffering Venereal Disease in the Early Eighteenth Century

Posted on March 5, 2013 by - Databases, Early Modern History, History of Medicine, Patients, Remedies

Lindsey Fitzharris (@ChirurgeonsAppr) recently discussed deformities caused by syphilis and the problems of prevention using early condoms (“Syphilis: A Love Story”). She also regularly tweets horrifying pictures of syphilis sufferers in the past, or the raddled syphilitic bones that remain. Evocative stuff.

One of the less revolting images. Head illustrating syptoms of syphilis, 1632. Credit: Wellcome Library, London.

But the day-to-day life of someone suffering from venereal disease wasn’t always so dramatic. Some Sloane letters hint at the physical and emotional experiences of those suffering from long-term venereal complaints.

In the early eighteenth century, many venereal symptoms were not immediately obvious to people. The skin rashes, pustules and chancres of late stage gonorrhoea might easily be confused with syphilis, which in turn could be mistaken for scurvy. Treatments for syphilis and scurvy might even be the same: the underlying problem seen as being hot and corrosive or a matter of poisoned blood. As William Salmon explained in a popular remedy book (1703), his family pills would cure, along with other diseases, “the Scurvy (the only reigning disease in this Kingdom) when it is grown so bad, as to become scandalous, so as many People think it to be the POX”.[1] To further confuse matters, any whitish discharge from the genitals—known as ‘whites’ in women, ‘gleets’ in men or ‘running of the reins’ in all— was potentially classed as a gonorrhoea. Gonorrhoea, they believed, might be caused by masturbation or accidents to the lower back, not just sexual intercourse.

The problem of diagnosis can be seen in the letters of Thomas Hewitt, Roger Cook and J. Hopson. In 1721, Hewitt treated an unnamed gentleman aged 60, described as being scorbutic (e.g. ulcerated skin, lethargy and pallor). The patient’s main troubles, though, were a continual need to defecate and rectal pain. He had several rectal growths, which were voiding a frothy substance. Hewitt was obviously of two minds about the cause of the ailments. Although he had administered mercurial purges (treatment for syphilis), he also insisted that the patient was “an honest trustworthy gentleman”. Sloane, incidentally, also prescribed a typical syphilis treatment: salivation. Cook, in his undated letter, reported suffering from weakness caused by a constant gleet and nocturnal pollutions. Although he didn’t specify gonorrhoea, this would have been a suspicion. Hopson, for example, immediately suspected gonorrhoea when he had “running of the reins” for a couple days.

The physical experience of venereal problems and their treatments was inevitably painful, though they varied widely. Henry Downing reported that he’d had a three-month salivation to treat venereal disease when he was in his twenties. By 1726, he was ricketty, frail, and sedentary. His physical symptoms included pain throughout his body; heart palpitations; heat and pain in his anus, scrotum and urethra; difficulty urinating; and scaly rough skin. A pretty miserable existence.

Hewitt’s patient took opiates to deal with his pain, or indeed perhaps some of his other treatments. In order to drain the pus, Hewitt had dilated his patient’s anal supporation with a sponge. Mercurial treatments also generally required extensive bed rest, owing the various leakages, skin eruptions, and tooth loosening. Not so different from the symptoms of syphilis it was meant to be treating!

The case of Mr Campbell, aged 63, also suggests the long-term health problems that people thought might occur. Thomas Molyneaux and other medical practitioners wrote to Sloane on Campbell’s behalf in 1724. While not obviously venereal symptoms, Molyneaux saw Campbell’s experience of clap in 1685 as significant. Campbell had trouble urinating afterwards. By 1724, Campbell had a blockage in the bladder, pain while sitting, and a hot and burning sensation in the urethra. He was also voiding slime instead of urine.

Worse yet, failure to disclose one’s venereal condition could be fatal. In August 1725, J. Hetherington wrote to Sloane about the death of a young man after being inoculated for smallpox. The underlying concern was that the inoculation, a novel treatment championed by Sloane, might have caused the death. Hethrington was adamant that the patient, who had not been in the “correct habit”, was the one to blame. The young man had failed to tell the inoculation surgeon about his venereal disease and recent treatment. (A physician applied a plaster to his swollen scrotum.) The treatment had successfully reduced the inflammation, but a fever started the next day. This, Hetherington was certain, caused the complications with the inoculation.

Given that these men were blamed for their poor bodily condition, stemming from lack of self-control, no wonder shame and fear were constant companions for the venereal sufferer. There are relatively few letters to Sloane discussing sexual problems of any kind, and some—such as that by E.W.—were anonymous.[2] Embarrassment might also suggest why Hetherington’s patient did not tell the surgeon. Once his problem was apparently gone, there was no need to tell anyone else, including the surgeon, about it. A sufferers’ physical condition also needs to be considered alongside his emotional one. Patients listed fear (Downing and Hopson), weariness (Downing), and melancholy (Hewitt’s patient) among their symptoms. Pain in early modern England was seen as simultaneously physical and emotional.

As their bodies leaked in unseemly ways and their skin turned ulcerated or rough, the sufferers who wrote to Sloane must have been terrified at what fate might yet await them: the fallen noses, blindness or ulcerated skin of syphilis or the swollen testicles and impotence of gonorrhoea.  And above all, they had only themselves to blame.


[1] William Salmon, Collectanea Medica, the Country Physician (London, 1703), p. 452.

[2] Women in particular are absent. This may partly be because of the many ways in which the ‘whites’ might be interepreted medically, if symptoms were present at all. Hopson had asked “the woman”, but she claimed to have no symptoms. As we know today, many women never have any symptoms. Women and their physicians might, deliberately or not, be able to avoid a more shameful venereal diagnosis that called the woman’s behaviour, or that of their husbands, into question.

On shame, see for example K. Siena, Venereal Disease, Hospitals and the Urban Poor: London’s Foul Wards, 1600-1800 (Rochester: University of Rochester Press, 2004).

On the moral implications of leaky bodies, see L.W. Smith, “The Body Embarrassed? Rethinking the Leaky Male Body in Eighteenth-Century England and France“, Gender and History 23, 1 (2011): 26-46.

Two great blog posts on v.d. (by Jennifer Evans) appeared just after I’d published this one!  One is on “The Secret Disease” and the other is on “Beauty and the Pox“.

Domesticity and Astronomy in Eighteenth-Century England

Posted on February 17, 2013 by - Databases, Early Modern History, Environment History, Family, Gender History, History of Medicine, History of Science, Patients, Philosophical Transactions, Religion

This past week has been an exciting time for portents! What with a meteor blasting into Russia, an asteriod passing close to earth, St. Peter’s Basilica being struck by lightning, and the Pope resigning, early modern people would have been getting a bit nervous…[1] As it is, some people believe that the lightning strike was a sign that God approves the Pope’s decision. Perhaps we live in a more optimistic era.

There are several letters in the Sloane Correspondence database about early modern astronomy, although only two that mention comets.[2] By the eighteenth century, there was a growing shift away from seeing dramatic astronomical events as portents. Clergyman William Derham (1657-1735), for example, wrote to Sloane regularly about natural philosophy and his letters (dated 28 March 1706) reveal a careful attention to matters of fact rather than a concern with religious signs.[3]

“Part of a Letter from the Reverend Mr W Derham, F.R.S. Concerning a Glade of Light Observed in the Heavens”. Philosophical Transactions, vol. 25, no. 305 (1706), p. 2221.

In one of Derham’s letters, which also appeared in the Philosophical Transactions (vol. 25, 1706), he described his star-gazing just before Easter. While observing the satellites of Saturn, he spotted a “glade of light” in the constellation of Taurus. The light had a tail like a comet, but a pointy upper end instead of a rounded one. This, Derham was certain, was similar to what Joshua Childrey and Giovanni Domenico Cassini had observed. When the following nights were cloudy, Derham was unable to spot the glade again–and, although Easter Day was fair, he “forgot it unluckily then”. By the time he was next able to look at the skies, the glade of light was gone.

This was the only bit of Derham’s rather long letter that was published in the Phil. Trans. this time. In the letter, Derham also dicussed sunspots and requested advice about his wife’s eye problems. This was typical of many of Sloane’s correspondents, whose letters blurred the boundaries between scholarly, social and medical matters.

Anna Derham, aged about 31, was suffering from eye problems. Sloane had recommended that she take a variety of medicines, including a purge (and rather revoltingly, woodlice), in addition to eye drops. The eye drops, Derham reported, did not agree with his wife and had caused an inflammation. The purge, moreover, had left Mrs. Derham with violent pains spreading from above her eye to throughout her head and face. Derham believed that the eye medicine had resulted in his wife’s cornea wasting away. The outcome of the eye problem was not noted, but a letter from later that year (30 August 1706) mentioned Mrs. Derham’s increasingly severe headaches, which worried both her and her husband. Whether her health improved (or Derham simply distrusted Sloane’s advice in this case) is unclear, but Derham did not mention his wife’s health again until November 1710 when he feared that she might die from peripneumonia. (Mrs. Derham didn’t, managing to outlive her husband.)

What strikes me as particularly interesting in Derham’s account is the small detail that he forgot to look at the skies on Easter Sunday. As a clergyman, he was no doubt very busy in the week leading up to and including Easter. It would be entirely understandable that he might forget… but he did manage to look out his telescope in the nights prior to Easter.

The rather pressing matter of his wife’s health, on the other hand, is the most likely reason. It’s clear that her symptoms were alarming and disabling (as would have been the treatments, as purges kept one very close to the chamberpot). To compound the domestic disruption, the couple had four children between the ages of two and six in 1706. At the very least, Derham was monitoring his wife’s health and overseeing her medical care.[4] Even with domestic help, Mrs. Derham’s poor health would have posed a challenge for the household at the best of times, but even more so at the busiest time of year for a clergyman’s family.

Early modern scientific endeavours often took place within the early modern household, meaning that these activities were inevitably subject to the rhythms and disruptions of daily life. With his ill wife, several young children, and Easter duties, Derham simply did not have time to remember.

 

[1] For other recent blogging on historical comets, see Darin Hayton on “Meteorites and Comets in Pre-Modern Europe” and Rupert Baker on the comets in the Philosophical Transactions (“Watch the Skies“).

[2] The other letter was from Leibniz (5 May 1702), which was an account in Latin of a newly discovered comet.

[3] On Derham and his family, see Marja Smolenaars, “Derham, William (1657-1735)”, Oxford Dictionary of National Biography. Oxford University Press, 2004. [http://www.oxforddnb.com/view/article/7528, accessed 7 June 2011.]

[4] For more on men’s medical caregiving roles within the family, see my article “The Relative Duties of a Man: Domestic Medicine in England and France, ca. 1685-1740”, Journal of Family History 31, 3 (2006): 237-256.

Hans Sloane’s New York Connections

Posted on February 10, 2013 by - Americas, Early Modern History, Hans Sloane, History of Medicine, Letter-writing, Networks, Patients, Royal Society

I was just in New York at a rather fun Cookbook Conference, speaking on medicinal remedies in manuscript recipe books. As I was preparing for my first trip to New York, I idly searched the Sloane database, wondering whether Sloane had any New York connections. I found two letters that refer to New York.

Central Park, New York, February 2013. Photo Credit and Copyright: Mark Gudgeon. Used with permission.

The first is from Patrick Gordon, a naval chaplain, who wrote to Sloane in late April 1702. Gordon apologised for missing the last Royal Society meeting and recent Philosophical Transactions. He asked if there were any commands from the Royal Society for his upcoming residence in New York. Gordon noted that he would be residing in New York for several years. The Royal Society (and Sloane) relied on the reports of men deemed reliable (such as Gordon) for information about medical and scientific matters from across the world.

At present, no subsequent letters from Gordon are in the database, but letters from other men in North America suggest how this relationship might have functioned. Col. William Byrd, for example, wrote a few letters from North America between 1706 and 1710. He clearly referred to Royal Society directives in the information he gathered. Byrd even sent samples, such as roots to cure snakebites.

Sometimes requests for assistance came to Sloane from the other side of the world. On 30 October 1716, William Vesey of New York wrote to Sloane to thank him for medical advice.

The spires of the third Trinity Church (c. 1846) against the backdrop of 1 World Trade Center. Credit and copyright: Lisa Smith.

Vesey had been receiving Sloane’s advice for smallpox and was now recovering from it. Vesey, who was one of the early rectors of Trinity Church in Manhattan, had visited England in 1714-15.(1) As payment, Vesey enclosed five guineas. This was the equivalent of about £444 in 2005 and would have bought one cow in 1720.(2)

Sloane’s reputation as a physician was indeed international! That said, most of his patients from outside Britain and Ireland came from Jamaica, France and the Netherlands. Many were people who had travelled abroad (such as Isabella Pierrepont, the Duchess of Kingston) or, like Vesey, had heard of Sloane while in London (such as the Swedish ambassador, Count Carl Gyllenborg).

Although Sloane’s New York connections are not in themselves particularly impressive, they were a small part of a much wider global network of travellers and shared ideas.

(1) This I discovered on an amble about Lower Manhattan after writing this post. Vesey has a street named after him and is mentioned on the sign outside Trinity Church. See also the Wikipedia entry for William Vesey.

(2) This was calculated using the National Archives historical currency converter. 

Note: this entry was updated on February 13, 2012 with the information about Vesey’s occupation and travels.

 

Preparing for an Epidemic in the Eighteenth Century

Posted on January 28, 2013 by - Early Modern History, Hans Sloane, History of Medicine, History of Science

Tonight BBC2 will be airing a show called Winter Viruses and How to Beat Them. The news was recently filled, of course, with reports on rapidly spreading epidemics of influenza and norovirus; medical historian Alun Withey even blogged about the contemporary and seventeenth-century fascination with the spread of disease. What intrigues me, however, is the actions people took to deal with their fear of disease.

In late May 1720, the plague entered Marseilles, the major trading port in South France, on ships coming in from Levant. The plague rapidly spready throughout the city in the next few months, disrupting commerce and daily life. The French government intervened with strict quarantine measures for both sick people and incoming ships.

Contemporary engraving of the Marseilles plague in 1720, the Quartier Belsunce. Source: Wikimedia Commons.

Meanwhile: back in England… South Sea stocks had been rising in an unrealistic way over the summer months, only to crash in September, resulting in bankrupt investors and panic spreading like an epidemic. Health suddenly became of national interest: protecting the teetering economy became of paramount importance. The fear? That the Marseilles plague might infect Britain via the trade routes.

The Lords Justices called in physician Richard Mead to consider how the plague might be prevented “for the Publick Safety” in 1720. That autumn, the Board of Trade and Plantations investigated methods of quarantine used elsewhere and recommended that Parliament bring in more border control and wider quarantine powers. But it was not until October 1721 that more decisive action was taken.

This time, Sir Hans Sloane, John Arbuthnot and Mead were summoned. In Sloane’s papers (British Library Sloane MS 4034), there are rough drafts of their advice for the Council on how to collect better information about contagious diseases from Bills of Mortality and how to set up barracks near London for quarantines. By December 1721, a Bill was passed that allowed the King to stop trade with infected countries, order fire on any potentially infected ship, establish a domestic military presence, quarantine towns, and remove the sick to lazarettos. The bill was widely criticised for being un-British and something that would only cause more fear. The French, critics argued, were more used to a standing army and harsh measures that limited people’s rights.

Even after the Bill was passed, complaints continued. Some of Sloane’s correspondents scolded him for allowing these “somewhat severe” recommendations.  ‘Belinda’ dramatically claimed that the country was “almost ruined by south sea” by a corrupt government, while “to complet the misery by the advice of Mead that scotch quack [Arbuthnot] wee are to be shutt up in pest houses garded by soldeirs and hired watchmen”. She begged that Sloane intervene: “it is commonly said that you Sr. was not for this barbarous act and I am very willing to… belive you were not haveing alwayes approved your self a person of great charity to thee poor”. The name ‘Belinda’ probably did not refer to a real woman, but was a pseudonym referencing Alexander Pope’s poem, “The Rape of the Lock”, in which Belinda appears as a satiric personification of Britain. Belinda’s letter, nonetheless, captures the fear that many people had about the Bill. The message was clear: the proposed cure for the nation was worse than the disease.

Little did Belinda know just how harsh the initial report by Mead, Arbuthnot and Sloane had been! In their rough draft, the doctors had actually recommended that searchers report any cases immediately to the Council of Health “on pain of death”, that medical practitioners and household heads face severe financial penalties for not alerting authorities, and that any Officers dealing with the plague wear special markings. These, at least, had not appeared in the Bill…

By February 1721/2, Parliament was forced to reconsider the Act and repealed the clauses about domestic measures. When the plague ended in 1722, the British government had not needed to invoke its new act. Sloane may have appeared to the concerned citizens as a possible ally because of his reputation of being charitable, but he also acted to represent and enforce state power.

Giants’ Shoulders #55: Curiosities, Utility and Authority

Posted on January 16, 2013 by - Collecting, History of Medicine, History of Science, Museums, Travel

Welcome to the 55th edition of The Giants’ Shoulders, a blog carnival that rounds up history of science blogging from the last month. This carnival takes as themes three issues that would have been very familiar to eighteenth-century collector and physician, Sir Hans Sloane: curiosities, utility and authority.

Richard Greene’s museum at Lichfield, the “Lichfield clock”
Credit: Wellcome Library, London.

Curiosities for Sloane were wide ranging and could include interesting natural objects, strange stories, or ingenius man-made ones. Over at depictedscience there is an excerpt from Robert Hooke’s Micrographia (1664): a detailed picture of a fly as seen through a magnifying glass, along with a short description. Strange stories always captured the interest of early modern scientific minds. Adrienne Mayor at Wonders and Marvels writes on Sir Arthur Conan Doyle and a sea monster, while Laetitia Barber at Morbid Anatomy has some ideas on making your own ghosts. New inventions showed human ingenuity, such as the umbrella-vator from the 1780s (The Appendix tumblr) and the stethoscope (The Rose Melnick Medical Museum). Richard Carter at The Friends of Darwin porposes a theory for what some ancient Roman jars might be, reminding me of early Philosophical Transactions letters. But the greatest curiosity of all this month is the ideal historian of science spotted over at The Renaissance Mathematicus, though perhaps Thomas Young the polymath, discussed at OpenScientist, might have fit the bill.

Sloane, like many eighteenth-century people, believed that knowledge should be beneficial, especially to society as a whole. From Seb Falk we learn that knowing how to use an astrolabe could save your life, while Jonathon Keats at Culture Lab wonders whether the science in Sherlock Holmes stories would actually have worked. Maria Popova (Brain Pickings) recounts the tale of Charles Babbage’s fight against noise pollution, a battle that he eventually (sort of) won. Jai Virdi has a series of posts, starting with “The Pretensions of Dr. Turnbull“, that look at the nineteenth-century debates about the efficacy of Turbull’s treatments for deafness. Turnbull’s methods may have been in question, but Alfred Russel Wallace’s 1876 map of evolution in the natural world has stood the test of time, since it was only just updated in 2012. RIP to Rita Levi-Montalcini, a truly useful person who brought benefits to society throughout her life. She recently died at the age of 103 after a full life in which she overcame anti-semitism, a male-dominated establishment and scientific dogma — and won the Nobel prize.

Sloane lived at a time when medical and scientific authority was in flux, as they tried to establish who should be considered reliable–a question that hasn’t gone away, just changed form. Seth LeJacq discusses the different treatments for breast cancer preferred by early modern surgeons and their patients, while Vanessa Heggie considers the history of dieting advice. Kirsten Walsh at Early Modern Experimental Philosophy suggests that Isaac Newton and his contemporary experimental philosophers had fundamentally different worldviews, while Thony Christie asks who kept Stephen Grey from publishing in the Philosophical Transactions. Possibly Sloane… In December, there was a hullabaloo about science, authority, and criticism, which is summed up nicely by Rebekah Higgit who wonders what scientists and historians each bring to the analysis of science in society.

Museums are sites where authority, utility, and curiosity all come together, much as they did in Sloane’s own collections. At American Science, Lukas Rieppel ponders the rise and fall of a research mission in a natural history museum: what does it say about the broader society when a museum decides that research is no longer important? Sloane, who collected so that he might understand the world around him, would have been troubled by the lack of curiosity in curiosities.

Giants’ Shoulders #56 will be hosted by Michael Barton (@darwinsbulldog) at The Dispersal of Darwin on February 16. See you there!

Suffering from Colds in the Eighteenth Century

Posted on January 9, 2013 by - Databases, Early Modern History, History of Medicine, Letter-writing, Patronage, Remedies

I apologise for my unexpectedly long absence from the blog, occasioned by a nasty cold followed by an even worse chest infection. But now that I’m on the mend thanks to a course of antibiotics, I have the luxury of sufficient oxygen in my blood stream to reflect on colds in days of yore.

A sick man with a cold. Coloured lithograph, 1833. Credit: Wellcome Library, London.

While nobody ever dies from the common cold, complications from colds can be debilitating or even fatal: chest infections, pneumonia, pleurisy… And these sorts of problems regularly developed in eighteenth-century patients. For fun, I trawled through the database for symptoms nearest my own to see how patients would have treated their colds. It’s not a pretty picture: lengthy and dangerous illnesses and ineffective and uncomfortable treatments.

Patients rarely consulted Sloane for recent or urgent problems, but colds often slipped into the chronic category. Elizabeth Southwell, in an undated letter,* noted that her cold had already lasted two weeks. In 1708, Elizabeth Howland referred to hers lasting three weeks. Lord Lempster, who had a chronic lung condition, had already been suffering from a cold for two weeks when his doctor James Keill wrote to Sloane on June 22, 1710. As if that wasn’t long enough, the winner of these misery sweepstakes was the Earl of Thanet who reported on July 31, 1712 that he had been taking remedies for is cold since June 12.

These weren’t just gracefully fading colds, moreover, but ones that worried sufferers. Keill had anticipated Lord Lempsters’s death, given his laboured breathing; the patient remained seriously ill when Keill wrote again on July 9. Lord Lempster, Southwell and Howland had all started to spit occasional blood in their phlegm. Southwell’s cough was so violent she had given up on taking most remedies, except diacodium (a painkiller made of poppies). The Earl of Thanet and Howland both suffered from chest pains, which can indicate the onset of a serious chest ailment, while the Earl and Southwell had sore throats. Howland was also constantly hot, which she attributed to a sharpness and heat in her blood. Colds that wouldn’t clear up might have different–and apparently hot–effects, as Dr. Keill suggested when diagnosing Lord Lempster’s problems as a stoppage of blood rather than the more serious inflammation of the lungs. Either way, these were serious complications from what started as a cold.

Although there were other remedies used, the treatments focused primarily on diet, bleeding, blistering and purging. The Earl and Howland both drank milk, then known for its healthful benefits in lung ailments. The Earl and Southwell ate fruit–possibly to keep their bowels regular. Southwell had eaten figs, while the Earl had tried and rejected oranges (proposing instead pears). All four patients were bled. Southwell, for example, had been bled twice and Lord Lempster at least three times (10 ounces, 8 ounces, and 8 ounces). Keill also suggested that Lord Lempster try blisters and purging; the Earl initially used blisters, but thought a bit of purging could also be useful. Other remedies described included powder of pearl (the Earl), chalybeates to cause vomiting (Lempster), barley water, linseed oil, sarsaparilla and China tea (Howland). The main goal of the remedies was to reduce inflammation of the lungs, break up the stoppages of the blood, or to cool the blood.

The fates of these eighteenth-century patients? Elizabeth Howland (c. 1658- 1719) and the Earl of Thanet (1644-1729) lasted many years after. Elizabeth Southwell (1674-1709) was the youngest sufferer and she died within a few years of her illness (though not necessarily related). Lord Lempster (1648-1711) was already chronically ill before he contracted his cold, and continued poorly for another year and a half before he died.

Whatever the rationale behind eighteenth-century explanations of and treatments for colds, I’m just glad that I didn’t have to suffer bleeding, purging, and blisters in addition to the misery of a chest infection!

*After 1705 when she had a son. The letter refers to visiting her young ill son.

An Eighteenth-Century Case of Hair Voided by Urine

Posted on December 17, 2012 by - Collecting, Early Modern History, History of Medicine, Patients, Philosophical Transactions, Remedies, Royal Society

“Honourable Sir!” wrote Thomas Knight to Sloane in February 1737 (British Library, Sloane MS 4034, ff. 34-5). He wished Sloane’s advice on an “uncommon Case”—the discovery of hairs discharged by a man who suffered from a burning pain during urinating. Knight thoughtfully enclosed the matter in a pill box for Sloane’s examination.

The patient must have been in great pain as all the adjacent parts, internal and external, were swollen and irritated. He had tried bleeding, clysters, emulsions, and opiates, all to no avail; he was only relieved when he finally passed the “hairy Substance with the gritty Matter that adheres to it”. Importantly, the patient had “kept a strict Regimen” for many years because of gout and “incontinency of urine”. As part of his regimen, he regularly drank cow’s milk.

L. Beale, Kidney diseases, uinary deposits, 1869.
Credit: Wellcome Library, London.

Knight theorized that the fine hairs had come from the skin of some animal that had gotten into the patient’s body and then circulated through the body until reaching the renal glands. “It is more possible”, he thought, “that they were extraneous, than that they were generated in the Urinary Passages”. He recognised that the veins in the body were indeed very small, but damp hairs “become very flexible, pliable and susceptible of being contorted and of assuming any Figure”. Perhaps “some of the downy-hair about the [cow’s] Udder might got along with the Milk”.

The oddity of the story is itself intriguing, but so too is the afterlife of the letter and sample. The details noted on the back of the letter by Sloane (or on his behalf) suggest the process of cataloguing in his collections.

Apr 27 1738

Ent’d in L.B.

Knight of Hair voided by Urine.

 

Ph. Tr. No. 460

VIII IX A letter from Mr T Knight to Sir Hans Sloane

pr. R. S. &c concerning Hair voided by Urine.

The letter and/or the sample were kept and entered into one of the collections in 1738. The letter was also passed on to the Royal Society and it was published in Philosophical Transactions no. 460.

So, what did the Royal Society make of Knight’s report? The Phil. Trans. editor in 1739, Cromwell Mortimer, remarked after the letter: “I doubt of these Substances being real Hairs; I imagine they are rather grumous Concretions, formed only in the Kidneys by being squeezed out of the excretory Ducts into the Pelvis”.

Painful enough, in any case, but at least no need to fear drinking milk!

Bed-wetting in the Eighteenth Century

Posted on November 28, 2012 by - Early Modern History, Gender History, History of Medicine, Patients

Sometimes the embarrassment and frustration of eighteenth-century sufferers seems to seep from their letters. One such case is that of a young boy, John Plowden. A Mr John Manley of Winchester wrote seven letters to Sloane in 1723-4, asking advice about the child’s lack of bladder control. The relationship between Manley and John is never made clear in the letters. The boy did not seem to be an apprentice and his father was still alive. His age was also not given, though it seems likely that he was at least the age of reason (seven)–but perhaps not much more. John’s own letter was composed in grammatical sentences, but he retained a childish script.

A man carrying a child’s commode. The child has just had an accident, according to the picture’s text. (1769) Credit: Wellcome Library, London.

In October 1723, Manley complained that John “has several times bepiss’d his Bed, & when ever that happens, it is always but midnight. He has also bepiss’t his Breeches about six times a day.” A month later, John and his nurse insisted that she had been “very careful & vigilant in complying” with providing John with his remedies. The real problem, though–as Manley claimed–was that John “is so negligent that he has sometimes bepiss’t his Breeches in the day time. I say tis his own negligence, for he is never deny’d leave to do down whenever he askes it”. A strong statement.

John reported in January 1724 that his control had improved. He was now able to wake himself up in the night when he needed to urinate and “don’t do it in my Sleep so often as I us’d to do”.  Manley noted that John had occasional mishaps in bed the previous month, but the nurse had spotted a pattern: the “mischances happen chiefly on those nights [when] at going to bed he makes but a small quantity of urine.” With the cause identified, it became possible to change John’s behaviour. Having John write his own letter to Sloane may also have been an attempt to make him take responsibility for his problem.

Setting aside the fact that toilet training is obviously a desirable goal, this case highlights the importance of bodily control from an early age in the eighteenth century. John’s guardian must have been deeply concerned about the “mischances” if he was consulting one of England’s leading physicians: few people wrote to Sloane about children and consulting Sloane was expensive (a guinea per letter). Manley saw this as a troubling matter.

In John’s case, his physical symptoms suggested a potentially worse problem–an underlying lack of self-control. By the early eighteenth century, there was a growing emphasis on masculine self-management in terms of mind, body and behaviour. Young boys were particularly vulnerable to learning bad habits that could have long-term effects. Manley’s letters reveal a tone of increased impatience with the boy’s repeated “negligence”, while John himself recognised a need to regain control of his own body. And this mastery needed to be as much mental as physical, including even the ability to wake himself when asleep. Much was at stake for young John Plowden.

I also discussed this case in “The Body Embarrassed? Rethinking the Leaky Male Body in Eighteenth-Century England and France”, Gender and History 23, 1 (2011): 26-46.

Update October 24, 2013: Hannah Newton has an excellent post up at earlymodernmedicine on remedies and explanations for bed-wetting (“Wet Beds & Hedgehogs”).

Gender, Bowel Movements and Data

Posted on November 20, 2012 by - Databases, Gender History, History of Medicine, Patients, Research and Writing

A diverting weekend on Twitter, at least if you’re a medical historian. It all started when John Gallagher (@earlymodernjohn) wondered:

On #earlymodern diaries: do #twitterstorians worry that our information about individuals is heavily weighted towards their bowel movements?

A fine question, which several Twitterstorians pondered. Elaine Chalus (@EHChalus) suggested that this was a gendered concern, since:

Bowels have never featured much in the women’s letters/corresp I’ve read over the years. ‘Face ache’ though does.

I had never paid much attention to the bowel movements of the patients I study, but had a memory that women discussed bowels frequently in a medical context. But what might my Sir Hans Sloane’s Correspondence Online have to offer by way of insight?

First, that I do not have a category for tracing patients’ discussions about their excretion. That said, “bowels”, “stomach”, “diarrhoea”, “constipation”, “stool”, “urination” and “urine” all appear as key terms.

Second, after a quick search for “bowels”, “stool” and “diarrhoea” (sixty-eight out of 713 medical letters), I found that men were indeed much more interested in bowel movements overall. Twenty-six of these letters involved women: most were written by medical practitioners (15) or by male relatives (6). The remainder involved women writing on behalf of other females (2) or male relatives (3). No women wrote about their own bowel movements. In contrast, sixteen men wrote about their own and eighteen wrote about other sufferers’ (eleven males and six females). Medical practitioners wrote for an equal number of male and female patients.

What surprised me most is how few letters discuss this issue. Perhaps there might be more references in the 164 letters mentioning “stomach”. However, it could also reflect the categories chosen for the database and a further choice on the part of individual researchers not to input this data because it is so common. As with any database, decisions must always be made.

Only, I’m left with a lingering question… Would it be meaningful to be able to trace the number of references to bowel movements in the eighteenth century?

An Invitation to View a ‘Monster’

Posted on October 29, 2012 by - Collecting, Early Modern History, Hans Sloane, History of Medicine, History of Science, Philosophical Transactions, Religion

Amidst Sloane’s letters is a handwritten advertisement:

An admirable Curiosity of Nature being a Surprising Instance of a monstrous and preternatural birth lately in France to Children Joyned together in the Body. With Two Backs one Breast one Heart and Two Entrails one Head and Two faces Three Tongues in one mouth. The Bodies having their Proper Members so that Monster has Four arms and Four hands on which are sixteen Fingers and Four Thumbs Four Thighs Four legs and Feet and Toes proportionable with perfect nails on both Toes and Fingers. It being at full birth and lived the Space of Four Days. This wonderful curiosity may be brought to any gentleman’s House.

It is an intriguing note, lacking an author’s name or date. But it makes me wonder: did Sloane arrange to view this curiosity?

There are several accounts of unusual births—severely deformed children or animals—in Sloane’s correspondence, some of which appear in the Philosophical Transactions. Monstrous births were a source of great fascination to early modern people; besides being the subject of many treatises and pamphlets, such curiosities were regularly exhibited (for a fee) across Europe.

Nicolaus Tulpius, Conjoined twins (1652).
Credit: Wellcome Library, London. Wellcome Images

The term ‘monster’ comes from Latin, meaning portent or warning. And this was how many people understood them—as a message from God that indicated the mother’s sins or served to caution the wider community about its morals. Other people were simply curious and wanted entertainment, keen to pay the money to see something so unusual. Natural philosophers such as Sloane, however, wanted to understand why such births occurred. Perhaps they were part of the natural world after all, just a matter of excess, or one of God’s secrets placed in nature for man to uncover. But first, natural philosophers needed to distinguish the real from the fake. Given the possibilities of profit and fame, trickery was certainly possible.

Sloane did not indicate that he saw the curiosity. He was a busy man and probably would have relied on word of mouth to decide whether or not it was worth his while to view it. Nonetheless, it is interesting that he bothered to keep the invitation at all. It is arguable that this was simply a random scrap of paper that was caught up in his papers, but I think it is more likely that the invitation acted as a memory device, either to recall that a particular curiosity had come to London or that it was one he had seen. Most significant of all, however, is that he never printed an account by anyone in the Philosophical Transactions that matches the description of this curiosity.

Not all monsters, apparently, were interesting—either as a hoax or medical case!