Bones, Blood, Barbers, and Butchers: Surgeons in the 18th Century

In the eighteenth century, the record for the fastest amputation at the thigh was nine seconds, start to finish, including sawing through the bone. Are you impressed yet? Even the average, thirty seconds, was pretty damned fast.

And speed was of the essence. Let’s face it. If you needed surgery in the eighteenth century or the first half of the nineteenth, you’d better be strong and brave, because it wasn’t a doddle. Not for the surgeon, and not at all for the patient.

Patients faced three major killers

They’d solved one of the major issues that killed people who needed surgery, reinventing ligatures to tie off blood vessels so the patient didn’t bleed out on the table. Before the sixteenth century, they’d used cautery—burning—to seal any gushers, vastly adding to the pain. And, of course, closing up the wound as fast as possible helped.

And pain was the second issue. No effective anesthetics. Not until the mid-nineteenth century. The patient was awake for the entire operation, which was the main reason why speed (and some strong helpers to hold the patient down) mattered.

The biggest killer was factor number three. Germs.

Not that they knew that, of course. The prevailing opinion was that wound infections were caused by air, though how nobody quite knew. They had no way of knowing that the surgeon’s hands and clothes, the bed sheets, the surgical instruments, the dressings, and a myriad of other surfaces that would come into contact with the patient were covered with organisms too tiny to see, but that would infect the wound. Most people sickened. More than half died.

Keep out the air to keep out the contagion

Some hospitals did pretty well. Their theory was that the infective element was carried in noxious fumes; that is, if it smelled like bad air, it would be bad for their patient. Alexander Monro (Primus and Secundus), a father and son team who headed the Royal Infirmary in Edinburgh, must have run a clean operation. They managed to get the death rate for amputations down to eight percent. Given that other hospitals of the time managed rates of 45 to 65 percent, that’s truly impressive.

Most surgeons relied on speed to limit the amount of time the wound was exposed to the air, thus—they hoped—cutting down on the damage the air did to the tissues.

More butchery than medicine

So a fast surgeon was far more likely to be a successful surgeon for three reasons: less blood flow, a shorter time of acute agony, and (they thought) less contagion. No wonder that, to the rest of the human race, surgery seemed more a matter of butchery than medicine.

Naturally, as they thought at the time, physicians did not perform surgery. Physicians had, since medieval times, been university trained. They were gentlemen’s sons with a medical doctorate, highly educated and knowledgeable about the humours of the body and the appropriate ways to balance them. In theory, their superior knowledge made them the only proper people to practice medicine and oversee surgery. They did not involve themselves in physical labour, but expected rather to command those who distilled the medicines they prescribed (apothecaries) or who carried out operations they deemed necessary.

Surgeons, barber surgeons and apothecary surgeons

Specialist surgeons learned their craft on the job, working as a surgeon’s mate in the navy or the army, or as the apprentice to a barber surgeon or an apothecary surgeon.

Barbers were good men with a blade, so an obvious choice for removing some part that shouldn’t be there or performing a beneficial bloodletting. The familiar red and white barber’s pole dates from the time of the barber surgeon, representing the rod the patient held tightly during the operation and the bloodied and clean bandages used. When washed and hung to dry, they would twist together in the wind, forming the spiral we see today.

Apothecary surgeons had won a landmark case in the first decade of the eighteenth century, when an apothecary was taken to court by the Guild of Physicians for compounding and administering medicines without the benefit of a physician’s advice. The Physicians won, but the Society of Apothecaries appealed to the House of Lords, who were unimpressed with the argument that allowing apothecaries to care for the sick would:

“Deprive the gentry of one of the processions by which their younger sons might honourably subsist and be a great detriment to the Universities.”

The Lords reversed the judgement.

The rise of a profession

By the eighteenth century, surgeons were giving physicians a run for their money, some attending university as well as learning their craft by apprenticeship. However, they seldom had any formal qualifications before the Royal College of Surgeons was founded in London in 1800. They were ‘Mister’ compared to the physician’s more prestigious ‘Doctor’, though the brilliant work of a plethora of eighteenth century surgeons raised their status and the work of medical teaching hospitals such as the Royal Infirmary mentioned above raised their knowledge.

By the time Victoria ascended the throne, the confidence of surgeons, and the income they could command, had risen to the point that the cheeky surgeons made the former insulting honorific into a badge of honour. In the UK, Eire and New Zealand to this day, surgeons are called ‘Mister’ rather than ‘Doctor’.

Jude Knight’s writing goal is to transport readers to another time, another place, where they can enjoy adventure and romance, thrill to trials and challenges, uncover secrets and solve mysteries, delight in a happy ending, and return from their virtual holiday refreshed and ready for anything.

She writes historical novels, novellas, and short stories, mostly set in the early 19th Century. She writes strong determined heroines, heroes who can appreciate a clever capable woman, villains you’ll love to loathe, and all with a leavening of humour.

A Raging Madness is out May 9th. Stop by our sister blog today to see surgery in action in a new excerpt and enter two giveaways!

Smallpox vs Edward Jenner: How One Doctor Invented Vaccination and Cured the World

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The deadly disease smallpox had been feared by man for thousands of years by the 1800s, and rightly so. It was highly contagious, incurable, and killed a third of those unlucky enough to catch it.

Those who survived it were rarely left unscathed. Aside from the inevitable permanent scarring, it could leave victims blind and doomed to spend the rest of their days battling lung or joint problems. The disease also did not discriminate between the rich or poor.

Several royals and world leaders contracted it. Queen Elizabeth I, George Washington and Joseph Stalin all had pock-marked faces which they took great pains to disguise. The 18th century fashion for wearing patches stemmed from the desire to hide the damage smallpox had done to aristocratic skin. Smallpox killed both King Louis XV of France and Queen Mary II of England, monarchs who could well afford the best physicians to try to save them, so the merest threat of it was enough to send the population into a panic.

Of course, it didn’t help matters that medical scientists had no idea how the disease was spread and had no way of treating it. The concept of bacteria and viruses would not begin to enter into medicine until 1861, so physicians were clueless. Theories abounded over time, blaming God, the alignment of the planets, and eventually evil miasmas (bad air) as the root cause of an epidemic. Treatments were equally as primitive. Prayer, smelling sweet nosegays, and bonfires were the only weapons the Western World had for centuries. As a result, outbreaks could kill thousands in a very short space of time with terrifying speed, especially children or the old. The only thing they did know, was once you had caught it, you couldn’t catch it again.

In the East where medicine was traditionally more advanced and largely unencumbered by religious interference, physicians expanded upon this idea. Using the healing scabs of a recovering smallpox victim, which they scratched into the skin of healthy people, they protected them. Although they did not realise it at the time, what they were doing was building up the body’s antibodies using a weakened dose of smallpox and thereby rendering the body resistant to any stronger. It’s still a common practice nowadays with certain diseases. Polio is a classic example. Variolation (or inoculation as we now know it) was brought to Britain in 1715 by Lady Wortley Montague, an ambassador’s wife who had suffered smallpox as a child and lost a brother to it.

Whilst inoculation did work in a great majority of cases, it was not without serious risk. By exposing people directly to smallpox, albeit a significantly weaker version of the disease, at least ten percent of those inoculated contracted full-blown smallpox in the process, often with fatal consequences. King George III lost his son Prince Frederick after he had the boy inoculated. When even the king could not guarantee its safety, a great many preferred not to take the risk. Inoculation was also very expensive, which put even more off it, so smallpox remained a devastating killer throughout the eighteenth century.

In 1784, after extensive study of smallpox victims during an epidemic in his hometown of Chester, Dr John Haygarth became convinced smallpox was transferred by human contact. He recommended quarantining anyone with smallpox and gave sound advice as to how anyone coming into contact with a victim should stop the infection spreading:

“During and after the distemper, no person, clothes, food, furniture, cat, dog, money, medicines or any other thing that is known or suspected to be bedaubed with matter, spittle, or other infectious discharges of the patient should go out of the house until they have been washed…When a patient dies of smallpox, particular care should be taken that nothing infectious be taken out of the house so as to do mischief.”

Haygarth’s methods were soon widely adopted. Wherever possible, smallpox victims were isolated away from the rest of the community. Every item of clothing and bedding used was burned to avoid contaminating others. Sometimes, this occurred using quarantine ships. These were hardly floating hospitals as there was little doctors could do other than let the disease run its course, however, moving sufferers offshore was fairly successful in containing the disease if they caught it quickly enough.

cowpoxThe big breakthrough came thanks to a country doctor called Edward Jenner. He decided to test the validity of an old wives’ tale which claimed all those who worked with cows were immune to smallpox. Over the course of many years, he discovered that those new to working with cattle–such as milk maids–often caught a relatively harmless disease from them. Cowpox caused a mild fever and an irritating skin rash in humans which quickly cleared up of its own accord. Jenner began to suspect cowpox was the key to the immunity from smallpox. However, to test his theory he would need to infect a human with cowpox who had never come into any contact with cows before.

In 1796 he paid the parents of James Phipps, and then injected the pus from a cowpox pustule into the boy. A few weeks later, he exposed the boy to smallpox and when nothing happened declared it a resounding success. He called his new treatment vaccination as the word vacca is Latin for cow and was convinced it was the only thing capable of defeating the ‘speckled monster’. However, the Royal Society did not welcome his research with open arms. They declared it too revolutionary and asked for more proof. It took until 1798, and several more experiments with cowpox including one on his own baby son, before they published his findings.

Although conclusive, the people were less enthusiastic to this new miracle prevention. There was an enormous backlash against Jenner’s vaccination accompanied by an extensive propaganda campaign. Aside from the fact the new prevention was more expensive than the old-fashioned inoculation, the widespread resistance came because of two things:

Firstly, and perhaps most importantly, vaccination was seen as ungodly. The very religious masses listened to the anti-vaccination sermons preached from pulpits the length and breadth of the British Isles. After all, in Corinthians is stated quite clearly: “All flesh is not the same flesh: but there is one kind of flesh of men, another flesh of beasts”. Mixing the two things was grossly unacceptable according to the scriptures.

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James Gillray, The Cow Pock. An anti-vaccination cartoon from 1802.

Secondly, although Jenner was able to prove vaccination did work with none of the risks caused by inoculation, he had no earthly idea why. Even the educated struggled to justify agreeing to vaccination without knowing the science behind it. Perhaps it was possible they would begin to sprout horns and udders in the future? Nobody could say for certain this wouldn’t happen.

Others were less resistant. Napoleon honoured Jenner with a medal after the Frenchman vaccinated his troops. Before that, more of his army were killed by smallpox than by battle. Another fan was President Thomas Jefferson who, in 1806, wrote a gushing letter of thanks to Edward Jenner:

“I avail myself of this occasion of rendering you a portion of the tribute of gratitude due to you from the whole human family. Medicine has never before produced any single improvement of such utility… Future nations will know by history only that the loathsome small-pox has existed and by you has been extirpated.”

While history proved Jefferson’s prediction correct, such accolades from Britain’s then enemies did not really do Edward Jenner any favours at home. Vaccination remained hugely unpopular with the masses and some dyed-in-the-wool physicians despite overwhelming evidence of its success and continued to be during Edward’s lifetime and beyond. He died in 1823 with his vaccination still as controversial then as it had been in 1796.

Things came to a bit of a head in the UK when the government stepped in. In 1840 they declared the old inoculation illegal, thus eliminating the choice. Then, the 1853 Vaccination Act made it compulsory in law for all babies to be vaccinated before they were three months old. Failure to do so resulted in a one pound fine and potentially the risk of prison. People argued they were now denied the right to decide what they could put into their own bodies and many took to the streets to protest. Compulsory vaccination was so unpopular, the government had to back down and stopped prosecuting those who refused.

It was only once the brilliant French scientist Louis Pasteur began to do more experiments on vaccination in the late 19th century, and was finally able to explain why it worked, that public objection lessened. Smallpox vaccination became widespread and the catastrophic and destructive epidemics died out. The last known recorded case of smallpox was in Somalia in 1977 and in 1980 the World Health Organization declared the disease eradicated save the few samples kept secure in laboratories. And all thanks an old wives’ tale and a tenacious, mild-mannered country doctor from Gloucestershire who never wanted to be famous.
virginia heath cover
Virginia Heath writes witty Regency romantic comedies for Harlequin Mills & Boon. The first book in her ‘Wild Warriners’ series, A Warriner to Protect Her, will be released in April 2017.

Mediomania: Spiritualism, Crisis, and Mediumistic Hysteria of the 19th Century

A depiction of table-turning in Le Magazine L’Illustration, 1853

Who doesn’t love a good ghost story?

The residents of Hydesville, New York were sure intrigued when rumors erupted of the Fox sisters and their ability to communicate with the dead through taps and rappings in their home. Kate and Margaret Fox invited the public to demonstrations of their abilities, asking the spirits to respond to questions with the correct number of knocks. And from these few taps, a religious movement grew.

But it wasn’t the need or the determination to speak with the dead that drove the development of Spiritualism. The religion came along at the right time when it was needed most by those wishing to enact social change. In the 1850s, Quakers were looking for an escape. Abolitionist Quakers in particular were in a fix. Their religion forbade them from taking a stance on measures such as abolition and women’s rights. But when the Fox sisters started knocking, those looking for an answer saw a way out.

Taking spiritualism by the horns, Quakers began to convert, picking up the torch of spiritualism in the name of women’s leadership, abolition, and a host of other social crusades. Spiritualists traveled the country to speak at assemblies and conventions, some on the subject of spiritualism, but most often at the conventions of social endeavors such as women’s right to vote and abolition. Spiritualism simply served as a means for working toward such change.

With such a surge in social improvement, women were put in a position of opportunity. Suddenly communicating with the dead meant women could assume leadership roles in the community. They became trance speakers, touring the country to speak to large assemblies. Trance mediums wrote books, counseled the distressed, and even ran for president. That would have been Victoria Woodhull in 1872. Women harnessed a power that seemed to favor the female body and used it to propel themselves up in terms of equality with men.

But with such upward movement came backlash, and such backlash took the shape of an accusation of insanity. Dr. R. Frederic Marvin finally gave a name to the disease of which spiritualism was considered to be a result. Mediomania was suddenly a diagnosis spread far and wide, labeling mediums with a type of female insanity. The female reproductive system was to blame, a system so much more “complex” than a man’s and thus in danger of such insanity. While it was not used in place of utromania, the two diseases were often linked. It was determined the angle of the uterus was the cause of the disease. If it were tilted too far forward, women would develop this mediomania and begin to exhibit its horrible symptoms.

Symptoms of this “mediumistic hysteria” often were a woman’s determination to leave traditional roles and her propensity to overuse her mind. Historian Ann Braude argues, “Doctors asserted that, if women used their brains to attempt the mental exertion required for higher education, they would overtax their systems and suffer gynecological disease.” As Marvin asserted, “She becomes possessed with the idea that she has some startling mission in the world.” Such an idea was horrifying by late 19th century standards, and mediums were deemed insane for such behavior.

Treatment was often forced upon the afflicted. I say forced because most often the cure of mediumship was the “Rest Cure.” It entailed the female subjecting to the will of the male doctor. It was believed she must no longer assert her own will in order to be healed. Such a cure inherently suggests a level of force upon the afflicted.

So while women enjoyed a blitz of equality through their abilities as mediums, it quickly came crashing down in the 1870s and into the 1880s as “science” proved these women to be simply insane. Spiritualism lost favor as it failed to organize successfully, and heretics took advantage. Doctors proclaiming the “rest cure” pronounced mediums fit for asylums, and hoax mediums caught in charades gave the movement a bad reputation. More, the movement had already accomplished a major goal in the abolition of slavery, and because of this, lost momentum in their endeavors. The Spiritualism movement would fade away by the 1880s, and with it the persecution of female mediums for their mediomania.

Jessie Clever

Source:

Braude, Ann. Radical Spirits: Spiritualism and Women’s Rights in Nineteenth-Century America. Bloomington: Indiana University Press, 2001.

Jessie Clever decided to be a writer because the job of Indiana Jones was already filled. Taking her history degree dangerously, Jessie tells the stories of courageous heroines, the men who dared to love them, and the world that tried to defeat them. Jessie makes her home in the great state of New Hampshire where she lives with her husband and two very opinionated Basset hounds.
Don’t miss To Save a Viscount. Find out more at jessieclever.com.

The “Poor-Whores Petition” and The Shrove Tuesday Riots of 1668

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You can’t read as much about prostitution as I do without coming across mention of the Shrove Tuesday Riots. They’re little more than a footnote now, but for years they were the terror of every working girl in greater London. Apprentices turned up in droves to participate in the “sport” of whore-bashing, which EJ Burford assures us was an ancient tradition.

Wait, what?

The Riots

For many years* in London, it was an annual tradition for the local apprentices to attack prostitutes and forcibly tear down brothels on Shrove Tuesday. It’s difficult to pinpoint exactly how many years, as these riots were so commonplace they were rarely mentioned unless the property damage was particularly notable.

The Shrove Tuesday Riots of 1668 were notable for a few reasons. They lasted for several days, involved thousands of people, and the damage was so extensive that eight apprentices were actually hanged for it. When two of Elizabeth Cresswell’s brothels were destroyed, she sponsored a satirical pamphlet beseeching Lady Castlemaine, Charles II’s then-mistress, to intercede on their behalf to protect them and their property from future attacks.

Samuel Pepys describes it in his diary entry from March 25th, 1668:

The Duke of York and all with him this morning were full of the talk of the ‘prentices, who are not yet [put] down, though the guards and militia of the town have been in armes all this night, and the night before; and the ‘prentices have made fools of them, sometimes by running from them and flinging stones at them. Some blood hath been spilt, but a great many houses pulled down; and, among others, the Duke of York was mighty merry at that of Damaris Page’s, the great bawd of the seamen; and the Duke of York complained merrily that he hath lost two tenants, by their houses being pulled down, who paid him for their wine licenses 15l. a year. But here it was said how these idle fellows have had the confidence to say that they did ill in contenting themselves in pulling down the little bawdyhouses, and did not go and pull down the great bawdy-house at White Hall.

The official reason for the riots was a general displeasure at the decadence of the Charles II’s court and disapproval at the immorality of London as a whole.

But was that it? Let’s take a closer look.

Apprentices

By 1660, it is estimated that there were 20,000 apprentices working in London. The whole city only had about 105,000 people at this point. Boys were apprenticed around age eleven, and would remain that way until about age twenty-four. During this thirteen-year period—almost half of the average lifespan—they worked without pay under masters obliged to monitor their behavior and see to their moral instruction as well as their vocational training. They were frequently beaten and relied on their masters for all of their basic necessities, including food, clothing, and shelter. They were forbidden from fornication, marriage, visiting taverns, or displaying immoral behavior such as violence or drunkenness.

In spite of the outrageously strict guidelines they had to agree to, London’s apprentices were notoriously rowdy. It’s not difficult to see why. One fifth of London’s total population and almost half of its men were essentially indentured servants forced to endure beatings and work long hours with no pay, little rest, and no accepted outlet for their energy short of attending church once a week. They were energetic, hormonal, and their systematic repression was so well established and legislated that it was an unquestioned aspect of society. Indeed, London’s commerce was largely dependent on the free labor provided by these boys in the name of training them in what amounted to one of history’s longest, most thankless internships.

However, guidelines are written not because everyone follows them, but because people don’t. London’s apprentices were not the models of sober, moral industry they were meant to be.

According to Peter Ackroyd, apprentices were known for heavy drinking, overindulgence, laziness, and starting fights with servants, foreigners, prostitutes, and random passersby. Additionally, they frequently rioted after football matches they attended in Cheapside (yes, really), proving once again that the more things change, the more they stay the same.

In addition to the annual Shrove Tuesday Riots during which apprentices assaulted prostitutes, looted, and physically pulled down brothels, they rioted over food shortages, out of drunkenness, or because of xenophobia. During the May Day riots of 1517, apprentices, artisans, and children looted the houses of foreigners in the city. In June of 1595 alone, apprentices rioted twelve times against the Lord Mayor over inflated food prices.

Apprentices were overworked, underfed, often abused, and rarely paid. Not only were they not allowed to visit prostitutes, but they couldn’t afford them. When business suffered, they were the first to be sacked, so they did not even have the security of a steady job. With no money to spend and no way to vent their frustrations, it’s no wonder they were so prone to fighting and crime. Many apprentices were executed at Tyburn for crimes from petty theft to even murder.

1280px-William_Hogarth_-_Industry_and_Idleness,_Plate_9;_The_Idle_'Prentice_betrayed_and_taken_in_a_Night-Cellar_with_his_Accomplice

In this plate from Hogarth’s Industry and Idleness, we can see an apprentice has turned to highway robbery and is betrayed to the law by a prostitute

Prostitutes

Of London’s 105,000 people, an estimated 3,600 were female prostitutes working from their own premises. That doesn’t sound like much until you consider the female population was only about 50,000 people, and a large number of them were children. The average person didn’t live to see their forties, and the vast majority of people in London were under thirty. This figure also does not include streetwalkers, casual prostitutes, or those operating primarily in the alleys and parks, of which there were many. It would not be an outrageous estimate to suggest that as many as thirty percent London’s women were employed as prostitutes in the latter half of the seventeenth century. Even with this generous estimate, apprentices would have outnumbered them at least two- or three-to-one.

Apprentices were badly behaved and prostitutes were frequently blamed for it. In his Industry and Idleness series, Hogarth uses a prostitute as shorthand for the apprentice’s depravity (above). Prostitutes were to be resisted at all costs: when apprentices assaulted the women, it was accepted, if not seen as completely justified. By tacitly encouraging vice with their very presence, what else could poor, impressionable boys do but resist with violent force?

When apprentice Thomas Savage was hanged at Tyburn in 1668 for murdering a fellow servant, he used his “last dying confession” to lay his fall from grace at the feet of a lewd woman:

“The first sin…was Sabbath breaking, thereby I got acquaintance with bad company, and so went to the alehouse and to the bawdy house: there I was perswaded to rob my master and also murder this poor innocent creature, for which I come to this shameful end.”

That escalated quickly.

While it’s not impossible to believe a woman could have persuaded Savage to rob his master, there’s no motive to wish her would-be paramour a murderer. It’s far more likely the unnamed woman was a convenient excuse. Prostitutes were seen as particularly toxic to apprentices and servants—a kind of gateway drug into all manner of immorality—so accusations of any misdeeds on their part would have gone unquestioned.

The_Whores'_Petition_(1668)The Poor-Whores Petition

It’s not difficult to see why London’s prostitutes were not overfond of apprentices. After the Shrove Tuesday Riots of 1668—a particularly bad year—Elizabeth Cresswell took action. She was a successful madam, and while her brothels had survived both the Great Plague and the Great Fire two years before, they were destroyed by apprentices that year. Cresswell co-sponsored a pamphlet addressed to Charles II’s mistress, Lady Castlemaine, asking her to intercede on their behalf as the highest-ranking whore in the country. I have transcribed it here:

The Poor-Whores Petition.
To the most Splendid, Illustrious, Serene and Eminent Lady of Pleasure, the Countess of CASTLEMAINE, & c.
The Humble Petition of the Undone Company of poor distressed Whores, Bawds, Pimps, and Panders, & c.

Humbly showeth,

That Your Petitioners having been for a long time connived at, and countenanced in the practice of our Venerial pleasures (a Trade wherein your Ladyship hath great Experience, and for your diligence therein, have arrived to high and Eminent Advancement for these last years), But now, We, through the Rage and Malice of a Company of London-Apprentices, and other malicious and very bad persons, being mechanic, rude and ill-bred Boys, have sustained the loss of our habitations, Trades and Employments; And many of us, that have had foul play in the Court and Sports of Venus, being full of Ulcers, but were in a hopeful way of Recovery, have our Cures retarded through this Barbarous and Un-Venus-like Usage, and all of us exposed to very hard (shifts), being made uncapable of giving that Entertainment, as the Honour and Dignity of such persons as frequented our Houses doth call for, as your Ladyship y your won practice hath experimented the knowledge of.

We therefore being moved by the imminent danger now impending, and the great sense of our present suffering, do implore your Honour to improve your Interest, which (all know) is great, That some speedy relief may be afforded us, to prevent Our Utter Ruine and Undoing. And that such a sure Course may be taken with the Ringleaders and Abetters of these evil disposed persons, that a stop may be put unto them before they come to your Honours Pallace, and bring contempt upon your worshipping of Venus, the great Goddess whom we all adore.

Wherefore in our Devotion (your Honour being eminently concerned with us) We humbly judge it meet, that you procure the French, Irish, and English Hectors, being our approved Friends, to be our Guard, Aid, and Protectors, and to free us from these ill home bread slaves, that threaten your destruction as well as ours, that so your Ladyship may escape our present Calamity, Else we know not how soon it may be your Honours Own Case: for should your Eminency but once fall into these Rough hands, you may expect no more Favour then they have shewn unto us poor Inferior Whores.

Will your Eminency therefore be pleased to consider how highly it concerns You to restore us to our former practice with Honour, Freedom, and Safety For which we shall oblige ourselves by as many Oaths as you please, To Contribute to Your Ladyship, (as our Sisters do at Rome & Venice to his Holiness the Pope) that we may have your petition to the Exercise of all our Venerial pleasures. And we shall endeavor, as our bounden duty, the promoting of your Great Name, and the preservation of your Honour, Safety and Interest, with the hazard of our Lives, Fortunes, and HONESTY.

Needless to say, Lady Castlemaine did not take this well.

In case you skimmed it, there was some top-notch seventeenth century shade in that petition. Yes, London’s whores had suffered violence and the destruction of their property at the hands of several thousand frustrated apprentices with more testosterone than sense, but the petition was firmly tongue-in-cheek. It was a satire, and possibly written by Cresswell’s lover, Sir Thomas Player, an anti-Catholic MP who detested Lady Castlemaine.

He wasn’t the only one, it so happens. Castlemaine was Catholic in a time when anti-Catholic sentiment was rife in England, with many suspecting Charles II of being Catholic himself. Castlemaine was known to be Charles’ mistress, but her elevated status as a married countess did not make her less of a whore in the eyes of London’s working girls. You may have noticed a few digs in there about Catholicism and the Pope—these were not idle comments, but pointed sedition. The concern expressed that the apprentices might be coming for her next is not only an insult to Castlemaine, but to Whitehall as a whole—the biggest, most debauched brothel of them all.

Interestingly enough, the official reason for the apprentices’ rioting was anger over the decadence of Charles’ court and London in general; the petition does not refute this, but drives it home by addressing it to the king’s mistress. If we accept that the riots were political protest as opposed to natural frustration boiling over and that the petition was moral criticism rather than just an elaborate burn on Lady Castlemaine, it would seem the apprentices and the whores were in agreement with each other with regards to the shortcomings of the court.

Although Lady Castlemaine did not intercede on behalf of London’s prostitutes as requested, the damage was such that eight apprentices were executed for rioting. Rioting was akin to treason at this point, and the penalty was likewise severe, if infrequently carried out.

While these riots are a thing of the past, Shrove Tuesday is not the only Spring holiday that has resulted in exuberant violence and sexual assault. You consider Mardi Gras and now Holi in India, which has made the news this week for the extremes one school in Delhi has gone to to keep their female students from being groped and it makes you wonder if maybe sexual repression is not the healthiest policy.

Jessica Cale

Sources

Ackroyd, Peter. London: The Biography.
Arnold, Catharine. The Sexual History of London.
Brooke, Alan and Brandon, David. Tyburn: London’s Fatal Tree.
Burford, E. J. Bawds and Lodgings: A History of the London Bankside Brothels c. 100 – 1675
Pepys, Samuel. Diary entry for March 25th, 1668.
Picard, Liza. Restoration London.

Notes

The header image is not from this riot. It illustrates sailors rioting in a brothel some years later in The Strand. Madam Damaris Page, coincidentally co-sponsor of The Poor-Whores Petition, was said to have press ganged dock workers visiting her brothel into the navy, which made her understandably unpopular. 

*At least throughout the sixteenth and seventeenth centuries. 

Civil War Hospitals Were Enough to Make You Sick

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A nurse and the wounded outside a hospital in Fredericksburg

When people find out that I wrote the non-fiction companion to Mercy Street, the PBS series set in a Union hospital during the American Civil War, they almost always ask me whether the show gets the historical details right. Particularly whether the medicine is accurate. I tell them that the series does a great job with historical accuracy with one exception: the television version of Mansion House Hospital isn’t dirty enough.

Today we think of hospitals as bastions of sanitation. But in the mid-19th century hospitals were dangerous, dirty, smelly places that many people rightly regarded as death traps. Add in the chaos of war and you had breeding grounds for contagious diseases, including smallpox, measles, pneumonia, influenza, tuberculosis, typhoid and yellow fever.

At the beginning of the war, the Union Army had a few hospitals attached to forts in the west, but none along the eastern seaboard. In order to cope with the crisis of illness and injury that began before the first battle was fought, the Army’s Medical Bureau requisitioned buildings for use as general hospitals throughout Washington DC and surrounding towns, primarily hotels and schools. Many of them were run down and most suffered from inadequate ventilation and poorly designed toilet facilities, which aggravated the problems of disease.

The largest of the Washington hospitals was the Union Hotel, where Louisa May Alcott served as a nurse for a little over a month. The hospital opened on May 25, 1861, and was soon infamous for its poor condition and worse smells. A report on its condition, made shortly after the first Battle of Bull Run in July 1861, stated that

…the building is old, out of repair, and cut up into a number of small rooms, with windows too small and few in number to afford good ventilation. Its halls and passages are narrow, tortuous and abrupt…There are no provisions for bathing, the water-closets and sinks are insufficient and defective and there is no dead-house [a room or structure where dead bodies could be stored before burial or transportation—a grim necessity in a Civil War hospital.] The wards are many of them overcrowded and destitute of arrangements for artificial ventilation. The cellars…are damp and undrained and much of the wood is actively decaying. (1)

Alcott was more blunt. In a letter home, she complained “a more perfect, pestilence-box than this house I never saw,–cold, damp, dirty, full of vile odors from wounds, kitchens, wash-rooms, and stables.”

Nurses, supported by convalescent soldiers, occasional chambermaids, and an army of laundresses, fought to keep hospitals clean in the face of a seemingly endless stream of mud, blood, and diarrhea—a common element of Civil War military life seldom mentioned in letters and memoirs of the period. (An average of 78 percent of the Union Army suffered from what they called the “Tennessee quick-step” at some point each year.) It was a monumental task, even by standards of cleanliness that required patients’ undergarments to be changed once a week and saw nothing wrong with reusing lightly soiled bandages.

Keeping a supply of clean shirts, clean underwear, clean sheets, and clean bandages required a heroic effort—especially when a given patient might require three clean bandages and a fresh shirt daily, all of which would need to be thrown away because they were so stained with blood and pus. The newly constructed general hospital at Portsmouth Grove, Rhode Island, reported boasted a new-fangled steam washing machine that could wash and mangle four thousand pieces of laundry a day. It was an innovation that hospitals improvised from hotels and schools could only dream of with envy. Most hospitals had to make do with wooden washtubs, soap-sized kettle for heating water, and elbow grease. Washable clothing, bed linens, bandages and rags were washed in hot water using soft soap and a scrub board, boiled to kill lice and insects, rinsed several times in hot water, allowed to cool, and then rinsed again in cool water. Water had to be carried by hand from water sources that varied in degree of inconvenience. Once acquired, water was heated in large kettles on wood- or coal-burning stoves and carried from kitchen to washtub. It was not unusual for a general hospital laundry to process two or three thousand pieces of laundry in one day.

Even the best efforts to keep hospitals clean did not deal with the root causes of contagion. A bacterial theory of disease was some decades in the future. The prevailing medical theory of the period focused on clean air rather than clean water because doctors believed that diseases were spread through the poisoned atmosphere of “miasmas.” Doctors interested in hospital sanitation were concerned with eradicating foul smells. New hospitals were built with an eye toward providing fresh air. Hospital designers would have been well advised to focus on handling human waste instead.

The sanitary arrangements in Civil War hospitals made it easy for diseases linked to contaminated water, like typhoid and dysentery, to spread. Many latrines and indoor water closets had to be flushed by hand, carried by hand from a water source some distance away. As a result, they were not flushed out as frequently as required to keep them sanitary. Worse, in some hospitals, latrines were located too close to the kitchens. Even when there was an adequate distance between the two, flies carried bacteria on their feet as they flew between latrines, kitchens and patients’ dinner trays.

It’s no wonder that disease was responsible for two-thirds of all Civil War deaths.

(1) Quoted in Hannah Ropes. Civil War Nurse: The Diary and Letters of Hannah Ropes, ed. John R. Brumgardt. (Knoxville: University of Tennessee Press, 1980) p. 40.

(2) Quoted in Ropes, p. 40

Further Reading

Humphreys, Margaret. Marrow of Tragedy: The Health Crisis of the American Civil War. Baltimore: Johns Hopkins University Press. 2013

Rutkow, Ira. M. Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine. New York: Random House. 2005.

Schultz, Jane E. Women at the Front: Hospital Workers in Civil War America. Chapel Hill and toler_heroinesofmercystreetLondon: University of North Carolina Press. 2004.

Pamela D. Toler is a freelance writer with a PhD in history and a large bump of curiosity. She is the author of Heroines of Mercy Street: The Real Nurses of the Civil War and is currently writing a global history of women warriors, with the imaginative working title of Women Warriors. She blogs about history, writing, and writing about history at History in the Margins.

“A Second St Domingo”: Sickness during the Walcheren Expedition of 1809

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Terrain of the Walcheren campaign, from France Militaire: histoire des Armees Francaises de terre de mer de 1792 a 1833…by A. Hugo, 1837.

In 1809, the British government sent an amphibious force of 40,000 men and 600 naval vessels to the Scheldt to destroy the French fleet and dockyards at Antwerp and Flushing. It was Britain’s biggest expeditionary undertaking since the beginning of the wars with France in 1793, part of the War of the Fifth Coalition and a diversion to assist the Austrians against Napoleon in central Europe.

The expedition, under the military command of John Pitt, 2nd Earl of Chatham, was a complete failure. The Austrian allies were defeated before the expedition left; although the British captured the island of Walcheren, they advanced too slowly across the neighbouring island of South Beveland, allowing the French to reinforce Antwerp. The expedition was finally withdrawn after a catastrophic outbreak of ‘Walcheren fever’, a combination of several diseases, including malaria.

The impact of this sickness can best be gauged through dry statistics. Of the 39,219 rank and file sent to Walcheren, 11,296 of them were on the sick lists by February 1810. By this time 3,960 were dead. A further 106 had died in battle, but those numbers were swallowed up in the sheer scale of the tragedy.

‘Walcheren fever’ struck the troops suddenly and savagely. One source, the anonymous Letters from Flushing, recorded fatalities from sickness as early as 12 August 1809, but on 8 August the British Chief of Staff reported ‘We have as yet no sick,’ and on 11 August the commander-in-chief Lord Chatham thought ‘the Troops upon ye whole continue healthy.’[1]

By 20 August, however, things had changed. The official Proceedings of the Army recorded on 22 August: ‘Sickness began to show itself among the Troops in South Beveland. On the 20th the number of Sick was 1564, and within the two following days it increased very considerably.’ The next day, the 23rd, the Proceedings recorded ‘Sickness increased very much within the last 24 hours.’ By the 24th the sickness had spread to Walcheren.[2]

At first the officers were not too worried. One of the aides-de-camp to Sir Eyre Coote (Chatham’s second-in-command) recorded in his diary on 24 August: ‘5000 French Troops are said to have fallen a victim to the climate last year, but I consider this as a very exaggerated statement, and at any rate, the constitutions of our men & their habits of life, are much better adapted to this moist atmosphere.’[3]

But by the 27th there were 3467 sick. The following day the officer compiling the official returns could not restrain his concern: ‘The sickness increased to an alarming Proportion, some of the General, and many other Officers were seized with fever, and the Number of Men on the Sick List was nearly 4000.’[4]

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The evacuation of South Beveland, August 1809

The sickness was described by Lieutenant William Keep of the 81st:

The disease comes on with a cold shivering, so great that the patient feels no benefit from the clothes piled upon him in bed, but continues to shiver still, as if enclosed in ice, the teeth chattering and cheeks blanched. This lasts some time and is followed by the opposite extremes of heat, so that the pulse rises to 100 in a small space. The face is then flushed and eyes dilated, but with little thirst. It subsides and then is succeeded by another paroxysm, and so on until the patient’s strength is quite reduced and he sinks into the arms of death.[5]

The British army had been sent to Walcheren with medical supplies for only 30,000 men. It was caught completely off-guard by the scale of the sickness. Things were not helped by the fact that the British had bombarded one of Walcheren’s largest merchant towns, Vlissingen (Flushing), in mid-August, which restricted the accommodation available to the British troops. By 30 August there were nearly 900 sick in Flushing alone, ‘all of them laying [sic] on the bare boards without Paillasses & many without Blankets.’ Two days later Coote’s aide concluded in despair: ‘This island is a mere Hospital and an Inspector of Hospitals will shortly be a more useful officer than the General Commanding.’[6]

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Flushing Harbour. Photograph by Jacqueline Reiter

All these circumstances contributed to an atmosphere of near-panic. Nobody knew who would be next, and no rank was exempt. ‘A considerable degree of apprehension of Climate and Disease has prevail’d too generally, and there has been much anxiety shewn to get away from this Island as if it had been a second St Domingo,’ the Chief of Staff reported disapprovingly, but by this time several generals (including General Mackenzie-Fraser, who later died) were dropping like flies.[7] By mid-September the Adjutant-General of the army was sending in daily (rather than weekly) sick reports, and Chatham decided to start sending the sick home ahead of official orders from the War Office.

According to one account, one doctor ‘and his assistant [had] nearly five hundred patients prostrate at the same moment … the whole concern was completely floored’. [8] By 23 September the army had almost completely run out of bark (now quinine, used to treat malaria) and the medical corps were of course also losing staff to sickness. Sir Eyre Coote (who took over from Chatham, who was recalled) reported to the Secretary of State for War: ‘I can assure Your Lordship, without any Fear of Exaggeration … that the Situation of the Troops in this Island is deplorable … The Sick are so crowded, as to lay Two in one Bed in several Places, and have no Circulation of Air.’ In Flushing, by contrast, many of these places had rather too much air circulation, owing to ‘the damaged State of the Roofs, never repaired since the Siege.’[9]

Totally overburdened, the medical corps became desperate in their attempts to stem the disease. They had no idea what was causing it: they knew it wasn’t contagious, but thought it was due to ‘local or endemic Causes, viz. the Miasmata or Exhalations from the Soil.’ They did, however, notice that the sailors on board the British ships remained healthy, with the exception of the ones who had gone ashore to help with the siege of Flushing (naturally, as mosquitoes do not breed around salt water). One proposed treatment therefore was to pack the British sick into ships and sail them around the islands, in the hope that the sea air and a change of scene would restore them to health. Unsurprisingly, this did not work.[10]

The impact of Walcheren fever on the British army was significant and long-lasting. The soldiers who had served on the campaign continued to relapse periodically for years after. In March 1812 Lord Wellington, in the midst of fighting in the Spanish Peninsula, lamented the fact that his troops had been ‘so much shaken by Walcheren.’ [11] The careers of the commander-in-chief of the Army, Lord Chatham, and the naval commander, Sir Richard Strachan, were destroyed by the disaster.

The British government that had planned the expedition under the Duke of Portland fell, and its successor nearly foundered during the ensuing parliamentary inquiry into the debacle. Two government ministers, Lord Castlereagh and George Canning, ended up fighting a duel. None of this, of course, was especially comforting to the four thousand men who had died from ‘Walcheren fever’.

References
[1] Letters from Flushing … by an Officer of the Eighty-First Regiment (London, 1809), p. 120; Sir Robert Brownrigg to Colonel Gordon, 8 August 1809, BL Add MSS 49505, f. 9; Chatham to Castlereagh, 11 August 1809, PRONI D3030/3220; John Webb to the Surgeon General, 27 August 1809, A Collection of Papers relating to the Expedition to the Scheldt (London, 1809), pp. 588-90.
[2] The National Archives WO 190, 22-4 August 1809.
[3] University of Michigan Coote MSS, Box 29/3, Diary of the Walcheren Expedition, 24 August 1809.
[4] The National Archives WO 190, 27-8 August 1809.
[5] Quoted by Martin Howard, Walcheren 1809, Barnsley, 2011, p. 161.
[6] University of Michigan Coote MSS, Box 29/3, Diary of the Walcheren Expedition, 30 August, 1 September 1809.
[7] Sir Robert Brownrigg to Colonel Gordon, 8 September 1809, BL Add MSS 49505 f. 69.
[8] Rifleman Harris, quoted by Howard, Walcheren 1809, p. 172.
[9] Sir Eyre Coote to Castlereagh, 17 September 1809, A Collection of Papers, pp. 137-40.
[10] Memorandum dated 25 September 1809, A Collection of Papers, pp. 623-5; Sir Eyre Coote to Lord Liverpool, 23 October 1809, A Collection of Papers, pp.177-8.
[11] Howard, Walcheren 1809. p. 215.

Further reading
Gordon Bond, The Grand Expedition (Athens, GA, 1971)
Martin R. Howard, Walcheren 1809 (Barnsley, 2011)
John Lynch, ‘The Lessons of Walcheren Fever, 1809’, Military Medicine 174(3) 2009, pp. 315-19
T.H. McGuffie, ‘The Walcheren Expedition and the Walcheren Fever’, English Historical Review jacquelinereiter_bookcover62(243) 1947, pp. 191-202

Jacqueline Reiter has a PhD in late 18th century political history from the University of Cambridge. A professional librarian, she lives in Cambridge with her husband and two children. She blogs at www.thelatelord.com and you can follow her on Facebook or Twitter. Her first book, The Late Lord: the life of John Pitt, 2nd Earl of Chatham, was published by Pen & Sword Books in January 2017.

Turn Up the Jazz: Murder and Mayhem in Prohibition New York City

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It was July 1929, and ex-convict Simon Walker walked into a speakeasy. He came with friends William “Red” Cassidy and Peter Cassidy, a couple of guys known as waterfront street fighters, and the bar was the Hotsy-Totsy Club at Broadway and Fifty-fourth Street. The speakeasy was owned by the gangster, Jack “Legs” Diamond, and his partner, Charles Entratta. Alcohol mixed with high tensions resulted in an argument between the Cassidy boys and Legs. Guns were drawn and shooting commenced. The orchestra played on, covering up the sounds of gunfire as Simon Walker was killed.

The murder of Simon Walker in the Hotsy-Totsy Club in 1929 was a common occurrence in the Prohibition days of New York City. Bootlegged liquor, speakeasies, and gangsters ruled the city, and the changing ideas of sexuality, class structure, and views on drinking turned the city upside down.

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Jack “Legs” Diamond

The Volstead Act went into effect January 1920, outlawing alcohol. It was the first time the government had attempted to control a moral principle in the citizens of the nation with the passage of law. Deemed the “noble experiment,” Prohibition sought to improve the lives of the poor by removing the vice of drinking. The noble experiment would be a colossal failure, and in no place would it be more spectacular than New York City.

Before Prohibition, saloons were the heartbeat of neighborhoods. Saloon owners were the first to raise money for patrons when an emergency happened or give loans until a patron could get back on his feet. Saloons were meeting places for unions and neighborhood groups. During the day when men were at work, mothers and their children would come to the saloons or children alone would be sent to pick up growlers for dinner, as the beer was safer than water to drink. The saloon was the first place an immigrant would learn how to manage the new world from those who had come before. Prohibition would end the idea of the saloon as a cultural center when drinking alcohol earned the glitter of being outlawed.

With the loosening of ideals around sexuality and drinking, speakeasies, cabarets and nightclubs flourished in a city that might not have even known of the Volstead Act if one just looked at the actions of its citizens. So enamored were the citizens of New York with this new, loose lifestyle, drinking became a sort of sport. While before Prohibition, it would damage one’s reputation to be arrested, being arrested for the violation of the Volstead Act became the cat’s pajamas. Members of high society would flaunt the fact that they had gone to jail for consuming alcohol, so neat was it to be caught drinking.

The nightclub evolved from the saloon as a way for establishments to slip under the radar of Prohibition agents. Such establishments would promote dancing as its main entertainment and not alcohol, just like cabarets. Using walnut or mahogany screens to shield windows, hidden doors inside other establishments, and even going so far as to move frequently, nightclubs and cabarets could offer the much sought-after alcohol while avoiding the scrutiny of the Prohibition Bureau. Even when speakeasies were padlocked for selling alcohol, the business would keep operating out of a back door, leaving the padlock in place as if the owners were abiding by the law.

Speakeasies became the place to see and be seen. They were often outrageously decorated with rich woods, glittering brass rails, and dazzling lights. The Aquarium even housed a giant fish tank. The Country Club had a mini golf course. The 21 Club became the exclusive haunt of midtown. Drinking was no longer a moral taboo. It was the center of nightlife in New York. People who had never drunk before were suddenly taking up the drink because it was the thing to do.

But this glamorous, carefree life came at a price. As liquor was outlawed, it was illegal to manufacture it, sell it, and consume it. Alcohol used in manufacturing was even poisoned to deter people from consuming it. They did anyway to dire consequences. But the speakeasies, cabarets and nightclubs had to find some way of getting alcohol for their patrons. This led to the extraordinary rise in organized crime in the 1920s. Bootleggers constructed elaborate rings to bring liquor into the city. The importers would hide their bootlegging businesses behind legitimate businesses like olive oil importing. The Menorah Wine Company even attempted to import over $100,000 in liquor on forged permits from the Prohibition Bureau under the guise of sacramental wine importation.

This organized crime had a little help from the inside. Prohibition agents were often unqualified for the job. Many were men returning from World War I and in need of a job. They would go into the bureau and start on the take from a gangster, earning more than they could ever dream. In return, the agent would tip off their gangster employer by calling from the bureau office the night of a raid. It got so bad the bureau turned off the phones in the office on raid nights. Agents would confiscate liquor from other bootleggers only to sell it to their gangster employers. A Prohibition agent was a great thing to be in the 1920s if you knew how to play your cards.

But it wasn’t just the gangsters of New York that were cashing in on this illegal trade. Ethnic groups, minorities, and new immigrants also found bootlegging as a way of just paying the bills and staying a breath above the poverty line. They would sell a shot of liquor out of a hip flask on the street, stand as guards in front of speakeasies to warn of raids, and set up shop as a “cordial,” where it was known liquor would be sold. In Harlem where unscrupulous landlords gouged rent prices, tenants staged rent parties near the end of the month, dishing out shots of liquor for high prices. They would collect enough to then pay the rent the next day.

But although the liquor was flowing and the jazz was roaring, the noble experiment caused a higher crime rate than ever before seen in New York City. Reputable businesses like the famed Delmonico’s were forced to close, and honest saloonkeepers forced out of business. It was with a reluctant heart that Franklin D. Roosevelt supported the wet movement in order to secure the democratic nomination in 1932. A dry from the beginning, FDR had no interest in repealing the Volstead Act, but popular consensus was against him. The noble experiment had failed. People were being killed for shots of liquor. Honest bartenders had been forced to carry out their trade in secret. Jobs were scarce, and the Great Depression loomed over it all. So when he took office in 1933, FDR stayed true to party platform and put into motion the steps that would end Prohibition. The roaring ‘20s were no more, and the sound of jazz faded into the night.

Sources:

Lerner, Michael A., Dry Manhattan. Cambridge: Harvard University Press, 2007.

Jessie Clever

jessieclever_tobeaspy_800pxIn the second grade, Jessie began a story about a duck and a lost ring. Two harrowing pages of wide ruled notebook paper later, the ring was found. And Jessie has been writing ever since.

Taking her history degree dangerously, Jessie tells the stories of courageous heroines, the men who dared to love them, and the world that tried to defeat them.

Jessie makes her home in the great state of New Hampshire where she lives with her husband and two very opinionated Basset Hounds.

Don’t miss To Be a Spy: A Spy Series Christmas Short Story. Find out more at jessieclever.com