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

1808_cruikshank-vaccinia

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 Flapper and the Virgin Birth: The Curious Case of Christabel Hart and John Russell

I enjoy writing about real people. For kiddos, I’m working on nonfiction books about Bethany Hamilton and Malala Yousafzai. For adults, I’ve got a fictional origin story about Bonnie and Clyde. What makes that story especially fun, besides digging into the lives of two of the most infamous outlaws, is that I’ve set it during the 1920s. The Roaring Twenties. The Jazz Age. The Age of Intolerance. The Age of Wonderful Nonsense.

During my research, I stumbled upon a dirty, sexy story that illustrates the age of intolerance and wonderful nonsense so well, and I’d love to share it with all you scandalous readers.

Meet Christabel Hart and John Russell.

christabel-hart-russellChristabel was a looker. She worked in a factory by day and, by night, danced the tango at high-society parties. She even shaved her armpits, something reserved for free-spirited flappers in sleeveless dresses. Here, she’s donning the large fur collar trend.

John was a 6’ 6’’ submarine officer, who often went by the nickname Stilts, due to his height.

Their “love” blossomed after Stilts put an advert in The Times looking for “young ladies” to correspond with him. Christabel answered. When Stilts was on leave, they met up in London.

Soon, Stilts proposed, and Christabel likely shrugged as she accepted, claiming, “I thought it would be nice and peaceful not to be pestered by men asking me to marry them.”
However, Christabel had a change of heart. She called it off. She then flippantly tried to elope with one of Stilts’ friends. The marriage never happened, due to legal formalities, and Christabel must’ve shrugged again as she telegraphed Stilts and agreed to marry him after all.

He telegraphed back an overjoyed, “Yes.” A week later, in 1918, they were married.

john-russell-in-dragBut Christabel wasn’t ready for children and didn’t want to consummate their marriage. In fact, the girl must’ve paid attention during PE class, and she insisted on abstinence. Zero hanky panky. Hell, Christabel insisted on different bedrooms.

Stilts agreed, to make her happy.

Some say Stilts’ pent up (and maybe backed up) frustration led to him attending dress balls in drag. That’s him on the left.

And during the few times he did sneak into her bed, Christabel declared that Stilts’ methods of birth control made pregnancy impossible. How? I’ll let your imagination do the work. But through it all, Christabel’s so-called virginity remained intact. So did her hymen.

Lo and behind, in 1921, Christabel realized she was five months pregnant. For me, this is a classic case of playing “just the tip”, but Stilts disagreed—even though it is possible for semen to pass through an unbroken hymen and also for sperm to be in the pre-cum. Nevertheless, Stilts was adamant Christabel was unfaithful and sued her for divorce, thus beginning a nasty trial.

Gynecologists confirmed her unbroken hymen. Christabel was cleared of any adulterous acts, though she did have “twenty to thirty [male] dancing friends.” Stilts was named the father. And, the trial even reached the likes of King George, who said the language used in court was worse than “the pages of the most extravagant French novel.”

So, there you have it. I call this the mother of 1920s scandal, lasting through 1937 when Christabel finally gave Stilts a divorce.becoming-bonnie-cover

Jenni L. Walsh is the author of Becoming Bonnie, a historical novel forthcoming from Tor/Forge (Macmillan) on May 9, 2017 that tells the untold story of how wholesome Bonnelyn Parker becomes half of the infamous Bonnie and Clyde duo during the 1920s. Learn more about Jenni and her books at jennilwalsh.com.

Sources

“John and Christabel.” Jazz Babies

Chicago Tribune Press Services. “‘Dream Baby’s’ Mother Given Final Decree” Chicago Tribune [Chicago] 22 January 1937 Published: Page 4. Print.

Venning, Annabel. “The Aristocrat in Frocks and His Man-mad Wife Who Gave Birth While Still a Virgin: Couple’s Grandson Sheds New Light on Britain’s Most Sensational Divorce Case.” Daily Mail Online. 01 Nov. 2013.

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.

“The Lays of Ancient Rome”: Pompeian Pornography and the Museum Secretum

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Priapus as Mercury. Pompeii

On August 24, 79AD, the day after Vulcanalia, the festival of the god of fire, Hell came to the Gulf of Naples. Vesuvius erupted and a searing pyroclastic cloud scorched, choked, and buried the prosperous provincial Roman cities of Pompeii and Herculaneum under thousands of tons of blistering ash and boiling mud. The thermal energy released dwarfed that of the atomic bombings of Japan, and to the witnesses and victims it must have felt like the apocalypse. ‘You could hear the shrieks of women, the wailing of infants, and the shouting of men,’ wrote Pliny the Younger, ‘People bewailed their own fate or that of their relatives, and there were some who prayed for death in their terror of dying. Many besought the aid of the gods, but still more imagined there were no gods left, and that the universe was plunged into eternal darkness for evermore’ (Hutchinson: 1931, 495).

Entombed and oddly preserved at the moment of their destruction, the ruins lay undisturbed for over 1,600 years, while above them the Roman Empire fell, the Ostrogoths, Byzantines, and Lombards fought for control of the region, the early-Christian Church became established, the Kingdom of Sicily rose, the Black Death decimated Europe, the Reformation came, and Florence, Milan, and Venice became the cultural hubs of the Renaissance. Then one day in 1709, a peasant in the small town of Resina came across some interestingly coloured marble and alabaster while digging a well…

Initial excavations in search of more of the valuable gallo antico yellow marble during the Austrian occupation of Southern Italy were inconclusive and abandoned after a couple of years. Almost thirty years later, when the region was once more under Spanish control, the army engineer Roque Joaquín de Alcubierre was overseeing the building of a new summer palace for King Charles of the Two Sicilies when he discovered – or more correctly rediscovered – the remains of Herculaneum. With permission and a modest grant from Charles of Bourbon, who saw the potential for the discovery and display of Roman artefacts as a symbol of the continuing cultural significance of Naples, Alcubierre began the first serious excavation of the site. His workmen soon unearthed the amphitheatre of Herculaneum, and over the next eight years provided a steady stream of remarkably well-preserved artefacts for the new Museo Borbonico in Naples.

By 1745, however, the stream had begun to run dry. Archaeologists and engineers therefore turned their attention to ‘Cività Hill,’ a few miles south-east of the Herculaneum dig. ‘Cività’ means ‘City,’ and under the hill, where local legend suggested a lost city lie, possibly the small seaside town of Stabiae (also obliterated by Vesuvius), Alcubierre found the much larger port of Pompeii. The going was much easier as the city had been buried by ash rather than the mud that had set like concrete over Herculaneum, and the first intact fresco was found in 1748, in what appeared to be a dining room in a house that also contained a skeleton clasping Julio-Claudian and Flavian coins, with all that implies for the unfortunate occupant’s priorities during the cataclysm.

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Fresco, House of the Centenary, Pompeii

Classical Graeco-Roman culture had always been the foundation of art and learning in Europe, a model for ‘Civilization,’ with obvious parallels in particular drawn between the might of the Roman Empire in the past and the British in the present, the global superpower that would dominate the 19th century. Never had the modern world had such a direct window to the ancient as the one afforded by these excavations, but despite what scholars thought they knew about the glory of Rome, they were not at all ready for what they found in the ashes. There were sculptures, ceramics and frescoes depicting Roman deities, natural, mythical and historical scenes, and celebrating sporting prowess; there was even political graffiti carved into walls, and plenty of those clean, white marble statues so beloved by classicists, symbolising purity of body and spirit through aesthetic perfection. So far, so good; nothing Thomas Babington Macaulay wouldn’t have included in his epic poem ‘Pompeii’ or the Lays of Ancient Rome. But there was also something else, and a lot of it; and by 1758 rumours began to circulate in antiquarian circles concerning apparently ‘lascivious’ frescoes being discovered beneath the ruins.

Up until the cities of Vesuvius were excavated, Roman artefacts existed as cultural diaspora, the result often of quite random finds, and subject to millennia of subtle Christian censorship and academic classification. This meant in practice that those clean marble statues became the mark of antiquity, while anything more raunchy or challenging was lost among the acceptable works of art, or possibly even quietly destroyed. But Herculaneum and, especially, Pompeii afforded a different opportunity for historical study. By being effectively frozen in time, the descendants of Rome finally saw how their ancestors really lived, and they lived in a world surrounded by dirty pictures.

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Relief found over a door in Pompeii

Explicit sexual imagery was everywhere, in public and private spaces, and across social classes; clearly, anyone could unproblematically own and view this material. Unsurprisingly, there were ‘lascivious’ pieces in brothels; but there were also paintings depicting couples making love in a variety of positions in the homes of artisans, merchants and politicians, in the quarters of their servants and their slaves, as well as the public baths, while erect phalluses were carved into paving stones and doorways as symbols of potent protection (right), and beautifully rendered statues of deities cavorting with both animals and human beings were proud centrepieces of any fashionable piazza. Discovered in its original context, whether an individual piece was intended to titillate, amuse, or ward off the evil eye, it was apparent that this was not untypical, and that erotic art must have been common throughout the empire and an everyday part of Roman life.

A particularly impressive and representative example was unearthed at the Villa dei Papiri, a country house about halfway up the slope of the volcano, believed to have been built by Lucius Calpurnius Piso Caesoninus, the father-in-law of Julius Caesar. The villa is named for its library, which contained nearly 2000 papyrus scrolls, charred but preserved, making it the most complete and intact classical library ever discovered. The villa was also notable for its owner’s large collection of statuary, which included an intact and intricately carved marble, about six inches tall, of the god Pan on his knees penetrating a she-goat (below). ‘It is impossible not to admire the expression of sensuous passion and intense enjoyment depicted on the Satyr’s features,’ wrote the French antiquarian Cesar Famin in his privately published catalogue Musee royal de Naples; peintures, bronzes et statyues Erotiques du cabinet secret, avec leur explication (1816), adding, ‘and even on the countenance of the strange object of his passion.’ He goes on to cite Herodotus, Virgil and Plutarch to demonstrate that ‘The crime of bestiality was not rare among the ancients’ (Fanin: 1871, 22).

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Pan copulating with a goat. Villa of the Papyri, Herculaneum.

And the shocking revelations did not stop there. Diggers also found ornate drinking bowl masks fashioned like mouths but with a penis instead of a tongue, several bronze tintinnabulums – a kind of hanging chime depicting a winged phallus with little bells attached to it (below right) – a terracotta lamp in the shape of a particularly well-endowed faun, icons of Priapus, fertility god, protector of livestock, fruit, gardens and male genitalia, usually depicted with a large and permanent erection (hence the term ‘priapism’), and a two-foot tall painted phallus on a limestone plinth in the garden. The Catholic archaeologists were nonplussed. In their culture, sex was the ultimate taboo, with the phallus and representations thereof completely hidden from view, let alone graven images doing it in public. Their instinct was to hide it up. King Charles himself therefore placed the statue of Pan and the goat under the supervision of the royal sculptor, Joseph Canart, with strict injunction that no one should be allowed to see it.

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A tintinnabulum

As the art historian Walter Kendrick has argued, similar artefacts found elsewhere over the centuries had very probably ‘succumbed to the zealous progress of Christianity’ (Kendrick, 1996: 10); but the sheer volume of explicit material unearthed around Vesuvius presented excavators with a problem not so easily disposed of, although some Pompeii frescoes were subsequently vandalised by outraged diggers. (We know this because contemporary records include sketches of paintings that survived the volcano but have since been obliterated.) Experts and politicians knew that these artefacts were of priceless archaeological and cultural value, and, in any event, the word was out about their collective existence. They could not be destroyed, but neither could they be publicly exhibited.

The solution was concealment. Like Pan and the goat, the erotic artefacts of Pompeii and Herculaneum were hidden. At the suggestion of Francesco Gennaro Giuseppe, Duke of Calabria and later Francis I, King of the Two Sicilies, over a hundred pieces were locked away in a special room in the Museo Borbonico known as the ‘Gabinetto degli Oggetti Osceni’ or ‘Cabinet of Obscene Objects.’ Access to these objects was limited to ‘persons of mature age and of proven morality’ (qtd in Tang: 1999, 29), which basically meant male scholars of notable social rank, who were deemed to be capable of rising above the baser instincts that exposure to these artefacts might provoke. A royal permit was required, and obviously women, children and members of the lower orders need not apply. What had begun as an Enlightenment project – the excavation of the ruins – had now become, in effect, proto-Victorian, and other ‘secret museums’ were established in Florence, Dresden and Madrid housing ‘obscene relics’ from not only Rome but also Egypt and Greece.

Thus was 19th century European culture reconciled with this erotic challenge from classical antiquity, a final invasion by the Imperium Rōmānum, unleashed from beyond the ashen grave of Vesuvius. And they needed this reconciliation, as Europe had fashioned itself in the Greco-Roman image. That this image was now demonstrably tarnished was potentially catastrophic to the collective sense of civilized identity. As historians such as Simon Goldhill, Lynda Nead and Walter Kendrick have persuasively argued, 19th century archaeologists and classicists overcame their dilemma by creating a new physical and cultural space, where both knowledge and morality were preserved, inventing the category of the ‘obscene object’ and then segregating it, with access both restricted and carefully monitored.

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Wall painting from a Pompeiian brothel

This was, in effect, a political act: the contents of the secret museums were part of classical culture, but not the part that we had inherited, and represented the dark decadence that had destroyed Rome and which the modern world must resist. Art, therefore, should only stimulate aesthetically and intellectually, never physically.

Nead, in fact, has made a strong case for the origin of the word ‘obscene’ as we understand it in the Latin term ob scena, which refers to the space off to the side of a stage (Tang: 1999, 29). While the presence of the material was not denied, museum authorities would act as if it did not exist, in exactly the same way that sex was central to the human condition yet never acknowledged in polite society. A new word was found to describe this material: pornography, from the Ancient Greek πορνογράφος ‎(pornográphos), which in turn was derived from πορνεία ‎(porneía, ‘fornication, prostitution’) and γράφω ‎(gráphō, ‘I depict’).

In 1865, the British Museum established its own Museum Secretum in order to house the erotic components of the private art collection of the antiquarian George Witt, whose bequest contained what amounted to an ‘all or nothing’ clause. Much of this material has now found its way into the main collections, but some of it is still kept under lock and key. My wife and I visited the Witt collection a few years back, while she was researching a paper, and there we saw, its access still restricted to scholars by prior appointment, a terracotta replica of the statue of Pan and the goat.

Works Cited

Fanin, Colonel. (1871). The Secret Erotic Paintings: Pictures and Descriptions of Classical Erotic Paintings, Bronzes and Statues. London.

Hutchinson, W.M.L. (ed). (1931). Letters of Pliny By Gaius Plinius Caecilius Secundus. William Melmoth, (trans). London: William Heinemann.

Kendrick, Walter. (1996). The Secret Museum: Pornography in Modern Culture. Berkeley: University of California Press.

Tang, Isabel. (1999). Pornography: The Secret History of Civilisation. London: Channel 4 Books.

Suggested Further Reading

Carver, Rachael. (2011). Pompeii, Pornography and Power. Norwich: University of the Arts.

Clarke, John R. (2007) Roman Life: 100 B.C. to A.D. 200. New York: Abrams.

— (2007) Looking at Laughter: Humour, Power, and Transgression in Roman Visual Culture, 100 B.C. – A.D. 250. Berkeley: University of California.

— (2006) Art in the lives of ordinary Romans: Visual Representation and Non-elite Viewers in Italy, 100 B.C.-A.D. 315. Berkeley: University of California.

— (2003) Roman Sex: 100 B.C. to A.D. 250. New York: Abrams.

— (2001) Looking at Lovemaking: Constructions of Sexuality in Roman Art, 100 B.C. – A.D. 250. Berkeley: University of California.

Gaimster, David. (2000). ‘Sex and Sensibility at the British Museum.’ History Today L (9), September.

Goldhill, Simon. (2011). Victorian Culture and Classical Antiquity. Princeton: University Press.

Grant, Michael. (1997). Eros in Pompeii: The Erotic Art Collection of the Museum of Naples. New York: Stewart, Tabori & Chang.

— (1979). The Art and Life if Pompeii and Herculaneum. New York, Newsweek.

— (1971). Cities of Vesuvius: Pompeii and Herculaneum. London: Book Club Associates.

Hunt, Lynn. (1993). The Invention of Pornography: Obscenity and the Origins of Modernity, 1500-1800. New York: Zone Books.

Nead, Lynda. (1992). The Female Nude: Art, Obscenity and Sexuality. London: Routledge.

Richun, Amy. ed. (1992). Pornography and Representation in Greece and Rome. Oxford: University Press.

Dr Stephen Carver is a cultural historian, editor and novelist. For sixteen years, he taught literature and creative writing at the University of East Anglia, spending three years in Japan as Professor of English at the University of Fukui. He is presently Head of Online Courses at the Unthank School of Writing. Stephen has published extensively on 19th century literature and history; he is the biographer of the Victorian novelist William Harrison Ainsworth and the author of Shark Alley: The Memoirs of a Penny-a-Liner, a historical novel about the wreck of the troopship Birkenhead. He is currently working on a history of the 19th century underworld for Pen & Sword, and a sequel to Shark Alley.

For more from Dr Carver, visit:

Shark Alley – ‘Re-imagining the Victorian Serial’

Author Blog: Confessions of a Creative Writing Teacher

Academic Blog: Essays on 19th Literature & The Gothic