VICTORIAN SCIENCE

Medical Treatments

During most of the Victorian era, people--including doctors--knew very little about the causes of disease. Health was a challenge because for most of the 19th century, people understand about germs. People had no idea why they became ill, and often, medicine was no more than guesswork. If a serious illness did not cause death, often some of the "remedies" might!

Frequently, people drank from the same unwashed cup which others had used. They did not take baths very often, and when settlers traveled, they typically slept on dirty sheets where many others had slept, or else they shared a bed. Settlers were ignorant as to what part cleanliness played in good health, and they knew nothing of the fact that germs thrive in dirty places.

In the first part of the 19th century, people generally believed that bathing too often removed protective oils from a person's skin, leaving them open to disease. If a person was ill, sunlight and fresh air were not allowed into their room. It was felt that cold, fresh air made people sicker. Sick people were told to stay in bed, not realizing how important it was for recovery to actually get a little exercise.

People believed that diseases traveled through the air, in the water, and underground. They associated sicknesses with "miasma" (a noxious or unpleasant vapour), and doctors carried scented sticks which supposedly kept the miasma from reaching the nose and entering the body.

"Playing Doctor"

Victorians typically had a strong faith in God, which allowed them to courageously face both illness and death. During the 19th century, death was simply "a part of life", something that the Victorians and Settlers just had to face. On the other hand, there were healthful benefits to living during the 19th century! The air was fresher; there was no smog to contend with. The sun shone more brightly, and food contained no chemical preservatives. People also had to walk long distances and do hard physical labour, both of which helped to maintain their bodies.

Unfortunately, however, early doctors were basically very limited in the ways they could treat patients. Because they did not know the cause of disease, they treated the symptoms only. For example, if a person had a rapid heartbeat, the doctor might give him/her a medication or herb to slow the heart rate, but would not cure the cause. Early doctors could not operate, and most medicine of the early 1800s was of little, or no help.

The most common methods of treatment used by 19th-century doctors were: 1) Bleeding (phlebotomy) 2) Blistering 3) Plastering 4) Amputation 5) Purging, Vomiting, and Sweating.

1) PHLEBOTOMY:

No matter if the illness was minor or serious, "phlebotomy" was the remedy most commonly used. Better known as "bloodletting" or "bleeding", it was believed that the use of phlebotomy released the "bad blood" which contained disease from a person's body.

There were a few different methods of bleeding a person. One way was to cut a patient with a "lancet"--a small knife. Later, an instrument called a "scarificator" was invented. This was a small box containing small, sharp blades, and it was used to scratch a person's skin, causing them to bleed. Then, a special cup was heated and placed over the scratches, creating a vacuum, allowing the blood to freely flow from the vein. This procedure was called "cupping".

Another common method of bloodletting was to apply "leeches" or bloodsuckers to a vein. In order to perform this procedure, first a leech was placed in a thin tube while the patient's skin was washed and shaved. To encourage the leech to bite, a drop of blood or milk was placed on the area of a vein. Then the tube with the leech in it was inverted over the spot, and the leech sucked blood from the vein. When it was felt that the leech had taken enough blood, salt was sprinkled on the leech, causing the leech to stop sucking and to let go of the skin.

Many people in a community performed bloodletting, and the same leeches were used many times. Leeches were kept in a jar by and used not only the doctor, but also the blacksmith, the apothecary, and even the barber! As a matter of fact, the colors of red and white seen on the striped pole outside barber shops originally stood for red blood and white bandages--the symbols of bloodletting!

Bleeding was used as a solution to many health ailments during the 1800s, but there were often serious consequences. For one thing, bleeding a person actually lessened the chances for a healthy recovery as it greatly weakened the patient. Doctors often bled patients until they fainted!

Doctors did not yet know about germs and the importance of sterilizing their instruments. Instruments were simply wiped clean of visible dirt and blood, but were not sterilized. Therefore, when these instruments were used, infection often occurred, and the treatment for the infection would typically be more bleeding, which meant that these dirty instruments would be used yet again...and so forth. Sometimes, doctors even used the same instruments on humans as they did animals!

2) BLISTERING:

Another popular early medical practice was called "blistering". Blistering was used as a treatment for anything from a fever or arthritis to serious illnesses such as cholera. Blistering did not actually cure any disease or ailment, but many Victorians believed in its effectiveness. This is because the pain of being blistered caused the patient to focus on a new pain, taking their minds away from the more serious pain from which they suffered.

In the early 1800s, it was believed that the body could only contain one illness at a time. When a second illness entered the body, the first was forced out. Therefore, if the skin of an ill person was made to blister, it was felt that the burn would force the illness from the body. Thus, acid or hot plasters would be poured on the skin to burn it and form a blister, which was then drained. Sometimes, hot pokers were used to burn the skin instead.

3) PLASTERING:

"Plasters" and "poultices" were made slightly differently, but both were popular "remedies" for a variety of ailments. Plasters were paste-like mixtures, made from a variety of ingredients, including even substances such as cow manure. They were applied to the chest or back of a person suffering from a chest cold, or an internal pain--even pneumonia. Poultices were made from bread and milk, and sometimes other ingredients were added such as potatoes, onions, herbs, and linseed oil. Poultices were applied to cuts, wounds, bites, and boils.

4) AMPUTATION:

For most of the first half of the 19th century, there was no real effective type of anaesthesia. Anaesthetics were not introduced until the 1840s (read more about anaesthetics on later pages in this series). Therefore, when a doctor performed an amputation (surgical removal of an arm, leg, or appendage), the patient was usually given wine to drink beforehand in an attempt to help deaden the pain.

Several years later, during the Civil War, amputation was the most prevalent surgery performed. Nearly three out of every four operations were amputations. Often for the army doctor, his operating table would be nothing more than a couple of boards placed between two barrels. He usually soaked a rag with chloroform and applied it to the patient's mouth and nose (a bit more useful in deadening pain than a glass of wine). He would, however, need to periodically remove the rag to avoid chloroform poisoning from occurring. The surgeon first used a tourniquet to tie off the blood flow. Then he used a scalpel to cut through the skin, flesh, and outer tissue, after which he used a saw (called a capital saw) to cut through the bone.

In the early years of the 19th century, the doctor finished the surgery by cauterizing the veins and arteries, then sealed the limb with hot tar so that it would not bleed. By the time of the Civil War, however, doctors usually sutured the limb with either silk (in the North) or cotton (in the South).

Once again, though, there was no knowledge of bacteria or viruses, nor antiseptics and sterilization, and frequently infection set in.

5) PURGING, PUKING, AND SWEATING:

"Purging" consisted of dosing a patient with powerful laxatives in order to expel poisons by relaxing the interior of the body. Despite its ineffectiveness, this was a common treatment for numerous ailments, widely practiced throughout the first half of the century--and beyond--by many doctors. The most commonly-used purgative was Calomel, a form of mercuric chloride.

"Puking" consisted of dosing a patient with emetics in order to produce vomiting. Advocated by Benjamin Rush (see entry below), and used by thousands of doctors during the era, the practice of puking was believed to relieve tension on arteries and to expel poisons from the body. The treatment was used to cure numerous diseases, but like most of Rush's treatments, puking did nothing to cure any illness at all.

"Sweating" was a common practice, originally advocated by Benjamin Rush, by which patients were made to "sweat out" the poisons that caused their disease. Therefore, people who suffered with a high fever were kept warmly dressed and under many layers of blankets. In many early settler communities, people sometimes visited nearby Indian villages for help with their maladies. There, a patient might be made to sweat in a "sweat-house"--that is, a tent or teepee which had been tightly closed, where hot stones had been placed in the center and drenched with water. A heavy steam would form inside the tent. When the patient was covered in sweat, he would be plunged into cold water and given a vigorous rubdown. A long nap followed, while the doctor prayed for the patient's recovery.

BENJAMIN RUSH: (Who advocated these medical practices?)

For the most part, the most influential practitioner of the time was a man named Benjamin Rush. Beginning in 1791, Rush was Professor of the Institute of Medicine at the University of Pennsylvania, and then, from 1783 - 1813, Physician to the Pennsylvania Hospital. Rush was known by his devoted followers as the "Hippocrates of American Medicine". As a believer in the Enlightenment era's philosophy of natural law, Rush lectured to and persuaded thousands of physicians and medical students to subscribe to his ideas and beliefs about medicine and the human body. Among the ideas that Rush promoted was the notion that Black people were black due to a form of leprosy, tobacco caused not only tuberculosis (consumption), but also insanity, and that yellow fever outbreaks were produced by "noxious miasmas". Rush advocated that the human body was a machine, and that all disease was one disease--that is, an over stimulation of the nerves and blood. His ideas about the treatment of disease were controversial to say the least, and many of his peers did in fact question Rush's methods. At the center of the controversy were his "heroic medicine" (bloodletting, blistering, puking, purging, and sweating) treatments which he believed would relieve nervous constriction of blood vessels caused by an accumulation of poisons from illness. While some of Rush's adversaries clearly opposed such therapies, claiming that they were ineffectual at best, and extremely harmful to the patient at worst, Rush's concepts held fast throughout the first half of the century. His work influenced numerous physicians, many of whom continued practicing bleeding and purging therapies through the 1870s, with some rural doctors continuing even beyond that.