Sunday, 3 November 2013

Caring For The Sick: A Look At Victorian Medicine

The early Victorian medical practises were a world away from what we are used to seeing today. In the first half of Victoria’s reign, treatments didn’t evolve the way they were expected to. In the previous century, great advancements were foundational yet no progression was made during the early 1800s. This said, early Victorian physicians had some understanding of anatomy. However, their ideas of the nervous system and understanding of blood was a far-cry from what is understood today.

Due to this elementary understanding of how the body functions, medicine and diagnosis were rather primitive. This is greatly highlighted by the first understanding of cholera and its causes. Before the epidemic of 1845, cholera was thought to be caused by “rancid or putrid food, by ‘cold fruits’ such as cucumbers and melons, and by passionate fear or rage.” (Victoria and Albert museum).  As one can imagine, the ‘medicine’ for this included avoidance of the foods suspected of spreading the disease. Of course, through what we know today, this is undeniably ridiculous. However, their lack of biological and medical understanding made these causes believable.

Treatments for illnesses such as smallpox, scarlet fever and measles called for a “‘change of air’, together with emetic and laxative purgation and bleeding by cup or leech.” (Victoria and Albert museum). These methods ridded the body of ‘impurities’ thought to cause illness.

An enema pump used for emetic purgation

 Surgery was another place that the Victorians struggled on. In the early Victorian era, surgeries were performed with no anaesthetic. Although a skilled surgeon could amputate a broken leg in thirty seconds, often the blood loss and pain would kill the patient before the surgery was done. During these times, the mortality rate was, on average, one in four. As the Victorian era went on, pseudo-anaesthesia was introduced: alcohol and opiates, though these did little in the way of making the pain at least tolerable. Surgery was often a last resort due to not only the pain and suffering the patient would go through but also a surgeon would often have to deal with a patient squirming out of pain or fear; some also tried to escape. Therefore, surgery was only used if no other treatment was thought to work.

It is possible to witness the lack of medical understanding that was wrought in the 1800s through Gaskell’s writing in Mary Barton. In the novel, Gaskell highlights the primitive nature of medical care: “wild herbs for drinks and medicine” (30). This shows the rural traditions took over the urban setting and that anything a countryman could get his hands on would be used, in some way, for medical practises. Of course, this was harder in the city, thus they turned to purgation, a practise that had been in circulation for centuries. Gaskell also showed the Victorian mind-set of using reliable, or understood, medicines for many types of illness: “[…]it was typhus fever […] and proceeded to make up a bottle of medicine, sweet spirits of nitre […] very good for slight colds, but utterly powerless to stop, for an instant, the raging fever of the poor man it was intended to relieve.” (88) This, again, is due to what they had to hand but also the sheer lack of knowledge of the differences of dissimilar medical ailments.

However, during the later Victorian years, medical improvements were vast; the practises were more recognisable to what we are familiar with today. These developments and improvements included “the opthalmoscope (sic) and improved microscopes that revealed micro-organisms, to instruments like the kymograph, to measure blood pressure and muscular contraction. By mid-century, the stethoscope, invented in France in 1817 to aid diagnosis of respiratory and cardiac disorders, became the symbolic icon of the medical profession.” (Victoria and Albert museum)
Stethoscopes used in the 19th century

During the infamous cholera outbreak of 1854, thought to be caused by miasmas (the idea that ‘bad air’ from rotting fruits spreads diseases such as cholera, chlamydia and the Black Death), Dr John Snow established that the epidemic was caused by “contaminated water from a public pump in crowded Soho” (Victoria and Albert Museum). This made physicians more aware of bacteria and all the effects that cleanliness and sanitation had on the health of others. They began to understand more about the causes of illnesses and how to avoid them more appropriately.

Snow also paved the way for anaesthesia, being one of the first physicians to use chloroform and ether as a more effective way of putting patients ‘to sleep’ during surgery. In both 1953 and 1957, Snow used chloroform during the birth of Queen Victoria’s children.

Other surgical advancements that happened during the latter Victorian years included John Lister’s ideas around bacteria, infection and antiseptics. He realised that a “surgical wound infection was the result of bacteria” (science magazine) and thus tried to develop medicinal treatments that would eradicate this problem. However, his methods were constantly changing and began to grow confusing as he didn’t understand the problem completely. He began using varying dilutions of carbolic acid. “He also used vaporizing sprays that emitted an unpleasant and irritating acidic mist in the vicinity of patient and surgeon, but later denounced the use of this equipment.” (science magazine). However, by the 1880s, most surgery was antiseptic. This happened by surgeons making sure their hands were clean and later, they began using white overalls – similar to what we are used to seeing today – as a way of keeping their everyday clothes from contaminating the patients.

Much greater developments, in terms of cleanliness and sterilisation, occurred in the 1890s with dressings allowing surgical wounds to heal more effectively and healthily, as well as instruments that could be easily sterilised, replacing the bone and wooden handled tools that were not able to be sterilised quite so easily.

Bone-handled scalpels

With the understanding of bacteria, the diagnosis of a person’s illness became more reliable, as well as the treatment, especially surgery. The Victorian’s ideas of illness and medicine, that previously wasn’t dissimilar to that of the medieval era, began to progress quickly and efficiently. By the end of the Victorian era, medical practises paved the way for even more advancement during the 20th century.

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