Plague Houses and Pandemics – Some comparisons between 1665 and 2020

Posted on by | Leave a comment

Charles ll issued an edict in 1665 that every parish should identify a shed, a tent or a house to accommodate those identified with the plague. Alison Wall looks at the role of such isolation in times of pandemic.

19th century lithograph of old plague houses in bleak setting

Pest houses Tothill Fields, Westminster, London, lithograph 1840, Wellcome Collection

Plague, pest or pestilence houses – the terms can be used interchangeably – were buildings set apart as places to isolate those suffering plague and smallpox. It seems that there was often a favourable outcome and people survived.

There were five pest houses in London, accommodating about 600 sufferers, and there are houses still standing across the country, some Grade ll listed.

Was there a degree of restraint for those confined to the pest house? There may well have been if we look at Samuel Pepys’s comments, in his diary of 1665: “A mayde having run away was taken back to the pest house in the pest coach.”

What was the pest coach? It was a special sedan chair painted black, with black curtains, so it was clear what its function was.

Then and now, the most important difference between the 21st and the 17th centuries was the realisation in the 17th century it was wrong to admit plague and smallpox sufferers into the general hospitals or hospitiums, as they were initially called. The latter were there to serve the poor and suffering and give general shelter and care.

Charles II looked back in history and understood the importance of isolation and care in the pest houses. Sadly, our equivalent Nightingale hospitals were erected in a very reactive and uncoordinated fashion. In our time, how many people were admitted into the general hospitals with some acute or chronic condition, unrelated to Covid but caught Covid in hospital and died? Many health professionals also died in the early days of Covid.

Another, if less significant contrast, is that in the time of the Great Plague in 1665, thousands of stray cats and dogs were slaughtered, as people believed they carried dirt and fleas. The cat population could have helped reduce the numbers of black rats that were carrying the plague carrying fleas. Conversely, during the Covid lockdown many people homed cats and dogs for companionship.

The spread of Covid across the world has had a massive impact. The isolation that plague victims must have experienced – and sometimes tried to escape – has echoes in that endured during lockdown in the period of Covid. Isolation causes huge psychological and emotional impacts, with greater understanding of this post Covid.

Inevitably there will be future pandemics. We need to reflect and plan for the future, remembering the value of those parish pest houses.

Alison Wall is a retired nurse, midwife and health visitor. She is the author of “Plague Houses and Pandemics”. Before her retirement she worked in Camden and Islington as a public health strategist.

Woman in pink dress with figure in red cloak and plague masque.

Alison Ward with a figure wearing plague masque

References and further reading

  1. https://www.nationalarchives.gov.uk/education/resources/great-plague/
  2. Byrne, J. Encyclopedia of the Black Death. Bloomsbury. 2024. p.217
  3. https://onlinelibrary.wiley.com/doi/abs/10.1111/nuf.12001
  4. Latham, R.C. & Matthews, W. (ed) 1885. The Diary of Samuel Pepys, Vol. Vl. p.120
  5. Boyd, D. Plagues and Pandemics. Pen and Sword. 2021. p. 67

Snake oil charms of popular medical history

Posted on by | Leave a comment

The mention of ‘snake oil charms’ in the King’s speech at the opening of Parliament in July reminded me of one of the most unusual cases I encountered in my final years as a consultant surgeon, writes Bryan Rhodes.

European adder in dried grass next to a log.

Adder photo by Illuvis, Pixabay

A middle-aged man had gone for a stroll close to Fell Foot Park in the Lake District and sat down on a flattened patch of long grass. Suddenly, an adder appeared between his legs, and as he lifted his arm in self-defence, it bit him on the right hand. Despite the administration of two different types of anti-venom in A&E, by the following day swelling and discolouration was spreading up his arm, and I was beginning to consider whether an amputation could become necessary.

The adder is Britain’s only venomous snake, so mortality from snake bites is quite rare in the UK, roughly one a decade. Worldwide however, snakebite envenoming kills about 100,000 people a year, so it is perhaps surprising that the snake has become such a widespread symbol of health and healing. Certainly, our patient survived, and fortunately, no surgical intervention was required.

Indeed, the coat of arms of the British Orthopaedic Association features the Greek demi-god of healing Asclepius, pictured as usual with a large snake winding its way up his staff, the snake’s head perilously close to the demi-god’s abdomen. There are many theories about the ‘Rod of Asclepius’ and associated snake including one that the snake’s ability to shed its old skin and generate a new healthy skin explains its presence. Another theory links it to the Old Testament story in which God tells Moses to ‘make a bronze snake, put it on a pole, and place it where people can see it; anyone who is bitten by a snake can look at it and live’.

White marble statue of Asclepius, Greek demi-god of healing, with his staff and serpent.

Greek demi-god of healing Asclepius Photo by Michael F. Mehnert, Museum of Epidaurus Theatre, via Wikimedia Commons

 

Folklore

In English folklore, adders were thought to be deaf, and oil derived from adders was considered a valuable treatment for deafness and earache. To obtain the oil an adder was caught and killed, its skin was lacerated multiple times, and it was hung in a warm location with a container placed below it to catch the viscous liquid dripping from its carcass. The Oxford Dictionary of English Folklore indicates that provincial chemists would purchase this snake oil from snake-catchers, presumably for onward sale to their customers.

The adder’s shed skin was also thought to have healing power: able to help extract thorns and splinters from a person’s hand. Traditional cures for an adder bite included oil from the offending snake, wrapping the victim in a fresh sheepskin, or applying a flat ‘snakestone’ to the site. Of all the strange historical treatments provided for adder bites in the centuries before anti-venoms, perhaps the most bizarre was that discovered in Wiltshire by the notable antiquary and natural historian, John Aubrey FRS (1626 – 1697) which involved fastening a succession of live pigeons to the site of the snake bite.

Norman Morrison, a retired Scottish police officer who developed a fascination for adders and published ‘The Life Cycle of the Adder’ in 1924 was himself bitten on the right hand by an adder and wrote about the experience and some of the traditional Hebridean ‘cures’ in his later publication ‘My Story’.

Snake oil salesman

The term ‘snake oil salesman’ now means the archetypal charlatan: the fast-talking seller of quack or fake cure-all remedies. The term has also spread more widely such that it is often applied to politicians, businessmen and anyone offering false hope or dubious treatments. The poor reputation of snake oil salesmen appears to be largely attributable to a Texan called Clark Stanley (b. 1854). In the late 1880s, Chinese itinerant railway workers commonly used a Chinese liniment derived from water snake oil.

Stanley produced an American alternative which he claimed to contain rattlesnake oil, which was sold widely across the US. The Pure Food and Drug Act of 1906 brought in a new era of scrutiny for all American products claiming medicinal properties, and Stanley’s Snake oil liniment was analysed in 1916. The product was found to be almost entirely mineral oil and didn’t contain any snake oil at all. Stanley was found guilty of ‘misbranding’ his product and fined $20.

Since the release of Captopril in 1980, an ACE inhibitor and anti-hypertensive drug developed following research by John Vane and Sergio Ferreira on a component of Brazilian pit viper venom, there has been increasing interest in the therapeutic possibilities of snake venom. There seems to be much less enthusiasm for the charms of snake oil!

Bryan Rhodes is a retired consultant orthopaedic surgeon. He is the book review editor of BSHM and the chair of the Lancaster Health and Medical Museum Collection.

References and further reading:

  1. A Dictionary of English Folklore, Editors: Jaqueline Simpson and Steve Roud, 2003, OUP
  2. Oliveira, A.L. al.  The chemistry of snake venom and its medicinal potential, Nature Reviews Chemistry, 6, 2022, pp451-469
  3. Morrison, N., My Story, 1937 Published in Inverness

 

 

 

 

The Bulletin: A meaning making mechanism for British polio disabled people

Posted on by | Leave a comment

Polio is highly culturally evocative – vaccines on sugar lumps, children in callipers and lifetimes in iron-lung respirators. The Bulletin, published by The British Polio Fellowship, provides an additional perspective. It gives an insight into how polio-disabled people understood and wished to represent themselves. Charlotte Stobart explains.

In 1939, Patricia Carey, who contracted polio in India as a child, and Frederic Morena, a stage actor who contracted polio at 42 and was subsequently wheelchair bound, founded the Infantile Paralysis Fellowship as an advocacy and self-help society.

This organisation, which became the British Polio Fellowship, initially attempted to address both the physical and social limitations of polio-disability, focusing on mutual support and personal development.  From its inception, the Fellowship published a bimonthly newsletter for members.

The first major British polio epidemic came in 1947, and outbreaks of polio (nicknamed the ‘summer scourge’) occurred regularly until the 1956 advent of the Salk Vaccine. The number of cases came down, but the disease left many people with lifelong disabilities. Many developed post-polio syndrome, sometimes as much as 40 years after the original infection.

Young men with polio disability are part of a regional water polo team

A regional water polo team. Young men with characteristic polio-disability. The Bulletin, May 1969, p. 8, The British Polio Fellowship Archive

By 1965, the fellowship had around 12,000 members to whom it circulated the newsletter, called the Bulletin. This was a bottom-up, collective project, and the polio-disabled readership provided the bulk of copy and photographs (including of sports days, holidays and weddings). Similarly, patients at the Spinal Injuries Unit at Stoke Mandeville Hospital in Buckinghamshire, wrote and edited their own community building publication, The Cord, from 1947.

Active and positive

The Bulletin consciously and consistently portrayed polio-disabled people enjoying a range of experiences, triumphing over polio and over societal assumptions about the limitations of disabled people. It challenged dominant sociocultural narratives of loss and trauma, and provided polio-disabled people with representational agency and a positive sense of identity and community.

The iconic ‘Action for the Crippled Child’ charity collection boxes of the 1960s showed a young boy with his crutches and callipers. He is despondent, evoking charitable pity (and hopefully, donations). Conversely, editions of The Bulletin from the 1960s used pictures of a group of young men on crutches playing football, a team of water polo players with characteristic signs of polio paralysis in their asymmetric legs and a man in a wheelchair being lifted (somewhat inexplicably) by crane onto a ship.

Through the 1960s, understandings of polio shifted as the public health threat waned. As their numbers and cultural purchase naturally decreased, polio-disabled people were increasingly overlooked by mass-media, and polio itself became increasingly regarded as a phenomenon of the past or other global regions.

Thanks in no small part to the work of the British Polio Fellowship and The Bulletin, the polio-disabled identity developed positive connotations: determination, hard-work and tenacity. The Bulletin allowed British polio-disabled people to continue to assert their presence and identity and raise funds for assistive technologies, activities and residential homes for their ageing cohort. The British Polio Fellowship continues to publish The Bulletin to this day, advocating for the 47,000 people in Britian still living with the late effects of polio.

Charlotte Stobart is an MA student of History of Technology, Science, and Medicine at the University of Manchester.

References and further reading

The British Polio Fellowship: https://www.britishpolio.org.uk/

The Bulletin Archive- stored at the British Polio Fellowship Office in CP House, Otterspool Way, Watford WD25 8HR.

Brady, Sam, The Cord, https://www.paralympicheritage.org.uk/blog/the-cord-journal-for-paraplegics, National Paralympic Heritage Trust, 20 July, 2020.

Couser, Thomas, “Disability, Life Narrative, and Representation.” PMLA 120:2 (2005): 602–6

Williams, Gareth, Paralysed with Fear: The Story of Polio. London: Palgrave MacMillan, 2013

 

Electricity and Pancakes

Posted on by | Leave a comment

Adrian Thomas describes how the poet William Cowper used electricity to treat a friend who suffered a stroke.

I had a significant birthday recently, and as a birthday treat, we decided to visit Olney in Buckinghamshire where the poet William Cowper (1731-1800)  lived. In his day Cowper was arguably the most popular and influential poet in the English language with his poems celebrating the countryside and ordinary life. He was also committed to the abolition of slavery writing The Negro’s Complaint, which was much admired by US civil rights leader Martin Luther King Jr. (1929-1968).

18th century man in formal dress with head covering

William Cowper (1731-1800), Published by Vernor & Hood, Poultry, 1 February 1801. (author’s collection)

We stayed at the excellent Bull Hotel in Olney where Cowper went in 1771 after his maid Molly contracted smallpox, and he was forced to leave his house. The fascinating Cowper & Newton Museum is located in the centre of Olney, and an electrical machine that Cowper used is displayed.  Opposite the museum is the excellent Olney Pancake Parlour, and Olney has its world famous pancake race.

Although he had considerable personal problems, Cowper was immensely creative. He lived in Olney for many years with his friend Mary Unwin (1724–1796). In 1791, Mary had a minor stroke, with a second stroke in 1792. ‘Her speech has been almost unintelligible from the moment when she was struck’ and ‘the use of her right hand and arm, she has entirely lost them’, Cowper wrote in a letter of 24 May 1792 to his cousin ‘my Dearest Coz’  Harriett Cowper (Lady Hesketh).

18th century machine for generating electricity

William Cowper’s electrical machine at the Cowper & Newton Museum in Olney. (author’s photograph)

Cowper’s biographer William Hayley (1745-1820) had installed an electrical machine near Cowper, and the Oxford physician William Austin (1754-1793) had recommended its use. In the same letter, Cowper said that he had borrowed and used the machine on Mary’s paralysed arm ‘and we think that it has been of material service.’ By 3 June, Mary was improving, and Cowper reported to Hayley that she had ‘a better opinion of your spark eliciting faculties than of mine.’ Cowper noted on 4 June that he was ‘thankful that in so small a village as this that I should be able to furnish myself with a complete electrical apparatus.’

Mary made some recovery from her stroke following Cowper’s treatments, and in a letter of 28 June, Cowper describes the continuation of the treatment, believing that the treatments were responsible for the improvement. Mary lived for another four years.

Classic works

The classic book on electrotherapy is the 1855 De l’Électrisation localisée et de son application à la physiologie, à la pathologie et à la thérapeutique (Localised use of electricity in physiology, disease and therapy) by Guillaume Duchenne de Boulogne (1806-1875), who promoted the science of electrophysiology. Duchenne illustrated the electrical treatment of muscles and recorded the changes following the electrical stimulation of paralytic muscular atrophy.

Cowper knew a local apothecary, who gave him a book by the Italian physicist, Tiberius Cavallo(s) (1749-1809), who ‘recommends gentle sparks and the fluid breathed from a wooden point, much rather than smarter sparks or shocks.’

Nineteenth century black & white line drawing of treatment using an electrical machine.

Electrical treatment using an electrical machine, from De l’Électrisation localisée (1855)

Paralysed and atrophic muscles may look more normal following electrical treatments; functional improvements are less likely to occur. However, the relationship between electricity and the body is complex, and previous generations, including Cowper and his group, were very impressed by the effects of electrotherapy.

During the 20th century, electrotherapy gradually passed out of use. Many of the conditions formerly treated with electricity were seen as psychological with a functional component. However, we can ask – should the use of electrotherapy in selected conditions be reconsidered since it was certainly effective in many conditions?

Adrian Thomas is a Visiting Professor at Canterbury Christ Church University where he teaches clinical reporting to radiographers, and he has a deep interest in the history of the radiological sciences. 

Further reading:

The definitive edition of Cowper’s letters is:  The Letters and Prose Writings of William Cowper: Volumes 1-4, 2011, Oxford University Press, edited by James King and Charles Ryskamp.

The classic history of electrotherapy is Colwell, A.A. (1922) An Essay on the History of Electrotherapy and Diagnosis. William Heinemann, London.

A good recent study of Victorian electricity is: Morus, I.R. 2011. Shocking Bodies. Life, Death & Electricity in Victorian England. Stroud: The History Press.

 

“The forgotten man of Africa”

Posted on by | 1 Comment

Standing on the deck of the exploring vessel Pleiad in July 1854, Edinburgh trained doctor William Balfour Baikie was about to lead an expedition into the interior of Africa to test the validity of a cure for malaria, writes Wendell McConnaha.

B&W photo of bearded man, formally dress, 19th century

William Faulkner Baikie at the time of his first voyage, Orkney Library

Baikie had been seconded to the mission sponsored by the merchant Macgregor Laird and the Royal Geographical Society, which would leave from Fernando Po, an island in Equatorial Guinea, now called Bioko. Baikie was initially to serve as naturalist and assistant surgeon, but a series of events had elevated him to the expedition’s leader.

For years, men had attempted to explore the path of this great river and, although they encountered natural barriers and local hostility, it was malaria that threatened to cut short the life of any European who ventured inland, and the Bight of Benin was referred to as the Whiteman’s Grave. As the anonymous rhyme said: “Beware and take care of the Bight of Benin. There’s one comes out for forty goes in.”

Although the death rate among Europeans traveling into the interior in this part of Africa often exceeded 70 percent, the focus up to the time of Baikie’s voyage was curing the disease rather than looking for a prevention, and even the preferred method for treating those contracting the disease remained in doubt.

Sailed 19th century exploring vessel
The exploring vessel Pleaid, Frank Cass & Co.

As early as 1630, Jesuit Brothers working in Peru had observed the Quechua Indians using bark from the cinchona tree in treating malaria. The bark was collected, dried, ground into a fine powder and mixed with water to form a strong tea. The treatment had quickly been adopted by the crews of slave ships traveling between Europe, Africa and South America. Royal Naval surgeons soon began utilizing the treatment for sailors who had contracted malarial fever. In 1817, two French chemists isolated the crystals within the bark naming their extract quinine. However, bloodletting and purgatives remained the standard methods of treating malaria within the general medical establishment.

Not just treating

In 1847 Dr Alexander Bryson, an Assistant Surgeon in the West Africa Squadron, presented the Admiralty with a report in which he announced the use of quinine had cut the mortality rate in half, and proposed quinine might also be used as a prophylactic. Baikie was convinced that Bryson was correct in his assumption.  Although the purpose of his mission was to explore the Niger and Benue rivers and establish trading sites, Baikie would also use his command position to conduct the first clinical trial testing Bryson’s theory.

Each crew member would be given two-thirds of a glass of wine containing five grains of quinine each morning and a second glass before retiring in the evening. Baikie was staking his reputation and the lives of those under his command on this untested theory. If he were correct, the centre of Africa would be opened to outside exploration.  If wrong, he could lose his life and the lives of all those entrusted to him.

On 7 November the Pleiad returned to Fernando Po. They had been on the river for 118 days, explored and charted over 600 miles, and established a series of trading sites. Most importantly, for the first time in the history of African exploration, they had completed the mission without the loss of a single life.

Baikie travelled to England, published the journal of his exploring voyage and then returned to the Niger, where he spent his last five years living alone among the Igbo. His enlightened approach in working with the indigenous people earned him such respect that to this day the Igbo word for “white man” is “Beke.” Baikie died at age 39 of tropical fever. Revered in Africa, his role in establishing a prevention for malaria is largely forgotten by the rest of the world.

Memorial to William Balfour Baikie
Memorial tomb to William Balfour Baikie (1825-1864),
St Magnus Cathedral, Kirkwall, Orkney Library and Archives

Professor Wendell McConnaha is a retired university professor in education who has worked around the world. When in Nigeria, he first learned of William Baikie and resolved to write his story, which he has now done in The King of Lokoja: William Balfour Baikie the Forgotten Man of Africa. 

References and further reading

Christopher Lloyd, The Search for the Niger, (London, Collins, 1973), pp. 21-22

C. M. Posser and G. W. Bruyn, An illustrated history of malaria, (New York, NY:

Alexander Bryson, Report on the Climate and Principal Diseases of the African Station, Printed by order of the Lords Commissioners of the Admiralty, (London, W. Clowes and Sons, 1847)