The Stagnant Practice of Clandestine Abortion

It is just over 50 years since the 1967 Abortion Act was passed. It therefore seems fitting to examine the history of abortion and consider how this practice has changed over time, from antiquity to the twentieth century. This blog uses evidence from ancient treatises and excerpts from a collection of personal accounts from the mid-twentieth century published by Marie Stopes International (see further reading). It argues that despite the transcendence of two millennia, there was little change in abortion practices as a result of the secretive and stigmatised nature of the act.

 

Physical exertion

Physical exertion was a traditional method used to try and induce an abortion. Although only successful in the most extreme of cases, it was a commonly held belief in antiquity that prevailed until the mid-twentieth century. The ancient Hippocratic Corpus describes the ‘Lacedaemonian Leap’ which involved jumping up and down, touching one’s buttocks with the heels at each leap, to try and induce a miscarriage.

This belief in the abortive properties of physical exertion is also evident in personal accounts from the mid-twentieth century. ‘Alice’ fell pregnant at just 16 in 1963. She describes how ashamed her parents were when they found out, and how her father physically abused her to try and achieve this aim: ‘We lived in a house in Clifton, which had very steep stairs. My dad was there and he literally punched me in the stomach and then pushed me down the stairs’.

 

Oral methods

A wide variety of oral abortifacients were employed in antiquity. These ranged from a concoction of common herbs and plants that could be grown in one’s own garden, to exotic substances more difficult to obtain. The popularity of purging oral substances, both diuretics and laxatives, for the purposes of abortion is evident in Soranus’ Gynaecology.

Returning to the case of sixteen-year-old ‘Alice’, she describes how she came home from school one day ‘to find this strange concoction brewing in the kitchen. It was a natural laxative my mother said. They thought it would bring on a miscarriage’. On another occasion, Alice reports that her father ‘produced some little black pills and told me to take them’.

An abortion method combining both physical and oral elements is found in the commonly held belief in the efficacy of hot baths and alcohol. This is particularly advocated by Soranus in the ancient period, who advises ‘lingering in the baths and drinking first a little wine and living on pungent food’ in order to induce an abortion.

Such methods are also evident in the mid-twentieth century. When ‘Isa’ was denied a recommendation for a termination in 1962, she describes ‘getting blind drunk on gin and taking hot baths and God knows what else’.

 

Douching methods

Douching was a popular abortion method in the mid-twentieth century. ‘Jane’ recounts her two experiences of backstreet abortion in the 1950s: ‘Both were done in the same way, by different backstreet abortionists, using a douche, Lux and Dettol’.

Interestingly, there is in fact evidence for the use of douching devices in antiquity, especially in Hippocratic times. However, douching tended to be used to promote conception, rather than to prevent or terminate a pregnancy. For example, Hippocrates’ Diseases of Women advises a solution of ‘mare’s milk’ to be injected into the womb using a douching device to help treat an ulcerated uterus that is preventing successful conception.

 

Surgical methods

Surgical methods were recognised as the most dangerous means of abortion in antiquity, and were only resorted to in the most desperate circumstances, typically when the fetus was fairly well-developed and other methods had failed. Celsus, writing in the first century AD, described the technique of surgical removal as ‘reckoned amongst the most difficult: for it both requires the highest prudence and tenderness, and is attended with the greatest danger’.

However, there is clear evidence to suggest that these procedures did occur. Celsus is particularly detailed in his medical account of the surgical removal of an already dead fetus that had not been intentionally aborted:

 

…if the head is nearest, a hook should be introduced, in every part smooth, with a short point, which is properly fixed either in the eye, or the ear, or the mouth sometimes even in the forehead; and then begin drawn outwards, brings away the child.


There is an argument that such instruments were only used in cases where the fetus had already expired and not as a means of procuring abortion. However, references to the instrument known as embruosphaktes (literally: ‘embryo-slayer’), suggests otherwise.

There is similar evidence for instrumental methods used in the mid-twentieth century. Again, it is generally accepted that such intervention would be resorted to only when other less invasive methods had failed. Given the potential for physical harm this is hardly surprising. ‘June’ shares her memories of backstreet abortion in 1959: ‘I knew that women had been damaged severely from abortions going wrong. Knitting needles. We’d all heard stories about knitting needles and coat hangers’.

The ‘crochet hook’ was another popular instrument used in attempted abortion, easily obtainable and a common household item like the knitting needle and the coat hanger. The similarities between the description of the hook-like instrument from antiquity and the mid-twentieth century crochet hook depicted below are striking:

 

Image 1: Crochet hook – a hooked instrument for removing an aborted fetus. Wellcome Images.

 

This blog has drawn attention to the significant parallels existing between abortion practices of antiquity and those of the mid-twentieth century, prior to the introduction of the 1967 Abortion Act. I suggest that it was the stigmatised culture of abortion that led to this stagnation in abortion practices.

 

 

Further reading

  • Soo Brookstone (Ed), Voices for Choice(London: Marie Stopes International, 1997).
  • Aulus Cornelius Celsus, Cornelius Celsus of medicine. In eight books. Translated by James Greive, (London, 1756).
  • Hippocrates, Hippocratic Writings, edited by G.E.R. Lloyd, (London: Penguin Books, 1983).
  • Soranus, Gynaecology, translated with an introduction by Owsei Temkin, (Baltimore: John Hopkins University Press, 1991).
  • Konstantinos Kapparis, Abortion in the Ancient World, (London: Duckworth Publishers, 2002)
  • John Riddle, Contraception and abortion from the ancient world to the Renaissance, (United States of America: Harvard University Press, 1992).

 

 

Lucy Havard

Medicine and War — Sir Harold Gillies: the father of plastic surgery

There is no doubt that war brings death and destruction, but it can also be a catalyst for medical advances. This is clearly demonstrated by the Great War and the developments made in plastic surgery. This blog is focused particularly on the work of Harold Gillies, a New Zealander who worked in Britain during the early twentieth century, and who headed pioneering research and practice in the field of plastic surgery.

The use of Maxim’s machine gun and the shrapnel from exploding shells in the Great War led to horrendous injuries and deformities of the soldiers who faced them. Such injuries often left soldiers disfigured and challenged their ability to function, especially when involving the loss of limbs.

 

Harold Delf Gilles. Credit: Science Museum, London.

 

Harold Gillies trained as a doctor at Cambridge University and went on to become a surgeon. He served in the Great War and experienced first-hand the terrible injuries suffered by the soldiers that he fought alongside. He understood not only how life-threatening these injuries could be but also the great psychological impact suffered by soldiers who could sometimes no longer recognise themselves in the mirror. Gillies became particularly interested in the surgery performed to repair injuries of the jaw and face, in order to try and reconstruct as much as possible the soldiers’ previous appearance. He paid particular attention not only to functionality, but also to aesthetics.

Gillies set up a hospital in Aldershot in 1915 which later moved to Sidcup in Kent. He treated many soldiers who had fought in the Battle of the Somme – one of the bloodiest battles of the Great War. Gillies is often referred to as the ‘father of plastic surgery’ and he pioneered novel techniques such as the ‘pedicle tube’ which enabled the grafting of healthy skin to areas of the body destroyed by the trauma of battle. Some of Gillies’ work can be seen in a book that he published in 1920 entitled ‘Plastic Surgery of the Face’, shown below:

 

Wellcome Images CC BY Credit: Science Museum, London

 

Harold Gillies laid the foundations for modern plastic surgery. His work helped thousands of soldiers who survived the War in living as normal a life as possible. After Gillies’ death, the American Society of Plastic and Reconstructive Surgery wrote the following which accurately describes his legacy:

 

The ideas engendered by his fertile brain have spread and are being spread afar, and generations of plastic surgeons will be affected by what he gave forth to the world. His memory may perish but his influence is immortal.

 

 

Further Reading

National Army Museum, ‘The Birth of Plastic Surgery.’ Accessed 7 June 2019. https://www.nam.ac.uk/explore/birth-plastic-surgery.

Oxford Dictionary of National Biography, ‘Gillies, Sir Harold Delf (1882-1960).’ Accessed 7 June 2019. https://www.oxforddnb.com/

 

Lucy Havard

 

 

 

 

The Worshipful Society of Apothecaries

This blog is all about the Worshipful Society of Apothecaries and their recent 3-day history of medicine course which ran from 1st-3rdMay. This fascinating course comprised a series of interesting lectures, spanning the history of medicine over two thousand years in Europe and beyond.

 

Image 1: Worshipful Society of Apothecaries Coat of Arms

 

The Worshipful Society of Apothecaries is quite simply an historical gem nestled in central London, a stone’s throw from St Paul’s Cathedral. Like many of the other London livery companies, the Society of Apothecaries looks rather unassuming from the street. But, walk into the courtyard, and then through the main entrance up a beautiful seventeenth-century staircase into the court room or parlour, and prepare to be met by gorgeous wood paneling, impressive life-size portraits of various Society benefactors and lots of rhinos – the Society’s emblem for over 400 years! The origins of the Grocers and Apothecaries of London can be traced back to 1180. In 1617, the Apothecaries separated from the Grocers to form the Worshipful Society of Apothecaries of London.

 

Image 2: The Court Room

The delegates that were attending the course were of varying backgrounds – medical students, practising doctors, pharmacists, historians, nurses, museum curators and those with a general interest in the history of medicine. Such an eclectic group of people made for probing questions and stimulating discussion at the end of each lecture.

The talks during the course covered a broad range of themes and topics – there really was something for everyone! Day one featured art and surgery, the history of the coroner, the founding of voluntary hospitals and disease and medicine in ancient Egypt. Day two brought talks focused on medicine in Scotland and Japan as well as women in medicine and a broad overview of Britain and world medicine. On the final day, we were treated to the history of pharmacy, the history of X-rays and a talk on the archaeological findings from Salisbury Plain as well as a general overview of the history of clinical medicine. All in all, a satisfying and fulfilling course that provided a comprehensive overview of the history of medicine.

Anyone interested in attending the History of Medicine course or applying for the Diploma in the History of Medicine (DHMSA) at the Worshipful Society of Apothecaries should consult the following website for the most up-to-date information:

 

https://www.apothecaries.org/diploma-in-the-history-of-medicine/

 

Image 3: Dürer’s Rhinoceros – emblem of the Worshipful Society of Apothecaries

 

Lucy Havard.

Now Walks Like Others

How were poor crippled children treated in England during the late 19th and early 20th centuries before the advent of free healthcare through the NHS and the Welfare State?

A group of  Northampton children – all very keen on medical history – believe that if medical history is to be truly relevant it must live. So one day, while happening to sit in an outpatient clinic they decided to answer the above question using the extensive historical archive held at Northampton General Hospital. They give their answers with a short film (20 mins, link at end of post).

 

        

Image 1: CC BY Credit: Science Museum, London

The Northampton Crippled Children’s Fund (NCCF, 1893-1925) provided medical care for ‘poor crippled children in straightened circumstances under 17 years of age’ initially in Northampton and eventually county-wide. It also gave long term dietary supplementation and summer seaside holidays. It had wide community support. In its final year before the opening of the Manfield Orthopaedic Hospital it treated 3000 children. Crippled Children’s Funds were widespread in the UK before the establishment of the National Health Service (NHS) but there are few surviving records and research has been limited in this area.

My day job is as a consultant community paediatrician. This film is a way of introducing medical history to my patients, keeping my day job interesting and giving something back to the community where I work.

The children involved in the film are my patients, their siblings and members of Theze Guyz Theatre Company, Northampton. Together, working with healthcare professionals and historians they relate, recreate and assess the work of the Northampton Crippled Children’s Fund within its historical context. The film includes full medical and dietetic reconstructions, and some cartoons. You can view it using the following link:

https://www.youtube.com/watch?v=vvU8suIPTiU

The film credits acknowledge the funders who made this film happen.

The film was written and directed by Professor Andrew N Williams PhD FRHistS consultant community paediatrician and curator of Archive, Northampton General Hospital.

 

Andrew Williams

Joseph Bazalgette (28/3/1819 – 15/3/1891)

Thames Water, the authority responsible forLondon’s water and sewage system, is currently building a massive new ‘Super Sewer’ known as “Tideway”. Approximately 25km in length and due for completion in 2024, this project is being undertaken to prevent the release of thousands of tons of untreated sewage into the River Thames on a daily basis. This contemporary, complex and sometimes controversial civil engineering project is a reminder of the birth of London’s sewage system, designed by Joseph Bazalgette, born two centuries ago last month.

 

Portrait of Sir Joseph Bazalgette. Credit: Wellcome Collection. CC BY.

 

161 years ago Victorian MPs were busy arguing and prevaricating over the cost and necessity (or not) of building and funding a proper purpose-built sewer system, designed by Bazalgette. They rapidly ceased all opposition to the project during the long hot summer of 1858 when low tides meant that huge quantities of untreated sewage that normally ran into the Thames were deposited on the river’s foreshores. The resulting appalling smell became known as “The Great Stink”. Believing, as most did at that time, that bad smells spread disease, MPs had to hang sheets soaked in carbolic against the windows in the Palace of Westminster to stop the suffocating stench. Before finally leaving The House ‘en masse’ the MPs quickly voted in the necessary funding for Joseph Bazalgette’s brilliantly conceived sewer system. It consisted of “intercepting sewers”, pumping stations and treatment works that are still being used today thanks to the high quality brick-lined tunnels and the use of durable Portland cement.

 

Civil engineering: construction drawings for the Thames Embankment. Coloured drawing, 1865, after Sir J. Bazalgette. Credit: Wellcome Collection. CC BY.

 

Bazalgette was a brilliant engineer, who started his career working on various railway projects. He was responsible not only for the London Sewer System but also for the Thames Embankment, and numerous major roads in London such as Shaftesbury Avenue and Northumberland Avenue. He strengthened or rebuilt 12 bridges over the Thames and freed them from tolls. He also engineered the Blackwall Tunnel and the Woolwich Ferry, and important parks such as Clissold Park, Finsbury Park and Victoria Park “the green lung of East London”.

 

However, it is Bazalgette’s sewer system for which he is probably most famous. He designed it anticipating a population increase in London from 2 million to 4 million – extremely far-sighted for the time. Given that the current population of London is approximately 8.5 million, no wonder a ‘Super Sewer’ is needed to provide for the increased strain on the system. More important than saving Londoners from a further ‘Great Stink’, Bazalgette’s work played a critical role in saving the lives of many thousands from deadly water-borne infections such as cholera. For this, he deserves to be remembered.

 

 

Further Reading

  • Stephen Halliday,The Great Stink of London: Sir Joseph Bazalgette and the Cleansing of the Victorian Metropolis(Sutton Publishing: Gloucestershire, 1999).
  • ‘Tideway – Reconnecting London with the River Thames,’ accessed 30/3/19, available at: https://www.tideway.london.
  • ‘Thames Water,’ accessed 30/3/19, available at: https://www.thameswater.co.uk/

 

 

Hermione Pool